BACKGROUND

Patients with severe nontraumatic brain injuries often present with disorders of unconsciousness. Immediate neurologic care, neuroprotection, and early neurorehabilitation are core principles for better outcomes. Neurorehabilitation, through both pharmacological and non-pharmacological strategies, aims to enhance neuroplasticity for faster recovery. Amantadine, primarily known as an antiviral and used in Parkinson’s treatment, has shown a potential role for accelerating neuronal recovery and neurorehabilitation.

OBJECTIVE

Available literature on the use of amantadine for nontraumatic brain injury patients is limited. This scoping review aims to identify the potential benefits and limitations of amantadine in neurorehabilitation.

METHODOLOGY

In the literature review, the keywords "Amantadine" AND "Neurorehabilitation" were used to search PubMed, EBSCO, and the Cochrane Library for articles published between January 1, 2003, and August 2024. Inclusion criteria required that articles have clear research objectives, strict subject eligibility criteria, a detailed methodology, and the administration of amantadine for nontraumatic brain injuries. Out of 57 identified articles, only 7 were included in the study.

RESULTS AND DISCUSSION

Its benefits include improving the level of consciousness, accelerating recovery, decreasing mortality, managing delayed post-hypoxic encephalopathy, and improving verbal fluency in nonfluent speech. Its adverse effects and the paucity of available literature recommending amantadine for neurorehabilitation are the possible limitations.

CONCLUSION

Amantadine accelerates the neurologic recovery of patients with disorders of unconsciousness secondary to nontraumatic brain injuries.

RECOMMENDATION

Future studies may conduct meta-analyses, systematic reviews, and randomized controlled trials of amantadine in patients with nontraumatic brain injury to further strengthen its promising role in neurorehabilitation.

Human ; Amantadine ; Neurological Rehabilitation ; Neurorehabilitation

BACKGROUND AND OBJECTIVES

Telerehabilitation is the remote delivery of rehabilitation services using telecommunication technologies. Its local adoption was catalyzed by the COVID-19 pandemic, prompting the need to assess user acceptance. This study aimed to determine the acceptance of stroke telerehabilitation among patients, carers, and rehabilitation providers in the Department of Physical Medicine and Rehabilitation at St. Luke’s Medical Center – Global City and Quezon City.

METHODS

This descriptive cross-sectional study used purposive sampling to recruit 73 rehabilitation providers and 10 consumers. Data were collected using a self-administered survey based on the Technology Acceptance Model, covering perceived ease of use, usefulness, and behavioral intent. Descriptive and inferential statistics were used for analysis.

RESULTS

Most providers (94.4%) were familiar with telerehabilitation, while only half of the consumers were aware of it. Acceptance was moderate among providers (mean score: 35.75 ± 8.67) and high among consumers (mean score: 31.6 ± 7.52). Female providers were less likely to accept telerehabilitation (p=0.049). Consumers identified financial constraints and lack of a companion as key barriers, while providers cited internet issues and technology use. Both groups viewed telerehabilitation positively for teleconsultation, teletherapy, and telemonitoring. Smartphones were the preferred device; Viber and Facebook Messenger were the most commonly chosen platforms.

CONCLUSION

Stroke telerehabilitation was moderately to highly accepted by rehabilitation stakeholders in two tertiary private hospitals in Manila. Findings may guide institutional planning for telerehabilitation services. Training, infrastructure support, and awareness campaigns can help address implementation barriers.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Remote Consultation ; Physical And Rehabilitation Medicine ; Tertiary Care Centers ; Telecommunications ; Telerehabilitation ; Cross-sectional Studies ; Technology ; Stroke ; Covid-19

Effective discharge planning is crucial for ensuring safe transitions and sustained occupational participation as clients transition from professional care to their desired community settings. Despite its importance, current discharge practices in occupational therapy remain inconsistent, often relying on informal communication, variable team coordination, and unstructured decision-making. These gaps contribute to client–caregiver unpreparedness, fragmented services, and increased readmissions. This manuscript presents the Building Rehabilitation Into Discharge Goals and Engagement (BRIDGE) Framework, a client-centered, occupation-focused conceptual model designed to structure and support the discharge planning process in occupational therapy.

The BRIDGE framework was developed through an iterative process of literature review, theoretical grounding, and integration of clinical experience. It synthesizes principles from the Canadian Practice Process Framework, Person–Environment–Occupation frameworks, the Kawa Model, and Bioecological Systems Theory. The framework outlines six discharge planning steps, ranging from goal and timeline setting to follow-up and monitoring, supported by four foundational pillars: patient and family factors, occupational therapy factors, interdisciplinary team factors, and environmental or system influences. Together, these components provide a comprehensive guide for clinical reasoning, collaborative planning, caregiver preparation, and transitional support.

The framework clarifies the role of occupational therapy, enhances interprofessional coordination, and promotes consistent transition planning. Future work should include empirical testing, case-based application, and population-specific adaptations.

Human ; Patient Discharge ; Residence Characteristics ; Rehabilitation ; Communication ; Clinical Reasoning

Abstract Background: This study aims to determine the effectiveness of programmed exercise with telerehabilitation at home in patients with obesity and knee osteoarthritis on visual analogue scale scores, body mass index, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Methods: This research is a pre–post study in patients with obesity and knee osteoarthritis. Research subjects performed a series of exercise programs at home for 28 days. Before the program, there was an initial assessment from a psychologist and a nutritionist. During the program, there was tele-education, telemonitoring, and teleconsultation from doctors. Twenty-six female subjects participated. Results: Visual analogue scale scores decreased statistically significantly every week, until the end of the fourth week, compared with before the intervention (p<0.001). Body mass index and WOMAC scores decreased statistically significantly at the end of the fourth week compared with before the intervention (both p<0.001). Further analysis of all WOMAC components in the intervention group, including pain, stiffness, and physical function, also showed a statistically significant decrease (p<0.001). Conclusion: Programmed exercise as part of telerehabilitation at home has been statistically proven to reduce visual analogue scale scores, body mass index, and WOMAC in patients with obesity and knee osteoarthritis.
Telerehabilitation ; Knee Osteoarthritis ; Obesity ; Body Mass Index ; Visual Analogue Scale ; WOMAC

Humans ; Critical Illness/rehabilitation* ; Child ; China

Stroke causes abnormality of brain physiological function and limb motor function. Brain-computer interface (BCI) connects the patient's active consciousness to an external device, so as to enhance limb motor function. Previous studies have preliminarily confirmed the efficacy of BCI rehabilitation training in improving upper limb motor function after stroke, but the brain mechanism behind it is still unclear. This paper aims to review on the brain mechanism of upper limb motor dysfunction in stroke patients and the improvement of brain function in those receiving BCI training, aiming to further explore the brain mechanism of BCI in promoting the rehabilitation of upper limb motor function after stroke. The results of this study show that in the fields of imaging and electrophysiology, abnormal activity and connectivity have been found in stroke patients. And BCI training for stroke patients can improve their upper limb motor function by increasing the activity and connectivity of one hemisphere of the brain and restoring the balance between the bilateral hemispheres of the brain. This article summarizes the brain mechanism of BCI in promoting the rehabilitation of upper limb motor function in stroke in both imaging and electrophysiology, and provides a reference for the clinical application and scientific research of BCI in stroke rehabilitation in the future.
Humans ; Brain-Computer Interfaces ; Stroke Rehabilitation ; Upper Extremity/physiopathology* ; Brain/physiopathology* ; Electroencephalography ; Stroke/physiopathology*

Post-stroke spasticity, a common sequelae of upper motor neuron lesions, results in motor control deficits and pathological hypertonia that not only reduce patients' activities of daily living but may also cause impairment of adaptive neuroplasticity. Repetitive peripheral magnetic stimulation (rPMS), as a novel non-invasive neuromodulation technique, demonstrates unique clinical potential through targeted modulation of electromagnetic coupling effects in the peripheral neuromuscular system. Although current international studies have validated the therapeutic potential of rPMS for spasticity, significant heterogeneity persists in elucidating its mechanisms of action, optimizing parameter protocols, and standardizing outcome assessment systems. This review innovatively synthesized recent randomized controlled trials (RCTs) and mechanistic evidence, systematically summarizing rPMS-mediated multidimensional intervention paradigms for upper- and lower-limb spasticity. It rigorously examined the correlations between stimulation frequency parameters (low-frequency vs. high-frequency), anatomical targeting (nerve trunk vs. motor point), and clinical outcomes including spasticity severity, motor function, and quality of life. Crucially, the analysis reveals that rPMS may ameliorate spasticity after stroke through dual mechanisms involving local neuroelectrophysiological modulation and central sensorimotor network reorganization, thereby providing a theoretical foundation for developing individualized rPMS clinical protocols and establishing precision treatment strategies.
Humans ; Lower Extremity/physiopathology* ; Upper Extremity/physiopathology* ; Muscle Spasticity/physiopathology* ; Stroke/physiopathology* ; Magnetic Field Therapy/methods* ; Spasm/etiology* ; Stroke Rehabilitation ; Randomized Controlled Trials as Topic

OBJECTIVE: To compare early graft healing between over-the-top (OTT) and anatomic single-bundle (SB) anterior cruciate ligament (ACL) reconstruction. METHODS: A clinical data of 40 patients underwent ACL reconstruction, who admitted between June 2021 and October 2022 and met the selective criteria, was retrospectively analyzed. Among them, 20 patients were treated with OTT reconstruction (OTT group) and 20 with SB reconstruction (SB group). There was no significant difference between groups ( P>0.05) in the gender, age, affected side, disease duration, degree of meniscus injury, body mass index, and preoperative International Knee Documentation Committee (IKDC) score, Lysholm score, pain visual analogue scale (VAS) score, and KT-2000 measurement. At 3, 6, and 12 months, MRI was performed to measure the signal noise quotient (SNQ) of the proximal end, middle, and distal end of the graft in the two groups, as well as at the corner of the graft with lateral femoral condyle and 1 cm around the femoral fixation point in the OTT group, to observe the degree of graft healing. Before operation and at 3, 6, and 12 months, the knee function and pain were evaluated by IKDC score, Lysholm score, and VAS score. Before operation and at 12 months after operation, the KT-2000 measurement was taken to evaluation the knee joint stability. RESULTS: All operations were successfully completed in both groups and the incisions healed by first intention. All patients were followed up 12-15 months (mean, 12.9 months), with no significant difference in the follow-up time between groups ( P>0.05). After operation, the IKDC score, VAS score, and Lysholm score improved gradually over time in both groups, with significant differences between different time points ( P<0.05). The differences between groups at 3, 6, and 12 months after operation were not significant ( P>0.05). The anterior and posterior stability of the knee joint improved significantly in both groups at 12 months after operation, and the difference in KT-2000 measurements was significant when compared with the preoperative value ( P<0.05), but the difference of pre- and post-operation between groups was not significant ( P>0.05). At 3, 6, and 12 months after operation, MRI showed that the differences in the SNQ of the proximal end and middle of the grafts between the two groups were not significant ( P>0.05), and the SNQ of distal end was significantly higher in the SB group than in the OTT group ( P<0.05). At each time point, grafts in the OTT group had the highest SNQ at the corner and the lowest at the fixation point, and the differences were significant compared to the other sites ( P<0.05). In the two groups, except for the fixation point, the SNQ of the remaining sites were highest at 6 months and lowest at 12 months ( P<0.05). In addition, there were significant differences in SNQ between the different sites of grafts ( P<0.05), and the SNQ was lowest at proximal end and highest at distal end. At last follow-up, the knee grafts in both groups were in good shape and no graft necrosis or loosening of the internal fixation was observed. CONCLUSION The knee joint function and graft healing after OTT reconstruction of ACL are similar to those of SB reconstruction, but it should be noted that the healing at the corner of the graft is slower.
Retrospective Studies ; Treatment Outcome ; Anterior Cruciate Ligament Reconstruction/rehabilitation* ; Follow-Up Studies ; Tibial Meniscus Injuries/surgery* ; Patient Positioning/methods* ; Recovery of Function ; Pain Measurement ; Knee Joint/surgery* ; Humans ; Male ; Female ; Adult ; Wound Healing

OBJECTIVE: To review the research progress of intelligent remote follow-up modes in the application after hip and knee arthroplasty. METHODS: Extensive literature on this topic published in recent years both domestically and internationally was reviewed, and the application of intelligent remote follow-up modes after hip and knee arthroplasty was summarized and analyzed. RESULTS: The intelligent remote follow-up mode is a novel follow-up method based on network information technology. Patients who undergo hip and knee arthroplasty require long-term follow-up and rehabilitation guidance after operation. Traditional outpatient follow-up is relatively time-consuming and inconvenient for some patients in terms of travel and transportation, which makes the application of intelligent remote follow-up modes increasingly widespread worldwide. The inherent attributes of remote interaction and instant feedback of this mode make it particularly valued in the field of hip and knee arthroplasty. Artificial intelligence (AI)-based voice follow-up systems and virtual clinics have significant advantages in improving follow-up efficiency, reducing human resource costs, and enhancing patient satisfaction. CONCLUSION The existing intelligent follow-up system has formed a standardized protocol in remote follow-up and rehabilitation guidance. However, there are still shortcomings in the formulation of personalized rehabilitation plans and the gerontechnological adaptation of human-computer interaction. In the future, it is necessary to construct a multimodal data fusion platform and establish technical application guidelines for different rehabilitation stages.
Humans ; Arthroplasty, Replacement, Knee/rehabilitation* ; Arthroplasty, Replacement, Hip/rehabilitation* ; Artificial Intelligence ; Follow-Up Studies ; Telemedicine

OBJECTIVE: To explore the feasibility of using biomechanical indicators as supplementary evaluation to the Musculoskeletal Tumor Society Scoring System (MSTS) for amputee patients. METHODS: Twenty-four patients who underwent hemipelvectomy between September 2018 and January 2025 were enrolled. There were 15 males and 9 females with an average age of 61.4 years (range, 45-76 years). Participants performed gait tests at self-selected speeds using three assistive devices (prosthesis, single crutch, and double crutches). Motion data were analyzed using a customized OpenSim model. Biomechanical indicators of the intact limb exhibiting common characteristics were screened through correlation and sensitivity analyses. Test-retest reliability [interclass correlation coefficient (ICC)] of selected parameters was assessed to evaluate their potential as MSTS score supplements. RESULTS: All biomechanical indicators showed significant positive correlations with MSTS scores across assistive devices ( P<0.05). Seven indicators demonstrated |Pearson correlation coefficients|>0.8, including walking speed, maximum hip angle, maximum hip moment, peak hip flexion moment, peak hip extension moment, hip flexion impulse, and hip extension impulse. Among these, maximum hip moment, hip flexion impulse, and hip extension impulse exhibited significant between-group differences in adjacent MSTS levels ( P<0.05), indicating high sensitivity, along with excellent test-retest reliability (ICC>0.74, P<0.01). CONCLUSION Biomechanical indicators statistically qualify as potential supplements to MSTS scoring. Maximum hip moment, hip flexion impulse, and hip extension impulse demonstrate particularly high sensitivity to MSTS score variations.
Humans ; Male ; Middle Aged ; Female ; Aged ; Biomechanical Phenomena ; Amputees/rehabilitation* ; Feasibility Studies ; Artificial Limbs ; Reproducibility of Results ; Amputation, Surgical ; Crutches ; Gait