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Search Results (362)

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Keywords = digital rehabilitation

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18 pages, 1384 KiB  
Article
Randomized Trial: A Pilot Study Investigating the Effects of Transcendental Meditation and Yoga Through Retinal Microcirculation in Cardiac Rehabilitation
by Adam Saloň, Karin Schmid-Zalaudek, Bianca Steuber, Maximilian Elliot Rudlof, Till Olaf Bartel, Petra Mächler, Andreas Dorr, Rainer Picha, Per Morten Fredriksen, Benedicta Ngwenchi Nkeh-Chungag and Nandu Goswami
J. Clin. Med. 2025, 14(1), 232; https://doi.org/10.3390/jcm14010232 - 3 Jan 2025
Viewed by 149
Abstract
Background/Objectives: Cardiovascular diseases are a leading cause of death, and psychosocial stress is considered a contributing factor to these issues. With the rising number of heart surgeries, proper rehabilitation post-surgery is essential. Previous studies have demonstrated the positive impact of yoga and transcendental [...] Read more.
Background/Objectives: Cardiovascular diseases are a leading cause of death, and psychosocial stress is considered a contributing factor to these issues. With the rising number of heart surgeries, proper rehabilitation post-surgery is essential. Previous studies have demonstrated the positive impact of yoga and transcendental meditation on the cardiovascular system. This pilot study aimed to investigate the effects of yoga and transcendental meditation on retinal microcirculation in cardiac patients before (admission), after (discharge), and following (3 weeks after discharge) rehabilitation. Methods: This study examined changes in retinal microcirculation in three rehabilitation groups of patients after heart surgery. The control group received standard exercise therapy, while the meditation group incorporated 20 min of meditation, and the yoga group incorporated 20 min of yoga practice, twice per day for the duration of four weeks of rehabilitation. Retinal images were captured using a non-mydriatic digital retinal camera (Canon CR-2, Canon Medical Systems Europe B.V., Netherlands), and the microcirculation parameters central retinal artery equivalent, central retinal vein equivalent, and artery-to-vein ratio were analyzed using MONA REVA software ((version 2.1.1), VITO, Mol, Belgium). Repeated measures ANOVA was performed to evaluate differences between the three groups in the course of rehabilitation. Results: None of the parameters revealed significant differences in retinal microcirculation between the three rehabilitation groups. Conclusions: The study evaluating changes in retinal microcirculation, as an indicator of central circulation in cardiac patients undergoing rehabilitation, did not observe any significant changes. As yoga and meditation are underestimated approaches in cardiac rehabilitation, this pilot study acts as a basis for providing preliminary information for future studies to encourage the research community to fill the gap in this area. Full article
(This article belongs to the Special Issue Recent Clinical Advances in Cardiac Rehabilitation)
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<p>CONSORT flow diagram.</p>
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<p>Overview of the study protocol (adapted from Rudlof and colleagues [<a href="#B21-jcm-14-00232" class="html-bibr">21</a>]).</p>
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<p>An optic disc focused image of the retina displayed in software (version 2.1.1) MONA-REVA during the analysis process. The table on the left side of the picture shows the list of the analyzed vessels. Arteries are displayed in red and venules are shown in blue. Boldly displayed vessels in the table, which correspond to the six biggest arteries and six largest venules from the picture, were used for the calculation of CRAE and CRVE. Central retinal artery equivalent (CRAE); central retinal vein equivalent (CRVE).</p>
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18 pages, 4115 KiB  
Article
Digital Health Technologies for Optimising Treatment and Rehabilitation Following Surgery: Device-Based Measurement of Sling Posture and Adherence
by Joss Langford, Ahmed Barakat, Engy Daghash, Harvinder Singh and Alex V. Rowlands
Sensors 2025, 25(1), 166; https://doi.org/10.3390/s25010166 - 31 Dec 2024
Viewed by 260
Abstract
Background: Following shoulder surgery, controlled and protected mobilisation for an appropriate duration is crucial for appropriate recovery. However, methods for objective assessment of sling wear and use in everyday living are currently lacking. In this pilot study, we aim to determine if a [...] Read more.
Background: Following shoulder surgery, controlled and protected mobilisation for an appropriate duration is crucial for appropriate recovery. However, methods for objective assessment of sling wear and use in everyday living are currently lacking. In this pilot study, we aim to determine if a sling-embedded triaxial accelerometer and/or wrist-worn sensor can be used to quantify arm posture during sling wear and adherence to sling wear. Methods: Four participants were asked to wear a GENEActiv triaxial accelerometer on their non-dominant wrist for four hours in an office environment, and, for two of those hours, they also wore a sling in which an additional GENEActiv accelerometer was secured. During sling wear, they were asked to move their arm in the sling through a series of pre-specified arm postures. Results: We found that upper arm angle and posture type during sling wear can be predicted from a sling sensor alone (R2 = 0.79, p < 0.001 and Cohen’s kappa = 0.886, respectively). The addition of a wrist-worn sensor did not improve performance. The optimisation of an existing non-wear algorithm accurately detected adherence (99.3%). Conclusions: the remote monitoring of sling adherence and the quantification of immobilisation is practical and effective with digital health technology. Full article
(This article belongs to the Special Issue Novel Sensing Technologies for Digital Health)
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<p>(<b>a</b>) Position of the GENEActiv fitted to the inner side of the sling next to the participant’s arm; (<b>b</b>) orientation of axes.</p>
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<p>Pre-specified arm postures during sling wear. Upper arm angles: neutral (10°), forward flexion (30°, 60°, 90°), side abduction (30°, 60°, 90°); external rotation angles (0°, 30°).</p>
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<p>The three nested datasets generated for each participant: (<b>a</b>) sling wear during pre-specified arm postures during sling wear with recorded upper arm angle; (<b>b</b>) sling wear in free-living ‘office environment’; (<b>c</b>) sling wear and non-wear in free-living ‘office environment’.</p>
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<p>Association between upper arm angle (displayed with jitter) and acceleration in the y axis of the sling sensor (Model 1).</p>
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<p>Discrimination between arm posture types using principal component analysis on sling sensor data with the dashed lines showing the boundaries of the simple classification schema.</p>
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<p>Association of upper arm angle with wrist elevation (<b>a</b>) and wrist rotation (<b>b</b>) (Model 5a).</p>
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<p>Arm posture during sling wear by second for all participants combined, with type predicted by cluster analysis on PC1 and PC2 from sling sensor data (Model 7) with the dashed lines showing the boundaries of the simple classification schema.</p>
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<p>Frequency of upper arm angle predicted from sling sensor by participant.</p>
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<p>Aitoff projection of wrist elevation and wrist rotation from the wrist sensor data during sling wear in a free-living office environment.</p>
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<p>Optimised sling non-wear state machine algorithm applied to consecutive minutes. ΔT = temperature difference (°C); SD = standard deviation of movement (<span class="html-italic">g</span>).</p>
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<p>Identification of wear and non-wear for each of the 4 participants in sequence.</p>
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<p>Mean wrist acceleration (<b>top</b>), wrist elevation (<b>middle</b>), and rotation (<b>bottom</b>) during sling wear (<b>left</b>) and free movement (<b>right</b>).</p>
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<p>Aitoff projection of wrist elevation and wrist rotation from the wrist sensor data during sling non-wear (black with transparency) and sling wear categorised by predicted arm posture during sling wear: neutral (blue), forward flexion (red), side abduction (yellow), and external rotation (green).</p>
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14 pages, 1376 KiB  
Article
Operational Protocol for Prosthetically Guided Reconstruction of Edentulous Sites Using a Custom-Made Technique
by Edoardo Brauner, Federico Laudoni, Lucia Terribile, Andrea Bellizzi, Giulia Amelina, Francesca De Angelis, Nicola Pranno and Stefano Di Carlo
Appl. Sci. 2025, 15(1), 203; https://doi.org/10.3390/app15010203 - 29 Dec 2024
Viewed by 468
Abstract
The success of dental implant placement and prosthetic reconstruction relies on sufficient bone volume at the implant site. Contemporary implantology integrates prosthetic planning with implant placement, emphasizing the importance of pre-established prosthetic goals. Guided Bone Regeneration (GBR) techniques have become crucial for bone [...] Read more.
The success of dental implant placement and prosthetic reconstruction relies on sufficient bone volume at the implant site. Contemporary implantology integrates prosthetic planning with implant placement, emphasizing the importance of pre-established prosthetic goals. Guided Bone Regeneration (GBR) techniques have become crucial for bone reconstruction. This study explores the use of custom-made GBR membranes, designed through CAD-CAM technology, in 10 patients with severe bone defects. Patients underwent meticulous preoperative planning, in which digital diagnostic wax-ups and RealGUIDE™ software for implant positioning were used. The custom-made membranes, which were designed based on the individual defects, exhibited successful adaptation. Surgical phases involved membrane placement, bone grafting, and subsequent implant placement. Clinical–radiographic follow-ups demonstrated favorable bone gain outcomes, which enabled prosthetic rehabilitation. Despite membrane exposure occurring in 30% of cases, it did not compromise overall success. The study underscores the potential of custom-made GBR membranes in achieving prosthetic goals, though challenges like exposure and the need for a second surgery require further investigations. The results indicate a promising alternative for predictable bone regeneration in complex cases, shedding light on the prosthetically guided approach for optimal functional and aesthetic outcomes. Full article
(This article belongs to the Special Issue Bioactive Dental Materials: A Paradigm Shift in Dentistry?)
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<p>Final design of custom-made mesh.</p>
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<p>Intraoperative surgical photos following the fixation of the meshes with screws for each of the 10 cases (<b>1</b>–<b>10</b>) reported in the study.</p>
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<p>Example of measurements performed on CBCT using the Horos Viewer™ software: pre-intervention and 6 months post-GBR (case n.10).</p>
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12 pages, 9122 KiB  
Case Report
A Digital Approach for a Complete Rehabilitation with Fixed and Removable Prostheses: A Technical Procedure
by Etienne Lefrançois, Victor Delanoue, Samuel Morice, Xavier Ravalec and Marie Desclos-Theveniau
Dent. J. 2025, 13(1), 7; https://doi.org/10.3390/dj13010007 - 25 Dec 2024
Viewed by 296
Abstract
Background: The present article describes a step-by-step maximally digitalized workflow protocol with computer-aided design and computer-aided manufacturing (CAD/CAM) in partial-arch edentulous patients rehabilitated with fixed dental prostheses and removable partial dentures (FDPs and RPDs). Methods: Facial digitalization, intraoral scans, and functional mandibular movement [...] Read more.
Background: The present article describes a step-by-step maximally digitalized workflow protocol with computer-aided design and computer-aided manufacturing (CAD/CAM) in partial-arch edentulous patients rehabilitated with fixed dental prostheses and removable partial dentures (FDPs and RPDs). Methods: Facial digitalization, intraoral scans, and functional mandibular movement recordings were used to create a 4D virtual patient on commercially available CAD software. The fixed components including post-and-cores, both metal–ceramic with extra-coronal attachment and monolithic zirconia crowns, and the RPDs were manufactured by computer numerical controlled direct milling. Results: This innovative digital approach using the virtual patient and the superimposition of interim RPDs fitted in the mouth has been used to provide fixed and removable rehabilitation to the patient without clinical complications with 2 years of follow-up. Conclusions: Within the limitations of this report, the developed combined prosthesis fabrication technique allowed optimization of the production by decreasing the clinical steps and laboratory procedures in partial-arch edentulous rehabilitated with FDPs and RPDs. Full article
(This article belongs to the Special Issue Digital Dentures: 2nd Edition)
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<p>Initial panoramic radiography.</p>
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<p>Digital view of the initial situation: (<b>A</b>) 3D images (TRIOS 4; 3Shape A/S) of maxillary, mandibular, and MMR captured by IOSs; (<b>B</b>) functional mandibular movements recording with the jaw motion tracer (MODJAW; MODJAW); and (<b>C</b>) facial scans (Bellus3D Face Camera Pro; Bellus3D) with AFT aligners.</p>
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<p>(<b>A</b>) Creation of a 4D virtual patient by aligning digital data on CAD software (Exocad DentalCAD; exocad GmbH) and (<b>B</b>) occlusal and frontal views of digital waxing.</p>
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<p>Digital impression of the entire root preparations without scan posts (Primescan; Dentsply Sirona): (<b>A</b>) external and (<b>B</b>) internal digital maxillary view of root canal preparations; (<b>C</b>) digital impression merged with digital waxing; and (<b>D</b>) post-and-cores digital design (3Shape Dental System; 3Shape).</p>
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<p>Digital impressions (TRIOS 4; 3Shape A/S): (<b>A</b>) mandibular arch with prosthesis (relined RPD); (<b>B</b>) maxillary arch with prostheses (FDPs and RPDs relined); (<b>C</b>) maxillomandibular relationship recording (with all dentures); (<b>D</b>) maxillary arch with FDPs; (<b>E</b>) maxillary arch without prosthesis; (<b>F</b>) mandibular arch without prosthesis; (<b>G</b>) maxillary RPD scanning out-of-mouth; and (<b>H</b>) mandibular RPD scanning out-of-mouth.</p>
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<p>Digital workflow based on a 4D virtual patient in a partial-arch edentulous patient rehabilitated with FDPs and RPDs. Numbers: chronology of matching. MMR: maxillomandibular relationship; JMT: jaw motion tracer.</p>
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<p>Occlusal views of maxillary and mandibular definitive prostheses: (<b>A</b>,<b>B</b>) on the printed casts; (<b>C</b>,<b>D</b>) in clinical situation; and (<b>E</b>) frontal view of prostheses in clinical situation.</p>
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<p>Follow-up at 2 years: (<b>A</b>) smile view; (<b>B</b>,<b>C</b>) occlusal views of maxillary and mandibular definitive prostheses; and (<b>D</b>) panoramic radiography.</p>
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14 pages, 4877 KiB  
Article
Systematic Evaluation of IMU Sensors for Application in Smart Glove System for Remote Monitoring of Hand Differences
by Amy Harrison, Andrea Jester, Surej Mouli, Antonio Fratini and Ali Jabran
Sensors 2025, 25(1), 2; https://doi.org/10.3390/s25010002 - 24 Dec 2024
Viewed by 348
Abstract
Human hands have over 20 degrees of freedom, enabled by a complex system of bones, muscles, and joints. Hand differences can significantly impair dexterity and independence in daily activities. Accurate assessment of hand function, particularly digit movement, is vital for effective intervention and [...] Read more.
Human hands have over 20 degrees of freedom, enabled by a complex system of bones, muscles, and joints. Hand differences can significantly impair dexterity and independence in daily activities. Accurate assessment of hand function, particularly digit movement, is vital for effective intervention and rehabilitation. However, current clinical methods rely on subjective observations and limited tests. Smart gloves with inertial measurement unit (IMU) sensors have emerged as tools for capturing digit movements, yet their sensor accuracy remains underexplored. This study developed and validated an IMU-based smart glove system for measuring finger joint movements in individuals with hand differences. The glove measured 3D digit rotations and was evaluated against an industrial robotic arm. Tests included rotations around three axes at 1°, 10°, and 90°, simulating extension/flexion, supination/pronation, and abduction/adduction. The IMU sensors demonstrated high accuracy and reliability, with minimal systematic bias and strong positive correlations (p > 0.95 across all tests). Agreement matrices revealed high agreement (<1°) in 24 trials, moderate (1–10°) in 12 trials, and low (>10°) in only 4 trials. The Root Mean Square Error (RMSE) ranged from 1.357 to 5.262 for the 90° tests, 0.094 to 0.538 for the 10° tests, and 0.129 to 0.36 for the 1° tests. Likewise, mean absolute error (MAE) ranged from 0.967 to 4.679 for the 90° tests, 0.073 to 0.386 for the 10° tests, and 0.102 to 0.309 for the 1° tests. The sensor provided precise measurements of digit angles across 0–90° in multiple directions, enabling reliable clinical assessment, remote monitoring, and improved diagnosis, treatment, and rehabilitation for individuals with hand differences. Full article
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<p>System architecture showing the data acquisition pathway.</p>
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<p>Overview of the glove system, showing key components: PCB, IMUs, microcontroller, and multiplexer.</p>
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<p>Software system architecture and data flow.</p>
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<p>Flowchart showing the processes of the glove system’s firmware.</p>
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<p>Experimental setup for validation of the IMU using the UR5e robotic arm, allowing rotation of sensor B in the x, y, and z axes shown.</p>
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<p>Robotic arm poses at rest (<b>a</b>) and at 90° rotation around <span class="html-italic">x</span>-axis (<b>b</b>), <span class="html-italic">y</span>-axis (<b>c</b>), and <span class="html-italic">z</span>-axis (<b>d</b>).</p>
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<p>Angle vs. Time plots measured from the IMU sensors (red) and robotic arms (blue), for all twelve trials of the 90° (<b>a</b>–<b>c</b>), 10° (<b>d</b>–<b>f</b>), and 1° (<b>g</b>–<b>i</b>) <span class="html-italic">x</span>-axis rotation, <span class="html-italic">y</span>-axis rotation, and <span class="html-italic">z</span>-axis rotation tests.</p>
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<p>Correlation heatmaps for all twelve trials of the (<b>a</b>) 90° <span class="html-italic">x</span>-axis and (<b>b</b>) 90° <span class="html-italic">y</span>-axis rotation tests.</p>
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20 pages, 1427 KiB  
Review
Applications of Artificial Intelligence-Based Patient Digital Twins in Decision Support in Rehabilitation and Physical Therapy
by Emilia Mikołajewska, Jolanta Masiak and Dariusz Mikołajewski
Electronics 2024, 13(24), 4994; https://doi.org/10.3390/electronics13244994 - 19 Dec 2024
Viewed by 671
Abstract
Artificial intelligence (AI)-based digital patient twins have the potential to make breakthroughs in research and clinical practices in rehabilitation. They make it possible to personalise treatment plans by simulating different rehabilitation scenarios and predicting patient-specific outcomes. DTs can continuously monitor a patient’s progress, [...] Read more.
Artificial intelligence (AI)-based digital patient twins have the potential to make breakthroughs in research and clinical practices in rehabilitation. They make it possible to personalise treatment plans by simulating different rehabilitation scenarios and predicting patient-specific outcomes. DTs can continuously monitor a patient’s progress, adjusting therapy in real time to optimise recovery. They also facilitate remote rehabilitation by providing virtual models that therapists can use to guide patients without having to be physically present. Digital twins (DTs) can help identify potential complications or failures at an early stage, enabling proactive interventions. They also support the training of rehabilitation professionals by offering realistic simulations of different patient conditions. They can also increase patient engagement by visualising progress and potential future outcomes, motivating adherence to therapy. They enable the integration of multidisciplinary care, providing a common platform for different professionals to collaborate and improve rehabilitation strategies. The article aims to trace the current state of knowledge, research priorities, and research gaps in order to properly guide further research and shape decision support in rehabilitation. Full article
(This article belongs to the Special Issue Advances in Intelligent and Adaptive Decision Support Systems)
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<p>DTs emerging against the backdrop of AI/ML developments (own version). Abbreviations: 1G–6G—first generation—sixth generation; ANN—artificial neural network; SVM—support vector machine; CNN—convolutional neural network.</p>
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<p>Evolution of DTs in rehabilitation and physiotherapy (own version). To date, all four approaches are being used.</p>
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<p>Bibliometric analysis procedure (own approach).</p>
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<p>A PRISMA flow diagram of the review process using selected PRISMA 2020 guidelines.</p>
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9 pages, 205 KiB  
Study Protocol
The Impact of Cardiac Telerehabilitation on Health-Related Quality of Life in Patients Undergoing Percutaneous Coronary Intervention (PCI): A Systematic Review Protocol
by Francesco Limonti, Andrea Gigliotti, Francesco Gravante and Nicola Ramacciati
Nurs. Rep. 2024, 14(4), 3984-3992; https://doi.org/10.3390/nursrep14040291 - 13 Dec 2024
Viewed by 421
Abstract
Background: Cardiac rehabilitation (CR) is an intervention to improve health and quality of life in patients undergoing percutaneous coronary intervention (PCI). The use of digital technology for healthcare promotion, such as telemedicine, has received growing attention in recent years due to the possibility [...] Read more.
Background: Cardiac rehabilitation (CR) is an intervention to improve health and quality of life in patients undergoing percutaneous coronary intervention (PCI). The use of digital technology for healthcare promotion, such as telemedicine, has received growing attention in recent years due to the possibility of offering remote and individualized cardiac rehabilitation to patients undergoing coronary interventions. However, the impact of cardiac telerehabilitation on health-related quality of life (HRQoL) is not fully understood. This systematic review aims to analyze through meta-analyses and synthesized comments the current knowledge on the effectiveness of cardiac telerehabilitation in improving HRQoL in patients undergoing PCI. Objectives: This manuscript presents a protocol for a systematic review to assess the effects of cardiac telerehabilitation on HRQoL in cardiac patients after PCI. Furthermore, the systematic review will explore the different modalities of remote rehabilitation documented in scientific literature. Methods: The literature review protocol was developed according to the PRISMA guidelines for systematic reviews. Search terms were structured according to the PIO (Population-Intervention-Outcome) framework. All relevant available studies will be identified using the main databases (PubMed, Scopus, CINAHL, Web of Science, and the Cochrane Library) and included in the review. Methodological quality and risk of bias will be evaluated using the Crowe Critical Appraisal Tool (CCAT). This review protocol has been registered on PROSPERO (No. CRD42024582933). Conclusions: This systematic review will comprehensively investigate the effects of cardiac telerehabilitation on QoL improvements in patients after PCI. Full article
13 pages, 1540 KiB  
Article
Digital Rehabilitation Program for Breast Cancer Survivors on Adjuvant Hormonal Therapy: A Feasibility Study
by Wing-Lok Chan, Yat-Lam Wong, Yin-Ling Tai, Michelle Liu, Bryan Yun, Yuning Zhang, Holly Li-Yu Hou, Dora Kwong, Victor Ho-Fun Lee and Wendy Wing-Tak Lam
Cancers 2024, 16(23), 4084; https://doi.org/10.3390/cancers16234084 - 5 Dec 2024
Viewed by 618
Abstract
Background: Breast cancer survivors often face physical and psychological challenges, including weight gain, metabolic syndrome, and reduced quality of life. To address these concerns, a mobile app-based rehabilitation program called “THRIVE” was developed to improve physical activity, medication adherence, and health-related quality [...] Read more.
Background: Breast cancer survivors often face physical and psychological challenges, including weight gain, metabolic syndrome, and reduced quality of life. To address these concerns, a mobile app-based rehabilitation program called “THRIVE” was developed to improve physical activity, medication adherence, and health-related quality of life (HRQoL) in this population. Methods: This prospective, single-arm study assessed the feasibility and effectiveness of the “THRIVE” app among breast cancer survivors undergoing hormonal therapy. Participants were recruited from Queen Mary Hospital in Hong Kong between December 2022 and June 2023. Eligible survivors had completed treatment within the last five years or had stable advanced disease on hormonal therapy. Participants monitored their exercise, medication adherence, and self-care via the app and a Fitbit activity tracker for 16 weeks. Primary outcomes included recruitment, dropout, adherence rates, and safety. Secondary outcomes, measured at baseline and week 16, included physical activity intensity, HRQoL, psychological stress, body composition, and app satisfaction. Results: A total of 50 participants, with a median age of 53 years, completed the study. The recruitment rate was 70.4% with no dropouts. The adherence rate, measured by completing exercises recommended in the mobile app at least three times per week, was 74%. No severe adverse events were reported. While physical activity intensity showed no significant changes from baseline to week 16 (p = 0.24), cognitive function (p = 0.021), future perspective (p = 0.044), arm symptoms (p = 0.042), depression (p = 0.01), and anxiety (p = 0.004) improved. All participants reported perfect medication compliance (100%). Satisfaction with the app was high. Conclusions: This mobile app-based rehabilitation program demonstrated good feasibility, with satisfactory recruitment, adherence, and safety, providing valuable insights into future definitive studies. Full article
(This article belongs to the Special Issue Digital Health Technologies in Oncology)
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<p>HADS (<b>a</b>) depression and (<b>b</b>) anxiety scores at Week 0 and Week 16.</p>
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<p>(<b>a</b>,<b>b</b>) Satisfaction on the mobile app.</p>
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15 pages, 2300 KiB  
Review
How Recent Findings in Electromyographic Analysis and Synergistic Control Can Impact on New Directions for Muscle Synergy Assessment in Sports
by Alessandro Scano, Valentina Lanzani and Cristina Brambilla
Appl. Sci. 2024, 14(23), 11360; https://doi.org/10.3390/app142311360 - 5 Dec 2024
Viewed by 588
Abstract
Muscle synergy is a state-of-the-art method for quantifying motor control with multichannel electromyographic (EMG) recordings. Muscle synergies have been used in many sports-related applications, including swimming, baseball, basketball, and other sports, for a biomechanical description of sports movements, improving athlete performance, preventing injuries, [...] Read more.
Muscle synergy is a state-of-the-art method for quantifying motor control with multichannel electromyographic (EMG) recordings. Muscle synergies have been used in many sports-related applications, including swimming, baseball, basketball, and other sports, for a biomechanical description of sports movements, improving athlete performance, preventing injuries, and promoting synergy-based rehabilitation strategies. However, despite the fact that it is clear that, in many sports, the assessments based on multi-muscle analysis are crucial for performance, the practical impact of muscle synergies on sports practice has been quite limited. Thus, so far, the potential of muscle synergy in sports has been poorly explored. However, recent advancements in synergistic models may strongly impact the understanding of motor control in sports. We identified several margins for improvement, which include novel models and updated algorithms: the separation of the EMG components (phasic and tonic) leading repertoires of synergies for motion and holding posture; the choice of multiple synergistic models (spatial/temporal/time-varying and others); the connection of synergies with the task space and the consequent role of non-linearities; the use of computational models and digital twins; and the fields and sports in which synergies can be applied. In this narrative review, we discuss how the novel findings from the biomedical field may fill the gap in the literature for the extensive use of muscle synergies in sports with several applicative examples. Full article
(This article belongs to the Special Issue Advances in Assessment of Physical Performance)
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<p>The figure is an original representation created with the data from a study by Moreira et al. [<a href="#B32-applsci-14-11360" class="html-bibr">32</a>] and Lanzani et al. [<a href="#B30-applsci-14-11360" class="html-bibr">30</a>]. Kinematic–muscular synergies from locomotion in four strides are shown at the top of the figure, and below, the corresponding temporal coefficients are portrayed. In kinematic–muscular synergies, the muscular part is in gray and it highlights the muscle activations, while the kinematic part is red and it shows the corresponding joint acceleration.</p>
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<p>Phasic (blue) and tonic (red) EMG of the anterior deltoid during a reaching movement of the upper limb towards a target. This EMG data were derived from a dataset presented in an upper limb study published in 2019 by Scano et al. [<a href="#B39-applsci-14-11360" class="html-bibr">39</a>]. The kinematic onset and offset of the movements are shown as well as the two components in which the EMG can be divided. Phasic EMG showed a typical biphasic burst structure, accounting for acceleration and deceleration, respectively, while tonic EMG is modeled with a linear ramp that connects the baseline EMG level before and after movement onset/offset.</p>
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<p>This figure is an original representation created using the upper limb EMG data presented in Scano et al. [<a href="#B39-applsci-14-11360" class="html-bibr">39</a>]. A gray-scale colormap portrays the magnitude of total EMG, phasic EMG, and tonic EMG for upper limb movements when aiming at different targets in the upper limb workspace, showing the very different structure of motion-related and posture EMG components. The muscles analyzed are as follows: erector spinae (ErSp), teres major (TerMa), infraspinatus (InF), lower trapezius (TrLow), middle trapezius (TrMid), upper trapezius (TrUp), anterior deltoid (Dant), middle deltoid (Dmid), posterior deltoid (Dpost), pectoralis (Pect), triceps long head (TrL), triceps lateral head (TrLat), biceps long head (BicLong), biceps short head (BicSh), brachioradialis (Brach), pronator teres (Pron).</p>
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<p>A schematic of how standard muscle synergy analysis could be enhanced with recent findings. Standard synergy analysis is usually performed with the NMF algorithm (mainly the spatial or temporal model); the green path of the scheme follows the main lines of research applied so far in sports; it is not comprehensive for all the models available and it provides mainly a picture of the motor control of athletes at a given stage. The proposed approaches (blue path) suggest separating phasic and tonic components and extracting kinematic–muscular synergies, muscle synergies with negative components, and functional synergies that might be crucial for the better application of synergistic approaches in sports, such as to create rehabilitation protocols or suitable training programs customized for athletes.</p>
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12 pages, 9673 KiB  
Technical Note
Impression Reference Technique for the Open Flap Digital Workflow in the Immediate Loading Rehabilitation of the Upper and Lower Jaws
by Gerardo Pellegrino, Gabriele Anselmo, Carlo Barausse, Stefano Ratti, Cristiana Breccia, Edoardo Mancuso, Amerigo Giudice, Pietro Di Bene and Pietro Felice
Prosthesis 2024, 6(6), 1479-1490; https://doi.org/10.3390/prosthesis6060107 - 3 Dec 2024
Viewed by 470
Abstract
Immediate loading implant surgery has emerged as a significant advancement in the rehabilitation of edentulous patients. This approach requires meticulous planning and precise execution to ensure successful outcomes. Transferring established intermaxillary and occlusal relationships to the definitive prostheses can be challenging. However, with [...] Read more.
Immediate loading implant surgery has emerged as a significant advancement in the rehabilitation of edentulous patients. This approach requires meticulous planning and precise execution to ensure successful outcomes. Transferring established intermaxillary and occlusal relationships to the definitive prostheses can be challenging. However, with a digital approach, this procedure can be standardized in cases of fully guided surgery with a flapless technique or by using disposable guides. Conversely, when extensive open flap implant surgery is required, such as in the treatment of severely atrophic patients (e.g., with zygomatic implants or simultaneous bone augmentation), the digital workflow can be demanding. The impression reference technique was proposed to enhance the digital workflow for immediate loading in zygomatic implant rehabilitation. This study aims to describe the impression reference technique, applied to both upper and lower jaws for immediate loading open flap rehabilitations, using standard implants. Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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<p>Digital workflow and preoperative 3D alignment for patient A who underwent lower jaw surgery.</p>
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<p>Impression reference design for patient A who underwent lower jaw surgery. (<b>A</b>) Impression reference (IR) design. (<b>B</b>) Digital copy of the prosthesis containing the IR. (<b>C</b>) IR final digital positioning. (<b>D</b>–<b>F</b>) IR digital positioning with screws.</p>
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<p>(<b>A</b>) Impression reference positioning stent, copy of the prosthesis containing a slot for the IR for patient A of lower jaw surgery. (<b>B</b>) Impression reference positioning stent, copy of the prosthesis containing a slot for the IR for patient B of upper jaw surgery.</p>
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<p>(<b>A</b>) Prosthetic template reproducing the final prosthesis contour for patient A with lower jaw surgery. (open guide). (<b>B</b>) Prosthetic template reproducing the final prosthesis contour for patient B with upper jaw surgery. (open guide).</p>
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<p>Impression reference (IR) positioned in patients A (<b>A</b>) and B (<b>B</b>), lower and upper jaw surgeries.</p>
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<p>Implant positioning using the customized open guide attached to the IR via a clip in patient A, who underwent lower jaw surgery.</p>
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<p>Scan abutments positioned in patients B (<b>A</b>) and A (<b>B</b>) for immediate intra-operatory intraoral scan.</p>
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<p>(<b>A</b>) Post-operative orthopantomography of patient A who underwent lower jaw surgery. (<b>B</b>) Post-operative orthopantomography of the patient who underwent upper jaw surgery.</p>
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<p>Alignment of the preoperative soft tissue scans with those taken while the IRs were in place in patient B with upper jaw surgery.</p>
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<p>Prosthesis design for patient A.</p>
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<p>(<b>A</b>) Lower jaw fixed, screw-retained, and metallic PMMA-based prostheses delivered within 72 h. (<b>B</b>) Upper jaw fixed, screw-retained, and metallic PMMA-based prostheses delivered within 72 h.</p>
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<p>Orthopantomography after the upper jaw’s prosthesis delivery in patient B.</p>
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17 pages, 1963 KiB  
Article
Electrical Bioimpedance-Based Monitoring of Intracochlear Tissue Changes After Cochlear Implantation
by Leanne Sijgers, Marlies Geys, Gunnar Geissler, Patrick Boyle, Alexander Huber and Flurin Pfiffner
Sensors 2024, 24(23), 7570; https://doi.org/10.3390/s24237570 - 27 Nov 2024
Viewed by 731
Abstract
Background: This study examined electrical bioimpedance as a biomarker for intracochlear tissue changes after cochlear implant surgery, comparing monopolar, three-point, and four-point impedance measurements over time and evaluating different measurement systems and approaches. Methods: Impedance measurements were obtained from 21 participants during surgery [...] Read more.
Background: This study examined electrical bioimpedance as a biomarker for intracochlear tissue changes after cochlear implant surgery, comparing monopolar, three-point, and four-point impedance measurements over time and evaluating different measurement systems and approaches. Methods: Impedance measurements were obtained from 21 participants during surgery and at four postoperative stages. Monopolar impedances were recorded using the Bionic Ear Data Collection System (BEDCS) and the Active Insertion Monitoring (AIM) system. Three- and four-point impedances were recorded directly using BEDCS, and indirect three-point impedances were additionally derived from Electrical Field Imaging matrices recorded using BEDCS or AIM. Results: There was an 11% relative error between monopolar measurements from BEDCS and AIM and a 25% discrepancy between direct and indirect three-point measurements. Despite this, direct and indirect measurements from both systems were useful for tracking postoperative impedance shifts. Three- and four-point measurements showed a strong relationship both during and after surgery. Our results suggest that three- and four-point measurements are more specific than monopolar impedances in capturing localized tissue changes. Conclusions: Three- and four-point impedance measurements are potential markers of intracochlear tissue changes over time. While direct three-point impedance measurements offer higher accuracy, indirect measurements provide a feasible alternative for monitoring intracochlear changes in clinical settings lacking the option of direct measurements. Full article
(This article belongs to the Special Issue Bioimpedance Sensors for Medical Monitoring and Diagnosis)
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<p>Comparison of the monopolar access resistance (R<sub>a</sub>) measurement conducted using BEDCS and AIM, using color coding to indicate the electrode number. All recordings were obtained during the second postoperative recording session.</p>
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<p>Bland–Altman plots for the monopolar impedance measurement conducted using BEDCS and AIM (<b>left</b>) and the direct and indirect three-point impedance measurements (<b>right</b>).</p>
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<p>Comparison of the direct three-point impedance measurement conducted using BEDCS, and the indirect measurement derived from the EFI matrix recorded using BEDCS or AIM. Symbols are used to indicate the recording session, while the measurement system is color-coded. In cases where EFI recordings were conducted using both BEDCS and AIM, the indirect three-point impedances were deduced from the BEDCS recordings.</p>
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<p>Comparison of monopolar R<sub>a</sub> and three-point impedance measurements. Symbols are used to indicate the recording session, with the upper plots employing color coding to indicate electrode number and the lower plots using color coding to differentiate participants. Note that the three-point impedances are displayed on a logarithmic scale, while the <span class="html-italic">x</span>-axis depicting R<sub>a</sub> is linear, in alignment with model 1. In cases where recordings were obtained using multiple systems or methods, recordings with BEDCS were used instead of recordings made with AIM, and direct three-point impedance measurements were favored over indirect recordings.</p>
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<p>Visualization of the monopolar and three-point impedance measurements against electrode number for each participant and recording session, indicated using color coding. In cases where recordings were obtained using multiple systems or methods, recordings with BEDCS were used instead of recordings made with AIM, and direct three-point impedance measurements were favored over indirect recordings. Participant 3 had a tip fold-over at electrode 4, while participants 12 and 17 had five and three extracochlear electrodes, respectively. Consequently, specific electrodes were deactivated in these participants’ implant settings, indicated by black dots. For participant 12, the deactivated electrodes had open circuits and are thus not depicted in the figure. Additionally, a few recordings from participant 1 were affected by amplifier saturation and were therefore excluded from the figure.</p>
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<p>Comparison of three- and four-point impedance measurements, including only direct recordings made with BEDCS. Symbols are used to indicate the recording session, with the upper plots employing color coding to indicate electrode number and the lower plots using color coding to differentiate participants. Both the <span class="html-italic">x</span>- and <span class="html-italic">y</span>-axes use a logarithmic scale, in alignment with model 2.</p>
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24 pages, 1036 KiB  
Review
Technological Resources for Physical Rehabilitation in Cancer Patients Undergoing Chemotherapy: A Scoping Review
by Anabela Amarelo, Marisa Mota, Bruno Amarelo, Marta Campos Ferreira and Carla Sílvia Fernandes
Cancers 2024, 16(23), 3949; https://doi.org/10.3390/cancers16233949 - 25 Nov 2024
Viewed by 709
Abstract
Background/Objectives: Cancer patients undergoing chemotherapy often face challenges that reduce their physical function and quality of life. Technological resources offer innovative solutions for physical rehabilitation, but the extent of their application in this context remains unclear. This scoping review aims to explore [...] Read more.
Background/Objectives: Cancer patients undergoing chemotherapy often face challenges that reduce their physical function and quality of life. Technological resources offer innovative solutions for physical rehabilitation, but the extent of their application in this context remains unclear. This scoping review aims to explore and map the various technological tools used to support physical rehabilitation in cancer patients during chemotherapy, focusing on their potential to improve outcomes and enhance patient care. Methods: A scoping review was conducted following the Joanna Briggs Institute (JBI) guidelines and the PRISMA-ScR framework. Comprehensive searches were performed in the MEDLINE, CINAHL, Scopus, SPORTDiscus, and COCHRANE databases. The included studies focused on the technological resources used in physical rehabilitation for cancer patients undergoing chemotherapy. Data extraction followed the World Health Organization’s “Classification of Digital Health Interventions v1.0” to categorize the technologies. Results: A total of 32 studies met the inclusion criteria. The most commonly used technologies included wearable devices (16 studies), web-based platforms and telerehabilitation systems (7 studies), mHealth applications (6 studies), virtual reality (2 studies), and exergaming (3 studies). These tools were designed to enhance physical function, manage treatment-related symptoms, and improve overall quality of life. Wearable devices were particularly effective for monitoring physical activity, while web-based platforms and mHealth applications supported remote rehabilitation and patient engagement. Conclusions: Technological resources offer significant opportunities for personalized rehabilitation interventions in cancer patients undergoing chemotherapy. However, further research is needed to evaluate the long-term effectiveness, cost-efficiency, and clinical integration of these tools to ensure broader accessibility and sustainable impact. Full article
(This article belongs to the Special Issue Socio-Demographic Factors and Cancer Research)
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<p>Article identification and inclusion process—PRISMA diagram flow (2020).</p>
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<p>Distribution of technology types and functionalities.</p>
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16 pages, 726 KiB  
Article
Exploring the Connections Between Grip Strength, Nutritional Status, Frailty, Depression, and Cognition as Initial Assessment Tools in Geriatric Rehabilitation—A Pilot Study
by Amalia Teodora Vancea Nemirschi, Andreea Alexandra Lupu, Kamer-Ainur Aivaz, Mădălina Gabriela Iliescu, Michel Deriaz, Mircea Marzan and Luiza Spiru
Medicina 2024, 60(12), 1916; https://doi.org/10.3390/medicina60121916 - 21 Nov 2024
Viewed by 720
Abstract
Background and Objective: In the context of the rapidly aging global population, the older adult vulnerability poses a significant challenge for public health systems. Frailty, cognitive and nutritional status, depression, and grip strength are essential parameters for staging the vulnerability of older adults. [...] Read more.
Background and Objective: In the context of the rapidly aging global population, the older adult vulnerability poses a significant challenge for public health systems. Frailty, cognitive and nutritional status, depression, and grip strength are essential parameters for staging the vulnerability of older adults. The objective of this study is to identify a rapid but multidimensional geriatric assessment tool that can enhance the rehabilitation process for older adults, tailored to their specific needs. Materials and Methods: This pilot study examines the relationships between grip strength, nutritional status, frailty, depression, and cognition in a group of 80 older adults with a mean age of 69.6 years, 49 male and 31 female, using standardized geriatric scales and digital grip strength measurements. The study employed a digital dynamometer, a portable and reliable tool that facilitated quick and accurate grip strength measurements. Results: The analysis revealed significant correlations among the parameters. Greater grip strength was associated with better cognitive performance (r = 0.237, p = 0.034) and improved nutritional status (r = 0.267, p = 0.016), while it was inversely related to frailty (r = −0.313, p = 0.005). Nutritional status also played a key role, showing an inverse relationship with frailty (r = −0.333, p = 0.003) and depression levels (r = −0.248, p = 0.027). Furthermore, frailty and depression were strongly interconnected, with those experiencing higher frailty levels also displaying more severe depressive symptoms (r = 0.545, p < 0.001). Marital status was also relevant: married participants exhibited higher grip strength, lower frailty, and fewer depressive symptoms, suggesting that social support positively influences both physical and mental health in older adults. Conclusions: These findings not only emphasize the need for integrated care approaches that simultaneously address physical health, nutrition, and cognitive function, but also provide a foundation for the development of a rapid and multidimensional assessment protocol, which consists of using a digital dynamometer and four geriatric scales. Such a tool could play a crucial role in the early detection of frailty syndrome and guide the implementation of multidisciplinary, tailored therapeutic strategies aimed at preserving the autonomy and improving the quality of life of older adults. Full article
(This article belongs to the Special Issue Clinical Recent Research in Rehabilitation and Preventive Medicine)
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<p>Squegg™ Smart Dynamometer, source: <a href="https://www.mysquegg.com/products/squegg-digital-grip-strengthener" target="_blank">https://www.mysquegg.com/products/squegg-digital-grip-strengthener</a> (accessed on 14 October 2024).</p>
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13 pages, 4316 KiB  
Article
Comparison of Full-Arch Intraoral Scans Immediately After Implant Insertion Versus Healed Tissue: A Multicentric Clinical Study
by Francesco Bagnasco, Maria Menini, Paolo Pesce, Armando Crupi, Umberto Gibello, Francesca Delucchi, Massimo Carossa and Francesco Pera
Prosthesis 2024, 6(6), 1359-1371; https://doi.org/10.3390/prosthesis6060098 - 20 Nov 2024
Viewed by 718
Abstract
Objectives: The purpose of this clinical study is to compare implant full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prostheses. Methods: Between September 2023 and March 2024, a total [...] Read more.
Objectives: The purpose of this clinical study is to compare implant full-arch intraoral scans taken immediately after implant placement with those obtained after tissue healing in patients rehabilitated with implant-supported fixed prostheses. Methods: Between September 2023 and March 2024, a total of 19 patients with compromised residual dentition (6 women; 13 men) were rehabilitated using 4-to-6 immediately loaded post-extraction implants. These implants supported fixed full-arch screw-retained prostheses either in the lower jaw (9 patients) or upper jaw (10 patients). Intraoral scans were taken immediately after implant placement (termed “immediate scan”). After a healing period of four months, the provisional prosthesis was removed, and a second intraoral scan was performed using the same scan bodies and scan pattern as the initial scan (termed “delayed scan”). The two scans were overlaid, and the discrepancies between them were measured. Results: The average discrepancy between the immediate and delayed scans was 0.1905 mm. Our statistical analysis revealed larger discrepancies for implants placed in the posterior areas, with the implant in site 1.6 (Implant 1) showing a discrepancy of 0.2326 mm, and the implant in site 2.6 (Implant 4) showing a discrepancy of 0.2124 mm (p = 0.05). No statistically significant difference was observed when comparing patients treated in the upper and lower jaws. Conclusions: Within the limitations of the study and based on this result, clinicians should be aware that an immediate post-surgical intraoral digital scan for implant-supported full-arch rehabilitations may result in a higher risk of imprecision. Furthermore, according to the results of the study, the accuracy of the digital impression on implant full-arch rehabilitations seems to be influenced by the clinician’s skills. Further studies with larger sample sizes are required to confirm our results. Full article
(This article belongs to the Collection Oral Implantology: Current Aspects and Future Perspectives)
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<p>Image of the post-surgical scan, performed immediately after surgery with scan bodies from Mech &amp; Human (Grisignano di Zocco, Italy).</p>
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<p>Image of the post-surgical scan, performed on healed tissue with scan bodies from Mech &amp; Human (Grisignano di Zocco, Italy).</p>
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<p>Points identified in the analysis.</p>
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<p>Correlation between average discrepancy between scans and time in which they were performed. As time increases, the value of the discrepancy between the implants decreases (<span class="html-italic">p</span>-value at 6%).</p>
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15 pages, 3074 KiB  
Article
A Case Study on Integrating an Eco-Design Tool into the Construction Decision-Making Process
by Kétlin Cornely, Guilherme Ascensão and Victor M. Ferreira
Appl. Sci. 2024, 14(22), 10583; https://doi.org/10.3390/app142210583 - 16 Nov 2024
Viewed by 1067
Abstract
To enhance the sustainability of construction and meet the sector’s environmental agenda, it is essential to comprehensively scrutinize the environmental, social, and economic impacts of construction projects from the project’s design stage. Such assessment is of utmost importance to minimize the impacts of [...] Read more.
To enhance the sustainability of construction and meet the sector’s environmental agenda, it is essential to comprehensively scrutinize the environmental, social, and economic impacts of construction projects from the project’s design stage. Such assessment is of utmost importance to minimize the impacts of both new construction and rehabilitation projects and is particularly critical during the selection of building materials and construction solutions. This work reports improvements in functionality and user-friendliness of an eco-design tool (UAveiroGreenBuilding) targeting the construction/rehabilitation sector and previously developed within our research group. The optimized version of the eco-design tool underwent validation through the assessment of competitive window frame materials (e.g., wood, PVC, and aluminum) for potential implementation in a rehabilitation project. Windows with PVC frames were identified as the preferred window configuration due to their superior environmental performance and favorable economic profile. Additionally, a digital communication interface was developed to connect the eco-design tool with building information modeling (BIM) projects, achieved through a routine integrated using a Dynamo application. Such successful integration not only streamlined and expedited the data transfer process by obviating the need for manual input but it also enabled the storage of environmental data throughout the life cycle of the project using a simple and reliable data storage protocol. Full article
(This article belongs to the Section Civil Engineering)
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<p>University of Aveiro Campus. (<b>a</b>) The red line highlights the Central Technical Area and (<b>b</b>) the plant of the Central Technical Area.</p>
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<p>Normalized environmental impact of different window frame materials.</p>
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<p>Normalized resource consumption of different window frame materials’ (<b>a</b>) consumption of non-renewable resources and (<b>b</b>) consumption of renewable resources.</p>
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<p>Economic assessment of different window frame solutions.</p>
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<p>Dynamo routine structure.</p>
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<p>Parameters entered into BIM (<b>a</b>) and imported data after executing the developed Dynamo routine (<b>b</b>).</p>
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