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Most-download articles are from the articles published in 2023 during the last six month.

Editorial: Outcome Measures in Rehabilitation Medicine

Pediatric rehabilitation

Motor Function Measurement in Children: Gross Motor Function Measure (GMFM)
Ja Young Choi
Ann Rehabil Med 2024;48(5):301-304.   Published online October 2, 2024
DOI: https://doi.org/10.5535/arm.240078
  • 4,906 View
  • 539 Download

Clinical Practice Guideline

Dysphagia

Clinical Practice Guidelines for Oropharyngeal Dysphagia
Seoyon Yang, Jin-Woo Park, Kyunghoon Min, Yoon Se Lee, Young-Jin Song, Seong Hee Choi, Doo Young Kim, Seung Hak Lee, Hee Seung Yang, Wonjae Cha, Ji Won Kim, Byung-Mo Oh, Han Gil Seo, Min-Wook Kim, Hee-Soon Woo, Sung-Jong Park, Sungju Jee, Ju Sun Oh, Ki Deok Park, Young Ju Jin, Sungjun Han, DooHan Yoo, Bo Hae Kim, Hyun Haeng Lee, Yeo Hyung Kim, Min-Gu Kang, Eun-Jae Chung, Bo Ryun Kim, Tae-Woo Kim, Eun Jae Ko, Young Min Park, Hanaro Park, Min-Su Kim, Jungirl Seok, Sun Im, Sung-Hwa Ko, Seong Hoon Lim, Kee Wook Jung, Tae Hee Lee, Bo Young Hong, Woojeong Kim, Weon-Sun Shin, Young Chan Lee, Sung Joon Park, Jeonghyun Lim, Youngkook Kim, Jung Hwan Lee, Kang-Min Ahn, Jun-Young Paeng, JeongYun Park, Young Ae Song, Kyung Cheon Seo, Chang Hwan Ryu, Jae-Keun Cho, Jee-Ho Lee, Kyoung Hyo Choi
Ann Rehabil Med 2023;47(Suppl 1):S1-S26.   Published online July 30, 2023
DOI: https://doi.org/10.5535/arm.23069
Objective
Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one’s physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia.
Methods
Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology.
Results
Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended.
Conclusion
This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Citations

Citations to this article as recorded by  
  • Using concept mapping to guide dysphagia service enhancements in Singapore: Recommendations from the speech-language pathology workforce
    Flora M.M Poon, Elizabeth C. Ward, Clare L. Burns
    International Journal of Speech-Language Pathology.2025; 27(1): 56.     CrossRef
  • Cough Suppression Therapy in Patients With Chronic Refractory Cough and Oropharyngeal Dysphagia
    ShengYing A. Chen, Jessica F. Kim, Priya Krishna, Ethan Simmons, Brianna K. Crawley, Thomas Murry
    American Journal of Speech-Language Pathology.2025; : 1.     CrossRef
  • Characterization of Beverage Viscosity Based on the International Dysphagia Diet Standardisation Initiative and Its Correspondence to the Japanese Dysphagia Diet 2021
    Mari Nakao-Kato, Aya Takahashi, Jin Magara
    Nutrients.2025; 17(6): 1051.     CrossRef
  • Factors influencing oropharyngeal dysphagia in individuals with chronic neurological disorders presenting to the outpatient swallowing disorder clinic
    Güleser Güney Yılmaz, Müberra Tanrıverdi, Remzi Doğan, Orhan Özturan
    Multiple Sclerosis and Related Disorders.2025; 97: 106387.     CrossRef
  • The Efficacy of Outpatient Swallowing Therapy: A Retrospective Longitudinal Cohort Study
    Tyler W. Crosby, Sonja Molfenter, Matina Balou, Uche C. Ezeh, Milan R. Amin
    Dysphagia.2025;[Epub]     CrossRef
  • The Role of Dysphagia on Head and Neck Cancer Patients’ Quality of Life, Functional Disabilities and Psychological Distress: Outcomes of Cancer Rehabilitation from an Observational Single-Center Study
    Špela Matko, Christina Knauseder, David Riedl, Vincent Grote, Michael J. Fischer, Samuel Moritz Vorbach, Karin Pfaller-Frank, Wilhelm Frank, Thomas Licht
    Current Oncology.2025; 32(4): 220.     CrossRef
  • The impact of physical therapy on dysphagia in neurological diseases: a review
    Kun Li, Cuiyuan Fu, Zhen Xie, Jiajia Zhang, Chenchen Zhang, Rui Li, Caifeng Gao, Jiahui Wang, Chuang Xue, Yuebing Zhang, Wei Deng
    Frontiers in Human Neuroscience.2024;[Epub]     CrossRef
  • Clinical Characteristics and Evaluation of Dysphagia in Patients with Parkinson’s Disease
    Seo Jung Yun, Han Gil Seo
    Journal of the Korean Dysphagia Society.2024; 14(1): 10.     CrossRef
  • Updated Clinical Practice Guidelines for the Diagnosis and Management of Long COVID
    Jun-Won Seo, Seong Eun Kim, Yoonjung Kim, Eun Jung Kim, Tark Kim, Taehwa Kim, So Hee Lee, Eunjung Lee, Jacob Lee, Yu Bin Seo, Young-Hoon Jeong, Young Hee Jung, Yu Jung Choi, Joon Young Song
    Infection & Chemotherapy.2024; 56(1): 122.     CrossRef
  • Association between the C-reactive protein/albumin ratio and mortality in older Japanese patients with dysphagia
    Chunhong Guo, Pingping Zheng, Shiyang Chen, Lin Wei, Xiuzhen Fu, Youyuan Fu, Tianhong Hu, Shaohua Chen
    Frontiers in Nutrition.2024;[Epub]     CrossRef
  • Compensatory strategies of dysphagia after anterior cervical spinal surgery: A case report
    Sung Joon Chung, Jun Ho Lee, Yunsoo Soh
    Medicine.2024; 103(29): e39016.     CrossRef
  • The Right ICD Code, Right Now: A Call to Action for Pragmatic Language Disorders After Right Hemisphere Stroke
    Jamila Minga, Shanika Phillips Fullwood, Deborah Rose, Danai Kasambira Fannin
    American Journal of Speech-Language Pathology.2024; 33(6): 3121.     CrossRef
  • Dysphagia Screening in Residential Long-Term Care Settings in the Republic of Ireland: A Cross-Sectional Survey
    Constantino Estupiñán Artiles, Claire Donnellan, Julie Regan, Mary Mooney
    Dysphagia.2024;[Epub]     CrossRef
  • Dysphagia and Dysphonia After Head and Neck Cancer
    Aaron Parsons, Karuna Dewan
    Oral Diseases.2024;[Epub]     CrossRef
  • The pathophysiology of dysphagia post‐lung transplant: A systematic review
    Sana Smaoui, Elly Cummins, Maryah Mena, Summer Scott, Rodrigo Tobar‐Fredes
    Laryngoscope Investigative Otolaryngology.2024;[Epub]     CrossRef
  • Effect of segmental tongue function training on tongue pressure attributes in individuals with dysphagia after receiving radiotherapy for nasopharyngeal carcinoma
    Fei Zhao, Chen Yang, Si-Ming Sun, Yao-Wen Zhang, Hong-Mei Wen, Zu-Lin Dou, Xiao-Mei Wei, Chun-Qing Xie
    BMC Oral Health.2024;[Epub]     CrossRef
  • Diagnosis and treatment of dysphagia
    Kyoung Hyo Choi
    Journal of the Korean Medical Association.2023; 66(10): 604.     CrossRef
  • 14,884 View
  • 133 Download
  • 15 Web of Science
  • 17 Crossref

Review Articles

Pediatric rehabilitation

Genetics of Cerebral Palsy: Diagnosis, Differential Diagnosis, and Beyond
Dae-Hyun Jang, Jaewon Kim, Aloysia Leisanne Schwabe, Timothy Edward Lotze
Ann Rehabil Med 2024;48(6):369-376.   Published online December 23, 2024
DOI: https://doi.org/10.5535/arm.240081
Cerebral palsy (CP) is the most common motor disability in children, characterized by diverse clinical manifestations and often uncertain etiology, which has spurred increasing interest in genetic diagnostics. This review synthesizes findings from various studies to enhance understanding of CP’s genetic underpinnings. The discussion is structured around five key areas: monogenic causes and copy number variants directly linked to CP, differential genetic disorders including atypical CP and mimics, ambiguous genetic influences, co-occurrence with other neurodevelopmental disorders, and polygenic risk factors. Case studies illustrate the clinical application of these genetic insights, underscoring the complexity of diagnosing CP due to the phenotypic overlap with other conditions and the potential for misdiagnosis. The review highlights the significant role of advanced genetic testing in distinguishing CP from similar neurodevelopmental disorders and assessing cases with unclear clinical presentations. Furthermore, it addresses the ongoing challenges in establishing a consensus on genetic contributors to CP, the need for comprehensive patient phenotyping, and the integration of rigorous genetic and functional studies to validate findings. This comprehensive examination of CP genetics aims to pave the way for more precise diagnostics and personalized treatment plans, urging continued research to overcome the current limitations and refine diagnostic criteria within this field.
  • 2,346 View
  • 91 Download

Others

AI in Rehabilitation Medicine: Opportunities and Challenges
Francesco Lanotte, Megan K. O’Brien, Arun Jayaraman
Ann Rehabil Med 2023;47(6):444-458.   Published online December 14, 2023
DOI: https://doi.org/10.5535/arm.23131
Artificial intelligence (AI) tools are increasingly able to learn from larger and more complex data, thus allowing clinicians and scientists to gain new insights from the information they collect about their patients every day. In rehabilitation medicine, AI can be used to find patterns in huge amounts of healthcare data. These patterns can then be leveraged at the individual level, to design personalized care strategies and interventions to optimize each patient’s outcomes. However, building effective AI tools requires many careful considerations about how we collect and handle data, how we train the models, and how we interpret results. In this perspective, we discuss some of the current opportunities and challenges for AI in rehabilitation. We first review recent trends in AI for the screening, diagnosis, treatment, and continuous monitoring of disease or injury, with a special focus on the different types of healthcare data used for these applications. We then examine potential barriers to designing and integrating AI into the clinical workflow, and we propose an end-to-end framework to address these barriers and guide the development of effective AI for rehabilitation. Finally, we present ideas for future work to pave the way for AI implementation in real-world rehabilitation practices.

Citations

Citations to this article as recorded by  
  • Blending Bytes and Bench Presses: The Future of Online Exercise and Artificial Intelligence-Enhanced Rehabilitation
    Rowena Naidoo, Verusia Chetty
    Journal of Physical Activity and Health.2025; 22(1): 2.     CrossRef
  • The potential role of artificial intelligence to promote the participation and inclusion in physical exercise and sports for people with disabilities: A narrative review
    João Paulo Pereira Rosa
    Journal of Bodywork and Movement Therapies.2025; 42: 127.     CrossRef
  • Estimation of elbow flexion torque using equilibrium optimizer on feature selection of NMES MMG signals and hyperparameter tuning of random forest regression
    Raphael Uwamahoro, Kenneth Sundaraj, Farah Shahnaz Feroz
    Frontiers in Rehabilitation Sciences.2025;[Epub]     CrossRef
  • From screens to scenes: A survey of embodied AI in healthcare
    Yihao Liu, Xu Cao, Tingting Chen, Yankai Jiang, Junjie You, Minghua Wu, Xiaosong Wang, Mengling Feng, Yaochu Jin, Jintai Chen
    Information Fusion.2025; 119: 103033.     CrossRef
  • Artificial intelligence in stroke rehabilitation: From acute care to long-term recovery
    Spandana Rajendra Kopalli, Madhu Shukla, B. Jayaprakash, Mayank Kundlas, Ankur Srivastava, Jayant Jagtap, Monica Gulati, Sridevi Chigurupati, Eiman Ibrahim, Prasanna Shama Khandige, Dario Salguero Garcia, Sushruta Koppula, Amin Gasmi
    Neuroscience.2025; 572: 214.     CrossRef
  • Deep Learning for Predicting Rehabilitation Success: Advancing Clinical and Patient-Reported Outcome Modeling
    Yasser Mahmoud, Kaleb Horvath, Yi Zhou
    Electronics.2025; 14(6): 1082.     CrossRef
  • AI-Driven Telerehabilitation: Benefits and Challenges of a Transformative Healthcare Approach
    Rocco Salvatore Calabrò, Sepehr Mojdehdehbaher
    AI.2025; 6(3): 62.     CrossRef
  • Harnessing Generative Artificial Intelligence for Exercise and Training Prescription: Applications and Implications in Sports and Physical Activity—A Systematic Literature Review
    Luca Puce, Nicola Luigi Bragazzi, Antonio Currà, Carlo Trompetto
    Applied Sciences.2025; 15(7): 3497.     CrossRef
  • Functional and motoric outcome of AI-assisted stroke rehabilitation: A meta-analysis of randomized controlled trials
    Tivano Antoni, Benedictus Benedictus, Stefanus Erdana Putra
    Brain Disorders.2025; 18: 100224.     CrossRef
  • Applying AI to Safely and Effectively Scale Care to Address Chronic MSK Conditions
    Anabela C. Areias, Dora Janela, Robert G. Moulder, Maria Molinos, Virgílio Bento, Carolina Moreira, Vijay Yanamadala, Fernando Dias Correia, Fabíola Costa
    Journal of Clinical Medicine.2024; 13(15): 4366.     CrossRef
  • RETRACTED ARTICLE: Using AI to navigate complex neurosurgical procedures in rare gliomas
    Mayur Wanjari, Gaurav Mittal, Roshan Prasad
    Neurosurgical Review.2024;[Epub]     CrossRef
  • Quantifying Asymmetric Gait Pattern Changes Using a Hidden Markov Model Similarity Measure (HMM-SM) on Inertial Sensor Signals
    Gabriel Ng, Aliaa Gouda, Jan Andrysek
    Sensors.2024; 24(19): 6431.     CrossRef
  • Artificial Intelligence in Medical Education and Mentoring in Rehabilitation Medicine
    Julie K. Silver, Mustafa Reha Dodurgali, Nara Gavini
    American Journal of Physical Medicine & Rehabilitation.2024; 103(11): 1039.     CrossRef
  • Artificial Intelligence and Its Revolutionary Role in Physical and Mental Rehabilitation: A Review of Recent Advancements
    Amir Rahmani Rasa, Alejandro L. Borja
    BioMed Research International.2024;[Epub]     CrossRef
  • Enhanced gait tracking measures for individuals with stroke using leg-worn inertial sensors
    Francesco Lanotte, Shusuke Okita, Megan K. O’Brien, Arun Jayaraman
    Journal of NeuroEngineering and Rehabilitation.2024;[Epub]     CrossRef
  • 8,398 View
  • 82 Download
  • 16 Web of Science
  • 15 Crossref

Neuromuscular disorders

Effectiveness of Non-Pharmacological Interventions for Spasticity Management in Multiple Sclerosis: A Systematic Review
Bhasker Amatya, Fary Khan, Krystal Song, Mary Galea
Ann Rehabil Med 2024;48(5):305-343.   Published online October 31, 2024
DOI: https://doi.org/10.5535/arm.240064
This systematic review aims to determine the effectiveness of non-pharmacological interventions for the management of spasticity in people with multiple sclerosis (pwMS). A comprehensive literature search in health science databases (MEDLINE, Embase, CENTRAL, CINHAL) was performed to identify randomized controlled trials (RCTs) (up to April 2024). Manual searching in journals and screening of the reference lists of identified studies were conducted. Two authors independently selected the studies, assessed the methodological quality, and summarized the evidence. A meta-analysis was not feasible due to the methodological, clinical, and statistical diversity of the included studies. Overall, 32 RCTs (n=1,481 participants) investigated various types of non-pharmacological interventions including: physical activity, transcranial magnetic stimulation (intermittent theta burst stimulation [iTBS], repetitive transcranial magnetic stimulation [rTMS]), electromagnetic therapy, transcutaneous electrical nerve stimulation, vibration therapy, shock wave therapy, self-management educational programs, and acupuncture. All studies scored ‘low’ on the methodological quality assessment, implying a high risk of bias. The findings suggest ‘moderate to low certainty’ evidence for physical activity programs used in isolation or combination with other interventions (pharmacological or non-pharmacological), and for iTBS/rTMS with or without adjuvant exercise therapy in improving spasticity in adults with MS. There is ‘very low certainty’ evidence supporting the use of other modalities for treating spasticity in this population. Despite a wide range of non-pharmacological interventions used for the management of spasticity in pwMS, there is a lack of conclusive evidence for many. More robust trials with larger sample sizes and longer-term follow-ups are needed to build evidence for these interventions.
  • 3,421 View
  • 78 Download

Original Article

Pediatric rehabilitation

Performance of Activities of Daily Living in Typically Developing Children in Korea: Normative Value of K-MBI
Mi-Jeong Yoon, Sungwoo Paek, Jongbin Lee, Youngdeok Hwang, Joon-Sung Kim, Yeun-Jie Yoo, Bo Young Hong
Ann Rehabil Med 2024;48(4):281-288.   Published online August 30, 2024
DOI: https://doi.org/10.5535/arm.230040
Objective
To determine the normative values of the Korean version of the Modified Barthel Index (K-MBI) score for typically developing children in Korea and assess its suitability for use in children.
Methods
Rehabilitation physicians and occupational therapists with children were invited through an online platform to participate in a survey assessing their children’s performance of activity of daily living (ADL) using the K-MBI. The questionnaire encompassed queries on sociodemographic information of children and the assessment criteria outlined in the K-MBI. The standardized K-MBI scores by age were estimated using the nonlinear least squares method.
Results
The analysis incorporated responses from a total of 206 individuals. K-MBI total scores showed a rapid increase over the first 8 years of life, with 99% of children achieving a score of 90 or higher by age 8. Mobility scores exhibited a swift increase during early childhood, surpassing 90% of the maximum score at 3 years of age and nearing 100% at 7 years of age. In contrast, self-care scores demonstrated a more gradual advancement, achieving approximately 100% of the maximum score by the age of 10 years.
Conclusion
Age-specific normative values for K-MBI scores of typically developing children were established, which can be used as a reference in clinical care. While the K-MBI captured the overall trajectory of children’s ADL development, it did not discern subtle differences across various developmental stages. There is a need for the development of more refined assessment tools tailored specifically to children.
  • 3,017 View
  • 63 Download

Review Articles

Neuromuscular disorders

The impact of disease-modifying therapy ranges from cure to no impact with a wide range of intermediates. In cases where the intermediate group reaches a plateau after the acquisition of some muscle strength, it is necessary to set a functional level appropriate for increased motor power and establish a long-term exercise plan to maintain it. As the disease status stabilizes and the life span increases, early nonsurgical interventions are required, such as using a standing frame to prevent joint contracture, applying a spinal brace at the early stage of scoliosis, and maintaining sitting postures that exaggerate lumbar lordosis. In cases where scoliosis and hip displacement occur and progress even after conservative managements are implemented, early referral to surgery should be considered. Oromotor activity and swallowing function are influenced not only by the effects of disease-modifying drugs, but also by post-birth experience and training. Therefore, although the feeding tube cannot be removed, it is necessary to make efforts to simulate the infant feeding development while maintaining partial oral feeding. Since the application period of non-invasive ventilators has increased, it has become more important to prevent long-term complications such as facial abrasion, skin allergy, orthodontic deformities, and maxillary flattening caused by the interface. Dual ventilator mode or interface can also be utilized.
  • 3,271 View
  • 60 Download

Dysphagia

Sarcopenic Dysphagia and Simplified Rehabilitation Nutrition Care Process: An Update
Shingo Kakehi, Eri Isono, Hidetaka Wakabayashi, Moeka Shioya, Junki Ninomiya, Yohei Aoyama, Ryoko Murai, Yuka Sato, Ryohei Takemura, Amami Mori, Kei Masumura, Bunta Suzuki
Ann Rehabil Med 2023;47(5):337-347.   Published online October 31, 2023
DOI: https://doi.org/10.5535/arm.23101
Sarcopenic dysphagia is characterized by weakness of swallowing-related muscles associated with whole-body sarcopenia. As the number of patients with sarcopenia increases with the aging of the world, the number of patients with sarcopenic dysphagia is also increasing. The prevalence of sarcopenic dysphagia is high in the institutionalized older people and in patients hospitalized for pneumonia with dysphagia in acute care hospitals. Prevention, early detection and intervention of sarcopenic dysphagia with rehabilitation nutrition are essential. The diagnosis of sarcopenic dysphagia is based on skeletal and swallowing muscle strength and muscle mass. A reliable and validated diagnostic algorithm for sarcopenic dysphagia is used. Sarcopenic dysphagia is associated with malnutrition, which leads to mortality and Activities of Daily Living (ADL) decline. The rehabilitation nutrition approach improves swallowing function, nutrition status, and ADL. A combination of aggressive nutrition therapy to improve nutrition status, dysphagia rehabilitation, physical therapy, and other interventions can be effective for sarcopenic dysphagia. The rehabilitation nutrition care process is used to assess and problem solve the patient’s pathology, sarcopenia, and nutrition status. The simplified rehabilitation nutrition care process consists of a nutrition cycle and a rehabilitation cycle, each with five steps: assessment, diagnosis, goal setting, intervention, and monitoring. Nutrition professionals and teams implement the nutrition cycle. Rehabilitation professionals and teams implement the rehabilitation cycle. Both cycles should be done simultaneously. The nutrition diagnosis of undernutrition, overnutrition/obesity, sarcopenia, and goal setting of rehabilitation and body weight are implemented collaboratively.

Citations

Citations to this article as recorded by  
  • Dual burden of sarcopenia and impaired oral status on activities of daily living, cognition and swallowing outcomes in post-stroke patients
    Yoshihiro Yoshimura, Hidetaka Wakabayashi, Fumihiko Nagano, Ayaka Matsumoto, Sayuri Shimazu, Ai Shiraishi, Yoshifumi Kido, Takahiro Bise, Takenori Hamada, Kouki Yoneda
    Archives of Gerontology and Geriatrics.2025; 129: 105648.     CrossRef
  • Progress in dysphagia management in older patients
    Gero Lueg, Maryam Pourhassan, Rainer Wirth
    Current Opinion in Clinical Nutrition & Metabolic Care.2025; 28(1): 14.     CrossRef
  • The rehabilitation nutrition oral care process: Implementing the triad of rehabilitation, nutrition, and oral management
    Hidetaka Wakabayashi
    Journal of General and Family Medicine.2025; 26(2): 114.     CrossRef
  • The Effect of Extremely Low-Frequency Magnetic Field on Stroke Patients: A Systematic Review
    Renata Marchewka, Tomasz Trzmiel, Katarzyna Hojan
    Brain Sciences.2024; 14(5): 430.     CrossRef
  • Malnutrition and cachexia may affect death but not functional improvement in patients with sarcopenic dysphagia
    Mai Yamanaka, Hidetaka Wakabayashi, Shinta Nishioka, Ryo Momosaki
    European Geriatric Medicine.2024; 15(3): 777.     CrossRef
  • Association between sarcopenia and urinary dysfunction in patients with dysphagia
    Shingo Kakehi, Hidetaka Wakabayashi, Eri Isono, Ryohei Takemura, Yuka Sato, Yukiko Otsuka, Takako Nagai, Shinta Nishioka, Ryo Momosaki
    Archives of Gerontology and Geriatrics.2024; 127: 105577.     CrossRef
  • Treatment of Esophageal Achalasia With Sarcopenic Dysphagia by Rehabilitation and Nutritional Support: A Case Report
    Fumiko Furukawa, Kiyohito Kakita
    Cureus.2024;[Epub]     CrossRef
  • Nutritional care in older adults: are we doing everything? An expert opinion review
    Elisabet Sanchez-Garcia, Alfonso J. Cruz-Jentoft, Paula Ravasco, Merja Suominen, Prof Kaisu Pitkälä
    Current Medical Research and Opinion.2024; 40(9): 1563.     CrossRef
  • Age and sex differences in sarcopenic dysphagia: A secondary data analysis
    Hidetaka Wakabayashi, Shingo Kakehi, Ayano Nagano, Masako Kishima, Masataka Itoda, Shinta Nishioka, Ryo Momosaki
    Journal of General and Family Medicine.2024; 25(6): 343.     CrossRef
  • Triad of rehabilitation, nutrition support, and oral management improves activities of daily living and muscle health in hospitalized patients after stroke
    Yoshihiro Yoshimura, Sayuri Shimazu, Ai Shiraishi, Hidetaka Wakabayashi, Fumihiko Nagano, Ayaka Matsumoto, Yoshifumi Kido, Takahiro Bise, Aomi Kuzuhara, Takenori Hamada, Kouki Yoneda
    Clinical Nutrition ESPEN.2024; 63: 837.     CrossRef
  • The Prevalence and Prognosis of Cachexia in Patients with Non-Sarcopenic Dysphagia: A Retrospective Cohort Study
    Shingo Kakehi, Hidetaka Wakabayashi, Takako Nagai, Shinta Nishioka, Eri Isono, Yukiko Otsuka, Junki Ninomiya, Ryo Momosaki
    Nutrients.2024; 16(17): 2917.     CrossRef
  • 7,866 View
  • 58 Download
  • 12 Web of Science
  • 11 Crossref

Spinal cord injury

Robot-Assisted Gait Training in Individuals With Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Jong Mi Park, Yong Wook Kim, Su Ji Lee, Ji Cheol Shin
Ann Rehabil Med 2024;48(3):171-191.   Published online June 28, 2024
DOI: https://doi.org/10.5535/arm.230039
Spinal cord injury (SCI) rehabilitation emphasizes locomotion. Robotic-assisted gait training (RAGT) is widely used in clinical settings because of its benefits; however, its efficacy remains controversial. We conducted a systematic review and meta-analysis to investigate the efficacy of RAGT in patients with SCI. We searched international and domestic databases for articles published until April 18, 2024. The meta-analysis employed a random effects model to determine the effect size as either mean difference (MD) or standardized MD (SMD). Evidence quality was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Twenty-three studies with a total of 690 participants were included in the final analysis. The overall pooled effect size for improvement in activities of daily living was 0.24, with SMD (95% confidence interval [95% CI], 0.04–0.43; GRADE: high) favoring RAGT over conventional rehabilitation. Muscular strength (MD, 0.23; 95% CI, 0.02–0.44; GRADE: high), walking index for SCI (MD, 0.31; 95% CI, 0.07–0.55; GRADE: moderate) and 6 min walk test distance (MD, 0.38; 95% CI, 0.14–0.63; GRADE: moderate) showed significant improvement in the robot group. Subgroup analysis revealed that subacute patients and intervention periods >2 months were more effective. This meta-analysis revealed that RAGT significantly improved activities of daily living, muscular strength, and walking abilities. Additional studies are needed to identify the optimal treatment protocol and specific patient groups for which the protocol is most effective.

Citations

Citations to this article as recorded by  
  • Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial
    Kap-Soo Han, Myoung-Hwan Ko
    Geriatrics.2025; 10(1): 23.     CrossRef
  • Advances and New Therapies in Traumatic Spinal Cord Injury
    Antonio Montoto-Marqués, Jesús Benito-Penalva, María Elena Ferreiro-Velasco, Mark Andrew Wright, Sebastian Salvador-De la Barrera, Hatice Kumru, Nelson Gaitán-Pérez, Agustin Hernández-Navarro, Antonio Rodríguez-Sotillo, Fernando Martins Braga, Angela Pale
    Journal of Clinical Medicine.2025; 14(7): 2203.     CrossRef
  • Factors influencing on functional independence outcomes after hospitalization and rehabilitation in children with spinal cord injury
    Hong-Bo Zhao, Xiang-Jiang Rong, Qi Zhang, Ting-Ting Ma, He Yan, Tian-Tian Zhou, Yan-Qing Zhang
    BMC Pediatrics.2025;[Epub]     CrossRef
  • 4,718 View
  • 50 Download
  • 3 Web of Science
  • 3 Crossref

Geriatric Rehabilitation

Improved Muscle Mass and Function With Protein Supplementation in Older Adults With Sarcopenia: A Meta-Analysis
Hyo Eun Kwon, Nayeon Ko, Doyoung Yuk, Seo Won Choi, Seong-Eun Koh
Ann Rehabil Med 2023;47(5):358-366.   Published online October 23, 2023
DOI: https://doi.org/10.5535/arm.23076
Objective
To systematically review the effects of protein supplementation in older adults with sarcopenia.
Methods
A systematic literature search was conducted in PubMed, Cochrane Library, and Embase databases until May 2023. The inclusion criteria were as follows: (1) randomized controlled trials with a quantitative study design; (2) studies with a study group of older adults with sarcopenia; (3) studies comparing muscle mass, muscle strength, and performance of older adults with sarcopenia after protein supplementation; and (4) studies published up to May 2023.
Results
Six retrospective comparative studies, including 715 patients, met the inclusion criteria. The nutritional supplementation group exhibited significant improvement in appendicular skeletal muscle mass (standardized mean difference [SMD]=0.41; 95% confidence interval [CI], 0.24–0.58; p<0.001; I2=1%), while handgrip strength (SMD=0.37; 95% CI, -0.32–1.07; p=0.29; I2=94%) and Short Physical Performance Battery (SPPB) (SMD=0.35; 95% CI, -0.47–1.18; p=0.40; I2=94%) showed a tendency for improvement.
Conclusion
Nutritional supplementation with protein increased appendicular muscle mass in older adults with sarcopenia and improved handgrip strength and SPPB scores.

Citations

Citations to this article as recorded by  
  • Age-related and cancer-related sarcopenia: is there a difference?
    Federico Bozzetti
    Current Opinion in Clinical Nutrition & Metabolic Care.2024; 27(5): 410.     CrossRef
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    Li‐Ning Peng, Ming‐Hsien Lin, Sung‐Hua Tseng, Ko‐Han Yen, Huei‐Fang Lee, Fei‐Yuan Hsiao, Liang‐Kung Chen
    Journal of Cachexia, Sarcopenia and Muscle.2024; 15(4): 1348.     CrossRef
  • SuperAgers and centenarians, dynamics of healthy ageing with cognitive resilience
    Md Ariful Islam, Ujala Sehar, Omme Fatema Sultana, Upasana Mukherjee, Malcolm Brownell, Sudhir Kshirsagar, P. Hemachandra Reddy
    Mechanisms of Ageing and Development.2024; 219: 111936.     CrossRef
  • Consumption of protein supplements/protein-fortified foods among young adults in Jeju
    Hyoju Lee, Youjeong Jang, Sumin Kim, Kyungho Ha
    Journal of Nutrition and Health.2024; 57(2): 261.     CrossRef
  • Impact of increased protein intake in older adults: a 12-week double-blind randomised controlled trial
    Janine Wirth, Annalisa Segat, Katy Horner, Domenico Crognale, Thomas Smith, Maurice O’Sullivan, Lorraine Brennan
    Age and Ageing.2024; 53(Supplement): ii13.     CrossRef
  • Nutrition resilience for healthy ageing
    Claire T McEvoy, Colin D McClure
    Age and Ageing.2024; 53(Supplement): ii1.     CrossRef
  • Study of whey protein on muscle mass and functional rehabilitation in postoperative total knee arthroplasty patients
    Mengshi Li, Qiongfang Shi, Xinle Che, Xingyan Du, Dongming Wang, Yufeng Song
    Journal of Back and Musculoskeletal Rehabilitation.2024; 37(5): 1381.     CrossRef
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    Iu. Samoilova, M. Matveeva, D. Podchinenova, Ya. Yakimova, L. Shuliko, V. Avkhimenko, D. Kudlay, E. Samoylov, E. Khoroshunova, A. Ragimov
    Vrach.2024; : 48.     CrossRef
  • 6,003 View
  • 49 Download
  • 6 Web of Science
  • 8 Crossref

Original Articles

Cardiopulmonary rehabilitation

Correlation of Sit-to-Stand Test and 6-Minute Walk Test to Illustrate Cardiorespiratory Fitness in Systolic Heart Failure Patients
Ivan Triangto, Aulia Syavitri Dhamayanti, Made Suariastawa Putra, Djoko Witjaksono, Rahmad , Lilik Zuhriyah, Yoga Waranugraha
Ann Rehabil Med 2025;49(1):23-29.   Published online February 28, 2025
DOI: https://doi.org/10.5535/arm.240057
Objective
To prove 5-time sit-to-stand (5-STS) and 30-second sit-to-stand (30sSTS) tests in assessing cardiorespiratory fitness in chronic heart failure (HF) patients with systolic dysfunction. Alternative tests, such as 5-STS and 30sSTS, may be used to assess cardiorespiratory fitness in patients with HF but have not been thoroughly evaluated. Thus, this study aimed to prove 5-STS and 30sSTS tests in assessing cardiorespiratory fitness in chronic HF patients with systolic dysfunction.
Methods
A cross-sectional study was done, evaluating chronic HF patients with systolic dysfunction that have received optimal guideline directed medical treatment for at least 3 months. All patients underwent the same intervention on the same day, starting with an initial 5-STS test, followed by a 30sSTS, and a 6-minute walk test (6MWT).
Results
A total of 34 patients were enrolled in this study. The median left ventricular ejection fraction was 44% (interquartile range=34%–48%). Mean values of 5-STS, 30sSTS, and 6MWT were 13.90±4.72, 13.29±3.38, and 463.65±87.04, respectively. 5-STS showed moderate correlation with 6MWT (r=-0.436, p=0.01). However, the 30sSTS revealed strong correlation with 6MWT (r=0.629, p<0.001).
Conclusion
The 30sSTS test had strong correlation with 6MWT. It could be used to illustrate cardiorespiratory fitness in chronic HF patients with systolic dysfunction.
  • 1,039 View
  • 46 Download

Others

Smartphone Usage and Postural Stability in Individuals With Forward Head Posture: A Nintendo Wii Balance Board Analysis
Weerasak Tapanya, Noppharath Sangkarit
Ann Rehabil Med 2024;48(4):289-300.   Published online July 24, 2024
DOI: https://doi.org/10.5535/arm.230034
Objective
To assess postural stability, specifically center of body sway during single-leg standing balance, among individuals with and without forward head posture (FHP) during smartphone use.
Methods
The research recruited 53 healthy smartphone users, aged 18–25, and categorized them into FHP group comprising 26 subjects and the normal (control) group with 27 subjects. Participants were assigned the task of maintaining balance while engaged in smartphone typing during single-leg standing. The experiment involved four specific conditions according to neck posture and stable of surface. The study meticulously quantified body center of pressure (COP) sway amplitudes using the Nintendo Wii Balance Board.
Results
The research revealed that individuals with FHP exhibited significantly greater body sway compared to the control group when using smartphones. Notably, distinct variations were observed in path length sway, anteroposterior (AP), and mediolateral (ML) sway amplitude, particularly evident when maintaining flexed neck positions on a soft surface while engaged with smartphones.
Conclusion
These findings strongly suggest that individuals with FHP encounter deteriorated postural stability during smartphone use, particularly in challenging head positions.

Citations

Citations to this article as recorded by  
  • Validity of a qualitative visual method for diagnosing forward head posture
    Shohei Shibasaki, Tomonori Kishino, Yoriko Sei, Keiichiro Harashima, Konomi Sakata, Hiroaki Ohnishi, Takashi Watanabe
    Musculoskeletal Science and Practice.2025; 76: 103282.     CrossRef
  • Assessment of balance in overweight and obese young adults: utilizing centre of pressure displacement variables in the single leg sit-to-stand test
    Noppharath Sangkarit, Weerasak Tapanya, Patchareeya Amput, Chananya Muangchuen, Piyaporn Seeta, Worrasak Paleeta
    International Journal of Adolescence and Youth.2025;[Epub]     CrossRef
  • Evaluating fall risk in community-dwelling older adults through balance assessment with the Nintendo Wii Balance Board
    Weerasak Tapanya, Noppharath Sangkarit, Puttipong Poncumhak, Saisunee Konsanit
    Human Movement.2025; 26(1): 161.     CrossRef
  • 5,965 View
  • 43 Download
  • 2 Web of Science
  • 3 Crossref

Neuromuscular disorders

Muscle Pathology Associated With Cardiac Function in Duchenne Muscular Dystrophy
Jin A Yoon, Heirim Lee, In Sook Lee, You Seon Song, Byeong-Ju Lee, Soo-Yeon Kim, Yong Beom Shin
Ann Rehabil Med 2024;48(6):405-412.   Published online December 16, 2024
DOI: https://doi.org/10.5535/arm.240006
Objective
To compare the progression of muscle fibrosis of various site and its relation between cardiac deterioration in Duchenne muscular dystrophy (DMD). In this study aimed to examine the associations between echocardiogram-based cardiac function indices and fibrosis of the abdominal and lower extremity muscles in patients with DMD to facilitate early detection of cardiac dysfunction and identify its predictors.
Methods
Twenty-one patients with DMD patients were enrolled in the study. The association between cardiac dysfunction and fibrosis of the abdominal and lower extremity muscles was determined by analyzing the echocardiography and elastography. Non-parametric Spearman rank correlation coefficients were used to examine the pairwise relationships between cardiac function and muscle elasticity.
Results
All patients were male and non-ambulant. Their mean age was 18.45±4.28 years. The strain ratios of the abdominal muscle and quadriceps muscles were significantly higher than those of the medial gastrocnemius. The strain ratio of the rectus abdominis muscle has a significant negative correlation with left ventricular ejection fraction. Cardiac function and valvular insufficiency were not significantly correlated with muscle strain ratio. According to the result of our study, the only skeletal muscle which showed significant correlation with cardiac dysfunction was degree abdominal muscle fibrosis.
Conclusion
The degree of fibrosis of respiratory muscles was also significantly associated with cardiac dysfunction; therefore, it can be used as a predictor of cardiac dysfunction in patients with DMD in clinical practice.
  • 1,163 View
  • 42 Download

Brain disorders

Validation of Korean Version of the Oxford Cognitive Screen (K-OCS), a Post Stroke-Specific Cognitive Screening Tool
Eunyoung Cho, Sungwon Choi, Nele Demeyere, Rina Kim, Ikhyun Lim, MinYoung Kim
Ann Rehabil Med 2025;49(1):5-14.   Published online February 13, 2025
DOI: https://doi.org/10.5535/arm.240099
Objective
To establish and evaluate the validity of the recently developed Korean version of the Oxford Cognitive Screen (K-OCS), this study verified its reliability, validity, and diagnostic accuracy.
Methods
Between November 2021 and December 2023, we recruited 72 patients with stroke from our hospital who agreed to participate in the study. The patients were repeatedly tested using K-OCS by the same or different assessors to estimate inter- and intra-rater reliability. To demonstrate the validity and usability of K-OCS, the test results of screening tools currently used in clinical practice, including the Korean-Mini Mental State Examination and the Korean version of the Montreal Cognitive Assessment, were used in comparison analyses.
Results
The subtests of K-OCS demonstrated excellent inter-rater reliability (intra-class correlation coefficient [ICC]=0.914–0.998) and test–retest reliability (ICC=0.913–0.994). We found moderate-to-strong correlations for convergent validity for the subsets (r=0.378– 0.979, p<0.01), and low-to-moderate discriminant validity correlations. The optimal cut-offs estimated for the subtests of the K-OCS showed a good-to-high range of specificity (94.8%– 100%). The positive predictive value was 58.2%–100% and negative predictive value was 65.6%–98.4%. Sensitivity was estimated at 25.6%–86.9%.
Conclusion
The results of this study indicate that K-OCS is a reliable and valid tool for screening cognitive impairment in patients post-stroke.
  • 1,152 View
  • 39 Download

Electrodiagnosis

Nerve Conduction Study, Sympathetic Skin Response Test, and Demographic Correlates in Type 2 Diabetes Mellitus Patients
Younggon Lee, So Hun Kim, Chang-Hwan Kim
Ann Rehabil Med 2025;49(1):40-48.   Published online February 6, 2025
DOI: https://doi.org/10.5535/arm.240042
Objective
To comprehensively assess the relationship between nerve conduction study (NCS), sympathetic skin response (SSR), and demographic factors in patients with diabetic neuropathy, exploring potential risk factors and mechanisms.
Methods
A retrospective study (N=184) included patients diagnosed with type 2 diabetes mellitus undergoing NCS and SSR. Demographic, clinical, and laboratory data were analyzed. Patients were categorized by diabetic peripheral neuropathy (DPN) and SSR stages for comparative analysis.
Results
HbA1c levels correlated with DPN progression. SSR stages exhibited age-related differences. Height correlated with DPN but not SSR stages. Body mass index showed no significant differences.
Conclusion
While DPN progression correlated with glycemic control and duration of diabetes, SSR was influenced by age. Unexpectedly, cholesterol levels remained within the normal range, challenging established concepts. Understanding these relationships is crucial for interpreting test results and developing targeted interventions for diabetic neuropathy.
  • 1,344 View
  • 39 Download

Others

Factors Affecting Life Satisfaction Among People With Physical Disabilities During COVID-19: Observational Evidence From a Korean Cohort Study
Myoungsuk Kim, Seung Hee Ho, Hayeon Kim, Jaemin Park
Ann Rehabil Med 2024;48(6):377-388.   Published online November 13, 2024
DOI: https://doi.org/10.5535/arm.240056
Objective
To determine the factors influencing the life satisfaction of people with physical disabilities during the COVID-19 pandemic, considering demographics, disability-related characteristics, health behaviors, and psychosocial characteristics.
Methods
We used cross-sectional data from 301 respondents of the 2021/2022 survey of the Korean Health Cohort Study for People with Physical Disabilities. Descriptive statistics were used to analyze the research subjects’ characteristics, and chi-square tests and multiple logistic regression were used to identify the determinants of life satisfaction.
Results
Among socio demographic variables, occupation had a strong association with life satisfaction. Significant health behavior variables included daily regular meals, weight control effort, and chronic pain. All psychosocial characteristics (perceived stress, depression, suicidal ideation, cognitive function assessment, subjective health status, family satisfaction, income satisfaction) were strongly associated with life satisfaction. Results of the analysis of factors affecting life satisfaction showed that unemployment, lack of regular exercise, elevated stress, suicidal thoughts, and dissatisfaction with family contributed to increased life dissatisfaction.
Conclusion
Economic support through job creation that considers the specific characteristics of people with disabilities, and social access through community integration services that encourage participation in social activities, should be prioritized.
  • 3,004 View
  • 39 Download

Cardiopulmonary rehabilitation

Would Integrating Inspiratory Muscle Training into Pulmonary Rehabilitation of Adults with Burn Injuries Have Any Advantageous Effects? a Randomized, Double-Blind, Sham-controlled Study
Nabil Mahmoud Abdel-Aal, Maged A. Basha, Saleh M. Aloraini, Alshimaa R. Azab, FatmaAlzahraa H. Kamel
Ann Rehabil Med 2025;49(1):30-39.   Published online February 28, 2025
DOI: https://doi.org/10.5535/arm.240092
Objective
To determine the effectiveness of adding inspiratory muscle training (IMT) alongside a pulmonary rehabilitation protocol in terms of inspiratory muscle strength, lung function, and exercise capacity in burned adults.
Methods
A randomized, double-blinded, sham-controlled study. Fifty-two adult patients with burn injuries, more than 20 years old and at least 20% total body surface area, were assigned randomly either to the experimental or the conventional group. The participants in the experimental group were given IMT plus a pulmonary rehabilitation program; the conventional group received only a pulmonary rehabilitation program. The interventions were performed for 8 weeks. At the beginning and after 8 weeks of training, the respiratory muscles’ strength, lung function and exercise capacity were all examined.
Results
After 2 months of training, the experimental group demonstrated statistically significant improvements than conventional group in maximum inspiratory pressure, maximum expiratory pressure, 6-minute walk test, forced vital capacity, and forced expiratory volume in 1 second (p<0.05).
Conclusion
An 8-week IMT program coupled with pulmonary rehabilitation increases respiratory muscle strength, pulmonary functions, and functional capacity in burn patients. IMT is a beneficial and efficient therapy that can be easily implemented for burn patients.
  • 880 View
  • 38 Download

Geriatric rehabilitation

Discordance Between Spine-Hip and Paretic-Nonparetic Hip Bone Mineral Density in Hemiplegic Stroke Patients: A Multicenter Retrospective Study
Seung Don Yoo, Tae-Woo Kim, Byung-Mo Oh, Seung Ah Lee, Chanwoo Kim, Ho Yeon Chung, Jung Eun Son, Ji Yeon Lee, Hyunji Lee, Hoo Young Lee
Ann Rehabil Med 2024;48(6):413-422.   Published online December 20, 2024
DOI: https://doi.org/10.5535/arm.240079
Objective
To identify the prevalence and factors associated with T-score discordance between the spine and hip, as well as between the paretic and non-paretic hips in hemiplegic stroke patients, this study investigated bone mineral density (BMD) patterns. Bone loss predominantly affects the paretic hip after a stroke, and typical clinical assessments using dual-energy X-ray absorptiometry (DXA) that scan the lumbar spine (LS) and a single hip may overlook an osteoporosis diagnosis. This oversight could potentially lead to suboptimal treatment for stroke patients.
Methods
This study was a multicenter retrospective analysis of 540 patients admitted for stroke rehabilitation between October 2014 and February 2022, who underwent DXA of LS and bilateral hips.
Results
The prevalence rates of concordance, low LS discordance, and low hip discordance between the LS and hips were 48.2%, 12.2%, and 39.6%, respectively. The discordance rate between bilateral hips was 17.0%. The paretic side had significantly lower total hip T-scores than the non-paretic side (p<0.001). Notably low paretic hip discordance was more prevalent during the chronic phase. DXA scans of the LS and both hips revealed a 0.7%–0.9% higher major discordance compared to LS and single hip DXA scans. The multivariate analysis revealed a significant correlation between a low paretic hip discordance and cognitive impairment (adjusted odds ratio 0.071, 95% confidence interval 0.931–1.003, p<0.05).
Conclusion
Since stroke survivors are at high risk for hip fractures, comprehensive BMD assessments, which include LS and bilateral hips, should be considered for post-stroke osteoporosis care to enhance diagnostic accuracy and timely treatment.

Citations

Citations to this article as recorded by  
  • Association between bone mineral density and stroke: a meta-analysis
    Peng Zhao, Huaxia Sun
    Frontiers in Neurology.2025;[Epub]     CrossRef
  • 1,322 View
  • 38 Download
  • 1 Web of Science
  • 1 Crossref

Brain disorders

Ultrasonography for Assessment and Intervention With Botulinum Toxin Injection for Tremors
So-Hyun Park, Joon-Ho Shin
Ann Rehabil Med 2024;48(6):396-404.   Published online December 16, 2024
DOI: https://doi.org/10.5535/arm.240065
Objective
Tremors are caused by contractions of reciprocally innervated muscles. The role of ultrasound in diagnosing tremors has not yet been investigated, although it appears to be promising because it can visualize muscle movements. In the present study, we report four cases of tremor (Holmes’ tremor, extremity tremor associated with palatal myoclonus, dystonic tremor, and tremor associated with dystonia), which were evaluated using ultrasound and treated with botulinum toxin injections.
Methods
The muscles of patients with tremors were examined using B- or M-mode ultrasound while they were in the supine position. Tremor was determined by involuntary muscular contraction (B-mode) or fasciculation (M-mode) from recorded sonography clips. Thereafter, tremors were measured as frequency and amplitude of specific muscles. Ultrasound-guided botulinum toxin type A injection was administered, and follow-up ultrasonography was used to assess tremors.
Results
Tremors, which manifest as a specific set of muscle contractions, were measured using ultrasonography and treated with botulinum toxin injection. Follow-up ultrasonography revealed improved tremors as seen with decreased frequency and amplitude of specific muscle after the intervention, which included medication and botulinum toxin injections.
Conclusion
Ultrasonography is an effective assessment tool for tremors, allowing further information regarding tremor characteristics with high sensitivity, playing a role in detecting specific muscles that are affected by tremors, and guiding an exact intervention with botulinum toxin.
  • 1,007 View
  • 38 Download

Brain disorders

Associations Between Stroke Outcome Assessments and Automated Tractography Fractional Anisotropy Incorporating Age
Midori Mochizuki, Yuki Uchiyama, Kazuhisa Domen, Tetsuo Koyama
Ann Rehabil Med 2025;49(1):15-22.   Published online February 13, 2025
DOI: https://doi.org/10.5535/arm.240073
Objective
To evaluate the association between outcomes, including affected extremity functions and activities of daily living (ADL), and fractional anisotropy (FA) derived from automated tractography incorporating age among patients after stroke.
Methods
This study enrolled stroke patients, and diffusion-tensor imaging was conducted during the second week. Standardized automated tractography was utilized to compute FA values in the corticospinal tract (CST), the inferior fronto-occipital fasciculus (IFOF), and the superior longitudinal fasciculus (SLF). Outcome evaluations were performed at discharge from our affiliated rehabilitation facility. Extremity functions were assessed using the total scores of the motor component of the Stroke Impairment Assessment Set (SIAS-motor). Independence levels in ADL were appraised through the motor and cognition components of the Functional Independence Measure (FIM). For each outcome measure, multivariate regression analysis incorporated the FA values of the CST, the IFOF, and the SLF, along with age.
Results
Forty-two patients were enrolled in the final analytical database. Among the four explanatory variables, the CST emerged as the most influential factor for SIAS-motor scores. Conversely, age proved to be the primary determinant for both the motor and cognition components of FIM, surpassing the impact of FA metrics, including the CST and the IFOF.
Conclusion
The key influencing factors exhibited significant variations based on the targeted outcome assessments. Clinicians should be aware of these differences when utilizing neuroimaging techniques to predict stroke outcomes.
  • 1,102 View
  • 37 Download

Physical Therapy

Cross-Cultural Translation and Validation of the Thai Version of the Scale for the Assessment and Rating of Ataxia (SARA-TH)
Duangnapa Roongpiboonsopit, Wattakorn Laohapiboolrattana, Taweewat Wiangkham, Olan Isariyapan, Jutaluk Kongsuk, Harinfa Pattanapongpitak, Thitichaya Sonkaew, Mana Termjai, Sudarat Isaravisavakul, Sirikanya Wairit, Waroonnapa Srisoparb
Ann Rehabil Med 2024;48(5):360-368.   Published online October 31, 2024
DOI: https://doi.org/10.5535/arm.240061
Objective
To culturally adapt the original English Scale for the Assessment and Rating of Ataxia to Thai (SARA-TH) and to evaluate the reliability and validity of the SARA-TH in assessing ataxia in acute ischemic stroke or transient ischemic attack (TIA) patients, as assessed by three healthcare professionals.
Methods
The SARA underwent translation and cross-cultural adaptation to Thai according to established guidelines. Reliability (e.g., internal consistency, intrarater reliability, interrater reliability) and validity (e.g., content validity, convergent validity) were assessed in a sample of 50 participants with ataxia after acute ischemic stroke or TIA. Spearman correlation analysis was used to examine the relationships between the SARA-TH and the Barthel Index (BI-TH), the National Institutes of Health Stroke Scale (NIHSS-TH), and the International Cooperative Ataxia Rating Scale (ICARS) to assess convergent validity. Interrater and intrarater reliability among experienced and novice neurologists, physiotherapists, and occupational therapists were assessed using weighted kappa.
Results
The SARA-TH demonstrated good comprehension and exhibited no significant floor or ceiling effects. It showed excellent internal consistency (Cronbach’s α≥0.776). Significant correlations were found between the SARA-TH score and the BI-TH score (rs=-0.743 to -0.665), NIHSS- TH score (rs=0.404–0.513), and ICARS score (rs=0.859–0.917). The intrarater reliability for each rater ranged from 0.724 to 1.000 (p<0.01), and the interrater reliability varied from 0.281 to 0.927 (p<0.01).
Conclusion
The SARA-TH has excellent internal consistency, validity, and intrarater reliability, as well as acceptable interrater reliability among health professionals with varying levels of experience. It is recommended for assessing ataxia severity in individuals following acute ischemic stroke or TIA.
  • 1,701 View
  • 37 Download

Physical therapy

Early Rehabilitation Interventions by Physical Therapists for Severe COVID-19 Patients Were Associated With Decreased Incidence of Post-ICU Physical Impairment
Shinya Oku, Junji Hatakeyama, Keibun Liu, Kentaro Tojo, Masafumi Idei, Shigeaki Inoue, Kazuma Yamakawa, Takeshi Nishida, Shinichiro Ohshimo, Satoru Hashimoto, Shuhei Maruyama, Yoshitaka Ogata, Daisuke Kawakami, Hiroaki Shimizu, Katsura Hayakawa, Yuji Fujino, Taku Oshima, Tatsuya Fuchigami, Hironori Yawata, Kyoji Oe, Akira Kawauchi, Hidehiro Yamagata, Masahiro Harada, Yuichi Sato, Tomoyuki Nakamura, Kei Sugiki, Takahiro Hakozaki, Satoru Beppu, Masaki Anraku, Noboru Kato, Tomomi Iwashita, Hiroshi Kamijo, Yuichiro Kitagawa, Michio Nagashima, Hirona Nishimaki, Kentaro Tokuda, Osamu Nishida, Kensuke Nakamura
Ann Rehabil Med 2025;49(1):49-59.   Published online February 28, 2025
DOI: https://doi.org/10.5535/arm.240066
Objective
To implement early rehabilitation interventions by physical therapists is recommended. However, the effectiveness of early rehabilitation for severe coronavirus disease 2019 (COVID-19) patients in the prevention of post-intensive care syndrome (PICS) is unclear. We analyzed a multicenter prospective observational study (Post-Intensive Care outcomeS in patients with COronaVIrus Disease 2019) to examine the association between early rehabilitation interventions and PICS physical impairment.
Methods
An analysis was performed on COVID-19 patients who were admitted to intensive care units (ICUs) between March 2020 and March 2021, and required mechanical ventilation. The primary outcome was the incidence of PICS physical impairment (Barthel Index≤90) after one year. Multivariate logistic regression analysis was used to estimate the association between early rehabilitation interventions and PICS physical impairment by adjusting ICU mobility scale (IMS) during seven-day following ICU admission, and clinically relevant risk factors.
Results
The analysis included 259 patients, 54 of whom developed PICS physical impairment one year later. In 81 patients, physical therapists intervened within seven days of ICU admission. There was no significant difference in mean IMS by day seven of admission between the early and non-early rehabilitation patients (0.70 and 0.61, respectively). Multivariate logistic regression analysis showed that early rehabilitation interventions were significantly associated with a low incidence of PICS physical impairment (odds ratio, 0.294; 95% confidence interval, 0.123–0.706; p=0.006).
Conclusion
Early rehabilitation interventions by physical therapists were an independent factor associated with the decreased development of PICS physical impairment at one year, even though early rehabilitation had no significant effect on IMS.
  • 1,045 View
  • 36 Download

Physical Therapy

The Assessment of Muscle Strength and Cardiorespiratory Parameters Using Simple Tests in Older Adults With Recovery From Mild COVID-19
Patchareeya Amput, Sirima Wongphon
Ann Rehabil Med 2024;48(6):389-395.   Published online December 10, 2024
DOI: https://doi.org/10.5535/arm.240033
Objective
To evaluate muscle strength and cardiorespiratory parameters, this study uses simple tests in older adults, including those who have and have not recovered from mild coronavirus disease 2019 (COVID-19).
Methods
Eighty older adults (age≥60 years old) were divided into two groups: those without previous COVID-19 (control group, n=40) and those with recovery from mild COVID-19 (recovered group, n=40). Muscle strength was assessed using a handgrip strength test and the sit-to-stand test (STS10). Cardiorespiratory parameters were evaluated with a 1-minute sitto- stand (1-min STS) test and a 6-minute walk test (6MWT).
Results
Both groups had normal values for body mass index, blood pressure, heart rate, and pulse oxygen saturation. The recovered group showed significant differences in handgrip strength test (24.73±6.99 vs. 22.03±4.36, p=0.041) and duration for the STS10 (25.15±6.11 vs. 33.40±7.56, p<0.001) when compared to the control group. Furthermore, the recovered group had significantly decreased repetitions of a 1-min STS (31.38±4.89 vs. 21.25±3.64, p<0.001) and increased the rate of perceived exertion (RPE) (7.43±1.20 vs. 8.95±1.01, p=0.01) and leg fatigue (1.49±1.13 vs. 3.00±1.04, p=0.03) after performing a 1-min STS when compared with the control group. Moreover, the recovered group had also significantly decreased distances for the 6MWT (421.68±8.28 vs. 384.35±6.17, p<0.001) and increased the post-test RPE (7.63±1.37 vs. 12.05±1.63, p<0.001) and the post-test leg fatigue (1.71±0.88 vs. 5.28±0.91, p<0.001) compared with the control group.
Conclusion
Older adults with recovery from mild COVID-19 reported reduced muscle strength and exercise tolerance when compared with older adults without COVID-19.
  • 1,124 View
  • 36 Download

Pain & Musculoskeletal rehabilitation

Change in Plantar Pressure and Plain Radiography in Pediatric Flexible Flatfoot: A Retrospective Cohort Study
Sungjoon Kim, Yong Gyun Kim, Jun Yup Kim, Si-Bog Park, Kyu Hoon Lee
Ann Rehabil Med 2024;48(5):352-359.   Published online October 31, 2024
DOI: https://doi.org/10.5535/arm.240041
Objective
To investigate longitudinal changes in plantar pressure examinations and plain radiographs and to assess the correlations between these two modalities in pediatric patients with flexible flatfoot (FFF).
Methods
Pediatric patients diagnosed with FFF were analyzed in this retrospective cohort study. Medical records were reviewed to collect data on plain radiographs and plantar pressure examinations. Changes in radiographic angles and plantar pressure parameters were analyzed over a follow-up period exceeding 1 year. Statistical analyses included paired t-test, Wilcoxon signed rank test, and Spearman’s correlation analysis.
Results
A total of 52 subjects was included in the plantar pressure analysis, with a mean age of 9.9 years at the first visit and a median follow-up duration of 52 months. The lateral tarso-first metatarsal angle decreased by 1.3° (p<0.001) and calcaneal inclination angle increased by 2.5° (p<0.001) in these patients. The percentage value of midfoot width (WMF) divided by forefoot width (WFF) decreased by an average of 9.8% p (p<0.001), and the maximal pressure on the medial midfoot (MMF) decreased by 1.6 N/cm2 (p<0.001). However, no correlations were found between plantar pressure and radiographic changes.
Conclusion
During follow-up of patients with FFF, the maximal pressure on the MMF and the ratio of WMF to WFF decreased in successive plantar pressure examinations. Changes observed in plantar pressure and plain radiographs were not consistent, indicating that these two testing modalities can complement each other.
  • 1,281 View
  • 36 Download

Pain & Musculoskeletal rehabilitation

Eccentric Versus Concentric Exercises in Patients With Rheumatoid Arthritis and Rotator Cuff Tendinopathy: A Randomized Comparative Study
Mina Magdy Wahba, Mona Selim, Mohammed Moustafa Hegazy, Rasmia Elgohary, Mohammed Shawki Abdelsalam
Ann Rehabil Med 2023;47(1):26-35.   Published online February 15, 2023
DOI: https://doi.org/10.5535/arm.22150
Objective
To determine the efficacy of concentric vs. eccentric exercise in improving shoulder function, pain, and tendon characteristics for patients with rheumatoid arthritis and rotator cuff tendinopathy.
Methods
Forty patients with rheumatoid arthritis and rotator cuff tendinopathy were divided into either concentric or eccentric exercise groups, with 20 patients in each group. Patients received 12 sessions at a pace of 3 sessions per week. Shoulder Pain and Disability Index (SPADI), the visual analogue scale (VAS), supraspinatus and subscapularis thickness, echo pixels, and the Disease Activity Score-28-erythrocyte sedimentation rate (DAS-28-ESR) were assessed at baseline and post-treatment.
Results
There was a significant difference between the concentric and eccentric groups regarding SPADI and VAS scores in favor of the eccentric group. However, there was no significant difference between the two groups regarding tendon thickness, echo pixels, or DAS-28-ESR.
Conclusion
Eccentric exercises were more effective than concentric exercises in improving shoulder function and pain intensity. However, neither of the two types of exercises was superior in improving tendon characteristics or disease activity.

Citations

Citations to this article as recorded by  
  • Response: Eccentric Versus Concentric Exercises in Patients With Rheumatoid Arthritis and Rotator Cuff Tendinopathy: A Randomized Comparative Study (Ann Rehabil Med 2023;47:26-35)
    Mina Magdy Wahba, Mona Selim, Mohammed Moustafa Hegazy, Rasmia Elgohary, Mohammed Shawki Abdelsalam
    Annals of Rehabilitation Medicine.2024; 48(1): 3.     CrossRef
  • Letter to the Editor: Eccentric Versus Concentric Exercises in Patients With Rheumatoid Arthritis and Rotator Cuff Tendinopathy: A Randomized Comparative Study
    Vanshika Agarwal, Jeyanthi. S, Adarsh Sharma
    Annals of Rehabilitation Medicine.2024; 48(1): 1.     CrossRef
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Editorial: Outcome Measures in Rehabilitation Medicine

Others

Outcome Measurement in Balance Problems: Berg Balance Scale
Kyung Lim Joa
Ann Rehabil Med 2024;48(2):103-104.   Published online April 23, 2024
DOI: https://doi.org/10.5535/arm.240029

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  • Exploring Nintendo Wii Balance Board as a tool to assess lower limb muscle strength for fall risk screening in elderly women
    Weerasak Tapanya, Noppharath Sangkarit, Patchareeya Amput
    Translational Medicine of Aging.2025; 9: 1.     CrossRef
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  • 1 Crossref

Review Article

Brain disorders

Post-Stroke Spastic Movement Disorder and Botulinum Toxin A Therapy: Early Detection And Early Injection
Jörg Wissel, Anatol Kivi
Ann Rehabil Med 2023;47(5):326-336.   Published online October 23, 2023
DOI: https://doi.org/10.5535/arm.23108
Post-stroke spastic movement disorder (PS-SMD) develops in up to 40% of stroke survivors after a first ever stroke within the first year. Chronic PS-SMD is often associated with severe disabilities and complications, emphasizing the importance of its early recognition and early adequate management. Extensive research has aimed to accurately predict and sensitively detect a PS-SMD. Symptomatic therapies include conventional rehabilitation and local intramuscular injections of botulinum toxin A (BoNT-A). The latter is widely used, but primarily in the chronic phase of stroke. However, recent studies have shown the safety and efficacy of BoNT-A therapy even in the acute phase and early sub-acute phase after stroke, i.e., within three months post-stroke, leading to an improved long-term outcome in stroke rehabilitation. Local BoNT-A injections evolve as the primary approach in focal, multifocal, and segmental chronic or acute/subacute PS-SMD. Patients at high risk for or manifest PS-SMD should be identified by an early spasticity risk assessment. By doing so, PS-SMD can be integral part of the patient-centered goal-setting process of a multiprofessional spasticity-experienced team. The benefit of an early PS-SMD treatment by BoNT-A should predominate putative degenerative muscle changes due to long-term BoNT-A therapy by far. This, as early treatment effectively avoids complications typically associated with a PS-SMD, i.e., contractures, pain, skin lesions. The management of PS-SMD requires a comprehensive and multidisciplinary approach. Early assessment, patient-centered goal setting, early intervention, and early use of BoNT-A therapy prevents from PS-SMD complications and may improve rehabilitation outcome after stroke.

Citations

Citations to this article as recorded by  
  • How many stroke survivors develop problematic spasticity requiring pharmacological therapy? An international (Europe and USA) observational study protocol
    Richard D Zorowitz, Laura Serrano Barrenechea, Simon Butet, Sergiu Groppa, David Hernández Herrero, Rama Prasad, Susan Sandars, Seema Meloni, Simon Page, Pascal Maisonobe, Alessandro Picelli
    BMJ Open.2025; 15(1): e087404.     CrossRef
  • The Role of Botulinum Toxin Type-A in Spasticity: Research Trends from a Bibliometric Analysis
    Salvatore Facciorusso, Stefania Spina, Alessandro Picelli, Alessio Baricich, Gerard E. Francisco, Franco Molteni, Jörg Wissel, Andrea Santamato
    Toxins.2024; 16(4): 184.     CrossRef
  • Botulinum Toxin in Treatments for Abnormal Movements
    María Gabriela González Chico, Xaviera Elizabeth Medina Godoy, Miliana Esperanza Estupiñan Bazurto, María José López Becerra
    Más Vita.2024; 6(2): 82.     CrossRef
  • Botulinum Toxin Type A (BoNT-A) Use for Post-Stroke Spasticity: A Multicenter Study Using Natural Language Processing and Machine Learning
    María Jesús Antón, Montserrat Molina, José Gabriel Pérez, Santiago Pina, Noemí Tapiador, Beatriz De La Calle, Mónica Martínez, Paula Ortega, María Belén Ruspaggiari, Consuelo Tudela, Marta Conejo, Pedro Leno, Marta López, Carmen Marhuenda, Carlos Arias-Ca
    Toxins.2024; 16(8): 340.     CrossRef
  • Risk factors for post-stroke spasticity: a retrospective study
    Chuanxi Zhu, Lingxu Li, Long Qiu, Guangcheng Ji
    Frontiers in Neurology.2024;[Epub]     CrossRef
  • Early is Better, Then, How Early and How to Apply: Practical Approach of Botulinum Toxin Injection
    Joon-Ho Shin
    Annals of Rehabilitation Medicine.2023; 47(6): 439.     CrossRef
  • 5,070 View
  • 34 Download
  • 5 Web of Science
  • 6 Crossref

Original Article

Geriatric Rehabilitation

Association of Diaphragm Thickness and Respiratory Muscle Strength With Indices of Sarcopenia
Yookyung Lee, Sunhan Son, Don-Kyu Kim, Myung Woo Park
Ann Rehabil Med 2023;47(4):307-314.   Published online August 28, 2023
DOI: https://doi.org/10.5535/arm.23081
Objective
To evaluate the relationship between respiratory muscle strength, diaphragm thickness (DT), and indices of sarcopenia.
Methods
This study included 45 healthy elderly volunteers (21 male and 24 female) aged 65 years or older. Sarcopenia indices, including hand grip strength (HGS) and body mass index-adjusted appendicular skeletal muscle (ASM/BMI), were measured using a hand grip dynamometer and bioimpedance analysis, respectively. Calf circumference (CC) and gait speed were also measured. Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) were obtained using a spirometer, as a measure of respiratory muscle strength. DT was evaluated through ultrasonography. The association between indices of sarcopenia, respiratory muscle strength, and DT was evaluated using Spearman’s rank correlation test, and univariate and multiple regression analysis.
Results
ASM/BMI (r=0.609, p<0.01), CC (r=0.499, p<0.01), HGS (r=0.759, p<0.01), and gait speed (r=0.319, p<0.05) were significantly correlated with DT. In the univariate linear regression analysis, MIP was significantly associated with age (p=0.003), DT (p<0.001), HGS (p=0.002), CC (p=0.013), and gait speed (p=0.026). MEP was significantly associated with sex (p=0.001), BMI (p=0.033), ASM/BMI (p=0.003), DT (p<0.001), HGS (p<0.001), CC (p=0.001) and gait speed (p=0.004). In the multiple linear regression analysis, age (p=0.001), DT (p<0.001), and ASM/BMI (p=0.008) showed significant association with MIP. DT (p<0.001) and gait speed (p=0.050) were associated with MEP.
Conclusion
Our findings suggest that respiratory muscle strength is associated with DT and indices of sarcopenia. Further prospective studies with larger sample sizes are needed to confirm these findings.

Citations

Citations to this article as recorded by  
  • The Role of Diaphragmatic Ultrasound in Identifying Sarcopenia in COPD Patients: A Cross-Sectional Study
    Nur Aleyna Yetkin, Sibel Akın, Derya Kocaslan, Burcu Baran, Bilal Rabahoglu, Fatma Sema Oymak, Nuri Tutar, İnci Gulmez
    International Journal of Chronic Obstructive Pulmonary Disease.2025; Volume 20: 1.     CrossRef
  • Relationship Between Diaphragm Function and Sarcopenia Assessed by Ultrasound: A Cross-Sectional Study
    Takahiro Shinohara, Toru Yamada, Shuji Ouchi, Suguru Mabuchi, Ryoichi Hanazawa, Kazuharu Nakagawa, Kanako Yoshimi, Tatsuya Mayama, Ayane Horike, Kenji Toyoshima, Yoshiaki Tamura, Atsushi Araki, Haruka Tohara, Akihiro Hirakawa, Takuma Kimura, Takeshi Ishid
    Diagnostics.2025; 15(1): 90.     CrossRef
  • Descriptive Epidemiology and Prognostic Significance of Diaphragm Thickness in the General Population: The Nagahama Study
    Yasuharu Tabara, Takeshi Matsumoto, Kimihiko Murase, Takahisa Kawaguchi, Kazuya Setoh, Tomoko Wakamura, Toyohiro Hirai, Kazuo Chin, Fumihiko Matsuda
    Journal of Cachexia, Sarcopenia and Muscle.2025;[Epub]     CrossRef
  • Diaphragm thickness and ICU admission risk in elderly COVID-19 patients: a CT-based analysis
    Mercan Tastemur, Cagla Ozdemir, Esin Olcucuoğlu, Gunes Arik, Ihsan Ates, Kamile Silay
    BMC Pulmonary Medicine.2025;[Epub]     CrossRef
  • Definition, diagnosis, and treatment of respiratory sarcopenia
    Shinjiro Miyazaki, Akira Tamaki, Hidetaka Wakabayashi, Hidenori Arai
    Current Opinion in Clinical Nutrition & Metabolic Care.2024; 27(3): 210.     CrossRef
  • Diaphragm Ultrasound in Different Clinical Scenarios: A Review with a Focus on Older Patients
    Carmine Siniscalchi, Antonio Nouvenne, Nicoletta Cerundolo, Tiziana Meschi, Andrea Ticinesi
    Geriatrics.2024; 9(3): 70.     CrossRef
  • Appropriate body position and site for diaphragm ultrasound: Comparison with inspiratory mouth pressure
    Kazunori Okada, Akiko Kamiya, Yusuke Yanagi, Masahiro Nakabachi, Yasuhiro Hayashi, Michito Murayama, Sanae Kaga
    WFUMB Ultrasound Open.2024; 2(2): 100052.     CrossRef
  • Evaluation of the Functional Reserve and Exercise Tolerance in Patients with CHF in Clinical Trials (Consent Document of the Editorial board of the Journal of Cardiology, the Board of the Society of Specialists in Heart Failure (SSHF) and Working Group “N
    Yu. L. Begrambekova, G. P. Arutynov, M. G. Glezer, N. A. Karanadze, E. A. Kolesnikova, T. A. Lelyavina, A. S. Lishuta, Ya. A. Orlova, Yu. N. Belenkov
    Kardiologiia.2024; 64(7): 4.     CrossRef
  • Validating respiratory sarcopenia diagnostic criteria by mortality based on a position paper by four professional organizations: Insights from the Otassha study
    Takeshi Kera, Hisashi Kawai, Manami Ejiri, Keigo Imamura, Hirohiko Hirano, Yoshinori Fujiwara, Kazushige Ihara, Shuichi Obuchi
    Geriatrics & Gerontology International.2024; 24(9): 948.     CrossRef
  • Evaluating Respiratory Muscle Strength in Sarcopenia Screening among Older Men in South Korea: A Retrospective Analysis
    Tae Sung Park, Sa-Eun Park, Ki-Hun Kim, Sang Hun Kim, Myung Hun Jang, Myung-Jun Shin, Yun Kyung Jeon
    The World Journal of Men's Health.2024; 42(4): 890.     CrossRef
  • Tongue pressure, respiratory muscle and limb strength and functional exercise capacity in oesophageal cancer
    Takuya Fukushima, Makoto Yamasaki, Nobuyuki Yamamoto, Yasuaki Arima, Takashi Harino, Soshi Hori, Yuki Hashimoto, Masaya Kotsuka, Kentaro Inoue, Kimitaka Hase, Jiro Nakano
    BMJ Supportive & Palliative Care.2024; 14(4): 434.     CrossRef
  • 5,282 View
  • 33 Download
  • 10 Web of Science
  • 11 Crossref

Letter to the Editor

Pain & Musculoskeletal rehabilitation

  • 693 View
  • 32 Download
Original Article

Cardiopulmonary rehabilitation

Effect of Pre- and Post-Dialysis Exercise on Functional Capacity Using Portable Ergometer in Chronic Kidney Disease Patients
Tae-Seok Chae, Da-Sol Kim, Myoung-Hwan Ko, Yu Hui Won
Ann Rehabil Med 2024;48(4):239-248.   Published online August 30, 2024
DOI: https://doi.org/10.5535/arm.240005
Objective
To assess whether performing exercises during hemodialysis reduces the risk of developing intradialytic hypotension and enhances exercise capacity in patients with chronic kidney disease.
Methods
This study included patients aged ≥18 years undergoing hemodialysis. Participants performed exercises using a portable lower extremity ergometer during hemodialysis sessions for 3 weeks. Data regarding walking distance, knee strength, quality of life, fat-free mass, arterial pressure, blood pressure, heart rate, frequency of intradialytic hypotension, fatigue, and duration of hemodialysis were collected and analyzed.
Results
Significant improvements in walking distance and knee strength were observed following the implementation of exercise training during hemodialysis. Although there was no significant reduction in the frequency of intradialytic hypotension, a decreasing trend was noted. Other parameters such as quality of life and fatigue did not show significant changes.
Conclusion
Using a portable ergometer during hemodialysis improved exercise capacity and knee strength in patients with chronic kidney disease. There was a trend toward reduced intradialytic hypotension, suggesting potential cardiovascular benefits. Further research with larger sample sizes is needed to confirm these findings.

Citations

Citations to this article as recorded by  
  • Can exercise reduce fatigue in people living with kidney disease?
    Thomas J. Wilkinson, Lisa Ancliffe, Jamie H. Macdonald
    Current Opinion in Clinical Nutrition & Metabolic Care.2025; 28(3): 200.     CrossRef
  • 2,971 View
  • 31 Download
  • 1 Web of Science
  • 1 Crossref
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