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Objective: To investigate the effects of reduced weight running on the antigravity (AG) treadmill on maintenance of normal muscle activation and reduction of plantar forces in healthy subjects. Design: Descriptive laboratory study. Setting: Clinical sports medicine center. Participants: Twenty healthy subjects (10 male and 10 female) aged 18 to 29 years. Independent Variables: Subjects running at 6.5 miles per hour on a standard treadmill and on the AG treadmill at 100%, 90%, 80%, 70%, 60%, and 50% of bodyweight levels. Main Outcome Measures: Dynamic plantar loading data were recorded using pressure insoles. Surface electromyography electrodes with imbedded accelerometers were used to estimate timing and magnitude of muscle activity, stride length, and cadence. Results: There was a significant, sequential reduction in peak pressure, maximum force, and force time integral (FTI) with decreasing bodyweight. A 50% bodyweight reduction resulted in a 51% reduction in maximum force and a 59% reduction in FTI in the heel, as compared with 19% to 28% at the metatarsal heads. There was reduced contact area in the heel and midfoot at and below 70% BW. Lower limb muscle activity decreases with reduced bodyweight while maintain normal muscle recruitment timing. Conclusions: The AG treadmill provides a reduction in loading forces while maintaining normal muscle recruitment patterns. Decreased BW running preferentially unloads the hindfoot. The AG treadmill can be an effective rehabilitation tool following foot or ankle injury and may prove superior to other limited weight-bearing methods. [ABSTRACT FROM AUTHOR]

An ankle sprain can be caused by daily activities such as running, walking, or playing sports. In many cases, the patient's ankle suffers severe or permanent damage that requires rehabilitation to return to its initial state. Thanks to technological advances, robotics has allowed for the development of machines that generate precise, efficient, and safe movements. In addition, these machines are manipulated by a specific control depending on the rehabilitation objective. Impedance control is used in ankle rehabilitation machines for active–resistive-type rehabilitation, where the patient participates by exerting a force on the machine repeatedly. Serious games are an example of an activity where the patient can interact with a video game while rehabilitating. Currently, most machines involving impedance control and targeted at serious gaming applications are mechanically composed of one degree of freedom, so the addition of another degree is a novelty. This paper presents simulation results comparing different impedance controls reported in the literature to determine the best option for applying a 2-DOF ankle rehabilitation machine using serious games. The results obtained are presented by comparing them according to the force applied to the rehabilitation machine (emulating the behavior of a patient). From the impedance controllers analyzed for horizontal (abduction/adduction) and vertical (dorsiflexion/plantarflexion) movements in the rehabilitation machine, it was determined that the PD control, which considers some mechanical parameters, presents a better performance. With this controller, fast and smooth angular movements are generated, while the consumption of kinetic energy is kept in a low range, proportional to the applied forces, compared to the other impedance controls analyzed. [ABSTRACT FROM AUTHOR]

Background: Abnormal patellar height (patella alta) has been reported to be one of the main predisposing factors for recurrent patellar dislocation, and it can be surgically corrected by distalizing tibial tubercle osteotomy (DTTO). Rehabilitation after DTTO often includes limitations on weightbearing and restrictions on knee range of motion by means of bracing, increasing the risk of slow progression of the rehabilitation. Hypothesis: An active rehabilitation program with no restrictions on weightbearing and range of movement would yield a low risk of postoperative complications and a fast recovery period. Study Design: Case series; Level of evidence, 4. Methods: Included were 102 consecutive knees in 80 patients who underwent DTTO between January 2010 and December 2017. In the majority of knees (89.2%), the patient underwent simultaneous medial patellofemoral ligament reconstruction. The mean age of the patients at the time of surgery was 19.39 ± 8.02 years, and 80.4% of the knees (82/102) were of female patients. The patients underwent an active rehabilitation program with immediate weightbearing as tolerated and active quadriceps and hip muscle exercises with no immobilization or bracing. The protocol was active (patient unsupervised), including daily exercises, as instructed by a physical therapist. Crutches were recommended for the first 3 to 4 weeks. Results: There were 3 acute failures of fixation (2.9% of knees) requiring revision surgery. In these cases, the patients had a fall, slip, or knee-twisting accident during the first 6 weeks after surgery. Two late failures characterized by tibial stress fracture at the distal part of the osteotomy level occurred at 2 and 3 months postoperatively and were considered unrelated to the early rehabilitation process. The stress fracture rate was 2%, and the overall DTTO failure rate was 6.9%. With the active rehabilitation program, adverse effects such as knee stiffness, arthrofibrosis, or delayed ability to perform daily activities were rare. Conclusion: An active rehabilitation program after DTTO was found to be safe and effective. Furthermore, the risk of failure related to surgical fixation strength and of later stress fracture was low. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThis study aimed to explore how peer mentors experience their role and practice in Active Rehabilitation camps for individuals with acquired brain injury.Sixteen peer mentors with acquired brain injury were interviewed, and the data were analysed using Systematic text condensation. Self-determination theory was used to interpret the results.Six themes were constructed: “Altruistic motives drive peer mentors” engagement”, “What does it mean to be a peer mentor?”, “Peer mentors question their qualifications”, “Camp is tough—Nothing can compare”, “Being a peer mentor—A part of one’s rehabilitation process”, and “Closeness and trust—A bubble of understanding”. The peer mentors reported personal benefits, such as increased knowledge about brain injury, self-esteem, motivation, physical activity, community participation, and social networks. They perceived that mutual understanding among peer mentors and mentees created a safe camp atmosphere, which led to positive experiences.The peer mentors benefitted from their role and described it as part of their rehabilitation journey. We recommend that peer mentors receive training before entering this position, feedback on their performance, and camp schedules that accommodate time for rest and informal meetings between mentees and peer mentors.Peer mentorship interventions for individuals with acquired neurological injury are becoming more popular. Because peer mentors are vital in such interventions, learning more about their perspectives is essential.Peer mentors with acquired brain injury (ABI) who engage in Active Rehabilitation camps report various personal benefits, such as heightened self-esteem, increased community participation, and establishment of a broader support network.To address challenges that peer mentors may perceive, we recommend that the organisers of these interventions ensure mentors receive adequate training before taking on their roles and receive ongoing feedback on their performance.Individuals with ABI who are interested in peer mentoring and fulfil the organisers’ criteria should be encouraged to apply for this role, as it can become a natural extension of their rehabilitation process.Peer mentorship interventions for individuals with acquired neurological injury are becoming more popular. Because peer mentors are vital in such interventions, learning more about their perspectives is essential.Peer mentors with acquired brain injury (ABI) who engage in Active Rehabilitation camps report various personal benefits, such as heightened self-esteem, increased community participation, and establishment of a broader support network.To address challenges that peer mentors may perceive, we recommend that the organisers of these interventions ensure mentors receive adequate training before taking on their roles and receive ongoing feedback on their performance.Individuals with ABI who are interested in peer mentoring and fulfil the organisers’ criteria should be encouraged to apply for this role, as it can become a natural extension of their rehabilitation process. [ABSTRACT FROM AUTHOR]

Copyright of Physiotherapy Canada is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Peer-based community interventions have shown promise in improving health management and fostering coping skills and psychosocial functioning among individuals with a disability. Active Rehabilitation camps are examples of peerbased community interventions that provide structured, time-limited peer mentorship in conjunction with sports and leisure activities. These camps hold potential benefits for individuals with acquired neurological injury. However, the specific impact of Active Rehabilitation camps on children or individuals with acquired brain injury remains unexplored. In this longitudinal, qualitative study, we explored children with an acquired brain injury and their caregivers' experiences with an Active Rehabilitation camp in Norway through observations and interviews with nine children and ten caregivers. Using an abductive thematic analysis, we identified an overarching theme: Active Rehabilitation peer mentorship camps enrich the lives of children with acquired brain injury and their caregivers. The theme contains three subthemes: (1) Interacting with peers made me wiser, (2) Nudging from peer mentors made me feel better, and (3) A sense of companionship through meeting peers. Peer mentorship, sports and leisure activities, and the safe camp atmosphere benefitted children with acquired brain injury and their caregivers. The children gained knowledge, motivation, and self-worth, and their caregivers had greater impetus to prioritize their children's independence. Meeting peers and peer mentors led to friendships and sustained social connections. The Self-Determination Theory was of assistance in explaining the informants' experiences. Active Rehabilitation camps provide children with acquired brain injury and their caregivers with an opportunity to develop better coping skills, improve psychological functioning, and build more robust social networks. [ABSTRACT FROM AUTHOR]

An ankle sprain can be caused by daily activities such as running, walking, or playing sports. In many cases, the patient’s ankle suffers severe or permanent damage that requires rehabilitation to return to its initial state. Thanks to technological advances, robotics has allowed for the development of machines that generate precise, efficient, and safe movements. In addition, these machines are manipulated by a specific control depending on the rehabilitation objective. Impedance control is used in ankle rehabilitation machines for active–resistive-type rehabilitation, where the patient participates by exerting a force on the machine repeatedly. Serious games are an example of an activity where the patient can interact with a video game while rehabilitating. Currently, most machines involving impedance control and targeted at serious gaming applications are mechanically composed of one degree of freedom, so the addition of another degree is a novelty. This paper presents simulation results comparing different impedance controls reported in the literature to determine the best option for applying a 2-DOF ankle rehabilitation machine using serious games. The results obtained are presented by comparing them according to the force applied to the rehabilitation machine (emulating the behavior of a patient). From the impedance controllers analyzed for horizontal (abduction/adduction) and vertical (dorsiflexion/plantarflexion) movements in the rehabilitation machine, it was determined that the PD control, which considers some mechanical parameters, presents a better performance. With this controller, fast and smooth angular movements are generated, while the consumption of kinetic energy is kept in a low range, proportional to the applied forces, compared to the other impedance controls analyzed.

This study explored the physical, social, and psychological benefits of an active rehabilitation (AR) camp as experienced by participants with spinal cord injury (SCI), and perceived fitness and mastery of being physically active six months after the camp. The study used a mixed-method design with pre- (n = 23), post- (n = 23), and follow-up questionnaires (n = 18) and individual interviews (n = 8). Fuzzy qualitative comparative analysis (fsQCA) was used to analyze the quantitative data and qualitative content analysis was used to analyze the qualitative data. Results showed that benefits were mainly experienced in the social and psychological domains. As for the physical domain, younger and more recently injured persons with tetraplegia reported more benefits. Six months after the camp, being in the preparation stage of change and being somewhat physically active were necessary and sufficient conditions for experiencing mastery of physical activity regardless of injury type, but only persons with paraplegia experienced fitness benefits. Qualitative data shed further light on the perceived benefits of the camp. The knowledge gained from this study might help practitioners to tailor interventions to individual needs and researchers to ask questions that take into consideration the complexity of active rehabilitation and changes in physical activity behavior for people with SCI. [ABSTRACT FROM AUTHOR]

Peer-based community interventions have shown promise in improving health management and fostering coping skills and psychosocial functioning among individuals with a disability. Active Rehabilitation camps are examples of peer-based community interventions that provide structured, time-limited peer mentorship in conjunction with sports and leisure activities. These camps hold potential benefits for individuals with acquired neurological injury. However, the specific impact of Active Rehabilitation camps on children or individuals with acquired brain injury remains unexplored. In this longitudinal, qualitative study, we explored children with an acquired brain injury and their caregivers' experiences with an Active Rehabilitation camp in Norway through observations and interviews with nine children and ten caregivers. Using an abductive thematic analysis, we identified an overarching theme: Active Rehabilitation peer mentorship camps enrich the lives of children with acquired brain injury and their caregivers. The theme contains three sub-themes: (1) Interacting with peers made me wiser, (2) Nudging from peer mentors made me feel better, and (3) A sense of companionship through meeting peers. Peer mentorship, sports and leisure activities, and the safe camp atmosphere benefitted children with acquired brain injury and their caregivers. The children gained knowledge, motivation, and self-worth, and their caregivers had greater impetus to prioritize their children's independence. Meeting peers and peer mentors led to friendships and sustained social connections. The Self-Determination Theory was of assistance in explaining the informants' experiences. Active Rehabilitation camps provide children with acquired brain injury and their caregivers with an opportunity to develop better coping skills, improve psychological functioning, and build more robust social networks.

Wrist exoskeletons are increasingly being used in the rehabilitation of stroke and hand dysfunction because of its ability to assist patients in high intensity, repetitive, targeted and interactive rehabilitation training. However, the existing wrist exoskeletons cannot effectively replace the work of therapist and improve hand function, mainly because the existing exoskeletons cannot assist patients to perform natural hand movement covering the entire physiological motor space (PMS). Here, we present a bioelectronic controlled hybrid serial-parallel wrist exoskeleton HrWr-ExoSkeleton (HrWE) which is based on the PMS design guidance, the gear set can carry out forearm pronation/supination (P/S) and the 2-DoF parallel configuration fixed on the gear set can carry out wrist flexion/extension (F/E) and radial/ulnar deviation (R/U). This special configuration not only provides enough range of motion (RoM) for rehabilitation training (85F/85E, 55R/55U, and 90P/90S), but also makes it easier to provide the interface for finger exoskeletons and be adapted to upper limb exoskeletons. In addition, to further improve the rehabilitation effect, we propose a HrWE-assisted active rehabilitation training platform based on surface electromyography signals.

The aim of this study was to assess wheelchair skills of persons with physical disabilities who attended the first Wheelchair Skills and Empowerment Camp in Morocco and their satisfaction with manual wheelchairs provided for the camp activities. 19 persons (13 male and 6 female) with physical disabilities took part in the project. The average time since injury or illness was 24 years. To assess wheelchair skills/user satisfaction, the researchers used the Queensland Evaluation of Wheelchair Skills test and the Quebec User Evaluation of Satisfaction with assistive Technology. Study participants improved their overall wheelchair mobility skills (p = 0.002; d = 0.20), especially their ability to ascend and descend a ramp (p = 0.012; d = 0.67). The participants reported significantly greater satisfaction with the new provided wheelchairs in comparison to their own wheelchairs in regard to five satisfaction items; i.e., ease in adjusting (p = 0.011; d = 0.96), safety and security (p = 0.014; d = 0.97), durability (p = 0.037; d = 0.81), ease to use (p = 0.045; d = 0.87), and comfort (p = 0.006; d = 1.03). Findings of this study indicate that persons with physical disabilities in Morocco need structured training in wheelchair skills and better-quality wheelchairs. The study also confirmed that community peer-based programmes in low-resource countries can play a significant role in rehabilitation of persons with physical disabilities, even many years after their injury or illness. The One World project educated local persons with disabilities and government officials about the need for buying appropriate wheelchairs and for providing them according to the World Health Organization guidelines. 19 persons who use wheelchairs participated in 6-days of wheelchair skills training sessions, which were led by three peer mentors who use a wheelchair: two with spinal cord injury, and one with polio complications. The 19 participants, who had lived with their disabilities on average for 24 years, advanced their general wheelchair mobility skills, which was assessed through a practical test. The results confirmed that community peer-based programmes in low-resource countries are important for improving wheelchair skills not only when beginning rehabilitation but even after individuals live many years with a disability. [ABSTRACT FROM AUTHOR]

Copyright of African & Mediterranean Journal of Architecture & Urbanism (AMJAU) is the property of Ecole Nationale d'Architecture and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

ClinicalScenario: Low-intensity aerobic exercise (LIAEX) below the threshold of symptom exacerbation has been shown to be superior to rest for resolving prolonged (>4 wk) symptoms following sport-related concussion (SRC), but the effects of LIAEX earlier than 4 weeks after SRC need to be elucidated. Focused Clinical Question: Does LIAEX within the first 4 weeks following SRC hasten symptom resolution? Summary of Key Findings: Two randomized controlled trials (RCT) and 1 nonrandomized trial involving adolescent athletes (10–19 y) were included. One RCT reported faster recovery time with LIAEX versus placebo stretching. Likewise, recovery time was faster with LIAEX versus rest in the nonrandomized trial, but not in the underpowered RCT, although effect sizes were similar between these studies (0.5 and 0.4, respectively). All 3 studies reported a reduction in concussion symptom severity with LIAEX; however, the magnitude of symptom reduction across the recovery timeline was greater in the LIAEX group than the rest group in the nonrandomized trial, but not the 2 RCTs. Importantly, no adverse effects or incidence of delayed recovery from LIAEX were reported in any of the studies. Clinical Bottom Line: LIAEX initiated within 10 days after SRC may facilitate a faster recovery time versus placebo stretching or rest, although additional clinical trials are strongly advised to verify this. Strength of Recommendation: Level 1b and 2b evidence suggests subsymptom exacerbation LIAEX may decrease Postconcussion Symptom Scale scores and hasten symptom resolution in adolescent athletes following SRC. [ABSTRACT FROM AUTHOR]

Background: A variety of physical interventions have been used to improve reactive balance in older adults. Purpose: To summarize the effectiveness of active treatment approaches to improve reactive postural responses in community-dwelling older adults. Design: Systematic review guided by PRISMA guidelines. Study Selection: A literature search included the databases PubMed, OVID, CINAHL, ClinicalTrials.gov, OTseeker, and PEDro up to December 2017. Randomized controlled trials that evaluated quantitative measures of reactive postural responses in healthy adults following participation in an active physical training program were included. Data Synthesis: Of 4,481 studies initially identified, 11 randomized controlled trials covering 313 participants were selected for analysis. Study designs were heterogeneous, preventing a quantitative analysis. Nine of the 11 studies reported improvements in reactive postural responses. Conclusions: Several clinically feasible training methods have the potential to improve reactive postural responses in older adults; however, conclusions on the efficacy of treatment methods are limited because of numerous methodological issues and heterogeneity in outcomes and intervention procedures. [ABSTRACT FROM AUTHOR]

Land degradation affects extensive drylands around the world. Due to long-term misuse, the Israeli Sde Zin dryland site has faced severe degradation. The study objective was to assess the feasibility of passive restoration in recovering the site. The study was conducted in four land-units along a preservation-degradation continuum: (1) an area that has not faced anthropogenic disturbances (Ecological land); (2) an area that was proclaimed as a national park in the 1970s (Rehabilitation); (3) an area that was prone, until recently, to moderate anthropogenic pressures (Triangle); and (4) a dirt road that was subjected to long-term off-road traffic (Dirtroad). Soil was sampled and analyzed for its properties. The soil physical quality followed the trend of Ecological land > Rehabilitation > Triangle > Dirtroad. Specifically, high soil salinity in the latter three land-units is attributed to long-term erosional processes that exposed the underlying salic horizons. Herbaceous and shrubby vegetation cover was also monitored. The herbaceous vegetation cover followed the trend of Ecological land (86.4%) > Rehabilitation (40.3%) > Triangle (26.2%) > Dirtroad (2.1%), while the shrubby cover was 2.8% in the Ecological land-unit, and practically zero in the other land-units. It seems that despite the effectiveness of passive restoration in recovering the soil's physical properties, the recovery of vegetation is limited by the severe soil salinity. [ABSTRACT FROM AUTHOR]

This study explored the physical, social, and psychological benefits of an active rehabilitation (AR) camp as experienced by participants with spinal cord injury (SCI), and perceived fitness and mastery of being physically active six months after the camp. The study used a mixed-method design with pre- (n = 23), post- (n = 23), and follow-up questionnaires (n = 18) and individual interviews (n = 8). Fuzzy qualitative comparative analysis (fsQCA) was used to analyze the quantitative data and qualitative content analysis was used to analyze the qualitative data. Results showed that benefits were mainly experienced in the social and psychological domains. As for the physical domain, younger and more recently injured persons with tetraplegia reported more benefits. Six months after the camp, being in the preparation stage of change and being somewhat physically active were necessary and sufficient conditions for experiencing mastery of physical activity regardless of injury type, but only persons with paraplegia experienced fitness benefits. Qualitative data shed further light on the perceived benefits of the camp. The knowledge gained from this study might help practitioners to tailor interventions to individual needs and researchers to ask questions that take into consideration the complexity of active rehabilitation and changes in physical activity behavior for people with SCI.

Purpose: Isolated reconstruction of the medial patellofemoral ligament (MPFL-R) has become the predominant stabilizing procedure in the treatment of recurrent lateral patellar dislocation (LPD). To minimize the risk of re-dislocations, isolated MPFL-R is recommended in patients with no significant trochlea dysplasia and tibial tuberosity trochlear groove distance < 20 mm on computed tomography (CT). Incidentally, these criteria are the same that are used to identify first time LPD patients where conservative treatment is recommended. The purpose of this study was therefore to compare MPFL-R with active rehabilitation for patients with recurrent LPD (RLPD) in absence of the above mentioned underlying anatomical high-risk factors for further patellar dislocations. Methods: RLPD-patients aged 12–30 without underlying anatomical high-risk factors for further LPD were randomized into treatment either with isolated MPFL-R or active rehabilitation provided and instructed by a physiotherapist. All patients underwent diagnostic arthroscopy for concomitant problems. The main outcome measure was persistent patellar instability at 12 months. Knee function at baseline and 12 months was asses using the following patient reported outcomes measures (PROMS); KOOS, Kujala, Cincinnati knee rating, Lysholm score and Noyes sports activity rating scale. Results: Between 2010 and 2019, 61 patients were included in the study (MPFL-R, N = 30, Controls, N = 31). Persistent patellar instability at 12 months was reported by 13 (41.9%) controls, versus 2 (6.7%) in the MPFL-group (RR 6.3 (95% CI 1.5–25.5). No statistically significant differences in activity level were found between the MPFL-group and the Controls at neither baseline nor follow up. The patients with persistent instability at 12 months did not score significantly lower on any of the PROMs compared to their stable peers, regardless of study group. Conclusion: Patients with recurrent patellar dislocations have a six-fold increased risk of persistent patellar instability if treated with active rehabilitation alone, compared to MPFL-R in combination with active rehabilitation, even in the absence of significant anatomical risk factors. Active rehabilitation of the knee without MPFL-R improves patient reported knee function after one year, but does not protect against persistent patellar instability. Level of evidence: 1. [ABSTRACT FROM AUTHOR]

Objectives: Examine the acute effects (pre-, during, post-intervention) of two different intensities of aerobic exercise or rest on autonomic, oculomotor, and vestibular function and symptom burden in patients with a recent sport-related concussion (SRC) and compare their responses to sex-matched, age-stratified, non-concussed (HEALTHY) student-athletes. Methods: Student-athletes between the ages of 13 and 18 that presented to the sports medicine clinic within Day 3–7 post-SRC and from local schools were recruited for a randomized controlled trial (RCT). The participants were administered the Vestibular/Ocular Motor Screening (VOMS), King-Devick (K-D), and Post-Concussion Symptom Scale (PCSS) before and after the intervention. Heart rate variability (HRV) and mean arterial pressure (MAP) were collected before, during, and after the intervention. The intervention was either a single, 20-min session of treadmill walking at 40% (40HR) or 60% of age-predicted max heart rate (60HR), or seated, rest (NOEX). Results: 30 participants completed the intervention with the SRC group treated 4.5 ± 1.3 days post-injury. Pre-exercise HRV and MAP were significantly different (p's < 0.001) during treatment but returned to pre-exercise values within 5 min of recovery in both the SRC and HEALTHY groups. Both the SRC and HEALTHY groups exhibited similar reductions pre- to post-intervention for symptom severity and count (p's < 0.05), three VOMS items (p's < 0.05) but not K-D time. Conclusions: To date, this is the first adolescent RCT to report the acute, systemic effects of aerobic exercise on recently concussed adolescent athletes. The interventions appeared safe in SRC participants, were well-tolerated, and provided brief therapeutic benefit. Trial registration: Clinicaltrials.gov Identifier NCT03575455. [ABSTRACT FROM AUTHOR]

The systematic review evaluated the evidence related to how physical activity affects recovery following a sport-related concussion (SRC) in adolescents. Databases indexed were PUBMED, MEDLINE, and SPORTDiscus. Inclusion criteria included 1) original research article, 2) -66% have an SRC diagnosed by a clinician, 3) human research, and 4) evaluated the effect of an SRC on physical activity in adolescents only (<18 yr). Participants were seen within 1-2 wk after SRC for acute studies and 4 wk after SRC for studies focused on prolonged recoveries, which are standard timelines across the literature. Twenty-two studies met the inclusion criteria [i.e., 8 regarding physical activity (PA-daily aerobic activity including light and moderate intensities), 8 evaluating active rehabilitation/exercise programs (20 min of daily aerobic exercise below symptom threshold), 6 examining a single bout of exertion]. The methodological quality of the literature was assessed using the Downs and Black risk of bias (ROB) checklist. The ROB scores ranged from 7 to 24, with only two randomized controlled trials included. Studies demonstrated that single bouts of exertion testing were safe and feasible. Daily PA or active rehabilitation/exercise programs led to a reduction in symptoms present and a decrease in number of days to medical clearance. Following a brief period of rest (24-48 h), individuals may gradually and safely return to PA below their physical symptom exacerbation thresholds. Further research is warranted to delineate how to optimize the timing, intensity, duration, and modality of PA impacts symptom resolution and physiological recovery following different subtypes of SRC. [ABSTRACT FROM AUTHOR]

Background: Active rehabilitation involving subsymptom threshold exercise combined with education and support promotes recovery in youth with concussion but is typically delivered in person, which may limit accessibility for families because of a lack of services in their communities or logistical challenges to attending in-person sessions. Objective: This paper describes the evidence-based and theory-informed development of the Tele-Active Rehabilitation (Tele-AR) intervention for pediatric concussion, which was specifically designed for remote service delivery. Methods: The intervention was designed by clinician-researchers with experience in pediatric concussion rehabilitation following the Medical Research Council guidance for developing complex interventions. Development involved a critical review of the literature to identify existing evidence, the expansion of the theoretical basis for active rehabilitation, and the modeling of the intervention process and outcomes. Results: Tele-AR is a 6-week home exercise and education and support program facilitated through weekly videoconferencing appointments with a clinician. Exercise consists of low- to moderate-intensity subsymptom threshold aerobic activity and coordination drills that are individualized to participant needs and interests (prescribed for 3 days per week). Education includes the evidence-supported Concussion & You self-management program, which covers topics related to energy management, nutrition, hydration, sleep hygiene, and return to activity. Elements of self-determination theory are incorporated to support motivation and engagement. We present a logic model describing predicted intervention effects using a biopsychosocial conceptualization of outcomes after concussion. Conclusions: The Tele-AR intervention may help to increase access to care that improves recovery and promotes a timely return to activity in youth with concussion. Future research is needed to evaluate the feasibility and efficacy of this approach. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Background and Purpose: Musculoskeletal disorders (MSKDs) are the most common causes of disabilities for older adults. The aim of this systematic review and meta-analysis is to assess the effectiveness of multimodal interventions including exercise rehabilitation for older adults with chronic MSKDs. Methods: A literature search was conducted up to February 2019 in 5 bibliographical databases to identify randomized controlled trials (RCTs) that compared multimodal interventions including exercise rehabilitation with usual medical care or no intervention. Randomized controlled trials were assessed with the Cochrane risk-of-bias tool. Meta-analyses were performed and pooled mean differences (MDs) or standardized mean differences (SMDs) were calculated. Results: Sixteen RCTs (n = 2322 participants) were included. One RCT was considered at low risk of bias, 8 had some concerns of bias, and 7 had a high risk of bias. Participants suffered from hip or knee osteoarthritis (OA) (n = 12 RCTs), low back pain (LBP) (n = 2 RCTs) and generalized chronic pain (GCP) (n = 2 RCTs). Multimodal interventions were significantly more effective than usual care to decrease pain (visual analog scale, out of 10 points) in the short term, MD: −0.71 (95% confidence interval [CI] −1.08 to −0.34, n = 900), and in the long term: MD: −0.52 (95% CI −0.98 to −0.05, n = 575), but these differences are not considered clinically important. In terms of disabilities, multimodal interventions were also significantly more effective than usual care. The SMDs were −0.47 (95% CI −0.61 to −0.34, n = 903) and −0.29 (95% CI −0.46 to −0.13, n = 568) for OA trials in the short and long terms, respectively, and −0.47 (95% CI −0.81 to −0.12, n = 211) for LBP and GCP trials in the short term. The magnitude of these effects may be considered as small to moderate. Conclusion: Multimodal intervention including exercise rehabilitation combined with usual medical care is an efficacious therapeutic option to reduce disabilities in older adults with chronic MSKDs. A significant but not clinically important effect was observed for pain. The most beneficial component of the multimodal interventions in terms of education, exercises, or medication remains to be determined. [ABSTRACT FROM AUTHOR]

Abstract Background Active Rehabilitation (AR) is a community peer-based concept for people with spinal cord injury (SCI) that is primarily delivered through brief residential training programmes. Despite a plethora of positive anecdotal evidence of AR programmes as life-changing experiences, the effects of AR-programmes have not been evaluated scientifically. Here, we present the protocol of the INTERnational Project for the Evaluation of “activE Rehabilitation” (inter-PEER) aiming to evaluate the effects of AR training programmes on community-dwelling individuals with SCI. Methods International prospective cohort study that recruits consecutive participants in AR training programmes. Evaluation is conducted through a web-based survey at 3 time-points: at the commencement and completion of the training programme, and 3 months after the end of the training programme. Evaluation also includes a practical wheelchair skills test at the first two time-points. The primary outcome measures are the Spinal Cord Independence Measure Self-report (SCIM-SR), the Queensland Evaluation of Wheelchair Skills test (QEWS), the Wheelchair Skills Test Questionnaire (WST-Q) and the Moorong Self-Efficacy Scale (MSES). The secondary outcome measures are the 11-item Life Satisfaction Questionnaire (LiSat-11), the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation), the Leisure Time Physical Activity Questionnaire for people with SCI (LTPAQ-SCI) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). We piloted the implementation of the protocol in Sweden in 7 participants with diverse SCI and sociodemographic characteristics and collected feedback from participants and peer-mentors about study procedures through interviews, a workshop and field observations. Discussion Inter-PEER is the first initiative to propose a systematic evaluation of the effects of AR training programmes among individuals with SCI. The project is a collaborative work of multiple stakeholders, including researchers, clinicians, peer mentors with SCI, and administrators of organisations providing AR programmes. The inter-PEER uses standardised outcome measures relevant to the AR context, it will facilitate quality evaluations of community peer-based programmes, stimulate international collaborations, and inform the design of randomised controlled trials on the effects of AR training programmes.

Objective To determine whether an active rehabilitation program that involves repetitive effortful muscle contractions, including core stability, balancing exercises, progressive resistance exercises, and running activities, after a sports hernia, is effective. Methods Forty soccer players with sports hernias were randomly divided into two equal groups: group A (active rehabilitation program) and group B (conventional treatment). The methods of assessment included a visual analog scale (VAS) and hip internal and external range of motion assessments. Group A received conventional treatment (heat, massage, transcutaneous electrical nerve stimulation, and mobilization) plus an active rehabilitation program, while group B received only conventional treatment. Three treatment sessions were given each week for 2 months. Evaluations were performed pre- and post-treatment. Results A decrease in VAS was seen in both groups at the end of treatment, 80.25% in group A and 41.93% in group B. The difference between the two groups was statistically significant (p=0.0001), whereas there were no statistical differences in internal and external rotation between the groups at the end of treatment (p>0.05). After treatment, an improvement in outcome measures of group A compared to group B (p=0.01) was seen. Thirteen patients in group A and only three patients in group B returned to sports activities without groin pain. Conclusion Active rehabilitation was effective for sports hernia management measured by a decrease in pain and the return to sports.

Concussion and persistent postconcussive symptoms (PPCS) are encountered by clinicians in sports medicine, pediatrics, neurology, physiatry, emergency medicine, and primary care. Clinical management may require a multidisciplinary approach. This article presents a structured method for the diagnosis of concussion and PPCS in the outpatient setting, which includes a history, physical examination, and additional tests as clinically indicated to help identify underlying symptom generators. Treatment for concussion and PPCS should be individualized, based on predominant signs and symptoms, and can include subsymptom threshold aerobic exercise, cervical physical therapy, vestibulo-ocular rehabilitation, behavioral and cognitive psychotherapy, and some symptom-specific pharmacological therapies. [ABSTRACT FROM AUTHOR]

Objective: (1) To determine the impact of providing participants aged 8 to 17 years who are slow to recover after a concussion with a well-developed active rehabilitation intervention (ARI), compared with receiving standard care alone, on postconcussion symptoms (PCS) at 2 and 6 weeks after the initiation of ARI; and (2) to investigate functional recovery 6 weeks after initiation of ARI. Design: A multicenter prospective quasi-experimental control group design. Setting: Tertiary care pediatric trauma center and community health care providers. Participants: Forty-nine youth were enrolled (experimental n = 36; control n = 13). Procedures: Participants were assessed on 3 different occasions: (1) initial visit (baseline); (2) 2 weeks; and (3) 6 weeks after enrollment. Main outcome measures: Child- and parent-reported PCS were obtained by the PCS Inventory Scale (primary outcome). Secondary outcomes included: (1) mood and anxiety; (2) quality of life; (3) energy level; (4) coordination and balance; (5) neurocognition; (6) parental anxiety; and (7) satisfaction with intervention. Results: Both groups reported decrease of PCS over time (child: P = 0.01; parent: P = 0.03). Children in the experimental group presented higher quality of life (P = 0.04) and less anger (P = 0.02). A trend toward significance was observed for better tandem gait (P = 0.07) and for less general fatigue on self-reported PCS (P = 0.09) in the experimental group. Conclusions: Active rehabilitation intervention does not affect the PCS beyond the usual management, but it increases their quality of life, decreases anger, and potentially increases energy level and balance. [ABSTRACT FROM AUTHOR]

Objective: To investigate the risk of new meniscal tears after treatment for anterior cruciate ligament (ACL) injury, in children and adults with and without ACL reconstruction.Design: Prognosis systematic review (PROSPERO registration number CRD42016036788).Methods: We searched Embase, Ovid Medline, Cochrane, CINAHL, SPORTDiscus, PEDro and Google Scholar from inception to 3rd May 2018. Eligible articles included patients with ACL injury (diagnosis confirmed by MRI and/or diagnostic arthroscopy), reported the number of meniscal tears at the time of ACL injury diagnosis/start of treatment and reported the number of new meniscal tears that subsequently occurred. Articles with fewer than 20 patients at follow-up, and articles limited to ACL revision surgery or multi-ligament knee injuries were excluded. Two independent reviewers screened articles, assessed eligibility, assessed risk of bias and extracted data. We judged the certainty of evidence using the Grading of Recommendations Assessment Development and Evaluation (GRADE) working group methodology.Results: Of 75 studies included in the systematic review, 54 studies with 9624 patients and 501 new meniscal tears were appropriate for quantitative analysis. Heterogeneity precluded data pooling. The risk of new meniscal tears was 0%-21% when follow-up was <2 years, 0%-29% when follow-up was 2 to 5 years, 5%-52% when follow-up was 5 to 10 years and 4%-31% when follow-up was longer than 10 years. The proportion of studies with high risk of selection, misclassification and detection bias was 84%, 69% and 68%, respectively. Certainty of evidence was very low.Conclusion: New meniscal tears occurred in 0%-52% of patients between 4 months and 20 years (mean 4.9±4.4 years) following treatment for ACL injury. The certainty of evidence was too low to guide surgical treatment decisions. This review cannot conclude that the incidence of new meniscal tears is lower if ACL injury is treated with surgery compared with treatment with rehabilitation only. [ABSTRACT FROM AUTHOR]

Background: Physiotherapy regimen is important in both Pre-Surgery and Post-Surgery phases. However, Despite its widespread knowledge of importance of physiotherapy in both pre and post operation phases and during conventional therapy, the efficacy of early active intervention of physiotherapy in post-operative ACL repair/reconstruction is limited on the basis of quantitative and qualitative analysis. Purpose: The aim of this meta-analysis was to analyze the randomized controlled trials having quantitative and qualitative improvement in parameters after active rehabilitation in subjects with post-repair/ reconstruction of Anterior Cruciate Ligament. Methods: The authors searched Google Scholar and PubMed from 2014 to 2019. Only downloadable randomized controlled trials were included in the study. Main results: Twelve trials were included in the study with. The schedule of treatments varied greatly from certain days to 6 weeks or even follow up of 12 weeks. Subgroup analysis performed on Qualitative and quantitative assessment of pre-operative and post-operative active physiotherapy regimen showed significant statistical difference. Conclusion: The result of the present study shows strong evidence to support the active physiotherapeutic treatment pre-operative as well as post-operative in subjects with ACL repair/reconstruction, which helps in improving both qualitative and quantitative parameters. [ABSTRACT FROM AUTHOR]

Human-machine interaction (HMI) technology shows an important application prospect in rehabilitation medicine, but it is greatly limited by the unsatisfactory recognition accuracy and wearing comfort. Here, this work develops a fully flexible, conformable, and functionalized multimodal HMI interface consisting of hydrogel-based sensors and a self-designed flexible printed circuit board. Thanks to the component regulation and structural design of the hydrogel, both electromyogram (EMG) and forcemyography (FMG) signals can be collected accurately and stably, so that they are later decoded with the assistance of artificial intelligence (AI). Compared with traditional multichannel EMG signals, the multimodal human-machine interaction method based on the combination of EMG and FMG signals significantly improves the efficiency of human-machine interaction by increasing the information entropy of the interaction signals. The decoding accuracy of the interaction signals from only two channels for different gestures reaches 91.28%. The resulting AI-powered active rehabilitation system can control a pneumatic robotic glove to assist stroke patients in completing movements according to the recognized human motion intention. Moreover, this HMI interface is further generalized and applied to other remote sensing platforms, such as manipulators, intelligent cars, and drones, paving the way for the design of future intelligent robot systems., (© 2023 Wiley-VCH GmbH.)

Background: Active Rehabilitation (AR) is a community peer-based concept for people with spinal cord injury (SCI) that is primarily delivered through brief residential training programmes. Despite a plethora of positive anecdotal evidence of AR programmes as life-changing experiences, the effects of AR-programmes have not been evaluated scientifically. Here, we present the protocol of the INTERnational Project for the Evaluation of "activE Rehabilitation" (inter-PEER) aiming to evaluate the effects of AR training programmes on community-dwelling individuals with SCI.Methods: International prospective cohort study that recruits consecutive participants in AR training programmes. Evaluation is conducted through a web-based survey at 3 time-points: at the commencement and completion of the training programme, and 3 months after the end of the training programme. Evaluation also includes a practical wheelchair skills test at the first two time-points. The primary outcome measures are the Spinal Cord Independence Measure Self-report (SCIM-SR), the Queensland Evaluation of Wheelchair Skills test (QEWS), the Wheelchair Skills Test Questionnaire (WST-Q) and the Moorong Self-Efficacy Scale (MSES). The secondary outcome measures are the 11-item Life Satisfaction Questionnaire (LiSat-11), the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation), the Leisure Time Physical Activity Questionnaire for people with SCI (LTPAQ-SCI) and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). We piloted the implementation of the protocol in Sweden in 7 participants with diverse SCI and sociodemographic characteristics and collected feedback from participants and peer-mentors about study procedures through interviews, a workshop and field observations.Discussion: Inter-PEER is the first initiative to propose a systematic evaluation of the effects of AR training programmes among individuals with SCI. The project is a collaborative work of multiple stakeholders, including researchers, clinicians, peer mentors with SCI, and administrators of organisations providing AR programmes. The inter-PEER uses standardised outcome measures relevant to the AR context, it will facilitate quality evaluations of community peer-based programmes, stimulate international collaborations, and inform the design of randomised controlled trials on the effects of AR training programmes. [ABSTRACT FROM AUTHOR]

Objective To determine whether an active rehabilitation program that involves repetitive effortful muscle contractions, including core stability, balancing exercises, progressive resistance exercises, and running activities, after a sports hernia, is effective. Methods Forty soccer players with sports hernias were randomly divided into two equal groups: group A (active rehabilitation program) and group B (conventional treatment). The methods of assessment included a visual analog scale (VAS) and hip internal and external range of motion assessments. Group A received conventional treatment (heat, massage, transcutaneous electrical nerve stimulation, and mobilization) plus an active rehabilitation program, while group B received only conventional treatment. Three treatment sessions were given each week for 2 months. Evaluations were performed pre- and post-treatment. Results A decrease in VAS was seen in both groups at the end of treatment, 80.25% in group A and 41.93% in group B. The difference between the two groups was statistically significant (p=0.0001), whereas there were no statistical differences in internal and external rotation between the groups at the end of treatment (p>0.05). After treatment, an improvement in outcome measures of group A compared to group B (p=0.01) was seen. Thirteen patients in group A and only three patients in group B returned to sports activities without groin pain. Conclusion Active rehabilitation was effective for sports hernia management measured by a decrease in pain and the return to sports. [ABSTRACT FROM AUTHOR]

Introduction.The consequences of spinal cord damages rank among the most serious dysfunctions of the human musculoskeletal system. In spite of the development of medicine, the effects of treatment and rehabilitation are still insufficient for patients and their families. Purpose. The aim of this study was to determine the effect of the participation of individuals with spinal cord injury in the introductory camps organized by the Foundation for Active Rehabilitation in the subjective sense of quality of life and the meaning of life and the motivation to search for the meaning of life. Material and methods. It involved a group of 100 participants of the introductory camp organized by the Foundation for Active Rehabilitation. These same 100 subjects were then followed up three months after the end of camp. Quality of Life Index Ferrans and Powers; PIL-Test ; SONG-Test. Results. As a result of camp participation of persons with spinal cord injury in the camp, significant increase was observed in the global Quality of Life Index score, health and functioning subscale and psychological/spiritual subscale. As a result of camp attendance, global PIL test score significantly increased, while global SONG test score significantly decreased. Conclusions. Participation by individuals with spinal cord injury in the introductory camps organized by the Foundation for Active Rehabilitation has a positive impact on the subjective quality of life, strengthens sense of the meaning of life and decreases the motivation to find its purpose.

Background: There is no consensus regarding the best treatment approach for skeletally immature children with anterior cruciate ligament (ACL) injuries. High-quality studies with long-term follow-up are lacking, and evidence to support decision making is limited. Purpose: To evaluate functional and patient-reported outcome, surgical history, and complications among young adults who sustained an ACL injury before the age of 13 years and were treated with active rehabilitation and the option of delayed ACL reconstruction if needed. Study Design: Case series; Level of evidence, 4. Methods: Forty-six children aged <13 years with a total intrasubstance ACL injury were included. None of these patients had additional injuries that warranted early surgery. At final follow-up at a mean 8 years after the time of injury, 44 patients remained in the study. The same test battery was conducted at baseline, 1 and 2 years, and final follow-up at approximately 18 years of age. The test battery included functional tests (hop tests and isokinetic muscle strength tests of quadriceps and hamstrings), patient-reported outcome measures (including the Knee injury and Osteoarthritis Outcome Score and the International Knee Documentation Committee Subjective Knee Form), and clinical examination. Medical records were reviewed to assess surgical history and complications. Results: At a mean 8 years of follow-up, 24 patients (55%) had undergone ACL reconstruction, and 16 (36%) had undergone meniscal surgery. Quadriceps muscle strength symmetry was >90% for 30 patients (68%). Mean leg symmetry indexes for hop and strength tests were consistently >90%, except for the single-hop test and hamstrings muscle strength for ACL-reconstructed knees. Mean ± SD International Knee Documentation Committee scores were 86.3 ± 13.7 for the ACL-reconstructed knees and 90.6 ± 11.8 for the nonreconstructed knees. At final follow-up, forty patients (91%) remained active in sports, but 29 (66%) restricted their activity level to nonpivoting sports. Conclusion: Active rehabilitation may have a role in treatment of children with ACL injury. Approximately 50% of children may cope well, even to adulthood, without a surgical intervention. The other half may develop instability that warrants ACL reconstruction, and one-third may require meniscal surgery. [ABSTRACT FROM AUTHOR]

In recent years, sport-related concussion related research has exponentially increased looking at the cause, treatment, and prevention. The research conducted has allowed medical personnel to adapt their methods of treatment from a sedentary approach to a more active approach involving multiple therapies. As more studies are completed, active treatment, including multiple therapies, (vestibular, ocular, or cervical rehabilitation) has proven to allow for a quicker recovery time while still ensuring a safe environment for the athlete (Schneider et al., 2014). Although these great benefits have been identified, further research should be conducted to continue to develop and establish better treatment plans for the safety of the athletes. A systematic review of literature on sport-related concussed athletes and their treatment protocol will inform health care providers what therapeutic interventions for sport-related concussion show the best benefit for the athlete. [ABSTRACT FROM AUTHOR]

Primary objective: Persistent concussion symptoms (PCS) affect 10-30% of individuals after sports-related concussion. This study evaluated the effect of exercise-based rehabilitation on symptom scores, brain-derived neurotrophic factor (BDNF), cognitive functions and static balance in a sample of participants with PCS. Research design: One group pre-test post-test pilot study. Methods and procedure: Nine participants with PCS received a structured exercise-based rehabilitation program. Changes in symptom scores, BDNF, cognitive functions and measures of static balance were used to evaluate the utility of the exercise program. Main outcome and results: The results of this pilot study indicate a significant improvement in symptom scores following treatment, as well as some associated benefits in regards to cognitive function and static balance. BDNF levels in the participants with PCS within this study are notably lower than in a previous study on healthy controls. Conclusions: The preliminary evidence reported in the current pilot study is clinically relevant as our findings suggest exercise-based treatments may improve PCS outcomes in a more favourable manner than rest-based treatment. [ABSTRACT FROM AUTHOR]

Objective: To identify key ingredients in a six-week active rehabilitation intervention from the perspectives of youth recovering from concussion and their parents. Methods: Surveys with open- and closed-ended questions were administered to youth (N = 38) ages 10-18 years (average = 14.5 years) and their parents (n = 36) immediately post intervention. Descriptive statistics and thematic analysis were used to analyse data. Results: One hundred percent (N = 38) of youth and 100% (N = 36) of parents reported that the active rehabilitation intervention was helpful. The most helpful ingredients according to youth were: energy management strategies (47.4%, N = 18), aerobic exercise (31.6%, N = 12) and sport coordination drills (21.1%, N = 8). Qualitative analysis of youth survey questions resulted in three themes: (1) learning energy management; (2) engaging in physical activity and (3) seeking help. Themes emerging from the parent survey were: (1) encouraging recovery and confidence through structured activity; (2) recognizing youth’s accountability and (3) learning to be patient and to accept uncertain timelines. Conclusions: Education about energy management is an important ingredient of the active rehabilitation intervention for youth with concussion. Parents benefit from learning how their child can be more accountable for their own rehabilitation and to be more accepting of unclear recovery timelines. [ABSTRACT FROM AUTHOR]

It is evident that the dominant therapy of functional electrical stimulation (FES) for stroke rehabilitation suffers from heavy dependency on therapists experience and lack of feedback from patients’ status, which decrease the patients’ voluntary participation, reducing the rehabilitation efficacy. This paper proposes a closed loop FES system using surface electromyography (sEMG) bias feedback from bilateral arms for enhancing upper-limb stroke rehabilitation. This wireless portable system consists of sEMG data acquisition and FES modules, the former is used to measure and analyze the subject’s bilateral arm motion intention and neuromuscular states in terms of their sEMG, the latter of multi-channel FES output is controlled via the sEMG bias of the bilateral arms. The system has been evaluated with experiments proving that the system can achieve 39.9 dB signal-to-noise ratio in the lab environment, outperforming existing similar systems. The results also show that voluntary and active participation can be effectively employed to achieve different FES intensity for FES-assisted hand motions, demonstrating the potential for active stroke rehabilitation. [ABSTRACT FROM AUTHOR]

In this paper the implementation of impedance controllers to develop active rehabilitation exercises are presented. For which it is used a parallel structure ankle rehabilitation prototype with a mechanism of the type 2-RRSP (two closed kinematic chains and consisting of joints: revolute-revolute-sphere in slot- fixed post with sphere). Free software is used to develop the computer programs associated with rehabilitation exercises. The results of active rehabilitation exercises are reported, wich involves the effect of resistance from the rehabilitation prototype to the user operation: low, medium and high opposition effects are considered. [ABSTRACT FROM PUBLISHER]

Background: Spinal muscular atrophy (SMA) is a progressive neuromuscular disorder that causes muscle weakness and is the leading genetic cause of infant mortality worldwide. While no definitive cure exists, the approval of 3 genetic-based therapies in Canada since 2018 has led to significant improvements in muscle function for children with SMA. With that, there are no evidence-based rehabilitation interventions and minimal evidence on the combined effects of genetic-based therapies and rehabilitation., Objective: This protocol describes the methodology to assess the feasibility of a twice-weekly outpatient rehabilitation intervention focusing on gross and fine motor function to inform the methodology and sample size of a definitive clinical trial., Methods: We will conduct a single-center nonrandomized pilot and feasibility trial to explore an outpatient rehabilitation intervention for children aged 6 months to 3 years with SMA treated with genetic-based therapies. Participation in the study will occur over a 25-week period, with a baseline assessment visit followed by a 12-week intervention period and a 12-week nonintervention period. The rehabilitation intervention comprises weekly physical and occupational therapy for 11 weeks. Assessments will occur at baseline (week 0), end of intervention or early withdrawal (week 12), and follow-up (week 24). Predetermined feasibility indicators will evaluate study feasibility across process (recruitment rates, eligibility criteria, adherence rates, retention rates, questionnaire suitability, and acceptability), resource (time, implementation, and execution), management (materials and data), and scientific (safety, tolerability, and preliminary efficacy) domains., Results: This project was funded in March 2022, and data will be collected between March 2023 and December 2023. Data analysis will occur between January 2024 and March 2024, with publication expected in the fall of 2024. The protocol for the feasibility trial will be considered successful if it meets the success criteria set out for the feasibility indicators. Indicators of specific interest include all process indicators, as well as time. Exploratory indicators will be reported. Pragmatically, the results of the feasibility trial will inform changes to the protocol and the start-up of a definitive multisite trial., Conclusions: This novel twice-weekly outpatient rehabilitation intervention will be the first step toward filling the need for an evidence-based rehabilitation intervention for children with SMA treated with genetic-based therapies. It is expected that consistent and intensive rehabilitation therapy will augment functional gains being observed in this population. In the future, a definitive trial will measure the efficacy of the intervention., Trial Registration: ClinicalTrials.gov NCT05638750; https://clinicaltrials.gov/study/NCT05638750., International Registered Report Identifier (irrid): DERR1-10.2196/46363., (©Christina Ippolito, Lathushikka Canthiya, Amanda Floreani, Kathleen Luckhart, Andrea Hoffman, Laura McAdam. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 02.11.2023.)

The aim of the study was to analyze functional capacity during the 1st level of the Active Rehabilitation camp of people after spinal cord injury (SCI) in cervical segment. The individual functional indicators as: self-service, sphincter control, mobility, locomotion and communication have been analyzed. The study included 30 men with SCI in cervical segment and in age of 18-45. The clinimetric scale for functional rating of neurological patients - The Functional Indicator "Repty" was used in the study. The test were conducted twice: immediately before the beginning of the camp and after. An improvement in functional capacity occurred among all respondents during the 1st level of the AR camp. The greatest improvements concerned the mobility and self-service, smaller improvement occurred in locomotion and sphincter control. There was no significant improvement in level of communication.

Kamińska-Gwóźdź Ewelina, Lewicki Romuald, Studnicki Rafał, Opuchlik Anna, Szłapińska Joanna, Kubicki Jacek, Włoch Anna. Wpływ obozów Fundacji Aktywnej Rehabilitacji na stan psychofizyczny osób po uszkodzeniu rdzenia kręgowego = The effect of foundation for active rehabilitation camps on psychophysical state following spinal cord injury. Journal of Education, Health and Sport. 2015;5(11):43-52. ISSN 2391-8306. DOIhttp://dx.doi.org/10.5281/zenodo.33231 http://ojs.ukw.edu.pl/index.php/johs/article/view/2015%3B5%2811%29%3A43-52 https://pbn.nauka.gov.pl/works/666326 Formerly Journal of Health Sciences. ISSN 1429-9623 / 2300-665X. Archives 2011–2014http://journal.rsw.edu.pl/index.php/JHS/issue/archive Deklaracja. Specyfika i zawartość merytoryczna czasopisma nie ulega zmianie. Zgodnie z informacją MNiSW z dnia 2 czerwca 2014 r., że w roku 2014 nie będzie przeprowadzana ocena czasopism naukowych; czasopismo o zmienionym tytule otrzymuje tyle samo punktów co na wykazie czasopism naukowych z dnia 31 grudnia 2014 r. The journal has had 5 points in Ministry of Science and Higher Education of Poland parametric evaluation. Part B item 1089. (31.12.2014). © The Author (s) 2015; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland and Radom University in Radom, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 05.09.2015. Revised 05.10.2015. Accepted: 30.10.2015. Wpływ obozów Fundacji Aktywnej Rehabilitacji na stan psychofizyczny osób po uszkodzeniu rdzenia kręgowego The effect of foundation for active rehabilitation camps on psychophysical state following spinal cord injury Ewelina Kamińska-Gwóźdź Instytut Fizjoterapii, Wydział Lekarski i Nauk o Zdrowiu, Uniwersytet Jana Kochanowskiego, Al. IX Wieków Kielc 19, Kielce Ewelina Kamińska-Gwóźdź Institute of Physiotherapy, Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce Romuald Lewicki Katedra Fizjoterapii, Wydział Wychowania Fizycznego i Turystyki, Wszechnica Świętokrzyska, ul. E. Orzeszkowej 15, Kielce Romuald Lewicki The Department of Physiotherapy, Faculty of Physical Education and Tourism, Swietokrzyska Academy, Kielce Rafał Studnicki Zakład Fizjoterapii, Wydział Nauk o Zdrowiu z Oddziałem Pielęgniarstwa i Instytutem Medycyny Morskiej i Tropikalnej, Gdański Uniwersytet Medyczny, ul. Marii Skłodowskiej-Curie 3A, Gdańsk Rafał Studnicki The Unit of Physiotherapy, Faculty of Health Sciences Division of Nursing and the Institute of Maritime and Tropical Medicine, Medical University of Gdansk, Gdansk Anna Opuchlik Świętokrzyskie Centrum Onkologii, Zakład Rehabilitacji, ul. Artwińskiego 3, Kielce Anna Opuchlik Rehabilitation Institute, The Holycross Cancer Center in Kielce, Kielce Joanna Szłapińska Zakład Kształcenia Ustawicznego i Doradztwa Zawodowego, Wydział Studiów Edukacyjnych, Uniwersytet im. Adama Mickiewicza, ul. Wieniawskiego 1, Poznań Joanna Szłapińska Department of Continuing Education and Vocational Guidance, Faculty of Educational Studies, Adam Mickiewicz University in Poznań Jacek Kubicki Gabinet Fizjoterapii i Pediatrii, ul. Edmunda Łopuskiego 19a, Kołobrzeg Jacek Kubicki Physiotherapy and Paediatrics Office, Kołobrzeg Anna Włoch Wyższa Szkoła Ekonomii Prawa i Nauk Medycznych, Jagiellońska 109a, Kielce Anna Włoch High School of Economy, Law and Medical Sciences, Kielce Słowa kluczowe: uszkodzenie rdzenia kręgowego, Aktywna Rehabilitacja, sport, Fundacja Aktywnej Rehabilitacji. Keywords: spinal cord injury, Active Rehabilitation, sports, Foundation for Active Rehabilitation. Streszczenie Wstęp. Uszkodzenia rdzenia kręgowego są jednymi z najpoważniejszych dysfunkcji narządu ruchu skutkujące z reguły nieprzemijalnym stanem niepełnosprawności. Jest to stan o charakterze przewlekłym, który ma niekorzystny wpływ na sferę somatyczną, psychiczną oraz społeczną człowieka. Cel. Celem pracy było określenie wpływu obozu pierwszego stopnia Fundacji Aktywnej Rehabilitacji na stan psychofizyczny u osób po uszkodzeniu rdzenia kręgowego. Materiał i metody. Badania trwały od marca 2009 roku do marca 2010. Badaniami została objęta grupa 100 osób po uszkodzeniu rdzenia kręgowego. W pierwszym etapie badanie przeprowadzono przed obozem pierwszego stopnia organizowanym przez Fundację Aktywnej Rehabilitacji. W drugim etapie zbadano te same osoby trzy miesiące po ukończeniu powyższego obozu. Uczestnicy badań mieli ukończony 18 rok życia. Wśród badanych było 86 mężczyzn i 14 kobiet, w tym 33 osoby z uszkodzeniem rdzenia kręgowego w odcinku szyjnym, 57 osób z uszkodzeniem rdzenia w odcinku piersiowym, oraz 10 osób z uszkodzeniem rdzenia w odcinku lędźwiowym. Obozy odbywały się w Spale, w Zamościu oraz w Zielonej Górze. W badaniu wykorzystano kwestionariusz ankiety własnej konstrukcji dotyczący stanu psychofizycznego osób po uszkodzeniu rdzenia kręgowego. Wyniki. W wyniku uczestnictwa w obozie pierwszego stopnia u osób po uszkodzeniu rdzenia kręgowego nastąpiła poprawa stosunków międzyludzkich, wzrosła aktywność fizyczna, niezależność od innych osób, zwiększyła się ilość osób uprawiających sport oraz nastąpiła znaczna poprawa w czynnościach życia codziennego. Wnioski. Obóz pierwszego stopnia Fundacji Aktywnej Rehabilitacji wpłynął pozytywnie na stan psychofizyczny osób po uszkodzeniu rdzenia kręgowego. Dzięki działaniom Fundacji Aktywnej Rehabilitacji osoby z uszkodzeniem rdzenia kręgowego mają możliwość skorzystania z doświadczeń profesjonalnej kadry obozów, co przekłada się u badanych na postęp w zakresie zdolności motorycznych poprawiający nie tylko ich komfort życia, ale również ich stan psychiczny. Summary Introduction. Spinal cord injuries are among the most serious motor dysfunctions usually resulting in a permanent state of disability. It is a chronic condition with negative effect on the somatic, psychological and social state of humans. Purpose. The aim of this study was to determine the effect of participation in the introductory camps organized by the Foundation for Active Rehabilitation on psychophysical condition in individuals with spinal cord injury. Material and methods. Study was conducted between March 2009 and March 2010. It involved a group of 100 individuals suffering from spinal cord injury. In the first part of the study, research was conducted prior to the beginning of an introductory camp organized by the Foundation for Active Rehabilitation. The second part involved the same individuals three months after the camp. All study participants were 18 years of age or older and included 86 males and 14 females. Camps took place in Spala, in Zamość and in Zielona Góra. The study used custom-designed questionnaire concerning psychophysical status of individuals with spinal cord injury. Results. Improved relationships, increased physical activity, independence from other people, increased number of individuals practicing sports and a significant improvement in activities of daily life have been observed as a result of participation in the introductory camp for individuals with spinal cord injury. Conclusion. Foundation for Active Rehabilitation introductory camp had a positive effect on the psychophysical status of individuals with spinal cord injury. Through the effort of the Foundation for Active Rehabilitation, individuals with spinal cord injury can benefit from the experience of professional camp staff. Development of new motor skills further affects not only their comfort in life, but also their mental state.

Robot-assisted therapy has become an important technology applied in rehabilitation engineering, allowing patients with motion impairment problems to perform training programs without continuous supervision from physiotherapists. The goal of this paper is to develop a gravity balanced exoskeleton for active rehabilitation training of upper limb. The mechanical structure and kinematics of the exoskeleton are described and optimized to enable natural interaction with user and avoid singular configurations within the desired workspace. The gravity balancing of the human arm and mechanism is achieved through a hybrid strategy making use of auxiliary links and zero-free-length springs to balance the effect of gravity over the range of motion. The balance errors resulting from the variation of anthropometric parameters are analyzed and discussed. Further experiments involving trajectories tracking tasks with and without gravity balancing are conducted to evaluate the improvement of the control performance and energetic efficiency made by the developed balanced mechanism. The experimental results indicate that the proposed balance strategy can achieve a reduction of 34.56% in overall power consumption compared with the cost in unbalanced condition. [ABSTRACT FROM AUTHOR]

This paper presents an effective application of Jerk to plan trajectory and control undesirable effects (e.g. patient's hesitations and tremors) in active rehabilitation training using some mechatronic devices. Jerk is the time derivative of acceleration, and it is associated to the rapidly changing of forces. It is more sensible than other parameters (e.g. speed or acceleration) to intercept undesirable conditions as the patient's tremors or sub-movements. This study proposes an innovative regulator system based on Minimum Jerk trajectory planning and formulation. The trajectory planning strategy of limb rehabilitation is described considering the clinical therapy requirements and patients' needs. A case study based on a path shape that simulates a point-to-point motion is illustrated to demonstrate the effectiveness of the proposed solution. The study presents the kinematic analysis of the mechatronic device and the formulation of the objective function to minimize Jerk along the trajectory. A controller was developed to attenuate the micro sub-movements that recreated the patient hesitations. A set of simulations of the mechatronic model was performed highlighting the reduction of the jerk peak magnitude and the deviation from pre-determined trajectory when the controller was activated, improving the rehabilitation training. [ABSTRACT FROM AUTHOR]

Exoskeleton robots, which can be worn on human limbs to improve or to rehabilitate their function, are currently of great importance. When these robots are used in rehabilitation, one aspect that must be fulfilled is their capacity to adapt to different patients without significantly varying their performance. This paper describes the application of a relatively new control technique called virtual decomposition control (VDC) to a seven degrees-of-freedom (DOF) exoskeleton robot arm, named ETS-MARSE. The VDC approach mainly involves decomposing complex systems into subsystems, and using the resulting simpler dynamics to conduct control computation, while strictly ensuring global stability and having the subsystem dynamics interactions rigorously managed and maintained by means of virtual power flow. This approach is used to deal with different masses, joint stiffness and biomechanical variations of diverse subjects, allowing the control technique to naturally adapt to the variances involved and to maintain a successful control task. The results obtained in real time on a 7DOF exoskeleton robot arm show the effectiveness of the approach. [ABSTRACT FROM AUTHOR]

Background: For implementing autonomous rehabilitation exercises for upper limb hemiplegic patients, interfaces and a rehabilitation scenario that allow lateral and bilateral motions in a rehabilitation exercise robot are proposed.Objective: The proposed method measures the motion information generated from the unaffected part and projects it to an affected part in which the affected part expresses motions of the unaffected part.Methods: Both the accelerometer and gyro data were merged for estimating the motion information of the unaffected part. Also, HDR and complementary filters were applied to improve measurement errors in a data merging process.Results: For verifying the proposed method, a device, which is similar to a human body joint, was fabricated. Then, the angular values estimated by using an inertial sensor and the encoder values from the device were compared. In addition, a camera analysis was used to verify the proposed rehabilitation scenario by applying the rehabilitation interface proposed in this study to an exo-skeleton robot arm.Conclusion: It is possible to apply the method proposed in this study to the control variables in different upper limb rehabilitation exercise robots. Thus, it is expected that patient centered active lateral/bilateral rehabilitation exercises can be performed through this interface method. [ABSTRACT FROM AUTHOR]