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Physical Therapy and Rehabilitation Support of the Elderly and People...
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Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities

A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Physiology and Pathology".

Deadline for manuscript submissions: closed (31 March 2024) | Viewed by 22926

Special Issue Editors

Prof. Dr. Toshiaki Tanaka

E-Mail Website
Guest Editor
1. Institute of Gerontology/ Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo 113-8654, Japan
2. Faculty of Health Sciences, Hokkaido University of Science, Hokkaido 006-8585, Japan
Interests: physical therapy; kinesiology; rehabilitation engineering; ergonomics
Special Issues, Collections and Topics in MDPI journals
Dr. Satoshi Shiroagne

E-Mail Website
Guest Editor
Chief of Clinical Evaluation Section, Department of Assistive Technology, Research Institute of National Rehabilitation, Center for Parson with Disabilities, Tokorozawa, Japan
Interests: assistive technology; physical therapy; wheelchair seating

Special Issue Information

Dear Colleagues,

Measures to cope with the rapidly declining birthrate and aging population are becoming an important issue, not only in Japan but worldwide generally. In particular, research and development in the field of support for the elderly, such as physical and mental healthcare, has focused on measures against frailty and frailty in the related fields of medical care and long-term care. Research on physical, psychological, and social factors that constitute frailty has progressed. In addition, the social development of "community-based comprehensive care systems," which provide housing, medical care, nursing care, prevention, and lifestyle support in an integrated manner to enable people to continue to live their own lives in their familiar communities, even when their physical and mental functions decline, has also led to the individualization of support for the elderly.

Under these circumstances, many elderly people have a high awareness of social contribution and possess knowledge, experience, and skills that younger people do not have. However, the field in which active elderly people can play an active role is still in the process of development, and not only social security and systems, but also various types of support through technology are required.

At the beginning, the discussion was mainly about information culture that connects multiple generations and VR for the elderly. On the other hand, recent years have seen the emergence of assistive technology that utilizes VR to deal with various social issues, such as “the problem of driving accidents involving the elderly and VR” and “360° VR opens up daily life in a super-aging society.” We are now in a situation where we can discuss how to use it.

In light of the above background, future research programs, titled "VR for Activity Maintenance and Rehabilitation Support of the Elderly," will feature methods to maintain, restore, and promote the physical and mental functions of the elderly using VR technology and VR-related technologies.  This theme might be called XR (ross reality) *rehabilitation. **Cross reality is the combination of all the realities along with the interaction between virtual and the real world.*

Special Areas: VR rehabilitation, Rehabilitation Engineering

Prof. Dr. Toshiaki Tanaka
Dr. Satoshi Shiroagne
Guest Editors

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Keywords

  • rehabilitation engineering to support higher brain dysfunction
  • virtual reality technology
  • robotics to support the elderly
  • rehabilitation engineering to support the life of the elderly
  • virtual reality technology
  • pathology of physical and mental functions of the elderly
  • Tele-rehabilitation to support the elderly in the community
  • Pathological kinematics of falls
  • balance training for the elderly

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Published Papers (11 papers)

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Research

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11 pages, 1016 KiB  
Article
30-Second Chair Stand and 5-Times Sit-to-Stand Tests Are Interesting Tools for Assessing Disability and Ability to Ambulate among Patients with Multiple Sclerosis
by Andrea Polidori, Mattia Malagoli, Rosario Giacalone, Giampaolo Brichetto, Margherita Monti Bragadin and Valeria Prada
Life 2024, 14(6), 703; https://doi.org/10.3390/life14060703 - 30 May 2024
Viewed by 1101
Abstract
Multiple Sclerosis (MS) is a demyelinating and chronic disease with variable neurological symptoms. There are different scales that score the level of disability, but only few papers have taken into consideration the 5-times sit-to-stand (5STS) test and the 30 s chair stand test [...] Read more.
Multiple Sclerosis (MS) is a demyelinating and chronic disease with variable neurological symptoms. There are different scales that score the level of disability, but only few papers have taken into consideration the 5-times sit-to-stand (5STS) test and the 30 s chair stand test (30CST), which are valid and easily obtainable indicators of other neurological diseases. The aim of our research is to verify the validity, reproducibility, and responsiveness of these tests. Patients afflicted with MS were enrolled in the AISM outpatient facility. The inclusion criterion was an EDSS score less than 6.5. We performed the 5STS, 30CST, and timed 25-foot walk (T25-FW) tests and recorded EDSS scores in the first evaluation. Then, we recorded the performance after 5 days (conducted by a second blind operator to ensure test–retest reproducibility), and the last evaluation was made after 12 sessions of physiotherapy. We recruited 38 patients diagnosed with MS. The results show significant data regarding validity, reproducibility, and responsiveness for both scales. The data argue in favor of adding these tests to the relevant clinical assessments. These two tests are simple, reliable, and easy to administer, and the data confirm that they can be included in the evaluation of patients with MS. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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21 pages, 3575 KiB  
Article
Examining How Interaural Differences Owing to Head Rotation during Walking Improve the Distance of Auditory Obstacle Perceptions among Individuals with Visual Impairment: A Case Study in Small-Scale Blind Group
by Takahiro Miura, Naoyuki Okochi, Masaki Matsuo, Ken-ichiro Yabu, Atsushi Katagiri, Keiichi Yasu, Masatsugu Sakajiri and Tohru Ifukube
Life 2024, 14(3), 356; https://doi.org/10.3390/life14030356 - 7 Mar 2024
Viewed by 1402
Abstract
The ability of individuals with visual impairment to recognize an obstacle by hearing is called “obstacle sense”. This ability is facilitated while they are moving, though the exact reason remains unknown. This study aims to clarify which acoustical factors may contribute to obstacle [...] Read more.
The ability of individuals with visual impairment to recognize an obstacle by hearing is called “obstacle sense”. This ability is facilitated while they are moving, though the exact reason remains unknown. This study aims to clarify which acoustical factors may contribute to obstacle sense, especially obstacle distance perception. First, we conducted a comparative experiment regarding obstacle distance localization by individuals who are blind (N = 5, five men with blindness aged 22–42 (average: 29.8)) while they were standing and walking. The results indicate that the localized distance was more accurate while walking than while standing. Subsequently, the head rotation angle while walking and acoustic characteristics with respect to obstacle distance and head rotation angle were investigated. The peaks of the absolute head rotation angle during walking ranged from 2.78° to 11.11° (average: 6.55°, S.D.: 2.05°). Regarding acoustic characteristics, acoustic coloration occurred, and spectral interaural differences and interaural intensity differences were observed in the blind participants (N = 4, four men including two blind and two control sighted persons aged 25–38 (average: 30.8)). To determine which acoustic factors contribute, we examined the threshold of changes for interaural differences in time (ITD) and intensity (IID) (N = 11, seven men and four women with blindness aged 21–35 (average: 27.4)), as well as coloration (ICD) (N = 6, seven men and a woman with blindness aged 21–38 (average: 29.9))—depending on the head rotation. Notably, ITD and IID thresholds were 86.2 μs and 1.28 dB; the corresponding head rotation angles were 23.5° and 9.17°, respectively. The angle of the ICD threshold was 6.30° on average. Consequently, IID might be a contributing factor and ICD can be utilized as the cue facilitating the obstacle distance perception while walking. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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11 pages, 1215 KiB  
Article
Effect of Video Camera Angle on the Detection of Compensatory Movements during Motion Observation
by Norio Kato and Yuki Fujino
Life 2023, 13(12), 2250; https://doi.org/10.3390/life13122250 - 23 Nov 2023
Viewed by 1164
Abstract
When exercise instructions are provided over the Internet, such as in online personal training, an instructor checks the user’s form by watching their motion video recorded using a single camera device. However, fixed shooting angles may affect the detection of incorrect forms, including [...] Read more.
When exercise instructions are provided over the Internet, such as in online personal training, an instructor checks the user’s form by watching their motion video recorded using a single camera device. However, fixed shooting angles may affect the detection of incorrect forms, including compensatory movements. This study aimed to verify whether differences in the shooting direction could influence compensatory movement detection by conducting motion observation using training motion videos shot from two angles. Videos of four training movements, including compensatory movements, were simultaneously captured from the front and side. Ten university students studying physical therapy watched the videos from each angle to detect compensatory movements. This study revealed significant differences between the plane of motion in which the compensatory action occurred and the direction of shooting for the false responses in the compensatory action detection for the three movements (p < 0.05). The results indicated that the shooting direction and the plane of motion in which the compensatory action occurred affected the detection of compensatory movements, which was attributable to differences in information on the amount of joint change depending on the direction of joint motion observation and to a lack of binocular visual information necessary for depth motion detection. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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11 pages, 2120 KiB  
Article
Comparison of Smoothness, Movement Speed and Trajectory during Reaching Movements in Real and Virtual Spaces Using a Head-Mounted Display
by Norio Kato, Tomoya Iuchi, Katsunobu Murabayashi and Toshiaki Tanaka
Life 2023, 13(8), 1618; https://doi.org/10.3390/life13081618 - 25 Jul 2023
Cited by 2 | Viewed by 1334
Abstract
Virtual reality is used in rehabilitation and training simulators. However, whether movements in real and virtual spaces are similar is yet to be elucidated. The study aimed to examine the smoothness, trajectory, and velocity of participants’ movements during task performance in real and [...] Read more.
Virtual reality is used in rehabilitation and training simulators. However, whether movements in real and virtual spaces are similar is yet to be elucidated. The study aimed to examine the smoothness, trajectory, and velocity of participants’ movements during task performance in real and virtual space. Ten participants performed the same motor task in these two spaces, reaching for targets placed at six distinct positions. A head-mounted display (HMD) presented the virtual space, which simulated the real space environment. The smoothness of movements during the task was quantified and analysed using normalised jerk cost. Trajectories were analysed using the actual trajectory length normalised by the shortest distance to the target, and velocity was analysed using the time of peak velocity. The analysis results showed no significant differences in smoothness and peak velocity time between the two spaces. No significant differences were found in the placement of the six targets between the two spaces. Conversely, significant differences were observed in trajectory length ratio and peak velocity time, albeit with small effect sizes. This outcome can potentially be attributed to the fact that the virtual space was presented from a first-person perspective using an HMD capable of presenting stereoscopic images through binocular parallax. Participants were able to obtain physiological depth information and directly perceive the distance between the target and the effector, such as a hand or a controller, in virtual space, similar to real space. The results suggest that training in virtual space using HMDs with binocular disparity may be a useful tool, as it allows the simulation of a variety of different environments. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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16 pages, 1262 KiB  
Article
Creation and Evaluation of a Severity Classification of Hyperkyphosis and Hypolordosis for Exercise Therapy
by David Kaps, Hannah L. Siebers, Ulrich Betz, Daniel Pfirrmann, Jörg Eschweiler, Frank Hildebrand, Marcel Betsch, Janine Huthwelker, Claudia Wolf, Philipp Drees and Jürgen Konradi
Life 2023, 13(6), 1392; https://doi.org/10.3390/life13061392 - 14 Jun 2023
Viewed by 1687
Abstract
The rise in the occurrence of musculoskeletal disorders, such as thoracic hyperkyphosis (THK) or lumbar hypolordosis (LHL), is a result of demographic changes. Exercise therapy is an effective approach that can reduce related disabilities and costs. To ensure successful therapy, an individualized exercise [...] Read more.
The rise in the occurrence of musculoskeletal disorders, such as thoracic hyperkyphosis (THK) or lumbar hypolordosis (LHL), is a result of demographic changes. Exercise therapy is an effective approach that can reduce related disabilities and costs. To ensure successful therapy, an individualized exercise program adapted to the severity of the disorder is expedient. Nevertheless, appropriate classification systems are scarce. This project aimed to develop and evaluate a severity classification focused on exercise therapy for patients with THK or LHL. A multilevel severity classification was developed and evaluated by means of an online survey. Reference limits of spinal shape angles were established by data from video rasterstereography of 201 healthy participants. A mean kyphosis angle of 50.03° and an average lordosis angle of 40.72° were calculated as healthy references. The strength of the multilevel classification consisting of the combination of subjective pain and objective spinal shape factors was confirmed by the survey (70% agreement). In particular, the included pain parameters were considered relevant by 78% of the experts. Even though the results of the survey provide important evidence for further analyses and optimization options of the classification system, the current version is still acceptable as therapeutic support. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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8 pages, 257 KiB  
Communication
The Relationship between Restrictions on Going Out and Motor Imagery among Medical University Students in Japan—Research with Small Samples
by Keisuke Itotani, Ippei Suganuma, Seiji Morimoto, Hideaki Nakai and Noriyuki Ogawa
Life 2023, 13(3), 797; https://doi.org/10.3390/life13030797 - 15 Mar 2023
Viewed by 1448
Abstract
Motor imagery is often used as a training method to improve physical performance. Previous studies have often reported that reduced motor imagery is more likely to occur in older adults and stroke patients. However, it has also been reported that it is difficult [...] Read more.
Motor imagery is often used as a training method to improve physical performance. Previous studies have often reported that reduced motor imagery is more likely to occur in older adults and stroke patients. However, it has also been reported that it is difficult to imagine exercises that cannot be performed. Therefore, we hypothesized that this may also have occurred in young people who were physically able to exercise but who were restricted by COVID-19 lockdowns, however, we could find no studies that investigated the impact of restricting outings. In this study, 83 healthy young people were measured for physical performance (maximum walking speed, grasp strength, Timed Up and Go test, imagined Timed Up and Go test, functional reach test, and five chair stand test). It was found that, while restricting outings did not influence physical performance in the subjects, it did influence motor imagery. Therefore, it should be borne in mind that training with motor imagery may not generate adequate actual motor imagery when restrictions are imposed on activities. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)

Review

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11 pages, 620 KiB  
Review
A Systematic Review on the Application of Virtual Reality for Muscular Dystrophy Rehabilitation: Motor Learning Benefits
by Pawel Kiper, Sara Federico, Joanna Szczepańska-Gieracha, Patryk Szary, Adam Wrzeciono, Justyna Mazurek, Carlos Luque-Moreno, Aleksandra Kiper, Mattia Spagna, Rita Barresi and Błażej Cieślik
Life 2024, 14(7), 790; https://doi.org/10.3390/life14070790 - 22 Jun 2024
Viewed by 1737
Abstract
Using virtual reality (VR) for Muscular Dystrophy (MD) rehabilitation promises to be a novel therapeutic approach, potentially enhancing motor learning, functional outcomes, and overall quality of life. This systematic review primarily aimed to provide a comprehensive summary of the current understanding regarding the [...] Read more.
Using virtual reality (VR) for Muscular Dystrophy (MD) rehabilitation promises to be a novel therapeutic approach, potentially enhancing motor learning, functional outcomes, and overall quality of life. This systematic review primarily aimed to provide a comprehensive summary of the current understanding regarding the application of VR in supporting MD rehabilitation. A systematic search was performed in PubMed, Scopus, Cochrane Library, and Web of Science to identify relevant articles. The inclusion criteria encompassed studies involving individuals diagnosed with MD who underwent VR interventions, with a primary focus on assessing functional improvement. Methodological quality of the studies was assessed by using the Physiotherapy Evidence Database (PEDro) scale. Seven studies, involving 440 individuals with Duchenne Muscular Dystrophy (DMD), were included in the review. Among these studies, six primarily explored the motor learning potential of VR, while one study investigated the impact of VR training on functional abilities. In conclusion, the qualitative synthesis supports VR-based interventions’ potential positive effects on motor learning, performance improvement, and functional outcomes in individuals with DMD. However, current usage mainly focuses on assessing the potential mechanisms’ benefits, suggesting the importance of expanding clinical adoption to harness their therapeutic potential for MD patients. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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Other

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20 pages, 1464 KiB  
Systematic Review
The Role of Physical Activity in Adjunctive Nursing Management of Neuro-Degenerative Diseases among Older Adults: A Systematic Review of Interventional Studies
by Majed Awad Alanazi
Life 2024, 14(5), 597; https://doi.org/10.3390/life14050597 - 7 May 2024
Cited by 1 | Viewed by 2638
Abstract
Neurodegenerative diseases such as dementia and Parkinson’s disease pose significant challenges to older adults globally. While pharmacological treatments remain primary, increasing evidence supports the role of non-pharmacological strategies like physical activity in managing these conditions. This systematic review critically evaluates the effectiveness of [...] Read more.
Neurodegenerative diseases such as dementia and Parkinson’s disease pose significant challenges to older adults globally. While pharmacological treatments remain primary, increasing evidence supports the role of non-pharmacological strategies like physical activity in managing these conditions. This systematic review critically evaluates the effectiveness of Nursing based physical activity interventions in improving cognitive function, physical functioning, mobility, and overall quality of life among older adults with neurodegenerative diseases. We conducted a comprehensive search across PubMed, EMBASE, Web of Science, CENTRAL, and other relevant databases, focusing on randomized controlled trials and observational studies that examined the impact of structured physical activity. Our findings from nineteen studies involving 1673 participants indicate that interventions ranging from aerobic exercises, resistance training, to mind-body exercises like Tai Chi and yoga have beneficial effects. Specifically, physical activity was consistently found to enhance cognitive performance, increase mobility, and improve balance and daily living activities, contributing to a better quality of life. However, these benefits vary depending on the type, intensity, and duration of the activity performed. Despite promising results, limitations such as small sample sizes, study heterogeneity, and short-term follow-up periods call for more robust, long-term studies to solidify these findings. This review underscores the potential of tailored physical activity programs as adjunctive therapy in the comprehensive management of neurodegenerative diseases among the elderly population. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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8 pages, 1405 KiB  
Brief Report
Development of Hallux Valgus Classification Using Digital Foot Images with Machine Learning
by Mitsumasa Hida, Shinji Eto, Chikamune Wada, Kodai Kitagawa, Masakazu Imaoka, Misa Nakamura, Ryota Imai, Takanari Kubo, Takao Inoue, Keiko Sakai, Junya Orui, Fumie Tazaki, Masatoshi Takeda, Ayuna Hasegawa, Kota Yamasaka and Hidetoshi Nakao
Life 2023, 13(5), 1146; https://doi.org/10.3390/life13051146 - 9 May 2023
Cited by 3 | Viewed by 2089
Abstract
Hallux valgus, a frequently seen foot deformity, requires early detection to prevent it from becoming more severe. It is a medical economic problem, so a means of quickly distinguishing it would be helpful. We designed and investigated the accuracy of an early version [...] Read more.
Hallux valgus, a frequently seen foot deformity, requires early detection to prevent it from becoming more severe. It is a medical economic problem, so a means of quickly distinguishing it would be helpful. We designed and investigated the accuracy of an early version of a tool for screening hallux valgus using machine learning. The tool would ascertain whether patients had hallux valgus by analyzing pictures of their feet. In this study, 507 images of feet were used for machine learning. Image preprocessing was conducted using the comparatively simple pattern A (rescaling, angle adjustment, and trimming) and slightly more complicated pattern B (same, plus vertical flip, binary formatting, and edge emphasis). This study used the VGG16 convolutional neural network. Pattern B machine learning was more accurate than pattern A. In our early model, Pattern A achieved 0.62 for accuracy, 0.56 for precision, 0.94 for recall, and 0.71 for F1 score. As for Pattern B, the scores were 0.79, 0.77, 0.96, and 0.86, respectively. Machine learning was sufficiently accurate to distinguish foot images between feet with hallux valgus and normal feet. With further refinement, this tool could be used for the easy screening of hallux valgus. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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14 pages, 1161 KiB  
Systematic Review
Effects of Neuromuscular Training on Physical Performance in Older People: A Systematic Review
by Yeny Concha-Cisternas, José Castro-Piñero, Ana María Leiva-Ordóñez, Pablo Valdés-Badilla, Carlos Celis-Morales and Eduardo Guzmán-Muñoz
Life 2023, 13(4), 869; https://doi.org/10.3390/life13040869 - 24 Mar 2023
Cited by 8 | Viewed by 4068
Abstract
This systematic review aimed to assess the available evidence on the effects of neuromuscular training on physical performance in older adults. A literature search was conducted across four databases (Psychology and Behavioral (EBSCO), Scopus, Web of Science and PubMed). The PRISMA guidelines were [...] Read more.
This systematic review aimed to assess the available evidence on the effects of neuromuscular training on physical performance in older adults. A literature search was conducted across four databases (Psychology and Behavioral (EBSCO), Scopus, Web of Science and PubMed). The PRISMA guidelines were followed. The PEDro scale and Cochrane risk of bias tool were used to assess the quality of and risk of bias in the studies, respectively. The protocol was registered in PROSPERO (code: CRD42022319239). The outcomes were muscle strength, cardiorespiratory fitness, postural balance and gait speed. From 610 records initially found, 10 were finally included in the systematic review, involving 354 older people with a mean age of 67.3 years. Nine of them reported significant changes in at least one variable related to physical performance in the intervention compared to the control groups. The neuromuscular training caused significant improvements in postural balance, flexibility, cardiorespiratory fitness, strength power of the upper and lower limbs and autonomy. The available evidence indicates that neuromuscular training has a positive effect on some variables of physical performance, especially in postural balance; however, the methodological quality and certainty of the evidence in the available literature are limited. Therefore, a greater number of high-quality studies are required to draw definitive conclusions. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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20 pages, 1069 KiB  
Systematic Review
Exercise Therapy in Nonspecific Low Back Pain among Individuals with Lower-Limb Amputation: A Systematic Review
by Agnieszka Wnuk-Scardaccione, Klaudia Zawojska, Marta Barłowska-Trybulec and Agnieszka Irena Mazur-Biały
Life 2023, 13(3), 772; https://doi.org/10.3390/life13030772 - 13 Mar 2023
Cited by 1 | Viewed by 3025
Abstract
Low back pain is very common condition that often becomes a long-lasting problem in prostheses users after lower limb amputation. The presented study aims to decide the potential benefits of exercise therapy on low back pain among lower limb amputees by using a [...] Read more.
Low back pain is very common condition that often becomes a long-lasting problem in prostheses users after lower limb amputation. The presented study aims to decide the potential benefits of exercise therapy on low back pain among lower limb amputees by using a systematic review. The PICO technique was used to answer the primary issue of this review: Does exercise treatment lessen the prevalence of low back pain in the population of lower limb amputees? Systematic review was conducted in the following databases: Medline-PubMed, EMBASE, Scopus, and Web of Science. Studies up to September 2010 published in English are included. Aim, target population, development and execution strategies, and treatment suggestions were among the data gathered. The primary outcomes of interest were exercise interventions as a therapy for low back pain but only two articles met including criteria. The search was broadened and 21 studies describing biomechanical changes in gait and pelvic-spine posture were analysed. This review indicates that movement therapy is a potential treatment strategy in low back pain among amputees. The major limitation of the study is the very heterogenous group of subjects in terms of amputation level, baseline activity level and comorbidities. We used a procedure that was registered in PROSPERO (CRD42022345556) to perform this systematic review of systematic reviews. There is a necessity of good quality research for concluding a consensus of exercise intervention. Full article
(This article belongs to the Special Issue Physical Therapy and Rehabilitation Support of the Elderly and People with Disabilities)
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