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Social isolation and loneliness greatly contribute to negative health consequences in older adults. Technological solutions can be an asset in promoting social connections and healthy behaviours. This paper presents an innovative structure for an Internet of Things (IoT) platform specifically tailored for older persons. The framework utilises a supervised learning algorithm to classify users into four identified profiles to facilitate the adoption and engagement of technology. The platform incorporates wearables, such as socks and smart bands, to track physical activity, and a messaging module to encourage social interaction. The platform processes the acquired data to quantify steps and deliver tailored interventions remotely to the older adults through the AGAPE Assistant, the mHealth solution of the platform. Furthermore, the AGAPE Assistant has a user interface design for older adults, with a focus on their specific needs. Additionally, improving digital literacy among older adults is crucial for maximizing the long-term compliance and benefits of such technological solutions. On the other hand, AGAPE Monitor is a web application used by formal caregivers to configure the tailored interventions. The platform's usability was assessed using different usability scale questionnaires, which revealed a mild level of user satisfaction and acceptance. The proposed framework is currently being deployed on more than 112 older adults across three countries: Italy, Romania, and Portugal. The proposed framework provides a holistic solution to encourage active ageing by adopting technology, implementing hybrid interventions, and promoting social interactions. [ABSTRACT FROM AUTHOR]

(1) Background: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a tool designed to measure disability in accordance with the International Classification of Functioning, Disability and Health. Measuring disability is becoming increasingly important due to its high prevalence, which continues to rise. Rehabilitation interventions can reduce disability and enhance functioning. (2) Objective: The present study aims to assess the impact of rehabilitation interventions on reducing disability, as measured by the WHODAS 2.0 questionnaire. It also seeks to identify which specific rehabilitation interventions are more effective and to explore other disability assessment questionnaires. (3) Methods: Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a systematic review, with the protocol registered with the identifier CRD42023495309, focused on "WHODAS" and "rehabilitation" using PubMed and Web of Science electronic databases. (4) Results: We identified 18 articles from various regions encompassing patients with various health conditions, related to stroke, the cardiovascular system (cardiovascular disease, chronic heart failure), the pulmonary system (chronic obstructive pulmonary disease), the neurologic system (Parkinson's disease, cerebral palsy, neurodegenerative disease), the musculoskeletal system (orthopaedic surgery), cancer, and chronic pain, and among frail elderly. These patients have received a wide range of rehabilitation interventions: from conventional therapy to virtual reality, robot-assisted arm training, exergaming, and telerehabilitation. (5) Discussion and Conclusions: A wide range of rehabilitation techniques can effectively improve disability with various comorbidities, offering numerous benefits. The WHODAS 2.0 questionnaire proves to be an efficient and reliable tool for measuring disability, and scores have a tendency to decrease after rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Sarcopenia is a syndrome characteristic in elderly patients and is also associated with a significant proportion of chronic disorders such as inflammatory bowel disease (IBD). In this case, it can lead to a worse prognosis of the disease and a decreased quality of life. Study Aim: This study aims to identify the best ways to diagnose sarcopenia in patients with IBD, establish its impact on the course of the disease, and find preventive methods to counteract the effects of sarcopenia in the outcome of patients with IBD and, therefore, minimize disabilities and increase the health-related quality of life (HRQoL). Material and Methods: A systematic review with the Prospero registration number CRD42023398886 was performed in PubMed and Web of Science databases, evaluating all original articles published in the last 10 years (clinical trials and randomized control trials) that describe sarcopenia and IBD in the human adult population. Results: From the 16 articles that were included, 5 articles defined sarcopenia by the skeletal muscle index (SMI) and reported data regarding its correlation with body composition: BMI; visceral fat (VF); subcutaneous fat (SC); and VF/SC index. Other articles evaluated the link between sarcopenia and the total psoas muscle area, thigh circumference, calf circumference, subjective global assessment, hand grip strength, and appendicular SMI, alongside inflammatory markers such as IL-6 and C-reactive protein, level of disability, malnutrition, frailty, resistance training alone and in combination with whey protein, and infliximab treatment. Discussions and Conclusions: There is a great heterogeneity regarding the assessment criteria and methods used to diagnose sarcopenia due to the variability of population characteristics, both anthropometric and socio-cultural, alongside the high variability in the cut-offs. Therefore, any method which identifies sarcopenia in IBD patients, thus enabling intervention, may provide good results for patient quality of life and outcomes. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate the effectiveness of radial extracorporeal shock wave therapy (rESWT) and conventional physical therapy (CPT) protocol on the gait pattern in stroke survivors through a new gait analysis technology. Fifteen (n=15) stroke survivors took part in this prospective, observational study and were assessed clinically and through an instrumented treadmill before and after rESWT and CPT. Spasticity grade 95% CI 0.93 (0.79 +/- 1.08), pain intensity 95% CI 1.60 (1.19 +/- 2.01), and clonus score decreased significantly 95% CI 1.13 (0.72 +/- 1.54). The sensorimotor function 95% CI -2.53 (-3.42 +/- 1.65), balance 95% CI -5.67 (-6.64 +/- - 4.69), and gait parameters were enhanced at the end of the program. Step length 95% CI -3.47 (-6.48 +/- 0.46) and step cycle were improved 95% CI -0.09 (-0.17 +/- -0.01), and hip 95% CI -3.90 (-6.92 +/- -0.88), knee 95% CI -2.08 (-3.84 +/- -0.32) and ankle flexion-extension 95% CI -2.08 (-6.64 +/- -4.69) were augmented. Adding the quantitative analysis to the clinical assessment, we gained easy access to track progress and obtained an individualized therapeutic approach for stroke survivors. [ABSTRACT FROM AUTHOR]

Introduction. With age, sex hormone deficiency leads to reduced bone mineral density (BMD) in men. The aim of our research is to analyze the role of serum sex steroids in assessing BMD in the men included in this study. Materials and methods. This cross-sectional study included 146 men aged 65-85 years old with osteopenia or osteoporosis (study group) and 121 men with normal BMD (control group). Serum levels of total testosterone (Tt) and free testosterone (Tf) were measured by immunoassay, and estradiol (E2) levels were measured by the immunoenzymatic method. Femoral neck and lumbar spine BMD was examined by dual-energy X-ray absorptiometry. Results. Tf and E2 deficiency was significantly associated with low BMD (p=0.007). No association was found between Tt deficiency and reduced BMD. Tf levels (p

Psoriasis is a complex immune-mediated inflammatory disorder that generates enormous interest within the scientific communities worldwide, with new therapeutic targets being constantly identified and tested. Despite the numerous topical and systemic medications available for the treatment of psoriasis, alternative therapies are still needed for the optimal management of some patients who present with localized, resistant lesions. Novel insights into the contribution of cutaneous neurogenic inflammation in the pathogenesis of psoriasis have yielded exciting new potential roles of nerve-targeting treatments, namely botulinum toxin type A (BoNT-A), for the management of this disease. This paper aims to review the existing literature on knowledge regarding the potential role of BoNT-A in psoriasis treatment, with a focus on its ability to interfere with the immunopathogenetic aspects of psoriatic disease. Furthermore, in our paper, we are also including the first report of psoriatic lesions remission following local BoNT-A injections that were administered for treating upper limb spasticity, in a patient that concomitantly suffered from psoriasis and post-stroke spasticity. [ABSTRACT FROM AUTHOR]

Post-COVID-19 telogen effluvium has been largely reported as a sequela in the post-acute phase of COVID-19, causing major emotional distress among the affected patients. The affected individuals are further exposed to a vast amount of misinformation from the internet and social media and it is important for physicians to be familiar with the phenomenon and provide appropriate counselling to their patients regarding this condition. This article aims to review the evidence-based complementary strategies that can help enhance hair regrowth after post-COVID-19 hair loss, from psychological support and patient education to the importance of optimal nutrition and potential indications and benefits of oral nutritional supplementation, as well as the role of both topical and injectable hair growth stimulators. [ABSTRACT FROM AUTHOR]

Substantiation: Pediatric rehabilitation is a field where child’s compliance is closely related to the parent’s one, and, for a successful therapy, it is necessary to convey the information and include the parent in the process. Therefore, it is important to know the degree of parent involvement. Objective: Assessment of the degree of parents’ compliance with the method of therapy induction during the period of child hospitalization for rehabilitation treatment. Materials and methods: One used an anonymous questionnaire with 23 questions and preformulated answers. One used statistical analysis with Excel software. Results: In most of the cases, mothers are those who accompany children to therapy, show interest in their involvement in the therapeutic programme after discharge, deem that the induction method and communication with the therapist and the medical team are very important. Children age and pathology were assigned to 5 categories. A significant segment of the participants in the study acknowledged the need to continue the programme at home but approached a healthcare professional for this. A small number did not continue the programme at home. Conclusions: mothers are open to continuing the therapy programme at home, the hospitalization period should be increased and access to outpatient pediatric services should by improved. [ABSTRACT FROM AUTHOR]

Objectives: Regular physical activity (PA) is considered important after total hip and knee arthroplasty (THA/TKA). Objective was to systematically assess literature on recommendations given by healthcare professionals to persons after THA and TKA and to provide an overview of existing interventions to stimulate PA and sports participation. Methods: A systematic review with a narrative synthesis including articles published between January 1995 and January 2021 reporting on recommendations and interventions. The PubMed, Embase, CINAHL and PsycInfo databases were systematically searched for original articles reporting on physical activity and sports recommendations given by healthcare professionals to persons after THA and TKA, and articles reporting on interventions/programs to stimulate a physically active lifestyle after rehabilitation or explicitly defined as part of the rehabilitation. Methodological quality was assessed with the Mixed Methods Appraisal Tool (MMAT). The review was registered in Prospero (PROSPERO:CRD42020178556). Results: Twenty-one articles reported on recommendations. Low-impact activities were allowed. Contact sports, most ball sports, and martial arts were not recommended. One study informed on whether health-enhancing PA recommendations were used to stimulate persons to become physically active. No studies included recommendations on sedentary behavior. Eleven studies reported on interventions. Interventions used guidance from a coach/physiotherapist; feedback on PA behavior from technology; and face-to-face, education, goal-setting, financial incentives and coaching/financial incentives combined, of which feedback and education seem to be most effective. For methodological quality, 18 out of 21 (86%) articles about recommendations and 7 out of 11 (64%) articles about interventions scored yes on more than half of the MMAT questions (0–5 score). Conclusion: There is general agreement on what kind of sports activities can be recommended by healthcare professionals like orthopedic surgeons and physiotherapists. No attention is given to amount of PA. The same is true for limiting sedentary behavior. The number of interventions is limited and diverse, so no conclusions can be drawn. Interventions including provision of feedback about PA, seem to be effective and feasible. [ABSTRACT FROM AUTHOR]

Lately, easier and shorter tests have been used in the functional evaluation of cardiac patients. Among these, walking speed (WS) and Timed Up and Go (TUG) tests are associated with all-cause mortality, mainly cardiovascular and the rate of re-hospitalization, especially in the elderly population. We prospectively analyzed a group of 38 patients admitted to the Cardiology Clinic from Elias Hospital, Romania, with chronic coronary syndrome (CCS) (n=22) and STEMI (n=16). We assessed the patients immediately after admission and before discharge with G-WALK between the 1st and 30th of September 2019. Our study group had a mean age of 62.7±12.1 years. Patients with a low WS were older (69.90±12.84 vs. 59.90±10.32 years, p=0.02) and had a lower serum hemoglobin (12.38±1.20 vs. 13.72±2.07 g/dl, p=0.02). The WS significantly improved during hospitalization (p=0.03) after optimal treatment. The TUG test performed at the time of admission had a longer duration in patients with heart failure (14.05 vs. 10.80 sec, p=0.02) and was influenced by patients' age (r=0.567, p=0.02), serum creatinine (r=0.409, p=0.03) and dilation of right heart chambers (r=0.399, p=0.03). WS and TUG tests can be used in patients with CCS and STEMI, and are mainly influenced by age, thus having a greater value among the elderly. [ABSTRACT FROM AUTHOR]

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The aim of this case report is to present an early individualized rehabilitative plan for a post-stroke patient with limb spasticity given that stroke is a leading cause for disability that involves prolonged hospital stay and neurorehabilitation strategies. The rehabilitation plan consisted of conventional physical therapy and radial extracorporeal shock wave therapy (rESWT), and the results were evaluated through clinical assessment together with an innovative gait analysis system. Two rESWT sessions and conventional physical therapy program decreased spasticity grade and pain intensity, and improved ankle range of motion, balance and gait. [ABSTRACT FROM AUTHOR]

Background/Aim: Lumbar radiculopathy refers to the disruption of one or more lumbosacral nerve root functions, usually causing radiating pain and functional impairments. Patients and Methods: We aimed to analyze the role of repetitive peripheral magnetic stimulation (rPMS) alone or in association with physiokinesiotherapy (PKT) in treating lumbar radiculopathy. A total of 41 patients diagnosed with lumbar radiculopathy were randomly allocated to the rPMS group and the rPMS plus PKT group. Subjects were then administered a total of 10 treatment sessions. Results: A statistically significant improvement was highlighted in both groups in terms of pain score, and electromyography (EMG) analysis depicted a far superior functional recovery in the rPMS plus PKT group. Conclusion: rPMS can constitute an effective treatment for subjects with lumbar radiculopathy and its association with a complex physical rehabilitation program could improve the outcome in these patients. [ABSTRACT FROM AUTHOR]

Background. It is considered relevant to contextualize the health care process to amputated people since the hospitalization until the acquisition of the prosthesis to adapt to the new living condition and determine the bioethical aspects involved in this process. In that sense, the research question in this study was: how did health care to people submitted to limb amputation take place from the perspective of bioethical analysis? And the study objectives were: to analyze the care delivered by health professionals throughout the amputation process from the perspective of the amputees and discuss the health care process for amputated people from the perspective of bioethical analysis. Aims. The overall objective of the standards and guidelines is to establish a basis for the provision of a service of excellence to the amputee population with equity of access throughout the Romania. It also aims to assist clinical governance and service development with standards presented in a format easily accessible for audit purposes. Methods. A qualitative, descriptive and exploratory study was conducted through semi-structured questionnaires with 175 people undergoing amputation in the period 2008-2020, in SC. Theranova Protezare SRL in Romania. The objectives were to analyze the care provided by health professionals throughout the amputation process in the perspective of the amputee patient; and discuss the process of health care to the person with amputation in the bioethical analysis perspective. Data were analyzed according to content analysis. Three thematic categories emerged: the process of amputation; team performance and rehabilitation. Bioethics permits reflection on the care provided to amputees and problematizes the relationship of the health care process with support available through public health policies. The professional involved in this process has to take responsibility for putting the process in practice and interdisciplinary is essential for the recovery of the amputated patient. Results. It was verified that the causes leading to amputation can be triggered by a chronic illness as well as by trauma, the latter determined by external causes. Despite different motives for the amputation, however, the care process is the same. In other words, based on the statements, it can be inferred that, despite the stakeholders’ different ages and needs, both end up in the same health care context: slow and fragmented. Conclusions. In addition, in the interval of almost twelve years since they were submitted to the respective amputation, a precarious situation of physical, social and economic independence was evidenced. In short, these qualitative research results do not permit generalizations but questions: is these people’s right to socio-professional integration being guaranteed? The question is: the amputated people and/or the health team’s lack of knowledge, or the disorganization of the health care process? [ABSTRACT FROM AUTHOR]

Objective: We evaluated the effects of neuromuscular electrical stimulation (NMES) therapy on functional capacity and oxidative stress in patients hospitalized for acute heart failure (AHF). Design: We included 30 consecutive patients admitted for AHF with a left ventricular ejection fraction ≤ 50% who were randomized into two groups: NMES therapy added on conventional rehabilitation (CR) (n = 15, 67.2 ±13.35 years) and CR alone (n = 15, 63.26 ± 10.29 years). NMES therapy was performed at the level of the quadriceps muscle bilaterally, daily, for 60 minutes with a frequency of 10 Hz. Results: The mean duration of NMES therapy was 6.93 ± 2.54 days. Functional capacity assessed by the 6 minute walk test was significantly improved in the group with NMES therapy (p=0.036). The oxidized LDL value showed a decreasing trend compared to the admission value in the group with NMES therapy, but without statistical significance. Conclusion: This paper shows that for patients with AHF, NMES therapy used for a short term and initiated early during the hospitalization period improves exercise tolerance, suggesting the importance and possible necessity of including it as standard cardiac recovery therapy. NMES did not influence the plasmatic value of oxidized LDL. [ABSTRACT FROM AUTHOR]

In the context of the onset of the COVID-19 pandemic, the European Commission adopted a series of measures meant to ensure a good cooperation between member states, which target both cross-border medical assistance and the financing and procurement of monetary resources necessary for the efficiency and cover of medical services required for the treatment of patients affected by this virus. In order to support this endeavor, conventions were adopted for the medical assistance of cross-border patients and for the acknowledgement of the medical professionals' qualifications, as well as for the formation of emergency medical teams with the aim of coordinating and financing cross-border medical assistance and emergency transport of patients infected with COVID-19. [ABSTRACT FROM AUTHOR]

The premises for adopting Decree no. 195 of March 16, 2020 regarding the establishment of the state of emergency on Romanian territory were the evolution of the epidemiological situation in Romania and the assessment of public health risks for the next period. This indicated a massive increase in the number of people infected with the SARS-CoV coronavirus 2, and considering the fact that failure to take urgent, exceptional social and economic measures to limit the infection with SARS-CoV-2 coronavirus among the population would have had a particularly serious impact, mainly on the right to live, and, alternatively, on the individuals' right to health. [ABSTRACT FROM AUTHOR]

Oxidative stress is an imbalance of oxidants/antioxidants in favor of oxidants as stated by Sies in 1985, and may arise due to excessive sports, physical and mental stress, high altitude exposure, diets, temperature variations, extreme cold or heat weather, smoking, hypoxia, immobilization stress and so on. It is also the main cause of the most common illnesses of the current age: cardiovascular disease, diabetes, infection, chronic fatigue syndrome, depression, malignancy, and neurodegenerative disorders. The early determination of oxidative stress, although important for health, is not always simple and often requires laborious and expensive analysis. Biocrystallization, also called sensitive crystallization, is a simple and inexpensive qualitative method used for almost 100 years in the study of herbs, foods and also in human health for orientation of diagnosis. The method also allows a rapid assessment of the therapeutic effectiveness of remedies or recommended procedures for patients with a certain pathology. In this paper we are looking to answer the following question: is it possible to use this method in order to assess the level of oxidative stress induced by varying environmental or internal factors and to observe the efficiency of the treatment? [ABSTRACT FROM AUTHOR]

The aim of this study is to provide information about Paralympians and the importance of their prosthetic devices. Many people today are encouraged to take part in some kind of sport activity, because many studies have shown that these activities have a positive influence on several aspects of one's life; improving physical health and also self-esteem, but also helps to reduce stress levels, improving concentration and problem-solving skills. A special category of people who are practicing some kind of sport activities are people who have suffered a limb loss or socalled amputation. Most of them having been very active people and practicing sport even before the amputation, have returned to their activities and are still competing in para sport activities. The methods used are interviewing the candidates and as materials we have written a series of questions that were sent to each of them. Working in the field of prosthetics and having the chance to work with such motivated people, we have tried to conclude the importance of using a prosthetic device in such activities. [ABSTRACT FROM AUTHOR]

Most studies on patients with normal pressure hydrocephalus (NPH) regard pre-post Tap test and long-term follow-up after shunt surgery. Quantitative and qualitative assessment tools specific to rehabilitation medicine can provide an objective measurement of the benefit of the neurosurgical intervention at 1-month follow-up. The aim of this retrospective study was to assess the early benefit of the ventriculoperitoneal shunt with low or medium pressure valve on the gait capacity of persons with NPH, one month after surgery. This is a retrospective study reviewing 19 inpatients with NPH who underwent neurosurgery for ventriculoperitoneal shunt with low or medium pressure valve, one month after a positive result on a tap test, in a 5-year period. The assessments regarding the gait abilities were performed 24 hours before the surgical intervention and one month after surgery. Assessment tools used were: the 3 meters Timed Up and Go Test (TUG), the 10 Meters Walking Test (10MWT) and the Berg Balance Scale. A positive response to the tap test predicted improvements of gait and balance in patients with NPH after shunt surgery. Best results in regards to gait and balance are achieved when early diagnosis and intervention are performed. Complex comorbidities generate and enhance significant and persistent gait impairment. [ABSTRACT FROM AUTHOR]

VITAMIN D DEFICIENCY IS ASSOCIATED WITH POOR MUSCULOSKELETAL FUNCTION IN THE ELDERLY, INCREASING THE LIKELIHOOD OF FALLS AND FRACTURES. VITAMIN D ADMINISTRATION INCREASES MUSCLE STRENGTH AT ALL LEVELS AND IMPROVES BALANCE. ACTIVE CORRECTION OF VITAMIN D DEFICIENCY IS AN ESSENTIAL MEASURE WITH CONSIDERABLE IMPACT ON THE HEALTH OF THE ELDERLY. [ABSTRACT FROM AUTHOR]

B Correction to: Eur Rev Aging Phys Act 19, 7 (2022) b B https://doi.org/10.1186/s11556-022-00285-1 b Following the publication of the original article [[1]] the authors reported that given name of one of the PAIR study group members Nikolay Toselli is not correct. Reference 1 Mooiweer Y, Stevens M, van den Akker-Scheek I. Being active with a total hip or knee prosthesis: a systematic review into physical activity and sports recommendations and interventions to improve physical activity behavior. [Extracted from the article]

Stroke remains one of the leading causes of disability in adults, and lower limb spasticity, affected stance, and balance impact everyday life and activities of such patients. Robotic therapy and assessment are becoming important tools to clinical evaluation for post-stroke rehabilitation. The aim of this study was to determine in a more objective manner the effects of visual feedback balance training through a balance trainer system and radial extracorporeal shock wave therapy (rESWT), along with conventional physiotherapy, on lower limb post-stroke spasticity, trunk control, and static and dynamic balance through clinical and stabilometric assessment. The study was designed as a randomized controlled trial. The experimental group underwent conventional physiotherapy, visual feedback balance training, and rESWT. The control group underwent conventional physiotherapy, visual feedback training and sham rESWT. The statistical analysis was performed using GraphPad Software and MATLAB. Primary clinical outcome measures were The Modified Ashworth Scale (MAS), passive range of motion (PROM), Visual Analogue Scale (VAS), and Clonus score. Secondary outcome measures were trunk performance, sensorimotor, and lower limb function. Stabilometric outcome measures were trunk control, static balance, and dynamic balance. Visual feedback training using the Prokin system and rESWT intervention, along with conventional physiotherapy, yielded statistically significant improvement both on clinical and stabilometric outcome measures, enhancing static and dynamic balance, trunk performance, sensorimotor outcome, and limb function and considerably diminishing lower limb spasticity, pain intensity, and clonus score in the experimental group. [ABSTRACT FROM AUTHOR]

Objectives: Stroke is followed by an inflammatory response lasting up to several months. Moreover, many of the stroke-related comorbidities (i.e., diabetes mellitus, dyslipidemia, cardiovascular disease, and atherosclerosis) are characterized by an pro-inflammatory status. Material and Methods: We designed this pilot study to evaluate the relation between the consumption of a nutritional supplement (ALAnerv®) and the dynamic of the inflammatory status in post-acute stroke patients undergoing rehabilitation. The study population comprised 28 patients which were assigned into two study groups, named (-) ALA and (+) ALA. All subjects followed the same rehabilitation program. There were no significant differences in respect to the standard medication between the groups. Moreover, patients from the (+) ALA group received ALAnerv® for two weeks (2 pills/day). We assessed IL-1α, IL-6, TNF-α, sICAM-1, and myeloperoxidase in blood samples taken at the beginning and at the end of the study period. Outcomes: In the (+) ALA group only IL-1α (- 9.9% ± 3.7, P = 0.013) and IL-6 (- 26.5% ± 8.2, P = 0.003) significantly decreased during the study period. The multiple regression analysis indicated that the ALAnerv® treatment was responsible for the significant decrease of IL-6 level (P = 0.008). Moreover, the percentage of IL-6 variation between the study groups reached statistical significance (8.4% ± 11.5 vs. - 26.5% ± 8.2, P = 0.034). Conclusions: These results indicate that ALAnerv® could be beneficial for the correction of the inflammatory status in post-acute stroke patients and underline the need of a longer treatment period with a higher dose. [ABSTRACT FROM AUTHOR]

In this study, it was achieved a parallel between one of the most used protocol for testing anaerobic effort capacity called the Wingate Test and the Total Work Performed Test, proposed by Szogy and Cherebetiu , which is used in Romania for about 4o years ago in order to estimate the top athletes. For this study the athletes performed only one 45 seconds maximal effort whereas data issued by the Monark cyclo-ergometer soft have been used to obtain both the significant parameters considered by the TW authors and the ones showed by Szogy and Cherebetiu within the Total Work Performed Test. This study results shoed high significant positive correlations existed between the Peak Power and the Total Work Performed on 10 seconds also between the Total Work Performed on 45 seconds and the Average Power on 30" (p<0.05 for all correlation coefficients). [ABSTRACT FROM AUTHOR]

Background. Postural stability and dynamic balance can be the gradual indicators of some neurological dysfunctions, the normality, or of some exceptional aptitudes (performance shooting, circus arts etc.), provided that they are objectively assessed. Aims. To identify the marks, the deviations and the way of scaling the frequency spectrums of the gravity center projection oscillations on the postural sustentation surface, in subjects apriorically representing different categories (from the postural stability and the dynamic balance points of view). Methods. Complex podometric investigations, on platforms and on carpets with pressure sensor matrices (about 10,000 sensors and a processing sofware), of the mechanogram and frequency density of the gravity center projection oscillations. Subjects were divided into four samples, as follows: a non-randomized sample made up of 30 subjects belonging to the statistical population called "healthy youth practicing sports (but not at the performance level) on a regular or moderate basis"; a sample of 30 "shooters (performance athletes)", with a rich experience in sports training and competitions; a sample of 30 persons diagnosed with sight impairments and a sample of 30 persons with dental pathology aspects. The standard postural indicators, with and without visual control, the balance dynamics in normal walking and the pressure distribution on soles (with a topographic scanning) were recorded. The computer-based processing assessed 18 intrinsic or relative parameters of postural stability and dynamic balance in normal walking. Results. Significant differences, at an acceptable threshold (p>0.05), among the investigated samples, regarding the postural stability classes (normostability, hyperstability, hypostability and instability), were obtained only for the histograms of the frequency density of the control and regulation feed-back systems. The synthetical indicators, the most relevant for the dynamic balance labeling, particularly the walking ones, seemed to be the gravity center projection trace on the sustentation surface and the gravity center position changing speed. Conclusions. There was a significant negative correlation (Cohen large coofficient = -0.65) between the frequency density in the somesthesic zone and the postural stability quality. In other words, the significant improvement of the postural stability quality is associated with the diminution of the low frequency oscillation incidence, which is probably due, to a great extent, to the somesthesic feed-backs, and less to the causal relation. The graphs of the frequency density show that the visual feedback has a tendency to increase its role in the postural stability adjustment in athletes, as compared to the control group, and a tendency to diminish its role in subjects with sight impairments or with dental pathology aspects. There are not significant statistical differences regarding the density of the oscillations controlled at the vestibular level, among the analyzed categories of subjects. It is hypothesized therefor that the postural stability degradation tendency is greater on the anterior-posterior plan than on the lateral one. [ABSTRACT FROM AUTHOR]

The purpose of this systematic review and meta-analysis is to evaluate the long-term efficacy of Extracorporeal Shock Wave Therapy (ESWT) on reducing lower limb post-stroke spasticity in adults. A systematic electronic search of PubMed/ MEDLINE, Physiotherapy Evidence Database (PEDro), Scopus, Ovid MEDLINE(R), and search engine of Google Scholar was performed. Publications that ranged from January 2010 to August 2020, published in English, French, Spanish, Portuguese, and Italian language and available as full texts were eligible for inclusion and they were searched without any restrictions of country. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines and followed the recommendations of the Cochrane Handbook for Systematic Reviews of Interventions. Two authors screened the references, extracted data, and assessed the risk of bias. The primary outcome was spasticity grade mainly assessed by the Modified Ashworth Scale (MAS). Secondary outcomes were passive range of motion (PROM), pain intensity, electrophysiological parameters, gait assessment, and adverse events. A total of seven recent randomized controlled trials (RCTs) were included in the systematic review and meta-analysis, and a beneficial effect on spasticity was found. The high level of evidence presented in this paper showed that ESWT ameliorates spasticity considering the parameters: MAS: standardized mean difference (SMD) = 0.53; 95% confidence interval (95% CI): (0.07–0.99); Modified Tardieu Scale (MTS): SMD = 0.56; 95% CI: (0.01–1.12); Visual Analogue Scale (VAS): SMD = 0.35; 95% CI: (−0.21–0.91); PROM: SMD = 0.69; 95% CI: (0.20–1.19). ESWT presented long-term efficacy on lower limb post-stroke spasticity, reduced pain intensity, and increased range of motion. The effect of this novel and non-invasive therapy was significant and the intervention did not present adverse events, proving a satisfactory safety profile. [ABSTRACT FROM AUTHOR]

Cerebral palsy is one of the most important causes of disability in children. Intensive rehabilitation in cerebral palsy is personalized in accord with the deficits, activity limitations and participation restrictions, but an early etiological and clinical diagnosis in a multidisciplinary approach, to differentiate cerebral palsy from other causes of neurodevelopmental disorders, is required to direct the pharmacological approach and prognosis. This paper presents the first study on a Romanian population in terms of the most relevant cerebral palsy risk factors and their relation to the age when cerebral palsy was diagnosed, aiming to support a possible early diagnosis prediction model. Retrospective study conducted on a group of 320 children diagnosed with developmental disorder admitted to the Department for Children Neuro-Psychomotor Rehabilitation of the Psychiatry Hospital in Sibiu during 2015-2018. The number of neurodevelopmental disorders generated by cerebral palsy in the examined group is relatively small (11.56%). The highest proportion of neurodevelopmental disorders in children with cerebral palsy (according to the subsequent diagnosis) was seen in children born under 30 weeks of pregnancy, exhibiting perinatal intracranial hemorrhage and displaying increased muscle tone and seizures. The study establishes correlations between the variables assessed, which may point to a formula for predicting the diagnosis of cerebral palsy in children initially examined for a developmental disorder. [ABSTRACT FROM AUTHOR]

Background: The number of people living with dementia is rapidly increasing. With dementia's impact on memory, communication, and self-identity, it is important to identify ways of meeting individual needs of diagnosed individuals and their caregivers. This study will test a new intervention, SENSE-GARDEN, that integrates autobiographical music, films, pictures, and scents with innovative technology to create an immersive environment tailored specifically for the individual. Objective: The SENSE-GARDEN study is an Active Assisted Living Program–funded multicenter project. The primary objective of the study is to assess whether a personalized, innovative technology-based intervention can improve the well-being of older adults living with moderate to severe dementia. The study will also assess whether the intervention can improve coping and reduce burden in caregivers. Methods: A controlled before-after study design will be used. There will be 3 sites in 3 trial countries: Belgium, Norway, and Portugal. A total of 55 people with dementia (PWDs) will be recruited. All eligible participants for the study will be randomized into the intervention or control group. For the first three months of the study, all participants will receive the SENSE-GARDEN intervention. For the final month of the study, the intervention group will continue visits to the SENSE-GARDEN, and the control group will discontinue visits. A mixed-methods approach will be used, including the use of standardized outcome measures, quantitative physiological data, and qualitative interview data. Results: The trials commenced recruitment in August 2019, and all data are expected to be collected by the end of May 2020. A user-centered design process is underway, with results from the first phase of user interviews indicating that people with mild cognitive impairment, family caregivers, and professional caregivers consider the SENSE-GARDEN to be a potentially valuable tool in providing numerous benefits to dementia care. Feasibility testing of the SENSE-GARDEN has been completed and results are expected to be published in October 2019. Conclusions: Findings from the SENSE-GARDEN trials will provide insights into the use of technology for personalizing interventions to the PWD. This will have potential implications on not only dementia research, but it may also have influences on care practice. International Registered Report Identifier (IRRID): DERR1-10.2196/14096 We help JMIR researchers to raise funds to pursue their research and development aimed at tackling important health and technology challenges. If you would like to show your support for this author, please donate using the button below. The funds raised will directly benefit the corresponding author of this article (minus 8% admin fees). Your donations will help this author to continue publishing open access papers in JMIR journals. Donations of over $100 may also be acknowledged in future publications. Suggested contribution levels: $20/$50/$100 [ABSTRACT FROM AUTHOR]

Idiopathic scoliosis evaluation remains a challenge for both the clinician and the patient for the entire period of morphological changes related to pubertal growth. Traditionally, idiopathic scoliosis evaluation and monitoring involves repeated exposure to X-rays, which can increase the risk of cancer in children. To reduce the consequences on human health, modern computer technology has developed non-invasive methods to monitor the evolution of scoliosis, such as raster-stereography, computerized photogrammetry and ultrasonography. The aim of the study is to identify, on the one hand, the methods of diagnosis and evaluation of scoliosis and, on the other hand, to present the advantages and disadvantages of each method, so that the clinician can establish an accurate diagnosis and risk-free monitoring over time. [ABSTRACT FROM AUTHOR]

Background. In recent years, gait rehabilitation research has focused on developing systems for central neurological diseases affecting the gait patterns of patients. However, most systems lack pelvis mechanisms that can control the rotational movements of the pelvis. RELIVE overground gait rehabilitation is a system designed to control obliquity. Aims. This study investigates how the alternator - the RELIVE’s subsystem that controls translational and rotational movement of the pelvis – influences gait in healthy subjects and is part of a more complex research. Methods. The study took place in 2021 in the Elias Emergency University Hospital and 15 healthy subjects participated. We used in-shoe sensors from Tekscan, for gathering data regarding plantar pressure distribution, during various gait sessions with the RELIVE system. The gait sessions included walking with hands alongside the body, with the alternator turned on or off and with different degrees of body weight support. The gathered data was statistically analyzed with IBM SPSS Statistics v28 tool. Results. When the alternator was turned on, the values of average plantar pressure decreased during the sessions characterized by walking hands free with the same percentage of body weight support. Statistically significant differences (p-value<0.05) were recorded comparing the gait sessions at 0 and 20% body weight offload. At 10% body weight offload, the differences were not statistically significant. Conclusions. The results showed that the alternator subsystem might be able to offload the participant’s weight to some extent. More investigations should be considered in the following studies, including more comparisons between other gait sessions. [ABSTRACT FROM AUTHOR]

Objectives: Stroke is a pathological condition associated with a redox imbalance. Both the acute and the post-acute phases after a stroke are characterized by a pro-oxidant state, which could be corrected through antioxidant supplementation. The aim of the present study was to evaluate the effect of the ALAnerv® upon the redox status of erythrocytes. Material and Methods: For this pilot study were enrolled 28 post-acute stroke patients. They were randomly divided into a control group [(-) ALA] and a study group [(+) ALA]. Patients were hospitalized for a period of two weeks. Blood samples were taken at the beginning and at the end of this period. Patients from (+) ALA group received the nutritional supplement ALAnerv®. Catalase, SOD, GPx, GRed and GT activities were assessed on erythrocytes' lysates. Also, the total antioxidant capacity as well as the concentration of total thiols were evaluated. Outcomes: During the study period only SOD (1393.48 ± 69.14 U/g Hb vs. 1514.06 ± 60.80) and GRed (4.47 ± 0.37 U/g Hb vs. 5.06 ± 0.24) significantly increased in (+) ALA group. Catalase (173.70 ± 14.62 k/g Hb vs. 123.41 ± 8.71) and GT (5.55 ± 0.26 U/g Hb vs. 4.95 ± 0.23) activities significantly decreased during the study period. Multiple regression indicated that only SOD, GT and GRed activities were influenced by the ALAnerv® consumption. There was no significant increase if the total thiols concentration. Conclusions: ALAnerv® consumption could be associated with a correction of the erythrocytes' redox status. There is a need to investigate if administration of ALAnerv® over a longer time period could have a more significant influence on the erythrocytes' antioxidant system. [ABSTRACT FROM AUTHOR]

Objectives: Diabetes mellitus is one of the most frequent stroke-related comorbid states, and it is characterized by accumulation of reactive carbonyl compounds (RCOs), leading to "carbonyl stress". This pilot study was aimed to evaluate the effect of the consumption of the nutritional supplement ALAnerv® on some serum carbonyl stress markers, as well as on the activity of erythrocytes' glyoxalases in post-acute stroke patients undergoing rehabilitation. Material and Methods: We created a study population of 28 patients, organized into (-) ALA and (+) ALA groups. Patients from (+) ALA group received ALAnerv® for two weeks (2 pills/day). All the subjects followed the same rehabilitation program. In both groups, blood samples were taken at the hospitalization and at the discharge moments, respectively. On these samples we assessed lactic acid, fructosamine and RCOs concentrations, as well as the activities of glyoxalases 1 and 2 from erythrocytes' lysates. Outcomes: In (-) ALA group the concentrations of fructosamine and RCOs significantly increased (0.90 ± 0.04 vs. 1.02 ± 0.04, p = 0.020; 0.19 ± 0.03 vs. 0.28 ± 0.07, p = 0.027) during the study period. Also, glyoxalase 2 activity decreased in this group (27.04 ± 6.10 vs. 14.43 ± 3.02, p = 0.027). In (+) ALA group, the variation of these parameters did not reach statistical significance. Only, the activity of Glo1, which catalyzes the rate-limiting step in the glyoxalase pathway, had an increasing trend in (+) ALA group. The percentage of variation of fructosamine between (-) ALA and (+) ALA groups reached statistical significance (14.8 ± 5.2 vs. - 1.0 ± 13.3, p = 0.047). Regression analysis indicated that the activity of glyoxalase 2 was significantly influenced by the treatment with ALAnerv® (p < 0.001), while the concentration of RCOs was significantly influenced by diabetes mellitus (p = 0.030). Conclusions: Our preliminary results suggest that ALAnerv® could be useful for the correction of the carbonyl stress status in post-acute stroke patients with diabetes. Also, this study underlines the need of a longer treatment period with a higher dose. [ABSTRACT FROM AUTHOR]

The physical rehabilitation of patients with cardiovascular pathology is poorly studied and developed in our country, especially in patients with heart failure. There are studies in the literature that confirm that a decrease in the grasping force of the hand is associated with an increase in morbidity and mortality. The physical deconditioning of patients with heart failure can be assessed with the help of the Amadeo robot, which is a device capable of measuring the flexion and extension force of the hand in kilograms. Material and methods. We prospectively analyzed a group of 44 patients diagnosed with heart failure class II-III NYHA who were hospitalized between June 17 and July 15, 2019 in the Cardiology Department of Elias Hospital. We evaluated the grasping force of the hand of patients with heart failure using the Amadeo robot. The Amadeo robot is a device used in the rehabilitation of stroke patients, which can measure the flexion and extension force of the hand using sensors attached to the hand and fingers. Results. By evaluating patients with heart failure using the Amadeo robot, the average value of the hand extension force was 2.364 kg at admission and 2.264 kg at discharge. The flex-ion force of the hand was 6.78 kg at admission and 7.361 kg at discharge. Patients enrolled in the study who had valvulopathies, atrial fibrillation and diabetes had a lower value of the extension force of the hand compared to patients with heart failure who did not have these pathologies. Patients with valvulopathies, high blood pressure, and ischemic heart disease also had a lower flexion strength than those without these diseases. Conclusions. It is known that the grasping force of the hand is an important indicator in assessing the fragility status of patients. Patients with heart failure are frail patients with multiple comorbidities in which physical deconditioning acts as a negative prognostic factor on morbidity, mortality, and increased hospitalization rates. Thus, the physical rehabilitation of patients with heart failure is essential for increasing the quality of life and also for decreasing morbidity and mortality and the rate of hospitalization. [ABSTRACT FROM AUTHOR]

Pain is the most important reason an individual seeks the help of a physician. It is a complex sensation which results from noxious stimulation by physical or chemical agencies. The subtle biochemical mechanisms of pain production have been well studied, and actual knowledge has helped us to better understand and treat pain. Pain appears only in the presence of a painful stimulus sensitizing the nociceptors - nervous cells capable of decoding the signal transmitted by the stimulus, transforming chemical into electrical energy. From this level, the painful signal is transmitted to the central nervous system where pain becomes a complex sensation, generating defense reactions. Physiological pain theories involve intense activity of sodium channels, TRP ion channels, sodium and potassium ions, among with many other physical and chemical mediators. Among this, the presence of acethilcoline, serotonine, histamine, plasma kinins, adenosin triphosphate, in different concentrations sensitizing the nociceptors, produce pain. Muscle pain appears during intense physical exercise, as a result of muscle fiber ability to receive and respond to a noxious stimulus. It is a normal evolution of intense physical exercise, under physiological circumstances, meaning the mismatching between the oxygen demand and offer at the muscle cell. With this review, we tried to open new research pathways to explore pain and muscle pain production and therapy. [ABSTRACT FROM AUTHOR]

Background. Stroke is a leading cause of long-term disability. Gait impairment post-stroke has a major implication for health and it is an essential predictor for functional independence. A common gait impairment is the presence of genu recurvatum in post-stroke patients, whether spastic or non-spastic. Aims. To evaluate the efficacy of the rehabilitation program and botulinum toxin upon gait spatial and temporal parameters, muscle spasticity, functionality of lower limb and risk of fall in post-stroke patients with spastic and non-spastic genu recurvatum. Methods. We conducted a two-year prospective study (April 2018 - April 2020) of forty hemiparetic patients with spastic (20) and non-spastic (20) genu recurvatum who underwent a rehabilitation program for three weeks and ultrasound guided botulinum toxin injection for the spastic group. Results. In the non-spastic group, statistically significant differences were observed post-treatment (after 3 weeks) in the case of gait speed from 0.457 meters/sec (T0) to 0.6265 m/sec (T1), TUG from 16.3 (T0) to 14.15 (T1) and LEFS from 32.45 (T0) to 34.7 (T1). In the spastic group, gait speed also had significant differences, from 0.467 (T0) to 0.7145 (T1). LEFS had an increase from 32.45 (T1) to 34.75 (T2). MAS had a decrease from 2.65 (T0) to 1.55 at (T1). Conclusions. Following a 3-week rehabilitation program and using ultrasound guided botulinum toxin injections, in the case of spasticity, improves gait spatiotemporal asymmetry and ameliorates functionality, lowering the risk of fall in hemiparetic patients with post-stroke genu recurvatum whether spastic or non-spastic. [ABSTRACT FROM AUTHOR]