Nadinne Roman

Background: Multiple sclerosis (MS) involves complex physical, cognitive and behavioral challenges that collectively affect quality of life. Integrating lifestyle components such as sleep optimization, dietary behaviors, stress management, and self-management strategies into rehabilitation may enhance outcomes beyond traditional approaches. This scoping review aimed to map rehabilitation interventions that combine psychomotor, cognitive, lifestyle-focused, or multimodal elements and assess quality of life in adults with MS. Methods: This scoping review was conducted in accordance with the PRISMA-ScR guidelines, which guided the identification, screening, and selection of studies. Screening and data extraction were conducted independently by two reviewers. From 135 records, nine primary studies and four secondary evidence sources were included. Results: Most studies involved adults with mild-to-moderate disability and predominantly relapsing–remitting multiple sclerosis. Physical or motor rehabilitation interventions were examined in five studies, while two studies evaluated multimodal rehabilitation programs, one study focused on cognitive rehabilitation, and one study investigated lifestyle-oriented or self-management-integrated approaches. Quality of life was assessed in all included studies, with improvements reported across multiple domains. Fatigue-related outcomes were reported in four studies, sleep-related outcomes in three studies, and digitally delivered or hybrid rehabilitation interventions were implemented in three studies, indicating an emerging trend toward technology-supported rehabilitation approaches. Conclusions: Contemporary MS rehabilitation is moving toward multidimensional, holistic models that integrate lifestyle components. Standardized outcomes, inclusion of more diverse MS phenotypes, and rigorous evaluation of integrated frameworks are required to strengthen the evidence base and inform clinical practice.

Knee osteoarthritis (OA) is a complex condition with varying pain, functional limitations, and structural changes. Traditional classification using radiographic grades may not fully reflect individual patient experiences. This study aimed to establish WOMAC score cut-offs for KL grades and identify knee OA phenotypes through cluster analysis in a cohort of 99 adults, examining functional and radiological status, factors such as age, sex, body mass index (BMI), comorbidities, and psychological status. Receiver operating characteristic (ROC) analysis helped establish WOMAC cut-off scores related to KL grades, and cluster analysis identified phenotypic subgroups. The analysis showed that higher WOMAC scores correlated with advanced KL grades, leading to a five-tier classification of symptomatic severity: minimal or no symptoms (≤24), mild (25–41), moderate (42–69), severe (70–86), and extreme (≥87). Cluster analysis identified four distinct phenotypic groups: (1) younger patients exhibiting minimal symptoms and low KL grades; (2) individuals with moderate disease are characterized by functional deficits; (3) patients presenting with moderate-to-severe symptoms and significant joint narrowing; and (4) a subgroup experiencing severe pain, high levels of disability, advanced KL grades, elevated psychological distress, and an increased BMI. The study supports WOMAC cut-offs as key indicators of knee OA severity and shows that cluster analysis can reveal distinct phenotypes, underscoring the need for personalized management strategies in knee OA treatment.

Background/Objectives: Diabetes mellitus presents significant management challenges, requiring comprehensive glycemic control, patient education, self-management, and routine monitoring. The study aims to evaluate existing tools and develop a customized questionnaire to investigate the multifaceted impact of diabetes mellitus on patients’ lives through a novel questionnaire. Methods: Utilizing Survey Monkey, we efficiently collected data from 150 diabetic patients during annual evaluations over five months (March 2024–July 2024). The sample included 88 men (58.67%) and 62 women (41.33%), with a notable representation of participants having a family history of diabetes (63.42%) and varying levels of education (20% with higher education). Statistical analyses were conducted using IBM SPSS (Version 20.0), and structural equation modeling (SEM) through Amos, including exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to validate the instrument and assess its psychometric properties. Results: The questionnaire targets four critical domains: the role of physical activity in diabetes management, the effects of diabetes on social relationships, the emotional status of diabetic patients, and the influence of diet on metabolic control. Conclusions: The findings provide valuable insights into patient attitudes toward diabetes management, emphasizing the importance of physical activity, social dynamics, emotional well-being, and dietary practices in improving health outcomes for individuals with diabetes.

Background/Objective: Surgical treatment of extensive tumors of the lower lip generates important defects in its structure and functions. Over time, a multitude of reconstruction options for these defects have been imagined. Unfortunately, the majority involve the use of both local and regional flaps, which either lack labial structure or disorganize the oral commissures as nodal oral function points. We set out to design a new reconstruction method that is not burdened by any of the above disadvantages, starting from the necessity to reconstruct large lower lip defects by exclusively using local and/or regional labial flaps belonging only to the healthy upper lip and the remaining structures of the lower lip after surgical tumor removal. In this way, the tissues involved in lower lip reconstruction will have a 100% labial structure and, supplementarily, the remaining oral commissures will not be damaged. Method: This new reconstruction method is based on the original association of WY-plasty to reduce the size of the large primary defect until it becomes congruent with the Abbe–Sabattini cross-lip flap. Results: Applied in a personalized manner, impressive results were obtained in several patients with lip tumors affecting about one-half of the lower lip length and in whom oncological surgical ablation produced defects in more than two-thirds of it. Conclusions: This new method is characterized by functional oral advantages, and can be applied in a personalized way to only certain categories of patients. Other disadvantages are characteristic and specific of Abbe–Sabattini cross-lip flap plasty.

Background: Knee osteoarthritis (KOA) is a common degenerative and progressive joint disorder that negatively influences patients’ quality of life. Intra-articular therapies, such as hyaluronic acid (HA) and platelet-rich plasma (PRP), have garnered attention for their potential to manage osteoarthritis OA symptoms effectively. This systematic review aims to identify the effectiveness and safety of HA and PRP treatment modalities in treating KOA. Methods: A literature search was conducted across MEDLINE (PubMed), Web of Science Core Collection, and Science Direct Collection Elsevier. Twenty-three randomized controlled trials, cohort studies, and observational studies were included in the review. The selection criteria focused on studies published in English within the last 10 years, involving subjects with KOA treated with intra-articular injections of HA or PRP and reporting on pain, function, or overall treatment efficacy outcomes. Results: The analysis showed that both HA and PRP significantly improve functionality and reduce pain in KOA patients. High molecular weight HA consistently reduced pain and improved joint mobility in various studies. PRP had better long-term outcomes when combined with HA, leading to greater pain reduction and functional improvement. Both therapies had generally favorable safety profiles, with only minor adverse events reported. However, there were potential biases identified across the studies, such as selection, performance, detection, and reporting biases, which impacted the reliability of the results. Conclusions: Intra-articular treatments with HA and PRP show promise in managing knee osteoarthritis, with personalized treatment plans and further research needed to confirm these findings.

Background: This systematic literature review aims to explore the impact of rehabilitation in post-stroke patients, particularly highlighting the roles of virtual reality (VR) technology and functional electrical stimulation (FES). Methods: To ensure all relevant studies were included, a thorough search was conducted in PubMed and Web of Science databases using keywords such as ‘post-stroke’, ‘FES’, ‘functional electrical stimulation’, ‘virtual reality’, and ‘VR’. Studies on rehabilitating upper limb function through VR and FES in post-stroke patients were included, regardless of publication year. Studies had to compare this combination therapy with conventional methods and report outcomes related to upper limb coordination, functional mobility, and daily activities. Studies not meeting these criteria were excluded. The selection process involved screening titles, abstracts, and full texts by four independent reviewers. The quality and risk of bias of the included studies were assessed using the PEDro scale and Robvis tool. Results: The review included four studies involving 135 post-stroke patients. Two articles examined the effectiveness of an approach involving virtual reality, robotic therapy, and functional electrical stimulation in rehabilitating upper limbs in post-stroke patients, showing significant improvements in motor function and quality of life. The other two studies explored the effects of rehabilitation therapy using virtual reality combined with functional electrical stimulation on upper limb function in stroke patients, finding that combined therapy (FES with VR) was superior to functional electrical stimulation or robotic therapy. Discussion: The review was limited by the small number of studies and participants, which may affect the generalizability of the results. Variations in intervention protocols and outcome measures across studies posed challenges in synthesis. Integrating these technologies brings benefits and increases the potential for personalizing and optimizing the rehabilitation process, enhancing patient engagement and satisfaction, and promoting a holistic approach to post-stroke management. Future research should focus on larger, more standardized trials to confirm these findings and optimize intervention protocols.

Considerable research efforts have been directed towards investigating neurogenic bladder dysfunction over the preceding decade. This condition stands as the most prevalent and incapacitating pelvic floor disorder amidst patients afflicted with specific upper motor neuron syndromes, including multiple sclerosis, stroke, and spinal cord injury. The current study aims to bring up-to-date findings on rehabilitation methods for treating neurogenic bladder. The Web of Science database (MEDLINE, PsychINFO, EMBASE, CENTRAL, ISRCTN, and ICTRP) was screened for randomized controlled studies and clinical studies using combinations of keywords including “neurogenic bladder”, “stroke”, “multiple sclerosis”, and “spinal cord injury”. The PEDro scale was used to assess the quality of the articles included in this study. After a thorough examination, eleven articles met the criteria for inclusion in our research. The outcome measures showed a variety of forms of electrostimulation that can be combined with or without PFMT. These interventions significantly enhance health-related quality of life, as evidenced by various assessment methods. The physical approach constitutes an effective therapeutic method that can reduce the severity of urinary incontinence.

Anxiety and depression are two of the most impactful diseases on quality of life and cause significant disability to patients. It burdens the medical system even as a stand-alone pathology or a secondary condition. These conditions can occur secondarily after a patient suffers from other illnesses, such as upper motor neuron lesions. Binaural beats are a new and emerging type of technology that can be used as an adjunct therapy for anxiety and depression as well as in neurologic conditions to some extent. We searched through the MEDLINE, PsychINFO, EMBASE, CENTRAL, ISRCTN, and ICTRP databases to identify studies using binaural beats as therapy for anxiety and depression. Twelve articles were declared eligible to be included in this review. Binaural beats, whether used in the form of pure beats or masked by another sound, have shown better results in alleviating symptoms of anxiety and depression compared to control conditions such as no music or the use of noise-canceling headphones alone. The results suggest that using binaural beats could be a promising and easy-to-use method to help alleviate the symptoms of anxiety and depression.

(1) Background: Since multiple sclerosis (MS) is a neurological pathology known for its disabling effects across many domains, the introduction of virtual reality (VR) usage has been attempted, as it represents a new method of approach to rehabilitation and treatment of chronic neurological pathologies. Encouraging research has explored the use of video game consoles and VR-assisted Robot-Assisted Gait Training (RAGT) to address balance disturbances in this population. (2) Methods: The search involved two databases, Web of Science and PubMed, utilizing a selection of terms including “Virtual reality”, “Multiple sclerosis”, “Balance”, and “Rehabilitation”. Two reviewers initiated and performed the search for articles, subsequently selecting and extracting data from the studies. The PEDro scale was the tool for evaluating the quality of the articles that we introduced in our research. (3) Results: After rigorous scanning, nine articles remained eligible for our study. VR interventions, particularly compared to standard balance training, consistently improved balance in multiple sclerosis. Robotic-assisted technology with 2D VR yielded superior results in balance rehabilitation. VR interventions had varied effects on walking speed. They have shown promise in decreasing the risk of falls and improving patients’ daily lives while reducing fatigue in multiple sclerosis. (4) Conclusions: VR offers comparable or superior benefits to classical exercise and no intervention for balance but does not significantly improve functional mobility. However, it shows the potential to improve quality of life and fatigue in MS patients. Investigation of VR alongside RAGT is important to be performed with larger sample sizes and comprehensive results are needed to fully understand its efficacy in MS rehabilitation.

Carpal tunnel syndrome is a common entrapment neuropathy that can occur in the upper limbs during pregnancy. However, it is often undervalued and underdiagnosed because the symptoms can be mistaken for regular changes during pregnancy. Delay or absence of diagnosis and treatment can lead to permanent nerve damage, which can affect a woman’s quality of life during and after pregnancy. Although the treatment protocols are well established for carpal tunnel syndrome in patients from the general population, there is a different situation among pregnant and postpartum women that requires a preventive and personalized approach to manage this pathology. Unfortunately, the range of available treatment options is limited due to the pregnant woman’s physiological status and influenced by the high possibility of the complete resolution of this pathology in the postpartum period without any treatment. To limit the possibility of unfavorable evolution of this syndrome during pregnancy, an early diagnosis and personalized approach are mandatory in each case involving a multidisciplinary team of general practitioners, obstetricians, hand surgeons, rehabilitation physicians, physiotherapists, and occupational therapists.