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This study aimed to review the impact of training on muscle power in patients with chronic obstructive pulmonary disease (COPD). Randomized controlled trials evaluating the effects of exercise-based interventions on limbs muscle power and rate of force development in COPD patients were investigated. Five international databases were searched until October 2022. Meta-analyses were performed calculating the mean difference or standardized mean difference. Risk of bias in studies was assessed using Cochrane Risk of Bias tool 2.0. A total of nine studies were included in the analysis. There were concerns about risk of bias in seven out of nine studies. Comparison of exercising and non-exercising groups showed a significant effect of exercise in improving muscle power (P=0.0004) and rate of force development (P

Objective To investigate the effects of continuous chest wall vibration with concurrent aerobic training in addition to a 4-week pulmonary rehabilitation program on dyspnea and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). Design Randomized, single-blind, placebo-controlled trial. Setting The Cardiopulmonary Rehabilitation Unit of a tertiary referral subacute rehabilitation center. Participants A sample of 146 consecutive patients with COPD (Global Initiative for Chronic Obstructive Lung Disease II-III-IV) were assessed for eligibility. The final sample of 40 patients (N=40) was randomized into 3 groups (intervention, sham intervention, control). Interventions All groups carried out 5 sessions per week for 4 weeks of standard pulmonary rehabilitation treatment. The 2 daily 30-minute sessions included aerobic training and resistance training or airway clearance techniques. The intervention group performed the aerobic training with the addition of continuous chest wall vibration applied during cycling, whereas the sham intervention group received continuous chest wall vibration as a placebo during cycling. Main Outcome Measures Six-minute walk distance (6MWD) and Barthel Index based on dyspnea (BID). Results A total of 36 participants completed the study (69±7 years; forced expiratory volume in 1 second percentage of predicted, 40.15%±15.97%). Intention to treat analysis showed no significant differences between groups for 6MWD and BID. However, the increase in 6MWD was a clinically important difference in the intervention group (42.57±43.87m, P=.003), with a moderate effect size (d=0.58). Conclusions Continuous chest wall vibration with concurrent aerobic training in addition to a standard pulmonary rehabilitation program might improve functional exercise capacity compared with usual care, but there were no effects on dyspnea, respiratory muscle function, or quality of life in patients with COPD.

To analyze temporal and kinematic parameters of chronic Low-Back Pain (cLBP) subjects compared to healthy subjects during Timed Up and Go Test (TUG) execution implemented with an Inertial Measurement Unit and to explore the correlations of those parameters with pain and disability.Observational cross-sectional study. Thirty-one subjects with cLBP [(19 females - 61%), mean age 61 ± 19] were allocated to the case group, and 14 healthy [(10 females - 71%), mean age 62 ± 6] subjects to the control group. Instrumented TUG was administered to both groups. The Roland Morris Disability Questionnaire and Numerical Pain Rating Scale (NPRS) were also administered for disability and pain assessment in the case group.Mean TUG time to completion [12.2 ± 3.5 s for cLBP; 8.1 ± 0.9 s for healthy] and the most of sub-phases duration significantly differed between groups (p 0.05). As for kinematic parameters, significant differences (p 0.05) were mainly retrieved in acceleration components during the sit-to-stand and stand-to-sit phase, with the cLBP group showing lower accelerations. Significant correlation [from strong (ρ = 0.75 of time to completion) to moderate (ρ = 0.43 of sit-to-stand)] was observed between RMQD score and all temporal parameters and with most of the kinematic parameters. No correlation with NPRS score was found.Instrumented TUG application into a cLBP population provides valuable information about movement behaviors with a deeper assessment of objective functional impairment and disability in respect of the classical stop-watch outcome of TUG, possibly allowing a better design of the rehabilitative intervention.

In experimental trials, new methods are tested against the "best" or "usual" care. To appraise control group (CG) interventions provided as "usual care," we focused on stroke as a leading cause of disability demanding rehabilitation as a complex intervention.For this methodological appraisal, we conducted a systematic review of RCTs without timespan limitation. The PICO included stroke survivors, rehabilitation, control group intervention, lower limb function. To assess the risk of bias, we used the Cochrane risk of bias tool (RoB). We identified the terminology describing the CG Program (CGP), performed a knowledge synthesis and conducted a frequency analysis of provided interventions.We included 155 publications. 13.6% of the articles did not describe the CG, and 11.6% indicated only the professionals involved. In the remaining 116 studies, three studies provided an intervention according to specific guidelines, 106 different "usual care" CGPs were detected, with nine proposed twice and two between four and five times. The most adopted terminology to state "usual care" was "conventional physiotherapy."This study shows that usual care in CG does not actually exist, as both specific terminology and consistency within CGP contents are missing. Reporting guidelines should give better assistance on this issue. These results should be verified in other fields.

Introduction: This study aimed to assess the reliability of a qualitative scoring system based on the movement analysis of the spine in different populations and after usual care rehabilitative intervention. If proven true, the results could further future research development in quantitative indexes, leading to a possible subclassification of chronic low back pain (cLBP). Methods: This was a preliminary exploratory observational study. Data of an optoelectronic spine movement analysis from a pathological population (cLBP population, 5 male, 5 female, age 58 ± 16 years) were compared to young healthy participants (5M, 5F, age 22 ± 1) and were analysed via a new qualitative score of the pattern of movement. Internal consistency was calculated. Two independent assessors (experienced and inexperienced) assessed the blinded data, and we calculated inter- and intrarater reliability. We performed an analysis for cLBP pre and post a ten session group rehabilitation program between and within groups. Results: Internal consistency was good for all movements (α = 0.84-0.88). Intra-rater reliability (Intraclass correlation coefficient-ICC) was excellent for overall scores of all movements (ICC(1,k) = 0.95-0.99), while inter-rater reliability was poor to moderate (ICC(1,k) = 0.39-0.78). We found a significant difference in the total movement scores between cLBP and healthy participants (p = 0.001). Within-group comparison (cLBP) showed no significant difference in the total movement score in pre and post-treatment. Conclusion: The perception of differences between normal and pathological movements has been confirmed through the proposed scoring system, which proved to be able to distinguish different populations. This study has many limitations, but these results show that movement analysis could be a useful tool and open the door to quantifying the identified parameters through future studies. ispartof: INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH vol:19 issue:15 ispartof: location:Switzerland status: published

OBJECTIVES: The aim of this study was to compare the impact of fast-track rehabilitation (FTR) and conventional rehabilitation (CR) on early recovery pattern after fast-track surgery for knee arthroplasty and conventional total knee arthroplasty (TKA). PATIENTS AND METHODS: This prospective, case-control study included a total of 43 adult patients (10 males, 33 females; mean age 69 years; range, 50 to 82 years) who were clinically stable and admitted for rehabilitation after fast-track surgery for knee arthroplasty or conventional TKA January 2016 and August 2016. The patients were divided into two groups as the FTR and CR treatment groups. The FTR program was designed as a patient-focused care, early mobilization, and standardized postoperative milestones. The CR program was designed by standard postoperative rehabilitation care. Primary outcomes were the length of stay (LOS) in the hospital and knee function. Secondary outcomes were pain and activities of daily living. RESULTS: At baseline, both groups were similar in terms of demographic data and primary outcomes. At discharge, intra-group analysis showed significant differences in both groups in all functional outcomes, except for pain, while the inter-group LOS was also significantly different (p

This paper presents a novel approach to support rehabilitation employing Action Observation Therapy (AOT), mixed reality (MR) and wearable technologies to foster common rehabilitative methods in restoring motor function. Here, the platform was specifically designed to support the standard physical treatments in post-stroke patients during upper limb rehabilitation. The proposed platform integrates 3D stereo view of egocentric AOT stimuli, multi-level exergaming in MR and motion tracking. This solution represents a practical method for both in/outpatients and at-home rehabilitation programs. A feasibility study on sub-acute post-stroke patients was performed and preliminary findings suggested the effectiveness of this integrated approach.

Gait impairments are among the main issues for stroke survivors as they are often linked with a lack of endurance capacity, balance impairments and functional limitations. These conditions can be carefully assessed by combining an endurance capacity test, the 6-minute walk test (6MWT), with the analysis of gait performed by an inertial measurement unit (IMU). We investigated the evolution of gait spatiotemporal and kinematic parameters during the 6MWT and compared it with age-matched healthy subjects. Moreover, gait parameters and 6MWT distance were associated with clinical outcome scales. In a postacute rehabilitation general hospital, we performed an observational study. Subjects with a single cortical stroke were recruited into the stroke group (SG). An age-matched healthy group (HG) was also recruited. All participants performed a 6MWT while wearing an IMU. The outcomes considered were 6MWT distance, gait spatiotemporal and kinematic parameters, and symmetry. Before the test at each subject, in the SG was administered Berg balance scale, Canadian neurological stroke scale and motricity index. 32 subjects were recruited into the SG, and 12 into the HG. Between the paretic and nonparetic limbs of the SG, there were differences in the stance phase and single support phase (P < 0.05). SG gait speed and stride length strongly correlated with balance, strength and disability scales. The SG walked fewer meters than the HG (Δ = -260.90 m; P < 0.001). Adopting an IMU during a 6mwt resulted valuable and effective in providing meaningful information regarding both the disability and functional capabilities of SG subjects.

Objectives Ethically, in every experimental trial new methods should be tested against the ‘best’ or, if not defined, the ‘usual’ care according to current Guidelines. To understand the latter, we focused on stroke rehabilitation as a case in point because stroke is a leading cause of disability and rehabilitation is a complex intervention whose need is increasing due to growth of chronicity and disability (World Health Organization). Our aim was to appraise stroke rehabilitation interventions provided as ‘usual care’ and the terminology used, comparing high to low quality randomised-controlled trials (RCTs). Method Systematic review of RCTs (2006–16). Inclusion criteria were as follows: stroke survivor patients, intervention, rehabilitation, control: rehabilitative ‘usual care’, outcome: lower limb function. We used the Cochrane ‘risk of bias’ tool, rating studies as low or high quality. We identified the terminology used to describe the Control Group Rehabilitation Program (CGP), performed a knowledge synthesis process and conducted a frequency analysis to sort the heterogeneity through the itemised identification of the CGP contents. Two quality groups of studies (high-low risk of bias) have been compared. Results We included 86 publications (23% low-risk of bias). Nine per cent of articles did not describe the CGP. In the remaining 78, we identified 64 interventions: 53 were proposed once, 8 were proposed twice and 3 were proposed in 3 papers. Two interventions (gait and balance) were proposed in 52% and 51% of papers, respectively. Results did not differ in the two RCT quality groups. Conclusions This case study on stroke rehabilitation has shown that the term ‘usual care’ in CGP is not adequately used: a good terminology to define interventions is missing and respecting CONSORT checklists does not avoid these problems. These results are clear, and involve authors, reviewers and both field-specific and generalist journals. Nevertheless, they should be verified by future studies in other fields, with this or other methodologies. Reporting guidelines should probably give better expert guidance on this issue.

Background In some studies, an association has been reported between laterality of the curve in scoliotic adolescents and hand dominance; however, additional studies have to be performed to confirm these findings. Objective The objective of this study is to evaluate the prevalence between trunk asymmetry and side dominance in hand, foot and visual laterality in adolescents. Methods This was a cross-sectional study secondary analysis. In total, 1029 children (491 females) were enrolled from the Secondary School of Brescia, Italy, with a mean age of 12 (SD = 0.9 years). All subjects underwent a screening program divided into three phases: Phase 1, collection of demographic and clinical characteristics; Phase 2, spine evaluation with a plumb line and Bunnell Scoliometer; and Phase 3, evaluation of side dominance of the eye, hand and foot with a 4-item survey. Results Our data showed a prevalence of 0.43%, 1.01% and 0.87% for thoracic, thoracolumbar and lumbar curves, respectively, with a right-side dominance and a prevalence of 2.72%, 2.54% and 0.65% for thoracic, thoracolumbar and lumbar curves, respectively, with a left-side dominance. Conclusion The left-side dominance could have a prevalence on trunk asymmetry in thoracic and thoraco-lumbar curves. Our study suggests that the clinical evaluation of trunk asymmetry should be associated with the evaluation of laterality.

Quantitative and qualitative measures of human movement can be two important features for clinical decision making. The purpose of this study is to evaluate the Intra-and inter- operator reliability of a novel hand protocol during grip movement. The experimental protocol required the positioning of 8 optoelectronic cameras and 24 markers. 5 healthy subjects have been recruited. Each subject received 2 markerizations by two different operators (A and B) and they carried out 3 tests at a time T0 and at a time T1 (a week after) for each markerization. Results have shown that Test-retest reliability of the markers positions measurements was good (test: 0,893, p

Background The literature did not show clearly if a correlation between trunk and facial asymmetry exists. The aim of this study was to verify the association between trunk and facial asymmetries, and trunk and facial sagittal configuration in adolescents. Methods This is a cross-sectional screening study. It was carried out in a small town in Northern Italy, from February to April 2014. Healthy children met the inclusion criteria. Exclusion criteria were subjects with physical and cognitive disability, genetic disease, and polymorphism. All subjects underwent a three phases for postural screening program. Results 1029 healthy children were 491 females and 538 males with mean age: 12 (range 11–16) years. The association of facial and trunk asymmetry had a point prevalence rate around 1% for the various regions of the spine, the association on the sagittal plane of almost 1.3% for hyperkyphosis and hyperlordosis. Overall, results showed a very low sensitivity, specificity, and predictive values of facial anomalies for trunk asymmetry and sagittal spinal posture. Conclusion While correlations between jaw position and body posture for cervical spine can exist, our study denied association with trunk and back in a general population: postural compensatory mechanism may have minimized the effects of one area on the other, if any existed.

The aim of this study was to describe the disease-related sagittal balance changes in relation to the sacro-pelvic morphology of Parkinson's Disease patients with different duration of disease.One hundred and seventy-five consecutive Parkinson's Disease (PD) patients (102 males, 73 females; age: 55-83 years) participated in the cross-sectional study. The clinical assessment included: Hoehn Yahr (HY) score; Tinetti score; plumb line (PL) distance from the spinous process of C7, L3 and S1 and kyphosis apex. Lumbar lordosis (LL), thoracic kyphosis (TK), spinosacral (SSA) and spinopelvic (SPA) angles, spinal tilt, pelvic incidence (PI), sacral slope (SS) and pelvic tilt (PT) were radiographically assessed.Spinosacral and spinopelvic were correlated with the duration of disease and Tinetti score, but not with age. We found a positive correlation between LL and both SSA and SPA. TK was significantly correlated with LL but not with pelvic parameters, while PI with SS and LL.Female gender, high PI and high LL together with a low PL-C7 distance can be considered as protective factors for spinal imbalance and fall risk; negative factors are represented by male gender, longer disease duration, higher HY Class, and low PL-L3 distance. Looking at the pelvis is revealing new important insights in spinal disease management, both surgical and rehabilitative.

The “Timed Up and Go” (TUG) test is widely used in various disorders to evaluate subject’s mobility, usually evaluating only time execution. TUG test specificity could be improved by using instrumented assessment based on inertial sensors. Position of the sensor is critical. This study aimed to assess the reliability and validity of an inertial sensor placed in three different positions to correctly segment the different phases in the TUG test. Finding demonstrated good reliability of the proposed methodology compared to the gold standard motion analysis approach based on surface markers and an optoelectronic system. Placing the sensor just beneath the lumbar-sacral joint reported the lower values of deviation with respect to the gold standard. Optimized position can extend the proposed methodology from the clinical context towards ubiquitous solutions in an ecological approach.

Total knee arthroplasty is a common intervention and it is usually followed by a rehabilitation period, to recover physical functioning. The aim of this study is to evaluate the changes of gait kinematic parameters due to rehabilitation after total knee arthroplasty. After inclusion and exclusion criteria the subjects were evaluated with Barthel Index (BI), International Knee Society Score (IKSS), Knee Flexion (KF), NRS and Instrumental Gait Analysis (GA), at admission (T0) and discharge (T1). Many parameters show a significant improvement during rehabilitation IKSS, BI, KF (P 0.05), all the significant evaluation scales and gait analysis parameters had a significant clinical effect size (Cohen’s d > 0.8). The rehabilitation process seems to be effective in improving gait parameters and knee functioning.

Background: The handgrip strength test is widely used by clinicians; however, little has been investigated about its reliability when used in subjects with Parkinson disease (PD). The purpose of this study was to investigate the test-retest reliability of the handgrip strength test for subjects with PD. Methods: The PD group consisted of 15 patients, and the control group consisted of 15 healthy subjects. Each patient performed 3 pain-free maximal isometric contractions on each hand on 2 occasions, 1 week apart. Intraclass correlation coefficient (ICC), standard error of measurement (SEM), and 95% limits of agreement (LOA) were calculated. The 2-way analysis of variance (ANOVA) was conducted to determine the differences between sides and groups. Results: Test-retest reliability of measurements of grip strength was excellent for dominant (ICC = 0.97; P = .001) and non-dominant (ICC = 0.98; P = .001) hand of participant with PD and (ICC = 0.99; P = .001) and (ICC = 0.99; P = .001) respectively, of healthy group. Conclusions: The Jamar hand dynamometer had fair to excellent test-retest reliability to test grip strength in participants with PD.

OBJECTIVE: The purpose of this study was to investigate the effectiveness of action observation therapy (AOT) compared with written information in patients submitted to a physical therapy program after primary total hip arthroplasty (THA). METHODS: We conducted a prospective clinical trial. Twenty-four patients with THA, 62.5% female (aged 69.0 ± 8.5 years), received AOT in addition to conventional physical therapy (experimental group) or written information in addition to conventional physical therapy (exercise and information group) for 10 sessions. Outcomes used were visual analog scale, hip active and passive range of motion, Barthel Index, Short Form 36 (SF-36) Health Survey, Tinetti Scale, and Lequesne Index measurements. All measures were collected at baseline and at the end of the intervention. Repeated measures analysis of variance was used to examine the interventions effects within groups and between groups. RESULTS: No relevant baseline differences were observed between groups. Both treatments produced statistically significant improvements on visual analog scale, active and passive range of motion, Barthel Index, SF-36, Tinetti Scale, and Lequesne Index immediately after the intervention (all, P < .001). SF-36 (physical functioning subscale) revealed a statistically significant intergroups difference (P = .02) after treatment. CONCLUSIONS: Both treatments were effective at improving pain, functional status, quality of life, and gait features in patients with primary THA. In addition to conventional physical therapy, AOT improved perceived physical function more than written information.

We investigated the effectiveness of three different rehabilitative programs: group exercise, individual core stability or balance training intervention with a stabilometric platform to improve balance ability in elderly hospitalized patients. We used a prospective quasi-experimental study design. Twenty-eight patients, 39.3% women [age (mean±SD) 72.4±6.5 years], known to have had at least a fall in the last 12 months, were consecutively assigned to one of the following three groups: group exercise intervention, individual core stability or balance training with a stabilometric platform (five sessions a week for 3 weeks in each group). Outcomes were collected at baseline and immediately following the intervention period. In each intervention group, patients showed improvement in balance and mobility, shown as an improvement in the three functional tests score (the Tinetti scale, the Berg Balance Scale, and the Time Up and Go test) (all, P