Archives of Allied Health Sciences

Rehabilitation in a patient with recent diagnosis of dementia: the physiatrist and the geriatrician compared in taking charge of a case report

Valerio Massimo Magro — 2026-08-25

The rehabilitation of a patient suffering from multiple comorbidities and locomotor disabilities was a difficult task from which the physiatrist does not shy away. The rehabilitation work was even more complex when a new diagnosis of dementia is added to these problems. An elderly patient with numerous comorbidities was hospitalized for spinal surgery and subsequently suffered from infectious complications. In fact, he underwent T12-L1 decompressive laminectomy surgery due to a stenosis of the spinal canal at the T12-L1 levels with myelopathy which was already manifested itself in the past with weakness in the right lower limb and presence of worsening lumbocruralgia with impaired walking. The patient was referred to have rehabilitation programs to regain his independence. However, during his hospitalization, he showed clinical signs that led to a suspected diagnosis of parkinsonism. Subsequently, he was diagnosed with cognitive impairments with frontotemporal dementia. A Parkinson-plus syndrome, also called atypical parkinsonism, is referred to a group of neurodegenerative movement disorders that resemble idiopathic Parkinson’s disease with certain distinguished clinical and pathophysiological features. In this regard, we described a clinical case report in which the skills of the geriatrician and those of the physiatrist were called upon to collaborate closely to take charge of this complex patient.

The effect of breath-holding and Valsalva manoeuvre on pain: a systematic review and meta-analysis

Kantheera Areerak — 2026-08-25

Breath-holding and the Valsalva manoeuvre are simple, non-pharmacological techniques that may modulate pain through autonomic and cardiovascular mechanisms. However, their effects on pain have not been systematically synthesized. This systematic review and meta-analysis aimed to evaluate the effect of breath-holding and the Valsalva manoeuvre on pain intensity. Electronic searches were conducted in PubMed, ScienceDirect, Embase, Scopus, and the Cochrane Library for studies published between 1996 and 2025. Experimental and quasi-experimental studies investigating breath-holding, breath retention, or the Valsalva manoeuvre with pain intensity as the primary outcome were included. Two reviewers independently screened studies and assessed methodological quality using the Downs and Black checklist. A random-effects meta-analysis was performed. Of 8,266 records identified, four studies involving 102 healthy young adults met the inclusion criteria for qualitative synthesis, and three studies involving 64 healthy young adults were included in the metaanalysis. All studies were rated as fair methodological quality. Meta-analysis showed that breath-holding significantly reduced pain intensity compared with normal breathing, with a pooled effect size of −0.93 on a 10-point pain scale (95% CI: −1.06 to −0.80; p-value < 0.001; I² = 0.00%). However, the certainty of evidence was rated as very low (GRADE), and effect sizes did not reach established minimal clinically important differences. Pain reduction was observed across most experimental pain models, although findings were condition-specific in thermal pain. These preliminary findings suggest that breath-holding may reduce pain intensity in healthy young adults, potentially through baroreceptor activation and vagal modulation. Further high-quality randomised controlled trials in diverse clinical populations are required to establish clinical effectiveness, safety, and applicability.

Effect of task-oriented training on postural control in children with spastic diplegic cerebral palsy: a randomized controlled trial

Thandar Aung — 2026-08-25

Cerebral palsy is a leading cause of childhood-onset motor disability. Impaired postural control in children with cerebral palsy limits daily participation and increases lifelong reliant on caregivers. Therefore, interventions should prioritize improving postural control in these groups. This study aimed to compare the effect of task-oriented training (TOT) and conventional physiotherapy (CPT) on postural control in children with spastic diplegic cerebral palsy. A single-blinded randomized controlled trial study was conducted with 28 participants aged 3-15 years, randomly allocated into the TOT group and the CPT group. Both groups practiced for 60 minutes sessions, 3 times per week, for 6 weeks. Postural control was assessed using Pediatric Balance Scale at baseline, after 4th week, and 6th week of treatment. Data were analyzed using Friedman test for within-group comparisons across time points, while the Wilcoxson Signed-Rank test and the Mann-Whitney U test were used for within- and between- groups comparisons at each assessment period. Statistical significance was set at p-value < 0.05. Both groups showed significant improvement after 6 weeks of treatment; however, the TOT group demonstrated greater improvements (mean differences value of 6.85 points) compared to the CPT group (mean differences value of 4.36 points). These findings indicate that TOT significantly improves postural control in children with spastic diplegic cerebral palsy, yielding better outcomes than CPT.

Effects of exercise programs in individuals with severe obesity scheduled for undergoing bariatric surgery: a quasi-experimental study

Maneepun Laophosri — 2026-08-25

Rapid weight reduction and improved physical fitness are essential for individuals with severe obesity who undergo bariatric surgery in helping surgeons to operate with fewer complications. However, there is limited evidence regarding the structure exercise programs combined with dietary control in these individuals. Therefore, this study proposed exercise programs, and assessed the feasibility and effectiveness of a short-duration exercise and dietary control program on weight reduction and physical fitness in 10 individuals with severe obesity preparing for bariatric surgery. Participants who were diagnosed with severe obesity (body mass index 54.4 ± 10.7 kg/m²) and were scheduled for bariatric surgery involved in the 2-week exercise program with the outcome measurement before and after the program. The exercise program consisted of stretching, weight training, and cardiovascular exercise, 60–90 minutes per session for a total of 10 sessions with a physical therapist closely supervising, encouraging, and monitoring the sessions to ensure safety. Concurrently, all participants followed a calorie-restricted diet of 500–800 kcal/day. The findings were compared using the Wilcoxon Signed Ranks Test The results demonstrated the significant bodyweight reduction (-5.84 ± 2.09 kg, -4 ± 1.3%) with physical fitness improvement, including handgrip strength (3.50 kg), the five times sit-to-stand test (-2.48 s), the chair sit-and-reach test (7.50 cm), and the 1-minute step test (8.5 repetitions) (p < 0.01). The findings suggest the clinical benefit of 2-week exercise programs in individuals with severe obesity scheduled for undergoing bariatric surgery.