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Eight years as associate editor of Annals of Physical and Rehabilitation Medicine: a farewell editorial 在《物理与康复医学年鉴》做了八年的副主编:告别社论。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-09-01 DOI: 10.1016/j.rehab.2025.102024
Sylvie Nadeau
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引用次数: 0
Effects of mindfulness and exercise on cognition and emotion in adults with mild deficits in the chronic post-stroke phase: A randomized controlled trial 正念和运动对慢性中风后轻度缺陷成人认知和情绪的影响:一项随机对照试验
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-08-21 DOI: 10.1016/j.rehab.2025.102008
Adrià Bermudo-Gallaguet , Mar Ariza , Daniela Agudelo , Neus Camins-Vila , Maria Boldó , Blai Ferrer-Uris , Albert Busquets , Guillem Pera , Cynthia Cáceres , Meritxell Gomis , Rosalia Dacosta-Aguayo , Imma C Clemente , Alberto García-Molina , Maria José Durà Mata , Pere Torán-Monserrat , Kirk I Erickson , Maria Mataró

Background

Individuals with stroke often face cognitive and emotional challenges. Mindfulness-based stress reduction (MBSR), physical exercise (PE), and computerized cognitive training (CCT) are promising approaches to incorporate into post-stroke rehabilitation.

Objectives

To determine whether adding MBSR or PE to CCT improves cognition and mental health more than CCT alone, and whether any benefits are mediated by gains in mindfulness or fitness.

Methods

The MindFit Project was a single-blind, parallel, 3-arm randomized controlled trial enrolling participants with chronic stroke, assigned to MBSR+CCT, PE+CCT, or CCT-only (1:1:1). All 12-week, home-based interventions were delivered online, with 5 sessions per week. The primary outcomes included 3 cognitive and 2 mental health measures; mindfulness and physical fitness were also assessed. Analyses used per-protocol and intention-to-treat approaches.

Results

A total of 141 individuals (mean [SD] age 57.7 [11.2] years; 40 % women) were randomly assigned to 3 groups (47 each). Participants were 28.54 (20.35) months post-stroke with a mean modified Rankin Scale score of 2.23 (1.04). Of these, 78 % (39 in MBSR+CCT, 34 in PE+CCT, and 37 in CCT-only) achieved an adherence rate of ≥80 % and were included in the per-protocol analysis. No significant between-group differences were found in primary outcomes (all P > 0.05). For secondary outcomes, the PE+CCT group showed significantly greater gains in leg strength than the others (F = 7.50, adjusted P = 0.009). These results were consistent with the intention-to-treat analysis. In the per-protocol sample, improvements in mindfulness significantly mediated emotional outcomes in the MBSR+CCT group (B = –1.08; 95 % bootstrapped CI, –2.77 to –0.01).

Conclusions

In participants with predominantly mild chronic post-stroke deficits, adding MBSR or PE to CCT did not improve primary cognitive or emotional outcomes beyond CCT alone. However, PE+CCT increased fitness, and MBSR+CCT yielded mindfulness-mediated emotional gains. Future studies involving larger and more severe stroke samples are needed.

Trial registration

NCT04759950 (www.ClinicalTrials.gov).
中风患者经常面临认知和情感方面的挑战。正念减压(MBSR)、体育锻炼(PE)和计算机认知训练(CCT)是卒中后康复中很有前途的方法。目的确定在CCT中加入正念减压或体育锻炼是否比单独加入CCT更能改善认知和心理健康,以及是否有任何益处是通过正念或健康的提高来介导的。方法:MindFit项目是一项单盲、平行、3组随机对照试验,纳入慢性卒中患者,分为正念减压+CCT、PE+CCT或仅CCT(1:1:1)。所有为期12周的以家庭为基础的干预都是在线进行的,每周5次。主要结局包括3项认知和2项心理健康指标;专注力和身体健康也被评估。分析使用了按协议和意向治疗方法。结果141例患者(平均[SD] 57.7[11.2]岁,女性占40%)随机分为3组,每组47例。参与者在中风后28.54(20.35)个月,平均修正Rankin量表得分为2.23(1.04)。其中,78% (MBSR+CCT组39例,PE+CCT组34例,仅CCT组37例)达到≥80%的依从率,并纳入每个方案分析。各组间主要结局无显著差异(均P >; 0.05)。对于次要结果,PE+CCT组的腿部力量比其他组明显增加(F = 7.50,调整后P = 0.009)。这些结果与意向治疗分析一致。在每个方案样本中,正念的改善显著调节了MBSR+CCT组的情绪结果(B = -1.08; 95%自举CI, -2.77至-0.01)。结论:在主要为轻度慢性卒中后缺陷的参与者中,在CCT中加入正念减压或体育锻炼并没有比单独CCT改善主要的认知或情绪结果。然而,体育锻炼+CCT增加健康,正念减压+CCT产生正念介导的情绪收益。未来的研究需要涉及更大、更严重的中风样本。试验注册nct04759950 (www.ClinicalTrials.gov)。
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引用次数: 0
A custom-made sling to achieve personal goals in shoulder pain or subluxation in the subacute stroke phase: a pilot study 一种定制的吊带实现亚急性中风阶段肩部疼痛或半脱位的个人目标:一项试点研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-08-21 DOI: 10.1016/j.rehab.2025.102014
Emmeline Montané , Magali Pradié , Inès Bigarre , Claire Lebely , Alizée Lelièvre , Camille Cormier , Jacqueline Butterworth , Benoît Lepage , Philippe Marque , Xavier de Boissezon , Evelyne Castel-Lacanal

Background

The efficacy of the different shoulder orthoses available to prevent hemiplegic shoulder complications still remains debatable.

Objectives

To evaluate how wearing a custom-made (CM) shoulder sling affected personal goals and complications among hemiplegic stroke patients undergoing realworld rehabilitation.

Methods

A prospective, single-center, non-randomized, pilot study on patients having a stroke within the last 6 months with hemiplegic shoulder pain/subluxation >5 mm. The primary outcome was achievement in three personal goals according to Goal Attainment Scaling one month after (week 5) compared to before (day 7) sling wearing.

Results

Twenty-two patients were included: 60 % male, 56.4 ± 12.1 years old. ≥1 goal was achieved by 90.5 % of patients after sling wearing (week 5) versus 36 % of patients before. VAS pain score (-1.3 ± 2.3; p = 0.01) and subluxation distance (-0.41±0.42 cm; p = 0.0001) were reduced at week 5. Both the Chedoke Arm and Hand Activity Inventory score (+9.0 ± 13.1; p = 0.0003) and Fugl-Meyer upper-extremity score (+9.5 ± 9.5; p = 0.00002) were improved after sling wearing.

Conclusion

We observed improvements in patient-desired outcomes, complications, and upper-limb functional recovery after CM sling wearing for 1-month.

Trial registration

NCT04028999.
背景:不同的肩部矫形器在预防偏瘫肩关节并发症方面的效果仍然存在争议。目的评价佩戴定制肩带对接受现实康复的偏瘫脑卒中患者的个人目标和并发症的影响。方法一项前瞻性、单中心、非随机、试点研究,研究对象为过去6个月内卒中并偏瘫肩关节疼痛/半脱位5mm的患者。主要结果是与佩戴吊带前(第7天)相比,在佩戴吊带一个月后(第5周)根据目标实现量表实现三个个人目标。结果共纳入22例患者,男性占60%,年龄56.4±12.1岁。佩戴吊带后(第5周)90.5%的患者达到≥1个目标,而佩戴吊带前的这一比例为36%。VAS疼痛评分(-1.3±2.3;p = 0.01)和半脱位距离(-0.41±0.42 cm; p = 0.0001)在第5周降低。Chedoke手臂和手活动量表评分(+9.0±13.1,p = 0.0003)和Fugl-Meyer上肢评分(+9.5±9.5,p = 0.00002)均改善。结论CM吊带佩戴1个月后,患者期望的结果、并发症和上肢功能恢复均有改善。registrationNCT04028999审判。
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引用次数: 0
Social cognition and behavioral problems persist after subarachnoid hemorrhage: a longitudinal cohort study 蛛网膜下腔出血后社会认知和行为问题持续存在:一项纵向队列研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-08-21 DOI: 10.1016/j.rehab.2025.102015
Lieke S. Jorna , Sara Khosdelazad , Sandra E. Rakers , Rob J.M. Groen , Ralf Koffijberg , Joke M. Spikman , Anne M. Buunk

Background

Aneurysmal subarachnoid hemorrhage (aSAH) and angiographically negative subarachnoid hemorrhage (anSAH) can result in problems in social cognition and behavior, potentially affecting societal participation.

Objectives

To assess the long-term course of social cognition and behavior, and their impact on societal participation in the chronic stage following aSAH and anSAH.

Methods

In this longitudinal, prospective cohort study, neuropsychological assessments were conducted at 3–6 months (T1) and 2–4 years (T2) after SAH. Social cognition was measured using tests for emotion recognition (FEEST) and Theory of Mind (Cartoon Test, Faux Pas Test). Social behavioral problems were assessed using items on social behavior from the Dysexecutive Questionnaire (DEX-Soc), rated by both participants and informants. Apathy was assessed using self- and informant-rated versions of the Apathy Evaluation Scale (AES). Societal participation was evaluated with the Role Resumption List (RRL).

Results

Eighty-one participants with SAH (59 aSAH and 22 anSAH) and 60 age-, sex-, and education-matched healthy individuals were included. At T1, participants with aSAH performed significantly worse than healthy individuals on the FEEST (P = 0.001) and Cartoon Test (P < 0.001), with no substantial improvement at T2. Participants with anSAH showed no deficits in social cognition at T1, and their scores remained stable over time. Behavioral problems in participants with aSAH remained stable, while informant-rated social behavioral problems (DEX-Soc-I) in the anSAH group increased over time (P = 0.003). In the total SAH group, lower FEEST scores correlated with higher AES-I scores at both time points (r = −0.26), while worse Cartoon Test scores correlated with AES-I at T1 only (r = −0.25). Behavioral problems at T1, not social cognition, were associated with reduced societal participation at T2 (r = 0.24–0.31).

Conclusion

Social cognition impairments after aSAH persist over time, while behavioral problems may worsen after anSAH and are related to long-term societal participation.
背景动脉瘤性蛛网膜下腔出血(aSAH)和血管造影阴性蛛网膜下腔出血(anSAH)可导致社会认知和行为问题,潜在地影响社会参与。目的探讨aSAH和anSAH慢性期患者社会认知和行为的长期发展过程及其对社会参与的影响。方法在这项纵向、前瞻性队列研究中,在SAH后3-6个月(T1)和2-4年(T2)进行神经心理评估。社会认知通过情绪识别测试(FEEST)和心理理论测试(卡通测试,失礼测试)来测量。社会行为问题的评估使用来自执行障碍问卷(DEX-Soc)的社会行为项目,由参与者和被调查者打分。冷漠的评估采用冷漠评估量表(AES)的自评版和自评版。社会参与评估采用角色恢复表(RRL)。结果纳入81例SAH患者(59例aSAH和22例anSAH)和60例年龄、性别和教育程度相匹配的健康个体。在T1时,aSAH参与者在FEEST (P = 0.001)和卡通测试(P < 0.001)上的表现明显差于健康个体,在T2时没有明显改善。患有anSAH的参与者在T1时没有表现出社会认知的缺陷,并且随着时间的推移,他们的得分保持稳定。aSAH参与者的行为问题保持稳定,而anSAH组的社会行为问题(dex - soc - 1)随时间增加(P = 0.003)。在总SAH组中,较低的FEEST分数与较高的AES-I分数在两个时间点相关(r = - 0.26),而较差的卡通测试分数仅在T1与AES-I相关(r = - 0.25)。T1时的行为问题与T2时社会参与减少有关,而与社会认知无关(r = 0.24-0.31)。结论aSAH后社会认知障碍持续存在,而行为问题可能加重,且与长期社会参与有关。
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引用次数: 0
Effectiveness of a 3D-printed silicone medial arch support on foot pain in individuals with pes planus: A randomized controlled trial 3d打印硅胶内侧足弓支架对平足患者足部疼痛的有效性:一项随机对照试验
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-08-16 DOI: 10.1016/j.rehab.2025.102007
Siranya Paecharoen , Somruethai Channasanon , Passakorn Tesavibul , Kan Ngamsopasirisakul , Nayada Choosawad , Siriporn Tanodekaew

Background

Pes planus, a foot deformity that causes foot pain and functional limitations, is often treated with custom-made foot orthoses as a conservative approach to managing symptoms. In this study, silicone medial arch orthotics produced by 3D printing technology were evaluated for their ability to reduce pain and improve foot function, compared to conventional Total Contact Insoles (TCI).

Objectives

To assess the effectiveness of 3D-printed orthoses made from soft and hard silicone by evaluating primary outcomes (pain and foot function) and secondary outcomes (plantar pressure, heel valgus angle, and satisfaction), in comparison to those of TCI.

Methods

A total of 78 participants were randomized into 3 groups: soft and hard 3D-printed arch supports, and TCI. Outcomes were assessed at baseline and 2, 6, and 12 weeks after orthotic wear using various tools, including numeric pain scales, Foot Function Index (FFI) questionnaires, plantar pressure measurements, goniometric measurements of heel valgus angle, and satisfaction surveys.

Results

All 3 groups showed a significant reduction in pain after a 12-week intervention (P < 0.001), with no significant difference between orthotic types. FFI demonstrated progressive and comparable improvement in all groups, with an advantage for TCI. Redistribution of plantar pressure was observed, with no significant difference between the orthoses. The heel valgus angle showed no significant change from baseline in all groups. High satisfaction scores (over 80 %) were achieved for all groups, with no significant differences between them.

Conclusion

The 3D-printed arch supports are as effective as TCI in reducing foot pain and improving foot function in participants with pes planus. They represent a viable alternative, but without demonstrated superiority.

Trial registration

Australian New Zealand Clinical Trials Registry (ACTRN12624000330549).
平足是一种引起足部疼痛和功能限制的足部畸形,通常使用定制的足部矫形器作为治疗症状的保守方法。在这项研究中,与传统的全接触式鞋垫(TCI)相比,通过3D打印技术生产的硅胶内侧弓矫形器评估了其减轻疼痛和改善足部功能的能力。目的通过评估主要结果(疼痛和足部功能)和次要结果(足底压力、足跟外翻角和满意度),与TCI进行比较,评估软硬硅胶3d打印矫形器的有效性。方法78例患者随机分为软硬3d打印足弓支架组和TCI组。使用各种工具,包括数字疼痛量表、足功能指数(FFI)问卷、足底压力测量、足跟外翻角测量和满意度调查,在基线、2周、6周和12周对结果进行评估。结果3组患者干预12周后疼痛均明显减轻(P <;0.001),不同矫形器类型间无显著差异。FFI在所有组中均表现出进行性和可比性改善,TCI具有优势。观察到足底压力的重新分布,矫形器之间没有显着差异。所有组的足跟外翻角度与基线相比无明显变化。两组患者满意率均在80%以上,两组间无显著差异。结论3d打印足弓支架与TCI在减轻足部疼痛和改善足部功能方面具有同等效果。它们代表了一种可行的替代方案,但没有表现出优越性。试验注册澳大利亚新西兰临床试验注册中心(ACTRN12624000330549)。
{"title":"Effectiveness of a 3D-printed silicone medial arch support on foot pain in individuals with pes planus: A randomized controlled trial","authors":"Siranya Paecharoen ,&nbsp;Somruethai Channasanon ,&nbsp;Passakorn Tesavibul ,&nbsp;Kan Ngamsopasirisakul ,&nbsp;Nayada Choosawad ,&nbsp;Siriporn Tanodekaew","doi":"10.1016/j.rehab.2025.102007","DOIUrl":"10.1016/j.rehab.2025.102007","url":null,"abstract":"<div><h3>Background</h3><div>Pes planus, a foot deformity that causes foot pain and functional limitations, is often treated with custom-made foot orthoses as a conservative approach to managing symptoms. In this study, silicone medial arch orthotics produced by 3D printing technology were evaluated for their ability to reduce pain and improve foot function, compared to conventional Total Contact Insoles (TCI).</div></div><div><h3>Objectives</h3><div>To assess the effectiveness of 3D-printed orthoses made from soft and hard silicone by evaluating primary outcomes (pain and foot function) and secondary outcomes (plantar pressure, heel valgus angle, and satisfaction), in comparison to those of TCI.</div></div><div><h3>Methods</h3><div>A total of 78 participants were randomized into 3 groups: soft and hard 3D-printed arch supports, and TCI. Outcomes were assessed at baseline and 2, 6, and 12 weeks after orthotic wear using various tools, including numeric pain scales, Foot Function Index (FFI) questionnaires, plantar pressure measurements, goniometric measurements of heel valgus angle, and satisfaction surveys.</div></div><div><h3>Results</h3><div>All 3 groups showed a significant reduction in pain after a 12-week intervention (<em>P</em> &lt; 0.001), with no significant difference between orthotic types. FFI demonstrated progressive and comparable improvement in all groups, with an advantage for TCI. Redistribution of plantar pressure was observed, with no significant difference between the orthoses. The heel valgus angle showed no significant change from baseline in all groups. High satisfaction scores (over 80 %) were achieved for all groups, with no significant differences between them.</div></div><div><h3>Conclusion</h3><div>The 3D-printed arch supports are as effective as TCI in reducing foot pain and improving foot function in participants with pes planus. They represent a viable alternative, but without demonstrated superiority.</div></div><div><h3>Trial registration</h3><div>Australian New Zealand Clinical Trials Registry (ACTRN12624000330549).</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 7","pages":"Article 102007"},"PeriodicalIF":4.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858274","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
Cardiorespiratory exercise during rehabilitation is associated with improved functional recovery early post-stroke: A cohort study 康复期间的心肺运动与卒中后早期功能恢复的改善有关:一项队列研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-08-16 DOI: 10.1016/j.rehab.2025.102006
Sarah Thompson , Augustine J. Devasahayam , Cynthia J. Danells , David Jagroop , Elizabeth L. Inness , Avril Mansfield

Background

Cardiorespiratory exercise (CRE) early post-stroke can improve cardiorespiratory fitness, facilitate participation in rehabilitation, and promote neuroplasticity.

Objectives

This study aimed to determine if CRE during routine inpatient stroke rehabilitation is associated with improved recovery of motor and cognitive function, functional ambulation, and motor impairment.

Methods

People (n = 503) admitted to 2 rehabilitation hospitals over 14 months were included in this cohort study. Participants were classified into 3 groups: “Prescribed,” where participants completed CRE that was included in their treatment plan; “Incidental,” where they completed CRE that was not included in their treatment plan; and “None,” where they did not complete any CRE. Analysis of covariance compared Functional Independence Measure (FIM), Functional Ambulation Category (FAC), and Chedoke-McMaster Stroke Assessment (CMSA) scores between groups at discharge, controlling for age, length of stay, comorbidities and scores at baseline. Multiple linear regression determined the relationship between time spent doing CRE during rehabilitation and admission to discharge change in FIM, FAC and CMSA scores, controlling for age, length of stay, comorbidities, and site.

Results

The Prescribed group had higher FIM total and motor sub-scores at discharge than the None (Site A; P < 0.001) or the Incidental group (Site B; P < 0.03). There were significant positive correlations between time spent doing CRE during rehabilitation and change in all outcomes (r > 0.15), except CMSA hand scores.

Conclusions

Findings support that CRE during routine inpatient rehabilitation early post-stroke is associated with improved functional independence, ambulation and motor recovery. However, given that the observational design limits causal inferences, controlled studies are needed to confirm the benefits of CRE early post-stroke.
脑卒中后早期进行心肺运动(CRE)可以改善心肺功能,促进康复,促进神经可塑性。目的:本研究旨在确定常规住院卒中康复期间的CRE是否与运动和认知功能、功能性行走和运动损伤的改善恢复有关。方法将在2家康复医院住院14个月以上的503例患者纳入队列研究。参与者被分为3组:“处方”组,参与者完成CRE,包括在他们的治疗计划中;“偶然的”,他们完成了不包括在治疗计划中的CRE;和“没有”,他们没有完成任何CRE。协方差分析比较功能独立测量(FIM)、功能活动分类(FAC)和Chedoke-McMaster卒中评估(CMSA)两组出院时的评分,控制年龄、住院时间、合并症和基线评分。多元线性回归确定了康复期间进行CRE的时间与入院至出院时FIM、FAC和CMSA评分变化之间的关系,控制了年龄、住院时间、合并症和地点。结果处方组出院时FIM总分和运动分值均高于无处方组(A点;P & lt;0.001)或偶发组(Site B;P & lt;0.03)。在康复期间进行CRE的时间与所有结果的变化之间存在显著的正相关(r >;0.15), CMSA手评分除外。结论研究结果支持卒中后早期常规住院康复期间的CRE与功能独立性、行走和运动恢复的改善有关。然而,考虑到观察设计限制了因果推断,需要对照研究来证实CRE在中风后早期的益处。
{"title":"Cardiorespiratory exercise during rehabilitation is associated with improved functional recovery early post-stroke: A cohort study","authors":"Sarah Thompson ,&nbsp;Augustine J. Devasahayam ,&nbsp;Cynthia J. Danells ,&nbsp;David Jagroop ,&nbsp;Elizabeth L. Inness ,&nbsp;Avril Mansfield","doi":"10.1016/j.rehab.2025.102006","DOIUrl":"10.1016/j.rehab.2025.102006","url":null,"abstract":"<div><h3>Background</h3><div>Cardiorespiratory exercise (CRE) early post-stroke can improve cardiorespiratory fitness, facilitate participation in rehabilitation, and promote neuroplasticity.</div></div><div><h3>Objectives</h3><div>This study aimed to determine if CRE during routine inpatient stroke rehabilitation is associated with improved recovery of motor and cognitive function, functional ambulation, and motor impairment.</div></div><div><h3>Methods</h3><div>People (<em>n</em> = 503) admitted to 2 rehabilitation hospitals over 14 months were included in this cohort study. Participants were classified into 3 groups: “Prescribed,” where participants completed CRE that was included in their treatment plan; “Incidental,” where they completed CRE that was not included in their treatment plan; and “None,” where they did not complete any CRE. Analysis of covariance compared Functional Independence Measure (FIM), Functional Ambulation Category (FAC), and Chedoke-McMaster Stroke Assessment (CMSA) scores between groups at discharge, controlling for age, length of stay, comorbidities and scores at baseline. Multiple linear regression determined the relationship between time spent doing CRE during rehabilitation and admission to discharge change in FIM, FAC and CMSA scores, controlling for age, length of stay, comorbidities, and site.</div></div><div><h3>Results</h3><div>The Prescribed group had higher FIM total and motor sub-scores at discharge than the None (Site A; <em>P</em> &lt; 0.001) or the Incidental group (Site B; <em>P</em> &lt; 0.03). There were significant positive correlations between time spent doing CRE during rehabilitation and change in all outcomes (<em>r</em> &gt; 0.15), except CMSA hand scores.</div></div><div><h3>Conclusions</h3><div>Findings support that CRE during routine inpatient rehabilitation early post-stroke is associated with improved functional independence, ambulation and motor recovery. However, given that the observational design limits causal inferences, controlled studies are needed to confirm the benefits of CRE early post-stroke.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 8","pages":"Article 102006"},"PeriodicalIF":4.6,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144858413","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
Effects of litigation on outcome after traumatic injury: A systematic review 诉讼对创伤后预后的影响:一项系统综述。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-08-05 DOI: 10.1016/j.rehab.2025.102004
Jimmy Muong , Mélanie Cogné , Alexis Schnitzler , Philippe Azouvi

Background

There is a widespread belief that litigation procedures may have a negative association with outcome.

Objectives

This systematic review aims to compare outcomes between people going through compensation procedures following traumatic injury vs those who are not going through compensation procedures following traumatic injury. This is the first systematic review on the subject that includes all types of trauma.

Methods

A PRISMA methodology was used to assess the association between compensation procedures and outcome following personal injury (excluding medical accidents), including articles published in English between 1st January 1980 and 1st September 2023, using the PubMed and Medline databases. We retrieved the data according to outcome measures and divided the data into 5 categories: overall disability and quality of life, cognitive, psychological, somatic, and social. The results were classified into 3 categories: those that showed a significant negative association between compensation procedures and outcome, those that showed a non-significant trend, and those that did not show a significant difference between compensation procedures and outcome. The quality of the studies was assessed using the Quality Assessment Tool for Studies with Diverse Designs (QATSDD) scale.

Results

From 467 articles initially screened, 27 met the inclusion criteria (total of 5,668 participants). Fifteen articles found a negative association between litigation and outcome, 8 found no significant effect, including 2 suggesting a non-significant trend. Four articles had different results according to the outcome measure.

Conclusion

While we expected stronger results in favor of the negative association between compensation procedures and outcome, and despite limitations due to methodological heterogeneity and the lack of valid evidence, we nevertheless found a trend towards poorer outcome on psychological, somatic, disability, and quality of life measures. These results suggest that there is a clinical relevance to considering the unconscious and conscious mechanisms of potential secondary benefits in cases of litigation.
背景:人们普遍认为诉讼程序可能与结果有负相关。目的:本系统综述旨在比较创伤后接受赔偿程序的人与未接受赔偿程序的人之间的结果。这是第一次系统地回顾这一主题,包括所有类型的创伤。方法:采用PRISMA方法评估人身伤害(不包括医疗事故)后赔偿程序与结果之间的关系,包括1980年1月1日至2023年9月1日期间发表的英文文章,使用PubMed和Medline数据库。我们根据结果测量方法检索数据,并将数据分为5类:总体残疾和生活质量、认知、心理、躯体和社会。结果分为三类:薪酬程序与结果之间存在显著负相关关系的、不存在显著趋势的和薪酬程序与结果之间不存在显著差异的。采用不同设计研究质量评估工具(QATSDD)量表对研究质量进行评估。结果:从最初筛选的467篇文章中,27篇符合纳入标准(共5,668名受试者)。15篇文章发现诉讼与结果呈负相关,8篇文章发现无显著影响,其中2篇文章提示无显著趋势。根据结果测量,四篇文章有不同的结果。结论:虽然我们期望更强的结果支持补偿程序和结果之间的负相关,尽管由于方法学的异质性和缺乏有效证据的限制,我们仍然发现心理、身体、残疾和生活质量测量的结果趋向于较差。这些结果表明,在诉讼案件中,考虑潜在的次要利益的无意识和有意识机制具有临床意义。
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引用次数: 0
Enlarged perivascular spaces are associated with worse gait velocity and recovery in individuals with a small ischemic hemisphere stroke: A cross-sectional study 一项横断面研究表明,小局部缺血性脑卒中患者的步态速度和恢复能力与血管周围空间增大有关。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2025-08-04 DOI: 10.1016/j.rehab.2025.102005
Jiangping Ma , Linghao Xu , Yuanjie Xie

Background

Enlarged perivascular spaces (EPVS) are commonly observed in individuals with cerebral small vessel disease (CSVD) and have been associated with gait impairments in older adults and are also linked to post-stroke disability. Among individuals with mild stroke, persistent gait disturbance limitations often pose significant challenges to the resumption of daily activities. The relationship between EPVS and gait disturbance and gait recovery in individuals with mild stroke, remains poorly understood.

Objective

This study aimed to examine the hypothesis that EPVS are associated with gait disturbance and delayed gait recovery in individuals with mild stroke.

Methods

Between May and November 2023, 164 participants with small ischemic hemisphere strokes were enrolled within one week of stroke onset. EPVS were assessed using magnetic resonance imaging (MRI), while gait disturbance was measured by gait velocity, cadence, and stride length, with metrics extracted using the BlazePose architecture. Gait recovery was monitored by tracking the return to independent gait over time. Linear and logistic regression models were used to explore the relationship between EPVS and gait disturbance, while multifactorial Cox regression models were employed to assess the impact of EPVS on gait recovery.

Results

The mean [SD] age of the participants was 66.8 [9.7] years, with 72 % of the cohort being male. In multiple linear regression analyses, the presence of EPVS in the basal ganglia (BG-EPVS) was found to be a significant predictor of reduced gait velocity (β= -0.06; [95 % CI, -0.09 to -0.03]). In the multifactorial Cox regression model, moderate to severe BG-EPVS were significantly associated with delayed recovery of independent gait among participants with stroke, adjusted hazard ratio (aHR) 0.55 [95 % CI, 0.38 to 0.79].

Conclusion

The presence of BG-EPVS was found to be significantly associated with gait disturbance and delayed recovery of independent gait in individuals with mild stroke, indicating the potential role of EPVS as a predictor of gait recovery.
背景:血管周围间隙扩大(EPVS)常见于脑小血管疾病(CSVD)患者,并与老年人步态障碍有关,也与卒中后残疾有关。在轻度中风患者中,持续的步态障碍限制通常对恢复日常活动构成重大挑战。EPVS与轻度中风患者步态障碍和步态恢复之间的关系尚不清楚。目的:本研究旨在验证EPVS与轻度脑卒中患者步态障碍和步态恢复延迟相关的假说。方法:在2023年5月至11月期间,164名小缺血性半球卒中患者在卒中发作一周内入组。使用磁共振成像(MRI)评估EPVS,通过步态速度、节奏和步幅测量步态障碍,并使用BlazePose架构提取指标。随着时间的推移,通过跟踪独立步态的恢复来监测步态恢复。采用线性和逻辑回归模型探讨EPVS与步态障碍之间的关系,采用多因素Cox回归模型评估EPVS对步态恢复的影响。结果:参与者的平均[SD]年龄为66.8[9.7]岁,其中72%为男性。在多元线性回归分析中,发现基底神经节EPVS (BG-EPVS)的存在是步态速度降低的显著预测因子(β= -0.06;[95% CI, -0.09 ~ -0.03])。在多因素Cox回归模型中,中度至重度BG-EPVS与卒中患者独立步态恢复延迟显著相关,校正风险比(aHR)为0.55 [95% CI, 0.38 ~ 0.79]。结论:发现BG-EPVS的存在与轻度脑卒中患者步态障碍和独立步态延迟恢复显著相关,提示EPVS可能作为步态恢复的预测因子。
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引用次数: 0
Ultrasonographic assessment of quadriceps muscle in people with knee osteoarthritis: A systematic review and meta-analysis 膝骨关节炎患者股四头肌超声评估:一项系统回顾和荟萃分析
IF 3.9 3区 医学 Q1 REHABILITATION Pub Date : 2025-07-08 DOI: 10.1016/j.rehab.2025.101998
Maurício Tatsch Ximenes Carvalho , Victor Hugo Guesser Pinheiro , Cristine Lima Alberton

Background

Knee osteoarthritis (OA) is a painful joint condition characterized by changes in quadriceps femoris muscle architecture and quality. Although ultrasound is an emerging tool for evaluating muscle conditions in this population, its usefulness and clinical implications remain unclear.

Objectives

To investigate the effects of knee OA on quadriceps muscle architecture, summarize ultrasound protocols used in studies, and explore the associations between muscle characteristics with symptoms and physical function.

Materials and methods

Searches across 3 electronic databases (PubMed, PEDro, and EMBASE) were performed by 2 independent investigators according to strict inclusion and exclusion criteria.

Results

The findings highlight that ultrasound protocols often lack detailed descriptions, even if there is growing interest in how the quadriceps femoris muscle changes in knee osteoarthritis people, particularly in muscle thickness and echo intensity. The meta-analysis revealed that vastus medialis muscle thickness was significantly lower in individuals with knee OA compared to healthy controls (mean difference:0.52 mm; 95 % CI -1.01 to -0.03; P = 0.037), whereas no significant differences were found for rectus femoris, vastus lateralis, or vastus intermedius thickness. In the qualitative synthesis, the systematic literature analysis showed muscle changes, including a decreased muscle quality in both the vastus medialis and vastus intermedius. Additionally, quadriceps femoris muscle thickness is associated with condition-specific, patient-reported outcomes and functional performance in people with knee OA, whereas there is a relationship between echo intensity and functional performance.

Conclusions

The study highlights the need for standardized ultrasound protocols to capture changes in quadriceps muscle architecture and quality, as some of these changes correlated to patient-reported outcomes measures and functional performance in knee OA people. Finally, we propose a recommendation to improve the measurement of muscle echo intensity in clinical practice.

Trial registration

PROSPERO database (registration number: CRD42023471617).
膝关节骨性关节炎(OA)是一种疼痛的关节疾病,其特征是股四头肌结构和质量的改变。尽管超声是评估这一人群肌肉状况的新兴工具,但其实用性和临床意义尚不清楚。目的探讨膝关节骨性关节炎对股四头肌结构的影响,总结研究中使用的超声方案,探讨肌肉特征与症状和身体功能之间的关系。材料和方法由2名独立研究者根据严格的纳入和排除标准对3个电子数据库(PubMed、PEDro和EMBASE)进行检索。结果:尽管人们对膝关节骨性关节炎患者股四头肌的变化,特别是肌肉厚度和回声强度的变化越来越感兴趣,但研究结果强调,超声检查方案往往缺乏详细的描述。荟萃分析显示,与健康对照组相比,膝关节OA患者的股内侧肌厚度显著降低(平均差异:0.52 mm;95% CI -1.01 ~ -0.03;P = 0.037),而股直肌、股外侧肌和股中间肌厚度无显著差异。在定性综合中,系统的文献分析显示肌肉变化,包括股内侧肌和股中间肌的肌肉质量下降。此外,股四头肌厚度与膝关节OA患者的病情特异性、患者报告的结果和功能表现有关,而回声强度与功能表现之间存在关系。结论:该研究强调需要标准化的超声方案来捕获股四头肌结构和质量的变化,因为这些变化与患者报告的结果测量和膝关节OA患者的功能表现相关。最后,我们提出了在临床实践中改进肌肉回声强度测量的建议。试验注册prospero数据库(注册号:CRD42023471617)。
{"title":"Ultrasonographic assessment of quadriceps muscle in people with knee osteoarthritis: A systematic review and meta-analysis","authors":"Maurício Tatsch Ximenes Carvalho ,&nbsp;Victor Hugo Guesser Pinheiro ,&nbsp;Cristine Lima Alberton","doi":"10.1016/j.rehab.2025.101998","DOIUrl":"10.1016/j.rehab.2025.101998","url":null,"abstract":"<div><h3>Background</h3><div>Knee osteoarthritis (OA) is a painful joint condition characterized by changes in quadriceps femoris muscle architecture and quality. Although ultrasound is an emerging tool for evaluating muscle conditions in this population, its usefulness and clinical implications remain unclear.</div></div><div><h3>Objectives</h3><div>To investigate the effects of knee OA on quadriceps muscle architecture, summarize ultrasound protocols used in studies, and explore the associations between muscle characteristics with symptoms and physical function.</div></div><div><h3>Materials and methods</h3><div>Searches across 3 electronic databases (PubMed, PEDro, and EMBASE) were performed by 2 independent investigators according to strict inclusion and exclusion criteria.</div></div><div><h3>Results</h3><div>The findings highlight that ultrasound protocols often lack detailed descriptions, even if there is growing interest in how the quadriceps femoris muscle changes in knee osteoarthritis people, particularly in muscle thickness and echo intensity. The meta-analysis revealed that vastus medialis muscle thickness was significantly lower in individuals with knee OA compared to healthy controls (mean difference:0.52 mm; 95 % CI -1.01 to -0.03; <em>P</em> = 0.037), whereas no significant differences were found for rectus femoris, vastus lateralis, or vastus intermedius thickness. In the qualitative synthesis, the systematic literature analysis showed muscle changes, including a decreased muscle quality in both the vastus medialis and vastus intermedius. Additionally, quadriceps femoris muscle thickness is associated with condition-specific, patient-reported outcomes and functional performance in people with knee OA, whereas there is a relationship between echo intensity and functional performance.</div></div><div><h3>Conclusions</h3><div>The study highlights the need for standardized ultrasound protocols to capture changes in quadriceps muscle architecture and quality, as some of these changes correlated to patient-reported outcomes measures and functional performance in knee OA people. Finally, we propose a recommendation to improve the measurement of muscle echo intensity in clinical practice.</div></div><div><h3>Trial registration</h3><div>PROSPERO database (registration number: CRD42023471617).</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 7","pages":"Article 101998"},"PeriodicalIF":3.9,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144571587","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
Were unmet rehabilitation needs associated with health deterioration during COVID-19? A cross-sectional study of Canadians with disabilities 未满足的康复需求是否与COVID-19期间的健康恶化有关?对加拿大残疾人的横断面研究
IF 3.9 3区 医学 Q1 REHABILITATION Pub Date : 2025-06-19 DOI: 10.1016/j.rehab.2025.101995
Dan Wang , Astrid DeSouza , Jessica J. Wong , Andrea D. Furlan , Sheilah Hogg-Johnson , Luciana Macedo , Silvano Mior , Pierre Côté

Background

The coronavirus disease 2019 (COVID-19) pandemic disrupted rehabilitation services, disproportionately affecting individuals with long-term conditions or disabilities. However, the health impacts of unmet rehabilitation needs in this population remain underexplored.

Objective

To determine the association between unmet rehabilitation needs and self-perceived health deterioration among Canadians with long-term conditions or disabilities during the first wave of COVID-19.

Methods

We analysed a national crowdsourced cross-sectional survey conducted by Statistics Canada (June 23–July 6, 2020). Participants included 13,483 Canadians aged 15 years and older with reported long-term conditions or disabilities. Unmet rehabilitation needs (independent variable) were defined as requiring but not receiving physiotherapy/massage therapy/chiropractic services, speech or occupational therapy, counselling or support groups due to the pandemic. Health deterioration (dependent variable) was self-reported as "much worse" or "somewhat worse" compared to pre-pandemic levels. We computed adjusted prevalence ratios (aPR) and 95 % confidence intervals (CI) using modified Poisson regression, controlling for sociodemographic factors and other unmet healthcare needs, including unmet medical attention for COVID-19. Analyses were stratified by age group, gender, and residence location.

Results

Overall, 47 % of participants reported health deterioration during the early stages of the pandemic. Among those with health deterioration, 59 % reported unmet rehabilitation needs due to the pandemic. Those with unmet rehabilitation needs were 33 % more likely to report health deterioration (adjusted PR = 1.33, 95 % CI 1.27–1.40), regardless of sociodemographic characteristics and other unmet healthcare needs. The associations were consistent across age groups, gender, and residential location.

Conclusions

In a sample of Canadians with long-term conditions or disabilities, unmet rehabilitation needs were associated with self-perceived health deterioration. Addressing these unmet needs is crucial for improving health outcomes and quality of life during public health emergencies. In the post-pandemic era, improved access and better integration of rehabilitation services within the broader healthcare system remain essential to support well-being and restore functioning in this population.

Database registration

Not applicable. This study involves secondary analysis of a publicly available, de-identified national dataset collected by Statistics Canada.
2019年冠状病毒病(COVID-19)大流行扰乱了康复服务,对患有长期疾病或残疾的个人造成了不成比例的影响。然而,未满足的康复需求对这一人群的健康影响仍未得到充分探讨。目的了解新冠肺炎第一波疫情期间加拿大长期疾病或残疾患者未满足的康复需求与自我感觉健康恶化之间的关系。方法:我们分析了加拿大统计局(Statistics Canada)于2020年6月23日至7月6日进行的全国性众包横断面调查。参与者包括13483名年龄在15岁及以上的加拿大人,他们报告有长期疾病或残疾。未满足的康复需求(自变量)定义为由于大流行需要但未接受物理治疗/按摩治疗/脊椎按摩服务、语言或职业治疗、咨询或支持团体。与大流行前的水平相比,自我报告的健康恶化(因变量)为“严重得多”或“有些恶化”。我们使用修正泊松回归计算校正患病率比(aPR)和95%置信区间(CI),控制社会人口因素和其他未满足的医疗需求,包括COVID-19未满足的医疗关注。分析按年龄组、性别和居住地进行分层。结果总体而言,47%的参与者报告在大流行的早期阶段健康状况恶化。在健康状况恶化的人中,59%的人报告说,由于大流行,康复需求未得到满足。无论社会人口学特征和其他未满足的医疗保健需求如何,未满足康复需求的患者报告健康恶化的可能性要高出33%(调整后的PR = 1.33, 95% CI 1.27-1.40)。这些关联在不同年龄组、性别和居住地点都是一致的。结论在加拿大长期残疾患者中,未满足康复需求与自我感知健康恶化相关。解决这些未满足的需求对于改善突发公共卫生事件期间的健康结果和生活质量至关重要。在大流行后时代,改善获得康复服务的机会并更好地将康复服务纳入更广泛的卫生保健系统,对于支持这一人群的福祉和恢复功能仍然至关重要。数据库注册不适用。这项研究涉及对加拿大统计局收集的公开可用的、去识别的国家数据集的二次分析。
{"title":"Were unmet rehabilitation needs associated with health deterioration during COVID-19? A cross-sectional study of Canadians with disabilities","authors":"Dan Wang ,&nbsp;Astrid DeSouza ,&nbsp;Jessica J. Wong ,&nbsp;Andrea D. Furlan ,&nbsp;Sheilah Hogg-Johnson ,&nbsp;Luciana Macedo ,&nbsp;Silvano Mior ,&nbsp;Pierre Côté","doi":"10.1016/j.rehab.2025.101995","DOIUrl":"10.1016/j.rehab.2025.101995","url":null,"abstract":"<div><h3>Background</h3><div>The coronavirus disease 2019 (COVID-19) pandemic disrupted rehabilitation services, disproportionately affecting individuals with long-term conditions or disabilities. However, the health impacts of unmet rehabilitation needs in this population remain underexplored.</div></div><div><h3>Objective</h3><div>To determine the association between unmet rehabilitation needs and self-perceived health deterioration among Canadians with long-term conditions or disabilities during the first wave of COVID-19.</div></div><div><h3>Methods</h3><div>We analysed a national crowdsourced cross-sectional survey conducted by Statistics Canada (June 23–July 6, 2020). Participants included 13,483 Canadians aged 15 years and older with reported long-term conditions or disabilities. Unmet rehabilitation needs (independent variable) were defined as requiring but not receiving physiotherapy/massage therapy/chiropractic services, speech or occupational therapy, counselling or support groups due to the pandemic. Health deterioration (dependent variable) was self-reported as <em>\"much worse\"</em> or <em>\"somewhat worse\"</em> compared to pre-pandemic levels. We computed adjusted prevalence ratios (aPR) and 95 % confidence intervals (CI) using modified Poisson regression, controlling for sociodemographic factors and other unmet healthcare needs, including unmet medical attention for COVID-19. Analyses were stratified by age group, gender, and residence location.</div></div><div><h3>Results</h3><div>Overall, 47 % of participants reported health deterioration during the early stages of the pandemic. Among those with health deterioration, 59 % reported unmet rehabilitation needs due to the pandemic. Those with unmet rehabilitation needs were 33 % more likely to report health deterioration (adjusted PR = 1.33, 95 % CI 1.27–1.40), regardless of sociodemographic characteristics and other unmet healthcare needs. The associations were consistent across age groups, gender, and residential location.</div></div><div><h3>Conclusions</h3><div>In a sample of Canadians with long-term conditions or disabilities, unmet rehabilitation needs were associated with self-perceived health deterioration. Addressing these unmet needs is crucial for improving health outcomes and quality of life during public health emergencies. In the post-pandemic era, improved access and better integration of rehabilitation services within the broader healthcare system remain essential to support well-being and restore functioning in this population.</div></div><div><h3>Database registration</h3><div>Not applicable. This study involves secondary analysis of a publicly available, de-identified national dataset collected by Statistics Canada.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"68 7","pages":"Article 101995"},"PeriodicalIF":3.9,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144314309","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
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Annals of Physical and Rehabilitation Medicine
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