European Journal of Physical and Rehabilitation Medicine 

About: European Journal of Physical and Rehabilitation Medicine is an academic journal published by Edizioni Minerva Medica. The journal publishes majorly in the area(s): Population & Rehabilitation. It has an ISSN identifier of 1973-9087. Over the lifetime, 1629 publications have been published receiving 35635 citations.

Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. A Cochrane systematic review.

Abstract: Background The widespread application of pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD) should be preceded by demonstrable improvements in function attributable to the programs Objectives To determine the impact of rehabilitation on health-related quality of life (QoL) and exercise capacity in patients with COPD Methods We identified randomized controlled trials (RCTs) from the Cochrane Airways Group Specialised Register We selected RCTs of rehabilitation in patients with COPD in which quality of life (QoL) and/or exercise capacity were measured Rehabilitation was defined as exercise training for at least 4 weeks with or without education and/or psychological support Control groups received conventional community care without rehabilitation Results A total of 31 RCTs met the inclusion criteria We found statistically significant improvements for all the outcomes In 4 important domains of QoL (Chronic Respiratory Questionnaire scores for Dyspnea, Fatigue, Emotional function and Mastery), the effect was larger than the minimal clinically important difference For exercise capacity, the effect was small and slightly below the threshold of clinical significance for the six-minute walking distance (WMD: 48 m; 95% CI: 32 to 65; n = 16 trials) Conclusions Rehabilitation relieves dyspnea and fatigue, improves emotional function and enhances patients' control over their condition These improvements are moderately large and clinically significant Rehabilitation forms an important component of the management of COPD

The relevance of clinical balance assessment tools to differentiate balance deficits

Abstract: Control of balance is complex and involves maintaining postures, facilitating movement, and recovering equilib- rium. Balance control consists of controlling the body center of mass over its limits of stability. Clinical balance assessment can help to assess fall risk and/or determine the underlying reasons for balance disorders. Most func- tional balance assessment scales assess fall risk and the need for balance rehabilitation but do not differentiate types of balance deficits. A system approach to clinical bal- ance assessment can differentiate different kinds of bal- ance disorders and a physiological approach can deter- mine underlying sensorimotor mechanisms contribut- ing to balance disorders. Objective measures of balance using computerized systems and wearable inertial sensors can bring more sensitive, specific and responsive bal- ance testing to clinical practice.

The learned nonuse phenomenon: implications for rehabilitation.

Abstract: Research on monkeys with a single forelimb from which sensation is surgically abolished demonstrates that such animals do not use their deafferented limb even though they possess sufficient motor innervation to do so, a phenomenon labeled learned nonuse. This dissociation also occurs after neurological injury in humans. Instruments that measure these two aspects of motor function are discussed. The effects of a neurological injury may differ widely in regard to motor ability assessed on a laboratory performance test in which movements are requested and actual spontaneous use of an extremity in real-world settings, indicating that these parameters need to be evaluated separately. The methods used in Constraint-Induced Movement therapy (CI therapy) research to independently assess these two domains are reliable and valid. We suggest that these tests have applicability beyond studies involving CI therapy for stroke and may be of value for determining motor status in other types of motor disorders and with other types of treatment. The learned nonuse formulation also predicts that a rehabilitation treatment may have differential effects on motor performance made on request and actual spontaneous amount of use of a more affected upper extremity in the life situation. CI therapy produces improvements in the former, but focuses attention on the latter and, in fact, spontaneous use of the limb is where this intervention has by far its greatest effect. The evidence suggests that this result is driven by use of a ''transfer package'' of techniques, which can be used with other therapies to increase the transfer of improvements made in the clinic to the life situation. The use of CI therapy in humans began with the upper extremity after stroke and was then extended for the upper extremity to cerebral palsy in young children (8 months to 8 years old) and traumatic brain injury. A form of CI therapy was developed for the lower extremities and was used effectively after stroke, spinal cord injury, and fractured hip. Adaptations of CI therapy have also been developed for aphasia (CI aphasia therapy), focal hand dystonia in musicians and phantom limb pain. The range of these applications suggests that CI therapy is not only a treatment for stroke, for which it is most commonly used, but for learned nonuse in general, which manifests as excess motor disability in a number of conditions which until now have been refractory to treatment.

How to apply the International Classification of Functioning, Disability and Health (ICF) for rehabilitation management in clinical practice.

Abstract: Rehabilitation aims to enable people experiencing or likely to experience disability to achieve and maintain optimal functioning. Consequently, the assessment of functioning is the starting point of a patient and goal oriented rehabilitation process. Within the International Classification of Functioning, Disability and Health (ICF) rehabilitation practitioners can rely for the first on a worldwide accepted model providing a universal language for the description and classification of functioning. To take advantage of the ICF in rehabilitation management there is a need to develop appropriate ICF Tools for clinical practice. Such ICF Tools, integrating the model and the classification of the ICF, have to be integrated in a problem solving approach provided by the Rehab-Cycle. ICF Tools have been developed for the use in the different steps of the Rehab-Cycle. Existing ICF Core Sets in combination with the use of ICF Qualifiers were the basis for this development. In clinical practice, these ICF Tools allow the description of a functioning state, the illustration of the patient's experience of functioning and the relation between rehabilitation goals and appropriate intervention targets, an overview over required resources to improve specific aspects of human functioning and finally, the changes in functioning states following rehabilitative interventions. The ICF Tools support a common understanding of functioning and the communication among team members when used in multidisciplinary rehabilitation. The development of electronic documentation systems, the assignment of standardized instruments to ICF categories and the operationalization of the ICF Qualifiers can contribute to further improvements of ICF based rehabilitation management in the future.

Role of exercise on sarcopenia in the elderly.

Abstract: Sarcopenia leads to a loss of strength, later on to a decreased functional status, impaired mobility, a higher risk of falls, and eventually an increased risk of mortality. There are many factors responsible for the decline of muscle mass and muscle strength associated with aging, although the complex, multi-factorial mechanisms driving the sarcopenic process are not clearly understood. Physical inactivity or a decreased physical activity level is a part of the underlying mechanisms of sarcopenia and therefore physical activity can be seen as an important factor to reverse or modify the development of this condition. Several treatments have been proposed for the treatment of this loss of muscle and strength, but there is no doubt that exercise represents the most important approach to prevent and treat sarcopenia. In this review, we describe first the conceptual distinctions between the terms sedentary behaviour, physical activity and exercise. In addition, we review the benefits of physical activity in the elderly population, including lower mortality and functional independence, and discuss the four categories for specific recommendations for exercises (aerobic exercise, progressive resistance exercise, flexibility and balance). Finally we discuss the principles governing the prescription of physical activity for older people with sarcopenia and make some specific advices for how to engage older adults in appropriate exercise.