Motor rehabilitation aims to help people after stroke to gain optimal motor functioning, independence and quality of life. This European Stroke Organisation (ESO) guideline provides updated, evidence-based support for clinical practice in six agreed critical areas: dose for upper limb and gait therapy, high-intensity gait training, effect of therapy transfer package, group versus individual therapy and sit-to-stand training. The guideline was developed according to ESO standard operating procedures and Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Expert consensus statements are provided where a GRADE recommendation cannot be made due to insufficient evidence. For therapy dose, very low quality evidence supports a weak recommendation to provide an additional minimal dose of 20 h of repetitive upper limb practice to improve arm capacity. For gait, expert consensus suggests that an additional minimal dose of 20 h of walking practice could be beneficial for walking capacity. For high-intensity gait training, moderate quality evidence supports a strong recommendation for high-intensity gait training to improve walking endurance in people with chronic stroke and stable cardiovascular status, while low quality evidence supports a weak recommendation for improving walking speed. An expert consensus suggests using a transfer package when providing upper limb task-specific training to enhance transfer to daily life. For group therapy, a weak recommendation based on very low quality evidence suggests that task-specific group-based therapy is non-inferior to individual therapy for improving balance, gait speed and walking endurance. A weak recommendation based on moderate quality evidence suggests additional sit-to-stand training to improve balance.

Coronavirus disease 2019 (COVID-19) has affected the healthcare system and the practice of physiotherapists. Telerehabilitation is an alternative method of delivering physiotherapy services. The aim of this study was to investigate physiotherapists’ knowledge, beliefs, and willingness to use telerehabilitation in Greece during the COVID-19 pandemic. In this cross-sectional study, Greek physiotherapists completed an online survey between January and February 2022. A questionnaire was distributed via the Panhellenic Physiotherapy Association (PSF). The questionnaire involved 26 items on demographic background, use of technology, overall perceptions, the experience of telerehabilitation, and their opinion on the future of telerehabilitation. The study protocol was approved by the Ethical Committee of the University of Patras, Greece. Participants in this study were 213 physiotherapists (female 57.7%; mean age 39.84±8 years). Most physiotherapists (n=118; 55.4%) were working in a private clinic in the areas of outpatient orthopedics, geriatrics, and neurorehabilitation. Overall, most participants (55%) reported increased use of telerehabilitation strategies during the COVID-19 pandemic. A total of 130 physiotherapists (n=61.3%) believed that telerehabilitation may be beneficial as a supplementary way of patient management. Greek physiotherapists made use of low-cost and easily accessible digital technologies, such as mobile phones and online meeting tools (e.g., Skype, Zoom). Although most physiotherapists (79.8%) reported that they wanted to receive more information about digital technology and telerehabilitation, only 42.1% of them did intend to work remotely after the pandemic. Most of the participants were willing to deliver physiotherapy via telerehabilitation. Specific education and training programs need to be provided to physiotherapists during and after the pandemic. Healthcare managers should consider the use of telerehabilitation and design guidelines and policies to manage telerehabilitation practices in Greece.

Urinary incontinence affects approximately 200 million people worldwide. The objective of this study was to investigate the effect of pelvic floor muscle (PFM) training with biofeedback (BF) in women with urinary incontinence in comparison to PFM training alone. The primary outcome was PFM strength with secondary outcomes being the severity of incontinence, other PFM parameters, quality of life (QoL), social life, satisfaction and adherence to treatment. Randomized controlled trials (RCTs) published from 2005 to 2023 in PubMed, MEDLINE, Scopus and Google Scholar were searched and evaluated with the PEDro scale. Nine moderate and two high methodological quality RCTs were selected. There was a statistically significant improvement in all parameters. In five studies, muscle strength and the severity of incontinence were statistically better in the BF group compared to the non-BF group. In most studies, no differences were found for QoL and social life between the groups. For adherence to treatment, the results were ambiguous. Τhe remaining variables (endurance, precontraction, function, adherence and satisfaction) had few studies to support the results. There was moderate level evidence that the group utilizing PFM exercises with BF showed significant improvements in the management of urinary incontinence. Concerning muscle strength and the severity of incontinence, findings were inconclusive, as only in some studies the results were statistically better in the BF group compared to the non-BF group.

Background and objectives: The aims of this study were to examine the relationship between neurological outcomes at 3- and 6-months corrected age with the neurodevelopmental outcome at 3 years of age; to identify the perinatal/neonatal risk factors for poor neurodevelopmental outcomes at 3 years of age. Materials and methods: In our single-centre longitudinal cohort study, of the 73 consecutive infants admitted to our Neonatal Intensive Care Unit (NICU), 49 infants (80%) received both Hammersmith Infant Neurological Examination (HINE) at 3- and 6-months corrected age and Bayley–III neurodevelopmental assessment at 2–3 years chronological age. At 3 months follow up, 8.2% had suboptimal scores (below 10th percentile) on the HINE. At 6 months follow up, 4.1% had suboptimal scores (below 10th percentile) on the HINE. The means(±SD) for Bayley-III cognitive, language, and motor subscales were (96.3 ± 9.8), (99.9 ± 11.9), (93.2 ± 9.9). Results: At 3 months corrected age, higher total HINE scores and subscores for function of cranial nerves, posture, tone, were associated with better cognitive scores while poorer scores for function of cranial nerves, posture, movements, tone, and total HINE score were associated with lower motor scores. Infants with a HINE subscore of function of cranial nerves in the suboptimal range have three times higher odds of having a motor delay. Infants with a HINE subscore of function of cranial nerves in the suboptimal range have more than two times higher odds of having a language delay. At 6 months corrected age, poorer scores for function of cranial nerves, movements, tone, reflexes, and total HINE score were associated with worse Bayley-III motor scores whilst infants who have a total HINE score and a subscore of reflexes in the suboptimal range have four and seven times, respectively, higher odds of having a motor delay. Conclusions: Early identification of infants at risk for adverse long-term outcomes is essential in introducing early intervention therapies for optimizing neurodevelopmental outcomes.

Aim: While deformational plagiocephaly (DP) is suspected to be associated with comorbidities, their nature and prevalence are unclear. This scoping review aims to report DP comorbidities occurring until the age of 2 years, their prevalence and whether they depend on the child's age and sex.Methods: Relevant studies were identified by searching the Cochrane, MEDLINE, EMBASE, PubMed and EBSCO databases from 1992 to 30 April 2021. Data on study characteristics, comorbidities and assessment instruments were extracted and qualitatively synthesised. Risk of bias was assessed and studies with high risk of bias were excluded.Results: Studies meeting selection criteria (n = 27) often evaluated groups from tertiary clinics, implying selection bias. Studies reported on developmental delay (n = 16), limited speech production (n = 1), auditory (n = 3), visual (n = 3), mandibular (n = 3) and neurological impairments (n = 1). The data did not allow prevalence calculation or modifying effect of sex. Due to biased data, the review provided no evidence on DP comorbidities. Weak evidence suggested that in the selective samples, DP was associated with motor and language delays in the first year.Conclusion: Due to biased data, no evidence on comorbidity in infants with DP was available. Our study underlined the need of risk of bias assessment in scoping reviews.