Annals of Physical and Rehabilitation Medicine最新文献

{"title":"Transcultural adaptation of the bath CRPS body perception disturbance scale into French","authors":"Sessi Acapo ,&nbsp;Julien Nizard ,&nbsp;Thomas Rulleau ,&nbsp;Nicolas Kacki ,&nbsp;Sabine Laurent-Chabalier ,&nbsp;Thibault Mura ,&nbsp;Arnaud Dupeyron","doi":"10.1016/j.rehab.2025.101979","DOIUrl":"10.1016/j.rehab.2025.101979","url":null,"abstract":"<div><div>Body perception disturbances are a typical symptom among people with Complex Regional Pain Syndrome (CRPS). To assess it, the Bath CRPS Body Perception Disturbance Scale (B-BPDS) is a comprehensive tool which was validated in English and translated/validated in German and Japanese. To date, no French version was available. We translated the B-BPDS in French using the forward-backward method to obtain a French version (B-BPDS-F). Then, we examined its internal consistency, concurrent validity and structural validity. 32 participants were included for the first evaluation and 21 for the second. Internal consistency of the B-BPDS-F was adequate after removing item 3 on attention. B-BPDS-F was significantly correlated with pain at rest, quality of life total score and anxiety/depression dimensions. Exploratory Factor Analysis showed 2 main factors which explain 63 and 31% of the total variance. ICC was found acceptable. Our results are in line with previous work and provide a valid measurement tool in French.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101979"},"PeriodicalIF":3.9,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887243","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}

{"title":"Pericapsular hip chemical denervation with phenol: A case report suggesting the interest of this new tool in rehabilitation medicine","authors":"Etienne Foussat ,&nbsp;Antoine Geffrier ,&nbsp;Charles Guignans ,&nbsp;Mickael Ropars ,&nbsp;Simon Butet ,&nbsp;Isabelle Bonan","doi":"10.1016/j.rehab.2025.101982","DOIUrl":"10.1016/j.rehab.2025.101982","url":null,"abstract":"<div><h3>Introduction</h3><div>Hip pain is a frequent complaint in Physical and Rehabilitation Medicine. The cause is often joint degradation, often exacerbated by the consequences of neurological or orthopedic conditions. Surgical treatment is not always feasible in fragile patients. When medical treatment is insufficient, the result is loss of autonomy. Based on an innovative technique of locoregional anaesthesia (PEricapsular Nerve Group block or PENG block) and recently adapted with phenol, our multidisciplinary team used it to improve function.</div></div><div><h3>Observation</h3><div>The case reported here is that of a 25-year-old woman presenting with luxating dysplasia of the right hip in the context of Costello syndrome. The main symptom reported was right hip pain with functional discomfort on walking. Medical treatment was only temporarily effective. The benefit/risk balance was unfavorable to surgery due to the young age and degree of dysplasia. In this context, phenol neurolysis of the hip pericapsular nerve group was performed, preceded by a prognostic anesthetic block. The procedure resulted in complete disappearance of hip pain and resumption of walking.</div></div><div><h3>Discussion</h3><div>The achievement of complete analgesia and recovery of the previous functional level in this case give this procedure prospects for use in clinical practice in physical medicine and rehabilitation. Chemical denervation of the anterior hip joint capsule is a simple, inexpensive procedure whose efficacy can be assessed beforehand by a prognostic anesthetic block. This procedure provides pain relief for frail patients, minimizing their loss of function while avoiding the risks of surgery.</div></div><div><h3>Conclusion</h3><div>Pericapsular hip chemical denervation appears to be an interesting alternative in the management of hip pain in therapeutic impasse, as it is likely to improve autonomy and even restore previous functional status.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101982"},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882256","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}

{"title":"Early intervention vocational rehabilitation for return to work following traumatic injury: A randomized controlled trial","authors":"Jennie Ponsford ,&nbsp;Marina G. Downing ,&nbsp;Emily O'Kearney ,&nbsp;Yash Bedekar ,&nbsp;Gillean Hilton ,&nbsp;Duncan Mortimer ,&nbsp;Ellie Fossey ,&nbsp;Linda Barclay ,&nbsp;John Olver ,&nbsp;Wendy Castle ,&nbsp;Andrew Nunn ,&nbsp;Dean McKenzie ,&nbsp;Pamela Ross","doi":"10.1016/j.rehab.2025.101972","DOIUrl":"10.1016/j.rehab.2025.101972","url":null,"abstract":"<div><h3>Background</h3><div>Returning to work (RTW) is an important goal for individuals sustaining traumatic injury (Multi-Trauma Orthopaedic [MTO], traumatic brain injury [TBI], and spinal cord injury [SCI]). Vocational rehabilitation is often unavailable or delayed, and controlled evaluation limited.</div></div><div><h3>Objectives</h3><div>This study evaluated the impact of providing an Early Intervention Vocational Rehabilitation Service (EIVRS) following traumatic injury on employment outcomes, mental health and quality of life 1- and 2-years post-injury.</div></div><div><h3>Methods</h3><div>A randomised parallel 2-group design was used to compare the EIVRS group with a control group receiving usual rehabilitation. Outcomes included hours worked and time to return to first job (primary outcomes), anxiety, depression and quality of life 1- and 2-years post-injury. Participants were adults aged 16–70, employed pre-injury. Eighty-eight EIVRS treatment and 82 controls were recruited; mean 47 days post-injury, 75% male, mean age 38 years. Dedicated EIVRS therapists provided activities associated with fostering hope for RTW, thinking about and preparing for returning to work, building RTW goals into rehabilitation, identifying an employer liaison, and peer support.</div></div><div><h3>Results</h3><div>There were no significant group differences in employment outcomes at 1-year follow-up, but EIVRS participants reported lower anxiety. Median quartile regressions revealed that at 2-year follow-up, the EIVRS group worked more hours (38, 24; 40) and took significantly less time from injury to RTW (166, 87; 280) than controls (29, 23; 36 and 238, 144; 325). Quartile regressions by diagnosis showed a significant main effect of group (<em>P</em> = 0.02) but no interaction between group and diagnosis (<em>P</em> = 0.60). Trends for shorter time to RTW were strongest in the MTO and TBI groups at 2 years. At 2 years there were no group differences in anxiety, depression or quality of life.</div></div><div><h3>Conclusions</h3><div>Offering EIVRS may reduce time to RTW and increase hours worked 2 years after traumatic injury.</div></div><div><h3>Trial registration</h3><div>#ACTRN12619000521123.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101972"},"PeriodicalIF":3.9,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143881682","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}

{"title":"Facilitators and barriers to orthosis prescription for people with knee osteoarthritis: a qualitative study","authors":"Charlotte Lanhers ,&nbsp;Etienne Dumas ,&nbsp;Benjamin Raud ,&nbsp;Aurore Chabaud ,&nbsp;Maxime Grolier ,&nbsp;Emmanuel Coudeyre","doi":"10.1016/j.rehab.2025.101987","DOIUrl":"10.1016/j.rehab.2025.101987","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101987"},"PeriodicalIF":3.9,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143882257","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}

{"title":"Pilates lessens pain and disability and improves quality of life in people with musculoskeletal conditions in the extremities: A systematic review","authors":"Talia Barnet-Hepples ,&nbsp;Anita Barros Amorim ,&nbsp;Clebeson de Azeyêdo Nogueira ,&nbsp;Maria Clara Silva de Melo ,&nbsp;Amabile Borges Dario ,&nbsp;Penelope Latey ,&nbsp;Sâmara Raquel Alves Gomes ,&nbsp;Liane de Brito Macedo","doi":"10.1016/j.rehab.2025.101973","DOIUrl":"10.1016/j.rehab.2025.101973","url":null,"abstract":"<div><h3>Background</h3><div>Pilates has gained popularity for its benefits in reducing pain and disability among people with low back pain. However, conflicting evidence exists regarding its efficacy for musculoskeletal conditions in the upper and lower limbs.</div></div><div><h3>Objectives</h3><div>Investigate the effect of Pilates on pain, disability, quality of life, and physical function in people with musculoskeletal conditions in the extremities.</div></div><div><h3>Methods</h3><div>A systematic review and meta-analysis of experimental studies using Pilates for musculoskeletal conditions in the extremities. Our outcomes included pain, disability, quality of life, and physical function. We searched eleven databases from inception to December 2023. Evidence was synthesised as standardised mean differences (SMD) with 95% confidence intervals (CI) using random-effects models. Risk of bias was assessed using the Revised Cochrane risk of bias tool or the ROBINS-I tool. GRADE was used to determine evidence certainty.</div></div><div><h3>Results</h3><div>Eleven studies (<em>n</em> = 444) were included. Studies had moderate to high risk of bias. Pilates lessened pain (5 studies; SMD 1.41, 95% CI, 0.54–2.28), and disability (5 studies; SMD 0.83, 95% CI, 0.15–1.50), and improved quality of life (2 studies; SMD 2.10, 95% CI, 0.34–3.86) compared to the control group. The effect of Pilates on strength compared to the control the group was estimated to be small (3 studies; SMD 0.35), with unclear true effect due to uncertainty (95% CI, -0.27-0.98). The effects of Pilates on further aspects of physical function, including balance, proprioception, and range of motion remain unclear due to a lack of data which prevented meta-analysis.</div></div><div><h3>Conclusion</h3><div>Pilates was found to lessen pain and disability and improve quality of life in people with musculoskeletal conditions in the extremities compared to control. However, this evidence is of a very low certainty. The effect of Pilates on physical function remains uncertain. The evidence supporting the superiority of Pilates over other exercise interventions is inconclusive.</div></div><div><h3>Review Registration</h3><div>PROSPERO (CRD42022375925).</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101973"},"PeriodicalIF":3.9,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143859752","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}

{"title":"Access to respiratory rehabilitation in France: Opinions of pulmonologists and people with chronic obstructive pulmonary disease","authors":"Marina Gueçamburu ,&nbsp;Jean-Marie Grosbois ,&nbsp;Odile Sauvaget ,&nbsp;Jésus Gonzalez-Bermejo ,&nbsp;Amandine Rapin ,&nbsp;Arthur Pavot ,&nbsp;Pauline Henrot ,&nbsp;Mathieu Delorme ,&nbsp;Grégory Reychler ,&nbsp;Frédéric Costes ,&nbsp;Maéva Zysman","doi":"10.1016/j.rehab.2025.101977","DOIUrl":"10.1016/j.rehab.2025.101977","url":null,"abstract":"<div><div>Despite its well-known benefits, respiratory rehabilitation (RR) remains underutilized among people with chronic obstructive lung disease (COPD) due to both patient- and physician-related barriers. This qualitative study (October 2023–March 2024) used two questionnaires: one for people with COPD to assess disease severity and access challenges, and another for pulmonologists to identify prescription obstacles. Distributed via associations and mailing lists, the survey reached 3,000 people with COPD and 500 pulmonologists, revealing shared concerns about facility shortages, poor information, and transportation issues. Enhancing RR access through better training, patient education, and expanded facilities should be a public health priority.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101977"},"PeriodicalIF":3.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852122","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}

{"title":"Predictors and outcomes of sleep problems following childhood traumatic brain injury: A prospective cohort study","authors":"Nicholas P. Ryan ,&nbsp;Edith Botchway-Commey ,&nbsp;Louise Crossley ,&nbsp;Stephen Hearps ,&nbsp;Cathy Catroppa ,&nbsp;Vicki Anderson","doi":"10.1016/j.rehab.2025.101958","DOIUrl":"10.1016/j.rehab.2025.101958","url":null,"abstract":"<div><h3>Background</h3><div>Sleep problems are a relatively common and disabling consequence of childhood traumatic brain injury (TBI). However, few studies have evaluated factors associated with persistent sleep problems or their effects on subsequent behavioral difficulties. Understanding these associations can inform the focus and timing of post-injury interventions and monitoring.</div></div><div><h3>Objectives</h3><div>This study aimed to identify early risk factors associated with sleep problems 1 year after childhood TBI, and the prospective associations between such sleep problems and subsequent internalizing and externalizing behavioral difficulties 2 years post-injury.</div></div><div><h3>Methods</h3><div>This longitudinal observational cohort study included children aged 5–15 who received emergency department care for TBI and matched community controls. Baseline measures of pre-injury child functioning were administered within 1 week of injury. Post-injury sleep problems were assessed after 1 year, and internalizing/externalizing behavioral difficulties after 2 years, using well-validated symptom rating scales, including the Child Behavior Checklist sleep problems composite and internalizing/externalizing broadband scales.</div></div><div><h3>Results</h3><div>The cohort comprised 144 children, categorized into three groups: 63 with mild TBI, 38 with moderate-to-severe TBI, and 43 community controls. The moderate-to-severe TBI group displayed higher levels of sleep problems compared to controls (mean difference, M diff, 0.68; 95 % CI 0.34–1.33) and children with mild TBI (M diff 0.72; 95 % CI 0.13–1.31). In multivariable adjusted models, lower family functioning (B 0.18; 95 % CI 0.05–0.32) and increased TBI severity (B -0.02; 95 % CI −0.03 to −0.01) were predictive of elevated sleep problems at 1-year post-injury. Furthermore, increased sleep problems at 1-year post-injury predicted higher internalizing and externalizing behavioral difficulties at 2 years post-injury after controlling for baseline sleep scores, pre-injury behavioral problems, age, sex, TBI severity, socioeconomic status, and family functioning.</div></div><div><h3>Conclusions</h3><div>This study underscores the need to address sleep problems in routine clinical screening, post-injury surveillance, and early preventive interventions after childhood TBI. Further research is warranted to evaluate whether family-centered, sleep-focused interventions can mitigate these problems and prevent the onset of later behavioral difficulties in children with TBI.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101958"},"PeriodicalIF":3.9,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143852276","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}

{"title":"Virtual reality effects on balance and mobility in people with Parkinson's disease: A systematic review with meta-analysis","authors":"Alexis Lheureux ,&nbsp;Thierry Lejeune ,&nbsp;Alexane Simons ,&nbsp;Aurore Gillis ,&nbsp;Gauthier Everard","doi":"10.1016/j.rehab.2025.101967","DOIUrl":"10.1016/j.rehab.2025.101967","url":null,"abstract":"<div><h3>Background</h3><div>Specific Virtual Reality (VR) systems designed for rehabilitation and non-specific VR systems intended for entertainment are used in Parkinson's disease (PD) rehabilitation, but their effects are unclear. The extent to which these systems integrate neurorehabilitation principles for PD rehabilitation is unknown. Previous meta-analyses exist but data are lacking on the impact of VR on mobility.</div></div><div><h3>Objectives</h3><div>Primary aim: to perform a systematic review with meta-analysis comparing the effects of VR and conventional therapy (CT) on balance and mobility in people with PD. Secondary aim: to perform subgroup analyses on VR type, disease severity, and treatment duration.</div></div><div><h3>Methods</h3><div>Randomized controlled trials comparing VR and CT effects on balance and mobility in adults with PD were selected from Pubmed and EMBASE until September 2024. Data were synthesized qualitatively and quantitatively using a standardized mean difference (SMD) with random-effects model. Subgroup analyses (VR type, disease severity, and treatment duration) and analysis of fulfilled neurorehabilitation principles were conducted. Risk of bias was assessed (PEDro checklist and Cochrane RoB-2).</div></div><div><h3>Results</h3><div>Twenty-eight studies (12 countries) were included: 1151 participants, mean Hoehn &amp; Yahr stage between 1.4 and 3.4, mean (SD) treatment duration 18.8 (11.5) hours in the qualitative analysis and 23 in the quantitative analysis. Overall risk of bias was high (10 studies), some concerns (13 studies), or low (5 studies). VR was more effective than CT for balance (630 participants; 11 studies; SMD 0.42; 95% CI, 0.19–0.65; <em>P</em> &lt; 0.001) and as effective as CT for mobility (591 participants; 10 studies; SMD 0.18; 95% CI, -0.03 to 0.40; <em>P</em> = 0.09). Balance and mobility outcomes did not differ between specific and non-specific VR. Subgroup analyses found no significant differences.</div></div><div><h3>Conclusions</h3><div>VR improved balance in people with PD more than CT (low-certainty evidence). VR improved mobility similarly to CT (moderate-certainty evidence). VR games should integrate neurorehabilitation principles.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101967"},"PeriodicalIF":3.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848313","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}

{"title":"Cardiac rehabilitation and physical activity decrease the risk of stroke after acute myocardial infarction: A nationwide cohort study in Sweden","authors":"Adam Viktorisson ,&nbsp;Dongni Buvarp ,&nbsp;Maria Bäck ,&nbsp;Margret Leosdottir ,&nbsp;Mia von Euler ,&nbsp;Katharina S Sunnerhagen","doi":"10.1016/j.rehab.2025.101971","DOIUrl":"10.1016/j.rehab.2025.101971","url":null,"abstract":"<div><h3>Background</h3><div>Stroke and acute myocardial infarction (AMI) rank among the leading causes of mortality. Physical activity and exercise are recommended as part of rehabilitation after AMI to prevent cardiovascular events, but the importance for stroke prevention has not been investigated using population-based data.</div></div><div><h3>Objectives</h3><div>To determine associations between participation in exercise-based cardiac rehabilitation (EBCR) and self-reported physical activity with the risk of total stroke, ischemic stroke, and intracerebral hemorrhage after AMI.</div></div><div><h3>Methods</h3><div>This was a nationwide, double cohort study conducted across all coronary care units in Sweden between 2005 and 2020, combined with registered data from the general population. Participation in EBCR (24 physiotherapist-led sessions over 4 months) and self-reported physical activity were assessed at a median of 55 days (range 28–90) after hospital discharge. Stroke incidence was followed until death or censoring on December 31, 2021.</div></div><div><h3>Results</h3><div>A total of 86,637 people with AMI (mean age 64.0, SD 9.0 years; 26 % female), and 259,911 (1:3) age, sex, and region of birth matched individuals from the general population were included. Participation in EBCR after AMI was associated with a lower risk of total stroke (adjusted hazard ratio, aHR 0.85; 95 % confidence interval, CI 0.80–0.91) compared to non-participants, as was ≥150 min of physical activity per week (aHR 0.79, 95 % CI 0.75–0.83). Those reporting physical activity 6 days per week after AMI did not have an increased risk of total stroke or ischemic stroke compared to the general population (aHR 1.03, 95 % CI 0.87–1.23; and aHR 1.17, 95 % CI 0.97–1.41), and were at lower risk of intracerebral hemorrhage (aHR 0.59, 95 % CI 0.35–0.98).</div></div><div><h3>Conclusions</h3><div>EBCR and higher levels of physical activity are associated with a decreased risk of stroke after AMI. Cardiac rehabilitation programs and regular and physical activity should be promoted after AMI to decrease the burden of stroke. Swedish Ethical Review Authority Registration number: 2021–03645.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 5","pages":"Article 101971"},"PeriodicalIF":3.9,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848145","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}

{"title":"Outdoor walking exercise therapy improves walking capacity and well-being in persons with multiple sclerosis: A randomized controlled trial","authors":"Lars G. Hvid ,&nbsp;Josephine L. Steenberg ,&nbsp;Freja Roy ,&nbsp;Lasse Skovgaard","doi":"10.1016/j.rehab.2025.101985","DOIUrl":"10.1016/j.rehab.2025.101985","url":null,"abstract":"<div><h3>Background</h3><div>While outdoor walking exercise therapy could likely elicit multiple beneficial effects in persons with multiple sclerosis (pwMS), little evidence exists.</div></div><div><h3>Objective</h3><div>To evaluate the effects of a 7-week group-based outdoor walking exercise therapy intervention on walking capacity and mental well-being as well as additional outcomes in pwMS.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, <em>n</em> = 62 ambulatory pwMS (49/62, 79% females; 51 years [range, 27–68 years]), patient-determined disease steps 1.7 (range, 0–4) were assigned to either a WALK group (a ‘personalized’ program suited to the starting level of each participant, including one continuous and one intermittent supervised walking session per week at moderate-to-high intensity) or a CONTROL group (continuation of habitual lifestyle). Tests were carried out at baseline (Pre) and after the intervention (Post). Walking capacity included 6-minute walk test (6MWT; primary outcome), timed 25-foot walk test (T25FWT), and six spot step test (SSST). Walking fatigability indexes were calculated from 6MWT data. Patient-reported outcomes included 12-item MS Walking Scale (MSWS), modified fatigue impact scale (MFIS), 7-item falls efficacy scale-international (FES-I), World Health Organization five well-being index (WHO5; main secondary outcome), and 0–100 visual analogue scale health-related quality of life (HR-QoL).</div></div><div><h3>Results</h3><div>Across the 7-week intervention period, <em>n</em> = 17 (5/17, 27%) pwMS dropped out. No adverse events were reported. Across all WALK sessions, 78% of the time was spent on forest/gravel trails. Substantial between-group changes were observed (beneficial changes in WALK vs no changes in CONTROL) in 6MWT (<em>mean change [95% CI];</em> +41 m [22;60]; deemed clinically relevant), T25FWT (+0.27 [0.15;0.39] m/s), SSST (-0.80 [-1.33;-0.27] s), WHO5 (+7.3 [0.1;14.5] points), MSWS (-5.1 [-9.2;-1.0] points), MFIS (-6.7 [-11.7;-1.7] points), FES-I (<em>trend</em>; -0.8 [-1.7;0.1] points), and HR-QoL (<em>trend</em>; +5.3 [-2.3;12.9] points). In contrast, walking fatigability indexes remained unaffected.</div></div><div><h3>Conclusions</h3><div>Outdoor walking exercise therapy elicited multiple beneficial effects in pwMS, especially evidenced by improvements in walking capacity and mental well-being.</div></div><div><h3>Trial registration</h3><div><span><span>ClinicalTrials.gov</span><svg><path></path></svg></span> identifier NCT05415956.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 6","pages":"Article 101985"},"PeriodicalIF":3.9,"publicationDate":"2025-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143848312","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}