Journal of Health and Rehabilitation Research

Impact of Exoskeleton-Assisted Rehabilitation on Gait Training in Patients with Spinal Cord Injury: A Longitudinal Observational Study

Tayyaba Niaz — 2024-12-31

Background Spinal cord injury (SCI) leads to significant impairments in mobility, functional independence, and quality of life. Exoskeleton-assisted rehabilitation has emerged as a promising intervention to enhance gait performance and functional outcomes in SCI patients. Objective: To evaluate the efficacy of exoskeleton-assisted rehabilitation in improving gait parameters, functional independence, and quality of life over six months in individuals with SCI. Methods: A longitudinal observational study was conducted with 99 SCI patients (63% male, mean age 42.3 ± 10.5 years). Participants underwent exoskeleton-assisted gait training three times per week for six months. Gait parameters (10-Meter Walk Test, 6-Minute Walk Test, Timed Up and Go Test), functional independence (SCIM III), and quality of life (SF-36) were assessed at baseline, three months, and six months. Data were analyzed using repeated-measures ANOVA in SPSS v25, with p < 0.05 considered statistically significant. Results: Significant improvements were observed in gait parameters: 10-Meter Walk Test (baseline: 37.2 ± 8.9 s, six months: 26.8 ± 6.1 s, p < 0.001), 6-Minute Walk Test (baseline: 148.7 ± 22.5 m, six months: 237.6 ± 30.4 m, p < 0.001), and Timed Up and Go Test (baseline: 19.8 ± 5.3 s, six months: 14.0 ± 4.1 s, p < 0.001). SCIM III scores improved from 47.5 ± 12.4 to 63.7 ± 16.8 (p < 0.001). Conclusion: Exoskeleton-assisted rehabilitation significantly enhanced gait performance, functional independence, and quality of life in SCI patients over six months. These findings highlight its potential as a safe and effective intervention in neurorehabilitation.

The Role of Gut Dysbiosis in Autoimmune Disorders Among General Population

Shafaq Ilyas — 2024-12-31

Background: Gut dysbiosis has been increasingly implicated in the pathogenesis of autoimmune disorders, yet there is limited research on its role in General Population. Differences in genetic, environmental, and dietary factors necessitate region-specific studies to better understand microbiota-autoimmunity interactions. Objective: To compare the gut microbiome composition between individuals with autoimmune disorders and healthy controls in a General population and identify microbiota alterations associated with autoimmune conditions. Methods: A case-control study was conducted with 138 participants, comprising 69 individuals with autoimmune disorders and 69 matched healthy controls. Data were collected on demographics, clinical history, and dietary habits. Stool samples were analyzed using 16S rRNA gene sequencing, targeting the V3–V4 regions to assess microbial diversity and taxonomic composition. Alpha diversity was evaluated using the Shannon index, and beta diversity was analyzed through Bray-Curtis dissimilarity. Statistical analyses included t-tests, chi-square tests, and logistic regression using SPSS version 25. Results: Cases exhibited significantly lower Shannon diversity index scores (2.8 ± 0.4 vs. 3.2 ± 0.5, p = 0.01) and reduced Firmicutes-to-Bacteroidetes ratio (1.5 vs. 2.2, p = 0.03). Enrichment of Prevotella (12.4%) and Collinsella (8.5%) was observed in cases (p < 0.001). Logistic regression identified reduced microbial diversity as an independent predictor of autoimmune disorders (OR: 2.3, 95% CI: 1.2–4.4, p = 0.03). Conclusion: Gut dysbiosis characterized by reduced microbial diversity and altered taxonomic composition was significantly associated with autoimmune disorders in a general population. These findings underscore the need for microbiome-targeted interventions in managing autoimmune conditions.

Exploring Public Awareness of Kidney Failure and Its Management in Sialkot, Punjab

Fatima Afzal — 2025-01-03

Background: Background: Kidney failure is a significant public health concern with high morbidity and mortality. Public awareness is crucial for early detection, prevention, and management of this condition.
Objective: To evaluate the level of awareness, knowledge gaps, and factors influencing kidney failure awareness among residents of Sialkot, Punjab, Pakistan.
Methods: A descriptive cross-sectional study was conducted from May to August 2024, involving 422 participants selected through convenience sampling. A structured and validated questionnaire collected socio-demographic data and knowledge about kidney failure, its risk factors, symptoms, diagnostics, and treatments. Data analysis was performed using SPSS version 25, employing descriptive statistics, chi-square tests, and logistic regression. Ethical approval was obtained in adherence to the Declaration of Helsinki.
Results: Of the 422 participants, 81.8% reported moderate awareness, while 18.2% had no knowledge of kidney failure. Awareness was significantly associated with education (p < 0.001), age (p = 0.03), and urban residence (p = 0.01). Only 26.5% identified all major risk factors, while 25.4% were aware of dialysis. Higher education (OR = 2.89, 95% CI: 1.56–5.32) and urban residence (OR = 1.97, 95% CI: 1.12–3.45) were strong predictors of awareness.
Conclusion: Despite moderate awareness, significant knowledge gaps remain, particularly in rural and less-educated populations. Targeted educational interventions are essential to bridge these gaps and promote effective kidney disease management.

Efficacy of Combined Task-Oriented Training and Mirror Therapy in Post-Stroke Upper Limb Recovery: A Randomized Controlled Trial

Amna Abbas — 2024-12-31

Background: Stroke-induced upper limb impairments significantly reduce functional independence and quality of life. Task-oriented training (TOT) and mirror therapy (MT) are established neurorehabilitation techniques. Combining these therapies may enhance recovery through synergistic mechanisms. Objective: To evaluate the efficacy of combining TOT and MT on upper limb motor function, spasticity, and functional independence in post-stroke patients. Methods: This randomized controlled trial included 40 post-stroke patients (20 per group) with upper limb hemiparesis. Participants were randomized into an intervention group (combined TOT and MT) and a control group (TOT alone). Both groups received 45-minute sessions, five days per week, for four weeks. Outcomes were assessed using the Fugl-Meyer Assessment Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), Modified Ashworth Scale (MAS), and Barthel Index. Data analysis was performed using repeated-measures ANOVA and SPSS version 25, with p < 0.05 considered statistically significant. Results: The intervention group demonstrated significantly greater improvements in FMA-UE (45.6 ± 4.9 vs. 38.2 ± 5.7, p < 0.001) and ARAT (31.2 ± 3.9 vs. 26.4 ± 4.1, p < 0.001). Spasticity reduction (MAS: -1.8 ± 0.4 vs. -1.2 ± 0.5, p = 0.002) and functional independence (Barthel Index: 8.4 ± 1.2 vs. 5.9 ± 1.3, p < 0.001) were also superior in the intervention group. Conclusion: Combining TOT and MT significantly improved upper limb motor function, spasticity, and functional independence in post-stroke patients, highlighting its potential as an effective rehabilitation strategy

Efficacy of Virtual Reality Games in Enhancing Motor Coordination in Children with Dyspraxia: A Randomized Controlled Trial

Ahmed Jamal — 2024-12-31

Background: Children with dyspraxia often face challenges in motor coordination, significantly affecting their functional independence and quality of life. Virtual reality (VR)-based interventions have shown promise in improving motor skills through engaging, interactive environments. Objective: This study aimed to evaluate the effectiveness of VR-based interventions in improving motor coordination, balance, fine motor skills, and quality of life in children with dyspraxia compared to conventional therapy. Methods: A randomized controlled trial was conducted with 60 children aged 6–12 years diagnosed with dyspraxia, randomized into intervention (VR-based therapy) and control (standard physiotherapy) groups (n=30 per group). The intervention group participated in VR sessions three times a week for 12 weeks, focusing on motor tasks such as object manipulation and balance. Motor coordination was assessed using the Movement Assessment Battery for Children (MABC), with secondary outcomes including balance, fine motor skills, and quality of life. Data were analyzed using SPSS version 25 with repeated-measures ANOVA. Results: The intervention group showed a significant improvement in MABC scores (mean change: 7.3 ± 3.1) compared to the control group (mean change: 1.8 ± 3.4; p<0.001p<0.001). Balance improved by 12.9% (p<0.001p<0.001), fine motor skills by 9.7% (p<0.001p<0.001), and quality of life by 11.8% (p<0.001p<0.001). Conclusion: VR-based interventions significantly enhanced motor coordination and related outcomes in children with dyspraxia, demonstrating their potential as an effective rehabilitation tool.

Prevalence of Atrial Fibrillation in Older Adults with Diabetes Mellitus: A Cross-Sectional Study

Adnan Khalid — 2024-12-31

Background: Atrial fibrillation (AF) is a common arrhythmia in older adults, with diabetes mellitus (DM) serving as a significant risk factor. The interplay of aging, glycemic control, and comorbid conditions such as hypertension and chronic kidney disease (CKD) heightens the prevalence and associated risks of AF in this population. Objective: To determine the prevalence of AF in older adults with DM and identify key associated risk factors. Methods: This cross-sectional study included 137 older adults with DM recruited from clinical settings. Participants underwent clinical evaluations, including demographic data collection, glycemic control assessment (HbA1c), and screening for comorbidities. Standard 12-lead electrocardiography was used to detect AF, with all diagnoses confirmed by certified cardiologists. Statistical analyses, including chi-square tests and multivariate logistic regression, were performed using SPSS version 25. Results: The overall prevalence of AF was 11.7% (16/137), with 43.8% (7/16) newly diagnosed cases and 31.3% (5/16) asymptomatic AF. Advanced age (OR: 1.45; 95% CI: 1.11–1.88; p=0.005) and CKD (OR: 2.87; 95% CI: 1.33–6.21; p=0.007) were significant independent predictors. Conclusion: The study highlights a significant prevalence of AF, including silent cases, in older adults with DM, emphasizing the need for routine screening and early intervention in high-risk populations.