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The effectiveness of social prescribing in the management of long-term conditions in community-based adults: A systematic review and meta-analysis. 社会处方在社区成人长期病症管理中的有效性:系统回顾与荟萃分析。
IF 2.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-10-01 Epub Date: 2024-06-11 DOI: 10.1177/02692155241258903
Declan J O'Sullivan, Lindsay M Bearne, Janas M Harrington, Jefferson R Cardoso, Joseph G McVeigh

Objective: The objective of this systematic review and meta-analysis was to evaluate the effectiveness of social prescribing interventions in the management of long-term conditions in adults.

Data sources: Eleven electronic databases were searched for randomised and quasi-randomised controlled trials.

Review methods: Outcomes of interest were quality of life, physical activity, psychological well-being and disease-specific measures. Bias was assessed with the Cochrane Risk of Bias 2 tool. A narrative synthesis and meta-analysis were performed.

Results: Twelve studies (n = 3566) were included in this review. Social prescribing interventions were heterogeneous and the most common risks of bias were poor blinding and high attrition. Social prescribing interventions designed to target specific long-term conditions i.e., cancer and diabetes demonstrated significant improvements in quality of life (n = 2 studies) and disease-specific psychological outcomes respectively (n = 3 studies). There was some evidence for improvement in physical activity (n = 2 studies) but most changes were within group only (n = 4 studies). Social prescribing interventions did not demonstrate any significant changes in general psychological well-being.

Conclusion: Social prescribing interventions demonstrated some improvements across a range of outcomes although the quality of evidence remains poor.

目的本系统综述和荟萃分析的目的是评估社会处方干预在成人长期疾病管理中的有效性:检索了 11 个电子数据库中的随机和准随机对照试验:研究结果包括生活质量、身体活动、心理健康和疾病特异性指标。偏倚采用 Cochrane Risk of Bias 2 工具进行评估。进行了叙述性综合和荟萃分析:本综述纳入了 12 项研究(n = 3566)。社会处方干预措施多种多样,最常见的偏倚风险是盲法不完善和自然减员率高。针对特定长期病症(如癌症和糖尿病)的社会处方干预分别显著改善了生活质量(2 项研究)和特定疾病的心理结果(3 项研究)。有证据表明,体育锻炼有所改善(2 项研究),但大多数变化仅限于群体内部(4 项研究)。结论:结论:社会处方干预在一系列结果方面都有所改善,但证据质量仍然较差。
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引用次数: 0
Oculomotor Behaviour in Individuals with Long COVID-19. 长 COVID-19 患者的眼球运动行为。
IF 2.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-10-01 Epub Date: 2024-08-02 DOI: 10.1177/02692155241265886
L González-Vides, J L Hernández-Verdejo, J A Gómez-Pedrero, A Ruiz-Pomeda, P Cañadas-Suárez

Objective: To determine, the impact of long COVID-19 on oculomotor behaviour.

Design: A case-control study.

Setting: Spanish Association of Persistent COVID.

Participant: Participants were 75 cases (64 women, 11 men, mean age 46.4 years ±8.9) and 42 controls (22 women, 20 men, mean age 53.5 years ±13.13).

Intervention: An eye-tracking test based on visual search paradigm and the Adult Developmental Eye Movement Test were used to evaluate the participants.

Main measures: The primary outcomes in the Adult Developmental Eye Movement Test were horizontal reading time, vertical reading time, and their ratio. And for the eye-tracking test the time to find the target, the duration, and the number of eye fixations.

Results: In cases and controls, eye movement test results were horizontal(Hadj) reading time 74.2 ± 22.7 s vs 52.0 ± 6.1 s (p < .0001); vertical(Vadj) reading time 67.6 ± 17.8 s vs 50.4 ± 6.9 s (p < .0001); Hadj/Vadj ratio 0.9 ± 0.1 vs 1.0 ± 0 (p = .0032), respectively; and eye-tracking test results were fixation number 11.3 ± 3.07 vs 3.51 ± 2.57 (p < .0001); fixation duration 2.01 ± 0.79 s vs 1.5 ± 0.4 s (p = .0013), and time to find target 24.5 ± 8.0 vs 18 ± 9.4 (p = .0034), respectively.

Conclusions: Data showed a lower performance in oculomotor behaviour in people with long COVID-19, compared to healthy individuals. It cannot be affirmed an ocular musculature dysfunction; the differentiated behaviour could be associated to cognitive alterations affected in these people. Both tests used could be an useful tool for the clinical assessment of these participants. Further studies are needed to explore the utility of these procedures.

目的:确定长 COVID-19 对眼球运动行为的影响:确定长COVID-19对眼球运动行为的影响:病例对照研究:西班牙持久性 COVID 协会:参与者:75 名病例(64 名女性,11 名男性,平均年龄为 46.4 岁 ±8.9 岁)和 42 名对照组(22 名女性,20 名男性,平均年龄为 53.5 岁 ±13.13 岁):干预措施:采用基于视觉搜索范式的眼动跟踪测试和成人发育眼动测试对参与者进行评估:成人发育眼动测试的主要结果是水平阅读时间、垂直阅读时间及其比率。眼动追踪测试的主要结果是找到目标的时间、持续时间和眼球固定的次数:结果:病例和对照组的眼动测试结果分别为水平(Hadj)阅读时间(74.2 ± 22.7 秒) vs 52.0 ± 6.1 秒(p p = .0032);眼球跟踪测试结果分别为固定次数(11.3 ± 3.07 vs 3.51 ± 2.57)(p p = .0013)和找到目标时间(24.5 ± 8.0 vs 18 ± 9.4)(p = .0034):数据显示,与健康人相比,长 COVID-19 患者的眼球运动能力较低。这并不能确定是眼部肌肉功能障碍;行为差异可能与这些人的认知改变有关。所使用的两种测试都可以作为对这些参与者进行临床评估的有用工具。还需要进一步的研究来探讨这些程序的实用性。
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引用次数: 0
Development and validation of the Unmet Needs Questionnaire for young stroke survivors. 针对年轻中风幸存者的 "未满足需求问卷 "的开发与验证。
IF 2.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-10-01 Epub Date: 2024-08-13 DOI: 10.1177/02692155241270968
Wen-Yu Kuo, Chen-Yin Chen, Ting-Yu Chang, Jeng Wang, Chin-Man Wang, Pei-Kwei Tsay

Objective: Owing to the lack of a suitable tool for detecting the unmet needs of young stroke survivors, this study aims to develop a validated questionnaire for evaluating these unmet needs.

Design: A cross-sectional, observational research design.

Setting: Chang Gung Memorial Hospital Linkou and Taoyuan branches in Taiwan.

Participants: A total of 211 participants (average age 53 years; within 6 months post-stroke) completed the questionnaire.

Main measures: A qualitative approach was used to create an item pool. Experts verified item suitability, and content validity was evaluated using the item content validity index. Item analysis was applied to determine item quality, and factor analysis was used to explore construct validity. In addition, parallel analysis was employed to ascertain the optimal number of factors.

Results: The scale development procedure resulted in a 27-item questionnaire that assesses the unmet needs of young stroke survivors after a stroke. The item content validity index was 1.0. The Unmet Needs Questionnaire has five factors: restoring prestroke abilities and life, rehabilitation-related resources, social support and self-adjustment, economic and post-stroke life adjustment, and stroke-related information. These five factors accounted for 54% of the variance. Cronbach's alpha for the total scale was 0.91, while the alpha for the subscales ranged from 0.74 to 0.88.

Conclusions: The Unmet Needs Questionnaire showed acceptable reliability and validity. It can help clinical professionals and government agencies identify stroke survivors' unmet needs and develop tailored care plans. Future research should explore the trajectory of post-stroke unmet needs using this tool.

摘要由于缺乏一个合适的工具来检测年轻脑卒中幸存者未得到满足的需求,本研究旨在开发一个有效的问卷来评估这些未得到满足的需求:设计:横断面观察研究设计:研究地点:台湾长庚纪念医院林口分院和桃园分院:共有 211 名参与者(平均年龄 53 岁,卒中后 6 个月内)完成了问卷调查:采用定性方法创建项目库。专家验证了项目的适用性,并使用项目内容效度指数评估了内容效度。项目分析用于确定项目质量,因子分析用于探讨构建有效性。此外,还采用了平行分析来确定因子的最佳数量:结果:量表开发过程产生了一份 27 个项目的问卷,用于评估中风后年轻幸存者未满足的需求。项目内容效度指数为 1.0。未满足需求问卷有五个因子:恢复卒中前的能力和生活、康复相关资源、社会支持和自我调整、经济和卒中后生活调整以及卒中相关信息。这五个因子占方差的 54%。总量表的 Cronbach's alpha 为 0.91,分量表的 Cronbach's alpha 为 0.74 至 0.88:未满足需求问卷的信度和效度均可接受。结论:未满足需求问卷的信度和效度均可接受,有助于临床专业人员和政府机构识别卒中 幸存者未满足的需求并制定有针对性的护理计划。未来的研究应使用该工具探索卒中后未满足需求的轨迹。
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引用次数: 0
Repetitive transcranial magnetic stimulation as a therapy for post-stroke dysphagia: An overview of systematic reviews and meta-analysis. 重复经颅磁刺激作为中风后吞咽困难的一种疗法:系统综述和荟萃分析。
IF 2.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-10-01 Epub Date: 2024-07-25 DOI: 10.1177/02692155241264757
Min Shen, Linlin Zhang, Chunjing Li, Xiaocen Wei, Yang Li, Hongxue Wu, Xiaobin Zhang, Shuzhong Gao, Yuning Ma, Yuxia Ma
<p><strong>Objective: </strong>Post-stroke dysphagia is a common swallowing disorder that occurs after a stroke, leading to an increased risk of aspiration pneumonia and malnutrition. There is a pressing need for effective and safe interventions for its rehabilitation. This review aims to answer two key scientific questions: (1) What is the efficacy of repetitive transcranial magnetic stimulation in the rehabilitation of post-stroke dysphagia? (2) Is repetitive transcranial magnetic stimulation a safe intervention for post-stroke dysphagia?</p><p><strong>Data sources: </strong>A comprehensive search was conducted across four electronic databases: PubMed, Cochrane Library, Web of Science, and Embase. The search aimed to identify relevant studies concerning our topic of interest and was completed on 28 May 2024.</p><p><strong>Review methods: </strong>In accordance with the PRISMA checklist, a comprehensive search of four databases was conducted, which identified 13 relevant systematic reviews. The inclusion criteria were systematic reviews that evaluated the efficacy and safety of repetitive transcranial magnetic stimulation for post-stroke dysphagia. Exclusion criteria were reviews that did not focus on post-stroke dysphagia or did not evaluate repetitive transcranial magnetic stimulation as a therapeutic intervention. The quality, bias, reporting, and overall evidence quality of these reviews were assessed using validated tools, including the AMSTAR 2 tool for assessing the methodological quality of systematic reviews, the ROBIS tool for assessing the risk of bias, and the GRADE approach for evaluating the overall quality of evidence. This rigorous approach ensures that our review provides a comprehensive and reliable overview of the current state of knowledge on the use of repetitive transcranial magnetic stimulation for post-stroke dysphagia.</p><p><strong>Results: </strong>The sample sizes for the individual studies included in the systematic reviews/meta-analyses ranged from 66 to 555. The total number of participants across all studies included in the overall analyses was 752. The evidence was limited by the methodological flaws and heterogeneity of the systematic reviews. The quality of the evidence varied from high to low, with most outcomes having moderate quality. Future research should adopt more rigorous, standardized, and comprehensive designs to confirm the efficacy and safety of repetitive transcranial magnetic stimulation for post-stroke dysphagia. The main reason for downgrading the evidence quality was the small sample size and high heterogeneity of the primary studies.</p><p><strong>Conclusion: </strong>This overview synthesized research on repetitive transcranial magnetic stimulation for dysphagia, aiming to inform clinical and policy decisions. However, the current evidence does not conclusively establish the safety and efficacy of repetitive transcranial magnetic stimulation for post-stroke dysphagia rehabilitation. The studi
目的:中风后吞咽困难是中风后常见的吞咽障碍,会增加吸入性肺炎和营养不良的风险。目前迫切需要有效、安全的康复干预措施。本综述旨在回答两个关键的科学问题:(1)重复经颅磁刺激在中风后吞咽困难康复中的疗效如何?(2)重复经颅磁刺激对中风后吞咽困难是否是一种安全的干预措施?对四个电子数据库进行了全面检索:PubMed、Cochrane Library、Web of Science 和 Embase。该检索旨在确定与我们感兴趣的主题相关的研究,于 2024 年 5 月 28 日完成:根据 PRISMA 核对表,对四个数据库进行了全面检索,确定了 13 篇相关的系统综述。纳入标准为评估重复经颅磁刺激治疗中风后吞咽困难的有效性和安全性的系统综述。排除标准为不关注中风后吞咽困难或未将重复经颅磁刺激作为治疗干预措施进行评估的综述。这些综述的质量、偏倚、报告和总体证据质量均采用有效工具进行评估,包括评估系统性综述方法质量的 AMSTAR 2 工具、评估偏倚风险的 ROBIS 工具和评估总体证据质量的 GRADE 方法。这种严谨的方法确保了我们的综述能够全面、可靠地概述当前使用重复经颅磁刺激治疗中风后吞咽困难的知识状况:纳入系统综述/元分析的各项研究的样本量从 66 到 555 不等。纳入总体分析的所有研究的参与者总数为 752 人。系统综述的方法缺陷和异质性限制了证据的有效性。证据的质量从高到低不等,大多数结果的质量为中等。未来的研究应采用更加严格、标准化和全面的设计,以证实重复经颅磁刺激治疗中风后吞咽困难的有效性和安全性。证据质量降级的主要原因是主要研究的样本量小且异质性高:本综述综合了有关重复经颅磁刺激治疗吞咽困难的研究,旨在为临床和政策决策提供参考。然而,目前的证据并不能最终确定重复经颅磁刺激治疗中风后吞咽困难康复的安全性和有效性。所审查的研究质量参差不齐,许多研究质量较差。因此,虽然有些研究表明重复经颅磁刺激可能带来益处,但在解释这些研究结果时应谨慎。目前迫切需要更严格、更高质量的研究来验证重复经颅磁刺激在中风后吞咽困难康复中的应用。一旦我们有了更有力的、基于证据的建议,这些研究结果对临床实践和政策的影响将更加明确。
{"title":"Repetitive transcranial magnetic stimulation as a therapy for post-stroke dysphagia: An overview of systematic reviews and meta-analysis.","authors":"Min Shen, Linlin Zhang, Chunjing Li, Xiaocen Wei, Yang Li, Hongxue Wu, Xiaobin Zhang, Shuzhong Gao, Yuning Ma, Yuxia Ma","doi":"10.1177/02692155241264757","DOIUrl":"10.1177/02692155241264757","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Post-stroke dysphagia is a common swallowing disorder that occurs after a stroke, leading to an increased risk of aspiration pneumonia and malnutrition. There is a pressing need for effective and safe interventions for its rehabilitation. This review aims to answer two key scientific questions: (1) What is the efficacy of repetitive transcranial magnetic stimulation in the rehabilitation of post-stroke dysphagia? (2) Is repetitive transcranial magnetic stimulation a safe intervention for post-stroke dysphagia?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Data sources: &lt;/strong&gt;A comprehensive search was conducted across four electronic databases: PubMed, Cochrane Library, Web of Science, and Embase. The search aimed to identify relevant studies concerning our topic of interest and was completed on 28 May 2024.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Review methods: &lt;/strong&gt;In accordance with the PRISMA checklist, a comprehensive search of four databases was conducted, which identified 13 relevant systematic reviews. The inclusion criteria were systematic reviews that evaluated the efficacy and safety of repetitive transcranial magnetic stimulation for post-stroke dysphagia. Exclusion criteria were reviews that did not focus on post-stroke dysphagia or did not evaluate repetitive transcranial magnetic stimulation as a therapeutic intervention. The quality, bias, reporting, and overall evidence quality of these reviews were assessed using validated tools, including the AMSTAR 2 tool for assessing the methodological quality of systematic reviews, the ROBIS tool for assessing the risk of bias, and the GRADE approach for evaluating the overall quality of evidence. This rigorous approach ensures that our review provides a comprehensive and reliable overview of the current state of knowledge on the use of repetitive transcranial magnetic stimulation for post-stroke dysphagia.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The sample sizes for the individual studies included in the systematic reviews/meta-analyses ranged from 66 to 555. The total number of participants across all studies included in the overall analyses was 752. The evidence was limited by the methodological flaws and heterogeneity of the systematic reviews. The quality of the evidence varied from high to low, with most outcomes having moderate quality. Future research should adopt more rigorous, standardized, and comprehensive designs to confirm the efficacy and safety of repetitive transcranial magnetic stimulation for post-stroke dysphagia. The main reason for downgrading the evidence quality was the small sample size and high heterogeneity of the primary studies.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This overview synthesized research on repetitive transcranial magnetic stimulation for dysphagia, aiming to inform clinical and policy decisions. However, the current evidence does not conclusively establish the safety and efficacy of repetitive transcranial magnetic stimulation for post-stroke dysphagia rehabilitation. The studi","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1289-1305"},"PeriodicalIF":2.6,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Effect of a transitional tele-rehabilitation programme on quality of life of adult burn survivors: A randomised controlled trial. 过渡性远程康复计划对成年烧伤幸存者生活质量的影响:随机对照试验。
IF 2.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-10-01 Epub Date: 2024-08-27 DOI: 10.1177/02692155241265930
Jonathan Bayuo, Frances Kam Yuet Wong, Loretta Yuet Foon Chung

Objective: To examine the effects of the transitional tele-rehabilitation programme on quality of life of adult burn survivors.

Design: A prospective, single centre, randomised controlled trial and reported according to the Consolidated Standards of Reporting Trials (CONSORT) guidelines.

Participants: Adult burn survivors aged ≥18 years with burn size ≥10% total body surface area irrespective of the depth was considered eligible to participate.

Intervention: The intervention was in two phases: pre-discharge and active follow-up phase (which occurred via WeChat). In both phases, comprehensive assessment and intervention guided by the Omaha System and evidenced-based protocols guided the care delivery over an 8-week period.

Main measures: The outcome of interest was quality of life. Two outcome measures were used to assess the outcome of interest: Burn Specific Health Scale-Brief (BSHS-B) and the EQ-5D-5L tools. The outcome was assessed at three time points: T0 (baseline), T1 (immediate post-intervention) and T2 (4 weeks from T1).

Results: In total, 60 adult burn survivors were randomly allocated to undergo the new programme. The transitional tele-rehabilitation programme elicited statistically significant improvement in simple abilities, affect, interpersonal relationship (T2) and overall quality life (T1 and T2) measured on the BSHS-B.

Conclusion: Ongoing rehabilitative care is essential to support the recovery process of burn survivors considering that some quality-of-life subscales may improve faster than others. The study findings highlight the potential of employing a social media platform to improve post-burn quality of life outcomes.

Trial registration: ClinicalTrials.govNCT04517721. Registered on 20 August 2020.

目的:研究过渡性远程康复计划对成年烧伤幸存者生活质量的影响:研究过渡性远程康复项目对成年烧伤幸存者生活质量的影响:设计:前瞻性、单中心、随机对照试验,根据试验报告综合标准(CONSORT)指南进行报告:成年烧伤幸存者,年龄≥18岁,烧伤面积≥体表总面积的10%,不论深度如何,均可参加:干预分为两个阶段:出院前和积极随访阶段(通过微信进行)。在这两个阶段中,在奥马哈系统和循证方案的指导下进行综合评估和干预,提供为期 8 周的护理服务:主要测量指标:关注的结果是生活质量。采用两种结果测量方法来评估相关结果:烧伤专用健康量表-简易版(BSHS-B)和 EQ-5D-5L 工具。结果在三个时间点进行评估:结果:共有 60 名成年烧伤幸存者被随机分配到新项目中。根据 BSHS-B 测量,过渡性远程康复计划在简单能力、情感、人际关系(T2)和整体生活质量(T1 和 T2)方面都有统计学意义上的显著改善:考虑到某些生活质量分量表的改善速度可能快于其他分量表,持续的康复护理对支持烧伤幸存者的康复过程至关重要。研究结果凸显了利用社交媒体平台改善烧伤后生活质量的潜力:试验注册:ClinicalTrials.govNCT04517721。注册日期:2020 年 8 月 20 日。
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引用次数: 0
Effectiveness of Pilates compared with home-based exercises in individuals with chronic non-specific low back pain: Randomised controlled trial 普拉提与在家练习对慢性非特异性腰背痛患者的疗效比较:随机对照试验
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2024-09-14 DOI: 10.1177/02692155241277041
Caroline Ribeiro Tottoli, Ângela Jornada Ben, Everton Nunes da Silva, Judith E Bosmans, Maurits van Tulder, Rodrigo Luiz Carregaro
ObjectiveTo investigate the effectiveness of a Pilates exercise program compared with home-based exercises in individuals with chronic non-specific low back pain.DesignA randomised controlled trial with a six-month follow-up.SettingRehabilitation clinic.ParticipantsOne hundred and forty-five individuals (18–50 years of age) with low back pain for ≥ 12 consecutive weeks were enrolled and randomly allocated to either Pilates ( n = 72) or home-based exercise groups ( n = 73).InterventionsMethod Pilates (Mat Pilates exercises using accessories) versus home-based exercise (postural exercises, muscle stretching and strengthening, and spine stabilisation/mobilisation), twice a week, for 6 weeks.Main measuresAssessments were performed at baseline, post-intervention, and six months follow-up. Outcomes were pain intensity, disability, and health-related quality of life.ResultsAt post-intervention, the Pilates group had significantly lower pain intensity (mean difference = −1.14; 95% CI −2.05; −0.23), less disability (mean difference = −6.7; 95% CI −11.3; −2.0), and higher health-related quality of life (mean difference = 0.102; 95% CI 0.054; 0151) compared to the home-based exercise group. At follow-up, the Pilates group had a significantly higher health-related quality of life (mean difference = 0.055; 95% CI 0.003; 0.106) compared with the home-based exercise group but there were no significant differences in pain and disability. A significant overall effect of Pilates compared to home-based exercise was found for disability (mean difference = −4.4; 95% CI −7.6; −1.1), and health-related quality of life (mean difference = 0.049; 95% CI 0.022; 0.076), but not for pain.ConclusionAlthough Pilates was significantly superior to home exercise for pain and disability, the differences were not considered clinically relevant. However, Pilates did provide significant and clinically relevant differences in utility.
研究人员145名(18-50岁)连续12周腰痛的患者,随机分配到普拉提组(72人)或家庭锻炼组(73人)。干预方法普拉提(使用配件进行垫上普拉提练习)与家庭锻炼(姿势练习、肌肉拉伸和强化以及脊柱稳定/活动),每周两次,为期 6 周。结果与家庭锻炼组相比,干预后普拉提组的疼痛强度明显降低(平均差异=-1.14;95% CI -2.05;-0.23),残疾程度降低(平均差异=-6.7;95% CI -11.3;-2.0),健康相关生活质量提高(平均差异=0.102;95% CI 0.054;0151)。在随访中,普拉提组的健康相关生活质量(平均差异=0.055;95% CI 0.003;0.106)明显高于在家锻炼组,但在疼痛和残疾方面没有明显差异。普拉提与家庭锻炼相比,在残疾(平均差异 = -4.4;95% CI -7.6;-1.1)和健康相关生活质量(平均差异 = 0.049;95% CI 0.022;0.076)方面具有明显的整体效果,但在疼痛方面没有明显效果。然而,普拉提确实在实用性方面提供了显著的临床相关性差异。
{"title":"Effectiveness of Pilates compared with home-based exercises in individuals with chronic non-specific low back pain: Randomised controlled trial","authors":"Caroline Ribeiro Tottoli, Ângela Jornada Ben, Everton Nunes da Silva, Judith E Bosmans, Maurits van Tulder, Rodrigo Luiz Carregaro","doi":"10.1177/02692155241277041","DOIUrl":"https://doi.org/10.1177/02692155241277041","url":null,"abstract":"ObjectiveTo investigate the effectiveness of a Pilates exercise program compared with home-based exercises in individuals with chronic non-specific low back pain.DesignA randomised controlled trial with a six-month follow-up.SettingRehabilitation clinic.ParticipantsOne hundred and forty-five individuals (18–50 years of age) with low back pain for ≥ 12 consecutive weeks were enrolled and randomly allocated to either Pilates ( n = 72) or home-based exercise groups ( n = 73).InterventionsMethod Pilates (Mat Pilates exercises using accessories) versus home-based exercise (postural exercises, muscle stretching and strengthening, and spine stabilisation/mobilisation), twice a week, for 6 weeks.Main measuresAssessments were performed at baseline, post-intervention, and six months follow-up. Outcomes were pain intensity, disability, and health-related quality of life.ResultsAt post-intervention, the Pilates group had significantly lower pain intensity (mean difference = −1.14; 95% CI −2.05; −0.23), less disability (mean difference = −6.7; 95% CI −11.3; −2.0), and higher health-related quality of life (mean difference = 0.102; 95% CI 0.054; 0151) compared to the home-based exercise group. At follow-up, the Pilates group had a significantly higher health-related quality of life (mean difference = 0.055; 95% CI 0.003; 0.106) compared with the home-based exercise group but there were no significant differences in pain and disability. A significant overall effect of Pilates compared to home-based exercise was found for disability (mean difference = −4.4; 95% CI −7.6; −1.1), and health-related quality of life (mean difference = 0.049; 95% CI 0.022; 0.076), but not for pain.ConclusionAlthough Pilates was significantly superior to home exercise for pain and disability, the differences were not considered clinically relevant. However, Pilates did provide significant and clinically relevant differences in utility.","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":"13 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rasch Analysis of the Chinese Version of the Nociception Coma Scale–Revised in Patients with Prolonged Disorders of Consciousness 对长时间意识障碍患者的中文版痛觉昏迷量表(修订版)进行拉施分析
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2024-09-14 DOI: 10.1177/02692155241280524
Yuhang Zheng, Xinyou Lin, Yuehong Huang, Steven Laureys, Haibo Di
ObjectivesThe aim of this study was to analyze the Chinese version of the Nociception Coma Scale–Revised in patients with prolonged disorders of consciousness within the framework of Rasch modeling, including investigating the invariance of total scores across different etiologies of disorders of consciousness.DesignProspective psychometric study.ParticipantsPatients with prolonged disorders of consciousness from the Rehabilitation and Neurology units in hospital.InterventionsNone.Main Outcome MeasureThe Nociception Coma Scale–Revised was undertaken by trained raters and the Coma Recovery Scale-Revised was used to assess patients’ consciousness. The psychometric properties within the Rasch model including item-person targeting, reliability and separation, item fit, unidimensionality, and differential item functioning were assessed.Results84 patients with prolonged disorders of consciousness (mean age 53 years; mean injury 5 months; 42 with Minimally Conscious State and 42 with Unresponsive Wakefulness Syndrome) of 252 observations were enrolled in the study. Through the procedure of repeated assessment and differential item function, a lower item bias Rasch set was purified. The Rasch model assumptions were examined and met, with item reliability and validity meeting the recommended threshold.ConclusionsThe Chinese version of the Nociception Coma Scale–Revised demonstrated unidimensionality, good reliability and separation, and good item fit, but dissatisfied person fit and item-person targeting. The verbal subscale showed a notable discrepancy between person responses and the difficulty of the items, suggesting limited clinical significance.
目的在Rasch模型的框架内分析中文版《痛觉昏迷量表(修订版)》在长期意识障碍患者中的应用情况,包括研究总分在不同病因引起的意识障碍中的不变性。干预措施无。主要结果测量由训练有素的评分员对患者进行痛觉昏迷量表(Nociception Coma Scale-Revised)评分,并使用昏迷恢复量表(Coma Recovery Scale-Revised)对患者的意识进行评估。评估了 Rasch 模型中的心理计量特性,包括项目-人目标、可靠性和分离度、项目拟合、单维性和差异项目功能。通过重复评估和差异项目功能的程序,纯化了一个项目偏差较低的 Rasch 集。结论中文版痛觉昏迷量表(修订版)具有单维性、良好的信度和分离度、良好的项目拟合度,但人的拟合度和项目-人的目标性不理想。言语分量表显示出人的反应与项目难度之间存在明显差异,这表明其临床意义有限。
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引用次数: 0
Efficacy of interferential current therapy plus exercise compared to sham interferential current plus exercise for pain relief in patients with knee osteoarthritis: A randomised controlled trial 干扰电流疗法加运动与假性干扰电流疗法加运动对缓解膝骨关节炎患者疼痛的疗效比较:随机对照试验
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2024-09-11 DOI: 10.1177/02692155241278949
Chalida Varapirom, Vilai Kuptniratsaikul, Rungsima Yamthed, Ananya Srisomnuek
ObjectiveTo compare the efficacy of interferential current (IFC) therapy combined with quadriceps strengthening exercise versus sham IFC plus exercise for pain relief and functional improvement in patients with knee osteoarthritis.Study DesignDouble-blind randomised controlled trial.SettingOutpatient rehabilitation clinic.SubjectsKnee osteoarthritis patients aged 50–85 years with a pain score ≥4/10.MethodsOne hundred forty-four participants were randomly allocated into the study and control groups. The study group received 20 min of IFC therapy (carrier frequency: 4000 Hz, beat frequency: 100 Hz) five times per week for three weeks, while the control group received sham IFC following the same protocol, followed by 10 min of exercise in both groups. Outcome measures included Numeric Rating Scale for Pain, Western Ontario and McMaster Universities Index (WOMAC) score, gait speed, and EuroQol-Five Dimensions-Five Levels questionnaire assessed at baseline, Week 3, and Week 6. Adverse events and patient satisfaction were evaluated at Week 3.ResultsAt Week 3, the study group demonstrated statistical improvement compared to the control group for Numeric Rating Scale for Pain, WOMAC Total, WOMAC Pain, and WOMAC Stiffness. The mean difference (95% confidence interval) between groups was 0.76 (0.21–1.30), 0.49 (0.03–0.95), 0.63 (0.13–1.13), and 0.62 (0.04–1.20), respectively. However, the mean differences between groups were below the Minimally Clinically Important Difference values for each outcome. Additionally, there were no significant differences between groups at Week 6 for any outcome measure.ConclusionIFC had no effect on pain reduction and functional improvement in patients with mild to moderate knee osteoarthritis.
研究设计双盲随机对照试验.地点康复门诊.受试者膝关节骨性关节炎患者,年龄 50-85 岁,疼痛评分≥4/10.方法将 144 名受试者随机分配到研究组和对照组。研究组接受 20 分钟的 IFC 治疗(载波频率:4000 Hz,节拍频率:100 Hz),每周五次,持续三周;对照组接受相同方案的假 IFC,随后两组均进行 10 分钟的锻炼。结果测量包括疼痛数字评分量表、西安大略和麦克马斯特大学指数(WOMAC)评分、步速和 EuroQol-Five Dimensions-Five Levels 问卷,分别在基线、第 3 周和第 6 周进行评估。结果第3周时,与对照组相比,研究组在疼痛数字评分量表、WOMAC总分、WOMAC疼痛和WOMAC僵硬度方面均有统计学改善。组间平均差异(95% 置信区间)分别为 0.76(0.21-1.30)、0.49(0.03-0.95)、0.63(0.13-1.13)和 0.62(0.04-1.20)。然而,各组间的平均差异均低于每项结果的最小临床重要差异值。结论 IFC 对轻度至中度膝骨关节炎患者减轻疼痛和改善功能没有影响。
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引用次数: 0
Assessment of mood after severe acquired brain injury: Interviews with UK clinical psychologists and medical professionals 严重后天性脑损伤后的情绪评估:访谈英国临床心理学家和医疗专业人员
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2024-09-11 DOI: 10.1177/02692155241278289
Alexandra E Rose, Breda Cullen, Sarah Crawford, Jonathan J Evans
ObjectiveMood assessment is challenging when people have cognitive and receptive communication impairments after severe brain injury. This study explored how UK-based medical and psychology professionals working with people with severe cognitive and communication impairments after brain injury assess mood in this population.DesignFollowing their participation in an online survey, professionals were invited to participate in individual semi-structured interviews. Interviews were analysed using thematic analysis to label explicit data (semantic themes) and implicit data (latent themes).ParticipantsTwenty-three clinical psychologists and nine medical professionals participated in online or in-person interviews.ResultsBoth groups explicitly reported using a combination of collateral information, history, observations, and patient interviews when assessing mood in this population. Medical professionals did not routinely use standardised measures and clinical psychologists often adjusted them when they used them. The respondents discussed difficulties conceptualising depression after brain injury, the experience needed by the assessor, and the need for an individualised approach for this population. Clinical psychologists discussed the pressures of working in healthcare systems and medical professionals discussed how symptoms may influence prescription choices. Seven latent themes were labelled which highlighted additional challenges and complexities experienced by those assessing mood, beyond the actual assessment process itself.ConclusionsNo ‘gold standard’ approach to assessing mood in those with cognitive and communication difficulties after severe brain injury was identified. There was overlap in assessment approaches but no clear consensus. Interviewees felt that mood assessment must be approached differently in this population and that self-report measures are not useful.
目标当人们在严重脑损伤后出现认知和接受性交流障碍时,情绪评估是一项具有挑战性的工作。本研究探讨了英国为脑损伤后有严重认知和交流障碍的患者提供服务的医学和心理学专业人员如何评估这类人群的情绪。设计在参与在线调查后,专业人员受邀参加个人半结构化访谈。采用主题分析法对访谈进行分析,以标注显性数据(语义主题)和隐性数据(潜在主题)。结果两组人都明确表示,在评估该人群的情绪时,会综合使用旁证信息、病史、观察和患者访谈。医务人员并不经常使用标准化的测量方法,而临床心理学家在使用这些方法时往往会对其进行调整。受访者讨论了脑损伤后抑郁概念化的困难、评估者所需的经验以及对这类人群采取个性化方法的必要性。临床心理学家讨论了在医疗保健系统中工作的压力,医疗专业人员讨论了症状如何影响处方选择。在实际评估过程本身之外,我们还发现了七个潜在的主题,这些主题强调了情绪评估者所经历的额外挑战和复杂性。评估方法存在重叠,但没有达成明确的共识。受访者认为,对这类人群的情绪评估必须采取不同的方法,而且自我报告的方法并不实用。
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引用次数: 0
The sustainability of exercise following colorectal surgery: A qualitative study of participants in the PREPARE-ABC trial. 结肠直肠手术后运动的可持续性:对 PREPARE-ABC 试验参与者的定性研究。
IF 3 3区 医学 Q1 REHABILITATION Pub Date : 2024-09-10 DOI: 10.1177/02692155241278936
J Naisby,K Baker,K Skarparis,J Murdoch,A Clark,S Stirling,D Turner,A M Swart,J Hernon,J Saxton
OBJECTIVEThis study aimed to explore perceptions regarding the sustainability of exercise following participation in a pre- and post-colorectal surgery exercise intervention trial (PREPARE-ABC).DESIGNQualitative interview study. Data were analysed using framework analysis and independently coded by two researchers.SETTINGSix United Kingdom National Health Service Trusts.PARTICIPANTSEighteen interviews (hospital-based exercise n = 9, home-based exercise n = 3, standard care n = 6) were conducted with patients 12-15 months after being randomised in the trial, after their 12 month appointment.INTERVENTIONIndividuals who participated in one of two exercise intervention groups (hospital-supervised or home-supported exercise) or a standard care control group of the PREPARE-ABC trial were invited to interview.RESULTSThe exercise interventions were reported to influence participants' recovery and future sustainability of exercise behaviour change. Several participants continued to engage in exercise over a year after their surgery. Reasons for this included being engaged with exercise prior to diagnosis, psychological benefits of exercise and wanting to be engaged with something to help recovery. Perceptions about the sustainability of active lifestyles were influenced by confidence to engage in structured exercise or physical activity and beliefs about its potential to promote future wellness.CONCLUSIONSSustainability varies among individuals and early assessment of physical activity engagement could be beneficial. Physical activity interventions immediately following surgery may be important for future engagement.
目的:本研究旨在探讨参加结直肠手术前后运动干预试验(PREPARE-ABC)后对运动可持续性的看法。采用框架分析法对数据进行分析,并由两名研究人员进行独立编码。参与者在随机参与试验 12-15 个月后,对患者进行了 18 次访谈(基于医院的运动 n = 9,基于家庭的运动 n = 3,标准护理 n = 6)。结果据报道,运动干预措施影响了参与者的康复和未来运动行为改变的可持续性。一些参与者在术后一年多仍坚持锻炼。其中的原因包括:在确诊前就参与了运动、运动带来的心理益处以及希望参与一些有助于康复的活动。对积极生活方式可持续性的看法受到参与有组织运动或体育锻炼的信心以及对其促进未来健康潜力的信念的影响。手术后立即进行体育锻炼干预可能对未来的参与很重要。
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引用次数: 0
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Clinical Rehabilitation
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