International Journal of Rehabilitation Research最新文献

Technological and social advances have improved prosthetic devices; however, discomfort during prosthesis use remains a persistent problem. Therefore, ongoing assessment of socket fit is essential. This process is key to ensuring long-term functionality and comfort for prosthetic users. This study aimed to adapt the Comprehensive Lower-limb Amputee Socket Survey (CLASS) into Turkish and evaluate its validity and reliability in individuals with combat-related unilateral lower-limb amputation at K3 and K4 mobility levels. We performed cross-cultural adaptation and validation using multiple outcome measures reflecting various aspects of socket fit. A cross-sectional test-retest design was used with 80 prosthesis-using participants recruited from a rehabilitation hospital. Reliability was assessed using the intraclass correlation coefficient (ICC) and internal consistency via Cronbach's α . The Turkish CLASS demonstrated strong test-retest reliability across its domains (ICC = 0.80-0.90) and high internal consistency (Cronbach's α ranging from 0.73 to 0.87 across subscales). No significant floor effects were observed. Validity was examined through correlations with the Trinity Amputation and Prosthesis Experiences Scale (TAPES), Satisfaction with Prosthesis Questionnaire (SAT-PRO), and Socket Comfort Score (SCS). The comfort domain of Turkish CLASS showed strong correlations with SAT-PRO ( r  = 0.62) and SCS ( r  = 0.74), while other domains had moderate correlations with TAPES subscales ( r  = 0.43-0.55), supporting concurrent validity. The minimum detectable change scores across the domains ranged from 9.3 (comfort) to 16.1 (appearance). These findings indicate that the Turkish CLASS is a valid and reliable instrument for assessing socket fit in unilateral lower-limb amputees and is suitable for routine clinical use.

This study aimed to determine the prevalence and associated risk factors of sarcopenia among patients with cardiovascular diseases (CVD) undergoing cardiac rehabilitation (CR) and to evaluate the diagnostic accuracy of phase angle (PhA) in identifying sarcopenia. This cross-sectional study included 100 patients with ischemic heart disease undergoing outpatient CR. Sarcopenia was diagnosed based on the criteria of the Asian Working Group for Sarcopenia 2019, which utilized measurements of muscle mass, handgrip strength, and gait speed. PhA was measured using bioelectrical impedance analysis. Multivariable logistic regression was used to identify factors associated with sarcopenia, and receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic performance of PhA. The prevalence of sarcopenia in the study population was 35%, with 23% classified as having severe sarcopenia. Female sex [adjusted odds ratio (aOR) 5.9, P  = 0.004] and lower BMI (aOR 0.71, P  = 0.005) were significantly associated with sarcopenia. Mean PhA values were significantly lower in patients with sarcopenia compared to those without (3.61 vs. 4.47 °, P  < 0.001). ROC curve analysis demonstrated good diagnostic accuracy of PhA for identifying sarcopenia, with an area under the curve of 0.83 (95% confidence intervals: 0.75-0.91). The optimal PhA cutoff value to distinguish sarcopenia was 4.01 °, yielding both sensitivity and specificity of 80%. Sarcopenia was prevalent among CVD patients undergoing CR, with female gender and lower BMI as significant risk factors. PhA demonstrated high diagnostic accuracy for detecting sarcopenia and may serve as a useful, noninvasive tool in clinical settings.

German social law provides a broad range of services aimed at maintaining work ability, facilitating return-to-work, and preventing permanent work disability; however, individuals with health impairments often lack information about available options and access, leading to underutilization of these services. This study (trial registration: DRKS00024648) evaluates the implementation of a multicomponent strategy designed to improve access to rehabilitation services and promote sustained work participation among individuals at elevated risk of permanent work disability. The intervention consisted of screening, postal contact, telephone counseling, initial interview, and case management. High-risk individuals were identified through a risk score based on administrative data (≥60 points indicating an increased 5-year probability of disability pension) and were invited by postal mail to call their regional case manager if support was required. Within the process evaluation, we assessed reach, dose delivered, fidelity, dose received, and participant satisfaction using case manager documentation and participant surveys at baseline and follow-up. Of 5300 individuals contacted, 277 engaged in case management. At baseline, participants reported an average of 20 weeks of sickness absence, multiple health conditions, and 63.7% rated their work ability as poor. Implementation fidelity exceeded 80%, and satisfaction with the intervention was high. Following case management, knowledge of rehabilitation services increased significantly ( P  < 0.001), and 55.6% applied for rehabilitation. The findings demonstrate that the intervention successfully reached its target population with high fidelity and participant satisfaction. Observed improvements in knowledge and increased utilization of rehabilitation services suggest the intervention's potential to enhance access for those in need.

Since early interventions have improved survival in traumatic spinal cord injury (TSCI), there is a shift toward addressing long-term outcomes like community reintegration and social participation. Despite its importance, community reintegration remains under-researched, particularly in Northern India. This study aims to explore societal reintegration in people with TSCI in Northern India using the Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF). The CHART-SF examines the impact of age, gender, injury level, terrain, and the ASIA impairment scale (AIS) on physical independence, cognitive independence, mobility, occupation, social integration, and economic self-sufficiency. This cross-sectional observational study included 91 individuals with TSCI who had an injury duration greater than 1 year and received inpatient and outpatient services from our department in a tertiary health care centre between October 2022 and April 2024. Community reintegration scores were low in all areas measured by the CHART-SF, such as physical independence (38.5), cognitive independence (64.5), mobility (38.9), social integration (70.9), and economic self-sufficiency, with occupation (13.6) being the most affected domain. The mean CHART-SF score was 226.4 (56.8) out of a maximum of 600, indicating poor reintegration. Being motor complete (AIS A-B) was moderately-to-strongly associated with worse physical independence ( rpb = 0.91, P  < 0.001), mobility (0.87, P  < 0.001), occupation status (0.56, P  < 0.001), and overall community reintegration (0.84, P  < 0.001). The cognitive independence (64.5) and social integration scores (70.93) were not correlated with any demographic and injury variables assessed and were among the highest-scoring domains. The results suggest significant challenges in societal reintegration among individuals with TSCI in Northern India, particularly in mobility, physical independence, and occupation. While cognitive and social integration were relatively better, overall reintegration remained low. The injury severity, terrain, and other demographic factors influenced outcomes, especially in physical domains.

The Visual Function Classification System (VFCS) provides a standardised framework for grading visual functioning in children with cerebral palsy (CP). This study evaluated the reliability and construct validity of the Croatian VFCS, and its ability to distinguish visual functioning across CP subtypes and functional classifications. Ninety-five children with CP (mean age: 11.8 years, range: 4-18) were assessed using VFCS, Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS). Reliability was tested using quadratic weighted kappa and intraclass correlation coefficients (ICCs); differences across CP types with the Kruskal-Wallis, and construct validity with Spearman correlations. The Croatian VFCS showed excellent interrater ( κ = 0.87) and intrarater reliability ( κ = 0.92), with ICCs greater than 0.90. VFCS levels differed significantly by CP subtype ( χ ² = 8.30, P = 0.016), with preliminary evidence suggesting that unilateral spastic CP may be associated with better visual function than bilateral spastic or dyskinetic CP. Moderate correlations with CFCS ( ρ = 0.557), MACS ( ρ = 0.392), and GMFCS ( ρ = 0.308) revealed clinically relevant divergences between visual and motor abilities. The Croatian VFCS is a reliable, valid, and clinically sensitive tool. This study provides preliminary evidence of its discriminative utility across CP subtypes and supports integrating VFCS into multidisciplinary assessment and individualised rehabilitation planning.

The aim of this study was to determine the validity of the Stroke Upper Limb Capacity Scale (SULCS) and its three hand categories in an acute inpatient stroke rehabilitation setting. We included 312 persons, about 10 days poststroke, with a mean National Institutes of Health Stroke Score (NIHSS) of 7.3. Participants were also assessed on the functional independence measure (FIM), Upper Extremity-Motricity Index (UE-MI), modified Charlson Comorbidity Index, and proportion of home discharges. Spearmans rho between total SULCS and FIM-self-care score and UE-MI at admission were strong at 0.72 and 0.82, respectively. Correlations were stronger between SULCS and individual FIM items of eating, grooming, and bathing [rho= 0.52-0.57, that is, 'more' activity of daily living (ADL)-like items] rather than walking, bowel, and expression (rho= 0.28-0.51, that is, 'less' ADL-like items). Admission and discharge FIM, NIHSS, and proportion of home discharges were higher with more favorable SULCS hand categories. Floor effect was 11.9% and ceiling effect was 14.7% with an acceptable internal consistency (Cronbach's alpha of 0.92). The SULCS is a valid measure of upper extremity capacity at admission to inpatient stroke rehabilitation. Further examination regarding ceiling effects and responsiveness in inpatient stroke rehabilitation is recommended.

The objective was to investigate the agreement between face-to-face and telephone application of the Fatigue Severity Scale (FSS) in the elderly. The participants were assessed using the FSS by telephone and face-to-face. Intraclass correlation coefficient (ICC-3,1) investigated the agreement between the FSS scores, for both scoring methods (sum and average), and quadratic weighted Kappa statistics to investigate the agreement between the individual items. The 55 individuals showed a total score ranging from 9 to 57 for the sum scoring method, from 1 to 6.3 for the average scoring method, and from 1 to 7 for the individual items. The level of agreement for the total scores was high ICC for the sum (0.84) and average (0.86) scoring method, while for each item, eight were considered moderate (0.21 ≤ κ ≤ 0.52), and one was low ( κ = 0.19). This study showed that the FSS is a reliable scale, for both scoring methods, to be applied by telephone in elderly individuals.

The 6-min walk test (6MWT) is used to assess gait capacity in patients with stroke; however, the standard 30-m version (6MWT-30 m) is often impractical in clinical settings because of space limitations. We investigated the validity and reliability of a 15-m version (6MWT-15 m) in 29 individuals with subacute stroke. Test-retest reliability was assessed using the intraclass correlation coefficient (ICC), minimal detectable change (MDC), and Bland-Altman analysis. Validity was evaluated through correlations with the 10-m walk test (10mWT), Berg Balance Scale (BBS), and Fugl-Meyer Assessment for the Lower Extremities (FMA-LE). The 6MWT-15 m demonstrated excellent reliability (ICC = 0.997) and acceptable measurement error (MDC = 19.5 m), with strong correlations with the 10mWT, BBS, FMA-LE, and 6MWT-30 m, supporting its validity. Regression analysis identified the 6MWT-15 m as the sole significant predictor of 6MWT-30 m ( R2 = 0.98) walking distance. These findings support the 6MWT-15 m as a reliable, valid, and practical alternative for assessing walking capacity in patients suffering from subacute stroke, particularly in space-limited clinical settings.

This study aimed to translate the Gait Assessment and Intervention Tool (G.A.I.T.) into Japanese and evaluate its reliability and validity. Translation and adaptation followed established cross-cultural guidelines. To assess reliability and validity of Japanese versions of the G.A.I.T, a cohort design was implemented. Sixty-three stroke patients participated in interrater reliability and validity assessments, and 50 patients in the test-retest evaluation. Reliability and validity were evaluated using intraclass correlation coefficients (ICC) and Pearson's correlation coefficients, respectively. The Japanese G.A.I.T. demonstrated excellent reliability in interrater (ICC = 0.975) and retest (ICC = 0.988). Significant correlations were observed between the G.A.I.T. scores and Fugl-Meyer Assessment-Lower Extremity ( r  = -0.774), Functional Ambulation Category ( r  = -0.720), Functional Independence Measure motor scores ( r  = -0.647), functional independence measure mobility ( r  = -0.688), and comfortable walking speed ( r  = -0.839). These findings suggest that the Japanese version of the G.A.I.T. is a reliable and valid assessment tool for evaluating gait coordination in Japanese stroke survivors.