Showing papers in "American Journal of Physical Medicine & Rehabilitation in 2017"
TL;DR: The lack of statistical significance between blinding and effect sizes should not be interpreted as meaning that an impact of blinding on effect size is not present in PT.
Abstract: OBJECTIVE
The aim of this study was to examine whether blinding of participants, assessors, health providers, and statisticians have an effect on treatment effect estimates in physical therapy (PT) trials.
DESIGN
This was a meta-epidemiological study. Randomized controlled trials in PT were identified by searching the Cochrane Database of Systematic Reviews for meta-analyses of PT interventions. Assessments of blinding in PT trials were conducted independently following established guidelines.
RESULTS
Three hundred ninety-three trials and 43 meta-analyses that included 44,622 patients contributed to this study. Only a quarter of the trials were adequately blinded (n = 80; 20%). Most individual components of blinding as well as what they were blinded to were also poorly reported. Although trials with inappropriate blinding of assessors and participants tended to underestimate treatment effects when compared with trials with appropriate blinding of assessors and participants, the difference was not statistically significant (effect size, -0.07; 95% confidence interval, -0.22 to 0.08; effect size, -0.12; 95% confidence interval, -0.30 to 0.06, respectively).
CONCLUSIONS
The lack of statistical significance between blinding and effect sizes should not be interpreted as meaning that an impact of blinding on effect size is not present in PT. More empirical evidence in a larger sample is needed to determine which biases are likely to influence reported effect sizes of PT trials and under which conditions.
94 citations
TL;DR: This review synthesized physical activity and exercise intervention literature for people with physical and cognitive disabilities including intervention characteristics, behavior change strategies, and types of technologies used to improve targeted outcomes to provide a roadmap for future exercise trials on understudied populations.
Abstract: This review synthesized physical activity and exercise intervention literature for the past 10 yrs for people with physical and cognitive disabilities including intervention characteristics, behavior change strategies, and types of technologies used to improve targeted outcomes. Systematic searches yielded 132 eligible studies. The major disability groups were multiple sclerosis (41%), stroke (15%), and spinal cord injury (12%). Research designs primarily involved randomized controlled trials (61%) versus quasi-experimental designs (39%). Approximately 20% of the interventions used some form of the following technology: information and communication technology (48%), interactive technology (37%), or electronic gauges (30%). Eighteen percent of studies used intervention strategies based on behavioral theory, which was typically combined with technology to promote activity and increase adherence in generally larger study samples. The three prevailing theories included social cognitive theory (58%), supportive accountability theory (21%), and transtheoretical model (21%). Upon completing the intervention, studies reported primarily significant outcomes (80%). Exercise research for PWD has grown in both quantity and quality, but several gaps remain. Study findings provide a roadmap for future exercise trials on understudied populations and highlight technology and behavior change theory as drivers of future intervention research.
84 citations
TL;DR: Home-based telesupervising rehabilitation is most likely as effective as the conventional outpatient rehabilitation for improving functional recovery in stroke survivors and could ease the burden of caregivers as conventional rehabilitation.
Abstract: ObjectiveThe aims of this work were to evaluate the effects of home-based telesupervising rehabilitation on physical function for stroke survivors with hemiplegia and to determine if the rehabilitation therapy can relieve the burden on caregivers.DesignThis study is a randomized, controlled, assesso
80 citations
TL;DR: Exercise training improves exercise tolerance and health-related quality of life in patients with very severe COPD, however, because few studies on severely affected patients are available and the training programs are Highly heterogeneous, larger RCTs are needed.
Abstract: ObjectiveTo evaluate the effectiveness of exercise training in patients with very severe chronic obstructive pulmonary disease (COPD).DesignWe searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and Cumulative Index to Nursing and Allied Health Literature databases using the fo
67 citations
TL;DR: It is demonstrated that Kinesio taping resulted in superior short-term effects on walking task, pain, and knee-flexion ROM compared with placebo taping in patients with knee osteoarthritis.
Abstract: ObjectiveThis study investigated the effect of Kinesio taping on the functionality, pain, range of motion (ROM), and muscle strength in patients with knee osteoarthritis compared with a placebo Kinesio tape (KT) application.DesignForty-two consecutive patients were randomized to a KT group and a pla
66 citations
TL;DR: Jobe test and full can test had high sensitivity and specificity for supraspinatus tears, and Hornblower sign performed well for infraspinatu tears.
Abstract: Objective The aim was to assess diagnostic accuracy of 15 shoulder special tests for rotator cuff tears. Design From February 2011 to December 2012, 208 participants with shoulder pain were recruited in a cohort study. Results Among tests for supraspinatus tears, Jobe test had a sensitivity of 88% (95% confidence interval [CI], 80%-96%), specificity of 62% (95% CI, 53%-71%), and likelihood ratio of 2.30 (95% CI, 1.79-2.95). The full can test had a sensitivity of 70% (95% CI, 59%-82%) and a specificity of 81% (95% CI, 74%-88%). Among tests for infraspinatus tears, external rotation lag signs at 0 degrees had a specificity of 98% (95% CI, 96%-100%) and a likelihood ratio of 6.06 (95% CI, 1.30-28.33), and the Hornblower sign had a specificity of 96% (95% CI, 93%-100%) and likelihood ratio of 4.81 (95% CI, 1.60-14.49). Conclusions Jobe test and full can test had high sensitivity and specificity for supraspinatus tears, and Hornblower sign performed well for infraspinatus tears. In general, special tests described for subscapularis tears have high specificity but low sensitivity. These data can be used in clinical practice to diagnose rotator cuff tears and may reduce the reliance on expensive imaging.
65 citations
TL;DR: Overall aims, guiding principles on sampling strategies, data collection modes, and reminder management are described, and expected results of the survey will be used for the basis of conducting stakeholder dialogs for policy reforms designed to improve the functioning, health maintenance, and well-being of persons with SCI.
Abstract: Objective The Learning Health System for Spinal Cord Injury (LHS-SCI) is an initiative embedded in the World Health Organization's (WHO's) Global Disability Plan and requires the statistical collection of data on the lived experience of persons with SCI to consequently formulate recommendations and policies. The International Spinal Cord Injury (InSCI) community survey has been developed as an initial step to gain information about the lived experience of persons with SCI within and across diverse nations. Design InSCI is a multinational community survey based on the International Classification of Functioning, Disability and Health Core Sets for SCI and involves 28 countries from all six WHO regions. The study will be implemented in 2017. Overall aims, guiding principles on sampling strategies, data collection modes, and reminder management are described. Conclusions InSCI will be the first survey to be conducted simultaneously in many countries and in all six WHO world regions that identifies the factors associated with functioning, health, and well-being of persons living with SCI. Expected results of the survey will be used for the basis of conducting stakeholder dialogs for policy reforms designed to improve the functioning, health maintenance, and well-being of persons with SCI.
62 citations
TL;DR: Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function, and the meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure.
Abstract: Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life.
In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool.
Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs.
Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.
62 citations
TL;DR: This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.
Abstract: A complete understanding of the experience of health requires information relevant not merely to the health indicators of mortality and morbidity but also to functioning-that is, information about what it means to live in a health state, "the lived experience of health." Not only is functioning information relevant to healthcare and the overall objectives of person-centered healthcare but to the successful operation of all components of health systems.In light of population aging and major epidemiological trends, the health strategy of rehabilitation, whose aim has always been to optimize functioning and minimize disability, will become a key health strategy. The increasing prominence of the rehabilitative strategy within the health system drives the argument for the integration of functioning information as an essential component in national health information systems.Rehabilitation professionals and researchers have long recognized in WHO's International Classification of Functioning, Disability and Health the best prospect for an internationally recognized, sufficiently complete and powerful information reference for the documentation of functioning information. This paper opens the discussion of the promise of integrating the ICF as an essential component in national health systems to secure access to functioning information for rehabilitation, across health systems and countries.
48 citations
TL;DR: The pain threshold of MTrPs have a great capacity to increase; even after multiple massage treatments additional gain in PPT was observed, and single and multiple massage applications increase PPT at MtrPs.
Abstract: ObjectiveThis study aimed to assess the effects of single and multiple massage treatments on pressure-pain threshold (PPT) at myofascial trigger points (MTrPs) in people with myofascial pain syndrome expressed as tension-type headache.DesignIndividuals (n = 62) with episodic or chronic tension-type
47 citations
TL;DR: An early rehabilitation program in survivors of critical illness led to an earlier discharge from the hospital, improved functional recovery, and was also cost-effective and safe.
Abstract: ObjectiveThe aim of this study was to evaluate if an early rehabilitation program for survivors of critical illness improves functional recovery, reduces length of stay, and reduces hospital costs.DesignThis was a prospective randomized controlled trial. Fifty-three consecutive survivors of critical
TL;DR: ESWT seems to be particularly effective in relieving pain associated with RPF, and should be considered when traditional treatments have failed.
Abstract: The objective of this meta-analysis was to investigate the efficacy of extracorporeal shock wave therapy in the treatment of recalcitrant plantar fasciitis without local anesthesia.
The Cochrane Library, EMBASE, PubMed, and Web of Science databases were searched from inception to September 2015 for randomized controlled trials comparing ESWT without local anesthesia versus placebo for treatment of plantar fasciitis in adults. The primary outcome was the 12-week post-intervention success rate of reducing the visual analog scale score by 60% from baseline at the first step in the morning, reducing the VAS score by 60% from baseline during daily activities, reducing the Roles and Maudsley score, reducing overall heel pain, and reducing pain after applying a force meter.
Nine studies were included in the meta-analysis. Compared with placebo, ESWT significantly improved the success rate of reducing overall heel pain, reducing the VAS score by 60% at the first step in the morning and during daily activities, improving the Roles and Maudsley score to excellent or good, and reducing heel pain after application of a pressure meter.
ESWT seems to be particularly effective in relieving pain associated with RPF. ESWT should be considered when traditional treatments have failed.
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Upon completion of this article, the reader should be able to (1) understand the recovery rates for nonsurgical treatment of plantar fasciitis, (2) understand the role of extracorporeal shockwave therapy (ESWT) in the treatment of recalcitrant plantar fasciitis, and (3) understand the indications to incorporate ESWT in the treatment plan of recalcitrant plantar fasciitis.
Advanced
The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
TL;DR: Evaluating the effects on common poststroke gait compensations of a soft wearable robot (exosuit) designed to assist the paretic limb during hemiparetic walking found it necessary to determine how exosuit-induced reductions in pareti hip hiking and circumduction during gait training could be leveraged to facilitate more normal walking behavior during unassisted walking.
Abstract: ObjectiveThe aim of the study was to evaluate the effects on common poststroke gait compensations of a soft wearable robot (exosuit) designed to assist the paretic limb during hemiparetic walking.DesignA single-session study of eight individuals in the chronic phase of stroke recovery was conducted.
TL;DR: Armeo robotic therapy is significantly more effective than conventional therapy in improving the upper limb quality of movement in children with hemiplegic cerebral palsy.
Abstract: OBJECTIVE The aim of this study was to examine the efficacy of Armeo robotic therapy, compared with conventional therapy, on upper limb function in children with hemiplegic cerebral palsy. DESIGN Thirty children with hemiplegic cerebral palsy, with ages ranging from 6 to 8 yrs, were selected for this randomized controlled study and randomly assigned to two groups. The study group (n = 15) received 12 wks of Armeo robotic therapy (45 min/session, 3 days/wk) and the control group (n = 15) received conventional therapy for the same period. The measured outcomes were the Modified Ashworth Scale and the Quality of Upper Extremity Skills Test, measured at baseline and after 12 wks of intervention. RESULTS Children in the study group showed significant improvement in the mean values of all the measured variables, compared with those in the control group (P < 0.05). Postintervention Modified Ashworth Scale scores for the study and control groups were 1.6 (0.3) and 2 (0.5), respectively. Postinterventional Quality of Upper Extremity Skills Test total scores for the study and control groups were 84.6 (2.7) and 79.1 (2), respectively. CONCLUSIONS Armeo robotic therapy is significantly more effective than conventional therapy in improving the upper limb quality of movement in children with hemiplegic cerebral palsy.
TL;DR: Assessment of the effectiveness of different dosages of local twitch responses elicited by deep dry needling in relation to pain intensity, pressure pain threshold, cervical range of movement, and disability degree in cervical myofascial pain patients found no significant changes.
Abstract: ObjectiveTo assess the effectiveness of different dosages of local twitch responses (LTRs) elicited by deep dry needling (DDN) in relation to pain intensity, pressure pain threshold (PPT), cervical range of movement (CROM), and disability degree in cervical myofascial pain patients.DesignA randomize
TL;DR: Whether walking aids facilitate activity and participation may depend on the user's ability to overcome obstacles and integrate them in daily life, and more high-quality research is needed to draw conclusions about their effectiveness.
Abstract: In this systematic literature review, we examined whether and how walking aids (i.e., canes, crutches, walkers, and rollators) enable activity and participation among adults with physical disabilities. Medline, Embase, all EBM reviews, PsychInfo, CINAHL, and Web of Science databases were used to identify studies published since 2008. Quantitative and qualitative designs were included. Data regarding participants, assistive device use, outcome measures, and domains of participation were extracted. Two reviewers independently rated the level of evidence and methodological quality of the studies. Outcomes were categorized per types of walking aids and activity and participation domains. Thirteen studies were included. Two studies involved canes, four pertained to rollators, and seven dealt with multiple types of walking aids. Mobility was the most frequently examined domain of activity and participation. Both negative and positive results were found. Negative outcomes were linked to the physical characteristics of the device, the use, environment, and personal reluctance. When incorporated in daily life, walking aids were found to enable several domains of activity and participation. Whether walking aids facilitate activity and participation may depend on the user's ability to overcome obstacles and integrate them in daily life. More high-quality research is needed to draw conclusions about their effectiveness.
TL;DR: Platelet-rich plasma treatment significantly improves pain, stiffness, and disability in patients with knee osteoarthritis compared with normal saline treatment and is recommended to enhance muscle strength recovery.
Abstract: ObjectiveNo studies comparing the effects of platelet-rich plasma (PRP) injection and placebo injection in bilateral knee osteoarthritis in the same patient, or discussing muscle strength after PRP injection, have been published.DesignTwenty patients with bilateral knee osteoarthritis were eligible,
TL;DR: Incidence and prevalence of SCI in individuals older than 60 years have increased, with prevalence increasing at a slower rate because of higher mortality rates in this age group.
Abstract: EPIDEMIOLOGY OF SPINAL CORD INJURY IN THE UNITED STATES The incidence of traumatic spinal cord injury (SCI) in the United States is estimated to be 40.1 cases per million, indicating approximately 12,500 new SCI occur each year. The prevalence of SCI is estimated to be 906 cases per million, or 276,000 individuals. Males are more likely to experience an SCI than females at a ratio of 2.25:1 and are estimated to account for 80% of all traumatic SCI cases. Between 1993 and 2012, there was an estimated decrease in incidence of SCI from 144 to 87 cases per million in younger males aged 16 to 24 years. Vehicular accidents are the leading cause of SCI in the United States, accounting for approximately 39.08% of all SCIs between 2005 and 2015. Unintentional falls (29.54%) ranked second, followed by acts of violence (14.41%; 13.01% from gunshot wounds) and sports/recreational activities (8.39%). The average life expectancy for an individualwith SCI has not changed since the 1980s and is significantly lower than an individual without SCI. The leading cause of mortality in SCI individuals is disease of the respiratory system, such as pneumonia, accounting for 21.6% of all deaths. Between 1997 and 2012, there was a significant increase in the incidence of acute traumatic SCIs as a result from unintentional falls. Incidence and prevalence of SCI in individuals older than 60 years have increased, with prevalence increasing at a slower rate because of higher mortality rates in this age group.
TL;DR: This review found low- to moderate-quality evidence that massage therapy is superior to nonactive therapies in reducing pain and improving certain functional outcomes and a need for large, methodologically rigorous randomized controlled trials investigating the effectiveness of massage therapy as an intervention for individuals with arthritis.
Abstract: BackgroundMassage therapy is gaining interest as a therapeutic approach to managing osteoarthritis and rheumatoid arthritis symptoms. To date, there have been no systematic reviews investigating the effects of massage therapy on these conditions.DesignSystematic review was used.ObjectivesThe primary
TL;DR: This scoping review identified a range of needs of stroke survivors as perceived by their caregivers, and incorporated the caregiver's preferences and values into clinical decisions may improve outcomes among stroke survivors.
Abstract: ObjectiveCaregivers usually are not involved while planning the stroke survivor's medical and rehabilitation goals and interventions. This review aimed to identify the needs of stroke survivors as perceived by their caregivers.DesignA literature search from 2003 to 2014 was conducted using Medline,
TL;DR: It was shown that this approach could have an influence on basic common points in the body and motion, including emotional and social aspects, supporting the concept of complex multimodal psychomotor adjustments in cerebral palsy young subjects.
Abstract: This randomized controlled clinical trial aimed to investigate the effect of dance in the functionality and psychosocial adjustment of young subjects with cerebral palsy (CP).
Twenty-six young subjects with CP, GMFCS (Gross Motor Function Classification System) levels from II to V, were randomized into two intervention groups: kinesiotherapy and dance (n = 13 each). Twenty-four sessions (1 hour, twice a week) were performed in both groups. Functional Independence Measure (FIM) and World Health Organization Disability Assessment Schedule (WHODAS) by International Classification of Functioning, Disability and Health (ICF) were used before and after each intervention.
Dance increased the classification of functioning (P = 0.001), independence function (P = 0.004), self-care (P = 0.01), mobility (P = 0.008), locomotion (P = 0.01), communication (P = 0.02), psychosocial adjustments (P = 0.04), and cognitive function (P = 0.03). Intergroup analysis evidenced significantly greater improvements in classification of functioning (P = 0.0002), independence function (P = 0.0006), self-care (P = 0.01), mobility (P = 0.001), locomotion (P = 0.002), communication (P = 0.0001), psychosocial adjustments (P = 0.002), and cognitive function (P = 0.0001) in dance group.
It was shown that this approach could have an influence on basic common points in the body and motion, including emotional and social aspects, supporting the concept of complex multimodal psychomotor adjustments. Dance promoted enhancement on functionality and social activities regarding psychosocial adjustments in cerebral palsy young subjects.
TL;DR: The InSCI questionnaire presents an efficient and feasible solution with satisfying comparability to other populations; however, its validity and reliability still needs to be confirmed.
Abstract: The International Spinal Cord Injury (InSCI) community survey has been developed to collect internationally comparable data on the lived experience of persons with spinal cord injury (SCI) in all 6 WHO regions. The InSCI survey provides a crucial first step to generate evidence on functioning, health maintenance, and subjective well-being in persons with SCI globally. A major challenge in setting up the InSCI community survey was to develop a data model and questionnaire that comprehensively captures what matters to people and, at the same time, is feasible and parsimonious in terms of participant's burden. This paper outlines the components of the InSCI data model and presents the question selection to operationalize the data model along the 4 guiding principles of efficiency, feasibility, comparability, and truth and discrimination. The data model consists of 6 components operationalized with 125 questions including functioning (n = 28 body functions and structures; n = 42 activities and participation), contextual factors (n = 26 environmental; n = 19 personal factors), lesion characteristics (n = 2), and appraisal of health and well-being (n = 8). The InSCI questionnaire presents an efficient and feasible solution with satisfying comparability to other populations; however, its validity and reliability still needs to be confirmed.
TL;DR: In relieving pain and improving self-report function, PRP showed no superiority over hyaluronic acid in well-designed double-blind trials, and beneficial effects of PRP in most trials probably resulted from insufficient blinding methods.
Abstract: ObjectiveThe aim of this study was to assess the efficacy of platelet-rich plasma (PRP) in pain and self-report function of patients with knee osteoarthritis on the basis of comparisons with hyaluronic acid or placebo.DesignBest-evidence synthesis of randomized controlled trials (RCTs) was conducted
TL;DR: Sleep disturbance after stroke was found to have negative effects on functional recovery, especially balance improvement in moderate stroke group, and the improvement of Korean version of the Berg Balance Scale was significantly lower in the any sleep disturbance group.
Abstract: Objective The aim of the study was to explore the impact of insomnia and sleep disturbance on the functional outcomes of mild and moderated stroke. Design A multicenter-observational and correlation study was performed. Two hundred eighty patients with mild-moderate severity stroke admitted to three acute hospitals rehabilitation departments. Diagnostic Statistical Manual of Mental Disorders, Fourth Edition, criteria were used to define patients with insomnia and any sleep disturbance. Patient's initial and final functions were evaluated using the Korean version of the Berg Balance Scale, the Korean version of Modified Barthel Index, the Korean version of Mini-Mental State Examination, the Korean version of the Frontal Assessment Battery, and the Korean version of National Institute of Health Stroke Scale. Sleep disturbance and function were assessed with respect to stroke severity as defined by the Korean version of National Institute of Health Stroke Scale. Results The prevalence of Diagnostic Statistical Manual of Mental Disorders, Fourth Edition insomnia and any sleep disturbance were 26.9% and 56.7%, respectively. After adjusting for age, sex, depression, anxiety, length of stay, and hypnotic usage, the improvement of Korean version of the Berg Balance Scale was significantly lower in the any sleep disturbance group. In the moderate stroke group, the Korean version of the Berg Balance Scale improvement was significantly lower in the any sleep disturbance group, whereas in the mild stroke group, the Korean version of the Berg Balance Scale improvement was not significant. Conclusions Sleep disturbance after stroke was found to have negative effects on functional recovery, especially balance improvement in moderate stroke group.
TL;DR: Evidence is found that mat Pilates improves dynamic balance, lower limb strength, hip and lower back flexibility, and cardiovascular endurance in elderly individuals and high-quality studies are necessary to clarify the effects of mat Pilate on other physical functional measurements among older adults.
Abstract: ObjectiveThe present meta-analysis aimed to examine evidence from randomized controlled trials to determine the effects of mat Pilates on measures of physical functional performance in the older population.DesignA search was conducted in the MEDLINE/PubMed, Scopus, Scielo, and PEDro databases betwee
TL;DR: It is confirmed that tai chi may be an effective cardiac rehabilitation method for patients with chronic heart failure and larger, well-designed randomized controlled trials are needed to exclude the risk of bias.
Abstract: AimThis meta-analysis aimed to update and evaluate evidence from randomized controlled trials of tai chi for patients with chronic heart failure.MethodBoth English and Chinese databases were searched from their inception to June 2, 2016 (PubMed, EMBASE, Cochrane Central Register of Controlled Trials
TL;DR: Results indicate that efforts should be made to increase the number of schools that provide disability awareness education through increased advocacy and providing additional resources to schools without a curriculum.
Abstract: This study was designed to: (1) determine how many American medical schools include disability awareness in their curriculum, (2) explore the format of disability awareness programs in existence, and (3) understand why some schools do not include disability awareness in their curriculum. An online survey was sent to deans of medical education (or equivalent positions) at accredited allopathic and osteopathic American medical schools (N = 167) in 2015. Seventy-five schools (45%) completed surveys. Fifty-two percent (39/75) reported having a disability awareness program. The most common format was people with disabilities or caregivers speaking in a large group setting. Programs were most likely to focus on adults with physical disabilities. Among schools without a program, the top barriers were no one advocating for inclusion in the curriculum and time constraints. Nearly half of schools without a program expressed interest in adopting an awareness curriculum if one was made available. Such results indicate that efforts should be made to increase the number of schools that provide disability awareness education through increased advocacy and providing additional resources to schools without a curriculum.
TL;DR: The following main themes related to integrating rehabilitation technology in real-world clinical practice will be discussed: the application of current evidence-based practice and knowledge in relation to treatment in the rehabilitation clinic, perspectives from rehabilitation professionals using robotic-aided therapy with regard to challenges, and strategies for problem solving.
Abstract: In this article, we discuss robotic-assisted therapy as an emerging and significant field of clinical rehabilitation and its value proposition for innovating rehabilitation clinical practice. Attempts to achieve integration among clinicians' practices and bioengineers' machines often generate new challenges and controversies. To date, the literature is indicative of a sizeable number and variety of robotic devices in the field of clinical rehabilitation, some are commercially available; however, large-scale clinical outcomes are less positive than expected. The following main themes related to integrating rehabilitation technology in real-world clinical practice will be discussed: the application of current evidence-based practice and knowledge in relation to treatment in the rehabilitation clinic, perspectives from rehabilitation professionals using robotic-aided therapy with regard to challenges, and strategies for problem solving. Lastly, we present innovation philosophies with regard to sustainability of clinical rehabilitation technologies.
TL;DR: Although suspended prone plank and the suspended roll-out plank were most efficient for the abdominal muscles, suspended and stable lateral planks were mostefficient for the lumbar muscles.
Abstract: ObjectiveThe aim of this cross-sectional study was to evaluate a variety of isometric plank exercises.DesignTwenty university students performed the following eight different variants of plank exercises in random order and with 1-min rest intervals: stable prone plank, suspended prone plank, stable
TL;DR: Investigation of the effect of an 8-wk structured strength training program on pain and sleep quality in patients with fibromyalgia found strength training is safe and effective in treating people with Fibromyalgia, and a significant decrease in sleep disturbances occurs after 8 wks of intervention.
Abstract: OBJECTIVE The study aimed to investigate the effect of an 8-wk structured strength training program on pain and sleep quality in patients with fibromyalgia. DESIGN Fifty-two patients with fibromyalgia were evaluated; 31 submitted to strength training and 21 comprised the control group. The instruments used were the Fibromyalgia Impact Questionnaire and The Pittsburgh Sleep Quality Index. The questionnaires were applied before the first training session, at 12 sessions, and after 24 sessions. Descriptive statistics (mean, SD, and frequency) and inferential tests were used. RESULTS After 8 wks of intervention, significant differences were found between groups in subjective quality of sleep (P = 0.03), sleep disturbance (P = 0.02), daytime dysfunction (P = 0.04), and total sleep score (P < 0.01). The correlation analysis using Spearman's test indicated a positive relationship between the variables of pain intensity and sleep quality (P < 0.01); when pain intensity increased in patients with fibromyalgia, sleep quality worsened. CONCLUSIONS Strength training is safe and effective in treating people with fibromyalgia, and a significant decrease in sleep disturbances occurs after 8 wks of intervention.