Journal of Rehabilitation Medicine最新文献

Objective: To investigate whether rehabilitation data share common characteristics across different health conditions and care settings within the EU Horizon PREPARE project.

Design: Qualitative content analysis, with a comparative study of existing clinical databases.

Subjects/patients: Individuals with hand and wrist disorders, idiopathic scoliosis, intermittent claudication, lower limb amputation, Parkinson's disease or Parkinsonism, hip or knee replacement, and temporomandibular disorders.

Methods: Seven rehabilitation-oriented clinical databases were analysed using the International Classification of Functioning, Disability and Health (ICF) framework. Variables were categorized as outcomes, modifiers, or baseline measurements. Commonalities and differences across data domains were identified through iterative consensus meetings among PREPARE partners.

Results: Substantial heterogeneity was observed in data type and depth. Pain and quality of life were the most commonly reported outcomes, whereas discharge status and participation-related measures were rarely reported. The most prevalent modifiers were pharmacological treatments, orthoses or prostheses, and exercise-based interventions. All databases reported baseline information on diagnosis, anthropometry, and demographics; however, assessments of gait autonomy and daily activities were inconsistently documented.

Conclusion: Despite some overlapping domains, rehabilitation data collection remains fragmented and predominantly focused on biomedical aspects. Greater standardization and systematic inclusion of psychosocial and contextual variables are needed for robust predictive modelling and personalized rehabilitation.

Objective: In light of the persistent concern identified by the World Health Organization (WHO) that small population countries tend to be ignored in international health research, preventing them from developing research capacity, this paper describes the participation of Andorra in an international spinal cord injury survey (InSCI) and resulting benefits.

Methods: Descriptive analysis of Andorra's health research situation and participation in InSCI.

Results: Andorra has successfully participated in an international survey improving health research capacity and governmental support.

Conclusion: In line with WHO recommendations to improve small country health research capacity, and specifically to improve their health information collection capacity, the described participation of Andorra in an international health survey demonstrates how this capacity can be improved without sacrificing methodological restrictions.

Objective: To compare characteristics of people with persisting post-concussion symptoms in a sample referred for treatment and in a sample from a prospective research study.

Design: Observational study.

Subjects: Participants, aged 18-60 years, with persisting post-concussion symptoms 3-18 months after mild head injury, 92 with mild traumatic brain injury followed from the emergency department ("prospective emergency department sample") and 106 patients with either mild traumatic brain injury or minimal head injury, referred to an outpatient rehabilitation clinic ("clinical rehabilitation sample").

Methods: Persisting post-concussion symptoms were defined as having British Columbia Post-Concussion Symptom Inventory scores indicating at least moderate persisting post-concussion symptoms and/or Rivermead Post Concussion Symptoms Questionnaire (RPQ) scores ≥ 12. Symptoms, functional outcome, work/school participation, resilience, and fatigue were examined at 3-18 months post injury.

Results: Compared with the prospective emergency department sample, the clinical rehabilitation sample had higher education, higher RPQ scores (30 vs 17), lower Glasgow Outcome Scale Extended scores (median 6 vs 7), and more had not returned to work or school (43% vs 18%).

Conclusion: Treatment-seeking patients with persisting post-concussion symptoms differed in clinically important ways from people who developed persisting post-concussion symptoms in an emergency department-based mild traumatic brain injury study. Results from studies of mild traumatic brain injury seen in the emergency department may not generalize to patients seeking specialized treatment for persisting post-concussion symptoms.

Objective: The incidence of non-traumatic spinal cord injury (NTSCI) is rising with an ageing population. This study identified diagnostic bone sites and risk factors for low bone mineral density (BMD) in patients with NTSCI and those with TSCI according to age category.

Design: Retrospective cross-sectional study.

Subjects/patients: 1,159 with TSCI and 475 with NTSCI at the National Rehabilitation Center in Korea.

Methods: Diagnostic bone sites and BMD using dual-energy X-ray absorptiometry (DXA) were compared between groups and BMD risk factors were assessed.

Results: The lumbar spine BMD and T-score values of osteoporosis were lower in the NTSCI group than in the TSCI group over 50 years old (p < 0.001, p < 0.001). There was no significant difference in the DXA results between the NTSCI and TSCI under 50 years of age. As an osteoporotic diagnostic site in the NTSCI group (≥ 50 years) (43%), the lumbar spine had higher proportions than in the TSCI group (29%). Female sex and low body mass index were risk factors for osteoporosis in both groups (≥ 50 years).

Conclusion: BMD evaluation in patients aged 50 years and older with NTSCI should include the lumbar spine area. Individuals with risk factors for SCI must undergo BMD assessment and close monitoring.

Objective: Examine the Spinal Cord Injury-Pressure Injury Resource (SCI-PIR) database to assess the prevalence and identify relationships among sleep disorders and cardiometabolic risk after spinal cord injury.

Design: Retrospective observational cohort study using the Department of Veterans Affair SCI-PIR database.

Subjects/patients: 18,894 Veterans living with spinal cord injury.

Methods: The SCI-PIR database was queried for ICD9 codes related to cardiovascular, metabolic, psychological, and sleep conditions to identify subgroups of spinal cord injury individuals with sleep disorders and associated clustering of cardiometabolic risk factors and sleep diagnoses. Multiple correspondence analysis probed the underlying associations. Cramer V statistics confirmed and quantified the associations.

Results: Sleep apnoea (6.7%) and insomnia (4.3%) were the most common sleep diagnoses. Multiple correspondence analysis demonstrated 2 phenotypic clusters: Cluster A showed robust links between sleep apnoea, hypersomnia, heart failure, and arrhythmias, and secondary associations with coronary artery disease, chronic kidney disease, obesity, diabetes, and hyperlipidaemia. Cluster B showed strong relationships between insomnia, anxiety, and post-traumatic stress disorder.

Conclusion: 2 distinct sleep clusters were identified for persons with spinal cord injury. This analysis supports previous findings that sleep disorders associate with overall health in individuals with spinal cord injury, and particularly cardiovascular health. ICD9 coding may under-report sleep diagnoses. Data-driven statistical analysis can uncover insights into the complex interplay between spinal cord injury and secondary health conditions.

Objective: This study was conducted to estimate the reliability and validity of the translated and culturally adapted Polish version of the Trunk Impairment Scale in post-stroke patients and to determine the strength of the relationship between trunk and upper limb physical function after stroke.

Design: The Polish version of the Trunk Impairment Scale was developed through cultural adaptation. Internal consistency, test-retest reliability, and inter-rater reliability were determined, and construct validity was evaluated by analysing the Polish version of the Trunk Impairment Scale, the Polish version of the Fugl-Meyer Assessment Scale, and the Polish version of the Action Research Arm Test.

Participants: Eighty patients with diagnosed stroke in the subacute and chronic stages.

Results: The internal consistency for the Polish version of the Trunk Impairment Scale was excellent (α = 0.85-0.91). Test-retest and inter-rater reliability were almost perfect (ICC = 0.94-1.0, κ = 0.92-1.0). Construct validity was moderate (rho = 0.71-0.76). A moderate correlation was also found between the Polish version of the Trunk Impairment Scale and Polish version of the Action Research Arm Test total scores (rho = 0.60).

Conclusion: The Polish version of the Trunk Impairment Scale is a reliable and moderately valid outcome measure to assess trunk impairment in Polish stroke survivors. Trunk function is moderately related to gross and fine motor skills of the arm, hand, and fingers among individuals with stroke.

Objective: To compare the prognostic value of somatosensory evoked potentials and motor evoked potentials for upper limb functional recovery in patients with subacute stroke.

Design: Retrospective observational analysis.

Subjects/patients: A total of 111 inpatients with subacute stroke who underwent upper limb somatosensory evoked potentials and motor evoked potentials testing within 1 week of admission and completed a standardized rehabilitation programme.

Methods: Somatosensory evoked potentials and motor evoked potentials were categorized as non-responsive, abnormal, or normal. Discharge outcomes included the Fugl-Meyer Assessment for upper limb, Box and Block Test, Functional Independence Measure, and Korean version of the modified Barthel Index. Mixed-effects models were applied to examine associations between somatosensory evoked potentials or motor evoked potentials status and discharge outcomes, adjusting for baseline score and admission duration, with patient ID as a random intercept. Effect sizes were calculated using Cohen's f 2.

Results: Normal somatosensory evoked potentials were associated with higher Functional Independence Measure and Korean version of the modified Barthel Index scores than non-responsive somatosensory evoked potentials, while abnormal somatosensory evoked potentials showed non-significant trends. For motor evoked potentials, the normal group showed higher Box and Block Test scores, and both abnormal and normal groups had higher Korean modified Barthel Index scores than non-responsive.

Conclusion: Admission somatosensory evoked potentials and motor evoked potentials provide complementary prognostic information in subacute stroke rehabilitation.

Background: Early rehabilitation within 4 h following total knee arthroplasty involves passive exercise with manual therapy.

Objective: The aim was to determine the beneficial effects of the single-joint hybrid assistive limb for rehabilitation within 4 h after total knee arthroplasty.

Methods: This single-blinded randomized controlled trial included 68 participants who underwent primary total knee arthroplasty for knee osteoarthritis and were assigned to the early single-joint hybrid assistive limb (n = 22), HAL-SJ (n = 23), and control (n = 23) groups.

Results: The Knee Injury and Osteoarthritis Outcome Score quality of life (p = 0.007) scores of the early single-joint hybrid assistive limb group showed significantly higher values than the control groups at 12 months. The recovery time for extension lag was significantly improved in the early single-joint hybrid assistive limb group compared with the single-joint hybrid assistive limb (p = 0.006) and control (p < 0.001) groups. Additionally, the knee flexion range of motion of the early single-joint hybrid assistive limb group showed significantly higher values than the single-joint hybrid assistive limb (p = 0.029) and control (p = 0.031) groups at 1 week.

Conclusions: Early single-joint hybrid assistive limb rehabilitation may improve patient-reported quality of life at 12 months without exacerbating postoperative pain or swelling. These results suggest that the single-joint hybrid assistive limb may be a feasible adjunct to early postoperative rehabilitation after total knee arthroplasty, while further studies are required to clarify its clinical relevance and long-term benefits.

Objective: This study aimed to examine the central nervous system activation in stroke patients with hand dysfunction during various hand tasks, reflecting central nervous system recruitment.

Design: A single-centre cross-sectional observational study.

Patients: This research selected stroke patients with hand dysfunction hospitalized in the authors' hospital from October 2022 to November 2023. Participants were aged 25-75 years, with a post-stroke duration ranging from 2 to 24 weeks.

Methods: A 35-channel functional near-infrared spectroscopy system was used to record cortical activity during the resting state, affected-hand grasping tasks, and hand-crank cycling tasks. The study compared the average brain activation extent and functional connectivity between grasping and handbike tasks, focusing on the primary sensorimotor cortex, dorsolateral prefrontal cortex, primary motor cortex, and primary somatosensory cortex as regions of interest.

Results: Comparative analysis of brain region activation revealed significant increases in activation across all regions of interest compared with the resting state (p < 0.001). When comparing grasping with handbike tasks, significant increases in activation were observed in all regions of interest except the right primary somatosensory cortex (p < 0.05). Additionally, the right dorsolateral prefrontal cortex exhibited stronger functional connectivity with bilateral primary motor cortex, primary sensorimotor cortex, and left primary somatosensory cortex during the grasping task compared with the handbike task (p < 0.05).

Conclusion: This study shows that grasping tasks recruit cognitive, sensory, and motor cortex activities in stroke patients with hand dysfunction relatively higher than handbike tasks.