Disability and Rehabilitation最新文献

Purpose: The Rivermead mobility index (RMI) is a patient self-reported outcome (PRO) that measures patients' mobility. This study aimed to translate and cross-culturally adapt the (RMI) into Arabic and to assess its validity and psychometric properties.

Method: RMI was translated into Arabic in accordance with international consensus guidelines. Using a cross-sectional design, one hundred patients with Multiple Sclerosis completed the Arabic version of the Rivermead Mobility Index (RMI-Ar), the Barthel Index (BI), and the Multiple Sclerosis Impact Scale-29 (MSIS-29), which includes two subscales for the physical (PHYS) and psychological (PSYCH). To assess test-retest reliability, fifty participants were asked to retake the RMI-Ar after a two-week interval.

Results: The RMI-Ar was simple and understandable to patients with MS in Saudi Arabia. The internal consistency of the RMI-Ar was excellent (Cronbach's alpha = 0.908), and test-retest reliability was strong (ICC = 0.908). The minimal detectable change between the test and retest was 26.8% for RMI. Additionally, the RMI-Ar demonstrated good face and content validity, confirming that all items were relevant, clear, and concise, as well as construct validity, shown by strong positive correlations with the Barthel Index (rho = 0.73) and weak negative correlations with the MSIS-29 psychological domain (rho = -0.23). No floor or ceiling effect was observed, affirming the scale's capacity to differentiate between participation levels.

Conclusion: The RMI-Ar questionnaire is a valid and reliable outcome measure to use in clinical and research settings.

Purpose: To explore the similarities and differences in clinical practice and intervention choices of Bobath- and non-Bobath-educated physiotherapists during a single post-stroke clinical session.

Methods: A qualitative interpretive description approach was used, incorporating stimulated recall with video-recorded treatment sessions and in-depth interviews. Thirty-two neurological physiotherapists from diverse clinical settings participated, including 16 Bobath educated (BG) and 16 non-Bobath educated (NBG) therapists. Video recordings provided primary data for intervention interpretation and were cross-referenced with interview data describing clinical reasoning. The Rehabilitation Treatment Specification System (RTSS), including treatment targets, ingredients, and mechanisms of action, was applied to clarify intervention selection and theoretical underpinnings.

Results: A total of 2507 interventions were analysed and categorised. The BG emphasised sensory stimulation, manual facilitation, and environmental organisation to influence body configuration, postural control, and sensorimotor integration, reflecting implicit neurophysiological mechanisms. The NBG prioritised task repetition, strength training, and verbal cueing, aligning practice with explicit motor learning principles. The BG used therapeutic touch more frequently (65.4%) and structured session around part-task progression, whereas the NBG employed more hands-off strategies (44.3%) and favoured task repetition.

Conclusion: The RTSS framework effectively illustrated differences in intervention structure, intent, clinical reasoning, and mechanisms of action between Bobath- and non-Bobath-educated physiotherapists.

Purpose: To evaluate the efficacy of CanCommunicate for improving perceived communication disability and quality of life in people with brain tumour, compared to usual care.

Materials & methods: A randomised trial with a waitlist control was used. Participants were randomised to CanCommunicate (immediate intervention) or a wait list (control). CanCommunicate involved a 7-week communication intervention guided by Goal Attainment Scaling with group and individualised sessions. Participants completed the Comprehensive Aphasia Test Disability Questionnaire (CAT DQ), Functional Assessment of Cancer Therapy - General (FACT-G), La Trobe Communication questionnaire (LCQ) and semi-structured interviews at baseline and post-intervention.

Results: 39 people participated (Immediate intervention n = 24, waitlist n = 15). There was a significant between-group difference on the CAT DQ over time (p = 0.04) in favour of the intervention group, but not for the LCQ (p = 0.58) or FACT-G (p = 0.80). When data were combined for all participants who completed CanCommunicate (n = 23), ratings were significantly improved on the CAT-DQ (p < 0.001) and LCQ (p = 0.04) at 6-week follow-up. Participants perceived CanCommunicate favourably and made suggestions for further optimisation.

Conclusion: The current study supports the benefits of communication intervention for people with brain tumour and reinforces the need for tailored, goal-based interventions.

Purpose: Parent engagement (PE) is crucial to achieving positive outcomes in pediatric rehabilitation. Measuring its characteristics may help healthcare professionals enhance PE. This study aims to translate into Italian and to validate the PRIME P scale, a tool useful for measuring PE in pediatric rehabilitation.

Methods: The cross-cultural translation followed recent guidelines. Caregivers (n = 124) were recruited from two Italian pediatric rehabilitation services. Participants completed the scale twice within 15 days. Internal consistency, test-retest reliability, and construct validity (via exploratory factor analysis) were analyzed. Associations between participants' characteristics and scale scores were also investigated.

Results: The IT-PRIME P exploratory factor analysis identified a two-dimensional structure: "Predisposition to treatment" and "Collaboration". The IT-PRIME P showed adequate internal consistency (Dimension 1: α = 0.87 - Dimension 2: α = 0.80) and good test-retest reliability (Dimension 1: ICC = 0.711; Dimension 2: ICC = 0.845). Correlations and regression analyses identified associations between the "Collaboration" dimension and the variables "child's age" and "type of therapy" (p < 0.05) and "parent's presence" (p < 0.05; β = 1.21; 95% CI = 0.04-2.38).

Conclusions: The PRIME-P IT demonstrates adequate psychometric properties, consistent with those of the original PRIME-P scale. These findings support its use for assessing PE in pediatric rehabilitation settings.

Purpose: To explore the needs and expectations of parents of children with chronic conditions regarding information exchange via mobile applications in pediatric rehabilitation.

Materials and methods: Qualitative online focus group study with parents of children undergoing rehabilitation. Maximum variation sampling included mothers and fathers of children with diverse ages, conditions, communication abilities, rehabilitation durations, and settings. Researchers conducted inductive content analysis until data saturation, with interpretations cross-checked by a parent-partner.

Results: Three focus groups involved 14 parents (mean age 41.5 ± 6 years; 10 women). Three categories emerged: (1) From fragmented rehabilitation pathways to integrated care: applications could centralize information, support holistic child-centered follow-up, enable personalized goal-setting, and facilitate knowledge sharing among peers and professionals; (2) Key components for success: applications should recognize parents' expertise and central role, involve all stakeholders early, offer user-friendly interfaces, and structure communication effectively; (3) Challenges in information sharing: effective implementation requires engagement of all stakeholders, attention to interpersonal dynamics, and secure, legally compliant data sharing.

Conclusions: Parents view applications as valuable tools for improving information exchange, personalized rehabilitation, and home guidance. Effective pediatric rehabilitation applications must support multi-stakeholder coordination, integrate peer support and professional expertise to ensure reliable knowledge, empower parents, and ensure secure, accessible data.

Purpose: Virtual reality (VR) provides engaging and motivating environments that may enhance motor recovery and patient engagement in stroke rehabilitation. However, clinical adoption remains limited in Japan. This study explored Japanese physical therapists' perspectives on VR use and identified factors influencing adoption.

Methods: A sequential explanatory mixed-methods design was used. In Phase 1, 141 physical therapists completed a survey adapted from the ADOPT-VR framework. Correlation and multiple regression analyses identified predictors of behavioral intention. In Phase 2, semi-structured interviews with 12 therapists provided in-depth insights, analyzed using thematic analysis.

Results: Compatibility (r = .456), perceived usefulness (r = .419), attitude (r = .415), time availability (r = .409), and technical support (r = .405) were moderately correlated with behavioral intention. Regression results indicated that compatibility, technical support, and social norms were significant predictors. Qualitative findings highlighted barriers such as limited training, equipment complexity, and unclear patient selection, while facilitators included peer modeling, hands-on learning, and leadership support.

Conclusion: Although attitudes toward VR are positive, adoption is constrained by contextual and organizational barriers. Clinically compatible implementation strategies, targeted training, and institutional support are needed to enhance VR integration in stroke rehabilitation.

Purpose: Functional Movement Disorder (FMD) is a debilitating condition with a growing prevalence. Students may encounter FMD in future practice, however, it is unclear if they feel prepared to provide high-quality care. This study will investigate undergraduate physiotherapy students' perspectives and understanding of FMD which may inform appropriate FMD content for undergraduate physiotherapy programmes.

Materials and methods: Focus groups were advertised to third-year undergraduate physiotherapy students studying at a South-West university in Bristol. England. Five researchers were involved in data collection and analysis.

Results: Five themes were identified following two focus groups (n = 8 participants). Students understanding of FMD stemmed primarily from the teaching they received during their undergraduate course. Whilst participants were generally positive about the teaching, it was clear that understanding was limited, and improvements could be made to feel more confident working with patients with FMD in the future.

Conclusion: Results indicate that students' understanding of FMD could be improved through more comprehensive teaching during the undergraduate physiotherapy course. Current gaps in knowledge include causes, diagnostic signs, and treatment interventions for FMD. Further research investigating gaps in qualified physiotherapists knowledge of FMD could provide more insights into what should be included in FMD teaching at the undergraduate level.

Purpose: To synthesise the evidence on the psychometric properties and utility of the WHODAS 2.0 in somatic patients in clinical settings.

Methods: A systematic search in PubMed, Embase, PsycINFO and CINAHL (years 2010-2025) using subject headings and free text was conducted. Additional grey literature and references were screened. Psychometric properties were appraised using Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) risk of bias and rating of psychometric properties. Certainty was graded with modified GRADE.

Results: Forty-one studies were included. WHODAS 2.0 showed sufficient test-retest reliability for the 12-item and 36-item versions. The 12-item version demonstrated sufficient construct validity and consistent responsiveness. Structural validity was inconsistent across versions, constraining interpretation of internal consistency. Evidence for measurement error and criterion validity was weak or inconclusive for the 12-item and 36-item versions. WHODAS 2.0 was feasible and acceptable, though heterogeneity in recall periods and scoring limited comparability.

Conclusion: WHODAS 2.0, particularly the 12-item version, is a clinically useful instrument for assessing functioning and disability across a range of clinical settings. Future research should prioritise standardised administration and scoring and strengthen structural and content validity through context-specific studies to optimise psychometric performance and clinical utility.

Purpose: People with dementia have worse balance and more falls than older adults with no cognitive impairment. Despite potential benefits, few physical rehabilitation programs exist for people with dementia. This study investigated people who support individuals with dementia's experiences and perspectives with physical rehabilitation.

Methods: In this qualitative descriptive study, 9 family members, 8 staff, 7 clinicians, and 6 researchers (n = 30) attended interviews or focus groups discussing balance, falls, rehabilitation, exercise, and cognitive impairment. Qualitative data were analyzed using reflexive thematic analysis, through an inductive and semantic approach.

Results: Physical rehabilitation for people with dementia may be lacking due to low expectations of abilities; safety concerns driving and limiting rehabilitation; and existing resources being inadequate. Low expectations of people with dementia's abilities to participate in rehabilitation led to exclusion. Safety concerns drove family members to pursue rehabilitation for the person with dementia, whilst risk aversion made staff and professionals hesitant to deliver rehabilitation to this population. Limited rehabilitation prompted family members to seek resources (exercises) provided by staff and professionals, which were viewed as not tailored or challenging enough for the person with dementia.

Conclusions: This study highlights the need for increased awareness about physical rehabilitation for people with dementia.

Purpose: This prospective study examined the psychometric properties of the Speed Precision ObsTacle courSe (SPOTS), a six-item, triangle-shaped obstacle course to assess walking adaptability in individuals with a central neurological disorder (CND).

Materials and methods: Inter- and intra-rater reliability, validity and sensitivity of the SPOTS were evaluated in adults with CND undergoing inpatient rehabilitation. The SPOTS was performed on 2 consecutive days, and 1 month later, alongside clinical assessments on the first and last day. Completion time was recorded, and three raters performed clinician-rated assessments for motor and cognitive function based on video recordings. Reliability of the clinician-rated SPOTS score was assessed with Intraclass Correlation Coefficients (ICC), Bland-Altman, and weighted Kappa analysis; validity with Spearman rank correlation coefficients and sensitivity to change with the minimal detectable change (MDC).

Results: Thirty-five independent walkers (FAC ≥3) with CND were recruited. The SPOTS showed excellent inter-rater (ICC: 0.90-0.93) and intra-rater reliability (ICC: 0.91-0.96). Adequate to excellent correlations (r = 0.36-0.66) were found with other common balance and gait assessments. An MDC value of 4.63 points (6.4% of SPOTS) was found.

Conclusion: The SPOTS is a new, promising, reliable, valid and sensitive tool for assessing advanced walking adaptability in patients with CND.