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 Table of Contents  
Year : 2021  |  Volume : 4  |  Issue : 5  |  Page : 1-10

Oral Abstracts

Date of Web Publication09-Nov-2021

Correspondence Address:
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2349-7904.330162

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How to cite this article:
. Oral Abstracts. J Int Soc Phys Rehabil Med 2021;4, Suppl S1:1-10

How to cite this URL:
. Oral Abstracts. J Int Soc Phys Rehabil Med [serial online] 2021 [cited 2022 May 20];4, Suppl S1:1-10. Available from: https://www.jisprm.org/text.asp?2021/4/5/1/330162


  Virtuale, 12/06/2021 - 15/06/2021 Top

  Topic: 1. Biomedical Sciences Top

  Sub Topic: 1.4 Neuroscience Top

  Print Code: OP1: 1 Top

Altered effective connectivity between the primary motor cortex and frontoparietal cortex as indicators of impairment severity following stroke

H. Yang1, H. Wang2, M. Fan1, J. Jia2

1East China Normal University, Shanghai, China, 2Department of Rehabilitation, Huashan Hospital, Shanghai, China

Background and Aims: Previous functional neuroimaging studies have demonstrated changes in neural activity in stroke patients with motor deficits. However, patterns in functional effective connectivity associated with the severity of motor deficits following stroke remain unclear. Methods: Stroke survivors with different severities of motor deficits (n=13, mild motor deficits; n=13, severe motor deficits) and healthy participants (n=13, sex-age-matched) were enrolled. Granger causality analysis(GCA) of resting-state functional magnetic resonance imaging(fMRI) data was performed to investigate the relationship between the severity of motor deficits and effective connectivity between the ipsilesional primary motor cortex(M1) and other brain regions. Results: Compared with healthy controls, the mild group demonstrated increased influence from ipsilesional M1 to ipsilesional middle frontal gyrus and decreased influence from ipsilesional thalamus to ipsilesional M1; While the severe group showed increased influence from bilateral primary somatosensory cortex(S1) and contralesional parietal and occipital lobes to ipsilesional M1, and decreased influence from ipsilesional M1 to contralesional M1 and from bilateral frontal lobes to ipsilesional M1. For between-group comparisons, the mild group showed decreased influence from contralesional S1 and visual cortex to ipsilesional M1 than the severe group, with their GCA values negatively correlated with the FMA scores.

Conclusions: The altered interactions between frontoparietal and motor execution cortices were associated with the severity of motor deficits after stroke, and the compensatory increased effective connectivity from the contralesional S1 and visual cortex seemed to be associated with poor recovery of motor function. The results of this study provide deep insight into the relationships between functional brain network reorganization and motor outcomes.

  Topic: 1. Biomedical Sciences Top

  Sub Topic: 1.4 Neuroscience Top

  Print Code: OP1: 2 Top

Effects of RTMS combined with treadmill training on locomotor function and the expressions of serotonin receptors in rats with spinal cord injury

S. Wang1,2, R. Yin1, P. Wang2, T. Zhou2, G. Xu1, H. Wang2

1College of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China, 2Department of Rehabilitation Medicine, Zhongda Hospital, Southeast University, Nanjing, China

Background and Aims: To investigate the effects of rTMS combined with treadmill training on locomotor function and the expressions of 5-HT1AR and 5-HT2AR in rats with spinal cord injury. Methods: Fifty SD rats were divided into sham-operation group, spinal cord injury group (Con), treadmill training group (Tr), Tr followed by rTMS group (Tr-rTMS) and rTMS followed by Tr group (rTMS-Tr). One-week post-surgery, Tr group were begun on treadmill training, while Tr-rTMS and rTMS-Tr group were performed rTMS and treadmill training. Locomotor recovery was evaluated using BBB scale, grid walking and Hmax/Mmax. The immunohistochemistry was used to detect the expressions of 5-HT1AR and 5-HT2AR. Results: The BBB scores of rTMS-Tr group were higher than that in Con group from seventh to ninth week (p<0.05). At the eighth and ninth week, the BBB scores of Tr-rTMS group were higher than that of Con group (p<0.05). The number of the hindlimb drops of rTMS-Tr group was lower than that of Con group at the seventh and ninth week (p<0.05). The Hmax/Mmax in Tr-rTMS and rTMS-Tr group was lower than that in Con group at the ninth week (p<0.05). The immunohistochemistry results showed that the combined treatment groups revealed a higher 5-HT1AR density than Con and Tr group (p<0.05). Compared with the other 4 groups, the expression of 5-HT2AR in Con group increased (p<0.05). Conclusions: rTMS combined with treadmill training can significantly promote the locomotor recovery through enhancing the differential expressions of 5-HT1AR and 5-HT2AR of SCI rats.

  Topic: 1. Biomedical Sciences Top

  Sub Topic: 1.1 Biomechanics Top

  Print Code: OP1: 3 Top

Comparison and evolution of 4 movement smoothness markers at stroke subacute stage: A REM-AVC ancillary study

G. Cornec1, M. Lempereur1, B. Medee1, R. Gross2, S. Bellaiche3, O. Remy-Neris1,4, N. Bayle5

1Physical and Rehabilitation Medecine Unit, Brest University Hospital, Brest, France, 2Physical and Rehabilitation Medecine Unit, Nantes University Hospital, Nantes, France, 3Neurological Physical and Rehabilitation Medecine Unit, Henry-Gabrielle Hospital, Hospices Civils de Lyon, Lyon, France, 4Université de Bretagne Occidentale, Brest, France, 5Laboratoire Analyse et Restauration du Mouvement, EA BIOTN 7377, Université Paris-Est Créteil, Créteil, France

Background and Aims: Assessment of paretic upper limb (UL) following stroke is clinically difficult and often rely on tools that are scarcely sensitive to short-time changes. A new measure of movement smoothness, the spectral arc length (SPARC)[1], has been developed to fix the movement duration dependence and the noise sensitivity of previous markers. Methods: In this ancillary study of the negative REM_AVC trial[2], patients underwent an assessment of UL Fugl Meyer (UL-FM) and Action Research Arm Test (ARAT), and an UL 3D motion analysis of 3 pointing movements both at inclusion (day 0) and at the end of the rehabilitation (day 30). Middle hand marker trajectory and movement duration were recorded and used to compute index of curvature (IoC), SPARC, log dimensionless jerk (LDLJ), number of sub-movements (nSUB) and normalized average rectified jerk (NARJ). Results: Out of the 37 patients included in the 3 centres concerned by this ancillary study, 31 completed the pointing movements. No significant difference was observed between REM_AVC groups. Considering the 2 groups as one, significant improvements were observed (Table). The SPARC at day 0 had stronger correlations with UL-FM (r=0,48) and ARAT (r=0,68) than the other markers, and was the only one significantly correlated to day 30 UL-FM (r=0,57) and ARAT (r=0,58). Conclusions: This study describes the first use of the SPARC as a marker of movement smoothness after stroke and provides data in favour of its stronger validity and robustness in pointing tasks over previously described markers. No specific effect of mechanized therapy over self-guided UL rehabilitation was identified.

  Topic: 1. Biomedical Sciences Top

  Sub Topic: 1.1 Biomechanics Top

  Print Code: OP1: 4 Top

Comparison of four smoothness markers for point-to-point upper limb movements in healthy subjects

N. Bayle1, M. Lempereur2, E. Hutin1, O. Remy-Neris2,3, J. Gracies2, G. Cornec2

1Laboratoire Analyse et Restauration du Mouvement, EA BIOTN 7377 Université Paris-Est Créteil, Créteil, France, 2Physical and Rehabilitation Medecine, Brest University Hospital, Brest, France, 3Université de Bretagne Occidentale, Brest, France

Background and Aims: Number of zero-crossings of the acceleration profiles (N0C), Log Dimensionless Jerk (LDLJ), Normalized Averaged Rectified Jerk (NARJ) in the temporal domain and Spectral Arc Length Measure (SPARC)[1] in the frequency domain are quantitative measures of movement smoothness; head-to-head comparisons between these metrics are scarce.[2] Methods: Thirty-two healthy participants (age 63±16 y) underwent 3D motion analysis of the upper limb (UL) while performing 2 sets of 3 pointing movements with each UL. Participants were seated, the palm of the hand facing down on the table; they performed successively a forward-pointing movement (FPM) at self-selected speed to a target located ahead at 90% arm length at shoulder height, and a backward pointing movement (BPM), back from the target to the initial position, with (set A) and without (set B) a 3-second pause between FPM and BPM. Kinematics were measured from middle hand marker and N0C, SPARC, LDLJ and NARJ were calculated. Results: All markers were sensitive to movement type, with FPM classified as less smooth for LDLJ, NARJ and N0C and smoother for SPARC. Only SPARC was not impacted by the movement set. No difference was observed between dominant (D) and non-dominant (ND) sides. The inter- and intra-subject coefficient of variation (CoV) were lowest for SPARC. LDLJ, NARJ and N0C were correlated with each other and movement duration, while SPARC was not. Conclusions: Major differences were observed between temporal domain, duration dependent, indexes and the SPARC, more robust and reliable. The SPARC could be a strong alternative to previously described markers of movement smoothness.

  Topic: 1. Biomedical Sciences Top

  Sub Topic: 1.1 Biomechanics Top

  Print Code: OP1: 5 Top

Estimating key gait events using leg kinematics for amputees: Assessment of accuracy against force plate data

Z. Aftab

Human-Centered Robotics Lab, University of Central Punjab, Lahore, Pakistan

Background and aims: Background and aims Quantitative gait analysis is a valuable tool in assessing gait deficits. It relies on detection of heel strike (HS) and toe-off (TO) events for gait segmentation. Algorithm-based estimation of gait event is done using the gait kinematics data but needs validation for the amputee population. The goal of this study is to quantify the accuracy of lower-leg angular velocity signal for the estimation of aforementioned gait events. Methods: Thirty Marker data of 18 subjects, divided into 2 groups (K2 and K3, limited vs. full community ambulators) from [1] is used. 239 walking trials of 10 subjects not using handrails are included. Lower leg angular velocity is calculated from tibia markers and gait events are predicted (pTO/pHS) using a rule-based algorithm similar to.[2] The error values (eTO/eHS) are calculated taking the difference between the predicted and actual events from the force plates. Results: TO on the sound side demonstrated the largest prediction error (median=84ms). The magnitude of error was higher for K2 group (94ms) than for the K3 group (72ms) and further correlated negatively with gait speed. The median error for TO on the prosthetic side was smaller (35ms). The median error in HS prediction was negligible on both sides (1ms and -8ms).

Conclusions: Leg velocity signal can accurately predict the HS event for amputees. However, the TO event presents large prediction error particularly on the sound side.


  1. Hood, et al. Sci Data 2020;7:150.
  2. Lee JK, Park EJ. Quasi real-time gait event detection using shank-attached gyroscopes. Med Biol Eng Comput 2011;49:707-12.

  Topic: 1. Biomedical Sciences Top

  Sub Topic: 1.5 Physiology Top

  Print Code: OP1: 6 Top

Comparison of exercise intensity during exergame, dual-task or single-task training sessions: A pilot transversal study

M. Gallou-Guyot1, A. Perrochon1, R. Marie2, E. Digbeu-Labbe3, S. Mandigout1

1Laboratoire HAVAE, Université de Limoges, Limoges, France, 23iL, Limoges, France, 3Mairie de Limoges, Limoges, France

Background and Aims: Cognitive-motor dual-task trainings are promising for the enhancement of cognitive, motor, and dual-task functions. These trainings may be realized through exergaming, and must be composed of demanding tasks to be effective (1). We aimed at comparing the exercise intensity during single-task and dual-task training realized with and without a custom designed exergame as support. Methods: Sixteen healthy young subjects (24 ± 3 years old) realized three different exercise session in a random order: exergame, dual-task and single-task trainings. Exercise sessions lasted 30 minutes and were separated with at least 24 hours. We assessed the intensity through mean and pic heart rates measured with Polar® H10 chest monitors, and the subjective evaluation of the intensity through the Borg scale. Results: We found no differences between the three exercise types in mean heart rates: exergame = 120±12, dual-task = 124±16, single task = 128 ±15 bpm (ANOVA F(2,45) = 1.33, p = 0.27). We found the same results for pic heart rates (ANOVA F(2,45) = 0.7, p = 0.5) and Borg scale scores (Friedman test χ²(2) = 1.85, p = 0.4). Conclusions: The exercise intensity was the same during exergame, dual-task and single-task sessions. This means that dual-task sessions are as physically demanding as more traditional motor training, qualifiable as moderate in healthy young adults. Future studies should assess if this is also found in elderly, who present higher cognitive-motor interferences (2) and therefore tend to prioritize a task more often. These exercises could also be more intense in older adults.

  Topic: 1. Biomedical Sciences Top

  Sub Topic: 1.5 Physiology Top

  Print Code: OP1: 7 Top

Ultrasound therapy effects on oxidative stress in knee osteoarthritis

R. A. Ungur1, V. M Ciortea1, L. Irsay1, S. Suciu2, E. C. Craciun3, E. Dronca4, A. D. Ciubean5, I. M. Borda1

1Department of Rehabilitation, University of Medicine and Pharmacy, Clinical Rehabilitation Hospital, Cluj-Napoca, Romania, 2Department of Physiology, University of Medicine and Pharmacy, Cluj-Napoca, Romania, 3Department of Biochemistry, University of Medicine and Pharmacy, Cluj-Napoca, Romania, 4Department of Genetics, University of Medicine and Pharmacy, Cluj-Napoca, Romania, 5Department of Rehabilitation, University of Medicine and Pharmacy, Cluj-Napoca, Romania

Background and Aims: The impact of ultrasound (US) therapy in knee osteoarthritis (KOA) represents a research topic far from elucidated. Previous studies demonstrated that US can increase NO production through upregulation of eNOS, improve antioxidant capacity and alleviate oxidative stress and inflamation in non neoplasic cells. Present study aimed to evaluate the pro-oxidative /antioxidative balance in KOA patients following exposure to US therapy. Methods: 64 patients included in the study were divided into two groups. The test group was exposed to 850 ± 5% KHz, 0.5W / cm2, 5 minutes / field, 10 daily sessions of US. Control group received sham US therapy. Patients of both groups were subjected to collection of plasma samples at three time points - at the beginning of the study, immediately after the end of US therapy, as well as two weeks after the therapy end, and pro-oxidative and anti-oxidant markers were evaluated. Results: Test group presented moderate, but significantly increased patterns of nitric oxide, as well as elevated arylesterase activity of paraoxonase-1 enzyme (marginally significant), as compared to control group. For the total sulfhydryl groups, glutathione peroxidase, catalase, superoxide dismutase and the paraoxonase activity of paraoxonase-1 no significant changes were recorded in test group as compared to control group. Conclusions: Data suggests that US therapy is able to offer antioxidant protection to OA patients through moderate increasing of NO synthesis and improvement in arylesterase activity of paraoxonase-1 enzyme.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP2: 1 Top

Improving of the effectiveness of motor-imagery training with BCI technology in hand exoskeleton in post-stroke rehabilitation

A. Rubakova1, G. Ivanova1, M. Bulatova 2, B. Polyaev 3

1Department of Medical Rehabilitation Researches, Center of Brain and Neurotechnologies, Moscow, Russia, 2Department of Medical Rehabilitation of Patients with CNS Dysfunctions No. 1, Center of Brain and Neurotechnologies, Moscow, Russia, 3Department of Medical Rehabilitation of Patients with CNS Dysfunctions No. 2, Center of Brain and Neurotechnologies, Moscow, Russia

Background and Aims: The brain-computer interface with hand exoskeleton activates mechanisms of neuroplasticity by the sensorimotor rhythm desynchronization, resulting in motor learning, but the contribution of perception to learning motor paradigms is currently not well explored.

Our study aimed to investigate the effectiveness of BCI-exoskeleton ideomotor training and to assess its’ effect on reducing spasticity in paretic hand. Methods: 58 patients (age 63±5.5, in early post-stroke period, > 13 on MoCa, neuropsychological examination results, according to the Schulte tables test data: work efficiency – 65.3±3, working capacity – 1.02±0.03, attention stability – 1.008±0.03) received 15±3 trainings on BCI-exoskeleton complex (“Exokist-2”, Russia) and standardized physical rehabilitation. Motor function of paretic hand was assessed before and after the course of procedures using the Fugl-Meyer, ARAT, Frenchay, FIM, Rivermead, Ashworth scales. Results: After 15 motor-imagery trainings muscle strength in the wrist joint improved in 69% patients (p<0.004). Improvements in the paretic hand movements were positively correlated with improvements in daily life skills (p<0.01). A positive correlation (p=0.66) was found between improvements in hand function and a high attention span level. Prescribing of ideomotor training to reduce muscle tone is ineffective, because there was no significant decrease in hand spasticity. Cognitive deficit did not influence the result of training. Development of the paretic hand functions after BCI-exoskeleton application is related to kinesthetic receptors activation and learning fine motor skills due to sensorimotor integration. Conclusions: The obtained data allows physicians to develop new criteria for more effective prescribing ideomotor rehabilitation trainings to post-stroke patients.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP2: 2 Top

Physical performance early after allogeneic hematological stem cell transplantation (allo-hsct): A new challenge for rehabilitation and exercise medicine

V. Pinelli 1, A. Cordival2

1IUCT Oncopôle, Toulouse, France, 2CHU Rangueil, Toulouse, France

Background and Aims: Allo-HSCT is the only curative treatment for some hematologic malignancies. Side effects include decrease in physical performance. No cardio-pulmonary exercise testing (CPET) data at post-allo-HSCT early stage is currently available. Our aim was to characterize it. Methods: 64 patients were evaluated between 2019 and 2021 with CPET, at 120-150 days after allo-HSCT, in Toulouse Oncological University Institute. CPET included step-by-step gas exchanges analysis, BP every minute, and continuous EKG. Patient had 2 minutes warm-up then progressive work up to exhaustion. History and recent data were gathered from medical files. Results: 56% patients were male, mean age was 52 yo. The rate of etiologies was representative of allo-HSCT indications with majority of acute myeloid leukemias ; of pre-allo-HSCT intensive or non-intensive chemotherapies ; and myeloablative or not conditioning regimens. Echocardiographic and functional respiratory investigation de novo abnormalities concerned 12 and 6 patients. 86% had effort intolerance including 42% moderate to severe. Asthenia and/or dyspnea was reported by more than 50%. Physical and mental quality of life (QoL) measured by SF-36 were respectively decreased to 56 and 55%. Mean peak VO2 was 60%, and anaerobic metabolism was precociously brought in for 69%. Conclusions: At 120-150 days post-allo-HSCT, most patients suffer from moderate to severe effort intolerance, objectified by CPET, and inherent symptoms and QoL alteration. Most deficiencies brought to evidence by this retrospective cross-sectional analysis are suitable for physical activity. The global complexity of these patients needs interdisciplinary approach, coordinated by PMR physician.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP2: 3 Top

Breast cancer population in Portuguese PMR services: A 5-year multicentric cohort study

F. D. Rocha1, J. Romano2, O. Romano1, T. Amaral3, L. Prates4, F. Antunes5, F. Gabriel6, C. Ângelo7, C. Gomes8

1Department of Physical Medicine and Rehabilitation, IPO do Porto FG, EPE, Porto, Portugal, 2Department of Physical Medicine and Rehabilitation, Hospital Pedro Hispano, Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal, 3Department of Physical Medicine and Rehabilitation, IPO de Lisboa FG, EPE, Lisboa, Portugal, 4Department of Physical Medicine and Rehabilitation, Hospital Prof. Doutor Fernando da Fonseca, EPE, Amadora, Portugal, 5Department of Physical Medicine and Rehabilitation, Hospital de Braga, EPE, Braga, Portugal, 6Department of Physical Medicine and Rehabilitation, Hospital de Santa Maria, Centro Hospitalar Lisboa Norte, EPE, Lisboa, Portugal, 7Department of Physical Medicine and Rehabilitation, Hospital São Francisco Xavier, Centro Hospitalar Lisboa Ocidental, Lisboa, Portugal, 8Department of Physical Medicine and Rehabilitation, IPO Coimbra FG, EPE, Coimbra, Portugal

Background and Aims: Breast cancer treatment, nowadays effective in prolonging patients’ life, still leads to physical impairments. We aim to characterize the breast cancer population referred to PMR appointments, through a nation-wide sample, and identify its main disabilities over a 5-year period. Methods: Five-years Prospective Multicentric Nationwide Cohort study. Demographic, disease, and treatments data were collected. Impairments and DASH scores were recorded regularly. Descriptive statistics were performed. Results: 134 women were included. Dominant side was affected in 47%. Half had a TNM-T >T1. 64% underwent total mastectomy and 61% were submitted to ALND (mean lymph nodes removed 10.6±7.4). Seroma was the most frequent surgical complication (40%). 68% underwent chemotherapy, intercurrences with functional impact arose in 32%. Radiotherapy was used in 75% (irradiated zones: axilla 60%, supraclavicular 44%, internal mammary nodes 24%). Of those who received hormonotherapy (89%), half were prescribed aromatase inhibitors and 19% had musculoskeletal pain. At 1st appointment, the main issues were shoulder limitation (80%; mean anterior elevation 134.3±36.7), pain (72%) and axillary web syndrome (11%); DASH score was 42±19. Skin fibrosis (31%) and radiodermitis (24%) were identified mostly at 1st postoperative year. Lymphedema incidence was higher between the 1st and 3rd years, but continued throughout follow-up. At end follow-up, 45% had shoulder limitation (mean anterior elevation 168.8±19.5), 29% had pain, 29% had lymphedema and DASH score mean was 27±20. Conclusions: Breast cancer treatment was associated with high morbidity, supporting the importance of PMR follow-up. The physiatrist’s focus should adapt according to the most frequent limitations in each follow-up year.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP2: 4 Top

Nutrition management of amyotrophic lateral sclerosis - Treatment strategies to prevent malnutrition

A. Paredes Coelho, L. Rovisco Branquinho, J. Nuno Malta, J. P. Branco

Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal

Background and Aims: Amyotrophic lateral sclerosis (ALS) is the most frequent adult-onset motor neuron disease. The prevalence of malnutrition varies between 16 and 55%. Symptoms of dysphagia, difficulty with self-feeding and fatigue increase the risk. Preventing malnutrition has a positive impact on survival and quality of life. The goal of this article is to review treatment strategies to prevent malnutrition. Methods: We reviewed evidence bearing on the nutrition management of patients with ALS. We search Pubmed from January 2005 to December 2020 combining MeSH Terms ALS AND nutrition. We reviewed 68 abstracts and examined 6 articles in their entirety. Results: Implementation of an adequate calorie diet, dietary texture modification, use of adaptive eating utensils, and placement of a feeding tube aid in preventing malnutrition. When nutrition status is compromised by dysphagia and while forced vital capacity (FVC) is >50% of the predicted value, a percutaneous endoscopic gastrostomy (PEG) placement is indicated. When FVC is <50%, a radiologically inserted gastrostomy (RIG) is the preferred means of enteral placement. Parenteral nutrition is indicated only when enteral nutrition is contraindicated or impossible. When interventions such as PEG or RIG feeding are initiated early in the course of the disease, survival can be improved. Conclusions: Effective nutrition management of ALS includes early education and intervention. The nutrition assessment includes a nutrition-related physical exam, dietary history, anthropometric measurements and the use of body impedance to monitoring body composition. For future research, it is necessary to study the optimal timing of nutritional therapy administered via PEG or RIG.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.7 Rehabilitation of Individuals with Post COVID-19 Impairments and Sequalae Top

  Print Code: OP2: 5 Top

Effectiveness of a telerehabilitation program for COVID-19 survivors (Tereco) on exercise capacity, pulmonary function, lower limb muscle strength, and quality of life: A randomized controlled trial

J. Wang1, J. Li1,2, W. Xia3, C. Zhan4, S. Liu1,2, Z. Yin 1,2, Y. Chong3, C. Zheng3, X. Feng4, W. Cheng4, J. D. Reinhardt5,6,7,8

1Center of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China, 2chool of Rehabilitation Medicine, Nanjing Medical University, Nanjing, China, 3Department of Rehabilitation Medicine, Hubei Province Hospital of integrated Chinese and Western Medicine, Wuhan, China, 4Department of Rehabilitation Medicine, Huangshi Traditional Chinese Medicine Hospital, Huangshi, China, 5Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechni, Sichuan University, Chendu, China, 6Swiss Paraplegic Research, Nottwil, Switzerland, 7Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland, 8XD Group Hospital, Xi’an, China

Background and Aims: To investigate superiority of a telerehabilitation program for Covid-19 (TERECO) over no rehabilitation with regard to functional exercise capacity, lower-limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL), and perceived dyspnoea.

Methods: Parallel-group randomised controlled-trial with 1:1 block-randomisation. Covid-19 survivors with modified Medical Research Council (mMRC) dyspnoea score of 2-3 who had been discharged from hospital were randomised. The control group received educational instructions. The TERECO group participated in a 6-week home-based, pulmonary rehabilitation program delivered via smartphone and monitored with chest-worn heart rate telemetry. Exercise types comprised breathing control and thoracic expansion, aerobic exercise, and LMS exercise. Primary outcome was 6-minute walking distance (6MWD) in metres. Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up). Results: 120 patients were randomised. 38 participants in the TERECO group complied with the exercise protocol. The adjusted between-group difference in change in 6MWD from baseline was 65.45 metres (p<0.001) at post-treatment and 68.62 metres (p<0.001) at follow-up. Treatment effects for LMS were 20.12 seconds (p<0.001) post-treatment and 22.23 seconds (p<0.001) at follow-up. No group differences were found for lung function apart from post-treatment MVV. Increase in SF-12 PCS was greater in the TERECO group with treatment effects estimated as 3.79 (p=0.004) at post-treatment and 2.69 (p=0.045) at follow-up. No significant between-group differences were found for improvements in SF-12 MCS. Conclusions: This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and SF-12 PCS. We found no persistent effects on pulmonary function, SF-12 MCS, and perceived dyspnoea.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP2: 6 Top

Correlation between postural balance, isokinetic trunk muscle strength and the severity of women stress urinary incontinence

S. Ghroubi1,2, N. Kallel1,2, Y. Zribi1,2, M. Ahmed1,2, S. Abidi1, M. Chlif3,4, M. H. Elleuch1,2

1Department of Physical Medicine and Functional Rehabilitation, HbibBourguiba University Hospital, Sfax, Tunisia, 2Laboratory of Evaluation and Management of Musculoskeletal System Patologies, LR20ESO9 University of Sfax, Tunisia, 3Department of Sport Science, EA 3300 APS and Motor Patterns, Adaptations-Rehabilitation, Picardie Jules Verne University, Amiens, France, 4Tunisian Research Laboratory Sport Performance Optimization, National Center of Medicine and Science in Sports, Tunis, Tunisia

Background and Aims: Studies showed that women withstress urinary incontinence (SUI) have difficulty controlling their postural balance (PB) compared to continent women.

The aim of our study was to assess PB and trunk muscle strength (TMS) in incontinent women and to investigate their associations withthe severity of SUI. Methods: We collected 25 incontinent women and 20 continent ones. The SUI severity was assessed by the one-hour Pad test and the Urogenital Distress Inventory (UDI-6). The postural evaluation was realised on a Satel® force platform. Trunk muscle strength was assessed using a Cybex Norm II ® dynamometer. Results: Incontinent women presented an impaired PB and a deficit in TMS. In fact, they presented a higher total length of displacement of the center plantar pressure (CPP) (P <0.001). Trunk flexors pic torque at 60°/sec was decreased in incontinent women (p = 0.004). A positive correlation was found between the severity of SUI andtotal lengthof displacement of CPP on a stable plane (r = 0.540; P = 0.005). Negative correlations were found between trunk muscle strength and severity of SUI (r = 0.604; p = 0.001). Negative correlations were also found between trunk flexor pic torque at 60° and total length (r= -0.509, p=0.009). Conclusions: The severity of SUI is related to the PB and to the abdominal muscle strength: indeed, the weaker the abdominal muscle strength, the more impaired the postural balance and the more severe the UI. Thus, a trunk muscle strengthening program and a postural reeducation may be effective for the treatment of SUI.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP3: 1 Top

Analysis of biofeedback based Balance training in patients with balance disorders: A pre-post study

Somya Saxena1, Mandeep S, Dhillo2

1Department of Physical Rehabilitation Medicine, Post Graduate Institute of Medical Education and Research, PGIMER, Chandigarh, India, 2Departments of PRM and Orthopedics, Post Graduate Institute of Medical Education and Research, PGIMER, Chandigarh, India

Background and Aims: Gait and Postural assessment is an upcoming clinical tool to assist in rehabilitation of neuromuscular patients. Analysis of postural sway of a human body can be successfully done by studying oscillations of centre of pressure (COP) in stationary and dynamic mode. The distribution of foot pressure over different regions namely correlates well with the postural balance. quantitative score of postural balance is very important in determining improvement of the patients suffering from balance disorder and may be obtained by studying position of COP of the body.

Objective: To assess quantitative changes in the postural stability of patients suffering from balance disorders after providing them biofeedback-based balance training. Methods: We used Force Sensing Resistors (FSRs) to sense the magnitude of forces acting at various points of both the feet. The COP was determined using the positions of various force points and magnitude of the force acting on them. The higher capability of the body to remain at that position implies higher postural stability and a lower power of sway. The force sensors produce signal proportional to the magnitude of the foot pressure. Repeat analysis showed the amount of change in patient’s postural behaviour, before and after training. Results: Higher postural performances scores were observed in patients post intervention which correlated with clinical findings. Conclusions: Such quantitative scores can be used to assess the postural performance of patients suffering from different postural disorders.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP3: 2 Top

Functional status of patients with lower-limb amputation: A follow-up home-based visit

A. Thibaut, G. Cicchellero, C. Beaudart, J. Kaux, B. Maertens de Noordhout, D. Pelzer

Department of Physical Medicine, Rehabilitation and Sport Traumatology, Liege, Belgium

Background and Aims: We aim to evaluate patients with lower limb amputation’s functional status and prosthetic use during a follow-up visit at home.

Methods: In this observational prospective study patients were seen during a consultation 1-month after the patient’s discharge (T1) and two months later at the patients’ home (T2). The Timed Up and Go (TUG), the Prosthetic Profile of the Amputee Locomotor Capabilities Index (PPA-LCI) and the Houghton Instrument were collected. A questionnaire aiming at assessing patients’ satisfaction and the use of their prosthesis and technical aids was developed. Data are presented as medians and interquartile range (25-75). Wilcoxon matched-pairs was used to compare the outcomes between T1 and T2. Results: 8 patients were included [6 men, 8(7.5-9) months post-amputation, 66.5(62.5-72.5) years-old]; 5 transtibial, 3 transfemoral; 6 arthritis, 1, traumatic, 1 oncologic complication. PPA-LCI scores remained unchanged, while the Houghton scores increased. No difference on the TUG was found between T1 and T2. On the visual analogue scale (VAS), patients evaluated their daily functional difficulties similarly at T1 and T2, while their appraisal to have reached their walking capacity and autonomy improved. The hours per day of prosthesis use was equal, while their comfort was enhanced. They evaluated their autonomy regarding the prosthetic placement as excellent both at T1 and T2. See [Table 1] for a summary of the results. Conclusions: These preliminary findings highlighted a significant enhancement on the Houghton scale, highlighting a better perception of prosthetic use. In addition, patients’ perception on their walking capacity and autonomy improved when reassessed at home.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP3: 3 Top

Assessment of pelvic floor and abdominal muscles function among continent and incontinent non-active women

S. Ghroubi1, S. Abidi2, O. Jelassi1, H. Ben Ayed3, M. Chlif4,5, M. H. Elleuch1

1Department of Physical Medicine and Rehabilitation, HabibBourguiba University Hospital, Laboratory of evaluation and, Sfax, Tunisia, 2Research Unit Education, Motricité, Sport et Santé, UR15JS01, High Institute of Sport and Physical Education of Sfax, Sfax, Tunisia, 3Department of Preventive Medicine and Hospital Hygiene, HediChaker University Hospital, Sfax, Tunisia, 4Department of Sport Science, EA 3300 APS and Motor Patterns, Adaptations-Rehabilitation, Picardie Jules Verne University, Amiens, France, 5Tunisian Research Laboratory Sport Performance Optimization, National Center of Medicine and Sciencein Sports, Tunis, Tunisia

Background and Aims: Studies have shown that there is co-activation between abdominal and pelvic floor muscles in physiological conditions. This study aimed to assess pelvic floor and isokinetic trunk flexors function in non-active incontinent women, and to investigate the relationship between the strength of these muscle groups and the severity of stress urinary incontinence (SUI). Methods: A cross-sectional study was carried out. Twenty-five incontinent women were enrolled after one-hour pad test results and compared to twenty asymptomatic women. The severity of SUI was determined by the Pad test and Urinary Distress Inventory, Short Form (UDI-6). Pelvic floor muscle (PFM) function was assessed using the modified Oxford Scale, intra-vaginal PFM electromyography, and PFM endurance. Trunk flexors strength was assessed using a Cybex Norm II dynamometer. Results: Incontinent women had a weaker PFM and isokinetic abdominal muscle strength compared to continent women (p<0,05). SUI severity was negatively correlated with PFM strength (r=-0,620, p=0,001), isokinetic trunk flexors strength (r=-0,605, p=0,001), and PFM endurance (r=-0,561, p=0,003) in incontinent women. A positive correlation between PFM function and isokinetic trunk flexors strength was found in incontinent women (r=0,488, p=0,013). Conclusions: Non-active incontinent women had weaker pelvic floor muscle and isokinetic trunk flexors strength compared to continent ones. The positive correlation found between these two muscle groups may be explained by their synergic activity. These findings suggest that the severity of SUI could be related not only to PFM strength but also to abdominal muscle weakness. Abdominal wall training could be an alternative method to strengthen PFM in women with SUI

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP3: 4 Top

Impact of outpatient rehabilitation on non-motor signs in people with Parkinson’s disease. a retrospective cohort study

A. Lambertucci1, P. Bisoglio1, S. Ercoletti1, L. Latini1, M. Grugnetti2, M. Hibel2, E. Andrenelli1, M. G. Ceravolo1,2, M. Capecci1,2

1Department of Experimental and Clinical Medicine, University Politecnica delle Marche, Ancona, Italy, 2Neurorehabilitation Clinic, University Hospital Azienda Ospedali Riuniti di Ancona, Ancona, Italy

Background and Aims: This study aims to assess the impact of a High-Intensity Training (HIT=>1200min/session) against a Low-Intensity (LIT=<900min/session) task-oriented outpatient rehabilitation on non-motor symptoms and related disability in people with Parkinson’s disease (pwPD). Methods: Eligible subjects were pwPD under stable drug treatment undergoing a single cycle/year of gait and balance training at a University Hospital, from 2011 to 2018. Primary outcomes: changes in MDS-UPDRS (part-I) and Non-Motor Symptoms Scale (NMSS) at the end of treatment (T1) and 4+2 months later (T2), respect to baseline. Secondary outcomes: changes in UPDRS II-III, Timed Up and Go test, 6MWT. Results: 53 patients (68±7 years old, 9.9±6 years of disease, 2-4 Hoehn&Yahr stage, LEDD 705±409mg) were studied. Twenty-nine received HIT, while 24 LIT. Treatment groups were similar by demographics and clinical data at baseline. NMSS and MDS-UPDRS-I scores improved significantly after treatment though only in the HIT group (p=.02). The total training duration was an independent explanatory variable of NMSS score at T1 and T2 (p=.02) irrespective of age, disease duration and severity. At T2, non-motor symptoms worsened in all subjects, though more in LIT. At T0, 48% subjects took antidepressants, at T2, 10% HIT cases stopped antidepressants, while 12% LIT cases started them (p=.007). All secondary outcomes improved at the end of training, in both groups, though UPDRS-II more in HIT than LIT, both at T1 (p=.02) and T2 (p=.01). Conclusions: A high intensity training has the potential for improving non motor symptoms in pwPD, ensuring a reduction of disease-related disability in the medium term.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.4 Complications/Sequelae (i.e., Spasticity, Immobilization and Frailty) Top

  Print Code: OP3: 5 Top

Osteosarcopenia and type 2 diabetes mellitus in post-menopausal women: A case-control study

A. Moretti1, M. Paoletta1, S. Liguori1, F. Zanfardino1, A. Battaglini1, L. Giordano1, G. Iolascon1, F. Gimigliano2

1Department of Medical and Surgical Specialties and Dentistry, University of Campania Luigi Vanvitelli, Napoli, Italy, 2Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli, Napoli, Italy

Background and Aims: Background: Osteosarcopenia is the concomitance of low bone density and sarcopenia. Osteoporosis is characterized by alterations in bone microarchitecture and decrease of bone mineral density (BMD) resulting in increased risk of fractures, whereas sarcopenia is the progressive decrease of both muscle mass and function that increase the risk of falls. Type 2 diabetes (T2D) is associated with poor bone strength and muscle wasting, although the risk of osteosarcopenia in patients with T2D is not known so far. Aim of this study is to analyse the association between osteosarcopenia and T2D in post-menopausal women (PMW).

Methods: Methods: Thirty-six PMW (12 T2D vs 24 non-T2D) were recruited. DXA evaluation to investigate bone density and body composition measures was performed. We carried out muscle strength and performance assessments. Outcome measures were femoral neck and lumbar spine BMD T-scores, appendicular lean mass (ALM), handgrip strength and Short Physical Performance Battery (SPPB). Results: Results: The frequency of osteosarcopenia was higher in T2D group (50% vs 17%; OR 5.0, 95% CI 1.05 to 23.79, p = 0.043). Handgrip strength was lower in T2D group (10.1 ± 4.0 kg vs 18.4 ± 6.8 kg; p = 0.001). The frequency of osteosarcopenia combined with limitation in physical performance (SPPB < 8) (severe osteosarcopenia) was higher in T2D group (42% vs 13%; OR 5.0, 95% CI 0.94 to 26.49), but not significant [Table 1]. Conclusions: Conclusions: Post-menopausal women with T2D seem to have 5 times higher risk of osteosarcopenia compared to non-diabetic ones. Further studies on larger cohorts are required to confirm these findings.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP3: 6 Top

Predicting anxiety in patients with post-concussion syndrome

J. Olver1,2,3, B. Fedele1,2,3, D. McKenzie1,3

1Epworth HealthCare, Melbourne, Australia, 2Epworth Monash Rehabilitation Medicine Unit, Melbourne, Australia, 3Monash University, Melbourne, Australia

Background and Aims: In 15% of patients, symptoms arising from concussion persist beyond a few weeks and are known as post-concussion syndrome. A multidisciplinary rehabilitation program at Epworth aims to treat these symptoms. This study evaluated the predictive value of the most commonly reported symptoms at clinic admission (dizziness, visual problems, light sensitivity, sleeping more than usual, trouble falling asleep and irritability) for presence or absence of anxiety on discharge. Methods: On clinic admission, persisting symptoms are assessed using the Oregon Post Concussion Symptom Checklist and the Depression Anxiety and Stress Scale (DASS-21). Anxiety is defined as a score of greater than or equal to 8. Best subset regression was used to find the subset of the 6 predictors most highly related to persisting anxiety on discharge. Results: The Clinic has discharged 92 patients, of which 84 have complete admission checklist data (analytic sample). Of the sample, anxiety was reported in 50% of patients on admission and in 19% at discharge. Patients not reporting anxiety initially did not develop anxiety during treatment. The best subset comprised two items: ‘sleeping more than usual’ (RR=3.3, 95% CI=1.3 to 8.08), and ‘dizziness’ (RR=2.2, 95% CI = 0.9 to 5.2). These 2 items exhibited a total area under the Receiver Operating Characteristic (ROC) Curve, of (0.73, 95% CI = 0.59 to 0.87), comparable to that of all 6 items (0.75, 95% CI = 0.61 to 0.89). Conclusions: Anxiety is a persisting symptom within post-concussion syndrome. Evaluating the predictive value of initial symptoms may result in extra attention towards alleviating anxiety.

  Topic: 3. Clinical Sciences Top

  Sub Topic: 3.1 Health Conditions (Neuro, MSK, CP, Trauma, Cardio-Pulmonary Conditions, Vascular and Vestibular Impairments) Top

  Print Code: OP3: 7 Top

Upward magnetic stimulation of nerve roots improves motor function of spinal cord injury through sensorimotor cortex remodeling

Y Zheng1, D Zhao1, D Xu2,3

1Tongji Hospital Affiliated to Tongji University School of Medicine, Shanghai, China, 2Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai, China, 3Shanghai University of Traditional Chinese Medicine, Shanghai, China

Background and Aims: This study was to explore the mechanism of nerve root magnetic stimulation on the motor function of spinal cord injury (SCI) by constructing a rat model of nerve root magnetic stimulation (RMS).

Methods: 3d after the establishment of SCI models, SCI+RMS group was treated with magnetic stimulation at the L5-6 spinal nerve roots for 3 weeks, while SCI+SS group were received the sham stimulus. Behavioural tests and electrophysiological tests were performed before modeling and 1, 3, 7, 14, and 21 days after modeling. Besides, the sensory-motor area of the cerebral cortex was scanned by transmission electron microscope to measure several parameters of synaptic ultrastructure, and was taken for transcriptome sequencing. Results: SCI+RMS group significantly improved motor function on 3d, 7d, 14d, 21d after modeling compared with SCI+SS group. The electrophysiological results of MEP latency, SEP latency and H/M ratio were significantly reduced, but there was no significant difference in SEP amplitude. The results of synaptic ultrastructural parameters revealed that the thickness of the postsynaptic membrane density, the length of the synaptic active area and the synaptic curvature of RMS-treated rats were significantly increased compared with that of SCI+SS group. Transcriptome sequencing results showed that the expression of genes related to cell-cell interactions in the cerebral cortex and spinal cord injury areas of SCI rats was obviously elevated. Conclusions: RMS can significantly improve the motor function, nerve conduction, synaptic structure, and synaptic plasticity-related gene expression in rats with SCI, which may be related to activation of the ascending nerve conduction tract and reshaping of cortex.

  Topic: 4. Therapeutics Top

  Sub Topic: 4.1 Exercise Top

  Print Code: OP4: 1 Top

Eight weeks of high-intensity interval static strength training improves skeletal muscle atrophy and motor function of aged rats via a PGC-1 a/FNDC5/UCP1 pathway

L. Fang

Shanghai University of TCM, Shanghai, China

Background and Aims: Sarcopenia is a syndrome characterized by loss of skeletal muscle mass and strength. Most studies focus on dynamic resistance exercise to prevent muscular decline, and maintain older people’s muscle strength. However, this training mode is often restricted by the elderly people with osteoarthritis and limited range of motion. The static strength training mode is more suitable for elderly people. So we need to determine the effect and mechanism of static strength training on sarcopenia. Methods: We developed a training device for the static training of the upper limbs of rat, which was designed to collect the training data and to evaluate the effects of the upper limbs of rat during static training. To determine whether PGC-1a transduction participate in the effects of high-intensity interval static training on the muscle strength, the regulation of PGC-1a was locally blocked by siRNA injection at the midpoint of the biceps. Then the rat’s motor capacity was measured after static strength training. Immunohistochemistry and western blot were applied to determine the levels of PGC-1a/FNDC5/UCP1 expressions in the muscle and adipose tissue. Results: It was observed that increased level of serum Irisin and local expressions of FNDC5, PGC-1a and UCP1 in biceps and surrounding fatty tissue after static strength training. Static strength training showed an advantage in reducing body weight and white fat accumulation while increasing muscle fibers volume which resulted in longer training time and shorter rest time. Conclusions: High-intensity interval static training prevents skeletal muscle atrophy and improved the aged rat’s motor function through the PGC-1a/FNDC5/UCP1 signaling pathway.

  Topic: 4. Therapeutics Top

  Sub Topic: 4.1 Exercise Top

  Print Code: OP4: 2 Top

Prehabilitation, based on mixed physical activity, for patients with multiple myeloma, during chemotherapy before autologous hematopoietic stem cells transplantation (auto-HSCT): Safe and efficient

V. Pinelli1, P. Cerutti, Y. Darolles2, M. Roussel1, B. Hebraud1, A. Perrot1

1IUCT Oncopôle, Toulouse, France, 2Réseau de Soins Partn’Air, Saint-Orens de Gameville, France

Background and Aims: Multiple myeloma (MM) concerns 3000 new patients each year in France. Before 68 years, treatment is based on high-intensity chemotherapy requiring auto-HSCT, preceded by several month of induction chemotherapy. Patients have various deficiencies: asthenia, exercise intolerance, pain, peripheral neuropathy, and anxiety, heightened during 3 month following auto-HSCT. Prehabilitation, based on physical activity (PA), allows better tolerance of major oncological procedures, but have never been tried in MM. The aim of our pilot study is to assess it in MM. Methods: Patients were addressed by hematologists to OncoRehabilitation Unit, for first cardiopulmonary exercise testing (CPET). With CPET data, patients-tailored home-based 12 weeks prehabilitation program was induced, supervised by a PA teacher. It associated aerobics, strengthening, and stretching exercises. A second CPET were performed before auto-HSCT. Results: Provisional schedule have been disrupted by Covid-19. 10 patients are included today. All of them had bone lesions on spine, ribs, or long bones ; back pain; and most of them were sedentary.

All completed the 12 weeks prehabilitation, without any significant adverse effect. Only delayed onset muscle soreness were reported. Observance was over recommended 3+ sessions a week. Resistance and duration of sessions constantly increased until week 12. CPET data showed a significant increase in oxygen consumption at effort acme and at first ventilatory threshold. Conclusions: Prehabilitation based on PA is feasible, safe, and significantly efficient for patients undergoing inductive chemotherapy for MM. They arrive in better shape to auto-HSCT. This study is still on track and data about post-allo-HSCT will soon be available.

  Topic: 4. Therapeutics Top

  Sub Topic: 4.5 Physical Modalities Top

  Print Code: OP4: 3 Top

Microinvasive percutaneous needle tenotomy to treat neurological foot deformations: A large retrospective study

F. Angioni1, M. Salga2, P. Denormandie2, F. Genet2, O. Haigh3, R. David4, L. Gatin2, A. Schnitzler1

1Université Paris INSERM U1153 CRESS EpiAgeing, Paris, France, 2Université Paris Saclay U1179 END ICAP HandiResp EA4047, Paris, France, 3Center for Immunology of Viral, Auto-Immune, Hematological and Bacterial Diseases (IMVA-HB), Infectious Diseases Models, Paris, France, 4Université de Poitiers, Service de Médecine Physique et de Réadaptation, Poitiers, France

Background and Aims: Acquired deforming hypertonia (ADH) induces joint deformity and pain, and is largely due to excessive muscle tone, caused by numerous chronic conditions. Medical treatment is not always effective and surgery is difficult to perform in frail patients. Tenotomy with a needle is an appealing alternative to open surgery because its minimally invasive nature allows avoidance of skin and general anesthesia complications. Objective: To evaluate the persistence of needle tenotomy functional efficacy in patients with ADH of the foot. Methods: A single center, retrospective study of all foot-involving needle tenotomy was performed. Tenotomy was carried out under short-acting sedation and concerned muscles involved in equinovarus foot and claw toe. Outcomes were assessed more than a year after the tenotomy using goal attainment scaling (GAS), patient global assessment (PGA), and recording occurrences of complications and changes in orthopaedic fitting. Funding: none. Results: Of 137 tenotomies involving feet performed, 100 were evaluated. Evaluation occurred on average 30 months after tenotomy. GAS were increased significantly at follow-up (p<0.01). The primary goal was met or exceeded for 64% of surgeries while an additional 17% achieved progress towards the goal without it being reached. Mean PGA was 8.65/10. No serious complications were reported.

Conclusions: Needle tenotomy to treat ADH of the foot in the frail population provided functional benefits, which persisted over a long period. This surgery was well tolerated, as risk of serious complications were overcome, and only few recurrences were observed. This treatment should be proposed more systematically, and could be an alternative to conventional surgery.

  Topic: 6. Health Policy and Systems Top

  Sub Topic: 6.1 Community Based rehabilitation Top

  Print Code: OP4: 4 Top

Postural control and muscle activity during stand-to-sit movement in individuals with knee osteoarthritis

S. Fu1, X. Wang1

1College of Rehabilitation Medicine, Fujian University of TCM, Fuzhou, China, 2Key Laboratory of Orthopedics and Traumatology of Traditional Chinese Medicine and Rehabilitation, Fuzhou, China

Background and Aims: Unlike sit-to-stand, sitting to a chair is performed by eccentric contraction of the muscles in order to lower the body, which requires more muscle control than concentric. We investigated whether knee osteoarthritis (knee OA) patients exist different muscle activation and movement characteristics during the descending phase in 30-second Chair Stand Test (30sCST).

Methods: Thirty patients with knee OA and thirty age-matched asymptomatic controls performed the 30sCST at a self-selected speed. Forward lean segment angles, joints range of motion (ROM) and joint moments were examined. To quantify postural control, the root-mean-square (RMS) amplitude and velocity of center of pressure (COP) were measured. Surface electromyography (sEMG) test included the gluteus maximus (GMAX), vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA) and medial head of gastrocnemius (MG). RMS% or integral EMG% reflected average or total muscle excitation level. Results: Knee OA patients displayed a smaller ankle ROM compared with the controls while no differences in other kinematic or kinetic data. In addition, patients reduced RMS% of TA, quadriceps femoris(i.e. VL, VM, RF) and increased GMAX, BF iEMG% than asymptomatic. Conclusions: This research indicates individuals with knee OA perform no impaired postural control, but they do exist different neuromuscular activation strategies and movement patterns to achieve the stand-to-sit transition. Due to quadriceps activation deficit, patients using more GMAX eccentric contraction to control descending the body against gravity. In the meantime, low TA activity results in reduced ankle ROM. In the future, pay attention to gluteus muscles in rehabilitation training may help improve the ability of daily activities.

  Topic: 6. Health Policy and Systems Top

  Sub Topic: 6.5 Rehabilitation across the Continuum of Care Top

  Print Code: OP4: 5 Top

An answer to COVID-19 pandemic: Cochrane rehabilitation REH-cover (rehabilitation – COVID-19 evidence-based response) action

M. Ceravolo1, E. Andrenelli1, C. Arienti2, A. DE Sire3,4, F. Negrini5, S. Lazzarini2, M Patrini2, C. Kiekens6, S. Negrini5,7

1Department of Experimental and Clinical Medicine, Politecnica delle Marche University, Ancona, Ancona, Italy, 2IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy, 3Department of Health Sciences, Physical and Rehabilitative Medicine, University of Eastern Piedmont, Novara, Italy, 4Ehabilitation Unit, Mons. L. Novarese Hospital, Moncrivello, Vercelli, Italy, 5IRCCS Istituto Ortopedico Galeazzi, Milan, Italy, 6Spinal Unit, Montecatone Rehabilitation Institute, Imola, Italy, 7Department of Biomedical, Surgical and Dental Sciences, University la Statale, Milan, Italy

Background and Aims: In 2020, the outbreak of the COVID-19 pandemic has made it necessary to alter priorities. In these challenging times, Cochrane Rehabilitation has established a new relevant project in line with pandemic needs: the REH-COVER (Rehabilitation – Covid-19 Evidence-based Response) action. The aim was to focus on the timely collection, review and dissemination of summarised and synthesised evidence relating to COVID-19 and rehabilitation. Methods: It includes systematically collecting all the current evidence on COVID-19, identifying the existing evidence on the expected sequalae of COVID-19 and its treatments, and other initiatives in collaboration with the World Health Organization (WHO) rehabilitation programme. The action was developed by an International Multi-professional Steering Committee, whose role will continue to advice on all initiatives included in this action. Results: Cochrane Rehabilitation REH-COVER action has included in 2020 five main initiatives: Rapid living Systematic Reviews on Rehabilitation and Covid-19; Interactive living evidence map on Rehabilitation and Covid-19; Definition of the research topics on Rehabilitation and Covid-19 in collaboration with the World Health Organization (WHO) rehabilitation programme; Cochrane Library Special Collection: Coronavirus (COVID-19): rehabilitation of patients with functional consequences of acute illness and its treatments; Collaboration with COVID-END for the topics rehabilitation and disability. Conclusions: Given the current COVID-19 situation, having the best available rehabilitation evidence is fundamental to help reduce clinical uncertainty. To update the rehabilitation community on the increasing growth of evidence on rehabilitation for patients with consequences due to Covid-19 and its treatments, Cochrane Rehabilitation launched the REH-COVER (Rehabilitation – Covid-19 Evidence-based Response) action.

  Topic: 7. Functioning and Disability Top

  Sub Topic: 7.4 Impairment Rating, Disability Evaluation and Certification Top

  Print Code: OP4: 6 Top

Effects of computer game assisted task specific exercises on upper extremity functionality, cognitive function and quality of life in stroke patients: A randomized control study

S. Ozen, H Boluk Senlikci, S Guzel

Department of Physical Medicine and Rehabilitation, Baskent University Faculty of Medicine, Ankara, Turkey

Background and Aims: Computer game assisted task specific exercises (CGATSE) have been shown to improve arm motor function following acute stroke. CGATSE may also enhance the development of problem solving skills following stroke. The aim of this study was to determine the effects of CGATSE on hemiplegic arm, hand, cognitive function and quality of life in stroke. Methods: Thirty stroke patients were randomized into two groups. All participants received twenty sessions of physical therapy (PT) and occupational therapy (OT). The CGATSE group received thirty minutes of conventional OT and thirty minutes of CGATSE using the Rejoyce gaming system; while the control group received one hour of OT. Motor function was evaluated using the Fugl Meyer upper extremity (FMUE), Brunnstrom stages of stroke recovery (BSSR) arm and hand, Rejoyce arm hand function test (RAHFT) and test duration (RAHFT time). Cognitive function was evaluated using the mini mental state exam, Montreal Cognitive Assessment (MoCA) and Stroke Specific Quality of Life (SS-QOL). Results: The FMUE, BSSR arm, RAHFT score and time, SSQOL improved in both groups (p<0.05). BSSR of the hand improved in the CGATSE group (p=0.024). MoCA scores significantly improved in the control group (p=0.008). Conclusions: CGATSE helps improve motor function and QOL in hemiplegic stroke patients and may be advantageous in providing continuation of care after stroke, especially during the Covid-19 pandemic when home based rehabilitation options are becoming increasingly important.


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