Telerehabilitation for neurological motor impairment: a systematic review and meta-analysis on quality of life, satisfaction, and acceptance in stroke, multiple sclerosis, and Parkinson’s disease

Telerehabilitation (TR) seems to be a viable and feasible solution to face the rehabilitative challenges posed by neurological impairments and to improve patients’ quality of life (QoL). This review aims to synthesize and analyze the evidence on the impact of physiotherapy intervention through TR on QoL in patients with stroke, Parkinson’s disease (PD), and multiple sclerosis (MS), together with an evaluation of their satisfaction and technology acceptance levels. Through a systematic search of the literature and a screening process, treatment effects were assessed with meta-analyses using the standardized mean difference, setting the confidence interval at 95%. We included 28 studies in the review, which were analyzed for methodological quality, whereas 16 studies were included in the meta-analyses. The results suggest a significant improvement in QoL in patients who underwent TR. We were unable to perform analyses for satisfaction and technology acceptance outcomes due to insufficient data. Overall, motor TR has a positive impact on the QoL of patients with neurological diseases, especially in stroke patients; although caution is needed in the interpretation of the results due to the high heterogeneity found. For PD and MS, TR seems to yield comparable results to in-person treatment

Does Psychological State Influence the Physiological Response to Cardiac Rehabilitation in Older Adults?

Background and Objectives: Cardiovascular diseases (CVDs) are a major global cause of death. Effective secondary prevention is crucial, involving risk factor modification and cardiac rehabilitation. However, mental factors, particularly depression, exert a significant influence on CVD outcomes by increasing cardiovascular risk and impeding treatment adherence. Therefore, the aim of this study is to assess the impact of psychological state on the effectiveness of rehabilitation in cardiac patients. Materials and Methods: Thirty-three patients referred for cardiac rehabilitation participated in a 3-week program, retrospectively categorized into two groups: those with and without depressive symptoms. The functional status of the patients was assessed using the R.A.M.P. protocol exercise test, conducted on a treadmill, during which resting and exercise heart rate (HR), systolic (SBP) and diastolic (DBP) blood pressure, and metabolic equivalent of task (MET) measurements were taken. The Hospital Anxiety and Depression Scale (HADS) and the Perceived Stress Scale (PSS-10) were utilized to evaluate the patients’ psychological state. Stepwise regression explored the psychological factors explaining physiological parameter variance. Results: Participants without depressive symptoms exhibited significantly greater improvements in exercise HR (15.58 vs. 1.07; p = 0.02), exercise SBP (7.93 vs. −2.05; p = 0.05), and exercise METs (1.52 vs. 0.50; p = 0.006) compared to those with depressive symptoms. The following predictors were found to be significant: for exercise HR—HADS-D (r2 = 12%; p = 0.04); for exercise DBP—PSS-10 (r2 = 27%; p = 0.002); and for METs—HADS-D and age (r2 = 26%; p = 0.01). Conclusions: In conclusion, cardiac rehabilitation improved psychological and physiological parameters in both groups, with greater effectiveness seen in those without depression. Depressive symptoms predicted exercise HR, SBP, and METs, highlighting their role in worsening cardiac disease. Emphasizing psychological factors, including depression and stress, in cardiac rehabilitation can enhance effectiveness and patient outcomes

Mineralogical and geochemical evidence for two-stage silicification of serpentinized peridotites from the Szklary Massif (NE Bohemian Massif)

Previously unknown exposures of silicified serpentinites have been documented within the Szklary Massif, which is a fragment of the tectonically dismembered Central Sudetic Ophiolite (NE Bohemian Massif). On the basis of textural, mineralogical and chemical differences, two types of silicified serpentinites have been distinguished in this study (Type I and Type II). Type I is characterized by well-preserved primary minerals cut by numerous veinlets filled with microscale euhedral quartz crystals. Studied samples of Type I are enriched in silica (from 62 to 69 wt.% SiO2) and depleted in magnesium (from 10 to 19 wt.% MgO) in comparison to serpentinized peridotites from the Szklary Massif. Type II is almost exclusively composed of amorphous or poorly crystalline silica, with microquartz aggregates being the most abundant form. Silicified serpentinites of Type II show extremely high values of silica (from 83 to 90 wt.% SiO2) and low magnesium concentrations (from 4 to 8 wt.% MgO). Both types of silicified serpentinites have elevated content of REE and many other trace elements generally regarded as incompatible. We infer that the earlier silicification event was caused by the percolation of Si-rich hydrothermal fluids derived from igneous rocks, which intruded this area from ca. 380 to 330 Ma. A subsequent silicification event is the result of silica remobilization during intense chemical weathering under tropical conditions, which could have occurred between Late Cretaceous and Miocene

Employment activity and mood disorders among physiotherapy graduates from the University School of Physical Education in Wroclaw

Background. The aim of the paper was to provide knowledge about socio-economic status and severity of mood disorders among 2012/2013 physiotherapy graduates from the University School of Physical Education in Wroclaw. Material and methods. The study analyzed 101 physiotherapy graduates (mean age 24.2). The research was carried out with the use of a diagnostic survey method. The self-made questionnaire examined the respondents’ employment and economic situation. In addition, the Beck Depression Inventory which assesses symptoms of depression demonstratively was used. Results. 75% of respondents were employed, 13% were unemployed, the others continued their education. One third of the employees were earning less than 10 PLN/h net, 26% of respondents indicated the option 10–15 PLN/h net, 20% of respondents had an income level above 16 PLN/h net. One fifth of graduates reported symptoms of depressed mood and mental health problems. Conclusions. A large number of respondents were economically active persons. On the other hand, unemployment was a huge problem whose rate is similar to the general unemployment rate in Poland

Virtual Therapeutic Garden: A Promising Method Supporting the Treatment of Depressive Symptoms in Late-Life: A Randomized Pilot Study

The multifactorial genesis of old-age depression requires multi-professional therapy combining physical activity and psychosocial interventions; however, there is still a percentage of older people who do not exhibit satisfactory improvements. The aim of this study was to evaluate the effectiveness of virtual therapy in the elderly for whom the previous multimodal, biopsychosocial therapeutic programme had not brought the expected results. Twenty-five elderly women with depressive symptoms were randomly divided into a virtual reality group (VR, n = 13) and a control group (Control, n = 12). The average age was 70.73 and the average intensity of depression symptoms amounted to 12.26 in the Geriatric Depression Scale (GDS-30). As a virtual reality source, the VRTierOne (Stolgraf®) device was used. The therapeutic cycle consisted of eight virtual therapy sessions, twice a week for four weeks. As primary and secondary outcome measures, the GDS-30 was performed at three time points. In the VR group, the GDS-30 score was reduced by 36%, and the result persisted in the follow-up tests. Immersive virtual therapy significantly lowered the intensity of depressive symptoms, as well as stress and anxiety levels in older women taking part in the group-based multimodal therapeutic programme, whose earlier therapy had not brought the expected results

Evaluation of the Impact of Virtual Reality-Enhanced Cardiac Rehabilitation on Depressive and Anxiety Symptoms in Patients with Coronary Artery Disease: A Randomised Controlled Trial

The aim of this study was to assess the efficacy of virtual reality (VR)-enhanced cardiac rehabilitation (CR) in reducing the intensity of depression and anxiety symptoms in patients undergoing phase II of CR in ambulatory conditions. One hundred participants (mean age 65.7 years) were divided randomly into two groups. Both groups took part in eight sessions of standard CR (three times per week). The experimental group was additionally supported by eight sessions of VR therapy using the VR TierOne device and the control group by eight sessions of Schultz Autogenic Training. The Hospital Anxiety and Depression Scale (HADS) was used as the primary outcome measure. The Perception of Stress Questionnaire was used as the secondary outcome measure. The data from 77 participants were subject to analysis. Post-intervention, in the experimental group, the overall HADS score was statistically significantly reduced by 13.5%, HADS-Depression by 20.8%, and the general stress level by 12.8% (p < 0.05). In the control group, the scores of the HADS, HADS-Anxiety and the general stress level were statistically significantly higher, by 4.8%, 6.5%, and 4.9%, respectively. VR-enhanced CR for individuals with cardiovascular disease reduced the level of anxiety and depression symptoms compared to standard CR

Financial situation, research activity, and mood disorders among PhD students

Background. The aim of the study was to provide information about the socio-economic status, research activity, and mood disorders among PhD students of the Academy of Physical Education in Wrocław, Poland. Material and methods. This study covered 61 PhD students (mean age 28.4 years). The research employed the diagnostic survey method. The author’s survey examined the employment status and economic situation. An additional method, used to assess depression symptoms, was Beck Depression Inventory. Results. In the fields of physiotherapy and physical education, 96% and 78% of PhD students, respectively, had found employment. The total of 72% of physical education and 50% of physiotherapy students had published at least once. As many as 30% of all respondents reported symptoms of mood disorders and complained about mental health problems. Conclusions. Mood disorders are a serious problem in PhD students of the Academy of Physical Education in Wrocław. While physical education students show greater activity in the field of scientific research, more physiotherapy students are professionally active

Monitoring physical activity with a wearable Sensor in patients with COPD during In-Hospital Pulmonary Rehabilitation Program: A Pilot Study

Accelerometers have become a standard method of monitoring physical activity in everyday life by measuring acceleration in one, two, or three axes. These devices provide reliable and objective measurements of the duration and intensity of physical activity. We aimed to investigate whether patients undertake physical activity during non-supervised days during stationary rehabilitation and whether patients adhere to the rigor of 24 h monitoring. The second objective was to analyze the strengths and weaknesses of such kinds of sensors. The research enrolled 13 randomly selected patients, qualified for in-patient, 3 week, high-intensity, 5 times a week pulmonary rehabilitation. The SenseWear armband was used for the assessment of physical activity. Participants wore the device 24 h a day for the next 4 days (Friday-Monday). The analysis of the number of steps per day, the time spent lying as well as undertaking moderate or vigorous physical activity (>3 metabolic equivalents of task (METs)), and the energy expenditure expressed in kcal showed no statistically significant difference between the training days and the days off. It seems beneficial to use available physical activity sensors in patients with chronic obstructive pulmonary disease (COPD); measurable parameters provide feedback that may increase the patient's motivation to be active to achieve health benefits