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Advances in Rehabilitation Science and Practice (AdvRSP) Editorial: A Journal Showcasing Exciting Developments in the Field of Rehabilitation in Medical Conditions. 康复科学与实践进展(AdvRSP)社论:一本展示医疗条件下康复领域令人兴奋的发展的杂志。
Q1 REHABILITATION Pub Date : 2022-11-29 eCollection Date: 2022-01-01 DOI: 10.1177/11795727221139517
Manoj Sivan
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引用次数: 1
Remote Delivery of Service: A Survey of Occupational Therapists' Perceptions. 远程提供服务:职业治疗师的认知调查。
Q1 REHABILITATION Pub Date : 2022-09-06 eCollection Date: 2022-01-01 DOI: 10.1177/11795727221117503
Tehila Almog, Yafit Gilboa

Background: Telehealth has been declared an accepted method of occupational therapy (OT) service delivery and has been shown to be effective. However, studies done before the outbreak of coronavirus disease (COVID-19) show that most occupational therapists didn't use it.

Aim: The aim of this exploratory study was to examine the perceptions of occupational therapists regarding remote delivery of service following the COVID-19 outbreak.

Material and methods: An online survey, including 11-item five-point Likert scale, and 2 open-ended questions were distributed to occupational therapists.

Results: Responses were received from 245 Israeli occupational therapists. The majority of the participants (60%) strongly agreed that remote delivery allows an ecological and effective intervention, while 76% strongly agreed that an ideal treatment is one that would combine telehealth with in-person intervention. Qualitative findings indicated that the most significant advantage was providing care in the natural environment and improving accessibility to the service. The most salient barriers were limitations of the therapeutic relationship and threats on clinical reasoning.

Conclusion: The study results highlight the complexity of telehealth. Findings indicate that overall occupational therapists perceive remote care as an effective and legitimate service delivery method that cannot be used as an alternative to in-person treatment. These findings can help in developing intervention programs for remote treatment, and their implementation.

背景:远程医疗已被宣布为一种公认的职业治疗(OT)服务提供方法,并已被证明是有效的。然而,在冠状病毒病(COVID-19)爆发之前进行的研究表明,大多数职业治疗师没有使用它。目的:本探索性研究的目的是研究COVID-19爆发后职业治疗师对远程提供服务的看法。材料与方法:对职业治疗师进行在线调查,包括11项五点李克特量表和2个开放式问题。结果:收到245名以色列职业治疗师的回复。大多数参与者(60%)强烈同意远程交付可以实现生态和有效的干预,而76%的人强烈同意理想的治疗方法是将远程医疗与现场干预相结合。定性调查结果表明,最显著的优势是在自然环境中提供护理和改善服务的可及性。最突出的障碍是治疗关系的限制和对临床推理的威胁。结论:研究结果突出了远程医疗的复杂性。研究结果表明,整体职业治疗师认为远程护理是一种有效和合法的服务提供方法,不能用作面对面治疗的替代方法。这些发现有助于制定远程治疗的干预方案并加以实施。
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引用次数: 4
Bioelectrical Impedance Vector Pattern and Biomarkers of Physical Functioning of Prostate Cancer Survivors in Rehabilitation. 前列腺癌康复患者生理功能的生物电阻抗矢量模式和生物标志物。
Q1 REHABILITATION Pub Date : 2021-12-16 eCollection Date: 2021-01-01 DOI: 10.1177/11795727211064156
Alexander Stäuber, Marc Heydenreich, Peter R Wright, Steffen Großmann, Niklas Grusdat, Dirk-Henrik Zermann, Henry Schulz

Background: Knowledge of clinically established factors of physical function such as body composition, bioelectrical phase angle (PhA) and handgrip strength (HGS) with mortality predictive and health-related relevance is limited in prostate cancer survivors (PCS). Therefore, the aim of this study was to characterise and compare body composition data of PCS with extensive reference data as well as to analyse PhA and HGS and the prevalence of critical prognostic values at an early stage of cancer survivorship.

Methods: One hundred and forty-eight PCS were examined at the start (T1) and end (T2) of a 3-week hospitalised urooncological rehabilitation, which began median 28 days after acute cancer therapy. Examinations included a bioimpedance analysis and HGS test. Comparison of body composition between PCS and reference data was performed using bioimpedance vector analysis (BIVA).

Results: BIVA of the whole PCS group showed abnormal physiology with a cachectic state and a state of overhydration/oedema, without significant changes between T1 and T2. The age- and BMI-stratified subgroup analysis showed that PCS aged 60 years and older had this abnormal pattern compared to the reference population. HGS (T1: 38.7 ± 8.9 vs T2: 40.8 ± 9.4, kg), but not PhA (T1/T2: 5.2 ± 0.7, °), changed significantly between T1 and T2. Values below a critical threshold reflecting a potentially higher risk of mortality and impaired function were found for PhA in 20% (T1) and 22% (T2) of PCS and in 41% (T1) and 29% (T2) for HGS.

Conclusions: BIVA pattern and the prevalence of critically low HGS and PhA values illustrate the necessity for intensive continuation of rehabilitation and survivorship care especially in these 'at risk' cases. The routine assessment of body composition, PhA and HGS offer the opportunity to conduct a risk stratification for PCS and could help personalising and optimising treatment in rehabilitation and ongoing survivorship care.

背景:前列腺癌幸存者(PCS)对临床确定的身体功能因素,如身体成分、生物电相角(PhA)和握力(HGS)与死亡率预测和健康相关的知识有限。因此,本研究的目的是将PCS的身体成分数据与广泛的参考数据进行表征和比较,并分析PhA和HGS以及早期癌症生存期关键预后价值的流行情况。方法:148例PCS在急性肿瘤治疗后中位28天开始的为期3周的泌尿肿瘤住院康复治疗的开始(T1)和结束(T2)进行检查。检查包括生物阻抗分析和HGS测试。采用生物阻抗矢量分析(BIVA)将PCS与参考数据进行体成分比较。结果:整个PCS组BIVA均出现生理异常,表现为病毒质状态和过水合/水肿状态,T1与T2间无明显变化。年龄和bmi分层亚组分析显示,与参考人群相比,60岁及以上的PCS具有这种异常模式。HGS (T1: 38.7±8.9 vs T2: 40.8±9.4,kg), PhA (T1/T2: 5.2±0.7,°)在T1和T2之间变化不显著。20% (T1)和22% (T2)的PCS患者和41% (T1)和29% (T2)的HGS患者的PhA低于反映潜在更高死亡和功能受损风险的临界阈值。结论:BIVA模式和严重低HGS和PhA值的流行说明了加强康复和生存护理的必要性,特别是在这些“高危”病例中。对身体成分、PhA和HGS的常规评估提供了对PCS进行风险分层的机会,可以帮助个性化和优化康复治疗和持续的生存护理。
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引用次数: 1
Safety, Feasibility, and Acceptability of a New Virtual Rehabilitation Platform: A Supervised Pilot Study. 一种新型虚拟康复平台的安全性、可行性和可接受性:一项有监督的试点研究。
Q1 REHABILITATION Pub Date : 2021-08-07 eCollection Date: 2021-01-01 DOI: 10.1177/11795727211033279
Ana María Escalante-Gonzalbo, Yoás Saimon Ramírez-Graullera, Herminia Pasantes, José Jonathan Aguilar-Chalé, Gloria Ixchel Sánchez-Castillo, Ximena Ameyalli Escutia-Macedo, Tania María Briseño-Soriano, Paulina Franco-Castro, Ana Lilia Estrada-Rosales, Sandra Elizabeth Vázquez-Abundes, David Andrade-Morales, Jorge Hernández-Franco, Lorena Palafox

Purpose: Stroke is the leading cause of disability in adults worldwide, with hemiparesis being the most prevalent consequence. The use of video games and movement sensors could contribute to improving patients' chances of recovery. We performed a supervised pilot study to validate the safety, feasibility, and acceptability of a new virtual rehabilitation platform in patients with chronic post-stroke upper limb hemiparesis.

Methods: The participants (n = 9) participated in 40 rehabilitation sessions, twice a week, for a period of 20 weeks. Their experiences with the platform were documented using a Likert-scale survey. Changes in motor function were evaluated using the Chedoke Arm and Hand Activity Inventory (CAHAI) and the Wolf Motor Function Test (WMFT).

Results and conclusions: All participants expressed that they enjoyed the experience and felt comfortable using the platform. Preliminary results showed significant motor recovery (P = .0039) according to the WMFT scores. Patients with significant impairment showed no improvement in upper limb task-oriented motor function after therapy.The new platform is safe and well-accepted by patients. The improvement in motor function observed in some of the participants should be attributed to the therapy since spontaneous functional recovery is not expected in chronic stroke patients.

目的:中风是全世界成年人致残的主要原因,其中偏瘫是最普遍的后果。视频游戏和运动传感器的使用有助于提高患者康复的机会。我们进行了一项有监督的试点研究,以验证一种新的虚拟康复平台在慢性卒中后上肢偏瘫患者中的安全性、可行性和可接受性。方法:9例患者共进行40次康复治疗,每周2次,为期20周。他们使用该平台的经历通过李克特量表调查记录下来。使用Chedoke手臂和手活动量表(CAHAI)和Wolf运动功能测试(WMFT)评估运动功能的变化。结果和结论:所有参与者都表示他们很享受这个体验,并且觉得使用这个平台很舒服。根据WMFT评分,初步结果显示运动恢复显著(P = 0.0039)。有明显损伤的患者在治疗后上肢任务导向运动功能没有改善。新平台安全可靠,深受患者欢迎。在一些参与者中观察到的运动功能的改善应归因于治疗,因为慢性卒中患者不期望自发功能恢复。
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引用次数: 6
The Potential of Computer Vision-Based Marker-Less Human Motion Analysis for Rehabilitation. 基于计算机视觉的无标记人体运动分析在康复中的潜力。
Q1 REHABILITATION Pub Date : 2021-07-05 eCollection Date: 2021-01-01 DOI: 10.1177/11795727211022330
Thomas Hellsten, Jonny Karlsson, Muhammed Shamsuzzaman, Göran Pulkkis

Background: Several factors, including the aging population and the recent corona pandemic, have increased the need for cost effective, easy-to-use and reliable telerehabilitation services. Computer vision-based marker-less human pose estimation is a promising variant of telerehabilitation and is currently an intensive research topic. It has attracted significant interest for detailed motion analysis, as it does not need arrangement of external fiducials while capturing motion data from images. This is promising for rehabilitation applications, as they enable analysis and supervision of clients' exercises and reduce clients' need for visiting physiotherapists in person. However, development of a marker-less motion analysis system with precise accuracy for joint identification, joint angle measurements and advanced motion analysis is an open challenge.

Objectives: The main objective of this paper is to provide a critical overview of recent computer vision-based marker-less human pose estimation systems and their applicability for rehabilitation application. An overview of some existing marker-less rehabilitation applications is also provided.

Methods: This paper presents a critical review of recent computer vision-based marker-less human pose estimation systems with focus on their provided joint localization accuracy in comparison to physiotherapy requirements and ease of use. The accuracy, in terms of the capability to measure the knee angle, is analysed using simulation.

Results: Current pose estimation systems use 2D, 3D, multiple and single view-based techniques. The most promising techniques from a physiotherapy point of view are 3D marker-less pose estimation based on a single view as these can perform advanced motion analysis of the human body while only requiring a single camera and a computing device. Preliminary simulations reveal that some proposed systems already provide a sufficient accuracy for 2D joint angle estimations.

Conclusions: Even though test results of different applications for some proposed techniques are promising, more rigour testing is required for validating their accuracy before they can be widely adopted in advanced rehabilitation applications.

背景:包括人口老龄化和最近的冠状病毒大流行在内的几个因素增加了对具有成本效益、易于使用和可靠的远程康复服务的需求。基于计算机视觉的无标记人体姿态估计是一种很有前途的远程康复方法,目前是一个热门的研究课题。它引起了人们对详细运动分析的极大兴趣,因为它在从图像中捕获运动数据时不需要安排外部基准。这对康复应用很有希望,因为它们可以分析和监督客户的锻炼,减少客户亲自拜访物理治疗师的需求。然而,开发一种具有精确关节识别、关节角度测量和高级运动分析精度的无标记运动分析系统是一个开放的挑战。目的:本文的主要目的是对最近基于计算机视觉的无标记人体姿态估计系统及其在康复应用中的适用性进行综述。还提供了一些现有的无标记康复应用的概述。方法:本文对最近基于计算机视觉的无标记人体姿势估计系统进行了综述,重点介绍了与物理治疗要求和易用性相比,它们提供的关节定位精度。从测量膝关节角度的能力方面,对其精度进行了仿真分析。结果:当前的姿态估计系统使用基于2D、3D、多视图和单视图的技术。从物理治疗的角度来看,最有前途的技术是基于单一视图的3D无标记姿势估计,因为这些技术可以对人体进行高级运动分析,而只需要一个摄像机和一个计算设备。初步的仿真表明,所提出的一些系统已经为二维关节角估计提供了足够的精度。结论:尽管一些提出的技术的不同应用的测试结果很有希望,但在广泛应用于高级康复应用之前,需要进行更严格的测试来验证其准确性。
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引用次数: 22
Toward a More Comprehensive Assessment of School Age Children with Hemiplegic Cerebral Palsy. 对学龄儿童偏瘫性脑瘫进行更全面的评估。
Q1 REHABILITATION Pub Date : 2021-04-27 eCollection Date: 2021-01-01 DOI: 10.1177/11795727211010500
Catherine R Hoyt, Sarah K Sherman, Shelby K Brown, Dillan J Newbold, Ryland L Miller, Andrew N Van, Joshua S Shimony, Mario Ortega, Annie L Nguyen, Bradley L Schlaggar, Nico Uf Dosenbach

Background: Cerebral palsy (CP) is the leading cause of disability in children. While motor deficits define CP, many patients experience behavioral and cognitive deficits which limit participation. The purpose of this study was to contribute to our understanding of developmental delay and how to measure these deficits among children with CP.

Methods: Children 5 to 15 years with hemiplegic CP were recruited. Cognition and motor ability were assessed. The brain injury associated with observed motor deficits was identified. Accelerometers measured real-world bilateral upper extremity movement and caregivers completed behavioral assessments.

Results: Eleven children participated, 6 with presumed perinatal stroke. Four children scored below average intelligence quotient while other measures of cognition were within normal limits (except processing speed). Motor scores confirmed asymmetrical deficits. Approximately one third of scores indicated deficits in attention, behavior, or depression.

Conclusions: Our findings corroborate that children with CP experience challenges that are broader than motor impairment alone. Despite the variation in brain injury, all participants completed study procedures.

Implications: Our findings suggest that measuring behavior in children with CP may require a more comprehensive approach and that caregivers are amenable to using online collection tools which may assist in addressing the therapeutic needs of children with CP.

背景:脑瘫(CP)是儿童致残的主要原因。虽然运动缺陷定义了CP,但许多患者经历了限制参与的行为和认知缺陷。本研究的目的是帮助我们了解发育迟缓和如何测量这些缺陷的CP儿童。方法:招募5至15岁的偏瘫CP儿童。评估认知和运动能力。脑损伤与观察到的运动缺陷相关。加速度计测量了真实世界的双侧上肢运动,护理人员完成了行为评估。结果:11名儿童参与,其中6名推定为围产期卒中。四个孩子的智商低于平均水平,而其他认知指标在正常范围内(处理速度除外)。运动得分证实了不对称缺陷。大约三分之一的分数表明注意力、行为或抑郁方面的缺陷。结论:我们的研究结果证实了CP患儿所经历的挑战比单纯的运动障碍更广泛。尽管脑损伤有所不同,但所有参与者都完成了研究程序。含义:我们的研究结果表明,测量CP儿童的行为可能需要更全面的方法,并且护理人员可以使用在线收集工具,这可能有助于解决CP儿童的治疗需求。
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引用次数: 2
Patient and Caregiver Perspectives on an eHealth Tool: A Qualitative Investigation of Preferred Formats, Features and Characteristics of a Presurgical eHealth Education Module. 患者和护理人员对电子健康工具的看法:手术前电子健康教育模块首选格式、功能和特点的定性调查。
IF 2.3 Q1 REHABILITATION Pub Date : 2021-04-21 eCollection Date: 2021-01-01 DOI: 10.1177/11795727211010501
Holly Reid, Somayyeh Mohammadi, Wendy Watson, Julie M Robillard, Morag Crocker, Marie D Westby, William C Miller

Introduction: Total hip and total knee replacement (THR and TKR) are suggested for reducing joint pain resulting from hip and knee osteoarthritis (OA), especially when other interventions have not resulted in desired outcomes. Providing prehabilitation education can improve patients' psychological and physical well-being before and after surgery. The use of electronic health (eHealth) tools can be considered an effective method to increase patients' access to prehabilitation, particularly for those facing barriers to attending diagnosis-specific in-person education sessions. However, limited attention is paid to both caregiver and patient perspectives regarding the delivery formats, features, and characteristics of eHealth tools.

Method: Patients with hip (n = 46) and knee OA (n = 14) and their family caregivers (n = 16) participated in in-person focus groups or phone interviews. Participants were shown a mock-up of an eHealth module, and asked to share their preferences regarding the formats, features, and characteristics of the eHealth prehabilitation tool. Data was transcribed verbatim and coded using primary thematic and secondary content analyses.

Result: Analyses revealed 3 main themes: 1. "easier to understand" emphasizes patients' preferences on delivery formats and features; 2. "what does that mean?" highlights requests for clear and simple information; and 3. "Preparation, right?" shows patients' perspectives on the best time to have access to the eHealth tool.

Discussion: Participants' preferences for prehabilitation tools included offering eHealth tools in multiple mediums of delivery (eg, written materials, pictures, videos). Participants preferred simplified information that emphasized the key points and rationale for the knowledge. There were differences in preferred timeline for having access to prehabilitation education, such as some participants wanting to receive prehabilitation well in advance, while others stated just before surgery was adequate. Our findings provide novel and actionable information about patient and caregiver perspectives on features and characteristics of prehabilitation education for patients with hip and knee OA.

导言:全髋关节和全膝关节置换术(THR 和 TKR)被建议用于减轻髋关节和膝关节骨性关节炎(OA)引起的关节疼痛,尤其是在其他干预措施未能达到预期效果的情况下。提供术前康复教育可以改善患者术前和术后的心理和生理健康状况。使用电子健康(eHealth)工具可被视为增加患者接受康复前教育机会的有效方法,特别是对于那些在参加特定诊断的面对面教育课程时面临障碍的患者。然而,人们对护理人员和患者对电子健康工具的交付形式、功能和特点的看法关注有限:方法:髋关节(46 人)和膝关节 OA 患者(14 人)及其家庭护理者(16 人)参加了现场焦点小组或电话访谈。向参与者展示了电子健康模块的模型,并要求他们分享自己对电子健康康复工具的格式、功能和特点的偏好。数据被逐字转录,并通过主要主题分析和次要内容分析进行编码:结果:分析揭示了三大主题:1. "更容易理解 "强调了患者对提供格式和功能的偏好;2."准备工作,对吗?"显示了患者对使用电子健康工具最佳时间的看法:讨论:参与者对康复前工具的偏好包括以多种媒介(如书面材料、图片、视频)提供电子健康工具。参与者更喜欢强调知识要点和原理的简化信息。在获得康复前教育的首选时间上存在差异,例如一些参与者希望提前很长时间接受康复前教育,而另一些参与者则表示在手术前接受康复前教育就足够了。我们的研究结果提供了关于患者和护理人员对髋关节和膝关节 OA 患者康复前教育的特点和特征的看法的新颖且可操作的信息。
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引用次数: 0
Tools and Techniques Used With Robotic Devices to Quantify Upper-Limb Function in Typically Developing Children: A Systematic Review. 与机器人设备一起用于量化典型发育儿童上肢功能的工具和技术:系统综述。
Q1 REHABILITATION Pub Date : 2020-12-14 eCollection Date: 2020-01-01 DOI: 10.1177/1179572720979013
Stephan Cd Dobri, Hana M Ready, Theresa Claire Davies

Background: Robotic devices have been used to quantify function, identify impairment, and rehabilitate motor function extensively in adults, but less-so in younger populations. The ability to perform motor actions improves as children grow. It is important to quantify this rate of change of the neurotypical population before attempting to identify impairment and target rehabilitation techniques.

Objectives: For a population of typically developing children, this systematic review identifies and analyzes tools and techniques used with robotic devices to quantify upper-limb motor function. Since most of the papers also used robotic devices to compare function of neurotypical to pathological populations, a secondary objective was introduced to relate clinical outcome measures to identified robotic tools and techniques.

Methods: Five databases were searched between February 2019 and August 2020, and 226 articles were found, 19 of which are included in the review.

Results: Robotic devices, tasks, outcome measures, and clinical assessments were not consistent among studies from different settings but were consistent within laboratory groups. Fifteen of the 19 articles evaluated both typically developing and pathological populations.

Conclusion: To optimize universally comparable outcomes in future work, it is recommended that a standard set of tasks and measures is used to assess upper-limb motor function. Standardized tasks and measures will facilitate effective rehabilitation.

背景:机器人设备已广泛用于成人的功能量化、识别损伤和运动功能康复,但在年轻人群中应用较少。随着孩子的成长,运动能力也会提高。在试图确定损伤和目标康复技术之前,量化神经典型人群的这种变化率是很重要的。目的:对于典型发育的儿童群体,本系统综述确定并分析了机器人设备用于量化上肢运动功能的工具和技术。由于大多数论文也使用机器人设备来比较神经正常人群和病理人群的功能,因此引入了第二个目标,将临床结果测量与确定的机器人工具和技术联系起来。方法:检索2019年2月- 2020年8月5个数据库,共检索到226篇文献,其中19篇纳入综述。结果:机器人设备、任务、结果测量和临床评估在不同环境的研究中不一致,但在实验室组中是一致的。19篇文章中有15篇评估了典型发育人群和病态人群。结论:为了在未来的工作中优化普遍可比较的结果,建议使用一套标准的任务和测量方法来评估上肢运动功能。标准化的任务和措施有利于有效的康复。
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引用次数: 6
Implementation of Dynamic Lycra® Orthoses for Arm Rehabilitation in the Context of a Randomised Controlled Feasibility Trial in Stroke: A Qualitative study Using Normalisation Process Theory. 在卒中随机对照可行性试验的背景下实施动态Lycra®矫形器进行手臂康复:一项使用归一化过程理论的定性研究。
Q1 REHABILITATION Pub Date : 2020-08-31 DOI: 10.1177/1179572720950210
Joke Delvaux, Alexandra John, Lucy Wedderburn, Jacqui Morris

Objective: To explore how non-research funded rehabilitation practitioners implemented dynamic Lycra® orthoses for arm recovery after stroke into rehabilitation practice, as part of a feasibility randomised controlled trial.

Design: Qualitative interview study.

Setting: Two in-patient stroke units and associated rehabilitation units.

Subjects: Fifteen purposefully selected stroke rehabilitation practitioners involved in delivery of dynamic Lycra® orthoses as part of a feasibility randomised controlled trial.

Methods: Semi-structured interviews conducted at the end of the trial. Interviews examined their experiences of orthosis implementation. Normalisation Process Theory structured the interview guide and informed data analysis. NVivo software supported data analysis.

Results: Practitioners intuitively made sense of the intervention in the face of uncertainty about its precise mechanisms of action (Normalisation Process Theory construct: coherence) and espoused commitment to the research, despite uncertainty about orthosis effectiveness (cognitive participation). They did however adapt the intervention based on perceived therapeutic need, their own skillsets and stroke survivor preference (collective action). They were uncertain about benefits (reflexive monitoring). Across the 4 theoretical constructs, ambivalence about the intervention was detected.

Conclusions: Ambivalence interfered with implementation - but only to an extent. 'Good-enough' coherence, cognitive participation, collective action and reflexive monitoring were sufficient to initiate normalisation - as long as implementation did not undermine the relationship between practitioner and stroke survivor. Ambivalence stemmed from practitioners' uncertainty about the intervention theory and mechanisms of action. Making intervention mechanisms of action more explicit to practitioners may influence how they implement and adapt a research intervention, and may determine whether those processes undermine or enhance outcomes.

目的:作为一项可行性随机对照试验的一部分,探讨非研究资助的康复从业者如何在康复实践中使用动态Lycra®矫形器进行中风后手臂恢复。设计:定性访谈研究。设置:两个中风住院病房和相关的康复病房。受试者:作为可行性随机对照试验的一部分,有目的地选择了15名参与提供动态Lycra®矫形器的中风康复从业者。方法:在试验结束时进行半结构化访谈。访谈调查了他们使用矫形器的经验。规范化过程理论构建了访谈指南和知情数据分析。NVivo软件支持数据分析。结果:尽管矫形器的有效性(认知参与)存在不确定性,但从业者在面对其确切作用机制的不确定性时直观地理解了干预(规范化过程理论结构:连贯性),并支持对研究的承诺。然而,他们确实根据感知的治疗需求、自己的技能和中风幸存者的偏好(集体行动)调整了干预措施。他们不确定收益(反射性监控)。在4个理论结构中,人们发现了对干预的矛盾心理。结论:歧义干扰了实施,但只是在一定程度上只要实施不破坏从业者和中风幸存者之间的关系,足够好的连贯性、认知参与、集体行动和反射性监测就足以启动正常化。歧义源于从业者对干预理论和行动机制的不确定性。使干预行动机制对从业者更加明确可能会影响他们如何实施和调整研究干预,并可能决定这些过程是否会破坏或增强结果。
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引用次数: 3
Systematic Review of Interventions Designed to Maintain or Increase Physical Activity Post-Cardiac Rehabilitation Phase II. 旨在维持或增加心脏康复后身体活动的干预措施的系统综述。
Q1 REHABILITATION Pub Date : 2020-08-25 eCollection Date: 2020-01-01 DOI: 10.1177/1179572720941833
Helen Graham, Kathy Prue-Owens, Jess Kirby, Mythreyi Ramesh

Background: Cardiovascular disease (CVD) continues to be the No. 1 cause of death in the United States and globally, and individuals with a history of a cardiac event are at increased risk for a repeat event. Physical inactivity creates health problems for individuals with chronic heart disease. Evidence shows that physical activity (PA), as a central component of cardiac rehabilitation phase II (CRII), decreases hospital readmission and mortality. Yet, individual adherence to PA tends to decline several months following CRII completion.

Objective: The purpose of this review was to evaluate current literature for interventions designed to assist individuals diagnosed with myocardial infarction (MI), coronary artery bypass graft (CABG), coronary artery disease (CAD), and percutaneous coronary intervention (PCI) to maintain or increase PA post-CRII.

Methods: A systematic search of 5 electronic databases including hand-searched articles between 2000 and 2019. Key Medical Subject Headings (MeSH) search terms included cardiac rehabilitation, intervention, exercise or PA, outcomes, compliance, adherence, or maintenance. Only interventions implemented following CRII program completion were included for review.

Results: Based on the inclusion criteria, the search yielded 19 randomized control trials retained for descriptive analysis. Interventions were categorized into 3 domains. The intervention designs varied widely in terms of duration of the intervention and the length of time to outcome measurement. Most interventions were short-term with only 2 studies offering a long-term intervention of greater than 1 year. Interventions using a theoretical approach most often included a cognitive-behavioral model.

Conclusions: Interventions offered shortly after completion of CRII may help cardiac patients maintain PA and reduce the risk of experiencing additional cardiac events; however, more quality research is needed. Additional research to examine PA maintenance in older adults (70 years and older) would be valuable based on the increase in average lifespan. Studies with larger and more diverse samples, and less variation in methods and outcomes would greatly increase the ability to conduct a high-quality meta-analysis.

背景:心血管疾病(CVD)仍然是美国和全球第一大死亡原因,有心脏事件史的个体再次发生心血管事件的风险增加。缺乏运动给慢性心脏病患者带来健康问题。有证据表明,身体活动(PA)作为心脏康复二期(CRII)的核心组成部分,可以降低再入院率和死亡率。然而,在中区填海工程完成几个月后,个人对PA的依从性趋于下降。目的:本综述的目的是评估目前的文献,旨在帮助诊断为心肌梗死(MI)、冠状动脉旁路移植术(CABG)、冠状动脉疾病(CAD)和经皮冠状动脉介入治疗(PCI)的个体在crii后维持或增加PA。方法:系统检索2000 - 2019年5个电子数据库的人工检索文章。关键医学主题标题(MeSH)搜索词包括心脏康复、干预、运动或PA、结果、依从性、依从性或维持。只有在CRII项目完成后实施的干预措施才被纳入评估。结果:根据纳入标准,检索得到19个随机对照试验用于描述性分析。干预措施分为3个领域。干预设计在干预的持续时间和结果测量的时间长短方面差异很大。大多数干预是短期的,只有2项研究提供了超过1年的长期干预。使用理论方法的干预通常包括认知行为模型。结论:在完成CRII后不久提供的干预可能有助于心脏患者维持PA并降低经历其他心脏事件的风险;然而,还需要更多高质量的研究。基于平均寿命的增加,对老年人(70岁及以上)的PA维持进行额外的研究将是有价值的。样本量更大、更多样化、方法和结果差异更小的研究将大大提高进行高质量荟萃分析的能力。
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引用次数: 9
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Rehabilitation Process and Outcome
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