Cara Vernacchia, Elizabeth Brown, Priya Mhatre, Leslie Rydberg
Physical medicine and rehabilitation (PM&R) is a specialty of medicine that focuses on function and the care of people with disabilities. Many medical schools offer PM&R content by means of PM&R clerkships for career development purposes with varying curricula and assessments; however, there is limited information regarding the optimal way to teach clinical skills relating to the field of PM&R. This narrative review study was performed to evaluate PM&R specific clinical curricular interventions. The review included a PubMed search that yielded 63 articles and a Cumulated Index to Nursing and Allied Health Literature (CINAHL) search of 175 articles. A total of 14 articles were selected for review. PM&R clerkships were found to have a variety of educational interventions, including inpatient and outpatient clinical experiences, lectures, Objective Structured Clinical Examinations (OSCEs), case discussions, written examinations, physical examination sessions, cadaver sessions, small group discussions, and virtual education. PM&R rotations can improve neurologic and musculoskeletal physical examination skills, PM&R specific knowledge, and confidence in PM&R skills. More research is needed to determine the optimal methods to teach and assess PM&R knowledge and skills in the clinical setting to drive future PM&R curriculum development and educational innovations.
{"title":"Physical medicine and rehabilitation clinical experiences: A narrative review of curricula and educational interventions","authors":"Cara Vernacchia, Elizabeth Brown, Priya Mhatre, Leslie Rydberg","doi":"10.1002/pmrj.13262","DOIUrl":"https://doi.org/10.1002/pmrj.13262","url":null,"abstract":"Physical medicine and rehabilitation (PM&R) is a specialty of medicine that focuses on function and the care of people with disabilities. Many medical schools offer PM&R content by means of PM&R clerkships for career development purposes with varying curricula and assessments; however, there is limited information regarding the optimal way to teach clinical skills relating to the field of PM&R. This narrative review study was performed to evaluate PM&R specific clinical curricular interventions. The review included a PubMed search that yielded 63 articles and a Cumulated Index to Nursing and Allied Health Literature (CINAHL) search of 175 articles. A total of 14 articles were selected for review. PM&R clerkships were found to have a variety of educational interventions, including inpatient and outpatient clinical experiences, lectures, Objective Structured Clinical Examinations (OSCEs), case discussions, written examinations, physical examination sessions, cadaver sessions, small group discussions, and virtual education. PM&R rotations can improve neurologic and musculoskeletal physical examination skills, PM&R specific knowledge, and confidence in PM&R skills. More research is needed to determine the optimal methods to teach and assess PM&R knowledge and skills in the clinical setting to drive future PM&R curriculum development and educational innovations.","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142251634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Miguel Ángel Rodríguez, Irene Crespo, Marcos Quintana‐Cepedal, María Fernández‐del Valle, Miguel del Valle, Hugo Olmedillas
ObjectivesThis systematic review with meta‐analysis aimed to examine the effect of blood flow restriction resistance training (BFR‐RT) on strength gains in untrained limbs (remote strength transfer [RST]).Literature SurveyA search for studies was performed using six databases (PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, SPORTDiscus, and ScienceDirect) up to February 2024.MethodologyStudies that assessed the RST phenomenon following BFR‐RT and measured muscle strength were included. Meta‐analyses of standardized mean differences (SMDs) were performed using a random‐effects model to determine the effect of BFR‐RT on RST.SynthesisEight studies were included in this systematic review, of which six were involved in the meta‐analyses. BFR‐RT was not found to enhance RST in comparison with RT (SMD 0.27, 95% confidence interval [CI]: −0.02 to 0.56; p = .07). These findings did not vary when the comparison was examined in upper limbs or measured using an isometric contraction.ConclusionsBFR‐RT does not enhance RST in comparison with traditional RT at the same load according to the meta‐analyses. Therefore, the usage of BFR is not recommended for RST.
{"title":"Can blood‐flow restriction resistance training enhance remote strength transfer? A systematic review with meta‐analysis","authors":"Miguel Ángel Rodríguez, Irene Crespo, Marcos Quintana‐Cepedal, María Fernández‐del Valle, Miguel del Valle, Hugo Olmedillas","doi":"10.1002/pmrj.13200","DOIUrl":"https://doi.org/10.1002/pmrj.13200","url":null,"abstract":"ObjectivesThis systematic review with meta‐analysis aimed to examine the effect of blood flow restriction resistance training (BFR‐RT) on strength gains in untrained limbs (remote strength transfer [RST]).Literature SurveyA search for studies was performed using six databases (PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, SPORTDiscus, and ScienceDirect) up to February 2024.MethodologyStudies that assessed the RST phenomenon following BFR‐RT and measured muscle strength were included. Meta‐analyses of standardized mean differences (SMDs) were performed using a random‐effects model to determine the effect of BFR‐RT on RST.SynthesisEight studies were included in this systematic review, of which six were involved in the meta‐analyses. BFR‐RT was not found to enhance RST in comparison with RT (SMD 0.27, 95% confidence interval [CI]: −0.02 to 0.56; <jats:italic>p</jats:italic> = .07). These findings did not vary when the comparison was examined in upper limbs or measured using an isometric contraction.ConclusionsBFR‐RT does not enhance RST in comparison with traditional RT at the same load according to the meta‐analyses. Therefore, the usage of BFR is not recommended for RST.","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141530106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Creating and confirming observable professional activities (OPAs): A pilot study evaluating the feasibility of OPAs on a residency inpatient spinal cord injury rotation","authors":"Shane N. Stone, Manasi Sheth, Leslie Rydberg","doi":"10.1002/pmrj.13194","DOIUrl":"https://doi.org/10.1002/pmrj.13194","url":null,"abstract":"","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Eric J. Roseen, Christopher Joyce, Sophie Winbush, Natalie Pavco‐Luttschwager, Natalia E. Morone, Robert B. Saper, Stephen Bartels, Kushang V. Patel, Julie J. Keysor, Jonathan F. Bean, Lance D. Laird
BackgroundClinical practice guidelines encourage primary care providers (PCPs) to recommend nonpharmacologic treatment as first‐line therapy for low back pain (LBP). However, the determinants of nonpharmacologic treatment use for LBP in primary care remain unclear, particularly in low‐income settings.ObjectiveTo pilot a framework‐informed interview guide and codebook to explore determinants of nonpharmacologic treatment use in primary care.MethodsIn this qualitative interview study, we enrolled PCPs and community health workers (CHWs) from four primary care clinics at a safety net hospital. A semistructured interview guide informed by the Consolidated Framework for Implementation Research (CFIR) guided inquiry on barriers/facilitators to nonpharmacologic treatments for LBP (eg, acupuncture, chiropractic care, physical therapy). We included questions on whether current CHW roles may address barriers to nonpharmacologic treatment use. Interviews were audio‐recorded, transcribed verbatim, and independently coded by four investigators. An a priori codebook composed of CFIR determinants and known CHW roles guided deductive content analysis to identify major themes.ResultsEight individuals (six PCPs, two CHWs; age range: 32–51 years, five female) participated in hour‐long interviews. Half had worked at the hospital for ≥15 years and all reported seeing patients with LBP (range: 2–20 patients per week). All participants identified the following CFIR factors as barriers/facilitators: nonpharmacologic treatment characteristics (perceived cost, relative advantage compared to other treatments); outer setting (patient needs/resources, limited connections with community‐based nonpharmacologic treatment) and PCP characteristics (attitudes/beliefs about nonpharmacologic treatments). Although participants indicated several CHW roles could be adapted to address barriers (eg, care coordination, resource linking, case management), other roles seemed less feasible (eg, targeted health education) in our health care system.ConclusionsPreliminary insight on key determinants of nonpharmacologic treatments for LBP should be further examined in large multisite studies. Future studies may also determine whether a CHW‐led strategy can improve nonpharmacologic treatment access and clinical outcomes in primary care.
{"title":"Primary care barriers and facilitators to nonpharmacologic treatments for low back pain: A qualitative pilot study","authors":"Eric J. Roseen, Christopher Joyce, Sophie Winbush, Natalie Pavco‐Luttschwager, Natalia E. Morone, Robert B. Saper, Stephen Bartels, Kushang V. Patel, Julie J. Keysor, Jonathan F. Bean, Lance D. Laird","doi":"10.1002/pmrj.13183","DOIUrl":"https://doi.org/10.1002/pmrj.13183","url":null,"abstract":"BackgroundClinical practice guidelines encourage primary care providers (PCPs) to recommend nonpharmacologic treatment as first‐line therapy for low back pain (LBP). However, the determinants of nonpharmacologic treatment use for LBP in primary care remain unclear, particularly in low‐income settings.ObjectiveTo pilot a framework‐informed interview guide and codebook to explore determinants of nonpharmacologic treatment use in primary care.MethodsIn this qualitative interview study, we enrolled PCPs and community health workers (CHWs) from four primary care clinics at a safety net hospital. A semistructured interview guide informed by the Consolidated Framework for Implementation Research (CFIR) guided inquiry on barriers/facilitators to nonpharmacologic treatments for LBP (eg, acupuncture, chiropractic care, physical therapy). We included questions on whether current CHW roles may address barriers to nonpharmacologic treatment use. Interviews were audio‐recorded, transcribed verbatim, and independently coded by four investigators. An a priori codebook composed of CFIR determinants and known CHW roles guided deductive content analysis to identify major themes.ResultsEight individuals (six PCPs, two CHWs; age range: 32–51 years, five female) participated in hour‐long interviews. Half had worked at the hospital for ≥15 years and all reported seeing patients with LBP (range: 2–20 patients per week). All participants identified the following CFIR factors as barriers/facilitators: nonpharmacologic treatment characteristics (perceived cost, relative advantage compared to other treatments); outer setting (patient needs/resources, limited connections with community‐based nonpharmacologic treatment) and PCP characteristics (attitudes/beliefs about nonpharmacologic treatments). Although participants indicated several CHW roles could be adapted to address barriers (eg, care coordination, resource linking, case management), other roles seemed less feasible (eg, targeted health education) in our health care system.ConclusionsPreliminary insight on key determinants of nonpharmacologic treatments for LBP should be further examined in large multisite studies. Future studies may also determine whether a CHW‐led strategy can improve nonpharmacologic treatment access and clinical outcomes in primary care.","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140842042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sean Dreyer, Christopher Lewis, Kyle Fahey, Hannah Martin, Larissa Pavone, Sofia Anastasopoulos, Gaurish Sohi, Leslie Rydberg, Prakash Jayabalan
BackgroundSurvivors of hospitalization for severe acute COVID‐19 infection faced significant functional impairments necessitating discharge to inpatient rehabilitation facilities (IRFs) for intensive rehabilitation prior to discharge home. There remains a lack of large cohort studies of the functional outcomes of patients admitted to IRFs with COVID‐19‐related impairments and the relationship to patient‐specific factors.ObjectiveTo characterize functional outcomes of patients admitted to IRFs for COVID‐19‐related debility and to investigate associations between functional outcomes and patient‐specific factors.DesignMultisite retrospective cohort study.SettingMultiple IRFs in a large urban city.ParticipantsAdult patients admitted to IRFs for rehabilitation after hospitalization for acute COVID‐19 infection.InterventionsNot applicable.Main Outcome MeasuresPrimary outcomes included change in GG Self‐Care and Mobility Activities subscales and Functional Independence Measure scores from admission to discharge from inpatient rehabilitation. Linear regression analysis was used to relate functional changes to demographic, medical, and hospitalization‐specific factors. Secondary outcomes included discharge destination from the IRF.ResultsThe analysis included n = 362 patients admitted to IRFs for COVID‐19‐related rehabilitation needs. This cohort showed significant improvements in mobility, self‐care, and cognition congregate scores (216.0%, 174.3%, 117.6% respectively). Patient‐specific factors associated with functional improvement, included age, body mass index, premorbid employment status, history of diabetes and cardiac disease and medications received in acute care, and muscle strength upon admission to IRF.ConclusionsPatients admitted to inpatient rehabilitation for COVID‐19‐related functional deficits made significant functional improvements in mobility, self‐care, and cognition. Many significant associations were found between patient‐specific factors and functional improvement, which support further investigation of these factors as possible predictors of functional improvement in an IRF for COVID‐19‐related deficits.
{"title":"The relationship between patient‐specific factors and functional progression of COVID‐19 survivors admitted to an inpatient rehabilitation facility","authors":"Sean Dreyer, Christopher Lewis, Kyle Fahey, Hannah Martin, Larissa Pavone, Sofia Anastasopoulos, Gaurish Sohi, Leslie Rydberg, Prakash Jayabalan","doi":"10.1002/pmrj.13187","DOIUrl":"https://doi.org/10.1002/pmrj.13187","url":null,"abstract":"BackgroundSurvivors of hospitalization for severe acute COVID‐19 infection faced significant functional impairments necessitating discharge to inpatient rehabilitation facilities (IRFs) for intensive rehabilitation prior to discharge home. There remains a lack of large cohort studies of the functional outcomes of patients admitted to IRFs with COVID‐19‐related impairments and the relationship to patient‐specific factors.ObjectiveTo characterize functional outcomes of patients admitted to IRFs for COVID‐19‐related debility and to investigate associations between functional outcomes and patient‐specific factors.DesignMultisite retrospective cohort study.SettingMultiple IRFs in a large urban city.ParticipantsAdult patients admitted to IRFs for rehabilitation after hospitalization for acute COVID‐19 infection.InterventionsNot applicable.Main Outcome MeasuresPrimary outcomes included change in GG Self‐Care and Mobility Activities subscales and Functional Independence Measure scores from admission to discharge from inpatient rehabilitation. Linear regression analysis was used to relate functional changes to demographic, medical, and hospitalization‐specific factors. Secondary outcomes included discharge destination from the IRF.ResultsThe analysis included <jats:italic>n</jats:italic> = 362 patients admitted to IRFs for COVID‐19‐related rehabilitation needs. This cohort showed significant improvements in mobility, self‐care, and cognition congregate scores (216.0%, 174.3%, 117.6% respectively). Patient‐specific factors associated with functional improvement, included age, body mass index, premorbid employment status, history of diabetes and cardiac disease and medications received in acute care, and muscle strength upon admission to IRF.ConclusionsPatients admitted to inpatient rehabilitation for COVID‐19‐related functional deficits made significant functional improvements in mobility, self‐care, and cognition. Many significant associations were found between patient‐specific factors and functional improvement, which support further investigation of these factors as possible predictors of functional improvement in an IRF for COVID‐19‐related deficits.","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832264","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sonal Oza, Andy Kramer, Jian Ying, Daniel M. Cushman
BackgroundPhysical function is associated with cancer‐related quality of life and survival. The correlation of patient‐reported and objective measures of physical function has not been quantified previously in the cancer rehabilitation medicine setting.ObjectiveTo correlate patient‐reported physical function with objective measures of physical function. The secondary aim is to correlate fatigue and social participation levels with objective measures of physical function.DesignRetrospective.SettingTertiary university cancer center.ParticipantsA total of 226 cancer survivors referred to an outpatient cancer rehabilitation medicine clinic.InterventionNot applicable.Main Outcome MeasureCorrelation of Patient‐Reported Outcomes Measurement Information System (PROMIS) Cancer Function Brief 3D Profile domains with objective physical function measured by the 30‐second sit‐to‐stand and hand grip strength.ResultsPearson correlation analysis revealed a moderate correlation between patient‐reported physical function and the 30‐second sit‐to‐stand test (r = 0.57; p <.001), and a weak correlation of patient‐reported physical function and handgrip strength (r = 0.27; p <.001). Multivariable regression modeling controlling for age, gender, and receipt of systemic therapy demonstrated a significant association between patient‐reported physical function and the 30‐second sit‐to‐stand test (estimated confidence interval 0.76 [0.60, 0.92], p < .01), in addition to patient‐reported function and handgrip strength (estimated 0.22 [0.10, 0.34], p < .01). Multiple myeloma but no other cancer type was inversely associated with lower physical function.ConclusionsPatient‐reported physical function correlated moderately with the 30‐second sit‐to‐stand test, whereas hand grip strength demonstrated a weak correlation. The 30‐second sit‐to‐stand test is a suitable substitute for patient‐reported physical function. Further work evaluating how measures relate to each other across cancer populations is needed before recommending a standardized set of outcome measures.
{"title":"The relationship between patient‐reported and objective measures of physical function among cancer survivors receiving rehabilitation care: A correlation analysis","authors":"Sonal Oza, Andy Kramer, Jian Ying, Daniel M. Cushman","doi":"10.1002/pmrj.13182","DOIUrl":"https://doi.org/10.1002/pmrj.13182","url":null,"abstract":"BackgroundPhysical function is associated with cancer‐related quality of life and survival. The correlation of patient‐reported and objective measures of physical function has not been quantified previously in the cancer rehabilitation medicine setting.ObjectiveTo correlate patient‐reported physical function with objective measures of physical function. The secondary aim is to correlate fatigue and social participation levels with objective measures of physical function.DesignRetrospective.SettingTertiary university cancer center.ParticipantsA total of 226 cancer survivors referred to an outpatient cancer rehabilitation medicine clinic.InterventionNot applicable.Main Outcome MeasureCorrelation of Patient‐Reported Outcomes Measurement Information System (PROMIS) Cancer Function Brief 3D Profile domains with objective physical function measured by the 30‐second sit‐to‐stand and hand grip strength.ResultsPearson correlation analysis revealed a moderate correlation between patient‐reported physical function and the 30‐second sit‐to‐stand test (<jats:italic>r</jats:italic> = 0.57; <jats:italic>p</jats:italic> <.001), and a weak correlation of patient‐reported physical function and handgrip strength (<jats:italic>r</jats:italic> = 0.27; <jats:italic>p</jats:italic> <.001). Multivariable regression modeling controlling for age, gender, and receipt of systemic therapy demonstrated a significant association between patient‐reported physical function and the 30‐second sit‐to‐stand test (estimated confidence interval 0.76 [0.60, 0.92], <jats:italic>p</jats:italic> < .01), in addition to patient‐reported function and handgrip strength (estimated 0.22 [0.10, 0.34], <jats:italic>p</jats:italic> < .01). Multiple myeloma but no other cancer type was inversely associated with lower physical function.ConclusionsPatient‐reported physical function correlated moderately with the 30‐second sit‐to‐stand test, whereas hand grip strength demonstrated a weak correlation. The 30‐second sit‐to‐stand test is a suitable substitute for patient‐reported physical function. Further work evaluating how measures relate to each other across cancer populations is needed before recommending a standardized set of outcome measures.","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140832295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
João Pedro Emrich Accioly, James Bena, Huijun Xiao, Stacy Jeong, Roger K. Khouri, Kenneth W. Angermeier, Molly Dewitt‐Foy, Gregory Nemunaitis, Hadley M. Wood
IntroductionPatient expectations and baseline health are important drivers of outcomes following major genitourinary reconstructive surgery for neurogenic bladder (NGB). Differences in expectations and quality of life (QoL) improvements among different populations with NGB remain insufficiently explored in the literature.ObjectiveTo compare decisional regret (DR) and urinary‐related QoL (UrQoL) in patients undergoing urinary diversion for NGB arising from spinal cord injury of acquired (A‐SCI) and congenital (C‐SCI) etiologies. We hypothesize that patients with A‐SCI have higher expectations of improvement in QoL following surgery when compared with C‐SCI, which may lead to higher DR and decreased UrQoL, postoperatively.DesignIn this cross‐sectional survey study, we compared A‐SCI to C‐SCI in terms of DR, UrQoL, and postoperative changes in self‐reported physical health, mental health, and pain using validated patient‐reported outcome measures.SettingParticipants were enrolled from a quaternary care institution via mail and MyChart.ParticipantsThe A‐SCI group consistied of 17 patients with traumatic spinal cord injury the C‐SCI group was composed of 20 patients with spina bifida.InterventionsNot applicable.Main Outcome MeasuresThe Decisional Regret Scale, Short form‐ Qualiveen (SF‐Qualiveen), and Patient‐reported outcomes measurement Information system‐10 (PROMIS‐10) Global Health surveys.ResultsThe A‐SCI group displayed poorer preoperative physical health than the C‐SCI cohort, but absolute postoperative changes in this score, along with mental health score and pain level, were not significant after adjusting for baseline scores and follow‐up time. SF‐Qualiveen scores revealed significantly worse impact of NGB in UrQoL for A‐SCI than for C‐SCI when adjusted for other factors. No differences in DR were seen between the groups.ConclusionsPatients with A‐SCI demonstrate lower self‐reported baseline physical health compared with patients with C‐SCI, which may have implications in setting patient expectations when undergoing urinary diversion. In this small cohort, we found a milder self‐reported postoperative impact of NGB in UrQoL in patients with C‐SCI.
{"title":"Decisional regret and impacts on quality of life following genitourinary reconstruction for neurogenic bladder: A comparison between acquired and congenital spinal cord injury","authors":"João Pedro Emrich Accioly, James Bena, Huijun Xiao, Stacy Jeong, Roger K. Khouri, Kenneth W. Angermeier, Molly Dewitt‐Foy, Gregory Nemunaitis, Hadley M. Wood","doi":"10.1002/pmrj.13157","DOIUrl":"https://doi.org/10.1002/pmrj.13157","url":null,"abstract":"IntroductionPatient expectations and baseline health are important drivers of outcomes following major genitourinary reconstructive surgery for neurogenic bladder (NGB). Differences in expectations and quality of life (QoL) improvements among different populations with NGB remain insufficiently explored in the literature.ObjectiveTo compare decisional regret (DR) and urinary‐related QoL (UrQoL) in patients undergoing urinary diversion for NGB arising from spinal cord injury of acquired (A‐SCI) and congenital (C‐SCI) etiologies. We hypothesize that patients with A‐SCI have higher expectations of improvement in QoL following surgery when compared with C‐SCI, which may lead to higher DR and decreased UrQoL, postoperatively.DesignIn this cross‐sectional survey study, we compared A‐SCI to C‐SCI in terms of DR, UrQoL, and postoperative changes in self‐reported physical health, mental health, and pain using validated patient‐reported outcome measures.SettingParticipants were enrolled from a quaternary care institution via mail and MyChart.ParticipantsThe A‐SCI group consistied of 17 patients with traumatic spinal cord injury the C‐SCI group was composed of 20 patients with spina bifida.InterventionsNot applicable.Main Outcome MeasuresThe Decisional Regret Scale, Short form‐ Qualiveen (SF‐Qualiveen), and Patient‐reported outcomes measurement Information system‐10 (PROMIS‐10) Global Health surveys.ResultsThe A‐SCI group displayed poorer preoperative physical health than the C‐SCI cohort, but absolute postoperative changes in this score, along with mental health score and pain level, were not significant after adjusting for baseline scores and follow‐up time. SF‐Qualiveen scores revealed significantly worse impact of NGB in UrQoL for A‐SCI than for C‐SCI when adjusted for other factors. No differences in DR were seen between the groups.ConclusionsPatients with A‐SCI demonstrate lower self‐reported baseline physical health compared with patients with C‐SCI, which may have implications in setting patient expectations when undergoing urinary diversion. In this small cohort, we found a milder self‐reported postoperative impact of NGB in UrQoL in patients with C‐SCI.","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140812244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Harpreet Sangha, Jordan Farag, Lawrence Robinson, Nimish Mittal
{"title":"Identifying deficiencies in palpation of lumbopelvic structures with ultrasound in PM&R residents","authors":"Harpreet Sangha, Jordan Farag, Lawrence Robinson, Nimish Mittal","doi":"10.1002/pmrj.13137","DOIUrl":"https://doi.org/10.1002/pmrj.13137","url":null,"abstract":"","PeriodicalId":20287,"journal":{"name":"Pm & R","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140798547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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