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A special issue of Healthcare (ISSN 2227-9032).

Deadline for manuscript submissions: 30 April 2024 | Viewed by 16131

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Dr. Tadashi Ito

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Three-Dimensional Motion Analysis Room, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki 444-0002, Japan
Interests: physiotherapy treatment; physiotherapy exercise; physical function; motion analysis; gait analysis; biomechanics; geriatric rehabilitation; stroke rehabilitation; physiotherapy; children; muscle training; motor control; prevention; health promotion; healthcare; proprioception; balance control; rehabilitation medicine; community health; rehabilitation engineering; low back pain; pain; pain rehabilitation
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Special Issue Information

Dear Colleagues,

To improve a patient’s physical ability, effective physiotherapy and occupational therapy treatment and an assessment of comprehensive rehabilitation appear to be important. Thus, proper understanding of clinical factors along with adequate physiotherapy and occupational therapy have become a critical component of any rehabilitation approach. In addition, the accurate assessment of physical or motor function can lead to the early detection and prevention of disease. Therefore, it is critically important that physiatrists, physiotherapists, and occupational therapists constantly develop their knowledge and techniques. This Special Issue aims to serve as a global forum for the discussion of all aspects of motion analysis, physiotherapy, occupational therapy, and rehabilitation studies, including evaluation, treatment, and prevention.

Dr. Tadashi Ito
Guest Editor

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Keywords

physiotherapy
rehabilitation
gait analysis
muscle training
motor control
physical medicine
comprehensive clinical medicine
prevention
healthcare
biomechanics
physical function
postural control
falls
low back pain
children’s health
physical activity

Published Papers (12 papers)

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Research

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10 pages, 1066 KiB

Open AccessArticle

Effects of Real-Time Feedback Methods on Static Balance Training in Stroke Patients: A Randomized Controlled Trial

by Il-Ho Kwon, Won-Seob Shin, Kyu-Seong Choi and Myung-Sun Lee

Healthcare 2024, 12(7), 767; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12070767 - 01 Apr 2024

Viewed by 556

Abstract

Background: The purpose of this study was to investigate the effects of real-time feedback methods on static balance training in stroke patients. There are two types of real-time feedback methods, as follows: one is Knowledge of Result (KR), and the other is Knowledge of Performance (KP). Method: Thirty stroke patients participated in this study and were randomly assigned to the KR group (n = 15) or the KP group (n = 15). All of the groups underwent real-time feedback training for four weeks (30 min per session, five sessions per week). The primary outcomes were sway length, sway velocity, and area 95%, which were assessed before and after the intervention. The secondary outcomes included the Berg Balance Scale, the Fugl Meyer Assessment for Lower Extremity, the Postural Assessment Scale for Stroke Trunk Impairment Scale, and the Fall Efficacy Scale. A group × time interaction was assessed using two-way ANOVA with repeated measures. Result: There was a significant increase over time in all outcomes (p < 0.05). Significant differences were observed for a group × time interaction in sway length and area 95% (p < 0.05). Conclusions: Real-time feedback training for static balance enhanced stroke patients’ static balance abilities, clinical outcome assessments, and promoted self-efficacy against falls. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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10 pages, 996 KiB

Open AccessArticle

Smartphone Use—Influence on Posture and Gait during Standing and Walking

by Marius Brühl, Jamil Hmida, Fabian Tomschi, Davide Cucchi, Dieter C. Wirtz, Andreas C. Strauss and Thomas Hilberg

Healthcare 2023, 11(18), 2543; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11182543 - 14 Sep 2023

Cited by 2 | Viewed by 1182

Abstract

Prolonged gaze at a smartphone is characterized by pronounced flexion of the cervical spine and is associated with health risks. In addition, it is suspected that smartphone distraction could lead to gait changes. Therefore, the aim of this study was to detect smartphone-associated postural changes at thoracic and lumbar levels as well as gait changes. Spinal analysis was performed prospectively in 21 healthy men using the DIERS 4Dmotion^®Lab in a controlled crossover design to evaluate posture-associated parameters while standing and walking. The examination sequence provided three randomized gaze directions: GN = Gaze Neutral; S1H = Smartphone one-handed; S2H = Smartphone two-handed. Results reveal a higher vertebra prominens (VP)-flexion in S1H (23.8° ± 6.9°; p ≤ 0.001) and S2H (22.4° ± 4.7°; p ≤ 0.001) compared to GN (17.6° ± 3.8°). Kyphosis angles were also different with higher values observed in S1H (58.8° ± 5.8°; p ≤ 0.001) and S2H (61.6° ± 4.9°; p ≤ 0.001) compared to GN (49.1° ± 4.6°). During walking, similar results were observed in kyphosis angles. No differences were observed in gait during smartphone use (p = 0.180–0.883). The study revealed a significantly increased inclination of the lower cervical and thoracic spine during smartphone use. However, the inclination was larger during S2H. Standing or walking conditions did not affect the measurement outcomes. Long-term smartphone use associated with a larger inclination of the cervical and thoracic spine might result in increased pressure and shear forces acting on vertebral bodies, intervertebral discs, and muscles, which potentially increases the risk of spinal pain and disease. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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10 pages, 607 KiB

Open AccessArticle

The Severity of Pain and Comorbidities Significantly Impact the Dependency on Activities of Daily Living among Musculoskeletal Patients in Jizan, Saudi Arabia

by Mohammed A. Zalah, Hana I. Alsobayel, Fahad S. Algarni, Vishal Vennu, Zohoor H. Ajeebi, Hatem M. Maeshi and Saad M. Bindawas

Healthcare 2023, 11(16), 2313; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11162313 - 16 Aug 2023

Cited by 1 | Viewed by 981

Abstract

Limited research has been carried out on the effects of pain, comorbidity, and impaired function in musculoskeletal patients in Jizan, Saudi Arabia. A cross-sectional study was conducted on 115 patients (aged ≥ 55 years) with physician-diagnosed musculoskeletal conditions in Jizan to investigate the association between pain severity, comorbidities, and dependence on activities of daily living (ADLs). Self-reported questionnaires were used to collect data on pain, comorbidities, and physical function measured by ADLs. In ADLs, participants were categorized as dependent (n = 36) or independent (n = 79). Logistic regression analysis was employed to determine the predictors of dependence. The results showed that higher pain severity (adjusted odds ratio (OR): 1.69, 95% confidence interval (CI): 1.21–2.38, p = 0.002) and a greater number of comorbidities (adjusted OR: 1.52, 95% CI: 1.06–2.17, p = 0.021) were independently associated with dependence in ADLs. These associations remained significant even after controlling for covariates. This study concluded that patients with musculoskeletal conditions in Jizan who experience high levels of pain and comorbidities are at risk of dependence on basic daily activities. Therefore, addressing pain and comorbidities is crucial for maintaining independence and improving quality of life. Personalized rehabilitation programs are needed to manage these conditions in this region. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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12 pages, 1415 KiB

Open AccessArticle

Biological Responses to Local Vibratory Stimulation for the Lower Legs and Lower Back and Criterion Values Based on Sweep Frequencies of Healthy Individuals: An Observational Study

by Keitaro Kawai, Yoshiji Kato, Tadashi Ito, Kazunori Yamazaki, Jo Fukuhara, Yoshihito Sakai and Yoshifumi Morita

Healthcare 2023, 11(16), 2243; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11162243 - 09 Aug 2023

Viewed by 684

Abstract

Declining proprioceptive function is associated with problems such as lower back pain and falls. Therefore, we developed a vibration device using sweep frequency to evaluate several proprioceptors with different response frequency ranges. This study aimed to elucidate the biological responses of healthy individuals to vibratory stimulation at different sites and frequency ranges and to propose cutoff values to determine the decline in proprioceptive function. Mechanical vibration was separately applied to the lower legs and lower back, and proprioceptive function was evaluated by defining the ratio of the center of pressure (CoP) in the anteroposterior direction during mechanical vibration to that during no vibration in the three frequency ranges. The cut-off value was defined as the mean value, with the standard deviation subtracted for each indicator. The cut-off values were higher in the lower legs than in the lower back at all frequency ranges and in the 30–53 Hz and 56–100 Hz frequency ranges for both the lower legs and lower back. In healthy individuals, 9.9% and 8.6% were below the cut-off values in the 30–53 Hz and 56–100 Hz frequency ranges for the lower legs, respectively. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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11 pages, 1050 KiB

Open AccessArticle

Evaluation of Muscle Oxygen Dynamics in Children’s Gait and Its Relationship with the Physiological Cost Index

by Yuya Shirai, Tadashi Ito, Yuji Ito, Naomichi Matsunaga, Koji Noritake, Nobuhiko Ochi and Hideshi Sugiura

Healthcare 2023, 11(2), 221; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11020221 - 11 Jan 2023

Viewed by 1699

Abstract

The response of muscle oxygen saturation, which is an index for the energy metabolism of muscles during walking in children, and its relationship to the physiological cost index, which indicates walking efficiency, are unknown. This study aimed to evaluate muscle oxygen saturation in lower extremity muscles during walking in children, its changes with age, and the relationship between the physiological cost index. The oxygen saturation was measured by the amount of change during a two-minute walk, and the physiological cost index was calculated from the change in heart rate before and after exercise and walking speed. Results were compared for each muscle, and the correlation between the two was examined. Changes in muscle oxygen saturation were greater in the lower leg muscles, significantly greater in the tibialis anterior at six to seven years, and in the gastrocnemius medial head at eight to ten years. The physiological cost index was significantly correlated with changes in muscle oxygen saturation in the tibialis anterior (r = 0.44, p < 0.001). The lower leg muscles were metabolically active in children’s gait, and their response varied with age. Moreover, the muscle oxygenation dynamics of the tibialis anterior may influence walking efficiency. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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7 pages, 247 KiB

Open AccessArticle

Physical Function of Japanese Preadolescents during the COVID-19 Pandemic

by Sho Narahara, Tadashi Ito, Yuji Ito, Hideshi Sugiura, Koji Noritake and Nobuhiko Ochi

Healthcare 2022, 10(12), 2553; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare10122553 - 16 Dec 2022

Viewed by 1052

Abstract

Children’s exercise habits have changed during the COVID-19 pandemic. This study aimed to examine the physical function and physical activity of preadolescent children before and during the COVID-19 pandemic. This cross-sectional study compared time spent in moderate-to-vigorous physical activity (MVPA), grip strength, single-leg standing time, and two-step tests of healthy children aged 10 to 12 years, enrolled from January 2018 to January 2020 (pre-COVID-19 group, n = 177) and from January 2021 to September 2022 (during-COVID-19 group, n = 69). The during-COVID-19 group had weaker grip strength (median: 14.4 vs. 15.8 kg; p = 0.012), worse performance on the two-step test (mean: 1.56 vs. 1.60; p = 0.013), and less MVPA (median: 4 vs. 7 h per week; p = 0.004). Logistic regression showed that the during-COVID-19 group was significantly related to weaker grip strength (odds ratio: 0.904, 95% CI: 0.829–0.986; p = 0.022) and worse performance in the two-step test (odds ratio: 0.976, 95% CI: 0.955–0.997; p = 0.028). The COVID-19 pandemic decreased exercise opportunities for preadolescent children, which may have had a negative impact on muscle strength and balance. It is essential to increase the amount of MVPA among preadolescent children. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

Review

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20 pages, 710 KiB

Open AccessReview

Rehabilitation Technologies for Chronic Conditions: Will We Sink or Swim?

by Amber LaMarca, Ivy Tse and Julie Keysor

Healthcare 2023, 11(20), 2751; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11202751 - 17 Oct 2023

Viewed by 1875

Abstract

Introduction: Chronic conditions such as stroke, Parkinson’s disease, spinal cord injury, multiple sclerosis, vestibular disorders, chronic pain, arthritis, diabetes, chronic obstructive pulmonary disease (COPD), and heart disease are leading causes of disability among middle-aged and older adults. While evidence-based treatment can optimize clinical outcomes, few people with chronic conditions engage in the recommended levels of exercise for clinical improvement and successful management of their condition. Rehabilitation technologies that can augment therapeutic care—i.e., exoskeletons, virtual/augmented reality, and remote monitoring—offer the opportunity to bring evidence-based rehabilitation into homes. Successful integration of rehabilitation techniques at home could help recovery and access and foster long term self-management. However, widespread uptake of technology in rehabilitation is still limited, leaving many technologies developed but not adopted. Methods: In this narrative review, clinical need, efficacy, and obstacles and suggestions for implementation are discussed. The use of three technologies is reviewed in the management of the most prevalent chronic diseases that utilize rehabilitation services, including common neurological, musculoskeletal, metabolic, pulmonary, and cardiac conditions. The technologies are (i) exoskeletons, (ii) virtual and augmented reality, and (iii) remote monitoring. Results: Effectiveness evidence backing the use of technology in rehabilitation is growing but remains limited by high heterogeneity, lack of long-term outcomes, and lack of adoption outcomes. Conclusion: While rehabilitation technologies bring opportunities to bridge the gap between clinics and homes, there are many challenges with adoption. Hybrid effectiveness and implementation trials are a possible path to successful technology development and adoption. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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14 pages, 481 KiB

Open AccessReview

Understanding the Role of Children’s Footwear on Children’s Feet and Gait Development: A Systematic Scoping Review

by Yuan Wang, Hanhui Jiang, Lin Yu, Zixiang Gao, Wei Liu, Qichang Mei and Yaodong Gu

Healthcare 2023, 11(10), 1418; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11101418 - 13 May 2023

Cited by 1 | Viewed by 2019

Abstract

Children’s footwear plays an important role in the healthy growth of foot and gait development during the growing stage. This review aims to synthesize findings of previous investigations and to explore the biomechanical influences of different types of children’s footwear on foot health and gait development, thus guiding the healthy and safe growth of children’s feet and gait. Online databases were searched for potential eligible articles, including Web of Science, Google Scholar, and PubMed. In total, nineteen articles were identified after searching based on the inclusion requirements. The following five aspects of biomechanical parameters were identified in the literature, including spatiotemporal, kinematics, kinetics, electromyography (EMG), and plantar pressure distribution. Children’s footwear can affect their foot health and gait performance. In addition, children’s shoes with different flexibility and sole hardness have different effects on children’s feet and gait development. Compared to barefoot, the stride length, step length, stride time, and step time were increased, but cadence was decreased with wearing shoes. Furthermore, the support base and toe-off time increased. Double support time and stance time increased, but single support time decreased. The hip, knee, and ankle joints showed increased range of motion in children with the rear-foot strike with larger ground reaction force as well. Future studies may need to evaluate the influence of footwear types on gait performance of children in different age groups. Findings in this study may provide recommendations for suitable footwear types for different ages, achieving the aim of growth and development in a healthy and safe manner. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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Other

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11 pages, 245 KiB

Open AccessBrief Report

Return to Work in Breast Cancer Patients following an Interdisciplinary Rehabilitation Program in a Community-Based Cancer Rehabilitation Center: A Pilot Study

by Matthew Rong Jie Tay, Chin Jung Wong and Hui Zhen Aw

Healthcare 2024, 12(7), 805; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare12070805 - 07 Apr 2024

Viewed by 413

Abstract

Despite curative treatment and discharge from acute hospital settings, breast cancer patients often have cancer- and treatment-related morbidity which impairs them from returning to work. Hence, the role of community-based return to work rehabilitation programs is important to help these patients transition back to work. This was a retrospective cohort study involving patients with breast cancer conducted at a community-based cancer rehabilitation center. Patients were involved in an interdisciplinary vocational rehabilitation program involving physiatrists, occupational therapists, physiotherapists and social workers. We recruited 63 patients for this study cohort, with 46 (73.0%) patients ≤ 60 years old. After undergoing the rehabilitation program, there were 37 (58.7%) participants who successfully returned to work. These participants returned to work at either within 6 months (27.0%), 12 months (29.7%) or 24 months (43.2%) after enrollment into the program, with a majority enrolling in white collar jobs. Multivariate regression analysis revealed that significant negative factors for return to work were advanced stage of cancer (p = 0.004), along with clinically significant fatigue, measured on the Brief Fatigue Inventory (p < 0.001). However, perceived work ability (p = 0.020) was found to be a positive factor. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

11 pages, 6461 KiB

Open AccessCase Report

Radiofrequency Cingulotomy as a Treatment for Incoercible Pain: Follow-Up for 6 Months

by Carlos Castillo Rangel, Gerardo Marin, Dylan Lucia Diaz Chiguer, Francisco Alberto Villegas López, Rodrigo Ramírez-Rodríguez, Alejandro Gómez Ibarra, Rosalba Aguilar-Velazquez and Julian Eduardo Soto Abraham

Healthcare 2023, 11(19), 2607; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11192607 - 22 Sep 2023

Cited by 1 | Viewed by 1052

Abstract

Incoercible or intractable pain is defined as pain that is refractory to pharmacological treatment to such an extent that opioid and analgesic adverse effects outweigh the therapeutic effects. The anterior cingulate cortex (ACC) is involved in the perception of pain, especially emotional pain, so it is logical that cingulotomy has an effective therapeutic effect. Therefore, we evaluated the effectiveness of cingulotomy for the treatment of incoercible pain. An observational, longitudinal, retrospective, and analytical study was carried out on a series of cases in which bilateral cingulotomy was performed for incoercible pain, and follow-up was performed 6 months after neurosurgery in the outpatient clinic at the Neurotraumatology Clinic. A positive correlation was observed between pain intensity and medication use, indicating that an increase in pain was associated with a greater requirement for analgesics. The result was a significant reduction in pain, as measured by the visual analog scale of pain, and decreased drug use after cingulotomy. We concluded that cingulotomy reduces incoercible pain and the need for medication. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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17 pages, 767 KiB

Open AccessSystematic Review

Effect of Conservative Rehabilitation Interventions on Health-Related Quality of Life in Women with Upper Limb Lymphedema Secondary to Breast Cancer: A Systematic Review

by María Nieves Muñoz-Alcaraz, Antonio José Jiménez-Vílchez, Luis Ángel Pérula-de Torres, Jesús Serrano-Merino, Álvaro García-Bustillo, Rocío Pardo-Hernández, Jerónimo Javier González-Bernal and Josefa González-Santos

Healthcare 2023, 11(18), 2568; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11182568 - 17 Sep 2023

Cited by 4 | Viewed by 1631

Abstract

Breast cancer-related lymphedema (BCRL) of the upper limb is a very common condition in women undergoing breast cancer treatment; it can cause considerable alterations in the daily life of patients and a decrease in their health-related quality of life (HRQoL). Currently, there are many conservative therapies that try to palliate the symptoms, but the results are still controversial and there are still no globally accepted treatments. The purpose of this article is to determine the effect, according to the current available evidence, on HRQoL of different conservative interventions in the rehabilitation of BCRL in the upper limb in women. Eighteen articles that compared the effects of standard treatments, such as manual lymphatic drainage-based decongestive therapy or compression measures, and other newer treatments, including new technologies and other types of treatment programs, were reviewed. According to the results of this review, the most recommended modality for the improvement of HRQoL would be a complex decongestive technique without manual lymphatic drainage. Although there are clinical trials that have demonstrated the effectiveness of various treatments, the results of the positive effects on HRQoL remain highly controversial. There is a need to continue to develop studies to help guide therapeutic decisions that can promote HRQoL in women affected by upper limb BCRL. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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9 pages, 6485 KiB

Open AccessCase Report

The Effect of Craniofacial Manual Lymphatic Drainage after Moderate Traumatic Brain Injury

by Wilmer Danilo Esparza, Arian Ramón Aladro-Gonzalvo, Antonio Ruíz-Hontangas, Daniela Celi and María Belén Aguirre

Healthcare 2023, 11(10), 1474; https://0-doi-org.brum.beds.ac.uk/10.3390/healthcare11101474 - 18 May 2023

Viewed by 1945

Abstract

Previous studies suggest that craniofacial manual lymphatic drainage (MLD) facilitates brain fluids clearance, reducing intracranial pressure and reabsorbing chronic subdural hematoma. This study aimed to explore the effect of craniofacial MLD in combination with pharmacological treatment for improving cranial pain intensity, vital signs, and cerebral edema (Hounsfield units, HUs) in moderate traumatic brain injury (mTBI). Patient 1 received pharmacological therapy, while patient 2 received both pharmacological and craniocervical MLD treatment. Patient 2 showed decreased cranial pain intensity and systolic blood pressure (66%–11.11%, respectively) after two 30 min daily sessions of treatment for three days. HUs in the caudate nucleus of both hemispheres (left 24.64%–right 28.72%) and in the left temporal cortical gray matter increased (17.8%). An increase in HU suggests a reduction in cerebral edema and vice versa. For patient 1, there were no changes in cranial pain intensity, but a slight increase in the systolic blood pressure was observed (0%–3.27%, respectively). HUs decreased in the temporal cortical (14.98%) and caudate nucleus gray matter (9.77%) of the left and right cerebral hemispheres (11.96%–16.74%, respectively). This case study suggests that craniofacial MLD combined with pharmacological treatment could reduce cerebral edema, decrease head pain intensity, and maintain vital signs in normal physiologic values in patients with mTBI. Full article

(This article belongs to the Special Issue Physical and Rehabilitation Medicine)

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