New Approaches in Invasive and Non-invasive Rehabilitation: From Basic Science to Clinical Intervention

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

Deadline for manuscript submissions: 31 August 2024 | Viewed by 13460

Special Issue Editors


E-Mail Website
Guest Editor
Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
Interests: physiotherapy; dry needling; ultrasound; anatomy electromyography; manual therapy
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC-Barcelona), C/Josep Trueta s/n, 08017 Sant Cugat del Vallès, Spain
Interests: ultrasonography; physiotherapy; rehabilitation; physical therapy
Special Issues, Collections and Topics in MDPI journals

E-Mail Website
Guest Editor
Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, 08195 Barcelona, Spain
Interests: anatomy; rehabilitation; sport; older people
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Rehabilitation is a multidisciplinary concept that is constantly advancing and, in recent years, a multitude of new techniques, treatments and evaluations have been implemented. This Special Issue aims to bring together high-quality articles focused on the subject of rehabilitation.

Both evaluation and treatment technique articles conducted in a clinical or laboratory setting will be evaluated.

  • Ultrasound
  • Invasive techniques
  • Manual Therapy
  • Exercise
  • Minimally invasive surgery

Dr. Jacobo Rodríguez-Sanz
Dr. Carlos López-de-Celis
Dr. Albert Pérez-Bellmunt
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Healthcare is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • dry needling
  • ultrasound
  • manual therapy
  • anatomy
  • percutaneous electrolysis
  • exercise
  • minimally invasive surgery

Published Papers (8 papers)

Order results
Result details
Select all
Export citation of selected articles as:

Research

Jump to: Other

10 pages, 1115 KiB  
Article
The Precision and Safety of Ultrasound-Guided versus Palpation-Guided Needle Placement on the Plantar Fascia and Flexor Digitorum Brevis Interface: An Anatomical Study
by Miguel Malo-Urriés, Sergio Borrella-Andrés, Carlos López-de-Celis, César Fernández-de-las-Peñas, Albert Pérez-Bellmunt, José L. Arias-Buría, Isabel Albarova-Corral and Jacobo Rodríguez-Sanz
Healthcare 2024, 12(10), 1000; https://doi.org/10.3390/healthcare12101000 - 13 May 2024
Viewed by 495
Abstract
Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety [...] Read more.
Background: Evidence suggests the plantar fascia and its interphase with the flexor digitorum brevis muscle can play a relevant role in plantar heel pain. Needling interventions could offer an appropriate treatment strategy to addressing this interface. Objective: We compared the accuracy and safety of ultrasound-guided versus palpation-guided procedures for the proper targeting of the interface between the plantar fascia and the flexor digitorum brevis with a solid needle. Methods: A crossover cadaveric study was conducted. Five experienced therapists performed a series of 20 needle insertions each (n = 100 in total, 10 landmark-guided and 10 ultrasound-guided) on 10 anatomical samples. The therapists were instructed to accurately place the needle on the interface between the plantar fascia and the flexor digitorum brevis muscle. The distance of the tip of the needle to the identified target (accuracy), the surrounding sensitive structures targeted (safety), the time needed for the procedure, the number of needle passes, and the needle length outside the skin were assessed. Results: The ultrasound-guided technique was associated with a significantly higher accuracy (p < 0.001) but without differences in safety (p = 0.249) as compared to the palpation-guided procedure. Conclusion: Our results suggest that ultrasound-guided insertion exhibits greater accuracy but not greater safety than palpation-guided insertion when targeting the interface between the plantar fascia and the flexor digitorum brevis. Full article
Show Figures

Figure 1

18 pages, 1296 KiB  
Article
Responsiveness of Isokinetic Dynamometry in Patients with Osteoarthritis after Knee and Hip Arthroplasty: A Prospective Repeated-Measures Cohort Study
by Ferdinand Prüfer, Monika Pavlović, Špela Matko, Stefan Löfler, Michael J. Fischer, Nejc Šarabon and Vincent Grote
Healthcare 2024, 12(3), 314; https://doi.org/10.3390/healthcare12030314 - 25 Jan 2024
Cited by 1 | Viewed by 1549
Abstract
Functional assessments are crucial for the evaluation of rehabilitation after total knee (TKA) and hip (THA) arthroplasty. Muscle strength, a key determinant of physical function (PF), is often measured with isokinetic dynamometry (ID), which is considered the gold standard. However, studies lack evaluations [...] Read more.
Functional assessments are crucial for the evaluation of rehabilitation after total knee (TKA) and hip (THA) arthroplasty. Muscle strength, a key determinant of physical function (PF), is often measured with isokinetic dynamometry (ID), which is considered the gold standard. However, studies lack evaluations of responsiveness—the ability to detect changes over time. This study aims to determine the responsiveness of ID in measuring PF in TKA and THA rehabilitation—is muscle strength a valid indicator for assessing improvement in rehabilitation processes? The pre- and post-surgery PF of 20 osteoarthritis patients (age 55–82) was assessed, using ID, performance-based and self-reported measures. Responsiveness was evaluated by comparing the observed relationship of changes in ID and PF scores with the a priori defined expected relationship of change scores. While the performance-based and self-reported measures showed significant improvements post-surgery (Cohen’s d [0.42, 1.05] p < 0.05), ID showed no significant differences. Moderate correlations were found between changes in some ID parameters and selected functional tests (r ≈|0.5|, p < 0.05). Responsiveness was solely found for the peak torque of knee extension at 180°/s on the operated side. Responsiveness is an often-overlooked psychometric property of outcome measurements. The findings suggest that ID may not be fully responsive to the construct of PF after TKA and THA, raising questions about its role and usefulness in this context and the need for more appropriate assessment methods. Full article
Show Figures

Figure 1

11 pages, 267 KiB  
Article
Effectiveness of Proprioceptive Body Vibration Rehabilitation on Motor Function and Activities of Daily Living in Stroke Patients with Impaired Sensory Function
by Hyunsik Yoon and Chanhee Park
Healthcare 2024, 12(1), 35; https://doi.org/10.3390/healthcare12010035 - 23 Dec 2023
Cited by 1 | Viewed by 1161
Abstract
Stroke patients experience impaired sensory and motor functions, which impact their activities of daily living (ADL). The current study was designed to determine the best neurorehabilitation method to improve clinical outcomes, including the trunk-impairment scale (TIS), Berg balance scale (BBS), Fugl-Meyer assessment (FMA), [...] Read more.
Stroke patients experience impaired sensory and motor functions, which impact their activities of daily living (ADL). The current study was designed to determine the best neurorehabilitation method to improve clinical outcomes, including the trunk-impairment scale (TIS), Berg balance scale (BBS), Fugl-Meyer assessment (FMA), and modified Barthel index (MBI), in stroke patients with impaired sensory function. Forty-four stroke survivors consistently underwent proprioceptive body vibration rehabilitation training (PBVT) or conventional physical therapy (CPT) for 30 min/session, 5 days a week for 8 weeks. Four clinical outcome variables–the FMA, TIS, BBS, and MBI–were examined pre- and post-intervention. We observed significant differences in the FMA, BBS, and MBI scores between the PBVT and CPT groups. PBVT and CPT showed significant improvements in FMA, BBS, TIS, and MBI scores. However, PVBT elicited more favorable results than CPT in patients with stroke and impaired sensory function. Collectively, this study provides the first clinical evidence of optimal neurorehabilitation in stroke patients with impaired sensory function. Full article
13 pages, 1696 KiB  
Article
The Effectiveness of a Single Dry Needling Session on Gait and Quality of Life in Multiple Sclerosis: A Double-Blind Randomized Sham-Controlled Pilot Trial
by Alberto Javier-Ormazábal, Montserrat González-Platas, Alejandro Jiménez-Sosa, Pablo Herrero and Diego Lapuente-Hernández
Healthcare 2024, 12(1), 10; https://doi.org/10.3390/healthcare12010010 - 19 Dec 2023
Viewed by 1245
Abstract
Introduction: Gait disorders are a major cause of disability and reduced health-related quality of life in people with multiple sclerosis (pwMS). Dry needling (DN) has demonstrated positive results to improve gait parameters in patients with stroke. The main aim of this study was [...] Read more.
Introduction: Gait disorders are a major cause of disability and reduced health-related quality of life in people with multiple sclerosis (pwMS). Dry needling (DN) has demonstrated positive results to improve gait parameters in patients with stroke. The main aim of this study was to evaluate the effect of a single session of DN in the gait performance of pwMS. Methods: A double-blind parallel randomized sham-controlled pilot trial was conducted. Study participants received a single session of active DN or sham DN in the gastrocnemius medialis muscle. Pre-treatment and immediately post-treatment measurements were taken, as well as at one and four weeks after the intervention. Outcomes related to gait performance (Timed 25-Foot Walk), self-perceived walking capacity (Multiple Sclerosis Walking Scale), risk of falls (Timed Up and Go test), disability level (Expanded Disability Status Score) and quality of life (Multiple Sclerosis Quality of Life-54 questionnaire and Analogic Quality of Life scale) were evaluated. Results: 18 patients who had multiple sclerosis participated in the study. The group who received active DN showed within-group significant statistical differences immediately after treatment for gait performance (p = 0.008) and risk of falls (p = 0.008), as well as for self-perceived walking capacity at one week (p = 0.017) and four weeks (p = 0.011) and quality of life at four weeks (p = 0.014). Regarding the comparison between groups, only significant results were obtained in the physical domain of the quality of life at four weeks (p = 0.014). Conclusions: DN seems to be a promising therapeutic tool for the treatment of gait disorders in pwMS. However, when results were compared with sham DN, no differences were found. Full article
Show Figures

Figure 1

8 pages, 581 KiB  
Communication
Does Lower-Limb Tendon Structure Influence Walking Gait?
by Alejandro Núñez-Trull, Javier Álvarez-Medina, Diego Jaén-Carrillo, Alberto Rubio-Peirotén, Ferrán Abat, Luis E. Roche-Seruendo and Eva M. Gómez-Trullén
Healthcare 2023, 11(24), 3142; https://doi.org/10.3390/healthcare11243142 - 11 Dec 2023
Viewed by 1413
Abstract
Background: Within the exploration of human gait, key focal points include the examination of functional rockers and the influential role of tendon behavior in the intricate stretch–shortening cycle. To date, the possible relationship between these two fundamental factors in the analysis of human [...] Read more.
Background: Within the exploration of human gait, key focal points include the examination of functional rockers and the influential role of tendon behavior in the intricate stretch–shortening cycle. To date, the possible relationship between these two fundamental factors in the analysis of human gait has not been studied. Therefore, this study aimed to analyze the relationship between the morphology of the patellar and Achilles tendons and plantar fascia with respect to the duration of the rockers. Methods: Thirty-nine healthy men (age: 28.42 ± 6.97 years; height: 173 ± 7.17 cm; weight: 67.75 ± 9.43 kg) were included. Data of the rockers were recorded using a baropodometric platform while participants walked over a 10 m walkway at a comfortable velocity. Before the trials, the thickness and cross-sectional area were recorded for the patellar tendon, Achilles tendon and plantar fascia using ultrasound examination. The relationship between the morphology of the soft tissue and the duration of the rockers was determined using a pairwise mean comparison (t-test). Results: A significant difference was found for rocker 1 duration, where a longer duration was found in the group of subjects with thicker patellar tendons. Regarding the Achilles tendon and plantar fascia, no significant differences were observed in terms of tendon morphology. However, subjects with thicker Achilles tendons showed a longer duration of rocker 1. Conclusions: The findings underscore a compelling association, revealing that an increased thickness of the patellar tendon significantly contributes to the extension of rocker 1 duration during walking in healthy adults. Full article
Show Figures

Figure 1

12 pages, 2008 KiB  
Article
Is the Straight Leg Raise Suitable for the Diagnosis of Radiculopathy? Analysis of Diagnostic Accuracy in a Phase III Study
by Alberto Montaner-Cuello, Elena Bueno-Gracia, Diego Rodríguez-Mena, Elena Estébanez-de-Miguel, Miguel Malo-Urriés, Gianluca Ciuffreda and Santos Caudevilla-Polo
Healthcare 2023, 11(24), 3138; https://doi.org/10.3390/healthcare11243138 - 11 Dec 2023
Viewed by 1314
Abstract
The straight leg raise test (SLR) has been proposed to detect increased nerve mechanosensitivity of the lower limbs in individuals with low back pain. However, its validity in the diagnosis of lumbosacral radiculopathy shows very variable results. The aim of this study was [...] Read more.
The straight leg raise test (SLR) has been proposed to detect increased nerve mechanosensitivity of the lower limbs in individuals with low back pain. However, its validity in the diagnosis of lumbosacral radiculopathy shows very variable results. The aim of this study was to analyse the diagnostic validity of the SLR including well-defined diagnostic criteria (a change in symptoms with the structural differentiation manoeuvre and the reproduction of the patient’s symptoms during the test or the asymmetries in the range of motion or symptoms location between limbs) in a sample of participants in phase III with suspicion of lumbar radiculopathy using the electrodiagnostic studies (EDX) as the reference standard. A phase III diagnostic accuracy study was designed. In total, 142 individuals with suspected lumbosacral radiculopathy referred for EDX participated in the study. Each participant was tested with EDX and SLR. SLR was considered positive using three diagnostic criteria. The sensitivity of the SLR for Criterion 3 was 89.02% (CI 81.65–96.40), the specificity was 25.00% (CI 13.21–36.79), and the positive and negative likelihood ratios were 1.19 (CI 1.01–1.40) and 0.44 (0.21–0.94), respectively. SLR showed limited validity in the diagnosis of lumbosacral radiculopathy. The incorporation of more objective diagnostic criteria (asymmetry in range of motion or localisation of symptoms) improved the diagnostic validity but the imprecision of the confidence intervals limited the interpretation of the results. Full article
Show Figures

Figure 1

Other

Jump to: Research

15 pages, 1327 KiB  
Systematic Review
Is Craniosacral Therapy Effective? A Systematic Review and Meta-Analysis
by Luis Ceballos-Laita, Edzard Ernst, Andoni Carrasco-Uribarren, Sara Cabanillas-Barea, Jaime Esteban-Pérez and Sandra Jiménez-del-Barrio
Healthcare 2024, 12(6), 679; https://doi.org/10.3390/healthcare12060679 - 18 Mar 2024
Viewed by 4150
Abstract
Objectives: The aim of this study was to evaluate the clinical effectiveness of craniosacral therapy (CST) in the management of any conditions. Methods: Two independent reviewers searched the PubMed, Physiotherapy Evidence Database, Cochrane Library, Web of Science, and Osteopathic Medicine Digital Library databases [...] Read more.
Objectives: The aim of this study was to evaluate the clinical effectiveness of craniosacral therapy (CST) in the management of any conditions. Methods: Two independent reviewers searched the PubMed, Physiotherapy Evidence Database, Cochrane Library, Web of Science, and Osteopathic Medicine Digital Library databases in August 2023, and extracted data from randomized controlled trials (RCT) evaluating the clinical effectiveness of CST. The PEDro scale and Cochrane Risk of Bias 2 tool were used to assess the potential risk of bias in the included studies. The certainty of the evidence of each outcome variable was determined using GRADEpro. Quantitative synthesis was carried out with RevMan 5.4 software using random effect models. Data Synthesis: Fifteen RCTs were included in the qualitative and seven in the quantitative synthesis. For musculoskeletal disorders, the qualitative and quantitative synthesis suggested that CST produces no statistically significant or clinically relevant changes in pain and/or disability/impact in patients with headache disorders, neck pain, low back pain, pelvic girdle pain, or fibromyalgia. For non-musculoskeletal disorders, the qualitative and quantitative synthesis showed that CST was not effective for managing infant colic, preterm infants, cerebral palsy, or visual function deficits. Conclusions: The qualitative and quantitative synthesis of the evidence suggest that CST produces no benefits in any of the musculoskeletal or non-musculoskeletal conditions assessed. Two RCTs suggested statistically significant benefits of CST in children. However, both studies are seriously flawed, and their findings are thus likely to be false positive. Full article
Show Figures

Figure 1

12 pages, 2014 KiB  
Systematic Review
The Effects of Soft-Tissue Techniques and Exercise in the Treatment of Patellar Tendinopathy—Systematic Review and Meta-Analysis
by Federico Ragone, Silvia Pérez-Guillén, Andoni Carrasco-Uribarren, Sara Cabanillas-Barea, Luis Ceballos-Laita, Pere Ramón Rodríguez-Rubio and Rosa Cabanas-Valdés
Healthcare 2024, 12(4), 427; https://doi.org/10.3390/healthcare12040427 - 7 Feb 2024
Viewed by 1439
Abstract
Background: Patellar tendinopathy is a degenerative clinical disorder that causes load-related pain in the lower pole of the patella or patellar tendon. It predominantly affects young male athletes engaged in sports involving repetitive tendon loading, particularly explosive jumping. The combination of manual techniques [...] Read more.
Background: Patellar tendinopathy is a degenerative clinical disorder that causes load-related pain in the lower pole of the patella or patellar tendon. It predominantly affects young male athletes engaged in sports involving repetitive tendon loading, particularly explosive jumping. The combination of manual techniques with therapeutic exercise is hypothesized to provide greater benefits than exercise alone. Objective: The aim of this study is to analyze the scientific evidence regarding the effects of soft-tissue techniques combined with therapeutic exercise versus therapeutic exercise alone on pain intensity and function in individuals with patellar tendinopathy. Methods: A systematic review with meta-analysis was conducted following the PRISMA guidelines. PubMed, Lilacs, IBECS, CENTRAL, WOS, SciELO, Academic Search, CINAHL, SportDiscus, PEDro, and Google Scholar databases were consulted. Randomized controlled trials and quasi-randomized trials focusing on the effects of soft-tissue techniques combined with therapeutic exercise (experimental group) versus therapeutic exercise alone (control group) on pain and function in individuals aged 16 years and older with patellar tendinopathy were selected. The Cochrane tool for risk-of-bias assessment and the PEDro scale for methodological quality were used. Results and Discussion: A total of six studies (n = 309; age range = 16–40 years), considered to have a low risk of bias and moderate-to-high methodological quality, were included. The results showed improvements in function in the experimental group (mean of 60% on the Visa-P scale) and pain in the experimental group (mean decrease of 2 points in the VAS scale). There were improvements in 50% of the studies when comparing variables between the experimental and control groups. Conclusions: The combination of manual techniques, such as dry needling, percutaneous electrolysis, transverse friction massage, and stretching, along with a squat on a 25° inclined plane, appears to be effective in the treatment of patellar tendinopathy. Static stretching of the quadriceps before and after the squat five times per week, along with dry needling or percutaneous electrolysis sessions twice a week for 8 weeks, is recommended. However, future studies analyzing groups with passive techniques versus therapeutic exercise are needed to standardize the treatment and establish the optimal dose. Full article
Show Figures

Figure 1

Back to TopTop