International Journal of Rehabilitation Research最新文献

Caring for a child with cerebral palsy (CP) is challenging and can significantly impact caregivers' quality of life. This study aimed to examine the psychological state, perceived social support, and quality of life of parents of children with CP in Benin, West Africa. This cross-sectional, case-control design included 50 parents of children with CP (mean age 39.4 ± 8.3 years, 46 mothers) paired with 58 parents of typically developing children (mean age 38.1 ± 7.4 years, 52 mothers) as controls. Both groups completed the Social Provisions Scale (SPS-10), Patient Health Questionnaire-9 (PHQ-9), and Medical Outcome Study Short Form (SF-12) to assess social support, depression, and quality of life. Additionally, parents of children with CP completed the Impact on Family Scale to evaluate caregiving burden. The results showed that parents of children with CP reported lower social support and higher depression levels than controls ( P  < 0.05). However, their quality of life (both physical and mental scores) was similar to the control group ( P  > 0.05). Only depression was significantly linked to lower quality of life ( P  < 0.05) in parents of children with CP. In conclusion, parents of children with CP have a comparable physical and mental health-related quality of life to parents of typically developing children, despite experiencing lower perceived social support and higher levels of depression in Benin country. These findings underscore the need for enhanced social and psychological support systems to improve the well-being of families caring for children with CP in such environments.

The aim of this study was to determine the validity and reliability of the 10-meter walk test modified by adding 5 and 17 cm obstacles (10MWT-O) in community-dwelling older adults and to examine its ability to differentiate between older and younger adults. The study included 65 older adults and 55 younger adults. 10MWT-O (obstacle height: 0, 5, 17 cm) was performed on two different days (day 1 and day 2). All participants were assessed by the same assessor on days 1 and 2. Berg Balance Scale (BBS), Time Up and Go (TUG) test, Mini Mental State Test, and Functional Reach Test (FRT) assessments were performed on day 1. 10MWT-O speed for all obstacle heights showed moderate to good correlations with FRT distance ( r  = 0.474-0.539, P  < 0.001), TUG Test time ( r  = -0.722 to -0.671, P  < 0.001), and BBS score ( r  = 0.619-0.660, P  < 0.001). Test-retest reliability (intraclass correlation coefficient = 0.924-0.960) was found to be within the excellent range for 10MWT-O speed across all obstacle heights. For obstacle heights of 0, 5, and 17 cm, the minimum detectable change for 10MWT-O speed was 0.16, 0.19, and 0.20 m/s, and the optimal cutoff values for differentiating older from young adults were 1.12, 0.98, and 0.85 m/s, respectively. The 10MWT-O is a reliable and valid clinical measure for assessing walking ability and adaptability in older adults. ClinicalTrials.gov identifier: NCT06307769.

The purpose of this study was to evaluate the separate effects of tactile stimulation (TS) and transcutaneous electrical nerve stimulation (TENS), combined with occupational therapy (OT) and physiotherapy (PT), on sensory-motor recovery in the upper limb of patients with stroke. Thirty-six patients were randomly assigned to three groups (mean age: TS group = 60.7, TENS group = 54.1, control group = 52.2 years). The average onset time was 9.7 months for the TS group, 11.1 months for the TENS group, and 10.2 months for the control group. Participants underwent a 2-week intervention provided in addition to standard OT and PT. The TS group received coarse sand stimulation (rubbing) over the affected hand and forearm for 15 min per session. The TENS group underwent electrical stimulation applied to the affected forearm for 30 min per session (10 Hz), while the control group received sham stimulation with 1 min of active current. Hand function was assessed with the Semmes-Weinstein monofilaments and grip strength, dexterity with the box and block test and Southampton hand assessment procedure, and performance in daily activities with the assessment of motor and process skills. In the TS group, patients significantly improved hand sensory perception, grip strength, and dexterity while the TENS group showed improvement in grip strength and dexterity. The control group exhibited no significant changes. Between-group comparisons revealed significant differences favoring TS for hand sensory perception and TENS for dexterity. These findings suggest that adding TS or TENS to OT and PT may enhance sensory-motor recovery after a stroke.

While botulinum toxin injections (BTX-A) have been long used to treat myofascial pain (MFP) in the neck and shoulder region, the evidence of its effectiveness remained unclear. Thus, we aimed to examine the existing evidence on the efficacy of BTX-A injections for reducing MFP in the neck and shoulder areas. This was a systematic review of Medline, Embase, Cinahl, Scopus, and Central databases. Only randomized controlled trials were included. Random effects meta-analysis with effect size index as weighted mean difference (WMD) was applied. The search resulted in 100 records, of them seven were considered relevant and included in the meta-analysis. In total, the data from 261 patients were analyzed. Five trials focused on entire neck/upper back and shoulder pain, one on the infraspinatus muscle and one on the trapezius muscle. The dose of BTX-A varied from 20 to 400 UI. The risk of systematic bias was high for three trials and low for four trials. The pooled WMD was statistically significant [-10.22 (95% confidence interval (CI) -12.77 to -7.68)] on a scale from 0 to 100 in favor of BTX-A over sham. However, the difference was not clinically significant. Also, the meta-regression coefficient was insignificant [-0.01 (95% CI -0.04 to 0.02)]. The overall quality of evidence was moderate. In conclusion, there is moderate evidence that BTX-A injections are not more effective than saline injections to treat MFP in the neck and shoulder region. The effect of BTX-A did not exceed the level of clinical significance. So far, BTX-A cannot be recommended for clinical use when dealing with MFP in the neck and shoulder.

Spondylodiscitis is a life-threatening neurological condition that, if not diagnosed early, can lead to severe complications, including progressive neurological deterioration. Diagnosis involves clinical evaluation, imaging, and microbiological testing. Delayed recognition, advanced age, virulent pathogens, and comorbidities increase the risk of poor outcomes. We report the case of a middle-aged male with diabetes, hypertension, and chronic kidney disease who developed noncontiguous multifocal spondylodiscitis. Initially presenting with progressive neck pain and urinary tract infection, his condition worsened over 3 months, resulting in lower limb weakness, bladder and bowel dysfunction, and quadriparesis. MRI spine revealed spinal infections at multiple levels and extended-spectrum beta-lactamase Escherichia coli in cultures. He underwent meropenem treatment, surgical decompression, and spinal fusion. Despite C6 quadriparesis, intensive rehabilitation enabled him to walk with assistance and achieve partial independence in daily activities within 6 months. This case underscores the necessity of early diagnosis, proper management, and long-term rehabilitation for optimal recovery.

Physical activity (PA) is recommended as a primary treatment to reduce pain and improve function in chronic low back pain (cLBP). However, adherence to PA guidelines and the limitation of sedentary behavior (SB) remain challenging for cLBP patients. While some studies focus on PA promotion, past results are mixed, and the role of SB has not been thoroughly investigated. This observational study aims to assess changes in PA and SB levels among cLBP patients participating in a rehabilitation program (RP) and explore related changes in both explicit and implicit motivational factors. Patients wore an accelerometer for 1 week before the RP (T1) and 3 months afterward (T4) to measure PA and SB. At the start (T2) and at the end (T4) of the RP, we measured motivation, including implicit attitudes, toward these two behaviors. Between T1 and T4 ( n  = 33), the results show a significant decrease in SB. Between T2 and T3 ( n  = 62), all motivational variables were significantly more in favor of an active lifestyle, but implicit attitudes did not significantly change. This study shows that an RP can transform behavior determinants and reduce SB but is less efficient to increase PA levels. It also emphasizes the need to work with patients to enhance adherence and objectively measure behaviors in the future.

The association between device-based (activPAL) and self-reported [Incidental Exercise and Planned Exercise Questionnaire (IPEQ)] measures of physical activity has not been investigated. This study aimed to determine the association between activPAL and IPEQ measures of physical activity in a sample of community-dwelling older people after stroke. Data from an exploratory analysis embedded within a randomized trial was used. Spearman correlation was used to assess the relationship between activPAL (upright time and step count) and IPEQ (self-reported total exercise time) measures at three timepoints [months 0 (n = 46), 6 (n = 39) and 12 (n = 36)] Strong Spearman correlation between upright time and self-reported total exercise time (r = 0.51-0.72) and step count and self-reported total exercise time was found at all timepoints (r = 0.54-0.62). Though further research could confirm these results in a larger sample, there is potential for the IPEQ to be used as a simple estimate of physical activity in a clinical setting.

Background: Physical activity (PA) is recommended as a primary treatment to reduce pain and improve function in chronic low back pain (cLBP). However, adherence to PA guidelines and the limitation of sedentary behavior (SB) remain challenging for cLBP patients. While some studies focus on PA promotion, past results are mixed, and the role of SB has not been thoroughly investigated.

Objective: This observational study aims to assess changes in PA and SB levels among cLBP patients participating in a rehabilitation program (RP) and explore related changes in both explicit and implicit motivational factors.

Methods: Patients wore an accelerometer for 1 week before the RP (T1) and 3 months afterward (T4) to measure PA and SB.

Results: At the start (T2) and at the end (T4) of the RP, we measured motivation, including implicit attitudes, toward these two behaviors. Between T1 and T4 (n = 33), the results show a significant decrease in SB. Between T2 and T3 (n = 62), all motivational variables were significantly more in favor of an active lifestyle, but implicit attitudes did not significantly change.

Conclusion: This study shows that an RP can transform behavior determinants and reduce SB but is less efficient to increase PA levels. It also emphasizes the need to work with patients to enhance adherence and objectively measure behaviors in the future.

The secondary prevention benefits of cardiac rehabilitation and similar exercise classes for stroke survivors are well established, however post-stroke exercise participation remains low. This research aimed to explore the factors affecting participation and engagement in UK-based post-stroke cardiac rehabilitation and exercise, from the perspective of the service user and service provider. An exploratory study, using semi-structured interviews, was conducted ( n  = 8, service user = 4), adopting a phenomenological approach. All interviews applied a topic guide informed by the Health Belief Model and the International Classification of Functioning, Disability and Health, and were analysed using inductive thematic analysis. Post-stroke cardiac rehabilitation and exercise participation was influenced by numerous factors, encompassed into three themes: Accessibility (describing the environmental pre-class limiting factors), Programme Structure (valuing in-class supervision, socialisation and adaptations) and Patient Characteristics (encompassing the influence of the service user's personality and experiences). Effective secondary prevention of stroke through cardiac rehabilitation and other exercise-based rehabilitation requires policy development and commissioning to ensure appropriate delivery. Further research should determine the feasibility of novel exercise class formats, in addition to larger trials investigating their clinical benefit and cost effectiveness.

The objective of this study was to further validate the Goal Processing Scale (GPS), an ecologically valid functional assessment of executive functioning requiring planning and executing a complex goal. Veterans (N = 69, mean age = 44.5 years) with a history of chronic mild traumatic brain injury and self-reported cognitive difficulties completed the GPS and neuropsychological measures of working memory, sustained attention, mental flexibility, inhibition, and memory during participation in one of three studies. Associations between overall GPS performance and composite neuropsychological measures of attention/executive functioning and memory were significant and medium-to-large in magnitude. Associations of similar magnitude also emerged between subcomponents of the GPS (e.g. self-monitoring, attentional switching, attention maintenance) and neuropsychological subdomains (e.g. mental flexibility, inhibition, working memory). Results suggest that the GPS facilitates structured assessment of goal-directed performance requiring integration of multiple executive functioning subdomains. The GPS may be valuable in assessing and predicting real-world functional difficulties not captured by traditional neuropsychological assessment.