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Feasibility and clinical outcomes of a high-intensity physical rehabilitation programme (REHABILITY) for children and adolescents with acquired brain injury. 获得性脑损伤儿童和青少年高强度身体康复方案的可行性和临床结果
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2026.2614948
Christiaan Gmelig Meyling, Ingrid Rentinck, Olaf Verschuren, Irene van der Steen, Raoul Engelbert, Jan Willem Gorter

Purpose: To evaluate the feasibility and safety of a high-intensity physical rehabilitation programme for children and adolescents with acquired brain injury (ABI) during inpatient rehabilitation. We also explored changes in outcomes of physical and cognitive functioning by structured monitoring of recovery trajectories with a coreset of clinical outcome measures.

Materials and methods: A prospective case-series design was used. Fourteen children and adolescents aged 6-20 years (mean 14,1 years, SD 2,7) with ABI were included. Feasibility and safety data were collected from children, parents and professionals, alongside measures of physical and cognitive functioning.

Results: Seventy-five percent of the 14 participants achieved the minimum of 3 h of physical activity per day (median 3h09m, IQR 1h33m). Improvements were observed on measures of physical and cognitive functioning. No adverse events were reported, indicating safety of the programme. The programme was well accepted by both families and professionals.

Conclusion: Our findings indicates that it is feasible and safe for children and adolescents with ABI during subacute rehabilitation to engage in high levels of physical activity (>3h p/day). We provide a foundation for future larger-scale studies on effectiveness of increased dosage of physical rehabilitation on daily functioning and participation of children and adolescents with ABI.

目的:评估儿童和青少年获得性脑损伤(ABI)住院康复期间高强度物理康复方案的可行性和安全性。我们还探讨了身体和认知功能的变化,通过有组织的监测恢复轨迹与临床结果测量的核心。材料和方法:采用前瞻性病例系列设计。14名6-20岁的儿童和青少年(平均14岁,1岁,标准差2,7)患有ABI。可行性和安全性数据从儿童、家长和专业人士那里收集,以及身体和认知功能的测量。结果:14名参与者中有75%的人达到了每天至少3小时的身体活动(中位数为3h09m, IQR为1h33m)。在身体和认知功能方面观察到改善。无不良事件报告,表明该方案的安全性。该课程深受家庭和专业人士的欢迎。结论:我们的研究结果表明,对于患有ABI的儿童和青少年来说,在亚急性康复期间进行高水平的体育锻炼(每天30 - 30小时)是可行和安全的。我们为未来更大规模的研究增加物理康复剂量对ABI儿童和青少年日常功能和参与的有效性提供了基础。
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引用次数: 0
What shapes beliefs about persisting symptoms after an isolated extremity injury? A qualitative study. 是什么形成了人们对孤立性肢体损伤后持续症状的看法?定性研究。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2025.2612457
Prudence Butler, Colleen Johnston-Devin, Nathalia Costa, Shaun O'Leary, Michele Sterling

Purpose: Injury beliefs can affect how people navigate recovery and influence how they seek treatments. The aim of this study was to explore what influences beliefs about the cause(s) of persisting symptoms after an isolated extremity injury.

Methods: Data were collected using semi-structured interviews. Participants (n = 12; 67% female) were purposively sampled from a cohort study exploring recovery trajectories after isolated extremity injuries. We used a descriptive approach to reflexive thematic analysis.

Results: Beliefs were formed through (1) expectations of what recovery entails (2) interactions with trusted others, (3) experience, and (4) prior knowledge and identity (Theme 1 and subthemes 1a-d). Persistent distress was understood as a normal response to an abnormal situation (Theme 2). Causal beliefs were influenced by concerns about judgement from others, particularly when symptoms did not match objective findings (Theme 3).

Conclusion: Beliefs about the cause of persisting post-injury symptoms can be understood as a network of interrelated beliefs, moulded by individual experience and knowledge, but also interpersonal elements such as therapeutic alliance and fear of not being taken seriously by others. Causal beliefs were sometimes at odds with what patients were told by healthcare professionals, leading patients to seek alternate views.

目的:受伤信念会影响人们如何引导康复并影响他们如何寻求治疗。本研究的目的是探讨是什么影响了孤立性肢体损伤后持续症状的原因。方法:采用半结构化访谈法收集资料。参与者(n = 12, 67%为女性)被有意从一项探索孤立性肢体损伤后恢复轨迹的队列研究中取样。我们使用描述性方法进行反身性主题分析。结果:信念是通过(1)对康复需要的期望(2)与信任的人的互动,(3)经验,(4)先验知识和身份(主题1和子主题1a-d)形成的。持续的痛苦被理解为对异常情况的正常反应(主题2)。因果信念受到对他人判断的担忧的影响,特别是当症状与客观发现不符时(主题3)。结论:关于伤后症状持续存在原因的信念可以理解为一个相互关联的信念网络,由个人经验和知识塑造,但也有人际因素,如治疗联盟和害怕不被别人重视。因果信念有时与医疗保健专业人员告诉患者的不一致,导致患者寻求其他观点。
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引用次数: 0
Correction. 修正。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2026.2614215
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引用次数: 0
Effectiveness of a group-based time-management intervention: a pragmatic randomised controlled trial. 基于群体的时间管理干预的有效性:一项实用的随机对照试验。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2026.2614218
Kajsa Lidström Holmqvist, Maria Wingren, Ruzan Udumyran, Marie Holmefur

Purpose: Time management is essential to handle daily life in today's society. This study aimed to evaluate the effectiveness of the Swedish version of the Let's Get Organised (LGO-S) intervention to improve time-management skills for adults with impaired time management due to attention deficit hyperactivity disorder (ADHD), autism or mental disorders compared to treatment as usual (TAU), which is individual occupational therapy.

Materials and methods: This was a multi-centre, open, two-armed pragmatic randomised controlled trial. The setting was out-patient adult habilitation centres and psychiatric clinics. At baseline the study had 75 participants aged 19-61 years (mean 32.3 years) whereof 44 were women.

Results: Both intervention groups showed statistically significant improvements in time-management skills, organisation and planning, emotional regulation, general self-efficacy and satisfaction with activities at post-intervention test. Most of these within-group improvements were sustained after 3 months. Changes in time-management skills between LGO-S and TAU intervention were not statistically significant at post-intervention or after 3-months. Programme completers in LGO-S had significantly better time management skills at the 3-month follow-up than non-completers.

Conclusions: This pragmatic RCT, conducted in a clinical environment including participants with complex difficulties, showed that both LGO-S and individual occupational therapy are clinically useful/applicable interventions that effectively improve time-management skills.

目的:在当今社会,时间管理是处理日常生活必不可少的。本研究旨在评估瑞典版的Let's Get organized (LGO-S)干预措施的有效性,以提高因注意力缺陷多动障碍(ADHD),自闭症或精神障碍而导致时间管理受损的成年人的时间管理技能,与常规治疗(TAU)相比,这是一种个体职业治疗。材料和方法:这是一项多中心、开放、双臂、实用的随机对照试验。地点是成人康复中心门诊和精神科诊所。在基线研究中,有75名参与者年龄在19-61岁(平均32.3岁),其中44名是女性。结果:干预组和干预组在时间管理能力、组织计划能力、情绪调节能力、自我效能感和活动满意度方面均有显著提高。大多数组内改善在3个月后持续。在LGO-S和TAU干预之间,时间管理技能的变化在干预后或3个月后无统计学意义。在为期3个月的随访中,LGO-S计划完成者的时间管理技能明显优于未完成者。结论:这项实用的随机对照试验,在临床环境中进行,包括有复杂困难的参与者,表明LGO-S和个体职业治疗在临床上都是有用的/适用的干预措施,有效地提高了时间管理技能。
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引用次数: 0
Effects of different neuromuscular electrical stimulation techniques applied to the multifidus muscle on the kinematics of the spine, pelvis, and hip during sit-to-stand in individuals with chronic nonspecific Low back pain. 不同神经肌肉电刺激技术应用于多裂肌对慢性非特异性腰痛患者坐立时脊柱、骨盆和髋关节运动学的影响。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2026.2614294
Duygu Yılmaz Uras, Nazif Ekin Akalan, Shavkat Nadir Kuchimov, Demet Tekdöş Demircioğlu, Tüzün Fırat

Purpose: To investigate the effects of two neuromuscular electrical stimulation (NMES) techniques applied to the lumbar multifidus on spine, pelvis, and hip kinematics during sit-to-stand (STS) in individuals with chronic nonspecific low back pain (CNLBP).

Methods: Twenty-two individuals with CNLBP were randomized into conventional NMES (CNMES; n = 11) or functional NMES (FNMES; n = 11) groups. A control group of ten healthy individuals was included for comparison. The CNMES group received stimulation in the prone position without voluntary contraction, whereas the FNMES group received stimulation during STS. Interventions were delivered three times weekly for eight weeks. Kinematic parameters were assessed using optoelectronic motion capture, and pain and disability using the Visual Analog Scale and Oswestry Disability Index.

Results: At baseline, CNLBP groups showed reduced range of motion and angular velocity during the flexion phase of STS. After the intervention, the FNMES group demonstrated significant improvements in spine, pelvis, and hip kinematics (p < 0.05), while only spine angular velocity improved in the CNMES group. Both NMES groups demonstrated significant reductions in pain and disability levels (p < 0.05).

Conclusion: FNMES was more effective than CNMES in improving movement patterns during the flexion phase of STS, demonstrating its potential as a phase-specific rehabilitation approach for individuals with CNLBP.

目的:研究应用于腰椎多裂肌的两种神经肌肉电刺激(NMES)技术对慢性非特异性腰痛(CNLBP)患者坐立(STS)过程中脊柱、骨盆和髋关节运动学的影响。方法:22例CNLBP患者随机分为常规NMES组(CNMES, n = 11)和功能性NMES组(FNMES, n = 11)。另设10名健康个体作为对照组进行比较。CNMES组在俯卧位时接受刺激,不伴有自发性收缩,而FNMES组在STS时接受刺激。干预措施每周进行三次,持续八周。采用光电运动捕捉技术评估运动学参数,采用视觉模拟量表和Oswestry残疾指数评估疼痛和残疾。结果:在基线时,CNLBP组在STS屈曲阶段的运动范围和角速度减小。干预后,FNMES组在脊柱、骨盆和髋关节运动学方面表现出显著改善(p p结论:FNMES在改善STS屈曲期的运动模式方面比CNMES更有效,表明其作为CNLBP患者阶段特异性康复方法的潜力。
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引用次数: 0
Telerehabilitation versus in-person therapy for work-related injuries: adjusted comparative outcomes in Italian routine care. 远程康复与现场治疗工伤:调整比较结果在意大利常规护理。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2025.2608718
Cosimo Gentile, Francesco Donato, Veronica Sferra, Annalisa Talerico, Emanuele Gruppioni, Amedeo Amoresano, Raimondo Casini, Enzo Pezzuto, Fabrizio Bologna

Purpose: Compare telerehabilitation with in-person therapy for work-related injuries in Italian routine care using the STRF as the primary outcome.

Materials and methods: A 29-month retrospective cohort included sub-acute patients treated by telerehabilitation (n = 107) or in-person therapy (n = 117). Post-treatment STRF was analyzed by ANCOVA adjusted for baseline STRF, age, sex, anatomical site, surgical status, and calendar period. Secondary outcomes were responder status (ΔSTRF ≥1; adjusted logistic regression) and pain (NPRS; ANCOVA adjusted for baseline NPRS). Sensitivity analyses excluded surgical cases; an exploratory treatment × period interaction was tested. The STRF, developed and validated in Italy, was used as a context-specific measure.

Results: Adjusted models showed no between-group differences for post-treatment STRF or NPRS. Responder odds did not differ, and patterns suggesting slower early recovery among patients with low baseline STRF in unadjusted summaries attenuated after adjustment. Magnetotherapy was not independently associated with outcomes. Sensitivity analyses were consistent.

Conclusion: In Italian routine care for work-related injuries, telerehabilitation and in-person therapy showed no adjusted differences in functional or pain outcomes at discharge. These findings should be interpreted given the retrospective, nonrandomized design, period effects, surgical imbalance, and the Italy-specific validation of STRF. Prospective studies with cross-cultural validation and longer-term (including return-to-work) outcomes are warranted.

目的:比较意大利常规护理中以STRF为主要结局的工伤远程康复与现场治疗。材料和方法:一项为期29个月的回顾性队列研究,包括接受远程康复治疗(n = 107)或现场治疗(n = 117)的亚急性患者。治疗后STRF通过ANCOVA分析基线STRF、年龄、性别、解剖部位、手术状态和日历时间。次要结局是应答状态(ΔSTRF≥1;经调整的logistic回归)和疼痛(NPRS; ANCOVA调整基线NPRS)。敏感性分析排除手术病例;探索性处理×周期交互作用检验。在意大利开发和验证的STRF被用作具体情况的衡量标准。结果:调整后的模型显示治疗后STRF或NPRS组间无差异。对应答者的赔率没有差异,在未调整的总结中显示基线STRF较低的患者早期恢复较慢的模式在调整后减弱。磁疗与预后无独立相关性。敏感性分析结果一致。结论:在意大利的工伤常规护理中,远程康复和现场治疗在出院时的功能或疼痛结局方面没有调整差异。考虑到回顾性、非随机设计、周期效应、手术不平衡以及STRF在意大利的特异性验证,这些发现应该得到解释。具有跨文化验证和长期(包括重返工作岗位)结果的前瞻性研究是必要的。
{"title":"Telerehabilitation versus in-person therapy for work-related injuries: adjusted comparative outcomes in Italian routine care.","authors":"Cosimo Gentile, Francesco Donato, Veronica Sferra, Annalisa Talerico, Emanuele Gruppioni, Amedeo Amoresano, Raimondo Casini, Enzo Pezzuto, Fabrizio Bologna","doi":"10.1080/09638288.2025.2608718","DOIUrl":"https://doi.org/10.1080/09638288.2025.2608718","url":null,"abstract":"<p><strong>Purpose: </strong>Compare telerehabilitation with in-person therapy for work-related injuries in Italian routine care using the STRF as the primary outcome.</p><p><strong>Materials and methods: </strong>A 29-month retrospective cohort included sub-acute patients treated by telerehabilitation (<i>n</i> = 107) or in-person therapy (<i>n</i> = 117). Post-treatment STRF was analyzed by ANCOVA adjusted for baseline STRF, age, sex, anatomical site, surgical status, and calendar period. Secondary outcomes were responder status (ΔSTRF ≥1; adjusted logistic regression) and pain (NPRS; ANCOVA adjusted for baseline NPRS). Sensitivity analyses excluded surgical cases; an exploratory treatment × period interaction was tested. The STRF, developed and validated in Italy, was used as a context-specific measure.</p><p><strong>Results: </strong>Adjusted models showed no between-group differences for post-treatment STRF or NPRS. Responder odds did not differ, and patterns suggesting slower early recovery among patients with low baseline STRF in unadjusted summaries attenuated after adjustment. Magnetotherapy was not independently associated with outcomes. Sensitivity analyses were consistent.</p><p><strong>Conclusion: </strong>In Italian routine care for work-related injuries, telerehabilitation and in-person therapy showed no adjusted differences in functional or pain outcomes at discharge. These findings should be interpreted given the retrospective, nonrandomized design, period effects, surgical imbalance, and the Italy-specific validation of STRF. Prospective studies with cross-cultural validation and longer-term (including return-to-work) outcomes are warranted.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":" ","pages":"1-12"},"PeriodicalIF":2.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967699","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}
引用次数: 0
Supporting self-management in chronic pain through eHealth - exploring the needs, challenges and solutions in general practice: a qualitative and participatory study. 通过电子健康支持慢性疼痛的自我管理——探索全科实践中的需求、挑战和解决方案:一项定性和参与性研究。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2025.2611577
Chris Djurtoft, Kristine Sørensen, Christian Odgaard, Morten Hoegh, Michael Skovdal Rathleff, Simon Kristoffer Johansen

Purpose: Digital transformation and integration of eHealth solutions into chronic pain management faces significant challenges that have not yet been met. The objective of this study is to explore the challenges, barriers, needs, and solutions experienced by patients and general practitioners (GPs) in the context of an eHealth solution designed for chronic pain management in general practice.

Materials and methods: The study used action-research as a methodological framework. We conducted two future workshops involving eight patients living with chronic pain and seven GPs with clinical experience in managing chronic pain. Through case vignettes and inspiration cards, the workshops stimulated discussions and shared construction of knowledge. Data were analyzed using reflexive thematic analysis, separated by the groups, and were synthesized via a matrix analysis.

Results: The analysis revealed five content summary themes: Theme 1-patients' experience of challenges in life with pain; Theme 2-challenges in treating patients with chronic pain; Theme 3-patients' suggestions for the structure of the eHealth solution; Theme 4-GP' suggestions for the structure of the eHealth solution; and Theme 5-differences and similarities: Visions for an eHealth solution.

Conclusions: Our study represents a significant advancement in developing personalized and innovative eHealth solutions for general practice, addressing key clinical challenges.

目的:数字化转型和将电子健康解决方案整合到慢性疼痛管理中面临着尚未解决的重大挑战。本研究的目的是探讨患者和全科医生(gp)在为全科慢性疼痛管理设计的电子健康解决方案的背景下所遇到的挑战、障碍、需求和解决方案。材料和方法:本研究采用行动研究作为方法框架。我们举办了两场研讨会,涉及8名慢性疼痛患者和7名具有慢性疼痛管理临床经验的全科医生。通过案例小品和启发卡,工作坊激发了讨论和知识建构的共享。数据采用自反性主题分析,分组分离,并通过矩阵分析进行综合。结果:分析揭示了五个内容总结主题:主题1-患者生活中遇到的挑战与疼痛;主题2:慢性疼痛患者治疗面临的挑战;主题3:患者对电子医疗解决方案结构的建议;主题4-GP对电子健康解决方案结构的建议;主题5:差异与相似之处:电子健康解决方案的愿景。结论:我们的研究在为全科医生开发个性化和创新的电子健康解决方案方面取得了重大进展,解决了关键的临床挑战。
{"title":"Supporting self-management in chronic pain through eHealth - exploring the needs, challenges and solutions in general practice: a qualitative and participatory study.","authors":"Chris Djurtoft, Kristine Sørensen, Christian Odgaard, Morten Hoegh, Michael Skovdal Rathleff, Simon Kristoffer Johansen","doi":"10.1080/09638288.2025.2611577","DOIUrl":"https://doi.org/10.1080/09638288.2025.2611577","url":null,"abstract":"<p><strong>Purpose: </strong>Digital transformation and integration of eHealth solutions into chronic pain management faces significant challenges that have not yet been met. The objective of this study is to explore the challenges, barriers, needs, and solutions experienced by patients and general practitioners (GPs) in the context of an eHealth solution designed for chronic pain management in general practice.</p><p><strong>Materials and methods: </strong>The study used action-research as a methodological framework. We conducted two future workshops involving eight patients living with chronic pain and seven GPs with clinical experience in managing chronic pain. Through case vignettes and inspiration cards, the workshops stimulated discussions and shared construction of knowledge. Data were analyzed using reflexive thematic analysis, separated by the groups, and were synthesized <i>via</i> a matrix analysis.</p><p><strong>Results: </strong>The analysis revealed five content summary themes: Theme 1-patients' experience of challenges in life with pain; Theme 2-challenges in treating patients with chronic pain; Theme 3-patients' suggestions for the structure of the eHealth solution; Theme 4-GP' suggestions for the structure of the eHealth solution; and Theme 5-differences and similarities: Visions for an eHealth solution.</p><p><strong>Conclusions: </strong>Our study represents a significant advancement in developing personalized and innovative eHealth solutions for general practice, addressing key clinical challenges.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":" ","pages":"1-21"},"PeriodicalIF":2.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967662","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}
引用次数: 0
The walking experience of persons with multiple sclerosis: a systematic review with evaluation of the sensitivity of the ICF framework to the lived experience. 多发性硬化症患者的行走经验:一项评估ICF框架对生活经验敏感性的系统综述。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1080/09638288.2025.2606104
Emily J Wood, Brook Galna, Georgios Mavropalias, Priyankara Manoj Rajakaruna, Yvonne C Learmonth

Purpose: Conduct a systematic review aimed to identify and synthesise evidence describing how walking impairment impacts the way persons with multiple sclerosis (MS) participate in activities within their homes and communities. Further, we assessed the sensitivity of the International Classification of Functioning, Disability and Health (ICF) framework to the lived walking experience for persons with MS.

Methods: Seven electronic databases were searched for peer-reviewed articles on the walking experience of persons with MS. Qualitative articles were included if they included quotes from persons with MS regarding community walking. Qualitative data were synthesised using a hybrid inductive and deductive thematic analysis, guided by the ICF framework and quality was appraised using the CASP tool.

Results: We included 90 eligible studies (214 quotes, 1813 participants). Study quality was high in 54% of studies. Four themes were identified: (1) adapting to physical barriers; (2) navigating society; (3) emotion and mindset; and (4) personal relationships.

Conclusions: The impact of walking impairment on community participation is perceived by persons with MS as negative and the cause of disconnect from those around them. Barriers are largely perceived as extrinsic to the self. Caution should be exercised when conceptualising walking experiences with MS using the ICF framework alone.

目的:进行一项系统综述,旨在识别和综合描述行走障碍如何影响多发性硬化症(MS)患者在家庭和社区中参与活动的证据。此外,我们评估了国际功能、残疾和健康分类(ICF)框架对多发性硬化症患者生活步行体验的敏感性。方法:检索了7个电子数据库,检索了关于多发性硬化症患者步行体验的同行评审文章。如果有多发性硬化症患者关于社区步行的引用,则纳入定性文章。在ICF框架的指导下,使用混合归纳和演绎主题分析综合定性数据,并使用CASP工具对质量进行评估。结果:我们纳入了90项符合条件的研究(214条引用,1813名受试者)。54%的研究质量较高。确定了四个主题:(1)适应物理障碍;(二)航海协会;(3)情绪与心态;(4)人际关系。结论:MS患者认为步行障碍对社区参与的影响是负面的,是导致他们与周围人脱节的原因。障碍在很大程度上被认为是外在的自我。在单独使用ICF框架概念化MS步行体验时应谨慎。
{"title":"The walking experience of persons with multiple sclerosis: a systematic review with evaluation of the sensitivity of the ICF framework to the lived experience.","authors":"Emily J Wood, Brook Galna, Georgios Mavropalias, Priyankara Manoj Rajakaruna, Yvonne C Learmonth","doi":"10.1080/09638288.2025.2606104","DOIUrl":"https://doi.org/10.1080/09638288.2025.2606104","url":null,"abstract":"<p><strong>Purpose: </strong>Conduct a systematic review aimed to identify and synthesise evidence describing how walking impairment impacts the way persons with multiple sclerosis (MS) participate in activities within their homes and communities. Further, we assessed the sensitivity of the International Classification of Functioning, Disability and Health (ICF) framework to the lived walking experience for persons with MS.</p><p><strong>Methods: </strong>Seven electronic databases were searched for peer-reviewed articles on the walking experience of persons with MS. Qualitative articles were included if they included quotes from persons with MS regarding community walking. Qualitative data were synthesised using a hybrid inductive and deductive thematic analysis, guided by the ICF framework and quality was appraised using the CASP tool.</p><p><strong>Results: </strong>We included 90 eligible studies (214 quotes, 1813 participants). Study quality was high in 54% of studies. Four themes were identified: (1) adapting to physical barriers; (2) navigating society; (3) emotion and mindset; and (4) personal relationships.</p><p><strong>Conclusions: </strong>The impact of walking impairment on community participation is perceived by persons with MS as negative and the cause of disconnect from those around them. Barriers are largely perceived as extrinsic to the self. Caution should be exercised when conceptualising walking experiences with MS using the ICF framework alone.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":" ","pages":"1-24"},"PeriodicalIF":2.0,"publicationDate":"2026-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967751","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}
引用次数: 0
Can cerebellar noninvasive brain stimulation improve lower limb function in stroke? Evidence from meta-analyses based on ICF. 小脑无创脑刺激能改善中风患者下肢功能吗?基于ICF的荟萃分析证据。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-11 DOI: 10.1080/09638288.2025.2612455
Xiaolong Yang, Lei Cao, Linlin Ye, Tiantian Zhang, Yi Shan, Lin Hua, Jin Xu, Weiqun Song, Jie Lu

Purpose: Lower limb dysfunction following a stroke substantially hinders mobility and independence. Cerebellar noninvasive brain stimulation (NIBS) has exhibited potential in enhancing lower limb functionality post-stroke. Our study aims to evaluate the effects from both statistical and clinical significance based on the International Classification of Functioning, Disability, and Health (ICF).

Materials and methods: We systematically searched PubMed, Embase, Web of Science, and Cochrane Library. With meta-analyses and network meta-analyses conducted. Data extraction and analyses based on Cochrane Handbook and ICF.

Results: Fifteen studies (n = 579 patients) were enrolled. Cerebellar NIBS revealed statistically significant differences in "Activity" components, including the Berg Scale (MD = 4.37), Timed Up and Go Test (TUG; MD = 3.32), and Barthel index (BI; MD = 8.01). However, no significant differences were noted in "Body" Functions (FMA-LL; MD = 2.97), with high-dose intermittent theta-burst stimulation indicating a potentially large effect size (MD = 5.26 vs. 0.68). The post-hoc network meta-analysis showed no statistical difference between electrical and magnetic cerebellar NIBS in "Activity" components.

Conclusions: As per the low-to-moderate level evidence, cerebellar NIBS demonstrated statistically significant improvements in the "Activity" components (Berg, TUG, and BI), albeit these improvements did not translate into clinically meaningful differences, except for BI.

目的:中风后下肢功能障碍严重阻碍了活动能力和独立性。小脑无创脑刺激(NIBS)已显示出增强中风后下肢功能的潜力。我们的研究旨在根据国际功能、残疾和健康分类(ICF)从统计和临床意义上评估效果。材料和方法:系统检索PubMed、Embase、Web of Science和Cochrane Library。进行了meta分析和网络meta分析。基于Cochrane手册和ICF的数据提取和分析。结果:纳入了15项研究(n = 579例患者)。小脑NIBS在Berg量表(MD = 4.37)、Timed Up and Go Test (TUG; MD = 3.32)和Barthel指数(BI; MD = 8.01)等“活动”成分上存在统计学差异。然而,在“身体”功能方面没有发现显著差异(FMA-LL; MD = 2.97),高剂量间歇性θ -burst刺激表明潜在的大效应大小(MD = 5.26 vs. 0.68)。事后网络荟萃分析显示,电性和磁性小脑NIBS在“活动”成分上无统计学差异。结论:根据低至中等水平的证据,小脑NIBS在“活动”成分(Berg、TUG和BI)方面表现出统计学上显著的改善,尽管这些改善并没有转化为临床有意义的差异,但BI除外。
{"title":"Can cerebellar noninvasive brain stimulation improve lower limb function in stroke? Evidence from meta-analyses based on ICF.","authors":"Xiaolong Yang, Lei Cao, Linlin Ye, Tiantian Zhang, Yi Shan, Lin Hua, Jin Xu, Weiqun Song, Jie Lu","doi":"10.1080/09638288.2025.2612455","DOIUrl":"https://doi.org/10.1080/09638288.2025.2612455","url":null,"abstract":"<p><strong>Purpose: </strong>Lower limb dysfunction following a stroke substantially hinders mobility and independence. Cerebellar noninvasive brain stimulation (NIBS) has exhibited potential in enhancing lower limb functionality post-stroke. Our study aims to evaluate the effects from both statistical and clinical significance based on the International Classification of Functioning, Disability, and Health (ICF).</p><p><strong>Materials and methods: </strong>We systematically searched PubMed, Embase, Web of Science, and Cochrane Library. With meta-analyses and network meta-analyses conducted. Data extraction and analyses based on Cochrane Handbook and ICF.</p><p><strong>Results: </strong>Fifteen studies (<i>n</i> = 579 patients) were enrolled. Cerebellar NIBS revealed statistically significant differences in \"Activity\" components, including the Berg Scale (MD = 4.37), Timed Up and Go Test (TUG; MD = 3.32), and Barthel index (BI; MD = 8.01). However, no significant differences were noted in \"Body\" Functions (FMA-LL; MD = 2.97), with high-dose intermittent theta-burst stimulation indicating a potentially large effect size (MD = 5.26 vs. 0.68). The post-hoc network meta-analysis showed no statistical difference between electrical and magnetic cerebellar NIBS in \"Activity\" components.</p><p><strong>Conclusions: </strong>As per the low-to-moderate level evidence, cerebellar NIBS demonstrated statistically significant improvements in the \"Activity\" components (Berg, TUG, and BI), albeit these improvements did not translate into clinically meaningful differences, except for BI.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":" ","pages":"1-23"},"PeriodicalIF":2.0,"publicationDate":"2026-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145953528","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}
引用次数: 0
Exploring the emerging concept of precision rehabilitation: a qualitative study. 探索精准康复的新兴概念:一项定性研究。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-10 DOI: 10.1080/09638288.2025.2607562
Annie Pouliot-Laforte, Evemie Dubé, Dahlia Kairy, Danielle E Levac

Purpose: This descriptive qualitative study explored knowledge users' perspectives on precision rehabilitation concepts, barriers, facilitators, and future directions as part of a convergent mixed methods scoping review.

Materials and methods: Sixteen clinicians, administrators, and researchers from three North American tertiary care rehabilitation centers were recruited using convenience and snowball sampling to participate in individual semi-structured interviews. Conventional qualitative content analysis followed a deductive thematic approach based on predetermined categories.

Results: Analyses revealed three main themes: (1) Although precision rehabilitation shares foundational concepts with precision medicine, there are certain elements, such as personalization, that are uniquely expressed; (2) Rehabilitation-specific facilitators to precision approaches include the use of unobtrusive technology to collect large amounts of data in real-world contexts, while barriers include rehabilitation's typically small, heterogeneous sample sizes; and (3) The future of precision rehabilitation will require collaborative data-sharing to focus on determining care trajectories that enhance functional outcomes.

Conclusion: Findings provide the first qualitative synthesis of knowledge users perspectives to complement quantitative evidence and inform the emerging field of precision rehabilitation.

目的:本描述性定性研究探讨了知识使用者对精确康复概念、障碍、促进因素和未来方向的看法,作为融合混合方法范围审查的一部分。材料和方法:采用便利和滚雪球抽样的方法,从三家北美三级护理康复中心招募了16名临床医生、管理人员和研究人员参加个人半结构化访谈。传统的定性内容分析遵循基于预定类别的演绎主题方法。结果:(1)精准康复与精准医疗虽有共同的基本概念,但在个性化等要素上有独特的表达;(2)康复特定的精确方法的促进因素包括使用不引人注目的技术在现实环境中收集大量数据,而障碍包括康复通常的小样本和异质样本量;(3)精准康复的未来将需要协作数据共享,以专注于确定提高功能结果的护理轨迹。结论:研究结果首次提供了知识使用者视角的定性综合,以补充定量证据,并为新兴的精准康复领域提供信息。
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引用次数: 0
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Disability and Rehabilitation
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