Clinical Rehabilitation最新文献

Objective: To assess the test-retest reliability, internal consistency, and construct validity of the 9-item Tampa Scale for Kinesiophobia in patients with chronic low back pain.

Design: Questionnaire validation study.

Setting: Study was conducted in an online environment.

Participants: We included people aged 18 to 50 years with self-reported low back pain lasting > three months and assessed the Pain-Related Catastrophizing Thoughts Scale and the 9-item Tampa Scale for Kinesiophobia.

Main measures: We used intraclass correlation coefficient, standard error of measurement, minimum detectable change, and Cronbach's alpha to assess the reliability and internal consistency of the 9-item Tampa Scale for Kinesiophobia. We tested correlations between the domains of the 9-item Tampa Scale for Kinesiophobia and the other variables to assess construct validity.

Results: A total of 174 participants with chronic low back pain were included in the analysis. No ceiling or floor effect was found. In terms of construct validity, there was a positive correlation between the domains of the 9-item Tampa Scale for Kinesiophobia and the other variables. In the reliability analysis, there was adequate test-retest reliability of the two domains of the 9-item Tampa Scale for Kinesiophobia: intraclass correlation coefficient = 0.99, standard error of measurement = 3.4%, and minimum detectable change = 9.6% for the activity avoidance domain; and intraclass correlation coefficient = 0.99, standard error of measurement = 3.5%, and minimum detectable change = 9.9% for the somatic focus domain. There was acceptable internal consistency (Cronbach's alpha ≥ 0.68) for both domains.

Conclusion: The 9-item Tampa Scale for Kinesiophobia has adequate measurement properties in patients with chronic low back pain.

Objective: To evaluate the effect of integrating a specific balance-training program focused on static balance to the conventional rehabilitation program on dynamic balance, risk of falls, and activities of daily living (ADLs) in older adults post-stroke.

Design: A single-blinded randomized controlled trial.

Setting: Institutional Intermediate Care Hospital.

Subjects: Post-stroke older adults in a subacute phase without cognitive impairment, aged 65 years and older, exhibiting trunk control in a seated position for 30 seconds without supporting the arms.

Intervention: The control group underwent the usual treatment, consisting of 60-minute physiotherapy sessions, 5 days per week, for 30 days. The experimental group integrated into the usual treatment 15 minutes of the balance-training program (45 min + 15 min).

Main measures: Balance impairment (Mini-BESTest and Berg Balance Scale (BBS), risk of falls (BBS), and independence for ADLs (Barthel Index)) were assessed at baseline, 15 and 30 days after the start of interventions.

Results: Seventy-one post-stroke patients (77.7 ± 9.0 years, 49.2% women) were randomized into the experimental (n = 35) or control (n = 36) groups. The experimental group showed improved dynamic balance at day 15 (Mini-BESTest: 2.90 [1.05-4.77], p = 0.003; BBS: 4.31 [1.41-7.23], p = 0.004) and day 30 (Mini-BESTest: 6.06 [2.85-9.27], p < 0.001; BBS: 8.24 [2.96-13.53], p = 0.003), as well as greater independence levels (11 [2.75-19.23], p = 0.010) compared to the control group. The control group showed higher risk of falls on day 15 (p = 0.035) and day 30 (p = 0.003) than the experimental group.

Conclusions: A simple, easily reproducible approach designed by and for the older adult to rehabilitate post-stroke impairments effectively improved balance, functional gait, risk of falls, and ADLs.

Objective: To map evidence on the characteristics, effectiveness, and potential mechanisms of motor imagery interventions targeting cognitive function and depression in adults with neurological disorders and/or mobility impairments.

Data sources: Six English databases (The Cochrane Library, PubMed, Embase, Scopus, Web of Sciences, and PsycINFO), two Chinese databases (CNKI and WanFang), and a gray literature database were searched from inception to December 2024.

Review methods: This scoping review followed the Joanna Briggs Institute Scoping Review methodology. Interventional studies that evaluated motor imagery for cognitive function and/or depression in adults with neurological disorders and/or mobility impairments were included.

Results: A total of 24 studies, primarily involving adults with cerebrovascular diseases, multiple sclerosis, and Parkinson's disease, were identified. Motor imagery was typically conducted at home/clinic, occurring 2 to 3 sessions per week for approximately 2 months, with each session lasting 20 to 30 minutes. The 62.5% of studies (n = 10) reported significant improvements in cognitive function, exhibiting moderate-to-large effect sizes (Cohen's d = 0.48-3.41), especially in memory, attention, and executive function, while 53.3% (n = 8) indicated alleviation in depression with moderate-to-large effect sizes (Cohen's d = -0.72- -2.56). Motor imagery interventions could relieve pain perception and promote beneficial neurological changes in brains by facilitating neurotrophic factor expression and activating neural circuits related to motor, emotional, and cognitive functions.

Conclusion: Motor imagery could feasibly be conducted at home, with promising effects on cognitive function and depression. More high-quality randomized controlled trials and neuroimaging techniques are needed to investigate the effects of motor imagery on neuroplasticity and brain functional reorganization, thereby aiding in the development of mechanism-driven interventions.

Objective: To examine the experiences of individuals with acquired brain injury and their partners regarding the effects of social cognition problems on their relationships.

Design: Qualitative interview study.

Setting: Interviews were conducted 1 to 5 years post-injury, either in the participants' home or at a care facility in the Netherlands.

Participants: Nine couples consisting of an individual with acquired brain injury and a partner without acquired brain injury. Scores on neuropsychological tests indicated social cognition difficulties in individuals with acquired brain injury.

Methods: Individual semi-structured interviews were conducted, audio recorded, and transcribed verbatim. Two independent analysts analyzed the data using thematic analysis aimed at finding common themes across the data set. Data analysis was carried out recursively and parallel to data collection to help determine when saturation was reached.

Results: Six themes were generated from the interview data: (1) partners feeling disappointed, lonely, and despondent, (2) individuals with acquired brain injury feeling insecure and ashamed of falling short, (3) relationship roles changing, (4) the aggravating role of fatigue and sensory hypersensitivity, (5) the importance of professional help, and (6) silver linings: increased awareness creating closeness.

Conclusion: Social cognition problems have the potential to strongly affect relationships between those with acquired brain injury and their partners in many ways. Addressing social cognition problems is recommended as it is greatly appreciated by individuals with acquired brain injury and their partners and holds promise for improving their relationship.

Objective: To explore the status of kinesophobia in patients with osteoporotic vertebral compression fractures and analyze the influencing factors of different kinesophobia profiles.

Design: Cross-sectional survey study.

Participants: A total of 245 patients with osteoporotic vertebral compression fractures who underwent surgical treatment at our Department of Orthopedics between January 2023 and March 2024 were selected.

Main measure: A general data questionnaire and Tampa Scale for Kinesiophobia were used in the investigation. Latent profile analysis was conducted to categorise kinesophobia in patients with osteoporotic vertebral compression fractures, while univariate logistic regression was performed to identify the factors influencing the latent profiles of kinesophobia.

Results: The average kinesophobia score of the patients with osteoporotic vertebral compression fractures was 45.38 ± 7.12 points. The patients were divided into three latent profile categories, namely high, medium, and low kinesophobia, with mean probabilities of 0.958, 0.966, and 0.970, respectively. Furthermore, age, gender, pain score, injury cause, and other injuries were significant influencing factors in the kinesophobia groups (P < 0.05).

Conclusion: Kinesophobia in patients with osteoporotic vertebral compression fractures is heterogeneous and affected by age, gender, pain score, injury cause, and other injuries. Clinical staff should recognise the characteristics of patients in different kinesophobia categories and actively adopt appropriate measures for those in the high kinesophobia group to enhance the alleviation of their fear status and mitigate the occurrence of fear-induced adverse outcomes, such as disability and weakness.

Objective: This study clarifies the association between ambiguity tolerance and psychological well-being in physical therapists engaged in geriatric rehabilitation.

Design: Multicentre cross-sectional study.Setting: Five facilities in Japan.

Methods and measures: A total of 143 physical therapists (response rate: 58.1%) participated in geriatric rehabilitation. The main outcome measures were the multidimensional attitude scale towards ambiguity, professional quality of life scale and quick inventory of depressive symptomatology.

Results: Hierarchical regression analyses showed associations of need for complexity (β = 0.40) with compassion satisfaction, discomfort with ambiguity (β = 0.30) with compassion fatigue, need for complexity (β = -0.34) and discomfort with ambiguity (β = 0.33) with burnout and discomfort with ambiguity (β = 0.30) with quick inventory of depressive symptomatology (p < .05). Sub-group analyses revealed that in the group with less than five years' experience, need for complexity was not associated with burnout, and in men, there were no significant variables for compassion fatigue and quick inventory of depressive symptomatology.

Conclusions: Among physical therapists in geriatric rehabilitation, discomfort with ambiguity was associated with compassion fatigue, burnout and depressive symptoms, whereas need for complexity was associated with compassion satisfaction. Management and education that reduces discomfort with ambiguity and increases need for complexity may improve physical therapists' psychological well-being.

Objective: To investigate the cost-effectiveness of a cardiac rehabilitation program in individuals with stroke compared with customary care.

Design: A Markov model was created using a 30-year time horizon, with cycle lengths of 1 year to determine the effectiveness and cost-effectiveness of a cardiac rehabilitation program in persons with stroke. Input parameters were based on recently published literature. Health states were defined as degree of disability evaluated by the modified Rankin scale score. Costs were based on recent cost-effectiveness analyses and inflated to 2024 US Dollars using the medical care component of the US Consumer Price Index.

Setting: Outpatient ambulatory setting.

Participants: Persons with mild disability after ischemic stroke.

Intervention: A model comparing cardiac rehabilitation versus usual care was created.

Main measures: Quality-adjusted life years (QALYs) were used to measure the effectiveness of cardiac rehabilitation versus usual care. The cost-effectiveness of cardiac rehabilitation versus usual care was compared with respect to incremental costs, incremental effectiveness, and incremental cost-effectiveness ratios (ICERs).

Results: Cardiac rehabilitation was the superior strategy, resulting in higher incremental effectiveness of 3.28 QALY at an increased incremental cost of $5704. The ICER was $1740/QALY. A two-way sensitivity analysis of these variables had no change, with cardiac rehab remaining the optimal strategy.

Conclusions: While numerous studies and systematic analyses have reported compelling evidence of the clinical benefits of cardiac rehabilitation for patients with stroke, the current study contributes to the existing body of literature, demonstrating that cardiac rehabilitation is also cost-effective in the stroke population.

Objective: To investigate the effectiveness of wrist stabilisation exercises compared to conventional intervention, whether it reduces pain and/or paraesthesia in the hand, as well as how the interventions affected activity ability, health-related quality of life and effects on hand function and grip strength in people with Hypermobility Diagnosis.

Design: A randomised controlled trial.Setting: Units of Occupational therapy in Primary Care, Kalmar County Council, SwedenParticipants: The study included 169 participants' data randomised to the Exercise group (n = 83) or the Control group (n = 86). The samples consisted of adults in diagnosed Hypermobility Spectrum Disorders or hypermobility Ehlers Danlos Syndrome with symptoms of pain and/or paraesthesia in the hands in the last three years.Interventions: The Exercise group trained according to structured progressive exercises and weights programme. The Control group used the hand orthosis during selected activities. Both groups performed randomised intervention for 12 weeks.Main measures: The primary outcome was the Disabilities of Arm, Shoulder, and Hand questionnaire. Secondary outcomes were the Grip Ability Test, the Jamar dynamometer and the EuroQol EQ-5D.

Results: There were 116 subjects who completed the intervention. There were no statistically significant difference between the wrist stabilisation exercise and the conventional intervention in terms of activity ability, health-related quality of life, hand function, grip strength, pain or paraesthesia in people with Hypermobility Spectrum Disorders or hypermobility Ehlers Danlos Syndrome.

Conclusion: There is no statistically significant difference between the Exercise group and the Control group regarding activity ability after 12 weeks intervention period.