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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。
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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。
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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
Neuromodulation techniques for enhancing lower extremity motor function in children with cerebral palsy (CP): a systematic review and meta-analysis of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) interventions. 神经调节技术增强脑瘫(CP)患儿下肢运动功能:重复经颅磁刺激(rTMS)和经颅直流刺激(tDCS)干预的系统回顾和荟萃分析。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-10 DOI: 10.1080/09638288.2025.2611576
Meysam Mansouri, Saba Amiri, Shahla Azizi

Purpose: To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on gait and brain alteration in cerebral palsy (CP) children.

Materials and methods: MEDLINE, Scopus, Google Scholar, Web of Science, and Cochrane were searched in February 2024 and updated in 9 October 2025. Randomized controlled trials (RCTs) with CP participants under 18, rTMS or tDCS intervention, and gait assessment were included. The risk of bias was assessed, and a meta-analysis was conducted using random-effect models.This review was registered in PROSPERO (ID: CRD42024555049).

Results: 21 studies met the inclusion criteria. tDCS led to significant improvements in velocity (MD = 0.17, 95% CI = 0 to 0.35), gross motor function measure (GMFM), and functional independence. However, changes in other parameters such as step length, and cadence were not statistically significant and showed high heterogeneity. rTMS also improved overall motor function and walking performance in several studies, though data variability prevented meta-analysis. Both methods were safe and well-tolerated.

Conclusion: Both interventions showed promise for improving velocity and GMFM in children with CP. However, due to inconsistent findings across other gait parameters and substantial heterogeneity, further large-scale, standardized RCTs with neuroimaging assessments are needed.

目的:探讨重复经颅磁刺激(rTMS)和经颅直流电刺激(tDCS)对脑瘫(CP)患儿步态和脑功能改变的影响。材料和方法:2024年2月检索MEDLINE、Scopus、谷歌Scholar、Web of Science和Cochrane,并于2025年10月9日更新。随机对照试验(rct)包括18岁以下CP参与者、rTMS或tDCS干预和步态评估。评估偏倚风险,并使用随机效应模型进行meta分析。本综述已在PROSPERO注册(ID: CRD42024555049)。结果:21项研究符合纳入标准。tDCS显著改善了速度(MD = 0.17, 95% CI = 0 ~ 0.35)、大运动功能测量(GMFM)和功能独立性。然而,步长和节奏等其他参数的变化没有统计学意义,显示出高度的异质性。在几项研究中,rTMS也改善了整体运动功能和行走表现,尽管数据差异阻碍了meta分析。两种方法都是安全且耐受性良好的。结论:两种干预措施都有望改善CP患儿的速度和GMFM。然而,由于其他步态参数的结果不一致,并且存在很大的异质性,需要进一步进行大规模、标准化的随机对照试验,并进行神经影像学评估。
{"title":"Neuromodulation techniques for enhancing lower extremity motor function in children with cerebral palsy (CP): a systematic review and meta-analysis of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) interventions.","authors":"Meysam Mansouri, Saba Amiri, Shahla Azizi","doi":"10.1080/09638288.2025.2611576","DOIUrl":"https://doi.org/10.1080/09638288.2025.2611576","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) on gait and brain alteration in cerebral palsy (CP) children.</p><p><strong>Materials and methods: </strong>MEDLINE, Scopus, Google Scholar, Web of Science, and Cochrane were searched in February 2024 and updated in 9 October 2025. Randomized controlled trials (RCTs) with CP participants under 18, rTMS or tDCS intervention, and gait assessment were included. The risk of bias was assessed, and a meta-analysis was conducted using random-effect models.This review was registered in PROSPERO (ID: CRD42024555049).</p><p><strong>Results: </strong>21 studies met the inclusion criteria. tDCS led to significant improvements in velocity (MD = 0.17, 95% CI = 0 to 0.35), gross motor function measure (GMFM), and functional independence. However, changes in other parameters such as step length, and cadence were not statistically significant and showed high heterogeneity. rTMS also improved overall motor function and walking performance in several studies, though data variability prevented meta-analysis. Both methods were safe and well-tolerated.</p><p><strong>Conclusion: </strong>Both interventions showed promise for improving velocity and GMFM in children with CP. However, due to inconsistent findings across other gait parameters and substantial heterogeneity, further large-scale, standardized RCTs with neuroimaging assessments are needed.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":" ","pages":"1-25"},"PeriodicalIF":2.0,"publicationDate":"2026-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145945579","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
Recommendations for adapting an online mindfulness program for people living with spinal cord injury: results from a pilot online survey with an integrated knowledge translation approach. 针对脊髓损伤患者调整在线正念计划的建议:采用综合知识翻译方法的试点在线调查结果。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-08 DOI: 10.1080/09638288.2025.2612456
Vjura Senthilnathan, Robert Simpson, Susan Jaglal, Beverley Catharine Craven, Mary-Jo Fetterly, Sonya Allin, Fiona Webster, Jasmine Hearn, Dorothy Luong, Sarah Ep Munce

Purpose: To determine the implementation considerations for an online mindfulness-based intervention (MBI) tailored to individuals with spinal cord injury (SCI) and determine whether the identified preferences vary by demographic and clinical characteristics.

Materials and methods: This study was a cross-sectional, online survey using an integrated knowledge translation (iKT) approach. Adults with SCI across Canada and the United States participated in this study. Participants stated their preferences and importance of different aspects of the program (e.g. delivery format, session structure). The survey content was informed by an earlier qualitative study and the Template for Intervention Description and Replication (TIDieR) framework.

Results: 361 adults with SCI (225 males, mean age 36 (SD 8.61)) completed the survey. Prerecorded webinars were the most preferred format for an online MBI. The preferred duration and frequency of the program were 6-8 weeks and 2 sessions per week, respectively. The preferred session length was 30-45 min. Participants preferred having the program be introduced during inpatient SCI rehabilitation.

Conclusions: This study identified the preferred adaptations for an online MBI for individuals with SCI in Canada and the United States. Survey results will inform the development and implementation of a tailored online MBI that is relevant and meaningful to individuals with SCI.

目的:确定为脊髓损伤(SCI)患者量身定制的在线正念干预(MBI)的实施考虑因素,并确定确定的偏好是否因人口统计学和临床特征而异。材料和方法:本研究是采用综合知识翻译(iKT)方法的横断面在线调查。加拿大和美国的成年脊髓损伤患者参与了这项研究。参与者陈述了他们对项目不同方面的偏好和重要性(例如交付形式、会议结构)。调查内容由早期的定性研究和干预描述和复制模板(TIDieR)框架提供。结果:361例成年脊髓损伤患者(男性225例,平均年龄36岁(SD 8.61))完成了调查。预先录制的网络研讨会是在线MBI最受欢迎的形式。项目的首选时间和频率分别为6-8周和每周2次。首选会话长度为30-45分钟。参与者更倾向于在脊髓损伤住院康复期间引入该计划。结论:本研究确定了加拿大和美国SCI患者在线MBI的首选适应性。调查结果将为开发和实施定制的在线MBI提供信息,该在线MBI与SCI患者相关且有意义。
{"title":"Recommendations for adapting an online mindfulness program for people living with spinal cord injury: results from a pilot online survey with an integrated knowledge translation approach.","authors":"Vjura Senthilnathan, Robert Simpson, Susan Jaglal, Beverley Catharine Craven, Mary-Jo Fetterly, Sonya Allin, Fiona Webster, Jasmine Hearn, Dorothy Luong, Sarah Ep Munce","doi":"10.1080/09638288.2025.2612456","DOIUrl":"https://doi.org/10.1080/09638288.2025.2612456","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the implementation considerations for an online mindfulness-based intervention (MBI) tailored to individuals with spinal cord injury (SCI) and determine whether the identified preferences vary by demographic and clinical characteristics.</p><p><strong>Materials and methods: </strong>This study was a cross-sectional, online survey using an integrated knowledge translation (iKT) approach. Adults with SCI across Canada and the United States participated in this study. Participants stated their preferences and importance of different aspects of the program (e.g. delivery format, session structure). The survey content was informed by an earlier qualitative study and the Template for Intervention Description and Replication (TIDieR) framework.</p><p><strong>Results: </strong>361 adults with SCI (225 males, mean age 36 (SD 8.61)) completed the survey. Prerecorded webinars were the most preferred format for an online MBI. The preferred duration and frequency of the program were 6-8 weeks and 2 sessions per week, respectively. The preferred session length was 30-45 min. Participants preferred having the program be introduced during inpatient SCI rehabilitation.</p><p><strong>Conclusions: </strong>This study identified the preferred adaptations for an online MBI for individuals with SCI in Canada and the United States. Survey results will inform the development and implementation of a tailored online MBI that is relevant and meaningful to individuals with SCI.</p>","PeriodicalId":50575,"journal":{"name":"Disability and Rehabilitation","volume":" ","pages":"1-20"},"PeriodicalIF":2.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919035","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
Knowledge mobilization through audit and feedback: a scoping review of applications in rehabilitation. 通过审计和反馈的知识动员:康复应用的范围审查。
IF 2 4区 医学 Q1 REHABILITATION Pub Date : 2026-01-08 DOI: 10.1080/09638288.2025.2607592
Pascale Simard, Julien Déry, Krista L Best, Marie-Eve Lamontagne

Purpose: To explore the scope of the methodologies reported for Audit & Feedback (A&F) in rehabilitation settings.

Method: The keyword search strategy was validated by a specialized librarian and conducted in the PubMed and CINAHL databases. Two reviewers screened the studies using Covidence software, and conflicts were resolved by a third person. The inclusion criteria were 1) to take place in a physical rehabilitation setting, 2) to use the A & F, and 3) to be written in English or French. Data were extracted into an Excel grid, and descriptive analyses were conducted to summarize the characteristics of the studies and A&F methodologies.

Results: Sixty studies were included. A&F are primarily used in the context of implementing a new program/intervention (40.0%), or to ensure adherence to guidelines and recommendations (55.5%). Principal data collection methods are audit of medical files (51.7%) and observations (6.7%). Nineteen studies (31.7%) provided both written and verbal feedback, yet thirteen studies (21.7%) did not clarify the feedback recipients (e.g. managers, clinicians). Research gaps identified included a lack of guiding frameworks for A&F reported in the studies and the absence of a detailed feedback procedure.

Conclusion: Our study reflects the importance of thorough reflections on best practices.

目的:探讨康复环境中审计与反馈(A&F)方法报告的范围。方法:关键词搜索策略由专业馆员验证,并在PubMed和CINAHL数据库中进行。两名审稿人使用covid - ence软件筛选研究,冲突由第三方解决。纳入标准是1)在物理康复环境中进行,2)使用a&f, 3)用英语或法语撰写。将数据提取到Excel网格中,并进行描述性分析,以总结研究的特点和A&F方法。结果:纳入60项研究。A&F主要用于实施新的规划/干预(40.0%),或确保遵守指南和建议(55.5%)。主要的数据收集方法是医疗档案审计(51.7%)和观察(6.7%)。19项研究(31.7%)提供了书面和口头反馈,但13项研究(21.7%)没有明确反馈接受者(如管理人员、临床医生)。确定的研究差距包括缺乏研究中报告的A&F的指导框架和缺乏详细的反馈程序。结论:我们的研究反映了对最佳实践进行彻底反思的重要性。
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Disability and Rehabilitation
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