International journal of rehabilitation research. Internationale Zeitschrift für Rehabilitationsforschung. Revue internationale de recherches de réadaptation
-
Review Meta Analysis
Effectiveness of repetitive transcranial magnetic stimulation in patients with fibromyalgia: a meta-analysis.
Even though repetitive transcranial magnetic stimulation (rTMS) has been used for a decade for the treatment of fibromyalgia, evidence of its effectiveness has not been definitely presented. The aim of this study was to investigate whether there is evidence of rTMS being effective in decreasing the severity of pain among patients with fibromyalgia. CENTRAL, MEDLINE, EMBASE, CINAHL, SCOPUS, WEB OF SCIENCE, and relevant references of the identified studies were searched. ⋯ Pain severity before and 1 week to 1 month after the last stimulation decreased by -0.7 points (95% confidence interval: -1.0 to -0.3). Both pooled results were below the minimal clinically important difference of 1.5 points. There is moderate evidence that rTMS is not more effective than sham in reducing the severity of pain in fibromyalgia patients, questioning the routine recommendation of this method for fibromyalgia treatment.
-
Although caregiving for stroke survivors is usually long-term, most studies on caregivers have generally involved only the first year following the event. We assessed and compared the long-term level of well-being measures among stroke survivors and their caregivers at more than 1 year following the stroke event and examined the associations between well-being, survivors' characteristics, and caregiver burden. We interviewed a convenience sample of 51 community-dwelling stroke survivors, at least 1 year after the last stroke event, and their primary caregivers. ⋯ Anxiety was the only characteristic of caregivers that was associated with overall caregiver burden. Our study suggests that there is a spillover effect of the disease on stroke patients' primary caregivers. Intervention programs for caregivers should focus on their mental state and address their specific needs.
-
Randomized Controlled Trial
Conflicting results of robot-assisted versus usual gait training during postacute rehabilitation of stroke patients: a randomized clinical trial.
Robot gait training has the potential to increase the effectiveness of walking therapy. Clinical outcomes after robotic training are often not superior to conventional therapy. We evaluated the effectiveness of a robot training compared with a usual gait training physiotherapy during a standardized rehabilitation protocol in inpatient participants with poststroke hemiparesis. ⋯ The experimental group showed a significant increase in functional independence and gait speed (10 m walk test) at the end of the treatment and follow-up, higher than the minimal detectable change. The control group showed a significant increase in the gait endurance (6-min walk test) at the follow-up, higher than the minimal detectable change. Both treatments were effective in the improvement of gait performances, although the statistical analysis of functional independence showed a significant improvement in the experimental group, indicating possible advantages during generic activities of daily living compared with overground treatment.
-
The aim of this study is to evaluate quality of life (QoL), disability, and psychological well-being (PWB) in patients with disc herniation and stenosis before and after decompressive surgery and to investigate factors associated with an improvement in the postoperative disability level. An observational longitudinal study was carried out to collect preoperative and postoperative data on QoL, disability, and PWB using European Health Interview Survey-Quality of Life (EUROHIS-QoL), WHO Disability Assessment Schedule, second version (WHODAS-II), and Psychological General Well-Being Index-Short (PGWB-S) questionnaires. Friedman's analysis of variance was performed to compare preoperative and postoperative test scores, whereas a one-sample t-test was calculated to compare the mean test scores with the general population. ⋯ The logistic regression showed that patients with worse preoperative WHODAS-II scores had higher odds achieving improvement in their disability level after surgery. This study showed that disability and PWB improve significantly after surgery, but further treatment and a healthy lifestyle are expected and recommended as the disability level remains high. In addition, more severe preoperative disability was a predictor of better clinical outcome.
-
The aim of this study was to review and critically assess the most used and clinimetrically sound outcome measures currently available for postsurgical scar assessment in rehabilitation. We performed a systematic review of the Medline and Embase databases to June 2015. All published peer-reviewed studies referring to the development, validation, or clinical use of scales or questionnaires in patients with linear scars were screened. ⋯ The eight outcome measures identified were as follows: Vancouver Scar Scale, Dermatology Life Quality Index, Manchester Scar Scale, Patient and Observer Scar Assessment Scale, Bock Quality of Life (Bock QoL) questionnaire, Stony Brook Scar Evaluation Scale, Patient-Reported Impact of Scars Measure, and Patient Scar Assessment Questionnaire. Scales were examined for their clinimetric properties, and recommendations for their clinical or research use and selection were made. There is currently no absolute gold standard to be used in rehabilitation for the assessment of postsurgical scars, although the Patient and Observer Scar Assessment Scale and the Patient-Reported Impact of Scars Measure emerged as the most robust scales.