Objective: Poor interdisciplinary team communication is a known barrier to increasing inpatient mobility. Understanding why and how clinicians from different disciplines communicate about mobility would help inform communication improvements. This qualitative interview study aimed to describe and explore clinician perceptions about written mobility communication, and perceived barriers and enablers to this communication.
Methods: A rapid deductive qualitative approach was used to efficiently capture information for local improvement. Clinicians (physical therapists, nurses, physicians, and occupational therapists) working on 3 internal medicine wards in a metropolitan teaching hospital in Brisbane, Australia were purposefully sampled and invited to participate in individual interviews. Questions were based on the Consolidated Framework for Implementation Research. Interviews were recorded, transcribed, and analyzed using deductive and inductive thematic methods.
Results: From 17 interviews, key themes identified that written communication about patient mobility is important and valued by clinicians; clinicians learn documentation on the job, often from physical therapists; clinicians are not aware of organizational responsibility for mobility communication; multiple purposes for written communication contribute to multiple locations and inconsistency; and clinicians perceive that improvement would require a multi-disciplinary and multi-level approach. Suggestions for improvement included use of a common language, consistent use of existing bedside communication tools, and clearer responsibility for written communication about mobility.
Conclusion: Written communication about patient mobility was valued by clinicians and a range of barriers to effective interdisciplinary communication identified. Clear professional roles and responsibility for written mobility communication is important. Suggestions for improvement included an interdisciplinary language supported by multi-disciplinary education and organizational governance.
Impact: Written communication about patient mobility is recognized as critical to safe, high-quality hospital care. Our findings suggest that successful mobility communication improvements must involve multiple disciplines and include clear organizational governance to support staff training, clear role responsibilities, and quality monitoring.
{"title":"\"It's Just Really Important for us all to be on the Same Page\": Qualitative Evaluation of Factors that Influence Written Mobility Communication.","authors":"Sally Yin, Prue McRae, Julie Adsett, Alison Mudge","doi":"10.1093/ptj/pzae158","DOIUrl":"https://doi.org/10.1093/ptj/pzae158","url":null,"abstract":"<p><strong>Objective: </strong>Poor interdisciplinary team communication is a known barrier to increasing inpatient mobility. Understanding why and how clinicians from different disciplines communicate about mobility would help inform communication improvements. This qualitative interview study aimed to describe and explore clinician perceptions about written mobility communication, and perceived barriers and enablers to this communication.</p><p><strong>Methods: </strong>A rapid deductive qualitative approach was used to efficiently capture information for local improvement. Clinicians (physical therapists, nurses, physicians, and occupational therapists) working on 3 internal medicine wards in a metropolitan teaching hospital in Brisbane, Australia were purposefully sampled and invited to participate in individual interviews. Questions were based on the Consolidated Framework for Implementation Research. Interviews were recorded, transcribed, and analyzed using deductive and inductive thematic methods.</p><p><strong>Results: </strong>From 17 interviews, key themes identified that written communication about patient mobility is important and valued by clinicians; clinicians learn documentation on the job, often from physical therapists; clinicians are not aware of organizational responsibility for mobility communication; multiple purposes for written communication contribute to multiple locations and inconsistency; and clinicians perceive that improvement would require a multi-disciplinary and multi-level approach. Suggestions for improvement included use of a common language, consistent use of existing bedside communication tools, and clearer responsibility for written communication about mobility.</p><p><strong>Conclusion: </strong>Written communication about patient mobility was valued by clinicians and a range of barriers to effective interdisciplinary communication identified. Clear professional roles and responsibility for written mobility communication is important. Suggestions for improvement included an interdisciplinary language supported by multi-disciplinary education and organizational governance.</p><p><strong>Impact: </strong>Written communication about patient mobility is recognized as critical to safe, high-quality hospital care. Our findings suggest that successful mobility communication improvements must involve multiple disciplines and include clear organizational governance to support staff training, clear role responsibilities, and quality monitoring.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142591307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"From Knowledge to Action: Fostering Advocacy Skills for Planetary Health in Physical Therapy.","authors":"Emma Swärdh, Filip Maric","doi":"10.1093/ptj/pzae130","DOIUrl":"10.1093/ptj/pzae130","url":null,"abstract":"","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11530356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mayuko Iijima, Geehong Hyun, Tara M Brinkman, Raja B Khan, Deo Kumar Srivastava, Leslie L Robison, Melissa M Hudson, Ching-Hon Pui, Kevin R Krull, Hiroto Inaba, Kirsten K Ness
Aobjective: The impact of fine motor impairment among adult survivors of childhood acute lymphoblastic leukemia (ALL) on life after treatment is unknown.
Methods: This study evaluated prevalence and utilized multivariate logistic regression to identify risk factors for fine motor impairment among survivors of ALL, and associations with educational attainment and social independence. Latent class analysis defined social independence (independent, moderately independent, dependent), using employment, independent living, personal care assistance, routine need assistance, driver's license status, and marital status inputs.
Results: Among 875 survivors who were ≥ 25 years old (age when most adults achieve independence) and ≥ 5 years from diagnosis (mean = 28.97 years), 33.6% had fine motor impairment, with scores at or below the 10th percentile of the scores of community controls (n = 460) on fine motor components of the physical performance test and the grooved peg-board test. Survivors exposed to cranial radiation had more fine motor impairment than those without (45.8% vs 20.2%). Male sex (exposed: odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.65-3.92; unexposed: OR = 3.02, 95% CI = 1.69-5.38) and lower scores on the Wechsler abbreviated scale of intelligence (exposed: OR = 0.46, 95% CI = 0.36-0.58; unexposed: OR = 0.43, 95% CI = 0.31-0.58) were risk factors for neuropathy. A 1-point-higher total neuropathy score was associated with 8% (95% CI = 1%-17%) increased odds of fine motor impairment. Fine motor impairment was associated with less than a college education (less than high school: OR = 2.23, 95% CI = 1.20-4.14; high school diploma/general equivalency diploma: OR = 2.66, 95% CI = 1.65-4.30; vocational education: OR = 2.07, 95% CI = 1.38-3.13) and less social independence (moderately independent: OR = 1.80, 95% CI = 1.15-2.83; dependent: OR = 2.65, 95% CI = 1.25-5.64).
Conclusion: Fine motor impairment in survivors of childhood ALL may interfere with optimal educational attainment and social independence.
Impact: Early identification of survivors at risk for fine motor impairment, with timely intervention, may improve long-term outcomes.
目的:儿童急性淋巴细胞白血病成年幸存者的精细运动障碍对治疗后生活的影响尚不清楚:儿童急性淋巴细胞白血病成年幸存者的精细运动障碍对治疗后生活的影响尚不清楚:本研究评估了急性淋巴细胞白血病幸存者中精细运动障碍的患病率,并利用多变量逻辑回归确定了精细运动障碍的风险因素,以及与受教育程度和社会独立性之间的关联。潜类分析使用就业、独立生活、个人护理协助、日常需求协助、驾照状况和婚姻状况输入来定义社会独立性(独立、中度独立、依赖):在875名年龄≥25岁(大多数成年人实现独立的年龄)且距离确诊时间≥5年(平均年龄=28.97岁)的幸存者中,33.6%的人存在精细运动障碍,在体能测试(Physical Performance Test)和凹槽木板测试(Grooved Peg-Board Test)中精细运动部分的得分达到或低于社区对照组(460人)得分的第10百分位数。受到颅内辐射的幸存者比未受到颅内辐射的幸存者(45.8% 对 20.2%)更容易出现精细运动障碍。OR=3.02,95.0% CI=1.69-5.38),以及韦氏智力缩略量表(Wechsler Abbreviated Scale of Intelligence)得分较低(暴露:OR=0.46,95.0% CI=1.69-5.38):暴露:OR = 0.46,95.0% CI = 0.36-0.58;未暴露:OR = 0.43,95.0% CI = 0.31-0.58)是神经病变的风险因素。神经病变总分高 1 分与精细运动障碍几率增加 8%(95.0% CI = 1%-17%)有关。精细运动障碍与大学教育程度以下有关(高中以下:OR = 2.23,95.0% CI = 1.20-4.14;高中文凭/普通同等学历文凭:OR=2.66,95.0% CI=1.65-4.30;职业教育:OR=2.07,95.0% CI=1.38-3.13),社会独立性较差(中度独立:OR=1.80,95.0% CI=1.15-2.83;依赖性:结论:结论:儿童急性淋巴细胞白血病幸存者的精细运动障碍可能会影响其达到最佳教育水平和社会独立性:影响:早期发现有精细动作障碍风险的幸存者并及时干预,可改善长期预后。
{"title":"Fine Motor Impairment and Its Impact on Social Outcomes in Survivors of Pediatric Acute Lymphoblastic Leukemia: St. Jude Lifetime Cohort Study.","authors":"Mayuko Iijima, Geehong Hyun, Tara M Brinkman, Raja B Khan, Deo Kumar Srivastava, Leslie L Robison, Melissa M Hudson, Ching-Hon Pui, Kevin R Krull, Hiroto Inaba, Kirsten K Ness","doi":"10.1093/ptj/pzae142","DOIUrl":"10.1093/ptj/pzae142","url":null,"abstract":"<p><strong>Aobjective: </strong>The impact of fine motor impairment among adult survivors of childhood acute lymphoblastic leukemia (ALL) on life after treatment is unknown.</p><p><strong>Methods: </strong>This study evaluated prevalence and utilized multivariate logistic regression to identify risk factors for fine motor impairment among survivors of ALL, and associations with educational attainment and social independence. Latent class analysis defined social independence (independent, moderately independent, dependent), using employment, independent living, personal care assistance, routine need assistance, driver's license status, and marital status inputs.</p><p><strong>Results: </strong>Among 875 survivors who were ≥ 25 years old (age when most adults achieve independence) and ≥ 5 years from diagnosis (mean = 28.97 years), 33.6% had fine motor impairment, with scores at or below the 10th percentile of the scores of community controls (n = 460) on fine motor components of the physical performance test and the grooved peg-board test. Survivors exposed to cranial radiation had more fine motor impairment than those without (45.8% vs 20.2%). Male sex (exposed: odds ratio [OR] = 2.55, 95% confidence interval [CI] = 1.65-3.92; unexposed: OR = 3.02, 95% CI = 1.69-5.38) and lower scores on the Wechsler abbreviated scale of intelligence (exposed: OR = 0.46, 95% CI = 0.36-0.58; unexposed: OR = 0.43, 95% CI = 0.31-0.58) were risk factors for neuropathy. A 1-point-higher total neuropathy score was associated with 8% (95% CI = 1%-17%) increased odds of fine motor impairment. Fine motor impairment was associated with less than a college education (less than high school: OR = 2.23, 95% CI = 1.20-4.14; high school diploma/general equivalency diploma: OR = 2.66, 95% CI = 1.65-4.30; vocational education: OR = 2.07, 95% CI = 1.38-3.13) and less social independence (moderately independent: OR = 1.80, 95% CI = 1.15-2.83; dependent: OR = 2.65, 95% CI = 1.25-5.64).</p><p><strong>Conclusion: </strong>Fine motor impairment in survivors of childhood ALL may interfere with optimal educational attainment and social independence.</p><p><strong>Impact: </strong>Early identification of survivors at risk for fine motor impairment, with timely intervention, may improve long-term outcomes.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11531345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heather A Feldner, Samuel W Logan, Sango Otieno, Anna Fragomeni, Carissa Kono, Katie Riordan, Bethany Sloane, Lisa K Kenyon
Objective: The objective of this study was to evaluate the effects of 2 short-term powered mobility interventions across developmental domains, participation, and perceptions of intervention implementation for young children with cerebral palsy and their families.
Methods: This randomized, crossover clinical trial compared 2 powered mobility interventions: the Explorer Mini (Permobil AB, Timra, Sweden) and an adapted ride-on toy car. Analyses included 24 children aged 12 to 36 months, recruited from 3 sites. Each device was trialed in the home for an 8-week period for a total of 16 weeks. Three in-person study visits took place at baseline, crossover, and study completion, and 2 additional virtual check-ins were conducted for each device trial period. Outcome measures included all domains of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4); Child Engagement in Daily Life (CEDL) participation questionnaire; and t3 perceptual implementation measures: Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Analyses included descriptive statistics, 2 by 3 group × time analysis of variance, and post hoc t tests as warranted.
Results: Statistically significant mean improvements were observed in all domains of the Bayley-4 and in the self-care subscale of the CEDL regardless of device order. Caregivers ranked both devices as acceptable and feasible to implement, although the Explorer Mini was ranked slightly more favorably than the adapted ride-on toy car, with a device order effect being observed.
Conclusion: Short-term powered mobility intervention may advance multiple domains of development and participation for young children with cerebral palsy. Caregivers rated 2 different powered mobility devices favorably as part of their child's early intervention strategies.
Impact: This study enhances the quality of evidence available to clinicians and families to support decision-making about powered mobility intervention for young children with motor disabilities, especially those who may be reluctant to begin powered mobility due to stigma or concern for motor skill development.
{"title":"Short-Term Powered Mobility Intervention is Associated With Improvements in Development and Participation for Young Children with Cerebral Palsy: A Randomized Clinical Trial.","authors":"Heather A Feldner, Samuel W Logan, Sango Otieno, Anna Fragomeni, Carissa Kono, Katie Riordan, Bethany Sloane, Lisa K Kenyon","doi":"10.1093/ptj/pzae152","DOIUrl":"https://doi.org/10.1093/ptj/pzae152","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to evaluate the effects of 2 short-term powered mobility interventions across developmental domains, participation, and perceptions of intervention implementation for young children with cerebral palsy and their families.</p><p><strong>Methods: </strong>This randomized, crossover clinical trial compared 2 powered mobility interventions: the Explorer Mini (Permobil AB, Timra, Sweden) and an adapted ride-on toy car. Analyses included 24 children aged 12 to 36 months, recruited from 3 sites. Each device was trialed in the home for an 8-week period for a total of 16 weeks. Three in-person study visits took place at baseline, crossover, and study completion, and 2 additional virtual check-ins were conducted for each device trial period. Outcome measures included all domains of the Bayley Scales of Infant and Toddler Development, Fourth Edition (Bayley-4); Child Engagement in Daily Life (CEDL) participation questionnaire; and t3 perceptual implementation measures: Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Analyses included descriptive statistics, 2 by 3 group × time analysis of variance, and post hoc t tests as warranted.</p><p><strong>Results: </strong>Statistically significant mean improvements were observed in all domains of the Bayley-4 and in the self-care subscale of the CEDL regardless of device order. Caregivers ranked both devices as acceptable and feasible to implement, although the Explorer Mini was ranked slightly more favorably than the adapted ride-on toy car, with a device order effect being observed.</p><p><strong>Conclusion: </strong>Short-term powered mobility intervention may advance multiple domains of development and participation for young children with cerebral palsy. Caregivers rated 2 different powered mobility devices favorably as part of their child's early intervention strategies.</p><p><strong>Impact: </strong>This study enhances the quality of evidence available to clinicians and families to support decision-making about powered mobility intervention for young children with motor disabilities, especially those who may be reluctant to begin powered mobility due to stigma or concern for motor skill development.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142505893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The study objective was to determine the effectiveness of a prehabilitation program to decrease postoperative musculoskeletal impairments in patients who have breast cancer and are receiving neoadjuvant therapy (NAT).
Methods: Patients who had breast cancer and were receiving NAT before surgery were invited to participate in this randomized controlled trial. Patients randomized to the intervention group participated in a group-based prehabilitation program consisting of Nordic walking, resistance training, and therapeutic education from month 4 of NAT until before surgery. Patients in the control group received usual care (no prehabilitation). The main outcome was arm function measured with the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire 1 month after surgery. Other measures included pain, range of motion, functional capacity, cancer-related fatigue, handgrip strength, physical activity, and arm circumferences.
Results: A total of 64 patients were randomized during the study period, and 61 completed all assessments. A significant difference in the main outcome (short version of the Disabilities of the Arm, Shoulder and Hand questionnaire) was found before surgery as patients in the control group experienced worsening in arm function (mean difference = -9.84, 95% CI = -17.7 to -2). In addition, they also showed increased symptom frequency/severity according to the combined scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) (mean difference = +6.7 points, 95% CI = 13.4 to 0.1) compared to the intervention group. Prehabilitation also improved functional capacity (mean difference = 67.6 m, 95% CI = 37.4 to 97.7) and physical activity levels and decreased cancer-related fatigue (mean difference = -1.3, 95% CI = -0.29 to -2.4) compared to the control group but had no effect on other secondary outcomes. After surgery, patients receiving prehabilitation also exhibited greater functional capacity at both 1 and 3 months. No other difference was observed.
Conclusion: A prehabilitation program was able to maintain arm function and increase functional capacity while decreasing fatigue in patients with breast cancer receiving NAT.
Impact: Prehabilitation programs should be offered to patients with breast cancer to maintain functionality and enhance physical performance before surgery.
Lay summary: An exercise program combined with therapeutic education in patients with breast cancer who receive neoadjuvant therapy before surgery can improve functional capacity and prevent declines of arm mobility and function.
{"title":"Effectiveness of an Exercise and Educational-Based Prehabilitation Program in Patients with Breast Cancer Receiving Neoadjuvant Chemotherapy (PREOptimize) on Functional Outcomes: A Randomized Controlled Trial.","authors":"Anabel Casanovas-Álvarez, Blanca Estanyol, Magda Ciendones, Josep Padròs, Jordi Cuartero, Agustí Barnadas, Bárbara García-Valdecasas, Rubèn González-Colom, Raquel Sebio-García, Jaume Masià","doi":"10.1093/ptj/pzae151","DOIUrl":"https://doi.org/10.1093/ptj/pzae151","url":null,"abstract":"<p><strong>Objective: </strong>The study objective was to determine the effectiveness of a prehabilitation program to decrease postoperative musculoskeletal impairments in patients who have breast cancer and are receiving neoadjuvant therapy (NAT).</p><p><strong>Methods: </strong>Patients who had breast cancer and were receiving NAT before surgery were invited to participate in this randomized controlled trial. Patients randomized to the intervention group participated in a group-based prehabilitation program consisting of Nordic walking, resistance training, and therapeutic education from month 4 of NAT until before surgery. Patients in the control group received usual care (no prehabilitation). The main outcome was arm function measured with the short version of the Disabilities of the Arm, Shoulder and Hand questionnaire 1 month after surgery. Other measures included pain, range of motion, functional capacity, cancer-related fatigue, handgrip strength, physical activity, and arm circumferences.</p><p><strong>Results: </strong>A total of 64 patients were randomized during the study period, and 61 completed all assessments. A significant difference in the main outcome (short version of the Disabilities of the Arm, Shoulder and Hand questionnaire) was found before surgery as patients in the control group experienced worsening in arm function (mean difference = -9.84, 95% CI = -17.7 to -2). In addition, they also showed increased symptom frequency/severity according to the combined scale of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30) (mean difference = +6.7 points, 95% CI = 13.4 to 0.1) compared to the intervention group. Prehabilitation also improved functional capacity (mean difference = 67.6 m, 95% CI = 37.4 to 97.7) and physical activity levels and decreased cancer-related fatigue (mean difference = -1.3, 95% CI = -0.29 to -2.4) compared to the control group but had no effect on other secondary outcomes. After surgery, patients receiving prehabilitation also exhibited greater functional capacity at both 1 and 3 months. No other difference was observed.</p><p><strong>Conclusion: </strong>A prehabilitation program was able to maintain arm function and increase functional capacity while decreasing fatigue in patients with breast cancer receiving NAT.</p><p><strong>Impact: </strong>Prehabilitation programs should be offered to patients with breast cancer to maintain functionality and enhance physical performance before surgery.</p><p><strong>Lay summary: </strong>An exercise program combined with therapeutic education in patients with breast cancer who receive neoadjuvant therapy before surgery can improve functional capacity and prevent declines of arm mobility and function.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Patients with chronic kidney disease reportedly have decreased muscle oxygen utilization, which most substantially decreases exercise capacity, followed by cardiac reserve. However, determinants of longitudinal changes in exercise capacity in patients on hemodialysis and the effects of long-term exercise interventions are unknown. This study was conducted to clarify these concerns.
Methods: This was a prospective cohort study. Patients on hemodialysis that were not hospitalized were followed from baseline up to 2 years, and cardiopulmonary exercise testing results, including peak oxygen uptake, peak work rate, heart rate reserve, and ventilatory equivalent for carbon dioxide slope, as well as implementation of exercise interventions were assessed. Based on the 2-year change in peak oxygen uptake, they were divided into improvement or declined groups.
Results: Forty-five patients who were not hospitalized completed the follow-up were analyzed. In the improvement group, the variation was determined by an increase in peak work rate, which is a peripheral factor (partial regression coefficient 0.08 [95% CI = 0.01 to 0.16]), while in the decline group, the variation was determined by a decrease in the ventilatory equivalent for carbon dioxide slope, which is a cardiac factor (partial regression coefficient = -0.12; 95% CI = -0.21 to -0.03). Moreover, exercise intervention was associated with the change in peak oxygen uptake (partial regression coefficient = 3.09; 95% CI = 1.45 to 4.72).
Conclusion: Exercise intolerance even in patients on hemodialysis that were not hospitalized and stable progressed over time with deterioration of cardiac reserve, whereas exercise interventions were associated with improved exercise capacity through enhanced peripheral function.
Impact: The results support the early measurement of cardiopulmonary or skeletal muscle reserve through cardiopulmonary exercise testing and the implementation of long-term exercise interventions based on the measurement results to address the potential deterioration in exercise capacity associated with reduced cardiac reserve, even in patients on hemodialysis that are asymptomatic and stable.
目的:据报道,慢性肾病患者的肌肉氧利用率下降,这对运动能力的影响最大,其次是心脏储备。然而,血液透析患者运动能力纵向变化的决定因素以及长期运动干预的效果尚不清楚。本研究旨在澄清这些问题:这是一项前瞻性队列研究。方法:这是一项前瞻性队列研究,对未住院的血液透析患者进行了长达 2 年的基线随访,并评估了心肺运动测试结果,包括峰值摄氧量、峰值做功率、心率储备和二氧化碳斜率通气当量,以及运动干预措施的实施情况。根据峰值摄氧量在两年内的变化,将他们分为改善组和下降组:结果:对完成随访的 45 名未住院患者进行了分析。在改善组中,变化取决于峰值工作率的增加,这是一个外周因素(部分回归系数为 0.08 [95% CI = 0.01 至 0.16]),而在下降组中,变化取决于二氧化碳通气当量斜率的下降,这是一个心脏因素(部分回归系数 = -0.12; 95% CI = -0.21 至 -0.03)。此外,运动干预与峰值摄氧量的变化有关(部分回归系数 = 3.09;95% CI = 1.45 至 4.72):结论:即使是未住院且病情稳定的血液透析患者,运动不耐受也会随着时间的推移而加重,导致心脏储备功能恶化,而运动干预与通过增强外周功能提高运动能力有关:研究结果支持通过心肺运动测试对心肺或骨骼肌储备进行早期测量,并根据测量结果实施长期运动干预,以解决因心脏储备减少而导致的潜在运动能力下降问题,即使是无症状且病情稳定的血液透析患者也不例外。
{"title":"Determinants of Longitudinal Changes in Exercise Capacity in Patients with Independent Functioning on Hemodialysis.","authors":"Naoto Usui, Junichiro Nakata, Akimi Uehata, Sho Kojima, Hideki Hisadome, Akihito Inatsu, Atsuhiro Tsubaki, Masakazu Saitoh, Shuji Ando, Tatsuro Kitayama, Kenta Maikusa, Yuki Nishiyama, Yusuke Suzuki","doi":"10.1093/ptj/pzae147","DOIUrl":"https://doi.org/10.1093/ptj/pzae147","url":null,"abstract":"<p><strong>Objective: </strong>Patients with chronic kidney disease reportedly have decreased muscle oxygen utilization, which most substantially decreases exercise capacity, followed by cardiac reserve. However, determinants of longitudinal changes in exercise capacity in patients on hemodialysis and the effects of long-term exercise interventions are unknown. This study was conducted to clarify these concerns.</p><p><strong>Methods: </strong>This was a prospective cohort study. Patients on hemodialysis that were not hospitalized were followed from baseline up to 2 years, and cardiopulmonary exercise testing results, including peak oxygen uptake, peak work rate, heart rate reserve, and ventilatory equivalent for carbon dioxide slope, as well as implementation of exercise interventions were assessed. Based on the 2-year change in peak oxygen uptake, they were divided into improvement or declined groups.</p><p><strong>Results: </strong>Forty-five patients who were not hospitalized completed the follow-up were analyzed. In the improvement group, the variation was determined by an increase in peak work rate, which is a peripheral factor (partial regression coefficient 0.08 [95% CI = 0.01 to 0.16]), while in the decline group, the variation was determined by a decrease in the ventilatory equivalent for carbon dioxide slope, which is a cardiac factor (partial regression coefficient = -0.12; 95% CI = -0.21 to -0.03). Moreover, exercise intervention was associated with the change in peak oxygen uptake (partial regression coefficient = 3.09; 95% CI = 1.45 to 4.72).</p><p><strong>Conclusion: </strong>Exercise intolerance even in patients on hemodialysis that were not hospitalized and stable progressed over time with deterioration of cardiac reserve, whereas exercise interventions were associated with improved exercise capacity through enhanced peripheral function.</p><p><strong>Impact: </strong>The results support the early measurement of cardiopulmonary or skeletal muscle reserve through cardiopulmonary exercise testing and the implementation of long-term exercise interventions based on the measurement results to address the potential deterioration in exercise capacity associated with reduced cardiac reserve, even in patients on hemodialysis that are asymptomatic and stable.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Matan Grunfeld, Taylor J Reif, S Robert Rozbruch, Jason S Hoellwarth
Objective: Lower-extremity transcutaneous osseointegration is a rehabilitation alternative to socket-suspended prostheses. The rehabilitation process, philosophies, and routines remain under-described. This review, primarily, identifies commonalities and differences among protocols. Secondarily, strategies are proposed to streamline future research of post-osseointegration surgery rehabilitation.
Methods: Two differently phrased queries of Google Scholar, Pubmed, Embase, and Web of Science were performed. First using either "osseointegration" or "osseointegrated" or "bone anchored prosthesis" AND [last name]. Second, replacing author name with "physical therapy" or "rehabilitation." Six hundred eighty-eight articles were identified describing lower-extremity rehabilitation following osseointegration. Following software-based deduplication, manual abstract and full-text review, article reference evaluation, and use of Google Scholar's "Cited by" feature, 35 studies were fully analyzed. First, a consolidated summary was made of protocols focusing on stages, timing, and other descriptions of postoperative rehabilitation. Subsequently, strengths and limitations of protocols were considered to propose potential strategies to investigate and optimize postoperative rehabilitation.
Results: All articles describe rehabilitation having this same order of goal progression: from surgery to gradual weight bearing and final goal of independent ambulation. The most impactful difference influencing the stated final goal of independent ambulation was whether 1 or 2 surgical stages were performed. No articles reported patient success rate achieving proposed goals and timing, or challenges during rehabilitation. Therefore, the first research suggestion is to investigate actual success rates achieving proposed goals and timing. Second, to further explore rehabilitation of performance deficits, beyond unaided ambulation. Finally, to incorporate technology such as mobility trackers to more objectively understand prosthesis use and mobility.
Conclusion: All lower-extremity osseointegration rehabilitation literature recommends identical goal progression order. No studies evaluate patient challenges or variation. Understanding and addressing such challenges may enhance postoperative rehabilitation.
Impact: This article consolidates published rehabilitation protocols post-osseointegration surgery. Specific analysis and experimentation of the protocols may enhance the uniformity and potential of patient rehabilitation.
目的:下肢经皮骨结合是一种替代插座悬吊式假体的康复方法。关于康复过程、理念和常规的描述仍然不足。这篇综述主要指出了各种方案之间的共性和差异。其次,还提出了简化未来骨结合手术后康复研究的策略:方法:对 Google Scholar、Pubmed、Embase 和 Web of Science 进行了两种不同措辞的查询。首先使用 "osseointegration "或 "osseointegrated "或 "bone anchored prosthesis "和[姓氏]。其次,将作者姓名替换为 "物理治疗 "或 "康复"。共找到 68 篇描述骨结合术后下肢康复的文章。经过基于软件的重复数据删除、人工摘要和全文审阅、文章参考文献评估以及使用谷歌学术的 "被引用者 "功能,对 35 篇研究进行了全面分析。首先,针对术后康复的阶段、时间和其他描述,对方案进行了综合总结。随后,考虑了方案的优势和局限性,提出了研究和优化术后康复的潜在策略:结果:所有文章对康复的描述都遵循相同的目标进展顺序:从手术到逐渐负重,最后达到独立行走的目标。影响所述独立行走这一最终目标的最大不同之处在于是进行一个还是两个手术阶段。没有文章报告患者实现既定目标的成功率、时间安排或康复过程中遇到的挑战。因此,第一项研究建议是调查实现既定目标和时间安排的实际成功率。其次,进一步探索除无辅助行走以外的康复表现缺陷。最后,结合移动跟踪器等技术,更客观地了解假肢的使用和移动情况:结论:所有下肢骨结合康复文献都推荐了相同的目标进展顺序。没有研究对患者面临的挑战或差异进行评估。了解并应对这些挑战可提高术后康复效果:本文整合了已发表的骨结合术后康复方案。对方案进行具体分析和实验,可提高患者康复的统一性和潜力。
{"title":"Lower Extremity Osseointegration Postoperative Rehabilitation Protocols: A Scoping Review.","authors":"Matan Grunfeld, Taylor J Reif, S Robert Rozbruch, Jason S Hoellwarth","doi":"10.1093/ptj/pzae139","DOIUrl":"https://doi.org/10.1093/ptj/pzae139","url":null,"abstract":"<p><strong>Objective: </strong>Lower-extremity transcutaneous osseointegration is a rehabilitation alternative to socket-suspended prostheses. The rehabilitation process, philosophies, and routines remain under-described. This review, primarily, identifies commonalities and differences among protocols. Secondarily, strategies are proposed to streamline future research of post-osseointegration surgery rehabilitation.</p><p><strong>Methods: </strong>Two differently phrased queries of Google Scholar, Pubmed, Embase, and Web of Science were performed. First using either \"osseointegration\" or \"osseointegrated\" or \"bone anchored prosthesis\" AND [last name]. Second, replacing author name with \"physical therapy\" or \"rehabilitation.\" Six hundred eighty-eight articles were identified describing lower-extremity rehabilitation following osseointegration. Following software-based deduplication, manual abstract and full-text review, article reference evaluation, and use of Google Scholar's \"Cited by\" feature, 35 studies were fully analyzed. First, a consolidated summary was made of protocols focusing on stages, timing, and other descriptions of postoperative rehabilitation. Subsequently, strengths and limitations of protocols were considered to propose potential strategies to investigate and optimize postoperative rehabilitation.</p><p><strong>Results: </strong>All articles describe rehabilitation having this same order of goal progression: from surgery to gradual weight bearing and final goal of independent ambulation. The most impactful difference influencing the stated final goal of independent ambulation was whether 1 or 2 surgical stages were performed. No articles reported patient success rate achieving proposed goals and timing, or challenges during rehabilitation. Therefore, the first research suggestion is to investigate actual success rates achieving proposed goals and timing. Second, to further explore rehabilitation of performance deficits, beyond unaided ambulation. Finally, to incorporate technology such as mobility trackers to more objectively understand prosthesis use and mobility.</p><p><strong>Conclusion: </strong>All lower-extremity osseointegration rehabilitation literature recommends identical goal progression order. No studies evaluate patient challenges or variation. Understanding and addressing such challenges may enhance postoperative rehabilitation.</p><p><strong>Impact: </strong>This article consolidates published rehabilitation protocols post-osseointegration surgery. Specific analysis and experimentation of the protocols may enhance the uniformity and potential of patient rehabilitation.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Laura Fuentes-Aparicio, Sofia Pérez-Alenda, Juan J Carrasco, Begoña Valls-Donderis, Lirios Dueñas, Mercè Balasch-Bernat
Objective: The purpose of this study was to evaluate the differences between primiparous and multiparous women at 6 months postpartum and nulliparous women regarding the thickness (including thickness pattern) and contractile function of the abdominal and lumbar muscles.
Methods: A cross-sectional observational study of 80 women, both primiparous (n = 29) and multiparous (n = 25), as well as including nulliparous as a comparison group (n = 26), was conducted. B-mode ultrasound imaging was used for the measurement of abdominal and lumbar muscle thickness in 2 conditions (resting and activation). Moreover, the contractile function of these muscles was determined by the thickness ratio.
Results: Significant differences between groups were observed in abdominal muscle thickness. During activation, the obliques showed a lower thickness in both groups of postpartum women compared to nulliparous women, while lower values for the thickness for the transverse abdominis (TrA) were only observed in primiparous women. The thickness pattern observed in nulliparous women both in resting and in activation (internal oblique [IO] > external oblique [EO] > TrA) was also achieved among postpartum women, despite no statistical differences observed between IO and EO in these groups. No significant differences between groups were observed for contractile function, showing the TrA greater values, followed by IO and EO in both nulliparous and postpartum women.
Conclusions: This study suggests that the thickness (and the thickness pattern) of the abdominal muscles in women at 6 months postpartum differs from nulliparous, while for the lumbar muscles, it is comparable to nulliparous. However, despite the obliques being thinner in postpartum women, the abdominal muscles are functionally competent.
Impact: This is believed to be the first study to compare abdominal and lumbar muscles thickness and contractile function specifically between primiparous and multiparous women. Although at 6 months' postpartum abdominal thickness differs from nulliparous women, these muscles are functionally competent. These findings provide valuable insights for use in the development of postpartum interventions.
{"title":"Differences in Abdominal and Lumbar Muscle Thickness and Contractile Function Between Nulliparous, Primiparous, and Multiparous Women 6 Months Postpartum.","authors":"Laura Fuentes-Aparicio, Sofia Pérez-Alenda, Juan J Carrasco, Begoña Valls-Donderis, Lirios Dueñas, Mercè Balasch-Bernat","doi":"10.1093/ptj/pzae141","DOIUrl":"https://doi.org/10.1093/ptj/pzae141","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the differences between primiparous and multiparous women at 6 months postpartum and nulliparous women regarding the thickness (including thickness pattern) and contractile function of the abdominal and lumbar muscles.</p><p><strong>Methods: </strong>A cross-sectional observational study of 80 women, both primiparous (n = 29) and multiparous (n = 25), as well as including nulliparous as a comparison group (n = 26), was conducted. B-mode ultrasound imaging was used for the measurement of abdominal and lumbar muscle thickness in 2 conditions (resting and activation). Moreover, the contractile function of these muscles was determined by the thickness ratio.</p><p><strong>Results: </strong>Significant differences between groups were observed in abdominal muscle thickness. During activation, the obliques showed a lower thickness in both groups of postpartum women compared to nulliparous women, while lower values for the thickness for the transverse abdominis (TrA) were only observed in primiparous women. The thickness pattern observed in nulliparous women both in resting and in activation (internal oblique [IO] > external oblique [EO] > TrA) was also achieved among postpartum women, despite no statistical differences observed between IO and EO in these groups. No significant differences between groups were observed for contractile function, showing the TrA greater values, followed by IO and EO in both nulliparous and postpartum women.</p><p><strong>Conclusions: </strong>This study suggests that the thickness (and the thickness pattern) of the abdominal muscles in women at 6 months postpartum differs from nulliparous, while for the lumbar muscles, it is comparable to nulliparous. However, despite the obliques being thinner in postpartum women, the abdominal muscles are functionally competent.</p><p><strong>Impact: </strong>This is believed to be the first study to compare abdominal and lumbar muscles thickness and contractile function specifically between primiparous and multiparous women. Although at 6 months' postpartum abdominal thickness differs from nulliparous women, these muscles are functionally competent. These findings provide valuable insights for use in the development of postpartum interventions.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Silvia Salvalaggio, Simone Gambazza, Martina Ando', Ilaria Parrotta, Francesca Burgio, Laura Danesin, Pierpaolo Busan, Sara Zago, Dante Mantini, Daniela D'Imperio, Marco Zorzi, Nicola Filippini, Andrea Turolla
Objective: People who have survived stroke may have motor and cognitive impairments. High dose of motor rehabilitation was found to provide clinically relevant improvement to upper limb (UL) motor function. Besides, mounting evidence suggests that clinical, neural, and neurophysiological features are associated with spontaneous recovery. However, the association between these features and rehabilitation-induced, rather than spontaneous, recovery has never been fully investigated.The objective was to explore the association between rehabilitation dose and UL motor outcome after stroke, as well as to identify which variables can be considered potential candidate predictors of motor recovery.
Methods: People who survived stroke were assessed before and after a period of rehabilitation using motor, cognitive, neuroanatomical, and neurophysiological measures. We investigated the association between dose of rehabilitation and UL response (ie, Fugl-Meyer Assessment for upper extremity [FMA-UE]), using ordinary least squares regression as the primary analysis. To obtain unbiased estimates, adjusting covariates were selected using a directed acyclic graph.
Results: Baseline FMA-UE was the only factor associated with motor recovery (b = 0.99; 95% CI = 0.83 to 1.15 points). Attention emerged as a confounder of the association between rehabilitation and final FMA-UE (b = 5.5; 95% CI = -0.8 to 11.9 points), influencing both rehabilitation and UL response.
Conclusion: Preserved attention in people who have survived stroke might lead to greater UL motor recovery, albeit estimates have high levels of variability. Moreover, the increase in the dose of rehabilitation can lead to 5.5 points improvement on the FMA-UE, a nonsignificant but potentially meaningful finding. The approach described here discloses a new framework for investigating the effect of rehabilitation treatment as a potential driver of recovery.
Impact: Attentional resources could play a key role in UL motor recovery. There is a potential association between amount of UL recovery and dose of rehabilitation delivered, needing further exploration. Preserved attention and rehabilitation dose are candidate predictors of UL motor recovery.
目的中风后幸存者可能存在运动和认知障碍。研究发现,大剂量的运动康复训练可在临床上改善上肢(UL)的运动功能。此外,越来越多的证据表明,临床、神经和神经生理学特征与自发康复有关。本研究旨在探讨康复剂量与脑卒中后上肢运动结果之间的关系,并确定哪些变量可被视为运动恢复的潜在候选预测因子:方法:对脑卒中幸存者进行康复治疗前后的运动、认知、神经解剖和神经生理学评估。我们使用普通最小二乘法回归作为主要分析方法,研究了康复剂量与 UL 反应(即上肢 Fugl-Meyer 评估 [FMA-UE])之间的关系。为获得无偏估计值,使用有向无环图选择调整协变量:结果:基线 FMA-UE 是与运动恢复相关的唯一因素(b = 0.99;95% CI = 0.83 至 1.15 分)。注意力是影响康复和最终FMA-UE之间关系的混淆因素(b = 5.5;95% CI = -0.8至11.9分),同时影响康复和UL反应:结论:中风后遗症患者保持注意力可能会导致更大的超能力运动恢复,尽管估计值存在很大的变异性。此外,康复剂量的增加可使 FMA-UE 提高 5.5 分,这一结果并不显著,但可能很有意义。本文所描述的方法为研究康复治疗作为康复潜在驱动力的效果提供了一个新的框架:影响:注意力资源可能在 UL 运动康复中发挥关键作用。UL恢复量与康复剂量之间存在潜在联系,需要进一步探讨。保持注意力和康复剂量是UL运动康复的候选预测因素。
{"title":"Modeling Upper Limb Rehabilitation-Induced Recovery after Stroke: The Role of Attention as a Clinical Confounder.","authors":"Silvia Salvalaggio, Simone Gambazza, Martina Ando', Ilaria Parrotta, Francesca Burgio, Laura Danesin, Pierpaolo Busan, Sara Zago, Dante Mantini, Daniela D'Imperio, Marco Zorzi, Nicola Filippini, Andrea Turolla","doi":"10.1093/ptj/pzae148","DOIUrl":"https://doi.org/10.1093/ptj/pzae148","url":null,"abstract":"<p><strong>Objective: </strong>People who have survived stroke may have motor and cognitive impairments. High dose of motor rehabilitation was found to provide clinically relevant improvement to upper limb (UL) motor function. Besides, mounting evidence suggests that clinical, neural, and neurophysiological features are associated with spontaneous recovery. However, the association between these features and rehabilitation-induced, rather than spontaneous, recovery has never been fully investigated.The objective was to explore the association between rehabilitation dose and UL motor outcome after stroke, as well as to identify which variables can be considered potential candidate predictors of motor recovery.</p><p><strong>Methods: </strong>People who survived stroke were assessed before and after a period of rehabilitation using motor, cognitive, neuroanatomical, and neurophysiological measures. We investigated the association between dose of rehabilitation and UL response (ie, Fugl-Meyer Assessment for upper extremity [FMA-UE]), using ordinary least squares regression as the primary analysis. To obtain unbiased estimates, adjusting covariates were selected using a directed acyclic graph.</p><p><strong>Results: </strong>Baseline FMA-UE was the only factor associated with motor recovery (b = 0.99; 95% CI = 0.83 to 1.15 points). Attention emerged as a confounder of the association between rehabilitation and final FMA-UE (b = 5.5; 95% CI = -0.8 to 11.9 points), influencing both rehabilitation and UL response.</p><p><strong>Conclusion: </strong>Preserved attention in people who have survived stroke might lead to greater UL motor recovery, albeit estimates have high levels of variability. Moreover, the increase in the dose of rehabilitation can lead to 5.5 points improvement on the FMA-UE, a nonsignificant but potentially meaningful finding. The approach described here discloses a new framework for investigating the effect of rehabilitation treatment as a potential driver of recovery.</p><p><strong>Impact: </strong>Attentional resources could play a key role in UL motor recovery. There is a potential association between amount of UL recovery and dose of rehabilitation delivered, needing further exploration. Preserved attention and rehabilitation dose are candidate predictors of UL motor recovery.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alexandre Luc, Nicolas Lambricht, Isabelle Aujoulat, Christine Detrembleur, Laurent Pitance
Objective: The purpose of this study was to explore the experiences of individuals with persistent nonspecific neck pain who used immersive virtual reality (VR) serious games at home for 2 weeks.
Methods: In this descriptive qualitative study, semi-structured one-on-one interviews were conducted at the participant's home after the 2-week period. Interviews were analyzed using qualitative content analysis. Sample size was determined using the information power concept (where "information power" refers to the amount of relevant information the sample provides for addressing the research question).
Results: Eleven adults with continuous or recurrent nonspecific neck pain participated in the study. Three main categories were identified. The first revolves around the home environment, revealing that participants had mixed perceptions about being at home, yet held a positive perspective on the utilization of immersive VR in that setting. The second pertains to immersive VR as a novel technology, indicating its overall comfort, user-friendliness, and varying degrees of immersion and presence experienced by the participants. The third focuses on exercising in immersive VR, drawing comparisons with conventional exercises, exploring the facilitators and barriers to usage, and addressing various aspects of integrating this technology into rehabilitation.
Conclusion: Immersive VR was deemed comfortable for almost all participants and easy to use. Participants found exercising in immersive VR motivating and enjoyable, compared to conventional exercises. The home environment proved suitable for using immersive VR, though challenges included autonomy and reduced human contact. Participants highlighted facilitators and barriers in using immersive VR serious games, as well as immersive VR's rehabilitation potential. They also underscored the crucial role of physical therapists for guidance, remote supervision, and personalized treatment.
Impact: These findings could help clinicians to better understand the experiences of individuals with persistent nonspecific neck pain when using immersive VR, as well as its use at home. This understanding can improve patient care and optimize the effectiveness of immersive VR as a treatment method.
{"title":"Experiences of People With Persistent Nonspecific Neck Pain Who Used Immersive Virtual Reality Serious Games in the Home Setting: A Qualitative Study.","authors":"Alexandre Luc, Nicolas Lambricht, Isabelle Aujoulat, Christine Detrembleur, Laurent Pitance","doi":"10.1093/ptj/pzae149","DOIUrl":"https://doi.org/10.1093/ptj/pzae149","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to explore the experiences of individuals with persistent nonspecific neck pain who used immersive virtual reality (VR) serious games at home for 2 weeks.</p><p><strong>Methods: </strong>In this descriptive qualitative study, semi-structured one-on-one interviews were conducted at the participant's home after the 2-week period. Interviews were analyzed using qualitative content analysis. Sample size was determined using the information power concept (where \"information power\" refers to the amount of relevant information the sample provides for addressing the research question).</p><p><strong>Results: </strong>Eleven adults with continuous or recurrent nonspecific neck pain participated in the study. Three main categories were identified. The first revolves around the home environment, revealing that participants had mixed perceptions about being at home, yet held a positive perspective on the utilization of immersive VR in that setting. The second pertains to immersive VR as a novel technology, indicating its overall comfort, user-friendliness, and varying degrees of immersion and presence experienced by the participants. The third focuses on exercising in immersive VR, drawing comparisons with conventional exercises, exploring the facilitators and barriers to usage, and addressing various aspects of integrating this technology into rehabilitation.</p><p><strong>Conclusion: </strong>Immersive VR was deemed comfortable for almost all participants and easy to use. Participants found exercising in immersive VR motivating and enjoyable, compared to conventional exercises. The home environment proved suitable for using immersive VR, though challenges included autonomy and reduced human contact. Participants highlighted facilitators and barriers in using immersive VR serious games, as well as immersive VR's rehabilitation potential. They also underscored the crucial role of physical therapists for guidance, remote supervision, and personalized treatment.</p><p><strong>Impact: </strong>These findings could help clinicians to better understand the experiences of individuals with persistent nonspecific neck pain when using immersive VR, as well as its use at home. This understanding can improve patient care and optimize the effectiveness of immersive VR as a treatment method.</p>","PeriodicalId":20093,"journal":{"name":"Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142472420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}