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New Frontiers in Rehabilitation

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 38111

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Prof. Dr. Umile Giuseppe Longo

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Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy
Interests: sports traumatology; arthroscopic surgery of shoulder, knee, and ankle; replacement surgery of shoulder, knee, and hip
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Prof. Vicenzo Denaro

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Full Professor and Consultant in Trauma and Orthopaedic Surgery, Department of Trauma and Orthopaedic Surgery, University Campus Bio-Medico of Rome, Via Álvaro Del Portillo, 200, 00128 Roma, Italy
Interests: spine surgery (scoliosis, spondylolisthesis, spinal stenosis, spinal disc herniation, myelopathy); hip, knee, and shoulder replacement surgery; foot surgery; hand surgery
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Special Issue Information

Dear Colleagues,

Rehabilitation plays a crucial role in the every field of medicine. Actual clinical needs may be faced with the huge opportunities provided by other research fields, from engineering to physiotherapy, orthopedics and so on. Personalized medicine is the new paradigm for health. Methodologies for personalized rehabilitation aim to identify the optimal management of patient care. Continuous monitoring of patients’ status during hospitalization or in the home environment, quantitative evaluation of motor abilities and physiological status allow to concretize the concepts of prevention, personalized medicine, accurate diagnosis.

This Special Issue aims to discuss the new frontiers in rehabilitation. It will focus on the novel procedures, methodologies and advances in rehabilitation.

Prof. Umile Giuseppe Longo
Prof. Vicenzo Denaro
Guest Editors

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Keywords

Rehabilitation
Physiotherapy
Orthopedics
personalized medicine
care

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Published Papers (7 papers)

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Research

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8 pages, 550 KiB

Open AccessArticle

Instability Severity Index Score Does Not Predict the Risk of Shoulder Dislocation after a First Episode Treated Conservatively

by Umile Giuseppe Longo, Rocco Papalia, Gianluca Ciapini, Sergio De Salvatore, Carlo Casciaro, Elisa Ferrari, Fabio Cosseddu, Michele Novi, Ilaria Piergentili, Paolo Parchi, Michelangelo Scaglione and Vincenzo Denaro

Int. J. Environ. Res. Public Health 2021, 18(22), 12026; https://doi.org/10.3390/ijerph182212026 - 16 Nov 2021

Cited by 4 | Viewed by 2975

Abstract

The first purpose of this study was to verify the association between Instability Severity Index Score (ISIS) and Recurrent Shoulder Dislocation (RSD) after a first episode treated conservatively. The second aim is to identify the risk factors associated with RSD after a primary acute shoulder anterior dislocation treated conservatively. A total of 111 patients with first traumatic anterior shoulder dislocation treated at a single trauma centre between January 2014 and March 2016 were enrolled. The main predictive variables of risk factors and the ISIS score were calculated. Among the 85 patients included, 26 cases of RSD were observed (30.6%). Considering the whole population, no significant association between ISIS and RSD were reported. Regarding other risk factors, high-risk working activities and rotator cuff injury had a significantly higher RSD risk. Sex, dominant limb, familiar history, hyperlaxity, contact or overhead sports, competitive sport, post-reduction physiokinesitherapy, return to sports activity time, Hill-Sachs lesion, bony Bankart lesion and great tuberosity fracture did not seem to influence the risk of RSD. No correlation between ISIS score and RSD in patients treated conservatively after a first episode of shoulder dislocation were reported. The only risk factors with a significant association to RSD were high-risk working activities and rotator cuff injury. Full article

(This article belongs to the Special Issue New Frontiers in Rehabilitation)

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12 pages, 1378 KiB

Open AccessArticle

A New Paired Associative Stimulation Protocol with High-Frequency Peripheral Component and High-Intensity 20 Hz Repetitive Transcranial Magnetic Stimulation—A Pilot Study

by Sabin Sathyan, Aleksandra Tolmacheva, Sergei Tugin, Jyrki P. Mäkelä, Anastasia Shulga and Pantelis Lioumis

Int. J. Environ. Res. Public Health 2021, 18(21), 11224; https://doi.org/10.3390/ijerph182111224 - 26 Oct 2021

Cited by 2 | Viewed by 3479

Abstract

Paired associative stimulation (PAS) is a stimulation technique combining transcranial magnetic stimulation (TMS) and peripheral nerve stimulation (PNS) that can induce plastic changes in the human motor system. A PAS protocol consisting of a high-intensity single TMS pulse given at 100% of stimulator output (SO) and high-frequency 100-Hz PNS train, or “the high-PAS” was designed to promote corticomotoneuronal synapses. Such PAS, applied as a long-term intervention, has demonstrated therapeutic efficacy in spinal cord injury (SCI) patients. Adding a second TMS pulse, however, rendered this protocol inhibitory. The current study sought for more effective PAS parameters. Here, we added a third TMS pulse, i.e., a 20-Hz rTMS (three pulses at 96% SO) combined with high-frequency PNS (six pulses at 100 Hz). We examined the ability of the proposed stimulation paradigm to induce the potentiation of motor-evoked potentials (MEPs) in five human subjects and described the safety and tolerability of the new protocol in these subjects. In this study, rTMS alone was used as a control. In addition, we compared the efficacy of the new protocol in five subjects with two PAS protocols consisting of PNS trains of six pulses at 100 Hz combined with (a) single 100% SO TMS pulses (high-PAS) and (b) a 20-Hz rTMS at a lower intensity (three pulses at 120% RMT). The MEPs were measured immediately after, and 30 and 60 min after the stimulation. Although at 0 and 30 min there was no significant difference in the induced MEP potentiation between the new PAS protocol and the rTMS control, the MEP potentiation remained significantly higher at 60 min after the new PAS than after rTMS alone. At 60 min, the new protocol was also more effective than the two other PAS protocols. The new protocol caused strong involuntary twitches in three subjects and, therefore, its further characterization is needed before introducing it for clinical research. Additionally, its mechanism plausibly differs from PAS with high-frequency PNS that has been used in SCI patients. Full article

(This article belongs to the Special Issue New Frontiers in Rehabilitation)

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17 pages, 3061 KiB

Open AccessArticle

Design and Preliminary Evaluation of a Tongue-Operated Exoskeleton System for Upper Limb Rehabilitation

by Zhenxuan Zhang, Boris I. Prilutsky, Andrew J. Butler, Minoru Shinohara and Maysam Ghovanloo

Int. J. Environ. Res. Public Health 2021, 18(16), 8708; https://doi.org/10.3390/ijerph18168708 - 18 Aug 2021

Cited by 5 | Viewed by 2980

Abstract

Stroke is a devastating condition that may cause upper limb paralysis. Robotic rehabilitation with self-initiated and assisted movements is a promising technology that could help restore upper limb function. Previous studies have established that the tongue motion can be used to communicate human intent and control a rehabilitation robot/assistive device. The goal of this study was to evaluate a tongue-operated exoskeleton system (TDS-KA), which we have developed for upper limb rehabilitation. We adopted a tongue-operated assistive technology, called the tongue drive system (TDS), and interfaced it with the exoskeleton KINARM. We also developed arm reaching and tracking tasks, controlled by different tongue operation modes, for training and evaluation of arm motor function. Arm reaching and tracking tasks were tested in 10 healthy participants (seven males and three females, 23–60 years) and two female stroke survivors with upper extremity impairment (32 and 58 years). All healthy and two stroke participants successfully performed the tasks. One stroke subject demonstrated a clinically significant improvement in Fugl-Meyer upper extremity score after practicing the tasks in six 3-h sessions. We conclude that the TDS-KA system can accurately translate tongue commands to exoskeleton arm movements, quantify the function of the arm, and perform rehabilitation training. Full article

(This article belongs to the Special Issue New Frontiers in Rehabilitation)

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13 pages, 1359 KiB

Open AccessArticle

Effects of In-Hospital Physical Therapy on Activities of Daily Living in Patients with Hepatocellular Carcinoma

by Hayato Narao, Keisuke Hirota, Shunji Koya, Manabu Tomita, Yuta Manako, Satosi Ogawa, Naomi Nakao, Tsubasa Tsutsumi, Dan Nakano, Ryuki Hashida, Takumi Kawaguchi, Hiroo Matsuse, Hiroaki Nagamatu and Takuji Torimura

Int. J. Environ. Res. Public Health 2020, 17(23), 9098; https://doi.org/10.3390/ijerph17239098 - 6 Dec 2020

Cited by 5 | Viewed by 2759

Abstract

Activities of daily living (ADL) are frequently impaired in patients with hepatocellular carcinoma (HCC). In this retrospective study, we aimed to investigate the effects of physical therapy on ADLs in patients with HCC during hospitalization for cancer treatment. Nineteen patients with HCC were enrolled. During hospitalization, patients performed a combination of resistance training, stretching, and aerobic exercise (20–60 min/day). ADLs were assessed using the functional independence measure (FIM). Changes in FIM were evaluated by before–after analysis. No significant difference was seen in Child–Pugh class before and after physical therapy. The bilateral knee extension strength and chair stand test were significantly increased after physical therapy compared with before physical therapy (p = 0.001 and p = 0.008, respectively). The total FIM score was significantly increased after physical therapy compared with that before physical therapy (p = 0.0156). Among the 18 indexes of FIM, the stairs index was significantly improved after physical therapy compared with that before physical therapy (5.9 vs. 6.4 points, p = 0.0241). We demonstrated that physical therapy improved muscle strength without worsening liver function. Furthermore, physical therapy improved FIM, especially in the stairs index, in patients with HCC. Thus, physical therapy may be beneficial in patients with HCC during cancer treatment. Full article

(This article belongs to the Special Issue New Frontiers in Rehabilitation)

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Review

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12 pages, 1143 KiB

Open AccessReview

Cost-Effectiveness of Supervised versus Unsupervised Rehabilitation for Rotator-Cuff Repair: Systematic Review and Meta-Analysis

by Umile Giuseppe Longo, Alessandra Berton, Laura Risi Ambrogioni, Daniela Lo Presti, Arianna Carnevale, Vincenzo Candela, Giovanna Stelitano, Emiliano Schena, Ara Nazarian and Vincenzo Denaro

Int. J. Environ. Res. Public Health 2020, 17(8), 2852; https://doi.org/10.3390/ijerph17082852 - 21 Apr 2020

Cited by 22 | Viewed by 4879

Abstract

Background: The objective of the present study was to compare the efficacy between supervised and unsupervised rehabilitation after rotator-cuff (RC) repair in terms of clinical outcomes, visual-analog-scale (VAS) score, range of motion (ROM), and risk of retear. Material: a comprehensive search of Pubmed, CINAHL, Cochrane, EMBASE, Ovid, and Google Scholar databases through a combination of the following keywords with logical Boolean operators: “informed”, “uninformed”, “unsupervised”, “supervised”, “rehabilitation”, “physical therapy”, “physical therapies”, “postoperative period”, “physical-therapy techniques”, “physical-therapy technique”, “exercise”, “exercise therapy”, “rotator cuff”, “rotator-cuff tear”, and “rotator-cuff repair”. For each article included in the study, the following data were extracted: authors, year, study design, sample size and demographic features, RC tear characteristics, clinical outcomes, ROM, VAS score, retear rate, and time of follow-up. Meta-analysis was performed in terms of VAS score. Results: Four randomized control trials with 132 patients were included. One study demonstrated significant improvement in VAS, active ROM, and the activity of the muscle’s motor units at stop and during maximal effort in supervised patients. Another one showed lower retear rates in the supervised group. The remaining two randomized controlled trials did not reveal any significant differences between supervised and unsupervised rehabilitation in terms of clinical outcomes. Moreover, higher costs were described for supervised rehabilitation. The VAS was not significantly different in the two groups (9.9 compared with 8.25, p = 0.23). Conclusions: although several publications address the problem of RC lacerations, there is a paucity of evidence in the literature regarding the effectiveness of supervised and unsupervised rehabilitation protocols. This systematic review and meta-analysis showed no significant differences between the two types of rehabilitation in terms of VAS scores, while outlining the pros and cons of each protocol. Full article

(This article belongs to the Special Issue New Frontiers in Rehabilitation)

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Other

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1 pages, 238 KiB

Open AccessErratum

Erratum: Longo, U.G., et al. Scapular Dyskinesis: From Basic Science to Ultimate Treatment. International Journal of Environmental Research and Public Health 2020, 17(8), 2974

by Umile Giuseppe Longo, Laura Risi Ambrogioni, Alessandra Berton, Vincenzo Candela, Carlo Massaroni, Arianna Carnevale, Giovanna Stelitano, Emiliano Schena, Ara Nazarian, Joseph DeAngelis and Vincenzo Denaro

Int. J. Environ. Res. Public Health 2020, 17(11), 3810; https://doi.org/10.3390/ijerph17113810 - 27 May 2020

Cited by 2 | Viewed by 2325

Abstract

The authors would like to correct the names and surnames of the following authors of their previous paper [...] Full article

(This article belongs to the Special Issue New Frontiers in Rehabilitation)

17 pages, 1532 KiB

Open AccessConcept Paper

Scapular Dyskinesis: From Basic Science to Ultimate Treatment

by Longo Umile Giuseppe, Risi Ambrogioni Laura, Alessandra Berton, Vincenzo Candela, Carlo Massaroni, Arianna Carnevale, Giovanna Stelitano, Emiliano Schena, Ara Nazarian, Joseph DeAngelis and Vincenzo Denaro

Int. J. Environ. Res. Public Health 2020, 17(8), 2974; https://doi.org/10.3390/ijerph17082974 - 24 Apr 2020

Cited by 34 | Viewed by 16974

Abstract

Background: This study intends to summarize the causes, clinical examination, and treatments of scapular dyskinesis (SD) and to briefly investigate whether alteration can be managed by a precision rehabilitation protocol planned on the basis of features derived from clinical tests. Methods: We performed a comprehensive search of PubMed, Cochrane, CINAHL and EMBASE databases using various combinations of the keywords “Rotator cuff”, “Scapula”, “Scapular Dyskinesis”, “Shoulder”, “Biomechanics” and “Arthroscopy”. Results: SD incidence is growing in patients with shoulder pathologies, even if it is not a specific injury or directly related to a particular injury. SD can be caused by multiple factors or can be the trigger of shoulder-degenerative pathologies. In both cases, SD results in a protracted scapula with the arm at rest or in motion. Conclusions: A clinical evaluation of altered shoulder kinematics is still complicated. Limitations in observing scapular motion are mainly related to the anatomical position and function of the scapula itself and the absence of a tool for quantitative SD clinical assessment. High-quality clinical trials are needed to establish whether there is a possible correlation between SD patterns and the specific findings of shoulder pathologies with altered scapular kinematics. Full article

(This article belongs to the Special Issue New Frontiers in Rehabilitation)

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