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Telephone-based validation of the Duke Activity Status Index in cardiac rehabilitation participants 心脏康复参与者Duke活动状态指数的电话验证
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-28 DOI: 10.1016/j.rehab.2025.102072
Tamara Costábile Sant’Anna , Júlia Isaac Bernardes , Janaine Cunha Polese , Maria da Glória Rodrigues-Machado
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引用次数: 0
Physician agreement on messages related to imaging findings in low back pain: a cross-sectional study 一项横断面研究表明,医生对腰痛影像学表现信息的认同
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-22 DOI: 10.1016/j.rehab.2025.102065
Christophe Demoulin , Stéphane Genevay , Gilles Avenel , Marco Tomasella , Camille Delaunoy , Katarina Destrée , Marc Vanderthommen , Florian Bailly
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引用次数: 0
Hip strengthening exercise compared to standard rehabilitation after revision hip replacement: a multicenter randomized controlled trial 髋关节强化运动与髋关节置换术后标准康复的比较:一项多中心随机对照试验
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1016/j.rehab.2025.102076
Martin G. Stisen , Alma B. Pedersen , Troels Kjeldsen , Frederik N. Foldager , Martin Lamm , Anders Assenholt , Kirstine L. Hvidberg , Morten K. Rasmussen , Peter K. Aalund , Christina F. Frandsen , Anders Holsgaard-Larsen , Martin H. Haubro , Theresa Bieler , Søren Overgaard , Torben Beck , Kim G. Ingwersen , Erik T. Parner , Inger Mechlenburg

Background

People undergoing revision total hip replacement (THR) typically experience slower recovery and greater functional limitations than those undergoing primary procedures. Rehabilitation practices following revision THR are inconsistent and often adapted from protocols for primary THR, despite limited specific evidence supporting their effectiveness.

Objectives

To compare the effectiveness of an exercise intervention targeting hip strengthening (NEMEX-STR) on functional performance at 4 months with the standard community-based rehabilitation (Usual care) in participants undergoing revision THR.

Methods

This multicenter, randomized, controlled, parallel-group, assessor-blinded superiority trial included participants undergoing revision THR who were randomized to NEMEX-STR or Usual care. The NEMEX-STR group underwent a 16-week intervention targeting hip strengthening, while the Usual care group received standard rehabilitation. The primary outcome was the between-group difference in functional performance assessed by the 30-second Chair Stand Test (30s-CST), from baseline (ie, prior to surgery) to 4 months after the start of the intervention. Secondary outcomes included the Hip Disability and Osteoarthritis Outcome Score (HOOS), the 40-meter Fast-Paced Walk Test (40m-FPWT), the 9-step Timed Stair Climb Test (9-step TSCT), and unilateral leg extensor muscle power.

Results

A total of 84 participants were recruited between November 2022 and June 2024 and were allocated to either NEMEX-STR (n = 43) or Usual care (n = 41). The mean changes from baseline to 4-month follow-up in the 30s-CST were 1.9 (95 % CI 0.8 to 3.0) in NEMEX-STR and 1.2 (95 % CI 0.6 to 2.3) chair stands in Usual care, with a between-group difference of 0.7 (95 % CI -0.8 to 2.3). Secondary outcomes showed no clinically relevant between-group differences in change for HOOS subscales, 40m-FPWT, 9-step TSCT, or unilateral leg extensor muscle power.

Conclusion

An exercise intervention targeting hip strengthening was not superior to standard community-based rehabilitation for improving functional performance at 4 months in participants undergoing revision THR.

ClinicalTrials.gov

NCT05657054.
背景:接受翻修型全髋关节置换术(THR)的患者通常比接受初级手术的患者恢复更慢,功能限制更大。尽管有有限的具体证据支持其有效性,但修订THR后的康复实践不一致,经常改编自原发性THR方案。目的比较以髋关节强化为目标的运动干预(NEMEX-STR)与标准社区康复(常规护理)在4个月时对THR修订参与者功能表现的影响。这项多中心、随机、对照、平行组、评估盲的优势试验包括接受修订THR的参与者,他们被随机分配到NEMEX-STR或常规护理组。NEMEX-STR组接受为期16周的髋关节强化干预,而常规护理组接受标准康复治疗。主要结果是通过30秒椅子站立测试(30s-CST)评估的组间功能表现差异,从基线(即手术前)到干预开始后4个月。次要结果包括髋关节残疾和骨关节炎结局评分(HOOS)、40米快节奏步行测试(40m-FPWT)、9步定时爬楼梯测试(9步TSCT)和单侧腿伸肌力量。结果在2022年11月至2024年6月期间共招募了84名参与者,并将其分配到NEMEX-STR (n = 43)或常规护理(n = 41)组。从基线到4个月随访,30 - cst组NEMEX-STR组的平均变化为1.9 (95% CI 0.8 - 3.0),常规护理组的平均变化为1.2 (95% CI 0.6 - 2.3),组间差异为0.7 (95% CI -0.8 - 2.3)。次要结果显示,HOOS亚量表、40m-FPWT、9步TSCT或单侧腿伸肌力量的变化在组间无临床相关差异。结论针对髋关节强化的运动干预并不优于标准的社区康复,以改善4个月后thr修订参与者的功能表现。
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引用次数: 0
Effects of preoperative maximal strength training on muscle strength and function in total knee arthroplasty: A randomized controlled trial 全膝关节置换术术前最大力量训练对肌力和功能的影响:一项随机对照试验
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-13 DOI: 10.1016/j.rehab.2025.102067
Mani Izadi , Tiril Tøien , Frank-David Øhrn , Otto Schnell Husby , Vigdis Kvitland Schnell Husby , Siri Bjørgen Winther , Ronan Sherman , Mathias Forsberg Brobakken , Eivind Wang , Ole Kristian Berg

Background

The efficacy of prehabilitation through preoperative strength training for individuals undergoing total knee arthroplasty (TKA) remains inconclusive.

Objective

The present study aimed to evaluate the effects of maximal strength training (MST) before operation on muscle strength and physical function 3 weeks following TKA.

Methods

48 individuals scheduled for fast-track unilateral primary TKA were randomized to MST (n = 24), performing 4 sets at 4 repetition maximum in seated leg press 3 times per week for 8 weeks, or control usual care (CON, n = 24). The primary outcome was bilateral leg press maximal strength. Secondary outcomes were performance-based physical function, including 10-step stair climbing, 30 s sit-to-stand, 40 m fast-paced walking, and unipedal stance tests, and self-reported physical function as knee injury and osteoarthritis outcome score-physical function short form (KOOS-PS), European quality of life 5 dimension, 5 Level, and forgotten joint score.

Results

MST improved bilateral leg press 1RM relative to body weight after intervention (mean change 0.45, P < 0.0001), and there were between-group differences in the delta changes from baseline to preoperation (mean difference 0.43, P < 0.0001) and postoperation (mean difference 0.27, P < 0.001), favoring MST. MST also led to better maintenance of postoperative stair climbing (mean difference −3.38 s, P = 0.0013). Although the MST group experienced a significant preoperative improvement in sit-to-stand (mean change 2 repetitions, P = 0.0019), walking ability (mean change −2.28 s, P < 0.001), and KOOS-PS (mean change 8, P < 0.0001), these effects did not extend to postoperative outcomes.

Conclusions

The findings indicate that preoperative MST is safe and effective in improving muscle strength and preserving stair-climbing ability for individuals undergoing TKA, positioning MST as a pragmatic prehabilitation strategy.

Clinical trial registration

NCT05892133.
背景:对于接受全膝关节置换术(TKA)的个体,术前力量训练对其康复的效果尚无定论。目的探讨术前最大力量训练(MST)对TKA术后3周肌力和身体功能的影响。方法48例计划进行快速通道单侧原发性TKA的患者随机分为MST组(n = 24),每周进行3次最多4次的坐式腿推4组,持续8周,或对照常规护理(n = 24)。主要结果是双侧腿按压的最大力量。次要结果是基于性能的身体功能,包括10步爬楼梯、30秒坐立、40米快节奏步行和单脚站立测试,以及自我报告的身体功能,如膝关节损伤和骨关节炎结局评分-身体功能简表(KOOS-PS)、欧洲生活质量5维度、5级和遗忘关节评分。结果干预后,smst改善了双侧腿压1RM相对于体重的变化(平均变化0.45,P < 0.0001),从基线到术前(平均差异0.43,P < 0.0001)和术后(平均差异0.27,P < 0.001)的δ变化在组间存在差异,有利于MST。MST还能更好地维持术后爬楼梯(平均差异- 3.38 s, P = 0.0013)。尽管MST组术前在坐姿到站立(平均变化2次,P = 0.0019)、行走能力(平均变化- 2.28 s, P < 0.001)和KOOS-PS(平均变化8次,P < 0.0001)方面均有显著改善,但这些影响并未延伸至术后结果。结论术前MST可以安全有效地改善TKA患者的肌力和保持爬楼梯能力,是一种实用的康复策略。临床试验注册号nct05892133。
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引用次数: 0
Determinants of standing 1 month after stroke in a large cohort: motor weakness, lateropulsion, and hypoesthesia 卒中后1个月站立的决定因素:运动无力、侧脱和感觉减退。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-12 DOI: 10.1016/j.rehab.2025.102077
Aurélien Hugues, Stéphanie Dehem, Rémi Lafitte, Jean-Pierre Karam, Eugénie Lhommée, Adélaïde Marquer , Dominic Pérennou

Background

Recovering standing balance after a stroke is an important milestone. However, the factors that affect post-stroke quiet standing balance remain unclear.

Objectives

To determine the clinical profile of individuals according to their standing ability.

Methods

This cross-sectional study was conducted as part of the DOBRAS (Determinants of Balance Recovery After Stroke) cohort, which included individuals aged 18 to 80 years who had experienced a first unilateral hemisphere stroke. Three groups were formed based on the Postural Assessment Scale for Stroke score at 30 days post-stroke (D30): those unable to stand alone, those able to stand alone with difficulty, and those able to stand alone rather well. Sensorimotor and cognitive impairments were comprehensively assessed at D30. Data were analyzed by multivariate regression (14 impairments + age).

Results

We analyzed data for 221 individuals (median age 67 years; 67 % male). Almost half (103/221, 47 %) could stand rather well, 33 % (73/221) could stand with difficulty, and 20 % (45/221) could not stand at all. The probability of being unable to stand alone increased with the severity of motor weakness (standardized logistic regression coefficient β0 = 6.4), lateropulsion (β0 = 4.4), and hypoesthesia (β0 = 3.3). The probability of standing with difficulty increased with the severity of motor weakness (β0 = 3.7), lateropulsion (β0 = 2.1), and hypoesthesia (β0 = 1.3) as well as with age (β0 = 0.7).

Conclusion

One month after a hemisphere stroke, 53 % (118/221) of individuals do not stand or stand with difficulty, a proportion stable for 20 years. The standing posture should be considered more explicitly in modern post-stroke balance assessments, with more manageable postural tasks. The clinical profile of individuals with difficulty standing or inability to stand combines impairments in the elementary motor command (weakness), vertical orientation (lateropulsion), and somatosensory perception (hypoesthesia). They are also older. Focusing on these impairments and balance training could help people recover their standing posture after a stroke. Older individuals require more balance training.
背景:中风后站立平衡的恢复是一个重要的里程碑。然而,影响中风后静站立平衡的因素尚不清楚。目的:根据站立能力确定个体的临床特征。方法:这项横断面研究是作为DOBRAS(中风后平衡恢复的决定因素)队列的一部分进行的,该队列包括18至80岁的首次经历单侧半球中风的个体。根据卒中后30天卒中姿势评估量表(D30)评分分为三组:无法独立者、独立能力较差者和独立能力较好的组。在D30时综合评估感觉运动和认知障碍。数据采用多元回归分析(14例损伤+年龄)。结果:我们分析了221例个体(中位年龄67岁,67%为男性)的数据。几乎有一半(103/221,47%)的人可以很好地站立,33%(73/221)的人站立困难,20%(45/221)的人根本无法站立。运动无力(标准化logistic回归系数β0 = 6.4)、侧裂(β0 = 4.4)和感觉减退(β0 = 3.3)的严重程度增加了无法独立站立的可能性。随着运动无力(β0 = 3.7)、侧脱(β0 = 2.1)、感觉减退(β0 = 1.3)以及年龄(β0 = 0.7)的严重程度,站立困难的可能性增加。结论:半脑卒中后1个月,53%(118/221)患者不能站立或站立困难,该比例稳定20年。站立姿势应该更明确地考虑在现代中风后的平衡评估,更易于管理的姿势任务。站立困难或无法站立的个体的临床特征结合了基本运动命令(无力)、垂直方向(侧推)和体感知觉(感觉减退)的损伤。他们也更老。关注这些损伤和平衡训练可以帮助人们在中风后恢复站立姿势。老年人需要更多的平衡训练。
{"title":"Determinants of standing 1 month after stroke in a large cohort: motor weakness, lateropulsion, and hypoesthesia","authors":"Aurélien Hugues,&nbsp;Stéphanie Dehem,&nbsp;Rémi Lafitte,&nbsp;Jean-Pierre Karam,&nbsp;Eugénie Lhommée,&nbsp;Adélaïde Marquer ,&nbsp;Dominic Pérennou","doi":"10.1016/j.rehab.2025.102077","DOIUrl":"10.1016/j.rehab.2025.102077","url":null,"abstract":"<div><h3>Background</h3><div>Recovering standing balance after a stroke is an important milestone. However, the factors that affect post-stroke quiet standing balance remain unclear.</div></div><div><h3>Objectives</h3><div>To determine the clinical profile of individuals according to their standing ability.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted as part of the DOBRAS (Determinants of Balance Recovery After Stroke) cohort, which included individuals aged 18 to 80 years who had experienced a first unilateral hemisphere stroke. Three groups were formed based on the Postural Assessment Scale for Stroke score at 30 days post-stroke (D30): those unable to stand alone, those able to stand alone with difficulty, and those able to stand alone rather well. Sensorimotor and cognitive impairments were comprehensively assessed at D30. Data were analyzed by multivariate regression (14 impairments + age).</div></div><div><h3>Results</h3><div>We analyzed data for 221 individuals (median age 67 years; 67 % male). Almost half (103/221, 47 %) could stand rather well, 33 % (73/221) could stand with difficulty, and 20 % (45/221) could not stand at all. The probability of being unable to stand alone increased with the severity of motor weakness (standardized logistic regression coefficient β<sub>0</sub> = 6.4), lateropulsion (β<sub>0</sub> = 4.4), and hypoesthesia (β<sub>0</sub> = 3.3). The probability of standing with difficulty increased with the severity of motor weakness (β<sub>0</sub> = 3.7), lateropulsion (β<sub>0</sub> = 2.1), and hypoesthesia (β<sub>0</sub> = 1.3) as well as with age (β<sub>0</sub> = 0.7).</div></div><div><h3>Conclusion</h3><div>One month after a hemisphere stroke, 53 % (118/221) of individuals do not stand or stand with difficulty, a proportion stable for 20 years. The standing posture should be considered more explicitly in modern post-stroke balance assessments, with more manageable postural tasks. The clinical profile of individuals with difficulty standing or inability to stand combines impairments in the elementary motor command (weakness), vertical orientation (lateropulsion), and somatosensory perception (hypoesthesia). They are also older. Focusing on these impairments and balance training could help people recover their standing posture after a stroke. Older individuals require more balance training.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 2","pages":"Article 102077"},"PeriodicalIF":4.6,"publicationDate":"2026-01-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145967931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Efficacy of nonsurgical interventions for the management of adults with cervicogenic headache: a systematic review and meta-analyses 非手术干预治疗成人颈源性头痛的疗效:系统回顾和荟萃分析
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-10 DOI: 10.1016/j.rehab.2025.102070
Laura Martins , Pablo Collet , Simon Lafrance , Anthony Demont

Background

The efficacy of commonly used medication and physical interventions for cervicogenic headache (CGH) in adults remains insufficiently assessed.

Objective

To evaluate the efficacy of nonsurgical interventions for managing adults with CGH.

Methods

A comprehensive search was conducted across 6 databases through September 2025, identifying randomized controlled trials (RCTs) that examined the efficacy of nonsurgical interventions in reducing CGH-related outcomes, including headache frequency, intensity, duration, neck disability, medication intake, and quality of life. 2 reviewers independently extracted data using a standardized form. Risk of bias was assessed with the Cochrane RoB 2.0 tool, and certainty of evidence with the GRADE approach. Meta-analyses were conducted for trials with similar interventions, comparators, and outcomes. Standardized mean differences (SMD) with 95 % confidence intervals were calculated using a random-effects model and the inverse-variance method. Heterogeneity was assessed using χ² and I² statistics. Effect sizes were interpreted according to Cohen’s thresholds. For RCTs not eligible for meta-analysis, a structured narrative synthesis was conducted.

Results

29 RCTs were included. Low-certainty evidence suggests that manual therapy reduced headache intensity compared with sham at 0–2 weeks post-intervention (SMD −1.60; 95 %CI −2.40 to −0.79; 5 RCTs; n = 144), but not at 12 months (SMD 0.09; 95 %CI −0.59 to 0,76; 2 RCTs; n = 265). Low-certainty evidence indicates that exercise therapy alone may reduce headache compared with usual care, but the difference was not statistically significant at 1–3 months (SMD −1.30; 95 %CI −2.61 to 0.02; 2 RCTs; n = 116) and at 12 months (SMD −1.25; 95 %CI −2.35 to −0.14; 2 RCTs; n = 116). Evidence is uncertain regarding the efficacy of both manual therapy and the combination of manual therapy and exercise therapy compared with usual care.

Conclusions

Manual therapy may offer short-term relief for adults with CGH. However, the long-term effects and added benefits of combined approaches remain unclear.

Trial Registration Prospero

#CRD42023390280.
背景:对于成人颈源性头痛(CGH)的常用药物和物理干预的疗效评估仍然不够充分。目的评价非手术干预治疗成人先天性先天性生长障碍的疗效。方法对截至2025年9月的6个数据库进行了全面检索,确定了随机对照试验(rct),这些试验检验了非手术干预在减少cgh相关结局(包括头痛频率、强度、持续时间、颈部残疾、药物摄入和生活质量)方面的有效性。2名审稿人使用标准化表格独立提取数据。用Cochrane RoB 2.0工具评估偏倚风险,用GRADE方法评估证据的确定性。对具有类似干预措施、比较物和结果的试验进行meta分析。采用随机效应模型和反方差法计算95%置信区间的标准化平均差(SMD)。采用χ²和I²统计量评估异质性。效应量根据Cohen的阈值进行解释。对于不符合meta分析条件的随机对照试验,进行结构化的叙事综合。结果共纳入29项随机对照试验。低确定性证据表明,干预后0 - 2周,手工治疗与假手术相比,头痛强度降低(SMD - 1.60; 95% CI - 2.40至- 0.79;5个随机对照试验;n = 144),但12个月时没有降低(SMD - 0.09; 95% CI - 0.59至0.76;2个随机对照试验;n = 265)。低确定性证据表明,与常规治疗相比,单独运动治疗可以减轻头痛,但在1-3个月时(SMD - 1.30; 95% CI - 2.61至0.02;2个随机对照试验;n = 116)和12个月时(SMD - 1.25; 95% CI - 2.35至- 0.14;2个随机对照试验;n = 116)差异无统计学意义。与常规治疗相比,手工治疗和手工治疗与运动治疗相结合的疗效尚不确定。结论手工治疗对成人CGH有短期缓解作用。然而,联合治疗的长期效果和额外益处仍不清楚。试验注册号:CRD42023390280。
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引用次数: 0
Singing-based respiratory training in people with post-COVID syndrome: a bicentric randomized feasibility study 基于唱歌的呼吸训练在covid - 19后综合征患者中的应用:一项双中心随机可行性研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-09 DOI: 10.1016/j.rehab.2025.102073
Anke Steinmetz , Alexander Hönning , Wiebke Käckenmester , Ingo Schmehl , Marc Secara , Sigrid Biffar , Ina Kim , Katja Bahcesular , Bernhard Lehnert , Kristin Lehnert , Marcus Dörr , Kristina Zappel

Background

People with post-COVID syndrome (PCS) often suffer from long-term pulmonary consequences. Singing-based respiratory training (SBRT) has proven to be a valuable rehabilitative therapy for people with chronic lung diseases.

Objectives

The aim of this study was to investigate the feasibility of SBRT in people with PCS breathing disorders, their compliance and adherence, and to obtain detailed findings on the effect of this training on people with PCS respiratory symptoms.

Methods

A randomized controlled, single-blind, bicentric study was conducted with 23 outpatient and 24 inpatient participants undergoing rehabilitation for PCS. Participants either received singing-based respiratory training with the intention of reducing breathing rate or training without the aim of influencing breathing rate. The main outcomes were patient compliance, determination of target parameters for a future efficacy study, and assessment of outcome differences between treatment groups.

Results

The 45 study participants were predominantly female (81 %) with a mean age of 51.5 (SD 10.44) years. There was a high level of compliance with SBRT, with 96 % of participants completing all training sessions led by vocal coaches. The overall comparison between baseline and follow-up assessments yielded improvements corresponding to medium effects in the physical component score of the Veterans RAND 12-Item Health Survey (VR-12) with a Cohen’s d of 0.52 (95 % Confidence Interval, CI 0.05 to 0.99]), in the Generalized Anxiety Disorder Scale-7 (GAD-7) with a Cohen’s d of 0.55 (95 % CI 0.11 to 0.9) and in the Patient Health Questionnaire-9 (PHQ-9) with a Cohen’s d of 0.50 (95 % CI 0.06 to 0.93).

Conclusion

SBRT was well-tolerated, with high adherence and compliance among participants in our study. Questionnaires assessing health-related quality of life and mental health may be suitable as primary outcomes for a future confirmatory study. The data suggest that SBRT aimed at reducing the respiratory rate does not have a positive effect compared to regular SBRT.

Trial registration

German Register of Clinical Trials (DRKS ID DRKS00028275).
新冠肺炎后综合征(PCS)患者通常会遭受长期肺部后果。以唱歌为基础的呼吸训练(SBRT)已被证明是一种有价值的慢性肺部疾病患者的康复治疗方法。目的本研究的目的是探讨SBRT在PCS呼吸障碍患者中的可行性、依从性和依从性,并获得该训练对PCS呼吸症状患者效果的详细结果。方法采用随机对照、单盲、双中心研究,门诊23例,住院24例。参与者要么接受以唱歌为基础的呼吸训练,目的是降低呼吸频率,要么接受不影响呼吸频率的训练。主要结果是患者的依从性,确定未来疗效研究的目标参数,以及评估治疗组之间的结果差异。结果45例研究参与者以女性为主(81%),平均年龄51.5岁(SD 10.44)。SBRT的依从性很高,96%的参与者完成了由声乐教练领导的所有培训课程。整体比较基线和随访评估了改进相应的介质效应的物理组件得分退伍军人兰德参与健康调查(VR-12)科恩的d为0.52(95%置信区间0.05 - 0.99),在广泛性焦虑障碍Scale-7 (GAD-7)科恩的d为0.55 (95% CI 0.11 - 0.9)和在病人健康Questionnaire-9 (phq - 9)科恩的d为0.50 (95% CI 0.06 - 0.93)。结论sbrt耐受性良好,在我们的研究中参与者中具有很高的依从性和依从性。评估健康相关生活质量和心理健康的问卷可能适合作为未来验证性研究的主要结果。数据表明,与常规的SBRT相比,旨在降低呼吸频率的SBRT没有积极的效果。试验注册德国临床试验注册(DRKS ID DRKS00028275)。
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引用次数: 0
Musculoskeletal deformities in children with spinal muscular atrophy: a multicenter cross-sectional study with longitudinal follow-up 脊髓性肌萎缩症儿童的肌肉骨骼畸形:一项纵向随访的多中心横断面研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-08 DOI: 10.1016/j.rehab.2025.102080
Xiaoyue Wang , Yun Zheng , Jinhua Lu , Xiaoli Li , Shujuan Chen , Yang Xue , Shuxiang Hu , Guilan Peng , Feng Zhang , Xiuying Zhao , Yun Liu , Yabei Fan , Hongyu Zhou , Cuili Liang , Liru Liu , Lu He , Jingbo Zhang , Weizhe Shi , Jinsheng Tian , Mingshan Han , Kaishou Xu

Background

The administration of Nusinersen has extended the life expectancy of children with spinal muscular atrophy (SMA) Type I, while the prevalence and progression of musculoskeletal deformities remain uncertain.

Objectives

To investigate the prevalence of scoliosis, joint contracture, and hip dislocation in children with SMA, and to assess whether Nusinersen combined with rehabilitation can stabilize or improve musculoskeletal conditions.

Methods

This multicenter study enrolled 229 children with SMA across nine hospitals in China, with 83 followed longitudinally for 1 to 2 years after Nusinersen initiation. Age, gender, SMA subtype, motor ability, and functional scores were collected. Radiological examinations confirmed scoliosis and hip dislocation, while joint contracture was evaluated through passive range of motion. Spearman’s correlation and logistic regression were used to identify associations and predictors.

Results

Overall, 59% of children had scoliosis, 62% had joint contracture, and 21% had hip dislocation. Among children with SMA Type I, 42% presented scoliosis, 46% joint contracture, and 25% hip dislocation. Age was identified as a significant predictor of musculoskeletal deformities, with the odds of scoliosis increasing by 1.379 per year, joint contracture by 1.303, and hip dislocation by 1.305 (P < 0.01). Musculoskeletal deformities correlated positively with age (P < 0.001) but negatively with SMA subtype (P < 0.01), motor ability (P < 0.05), and HFMSE scores (P < 0.01). During follow-up, scoliosis remained stable in 33% of children at 1 year and 42% at 2 years. Knee contracture stability was observed in 12% at 1 year, while ankle contracture remained stable in 25% at 1 and 2 years, with improvement in 25% at 2 years.

Conclusions

Musculoskeletal deformities are highly prevalent in children with SMA, particularly among Type I. Age and SMA subtype were significant predictors. Our findings suggest that an integrated approach combining Nusinersen treatment with rehabilitation management may help stabilize or improve musculoskeletal outcomes in this population.

Data registration reference

NCT04089566.
Nusinersen的使用延长了脊髓性肌萎缩症(SMA) I型儿童的预期寿命,而肌肉骨骼畸形的患病率和进展仍不确定。目的调查SMA患儿脊柱侧凸、关节挛缩和髋关节脱位的患病率,并评估Nusinersen联合康复治疗是否能稳定或改善肌肉骨骼状况。该多中心研究招募了229名来自中国9家医院的SMA患儿,其中83人在Nusinersen启动后进行了1 - 2年的纵向随访。收集年龄、性别、SMA亚型、运动能力和功能评分。放射学检查证实脊柱侧凸和髋关节脱位,同时通过被动活动范围评估关节挛缩。使用Spearman相关和逻辑回归来确定关联和预测因素。结果患儿脊柱侧凸发生率为59%,关节挛缩发生率为62%,髋关节脱位发生率为21%。在1型SMA患儿中,42%表现为脊柱侧凸,46%表现为关节挛缩,25%表现为髋关节脱位。年龄被认为是肌肉骨骼畸形的重要预测因素,脊柱侧凸的几率每年增加1.379,关节挛缩增加1.303,髋关节脱位增加1.305 (P < 0.01)。骨骼肌畸形与年龄呈正相关(P < 0.001),与SMA亚型(P < 0.01)、运动能力(P < 0.05)、HFMSE评分呈负相关(P < 0.01)。在随访期间,33%的儿童1岁时脊柱侧凸保持稳定,42%的儿童2岁时脊柱侧凸保持稳定。1年后有12%的患者膝关节挛缩稳定,而25%的患者在1年和2年后踝关节挛缩保持稳定,25%的患者在2年后有所改善。结论肌肉骨骼畸形在儿童SMA中非常普遍,尤其是在i型中。年龄和SMA亚型是重要的预测因素。我们的研究结果表明,将Nusinersen治疗与康复管理相结合的综合方法可能有助于稳定或改善该人群的肌肉骨骼预后。数据注册参考:enct04089566。
{"title":"Musculoskeletal deformities in children with spinal muscular atrophy: a multicenter cross-sectional study with longitudinal follow-up","authors":"Xiaoyue Wang ,&nbsp;Yun Zheng ,&nbsp;Jinhua Lu ,&nbsp;Xiaoli Li ,&nbsp;Shujuan Chen ,&nbsp;Yang Xue ,&nbsp;Shuxiang Hu ,&nbsp;Guilan Peng ,&nbsp;Feng Zhang ,&nbsp;Xiuying Zhao ,&nbsp;Yun Liu ,&nbsp;Yabei Fan ,&nbsp;Hongyu Zhou ,&nbsp;Cuili Liang ,&nbsp;Liru Liu ,&nbsp;Lu He ,&nbsp;Jingbo Zhang ,&nbsp;Weizhe Shi ,&nbsp;Jinsheng Tian ,&nbsp;Mingshan Han ,&nbsp;Kaishou Xu","doi":"10.1016/j.rehab.2025.102080","DOIUrl":"10.1016/j.rehab.2025.102080","url":null,"abstract":"<div><h3>Background</h3><div>The administration of Nusinersen has extended the life expectancy of children with spinal muscular atrophy (SMA) Type I, while the prevalence and progression of musculoskeletal deformities remain uncertain.</div></div><div><h3>Objectives</h3><div>To investigate the prevalence of scoliosis, joint contracture, and hip dislocation in children with SMA, and to assess whether Nusinersen combined with rehabilitation can stabilize or improve musculoskeletal conditions.</div></div><div><h3>Methods</h3><div>This multicenter study enrolled 229 children with SMA across nine hospitals in China, with 83 followed longitudinally for 1 to 2 years after Nusinersen initiation. Age, gender, SMA subtype, motor ability, and functional scores were collected. Radiological examinations confirmed scoliosis and hip dislocation, while joint contracture was evaluated through passive range of motion. Spearman’s correlation and logistic regression were used to identify associations and predictors.</div></div><div><h3>Results</h3><div>Overall, 59% of children had scoliosis, 62% had joint contracture, and 21% had hip dislocation. Among children with SMA Type I, 42% presented scoliosis, 46% joint contracture, and 25% hip dislocation. Age was identified as a significant predictor of musculoskeletal deformities, with the odds of scoliosis increasing by 1.379 per year, joint contracture by 1.303, and hip dislocation by 1.305 (<em>P</em> &lt; 0.01). Musculoskeletal deformities correlated positively with age (<em>P</em> &lt; 0.001) but negatively with SMA subtype (<em>P</em> &lt; 0.01), motor ability (<em>P</em> &lt; 0.05), and HFMSE scores (<em>P</em> &lt; 0.01). During follow-up, scoliosis remained stable in 33% of children at 1 year and 42% at 2 years. Knee contracture stability was observed in 12% at 1 year, while ankle contracture remained stable in 25% at 1 and 2 years, with improvement in 25% at 2 years.</div></div><div><h3>Conclusions</h3><div>Musculoskeletal deformities are highly prevalent in children with SMA, particularly among Type I. Age and SMA subtype were significant predictors. Our findings suggest that an integrated approach combining Nusinersen treatment with rehabilitation management may help stabilize or improve musculoskeletal outcomes in this population.</div></div><div><h3>Data registration reference</h3><div>NCT04089566.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102080"},"PeriodicalIF":4.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Preoperative disability predicts goal attainment failure after selective tibial neurotomy and rehabilitation: a 5-year follow-up study 术前残疾预测选择性胫骨神经切除术和康复后目标实现失败:一项5年随访研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-08 DOI: 10.1016/j.rehab.2025.102066
Corentin Dauleac , Jacques Luaute , Gilles Rode , Patrick Mertens

Background

Studies assessing the effectiveness of selective tibial neurotomy (STN) assume that the procedure, combined with a rehabilitation program, reduces foot spasticity and allows the achievement of personal goals. However, few studies have reported failures in goal attainment or recurrence of spasticity, and no predictive factors have been established.

Objectives

To identify predictors associated with the failure to achieve personal goals after STN and rehabilitation programs.

Methods

Eighty-eight adult participants with spastic foot, irrespective of the etiology, who underwent STN followed by a rehabilitation program were included. Personal goals were assessed using the Goal Attainment Scaling methodology, with T-scores calculated through a 5-year follow-up. Spasticity recurrence was defined as worsening of spasticity on the modified Ashworth scale compared with the clinical status 1 year after STN. Clinical characteristics were analyzed to identify independent predictors, which were subsequently confirmed using logistic regression.

Results

At the 5-year follow-up, 10 participants (10/88, 11 %) had a T-score <50. Logistic regression identified the degree of preoperative disability (modified Rankin Scale ≥3, P = 0.003) as the only significant predictor of failure to achieve personal goals. Spasticity-free survival was significantly higher among participants who had achieved their goals at least as expected (P < 0.0005), suggesting a strong relationship between long-term functional gains and sustained spasticity reduction.

Conclusion

Failure to achieve personal goals after STN and a rehabilitation program is rare. However, greater preoperative disability was identified as a predictor of goal attainment failure over time.
背景:评估选择性胫骨神经切开术(STN)有效性的研究假设该手术与康复计划相结合,可以减少足部痉挛并实现个人目标。然而,很少有研究报道目标实现失败或痉挛复发,也没有建立预测因素。目的确定与STN和康复计划后未能实现个人目标相关的预测因素。方法纳入88名患有痉挛性足的成年参与者,无论病因如何,均接受STN和康复计划。使用目标实现量表方法评估个人目标,并通过5年随访计算t分数。痉挛复发定义为经改良Ashworth评分后与STN后1年的临床状况相比,痉挛加重。分析临床特征以确定独立预测因素,随后使用逻辑回归进行确认。结果随访5年,10例(10/88,11%)患者t评分为50。Logistic回归发现术前残疾程度(修正Rankin量表≥3,P = 0.003)是未能实现个人目标的唯一显著预测因子。在至少达到预期目标的参与者中,无痉挛生存率显着提高(P < 0.0005),表明长期功能获得与持续痉挛减少之间存在密切关系。结论经STN及康复治疗后未能实现个人目标的情况较为少见。然而,随着时间的推移,更大的术前残疾被确定为目标实现失败的预测因素。
{"title":"Preoperative disability predicts goal attainment failure after selective tibial neurotomy and rehabilitation: a 5-year follow-up study","authors":"Corentin Dauleac ,&nbsp;Jacques Luaute ,&nbsp;Gilles Rode ,&nbsp;Patrick Mertens","doi":"10.1016/j.rehab.2025.102066","DOIUrl":"10.1016/j.rehab.2025.102066","url":null,"abstract":"<div><h3>Background</h3><div>Studies assessing the effectiveness of selective tibial neurotomy (STN) assume that the procedure, combined with a rehabilitation program, reduces foot spasticity and allows the achievement of personal goals. However, few studies have reported failures in goal attainment or recurrence of spasticity, and no predictive factors have been established.</div></div><div><h3>Objectives</h3><div>To identify predictors associated with the failure to achieve personal goals after STN and rehabilitation programs.</div></div><div><h3>Methods</h3><div>Eighty-eight adult participants with spastic foot, irrespective of the etiology, who underwent STN followed by a rehabilitation program were included. Personal goals were assessed using the Goal Attainment Scaling methodology, with T-scores calculated through a 5-year follow-up. Spasticity recurrence was defined as worsening of spasticity on the modified Ashworth scale compared with the clinical status 1 year after STN. Clinical characteristics were analyzed to identify independent predictors, which were subsequently confirmed using logistic regression.</div></div><div><h3>Results</h3><div>At the 5-year follow-up, 10 participants (10/88, 11 %) had a T-score &lt;50. Logistic regression identified the degree of preoperative disability (modified Rankin Scale ≥3, <em>P</em> = 0.003) as the only significant predictor of failure to achieve personal goals. Spasticity-free survival was significantly higher among participants who had achieved their goals at least as expected (<em>P</em> &lt; 0.0005), suggesting a strong relationship between long-term functional gains and sustained spasticity reduction.</div></div><div><h3>Conclusion</h3><div>Failure to achieve personal goals after STN and a rehabilitation program is rare. However, greater preoperative disability was identified as a predictor of goal attainment failure over time.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102066"},"PeriodicalIF":4.6,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Effectiveness of physical exercise on quality of life in women with breast cancer undergoing chemotherapy: a network meta-analysis 体育锻炼对乳腺癌化疗妇女生活质量的影响:一项网络荟萃分析
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2026-01-08 DOI: 10.1016/j.rehab.2025.102064
Miguel Contreras Molina , Susana Priego Jiménez , Celia Álvarez Bueno , Beatriz Rodríguez Martín , Blanca Zuheros Lara , Marta Carolina Ruiz Grao

Background

Breast cancer is the most prevalent cancer among women worldwide and poses significant challenges because of its high incidence and treatment-related sequelae. Although the benefits of physical exercise across treatment phases are well documented, evidence specifically assessing its effects during chemotherapy remains limited.

Objective

To evaluate the effectiveness of different types of physical exercise in improving overall health-related quality of life (HRQoL) in women with breast cancer undergoing chemotherapy.

Methods

A network meta-analysis (NMA) of randomized controlled trials (RCTs) was conducted to compare the impact of various exercise modalities on HRQoL during chemotherapy. Literature searches were conducted through August 2025. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and the evidence quality was rated using GRADE. Pairwise and NMA were conducted via random effects models. Surface under the cumulative ranking curve (SUCRA) values were calculated to rank the interventions.

Results

Eighteen RCTs with 1539 participants were included. Compared with the control interventions, the combined and endurance-based exercise interventions had greater effect sizes (ES = 0.41; 95 % CI, 0.15–0.68 for both). These programs significantly improved overall HRQoL in women undergoing chemotherapy.

Conclusions

Physical exercise during chemotherapy effectively enhances HRQoL in women with breast cancer. Combined and endurance interventions are the most beneficial.

Implications for practice

Findings support the use of structured, supervised exercise, especially combined or endurance-based exercise, in routine care. Programs with relaxation components (eg, yoga) are particularly effective for addressing stress and anxiety. Tailored interventions may optimize adherence and therapeutic outcomes.

PROSPERO registration

CRD42024555581
乳腺癌是世界范围内女性中最常见的癌症,由于其高发病率和治疗相关的后遗症,它带来了巨大的挑战。尽管体育锻炼在整个治疗阶段的益处已被充分记录,但专门评估其在化疗期间效果的证据仍然有限。目的评价不同类型体育锻炼对改善乳腺癌化疗妇女总体健康相关生活质量(HRQoL)的效果。方法采用随机对照试验(rct)的网络meta分析(NMA),比较不同运动方式对化疗期间HRQoL的影响。文献检索一直进行到2025年8月。使用Cochrane RoB 2.0工具评估偏倚风险,使用GRADE评定证据质量。通过随机效应模型进行两两和NMA分析。计算累积排序曲线下曲面(SUCRA)值对干预措施进行排序。结果共纳入18项随机对照试验,1539名受试者。与对照干预相比,联合和基于耐力的运动干预具有更大的效应量(ES = 0.41; 95% CI, 0.15-0.68)。这些方案显著提高了接受化疗妇女的总体HRQoL。结论化疗期间进行体育锻炼可有效提高乳腺癌患者的HRQoL。联合和持久干预是最有益的。实践意义研究结果支持在日常护理中使用有组织的、有监督的运动,特别是联合或耐力运动。有放松成分的项目(如瑜伽)对缓解压力和焦虑特别有效。量身定制的干预措施可以优化依从性和治疗结果。普洛斯彼罗registrationCRD42024555581
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引用次数: 0
期刊
Annals of Physical and Rehabilitation Medicine
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