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Alashram AR. Combined noninvasive brain stimulation virtual reality for upper limb rehabilitation poststroke: A systematic review of randomized controlled trials. Neurol Sci 2024; 45:2523-2537. [PMID: 38286919 DOI: 10.1007/s10072-024-07360-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/22/2024] [Indexed: 01/31/2024]
Abstract
Upper limb impairments are common consequences of stroke. Noninvasive brain stimulation (NIBS) and virtual reality (VR) play crucial roles in improving upper limb function poststroke. This review aims to evaluate the effects of combined NIBS and VR interventions on upper limb function post-stroke and to provide recommendations for future studies in the rehabilitation field. PubMed, MEDLINE, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched from inception to November 2023. Randomized controlled trials (RCTs) encompassed patients with a confirmed stroke diagnosis, administrated combined NIBS and VR compared with passive (i.e., rest) or active (conventional therapy), and included at least one outcome assessing upper limb function (i.e., strength, spasticity, function) were selected. The quality of the included studies was assessed using the Cochrane Collaboration tool. Seven studies met the eligibility criteria. In total, 303 stroke survivors (Mean age: 61.74 years) were included in this review. According to the Cochrane Collaboration tool, five studies were classified as "high quality," while two were categorized as "moderate quality". There are mixed findings for the effects of combined NIBS and VR on upper limb function in stroke survivors. The evidence for the effects of combined transcranial direct current stimulation and VR on upper limb function post-stroke is promising. However, the evidence regarding the effects of combined repetitive transcranial magnetic stimulation and VR on upper limb function is limited. Further randomized controlled trials with long-term follow-up are strongly warranted.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR. Gufoni maneuver for treatment of horizontal canal benign paroxysmal positional vertigo: a systematic review of randomized controlled trials. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08712-y. [PMID: 38705895 DOI: 10.1007/s00405-024-08712-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Accepted: 04/29/2024] [Indexed: 05/07/2024]
Abstract
PURPOSE This review aims to investigate the effects of the Gufoni maneuver on horizontal semicircular canal benign paroxysmal positional vertigo (HC-BPPV). METHODS A comprehensive search, including PubMed, PEDro, REHABDATA, SCOPUS, EMBASE, and Web of Science, was conducted to determine randomized clinical trials (RCTs) studying the effects of the Gufoni maneuver for HC-BPPV from inception to March 1, 2024. The quality of the included studies was estimated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS Ten randomized controlled trials (RCTs) were included in this review with a total of 1025 HC-BPPV patients (mean age = 58.58 years; 63% female; 55% right-side HC-HBPPV; 49% geotropic HC-BPPV). The included RCTs ranged from 4 to 9 out of 10 (median = 6.5) on the PEDro scale. The included studies showed that the Gufoni maneuver revealed efficacy when compared to the sham maneuver but not when compared to other maneuvers such as the Barbecue roll maneuver, the Appiani maneuver, the Mastoid oscillation, the head shaking, and the modified Gufoni maneuver. CONCLUSIONS The Gufoni maneuver is considered an option for treating patients with geotropic or apogeotropic HC-BPPV. Precise diagnosis of the BPPV, the subtype of HC-BPPV, symptom duration, history of previous BPPV attacks, the applied methods of maneuver and the proficiency of the clinician performing the maneuver, proper diagnosis, presence of any underlying health conditions are critical for successful treatment. Further studies are strongly warranted.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Airport Road 1666, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR. Letter to the Editor on "Cognitive-and-motor Therapy After Stroke Is Not Superior to Motor and Cognitive Therapy Alone to Improve Cognitive and Motor Outcomes: New Insights From a Meta-analysis". Arch Phys Med Rehabil 2024; 105:1019. [PMID: 38286215 DOI: 10.1016/j.apmr.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/03/2024] [Accepted: 01/04/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Anas R Alashram
- Physiotherapy Department, Middle East University, Amman, Jordan; Applied Science Research Center, Applied Science Private University, Amman, Jordan; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR. Efficacy of arm crank ergometry on individuals with spinal cord injury: A systematic review of randomized controlled trials. PM R 2024. [PMID: 38581364 DOI: 10.1002/pmrj.13143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/31/2023] [Accepted: 01/18/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVES To investigate the efficacy of arm crank ergometry (ACE) on physical, psychological, and quality of life outcomes in individuals with spinal cord injury (SCI). LITERATURE SURVEY A comprehensive search was conducted on PubMed, Scopus, MEDLINE, Physiotherapy Evidence Database (PEDro), Web of Science, REHABDATA, and Embase from inception until July 2023. METHODOLOGY Studies were included if the sample was composed of individuals with SCI, the intervention followed an ACE intervention, and the study was a randomized controlled trial including at least one outcome measure evaluating physical, psychological, or quality of life. The PEDro scale was used to assess the methodological quality of the included studies. The meta-analysis was not feasible due to the heterogeneity in the treatment protocols and outcome measures among the selected studies. SYNTHESIS Of 1013 articles, seven studies (n = 200), with 16% of participants being female, were included in this review. The scores on the PEDro scale ranged from 6 to 8, with a median score of 7. There were variations in treatment protocols and outcome measures, resulting in heterogeneous findings. The effects of the ACE interventions on physical, psychological, and quality of life outcomes showed inconsistency. CONCLUSIONS ACE training proves to be a suitable and safe intervention for individuals with traumatic SCI. Nevertheless, the existing evidence concerning its effects on physical, psychological, and quality of life outcomes in individuals with SCI is limited. Further trials are required to investigate the effects of various ACE training protocols on SCI populations.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR. Letter to the Editor on "Effects of Anodal Transcranial Direct Current Stimulation With Overground Gait Training on Lower Limb Performance in Individuals With Incomplete Spinal Cord Injury". Arch Phys Med Rehabil 2024:S0003-9993(24)00906-7. [PMID: 38554794 DOI: 10.1016/j.apmr.2024.02.738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Accepted: 02/06/2024] [Indexed: 04/02/2024]
Affiliation(s)
- Anas R Alashram
- Physiotherapy Department, Middle East University, Amman, Jordan; Applied Science Research Center, Applied Science Private University, Amman, Jordan; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR. Semont maneuver for posterior canal benign paroxysmal positional vertigo: a systematic review of randomized controlled trials. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08586-0. [PMID: 38530461 DOI: 10.1007/s00405-024-08586-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/27/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE This review aimed to examine the effects of the Semont maneuver on posterior canal benign paroxysmal positional vertigo (BPPV). METHODS PubMed, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched comprehensively from inception to January 2024. The Physiotherapy Evidence Database (PEDro) scale was employed to evaluate the quality of the selected studies. RESULTS In total, 18 randomized controlled trials met the eligibility criteria. A total of 2237 participants with BPPV (mean age = 58.10 years) were included in this review. Among them, 37.5% were males, and 58% presented with right-sided BPPV. The included studies ranked from 5 to 9 out of 10 (Median = 7), suggesting good to excellent quality on the PEDro scale. The available literature revealed that the Semont maneuver is effective in improving posterior canal BPPV symptoms. CONCLUSION The Semont maneuver is considered a standard option for treating posterior canal BPPV, with a high success rate of around 80%. It is suggested as the primary option for managing posterior canal BPPV in individuals who complain of cervical or lumbar problems, severe cardiac or respiratory conditions. Further studies are strongly needed to understand the long-term effects of the Semont maneuver and to identify the recurrence rate.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Airport Road 1666, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
- Centre of SpaceBio-Medicine, Department of Systems Medicine, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", 00133, Rome, Italy.
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Alashram AR. Effectiveness of aerobic exercise on cognition in individuals with traumatic brain injury: A systematic review. Appl Neuropsychol Adult 2024:1-9. [PMID: 38470898 DOI: 10.1080/23279095.2024.2327829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/14/2024]
Abstract
Cognitive deficits are among the most common impairments in individuals with traumatic brain injury (TBI). Aerobic exercise is a repetitive and structured physical activity that influences structural and functional brain alterations differently. This review aims to examine the effects of aerobic exercise on cognition in individuals with TBI. PubMed, CINAHL, EMBASE, SCOPUS, MEDLINE, and Web of Science were searched from inception to December 20, 2023. Studies designed as randomized controlled trials (RCT), clinical controlled trials (CCT), and pilot studies included individuals with a confirmed diagnosis of TBI, comparing aerobic exercise with passive, active, or no control group and included at least one outcome measure assessing any cognitive domain were selected. The quality of the selected studies was assessed using the Physiotherapy Evidence Database (PEDro) scale. Six studies met the eligibility criteria (n = 118), with 53% of participants being female. Four studies were of good quality, fair quality (n = 1), and poor quality (n = 1) on the PEDro. Two of the selected studies showed significant improvements in cognition after moderate and vigorous aerobic exercises, while four studies indicated that moderate and vigorous aerobic exercise did not improve cognition post-TBI. The evidence on the effects of moderate and vigorous aerobic exercise on cognitive function post-TBI remains limited. Additional studies are strongly warranted to understand aerobic exercise's effects on cognition post-TBI.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR, Janada Q, Ghrear T. Noninvasive brain stimulation for spasticity rehabilitation in multiple sclerosis: A systematic review of randomized controlled trials. PM R 2024; 16:268-277. [PMID: 37574913 DOI: 10.1002/pmrj.13055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 06/29/2023] [Accepted: 08/01/2023] [Indexed: 08/15/2023]
Abstract
OBJECTIVE To investigate the effects of noninvasive brain stimulation (NIBS) on spasticity in people with multiple sclerosis (PwMS). LITERATURE SURVEY We searched PubMed, SCOPUS, MEDLINE, REHABDATA, PEDro, CINAHL, AMED, and Web of Science until December 2022. METHODOLOGY Studies were selected if they included PwMS, used transcranial direct current stimulation (tDCS) or repetitive transcranial magnetic stimulation (rTMS) as a main intervention, and were randomized controlled trials (RCTs) including at least one outcome measure evaluating spasticity. Two researchers individually screened the selected studies. The study's quality was assessed using the Cochrane Collaborations tool. The researchers decided that the meta-analysis was not possible because the treatment interventions varied among the selected studies. SYNTHESIS In total, 147 studies were reviewed. Of them, nine studies met the eligibility criteria and included 193 PwMS (mean age = 43.2 years), 54.4% of whom were female. Eight studies were considered "high" quality and one was considered "moderate" quality. Seven studies that used rTMS demonstrated a significant decrease in spasticity in PwMS after the intervention. The remaining studies that provided tDCS did not show meaningful effects. CONCLUSIONS The evidence for the influences of rTMS on spasticity in PwMS is promising. The evidence for the impact of tDCS on spasticity in PwMS was limited. Further RCTs with long-term follow-ups are encouraged.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Qusai Janada
- Department of Physiotherapy, Middle East University, Amman, Jordan
| | - Tamara Ghrear
- Department of Physiotherapy, Middle East University, Amman, Jordan
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Alashram AR. Letter to the Editor On "Effectiveness and Equity in Community-Based Rehabilitation on Pain, Physical Function, and Quality of Life After Unilateral Lower Limb Amputation: A Systematic Review". Arch Phys Med Rehabil 2024:S0003-9993(24)00813-X. [PMID: 38373621 DOI: 10.1016/j.apmr.2023.12.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 02/21/2024]
Affiliation(s)
- Anas R Alashram
- Physiotherapy Department, Middle East University, Amman, Jordan; Applied Science Research Center, Applied Science Private University, Amman, Jordan; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR. Effectiveness of brandt-daroff exercises in the treatment of benign paroxysmal positional vertigo: a systematic review of randomized controlled trials. Eur Arch Otorhinolaryngol 2024:10.1007/s00405-024-08502-6. [PMID: 38341824 DOI: 10.1007/s00405-024-08502-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 01/23/2024] [Indexed: 02/13/2024]
Abstract
PURPOSE This review aims to examine the effects of Brandt-Daroff exercises (BDEs) on individuals with posterior canal Benign Paroxysmal Positional Vertigo (BPPV) and to provide recommendations for future research on this topic. METHODS PubMed, MEDLINE, PEDro, SCOPUS, REHABDATA, EMBASE, and Web of Science were searched from inception to November 2023. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the included studies. RESULTS In total, ten randomized controlled trials met our eligibility criteria. A total of 880 individuals with BPPV (63.6% females) were included in this review. The included studies were ranked "good quality" on the PEDro scale. The available literature showed that BDEs do not significantly reduce symptoms or promote recovery in people with posterior canal BPPV compared to other interventions, such as Epley and Semont maneuvers. CONCLUSIONS The evidence for the effects of BDEs on patients with BPPV is limited. Further high-quality studies with long-term follow-ups are strongly required to investigate the long-term effects of BDEs in posterior canal BPPV, define the optimal application of BDEs, and identify the factors associated with treatment response and recovery.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Airport Road, Amman, Jordan.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR, D'Onofrio R, Sannicandro I, Manzi V, Padua E, Youssef T, Annino G. Return to training in soccer players after anterior cruciate ligament reconstruction: reflections and considerations. J Sports Med Phys Fitness 2024:S0022-4707.23.15448-X. [PMID: 38324269 DOI: 10.23736/s0022-4707.23.15448-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
This clinical and rehabilitative overview focuses on the return to unrestricted sporting activity, aiming to consolidate the scientific evidence surrounding the structural progression of athletes, particularly footballers, undergoing anterior cruciate ligament reconstruction (ACLR). A multidisciplinary approach necessitates a shared language and standardized methodologies. Unfortunately, significant disparities persist in the structural strategies guiding the decision-making process for returning to on-field activities, the latter stages of rehabilitation, and subsequent restoration of technical and tactical football abilities. Divergences in definitions, terminologies, and rehabilitation protocols can substantially influence final outcomes. Presently, scientific consensus studies regarding the decision-making process during the final stages of on-field rehabilitation are lacking. Nevertheless, this overview outlines and defines pivotal language parameters crucial for effective communication and the seamless integration of clinical and rehabilitative data among the diverse professionals involved in facilitating the athlete's return to peak performance. In conclusion, the successful resumption of competitive sporting activities for footballer's post ACLR demands a collaborative decision-making approach encompassing various professionals. Additionally, it necessitates a cohesive transition from rehabilitation to on-field work, aiming at reinstating athleticism, technical prowess, and tactical acumen.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan -
- Applied Science Research Center, Applied Science Private University, Amman, Jordan -
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy -
| | - Rosario D'Onofrio
- Medical-Scientific Multidisciplinary Commission, Italian Football Doctors Association, L.A.M.I.CA., Rome, Italy
| | - Italo Sannicandro
- Experimental and Clinical Department, University of Foggia, Foggia, Italy
| | - Vincenzo Manzi
- Department of Humanities Science, Pegaso Open University, Naples, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Tarek Youssef
- Department of Physiotherapy, Middle East University, Amman, Jordan
| | - Giuseppe Annino
- Center of Space Bio-Medicine, Department of Medicine Systems, Tor Vergata University, Rome, Italy
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Alashram AR. Compensatory cognitive training for people with traumatic brain injury: A systematic review of randomized controlled trial. Appl Neuropsychol Adult 2024:1-9. [PMID: 38285433 DOI: 10.1080/23279095.2024.2306133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
Cognitive impairments are a common consequence in people with traumatic brain injury (TBI). Compensatory cognitive training is a therapeutic strategy that offers alternative methods to manage cognitive deficits. This systematic review aims to examine the effects of compensatory cognitive training on cognitive function in people with TBI. We searched PubMed, SCOPUS, MEDLINE, PEDro, Web of Science, REHABDATA, and EMBASE from inception until October 2023. The Cochrane Collaboration tool was used to assess the methodological quality of the selected studies. Of 318 articles, eight studies (n = 615), with 8% of participants being females, were included in this review. Four studies were classified as having 'high' quality according to the Cochrane Collaboration tool, while four were categorized as 'moderate' quality. There were variations in treatment protocols and outcome measures, resulting in heterogeneous findings. The effects of compensatory cognitive training on cognitive outcomes showed inconsistency. In conclusion, the evidence for the effects of compensatory cognitive training on cognition in people with TBI is promising. Further trials are needed to investigate the effects of compensatory cognitive training on various cognitive domains in people with TBI.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR. Effects of robotic therapy associated with noninvasive brain stimulation on motor function in individuals with incomplete spinal cord injury: A systematic review of randomized controlled trials. J Spinal Cord Med 2024:1-16. [PMID: 38265422 DOI: 10.1080/10790268.2024.2304921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
CONTEXT Motor deficits are among the most common consequences of incomplete spinal cord injury (SCI). These impairments can affect patients' levels of functioning and quality of life. Combined robotic therapy and non-invasive brain stimulation (NIBS) have been used to improve motor impairments in patients with corticospinal tract lesions. OBJECTIVES To examine the effects of combined robotic therapy and NIBS on motor function post incomplete SCI. METHODS PubMed, SCOPUS, MEDLINE, PEDro, Web of Science, REHABDATA, CINAHL, and EMBASE were searched from inception until July 2023. The Physiotherapy Evidence Database (PEDro) scale was employed to evaluate the selected studies quality. RESULTS Of 557 studies, five randomized trials (n = 122), with 25% of participants being females, were included in this review. The PEDro scores ranged from eight to nine, with a median score of nine. There were variations in treatment protocols and outcome measures, resulting in heterogeneous findings. The findings showed revealed evidence for the impacts of combined robotic therapy and NIBS on motor function in individuals with incomplete SCI. CONCLUSIONS Combined robotic training and NIBS may be safe for individuals with incomplete SCI. The existing evidence concerning its effects on motor outcomes in individuals with SCI is limited. Further experimental studies are needed to understand the effects of combined robotic training and NIBS on motor impairments in SCI populations.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR. Comments on Effectiveness of Therapeutic Exercise Models on Cancer-Related Fatigue in Patients With Cancer Undergoing Chemotherapy: A Systematic Review and Network Meta-analysis. Arch Phys Med Rehabil 2024; 105:181. [PMID: 37769930 DOI: 10.1016/j.apmr.2023.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 10/03/2023]
Affiliation(s)
- Anas R Alashram
- Physiotherapy Department, Middle East University, Amman, Jordan; Applied Science Research Center, Applied Science Private University, Amman, Jordan; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR. Letter to the Editor on: "Effect of Repetitive Peripheral Magnetic Stimulation on Patients With Low Back Pain: Comments on a Meta-analysis of Randomized Controlled Trials". Arch Phys Med Rehabil 2023; 104:2173-2174. [PMID: 37643673 DOI: 10.1016/j.apmr.2023.07.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/31/2023]
Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan; Applied Science Research Center, Applied Science Private University, Amman, Jordan; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
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Alashram AR, Padua E, Annino G. Noninvasive brain stimulation for cognitive rehabilitation following traumatic brain injury: A systematic review. Appl Neuropsychol Adult 2023; 30:814-829. [PMID: 35771044 DOI: 10.1080/23279095.2022.2091440] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Traumatic brain injury (TBI) can cause numerous cognitive deficits. These deficits are associated with disability and reduction in quality of life. Noninvasive brain stimulation (NIBS) provides excitatory or inhibitory stimuli to the cerebral cortex. This review aimed to examine the effectiveness of NIBS (i.e., rTMS and tDCS) on cognitive functions in patients with TBI. PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, and Web of Science were searched from inception to May 2021. The risk of bias in the randomized controlled trials was assessed using the Cochrane Collaboration's instrument. The Physiotherapy Evidence Database (PEDro) scale was applied to evaluate the risk of bias in the non-randomized controlled trials. Ten studies met our inclusion criteria. Six studies used repetitive Transcranial Magnetic Stimulation (rTMS), and four used transcranial Direct Current Stimulation (tDCS) as cognitive rehabilitation interventions. The results showed heterogenous evidence for the effects of rTMS and tDCS on cognitive function outcomes in individuals with TBI. The evidence for the effects of NIBS on cognition following TBI was limited. TDCS and rTMS are safe and well-tolerated interventions post-TBI. The optimal stimulation sites and stimulation parameters remain unknown. Combining NIBS with traditional rehabilitation interventions may contribute to greater enhancements in cognitive functions post-TBI.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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Alashram AR, Janada Q, Ghrear T, Annino G. Role of music therapy in improving cognitive function post-traumatic brain injury: A systematic review. Appl Neuropsychol Adult 2023:1-10. [PMID: 37389826 DOI: 10.1080/23279095.2023.2228951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Cognitive deficits are one of the most prevalent impairments in patients with traumatic brain injury (TBI). Music therapy has the potential to be a valuable intervention for improving cognitive function. This review aimed to investigate the effects of music therapy on cognitive function in patients with TBI. Scopus, PubMed, REHABDATA, PEDro, EMBASE, and web of science were searched for experimental trials examining the impacts of music therapy on cognition in patients with TBI from inception until December 2022. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of the included studies. Five studies met the inclusion criteria. A total of 122 patients with TBI were included in this review, 32% of whom were females. The PEDro scores ranged from four to seven, with a median of five. The findings showed that music therapy could be effective in improving executive function post-TBI, with limited evidence for the effects on memory and attention. Music therapy might be safe in patients with TBI. The evidence for the effect of music therapy on executive function in patients with TBI is promising. Further studies with larger sample sizes and long-term follow-ups are strongly needed.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Qusai Janada
- Department of Physiotherapy, Middle East University, Amman, Jordan
| | - Tamara Ghrear
- Department of Physiotherapy, Middle East University, Amman, Jordan
| | - Giuseppe Annino
- Centre of SpaceBio-Medicine, Department of Systems Medicine, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Rome, Italy
- Sport Engineering Lab, Department of Industrial Engineering, University of Rome "Tor Vergata", Rome, Italy
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Alashram AR, Annino G. A Novel Neurorehabilitation Approach for Neural Plasticity
Overstimulation and Reorganization in Patients with Neurological
Disorders. Physikalische Medizin, Rehabilitationsmedizin, Kurortmedizin 2023. [DOI: 10.1055/a-2004-5836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
AbstractNeurological disorders are those that are associated with impairments in the
nervous system. These impairments affect the patient’s activities of
daily living. Recently, many advanced modalities have been used in the
rehabilitation field to treat various neurological impairments. However, many of
these modalities are available only in clinics, and some are expensive. Most
patients with neurological disorders have difficulty reaching clinics. This
review was designed to establish a new neurorehabilitation approach based on the
scientific way to improve patients’ functional recovery following
neurological disorders in clinics or at home. The human brain is a network, an
intricate, integrated system that coordinates operations among billions of
units. In fact, grey matter contains most of the neuronal cell bodies. It
includes the brain and the spinal cord areas involved in muscle control, sensory
perception, memory, emotions, decision-making, and self-control. Consequently,
patients’ functional ability results from complex interactions among
various brain and spinal cord areas and neuromuscular systems. While white
matter fibers connect numerous brain areas, stimulating or improving non-motor
symptoms, such as motivation, cognitive, and sensory symptoms besides motor
symptoms may enhance functional recovery in patients with neurological
disorders. The basic principles of the current treatment approach are
established based on brain connectivity. Using motor, sensory, motivation, and
cognitive (MSMC) interventions during rehabilitation may promote neural
plasticity and maximize functional recovery in patients with neurological
disorders. Experimental studies are strongly needed to verify our theories and
hypothesis.
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Affiliation(s)
- Anas R. Alashram
- Department of Physiotherapy, Middle East University, Amman,
Jordan
- Applied Science Research Center, Applied Science Private
University
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor
Vergata”, Rome, Italy
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19
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Alashram AR, Annino G, Romagnoli C, Raju M, Padua E. Proprioceptive Focal Stimulation (Equistasi ®) for gait and postural balance rehabilitation in patients with Parkinson's disease: A systematic review. Proc Inst Mech Eng H 2023; 237:179-189. [PMID: 36515387 DOI: 10.1177/09544119221141945] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Gait and postural deficits are the most common impairments in patients with Parkinson's Disease (PD). These impairments often reduce patients' quality of life. Equistasi® is a wearable proprioceptive stabilizer that converts body thermic energy into mechanical vibration. No systematic reviews have been published investigating the influences of Equistasi® on gait and postural control in patients with PD. This review aimed to examine the effects of proprioceptive focal stimulation (Equistasi®) on gait deficits and postural instability in patients with PD. PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. Five studies met the eligibility criteria. The scores on the PEDro scale ranged from 3 to 8, with a median score of 8. The results showed evidence for the benefits of the proprioceptive focal stimulation (Equistasi®) on gait and postural stability in individuals with PD. Proprioceptive focal stimulation (Equistasi®) appears to be safe and well-tolerated in patients with PD. Proprioceptive focal stimulation (Equistasi®) may improve gait ability and postural stability in patients with PD. Further high-quality studies with long-term follow-ups are strongly needed to clarify the long-term effects of proprioceptive focal stimulation (Equistasi®) in patients with PD.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan.,Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata," Rome, Italy
| | - Cristian Romagnoli
- Sport Engineering Lab, Department Industrial Engineering, University of Rome "Tor Vergata," Rome, Italy.,Science and Culture of Well-being and Lifestyle, "Alma Mater" University, Bologna, Italy
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR, Padua E, Aburub A, Raju M, Annino G. Transcranial direct current stimulation for upper extremity spasticity rehabilitation in stroke survivors: A systematic review of randomized controlled trials. PM R 2023; 15:222-234. [PMID: 35286007 DOI: 10.1002/pmrj.12804] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To examine the effects of transcranial direct current stimulation (tDCS) on upper extremity spasticity after stroke and to define the most effective tDCS parameters. LITERATURE SURVEY Systematic review in the following databases: PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases. Studies up to June 2020 were included. METHODOLOGY Studies were included if the sample was composed of individuals with stroke, the intervention followed a tDCS intervention (alone or combined with another intervention), and the study was a randomized controlled trial including at least one measurement assessing upper extremity spasticity. Two authors independently screened the included studies. Conflicting decisions between authors were resolved by discussion with the third author. The methodological quality was assessed using the Cochrane Collaboration's tool. The authors determined that the meta-analysis was not feasible due to the heterogeneity in the protocols among the included studies. SYNTHESIS After the screening of 1204 records, a total of seven studies met the specified inclusion criteria and involved 320 participants (mean age = 60.3), 31.1% of whom were females. Patients with ischemic stroke comprised 77.2% of the total patients, and 42.2% were with right hemispheric stroke. Six studies exhibited "high" quality and one exhibited "moderate" quality. Five of the selected studies that combined the tDCS intervention and other traditional interventions showed a significant reduction in upper extremity spasticity after stroke following tDCS intervention. The other two studies that delivered tDCs alone did not show a significant difference. CONCLUSIONS The evidence for the effect of tDCS on upper extremity spasticity after stroke was limited. The optimal tDCS treatment dosage remains unclear. Additional studies with large sample sizes and long-term follow-up are strongly warranted.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Aseel Aburub
- Department of Physiotherapy, Isra University, Amman, Jordan
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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21
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Alashram AR, Annino G, Padua E. Rehabilitation interventions for cognitive deficits in stroke survivors: A systematic review of randomized controlled trials. Appl Neuropsychol Adult 2022:1-27. [PMID: 36194642 DOI: 10.1080/23279095.2022.2130319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Cognitive deficits are one of the most common impairments after stroke. It negatively affects physical and social functioning. Rehabilitation interventions for cognitive deficits post-stroke have taken less consideration. The present study aimed to provide an overview of the effects of various rehabilitation interventions on cognitive functions in patients with stroke. PUBMED, SCOPUS, PEDro, EMBASE, MEDLINE, and REHABDATA were searched for randomized controlled trials (RCTs) investigating the effects of rehabilitation interventions on cognitive domains poststroke until August 2021. The methodological quality of the selected studies was evaluated using the Cochrane Collaboration tool, and the effect sizes were calculated. Forty-four studies met the inclusion criteria. A total of 3561 individuals with stroke, 57.60% of whom were males. The mean age for all participants was 65.48 years. Eighteen RCTs were high, moderate (n = 17), and low methodological quality (n = 9). The results showed evidence for the beneficial effects of many rehabilitation interventions on cognition in individuals with stroke. Rehabilitation plays a crucial role in improving cognitive functions in stroke patients with mild cognitive deficits. Virtual reality (VR), computer-based cognitive rehabilitation (CBCR), and non-aerobic exercises may promote cognitive functions in patients with stroke.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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22
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Alashram AR, Padua E, Annino G. Virtual reality for balance and mobility rehabilitation following traumatic brain injury: A systematic review of randomized controlled trials. J Clin Neurosci 2022; 105:115-121. [PMID: 36182811 DOI: 10.1016/j.jocn.2022.09.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/11/2022] [Accepted: 09/14/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Balance and mobility deficits are most prevalent impairments in patients with traumatic brain injury (TBI). The evidence has proposed that rehabilitation plays an important role in improving balance and mobility post-TBI. Virtual reality (VR) is a computer technology that provides immersed users to generate feedback such as visual, audio, and haptic. OBJECTIVE This review aimed to examine the effects of the VR treatment intervention on balance and mobility in patients with TBI and to define the most effective VR treatment protocol. METHODS SCOPUS, PEDro, PubMed, REHABDATA, EMBASE, and the web of science were searched for experimental trials examining the impacts of VR training on balance and mobility in patients with TBI from inception until July 2022. Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies. RESULTS Five randomized controlled trials (RCTs) met the inclusion criteria. The PEDro scores ranged from 6 to 8, with a median of 6. A total of 157 patients with TBI were included in this review, 31.2% of whom were females. The findings showed that VR intervention is not superior to traditional physiotherapy interventions in improving balance and mobility post- TBI. CONCLUSIONS The preliminary findings showed that the influence of VR on the balance and mobility ability in patients with TBI is promising. Combining VR with other concurrent rehabilitation interventions may show more significant improvements in balance and mobility compared to VR interventions alone. The optimal VR treatment protocol remains unclear. Further randomized controlled trials are strongly needed.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Middle East University, Amman, Jordan; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Italy
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23
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Alashram AR, Padua E, Annino G. Effects of Brain-Computer Interface Controlled Functional Electrical Stimulation on Motor Recovery in Stroke Survivors: a Systematic Review. Curr Phys Med Rehabil Rep 2022. [DOI: 10.1007/s40141-022-00369-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Romagnoli C, Gatta G, Lamouchideli N, Bianco A, Loddo S, Alashram AR, Bonaiuto V, Annino G, Padua E. Specificity of weightlifting bench exercises in kayaking sprint performance: A perspective for neuromuscular training. Front Physiol 2022; 13:898468. [PMID: 35936907 PMCID: PMC9354820 DOI: 10.3389/fphys.2022.898468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/01/2022] [Indexed: 11/13/2022] Open
Abstract
Several studies showed significant differences between bench lift exercises without investigating which is more related, in biomechanical and neuromuscular terms, to improve the sprint flatwater kayak performance. This study aims to compare the power-load and velocity-load neuromuscular parameters performed in prone bench pull (PBP), and bench press (BP) exercises to identify which of them meet the gesture specificity in sprint flatwater kayak performance. Ten elite kayakers participated in this study. Power-load, velocity-load relationships, the maximum dynamic strength, and the kayak sprint performance test were assessed. The power-load and velocity-load relationships showed significant differences between the PBP and BP for each considered load. The kayakers showed a significant correlation between maximum power performed on the PBP and the maximum velocity reached in the kayak sprint (r = 0.80, p < 0.01) and the stroke frequency (r = 0.61, p < 0.05). Conversely, the maximum power performed on the BP did not correlate with the kinematic parameters analyzed. In addition, the maximum dynamic strength in the PBP and BP did not correlate with the maximum velocity and stroke frequency. Furthermore, no significant difference was observed in both the bench exercises for the maximum dynamic strength (p > 0.05). The results of this study suggest that the maximal muscular power expressed in PBP exercise only seems to be more specific in kayak velocity performance compared with maximal dynamic strength and with all dynamic parameters recorded in the BP. This will allow coaches and trainers to use specific bench exercises for specific neuromuscular kayakers’ adaptations during the whole competitive season.
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Affiliation(s)
- Cristian Romagnoli
- Department for Life Quality Studies University of Bologna, Bologna, Italy
- Sport Engineering Lab, Department Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Giorgio Gatta
- Department for Life Quality Studies University of Bologna, Bologna, Italy
| | - Niloofar Lamouchideli
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | | | | | - Vincenzo Bonaiuto
- Sport Engineering Lab, Department Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Giuseppe Annino
- Sport Engineering Lab, Department Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
- Centre of Space Bio-Medicine, “Tor Vergata” University of Rome, Rome, Italy
- *Correspondence: Giuseppe Annino,
| | - Elvira Padua
- Department of Human Science and Promotion of Quality of Life, San Raffaele Open University of Rome, Rome, Italy
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Alashram AR. Letter to the Editor: Effectiveness of a Web-Based Direct-to-User Transfer Training Program: Comments on A Randomized Controlled Trial. Arch Phys Med Rehabil 2022; 103:2063. [DOI: 10.1016/j.apmr.2022.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 04/14/2022] [Indexed: 11/27/2022]
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Alashram AR, Padua E, Romagnoli C, Raju M, Annino G. Clinical effectiveness of focal muscle vibration on gait and postural stability in individuals with neurological disorders: A systematic review. Physiother Res Int 2022; 27:e1945. [PMID: 35279915 DOI: 10.1002/pri.1945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 12/17/2021] [Accepted: 02/24/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Gait deficits and postural instability are common impairments among patients with neurological disorders. These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the nervous system. No systematic review has been published examining the influence of FMV on gait ability and postural stability in individuals with neurological disorders. OBJECTIVES This study aimed to investigate the effects of FMV on gait and postural stability parameters in individuals with neurological disorders. METHODS PubMed, Scopus, PEDro, REHABDATA, web of science, CHAINAL, EMBASE, and MEDLINE were searched from inception to July 2021. The methodological quality of the selected studies was evaluated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS Five randomized controlled trials (RCTs) met the eligibility criteria. The scores on the PEDro scale ranged from seven to nine, with a median score of eight. The results showed evidence for the benefits and non-benefits of the FMV intervention on gait and postural stability in individuals with neurological disorders. CONCLUSIONS The FMV intervention is safe and well-tolerated in individuals with neurological disorders. The evidence for the effects of FMV on individuals with neurological disorders was limited. Further high-quality studies with long-term follow-up are strongly needed.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Isra University, Amman, Jordan.,Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Cristian Romagnoli
- PhD School in Science and Culture of Well-being and Lifestyle, Alma Mater University, Bologna, Italy
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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Alashram AR, Padua E, Romagnoli C, Annino G. Hyperbaric oxygen therapy for cognitive impairments in patients with traumatic brain injury: A systematic review. Appl Neuropsychol Adult 2022:1-12. [PMID: 35213282 DOI: 10.1080/23279095.2022.2041418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Cognitive deficits are the most common impairments after traumatic brain injury (TBI). It can be linked with poor physical function. Hyperbaric oxygen therapy (HBOT) increases blood flow and oxygen supply to the brain. This review aimed to summarize and evaluate the available literature on the influences of HBOT on cognitive deficits in patients with TBI. PubMed, SCOPUS, PEDro, REHABDATA, MIDLINE, CHINAL, EMBASE, and Web of Science were searched from inception until June 2021. The methodological quality was measured using the physiotherapy evidence database (PEDro) scale. Ten studies met the eligibility criteria. Six studies were randomized controlled trials, and four were pilot studies. The scores on the PEDro scale ranged from two to nine, with a median score of seven. The included studies showed heterogeneity results for the beneficial effects of HBOT on improving cognitive functions in patients with TBI. The evidence for the beneficial effects of HBOT on cognitive functions post-TBI was limited. Further randomized controlled trials with large sample sizes are strongly needed to understand the effects of HBOT on cognitive functions in patients with TBI.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Cristian Romagnoli
- PhD School in Science and Culture of Well-being and Lifestyle, Alma Mater University, Bologna, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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28
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Alashram AR, Annino G, Mercuri NB. Changes in spasticity following functional electrical stimulation cycling in patients with spinal cord injury: A systematic review. J Spinal Cord Med 2022; 45:10-23. [PMID: 32406810 PMCID: PMC8890523 DOI: 10.1080/10790268.2020.1763713] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Spasticity is one of the most common secondary impairment after spinal cord injury (SCI). It can lead to an increase in the level of disability. The functional electrical stimulation cycling (FES-cycling) promotes recovery in patients with SCI. No systematic review has been published examining the influence of FES-cycling on the spasticity of lower extremities post-SCI.Objective: This review aimed to investigate the effects of the FES-cycling on the lower extremities spasticity in patients with SCI.Methods: PubMed, Scopus, PEDro, REHABDATA, Web of Science, and MEDLINE were searched until December 2019. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale.Results: Ten studies were met the inclusion criteria. Two were randomized clinical trials, cohort study (n = 2), and pilot study (n=6). The scores on the PEDro scale ranged from one to nine, with a median score of three. The results showed evidence for the beneficial effects of FES-cycling on the spasticity of lower extremities in individuals with SCI.Conclusion: The FES-cycling intervention may reduce the lower extremities spasticity in patients with various injury levels of SCI. It is not a suitable intervention for medically unstable patients or with contraindication for lower extremities movement. Further randomized controlled trials with a large sample size strongly warranted to confirm our findings.
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Affiliation(s)
- Anas R. Alashram
- School of Neuroscience, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Rome, Italy,Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy,Correspondence to: Anas R. Alashram, Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Via Cracovia, 50, 00133Roma RM, Italy.
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
| | - Nicola Biagio Mercuri
- School of Neuroscience, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Rome, Italy,Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
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29
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Alashram AR, Padua E, Raju M, Romagnoli C, Annino G. Transcutaneous spinal cord stimulation effects on spasticity in patients with spinal cord injury: A systematic review. J Spinal Cord Med 2021:1-8. [PMID: 34855565 DOI: 10.1080/10790268.2021.2000200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
CONTEXT Spasticity is one of the most prevalent impairments following spinal cord injury (SCI). It can lead to a decrease in the patient's functional level. Transcutaneous spinal cord stimulation (tSCS) has demonstrated motor function improvements following SCI. No systematic reviews were published examining the influences of tSCS on spasticity post-SCI. OBJECTIVES This review aimed to investigate the effects of tSCS on spasticity in patients with SCI. METHODS PubMed, SCOPUS, PEDro, CINAHL, MEDLINE, REHABDATA, AMED, and Web of Science databases were searched until June 2021. The Physiotherapy Evidence Database (PEDro) scale was used to assess the methodological quality of the selected studies. RESULTS Six studies met the inclusion criteria. Five studies were pilot studies, and one was a case series. The scores on the PEDro scale ranged from two to four, with a median score of four. The results showed heterogenous evidence for the effects of tSCS on spasticity reduction post-SCI. CONCLUSIONS TSCS appears safe and well-tolerated intervention in patients with SCI. The evidence for the effectiveness of tSCS on spasticity in chronic SCI patients is limited. Further randomized controlled studies are strongly needed to study the effects of tSCS on patients with SCI.
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Affiliation(s)
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Manikandan Raju
- Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Cristian Romagnoli
- PhD School in Science and Culture of Well-being and Lifestyle, Alma Mater University, Bologna, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
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Alashram AR, Annino G, Padua E. Robot-assisted gait training in individuals with spinal cord injury: A systematic review for the clinical effectiveness of Lokomat. J Clin Neurosci 2021; 91:260-269. [PMID: 34373038 DOI: 10.1016/j.jocn.2021.07.019] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/04/2021] [Accepted: 07/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Spinal cord injury (SCI) is a critical medical condition that causes numerous impairments leading to accompanying disability. Robotic-assisted gait training (RAGT) offers many advantages, including the capability to increase the intensity and total duration of training while maintaining a physiological gait pattern. The effects of the RAGT 'Lokomat' on various impairments following SCI remain unclear. OBJECTIVES This review was conducted to examine the impacts of the RAGT 'Lokomat' on the impairments following SCI. METHODS We searched PubMed, SCOPUS, PEDro, REHABDATA, MEDLINE, EMBASE, and web of science from inception to January 2021. Experimental studies examining the effects of the Lokomat on the impairments following incomplete SCI were selected. The methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. RESULTS Sixteen studies were met the inclusion criteria. Thirteen were randomized controlled trials, two were clinical trials, and one was a pilot study. The scores on the PEDro scale ranged from two to eight, with a median score of six. The results showed evidence for the beneficial effects of the Lokomat on many motor impairments following incomplete SCI. CONCLUSIONS The Lokomat may improve gait speed, walking distance, strength, range of motion, and mobility after incomplete SCI. There is insufficient evidence for the effect of the Lokomat on balance, depression, cardiorespiratory fitness, and quality of life. The effects of the Lokomat on the lower extremity spasticity were limited.
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Affiliation(s)
- Anas R Alashram
- Department of Physiotherapy, Isra University, Amman, Jordan.
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR, Alghwiri AA, Padua E, Annino G. Efficacy of proprioceptive neuromuscular facilitation on spasticity in patients with stroke: a systematic review. Physical Therapy Reviews 2021. [DOI: 10.1080/10833196.2021.1892281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Anas R. Alashram
- PhD School in Neuroscience, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Rome, Italy
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
- Department of Physiotherapy, Isra University, Amman, Jordan
| | - Alia A. Alghwiri
- Physical Therapy Department, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
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Alashram AR, Annino G. Bilateral Arm Training vs Unilateral Arm Training for Severely Affected Patients With Stroke: Comments on Exploratory Single-Blinded Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102:1236. [PMID: 33711276 DOI: 10.1016/j.apmr.2021.01.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Anas R Alashram
- School of Neuroscience, Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, Faculty of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy
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Alashram AR, Annino G. Comments on "The Beneficial Effects of Mind-Body Exercises for People With Mild Cognitive Impairment: A Systematic Review With Meta-analysis". Arch Phys Med Rehabil 2020; 102:159. [PMID: 32958207 DOI: 10.1016/j.apmr.2020.05.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 04/28/2020] [Accepted: 05/05/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Anas R Alashram
- School of Neuroscience, Faculty of Medicine and Surgery, Department of Medicine Systems, University of Rome "Tor Vergata", Rome, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Manzi V, Iellamo F, Alashram AR, D'onofrio R, Padua E, Casasco M, Annino G. Effects of three different stretching protocols on hamstring muscle flexibility in professional soccer players: a randomized study. J Sports Med Phys Fitness 2020; 60:999-1004. [PMID: 32597617 DOI: 10.23736/s0022-4707.20.10562-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The current study aimed to investigate and compare the influences of global postural rieducation techniques (GPR), stretching exercises on a whole-body vibration platform (WBV), and static stretching exercises on hamstrings flexibility in elite soccer players. METHODS 24 professional soccer players were randomly assigned to either global postural re-education (N.=8), stretching on whole-body vibration group (N.=8) or static stretching (N.=8), during the first 4 weeks of the precompetitive season. Assessment of hamstring muscle flexibility was performed using a straight leg raise test. All participants were assessed three times: at baseline, at the end of the study protocol and 14 days after the end of the study protocol. RESULTS The short-term increase in hamstring muscle flexibility was observed in all 3 groups, without significant differences among groups. However, after 14 days from the end of the interventions only the WBV group maintained the flexibility level achieved just at the end of the protocol with no significant changes in both legs whereas a significant decrease in the SLRT in GPR and SS groups, in right and left legs (GPR, P=0.002; P=0.015; SS, P=0.0001; P=0.0001), was observed. CONCLUSIONS These results would suggest that GPR, static stretching on whole-body vibration and static stretching techniques all improve hamstring muscle flexibility, but only stretching on WBV maintains the effect over time in professional soccer players.
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Affiliation(s)
| | - Ferdinando Iellamo
- IRCCS San Raffaele Pisana, Rome, Italy.,Department of Clinical Sciences and Translational Medicine, School of Sports Medicine, Tor Vergata University, Rome, Italy
| | - Anas R Alashram
- Department of Medicine Systems, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
| | - Rosario D'onofrio
- Scientific Society of Sport Rehabilitation and Posturology, Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy
| | | | - Giuseppe Annino
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele University, Rome, Italy - .,Department of Medicine Systems, Faculty of Medicine and Surgery, Tor Vergata University, Rome, Italy
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Alashram AR, Annino G, Raju M, Padua E. Effects of physical therapy interventions on balance ability in people with traumatic brain injury: A systematic review. NeuroRehabilitation 2020; 46:455-466. [PMID: 32508337 DOI: 10.3233/nre-203047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Balance deficits are common impairments in individuals with post-traumatic brain injury (TBI). Balance deficits can restrict the activities of daily living and productive participation in social life. To date, no systematic reviews have examined the impact of physical therapy intervention on balance post-TBI. OBJECTIVE To examine the effects of physical therapy interventions on balance impairments in individuals with TBI. METHODS We systematically searched in PubMed, EMBASE, Scopus, PEDro, MEDLINE, REHABDATA, and Web of Science for randomized controlled trials (RCTs), clinical control trials, and pilot studies that examined the effects of physical therapy interventions on balance deficits in individuals post-TBI. The methodological quality was estimated using the Physiotherapy Evidence Database (PEDro) scale. RESULTS Eight studies published from 2003 to 2019 were included in this study. A total of 259 TBI participants post-TBI were included in this review, 71 (27.41%) of which were females. The methodological quality of the selected studies ranged from low to high. There were no significant differences between experimental interventions, virtual reality (VR), vestibular rehabilitation therapy (VRT), control group interventions, and other traditional physical therapy interventions. CONCLUSIONS The evidence about the effects of the physical therapy interventions in improving the balance ability post-TBI was limited. Further randomized controlled trials are strongly warranted to understand the role of physical therapy in patients with TBI who complain about balance deficits.
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Affiliation(s)
- Anas R Alashram
- PhD School of Neuroscience, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Italy.,Department of Medicine Systems, University of Rome "Tor Vergata", Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Italy
| | - Manikandan Raju
- School of Clinical/Experimental Neuroscience and Psychology, Department of Neuroscience Umane, University of Sapienza, Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
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Alashram AR, Padua E, Hammash AK, Lombardo M, Annino G. Effectiveness of virtual reality on balance ability in individuals with incomplete spinal cord injury: A systematic review. J Clin Neurosci 2020; 72:322-327. [DOI: 10.1016/j.jocn.2020.01.037] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 01/05/2020] [Indexed: 10/25/2022]
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Alashram AR, Padua E, Romagnoli C, Annino G. Effectiveness of focal muscle vibration on hemiplegic upper extremity spasticity in individuals with stroke: A systematic review. NeuroRehabilitation 2019; 45:471-481. [DOI: 10.3233/nre-192863] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Anas R. Alashram
- School of Neuroscience, Faculty of Medicine and Surgery, University of Rome “Tor Vergata”, Rome, Italy
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Cristian Romagnoli
- Science and Culture of Well-being and Lifestyle, Alma Mater University, Bologna, Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor Vergata”, Rome, Italy
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Abstract
Background: Upper extremity deficits are the most popular symptoms following stroke. Task-oriented training has the ability to increase motor area excitability in the brain, which can stimulate the recovery of motor control.Objective: This study was aimed to examine the efficiency of the task-oriented approach on paretic upper extremity following a stroke, and to identify efficient treatment dosage in those populations.Method: We searched through PubMed, Scopus, Physiotherapy Evidence Database (PEDro), National Rehabilitation Information (REHABDATA), and Web of Science databases. Randomized clinical trials (RCTs) and pseudo-RCTs those investigating upper extremity in patients with stroke published in English language were selected. Different scales and measurement methods to assess range of motion, strength, spasticity, and upper extremity function were considered. The quality assessment of included articles was evaluated utilizing the PEDro scale. Effect sizes were calculated.Results: Six RCTs were included in the present study. The quality assessment for included studies ranged from 6 to 8 with 6.5 as a median. A total of 456 post-stroke patients, 41.66% of which were women, were included in all studies. The included studies demonstrated a meaningful influence of task-oriented training intervention on the hemiplegic upper limb motor functions but not spasticity post-stroke.Conclusion: Task-oriented training does not produce a superior effect than other conventional physical therapy interventions in treating upper extremity in patients with stroke. There is no evidence supporting the beneficial effect of task-oriented on spasticity. Task-oriented training with the following dosage 30 to 90 minutes/session, 2 to 3 sessions weekly for 6 to 10 weeks may improve motor function and strength of paretic upper extremity post-stroke.
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Affiliation(s)
- Anas R. Alashram
- Faculty of Medicine and Surgery, University of Rome “Tor Vergata,” Italy
- Department of Medicine Systems, University of Rome “Tor Vergata,” Italy
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome “Tor Vergata,” Italy
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Nicola Biagio Mercuri
- Faculty of Medicine and Surgery, University of Rome “Tor Vergata,” Italy
- Department of Medicine Systems, University of Rome “Tor Vergata,” Italy
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Alashram AR, Annino G, Padua E, Romagnoli C, Mercuri NB. Cognitive rehabilitation post traumatic brain injury: A systematic review for emerging use of virtual reality technology. J Clin Neurosci 2019; 66:209-219. [PMID: 31085075 DOI: 10.1016/j.jocn.2019.04.026] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 04/29/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Traumatic brain injury (TBI) can causes numerous cognitive impairments usually in the aspects of problem-solving, executive function, memory, and attention. Several studies has suggested that rehabilitation treatment interventions can be effective in treating cognitive symptoms of brain injury. Virtual reality (VR) technology potential as a useful tool for the assessment and rehabilitation of cognitive processes. OBJECTIVES The aims of present systematic review are to examine effects of VR training intervention on cognitive function, and to identify effective VR treatment protocol in patients with TBI. METHODS PubMed, Scopus, PEDro, REHABDATA, EMBASE, web of science, and MEDLINE were searched for studies investigated effect of VR on cognitive functions post TBI. The methodological quality were evaluated using PEDro scale. The results of selected studies were summarized. RESULTS Nine studies were included in present study. Four were randomized clinical trials, case studies (n = 3), prospective study (n = 1), and pilot study (n = 1). The scores on the PEDro ranged from 0 to 7 with a mean score of 3. The results showed improvement in various cognitive function aspects such as; memory, executive function, and attention in patients with TBI after VR training. CONCLUSION Using different VR tools with following treatment protocol; 10-12 sessions, 20-40 min in duration with 2-4 sessions per week may improves cognitive function in patients with TBI. There was weak evidence for effects of VR training on attention post TBI.
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Affiliation(s)
- Anas R Alashram
- Department of Neurology, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Italy.
| | - Giuseppe Annino
- Department of Medicine Systems, University of Rome "Tor Vergata", Italy; Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome, Italy.
| | - Cristian Romagnoli
- PhD School in Science and Culture of Well-being and Lifestyle, Alma Mater University, Bologna, Italy.
| | - Nicola Biagio Mercuri
- Department of Neurology, Faculty of Medicine and Surgery, University of Rome "Tor Vergata", Italy; Department of Medicine Systems, University of Rome "Tor Vergata", Italy.
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Annino G, Alashram AR, Alghwiri AA, Romagnoli C, Messina G, Tancredi V, Padua E, Mercuri NB. Effect of segmental muscle vibration on upper extremity functional ability poststroke: A randomized controlled trial. Medicine (Baltimore) 2019; 98:e14444. [PMID: 30762754 PMCID: PMC6408108 DOI: 10.1097/md.0000000000014444] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Upper extremity functional impairments are common consequences of stroke. Therefore, continuous investigation of effective interventions for upper extremity functions after stroke is a necessity. Segmental muscle vibration (SMV) is one of the interventions that incorporate sensory stimulation to improve motor cortical excitability. The aim of this study was to investigate the influence of 5-minute SMV application along with supervised physical therapy (SPT) on improving activities of daily living and motor recovery on the hemiparetic upper extremity in patients with stroke. METHODS A sample of 37 patients poststroke (29 males) was randomly allocated to either SPT control group (n = 18) or SPT and SMV (SPT-SMV) experimental group (n = 19). All patients received 3 sessions per week of SPT for 8 weeks. The SPT-SMV experimental group received SMV at the end of each SPT session. Outcome measures used were Barthel index (BI), modified Ashworth scale, manual muscle testing, and goniometry for range of motion (ROM) assessment. RESULTS Thirty-four patients completed the study. Patients in both groups improved significantly after treatment in BI, elbow ROM, and elbow muscles strength. However, muscle tone in elbow joint of the hemiplegic upper extremity improved significantly after SMV only in the experimental group (SPT-SMV). CONCLUSION The SPT intervention can improve functional outcomes of upper extremity in people after stroke. However, using SMV may have superior effect on improving muscle tone after stroke.
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Affiliation(s)
- Giuseppe Annino
- Department of Medicine Systems, University of Rome, “Tor Vergata”
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome
| | - Anas R. Alashram
- Faculty of Medicine and Surgery, University of Rome, “Tor Vergata,” Italy
| | - Alia A. Alghwiri
- Department of Physical Therapy, School of Rehabilitation Sciences, The University of Jordan, Amman, Jordan
| | | | - Giuseppe Messina
- Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Virginia Tancredi
- Department of Medicine Systems, University of Rome, “Tor Vergata”
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Rome
| | | | - Nicola Biagio Mercuri
- Department of Medicine Systems, University of Rome, “Tor Vergata”
- Faculty of Medicine and Surgery, University of Rome, “Tor Vergata,” Italy
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