首页 > 最新文献

Annals of Physical and Rehabilitation Medicine最新文献

英文 中文
Transcranial magnetic stimulation to improve aphasia after right hemispheric stroke: A single case experimental design 经颅磁刺激改善右侧大脑半球中风后的失语症:单例实验设计
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-05 DOI: 10.1016/j.rehab.2024.101858
Sophie Arheix-Parras, Mathilde du Puy de Goyne, Julie Franco, Marie Villain, Bertrand Glize , Grégoire Python
{"title":"Transcranial magnetic stimulation to improve aphasia after right hemispheric stroke: A single case experimental design","authors":"Sophie Arheix-Parras, Mathilde du Puy de Goyne, Julie Franco, Marie Villain, Bertrand Glize , Grégoire Python","doi":"10.1016/j.rehab.2024.101858","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101858","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 6","pages":"Article 101858"},"PeriodicalIF":4.6,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141250649","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
Development and validation of a nomogram for tracheotomy decannulation in individuals in a persistent vegetative state: A multicentre study 开发和验证用于持续植物人气管切开拔管的提名图:一项多中心研究。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-02 DOI: 10.1016/j.rehab.2024.101849
Hongji Zeng , Xi Zeng , Nanxi Liu , Yu Ding , Junfa Wu , Fangquan Zhang , Nana Xiong

Background

Decannulation for people in a persistent vegetative state (PVS) is challenging and relevant predictors of successful decannulation have yet to be identified.

Objective

This study aimed to explore the predictors of tracheostomy decannulation outcomes in individuals in PVS and to develop a nomogram.

Method

In 2022, 872 people with tracheostomy in PVS were retrospectively enrolled and their data was randomly divided into a training set and a validation set in a 7:3 ratio. Univariate and multivariate regression analyses were performed on the training set to explore the influencing factors for decannulation and nomogram development. Internal validation was performed using 5-fold cross-validation. External validation was performed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) on both the training and validation sets.

Result

Data from 610 to 262 individuals were used for the training and validation sets, respectively. The multivariate regression analysis found that duration of tracheostomy tube placement≥30 days (Odds Ratio [OR] 0.216, 95 % CI 0.151–0.310), pulmonary infection (OR 0.528, 95 %CI 0.366–0.761), hypoproteinemia (OR 0.669, 95 % CI 0.463–0.967), no passive standing training (OR 0.372, 95 % CI 0.253–0.547), abnormal swallowing reflex (OR 0.276, 95 % CI 0.116–0.656), mechanical ventilation (OR 0.658, 95 % CI 0.461–0.940), intensive care unit (ICU) duration>4 weeks (OR 0.517, 95 % CI 0.332–0.805), duration of endotracheal tube (OR 0.855, 95 % CI 0.803–0.907), older age (OR 0.981, 95 % CI 0.966–0.996) were risk factors for decannulation failure. Conversely, peroral feeding (OR 1.684, 95 % CI 1.178–2.406), passive standing training≥60 min (OR 1.687, 95 % CI 1.072–2.656), private caregiver (OR 1.944, 95 % CI 1.350–2.799) and ICU duration<2 weeks (OR 1.758, 95 % CI 1.173–2.634) were protective factors conducive to successful decannulation. The 5-fold cross-validation revealed a mean area under the curve of 0.744. The ROC curve C-indexes for the training and validation sets were 0.784 and 0.768, respectively, and the model exhibited good stability and accuracy. The DCA revealed a net benefit when the risk threshold was between 0 and 0.4.

Conclusion

The nomogram can help adjust the treatment and reduce decannulation failure.

Registration

Clinical registration is not mandatory for retrospective studies.

背景:为持续植物状态(PVS)患者解除气管插管具有挑战性,成功解除气管插管的相关预测因素尚未确定:本研究旨在探索 PVS 患者气管插管减压结果的预测因素,并制定一个提名图:2022年,872名PVS气管切开术患者被回顾性纳入研究,他们的数据按7:3的比例随机分为训练集和验证集。对训练集进行单变量和多变量回归分析,以探究取消气管插管的影响因素并制定提名图。内部验证采用 5 倍交叉验证。在训练集和验证集上使用接收器操作特征曲线(ROC)、校准曲线和决策曲线分析(DCA)进行外部验证:结果:训练集和验证集分别使用了 610 人和 262 人的数据。多变量回归分析发现,气管插管时间≥30 天(Odds Ratio [OR] 0.216,95 % CI 0.151-0.310)、肺部感染(OR 0.528,95 % CI 0.366-0.761)、低蛋白血症(OR 0.669,95 % CI 0.463-0.967)、无被动站立训练(OR 0.372,95 % CI 0.253-0.547)、吞咽反射异常(OR 0.276,95 % CI 0.116-0.656)、机械通气(OR 0.658,95 % CI 0.461-0.940)、重症监护室(ICU)持续时间>4 周(OR 0.517,95 % CI 0.332-0.805)、气管插管持续时间(OR 0.855,95 % CI 0.803-0.907)、年龄较大(OR 0.981,95 % CI 0.966-0.996)是解栓失败的危险因素。相反,经口喂养(OR 1.684,95 % CI 1.178-2.406)、被动站立训练≥60 分钟(OR 1.687,95 % CI 1.072-2.656)、私人看护(OR 1.944,95 % CI 1.350-2.799)和重症监护室持续时间则是解痉失败的风险因素:结论:提名图有助于调整治疗方法并减少拔管失败:注册:回顾性研究无需进行临床注册。
{"title":"Development and validation of a nomogram for tracheotomy decannulation in individuals in a persistent vegetative state: A multicentre study","authors":"Hongji Zeng ,&nbsp;Xi Zeng ,&nbsp;Nanxi Liu ,&nbsp;Yu Ding ,&nbsp;Junfa Wu ,&nbsp;Fangquan Zhang ,&nbsp;Nana Xiong","doi":"10.1016/j.rehab.2024.101849","DOIUrl":"10.1016/j.rehab.2024.101849","url":null,"abstract":"<div><h3>Background</h3><p>Decannulation for people in a persistent vegetative state (PVS) is challenging and relevant predictors of successful decannulation have yet to be identified.</p></div><div><h3>Objective</h3><p>This study aimed to explore the predictors of tracheostomy decannulation outcomes in individuals in PVS and to develop a nomogram.</p></div><div><h3>Method</h3><p>In 2022, 872 people with tracheostomy in PVS were retrospectively enrolled and their data was randomly divided into a training set and a validation set in a 7:3 ratio. Univariate and multivariate regression analyses were performed on the training set to explore the influencing factors for decannulation and nomogram development. Internal validation was performed using 5-fold cross-validation. External validation was performed using receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) on both the training and validation sets.</p></div><div><h3>Result</h3><p>Data from 610 to 262 individuals were used for the training and validation sets, respectively. The multivariate regression analysis found that duration of tracheostomy tube placement≥30 days (Odds Ratio [OR] 0.216, 95 % CI 0.151–0.310), pulmonary infection (OR 0.528, 95 %CI 0.366–0.761), hypoproteinemia (OR 0.669, 95 % CI 0.463–0.967), no passive standing training (OR 0.372, 95 % CI 0.253–0.547), abnormal swallowing reflex (OR 0.276, 95 % CI 0.116–0.656), mechanical ventilation (OR 0.658, 95 % CI 0.461–0.940), intensive care unit (ICU) duration&gt;4 weeks (OR 0.517, 95 % CI 0.332–0.805), duration of endotracheal tube (OR 0.855, 95 % CI 0.803–0.907), older age (OR 0.981, 95 % CI 0.966–0.996) were risk factors for decannulation failure. Conversely, peroral feeding (OR 1.684, 95 % CI 1.178–2.406), passive standing training≥60 min (OR 1.687, 95 % CI 1.072–2.656), private caregiver (OR 1.944, 95 % CI 1.350–2.799) and ICU duration&lt;2 weeks (OR 1.758, 95 % CI 1.173–2.634) were protective factors conducive to successful decannulation. The 5-fold cross-validation revealed a mean area under the curve of 0.744. The ROC curve C-indexes for the training and validation sets were 0.784 and 0.768, respectively, and the model exhibited good stability and accuracy. The DCA revealed a net benefit when the risk threshold was between 0 and 0.4.</p></div><div><h3>Conclusion</h3><p>The nomogram can help adjust the treatment and reduce decannulation failure.</p></div><div><h3>Registration</h3><p>Clinical registration is not mandatory for retrospective studies.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 6","pages":"Article 101849"},"PeriodicalIF":4.6,"publicationDate":"2024-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238709","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 a 12-week telerehabilitation training in people with long COVID: A randomized controlled trial 为期12周的远程康复训练对长期COVID患者的效果:随机对照试验。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-01 DOI: 10.1016/j.rehab.2024.101853
Chia-Ying Lai , Chia-Huei Lin , Ta-Chung Chao , Chueh-Ho Lin , Cheng-Chiang Chang , Chien-Yao Huang , Shang-Lin Chiang

Background

Telerehabilitation has been developed and applied for years for cardiac and pulmonary diseases with good clinical outcomes. However, its application to participants with long COVID remains limited.

Objectives

To investigate the effectiveness of a 12-week telerehabilitation training program in participants with long COVID. The primary outcome was cardiorespiratory fitness (CRF), and secondary outcomes were physical activity (PA) amounts, exercise self-efficacy, sleep quality, and health-related quality of life (HRQOL).

Methods

A parallel-group, randomized controlled trial was conducted. Eligible participants with long COVID (n = 182) were randomly assigned in a 1:1 ratio to either the experimental group (EG) or the control group (CG). The EG received 12 weeks of telerehabilitation training with weekly remote monitoring for exercise maintenance and support. The CG received PA counseling only. CRF, PA amounts, exercise self-efficacy, sleep quality, and HRQOL were assessed at baseline and 12 weeks. Generalized estimating equations were used to analyze the intervention effects by examining the interaction between time and group.

Results

One hundred twenty-two participants (67 %) completed the study, and 182 were included in the intention-to-treat analysis. The EG had greater walking behavior (β = –763.3, p < 0.001), total amount of PA (β= –711, p = 0.003), exercise self-efficacy (β = –1.19, p < 0.001), and better sleep quality (β = 1.69, p = 0.012) after the 12-weeks of telerehabilitation training than the CG. However, there were no significant differences in any CRF parameters or HRQOL at 12 weeks between the EG and CG.

Conclusion

Telerehabilitation training offers a personalized and convenient approach that can increase exercise willingness and PA amounts and improve sleep quality. These findings underscore the potential benefits of telerehabilitation training for promoting healthier lifestyles and improving overall health outcomes.

Clinical Trial Registration

The study was registered at ClinicalTrials.gov (NCT05205460) on January 25, 2022.

背景:多年来,远程康复技术一直被开发和应用于心脏和肺部疾病的治疗,并取得了良好的临床效果。然而,远程康复在长期慢性阻塞性肺病患者中的应用仍然有限:目的:研究为期 12 周的远程康复训练计划对长期 COVID 患者的效果。主要结果是心肺功能(CRF),次要结果是体力活动(PA)量、运动自我效能、睡眠质量和健康相关生活质量(HRQOL):方法:进行了一项平行分组随机对照试验。符合条件的长期 COVID 患者(n = 182)按 1:1 的比例被随机分配到实验组(EG)或对照组(CG)。实验组接受为期 12 周的远程康复训练,每周接受远程监控,以维持和支持运动。对照组只接受 PA 咨询。在基线和 12 周时对 CRF、PA 量、运动自我效能、睡眠质量和 HRQOL 进行评估。通过研究时间与组别之间的交互作用,使用广义估计方程分析干预效果:122名参与者(67%)完成了研究,其中182人被纳入意向治疗分析。与 CG 相比,EG 在 12 周的远程康复训练后的步行行为(β = -763.3,p <0.001)、PA 总量(β = -711,p =0.003)、运动自我效能感(β = -1.19,p <0.001)和睡眠质量(β = 1.69,p =0.012)均有所提高。然而,在12周的CRF参数或HRQOL方面,EG和CG之间没有明显差异:远程康复训练提供了一种个性化的便捷方法,可以提高运动意愿和运动量,改善睡眠质量。这些发现强调了远程康复训练在促进更健康的生活方式和改善整体健康结果方面的潜在益处:该研究于 2022 年 1 月 25 日在 ClinicalTrials.gov (NCT05205460) 上注册。
{"title":"Effectiveness of a 12-week telerehabilitation training in people with long COVID: A randomized controlled trial","authors":"Chia-Ying Lai ,&nbsp;Chia-Huei Lin ,&nbsp;Ta-Chung Chao ,&nbsp;Chueh-Ho Lin ,&nbsp;Cheng-Chiang Chang ,&nbsp;Chien-Yao Huang ,&nbsp;Shang-Lin Chiang","doi":"10.1016/j.rehab.2024.101853","DOIUrl":"10.1016/j.rehab.2024.101853","url":null,"abstract":"<div><h3>Background</h3><p>Telerehabilitation has been developed and applied for years for cardiac and pulmonary diseases with good clinical outcomes. However, its application to participants with long COVID remains limited.</p></div><div><h3>Objectives</h3><p>To investigate the effectiveness of a 12-week telerehabilitation training program in participants with long COVID. The primary outcome was cardiorespiratory fitness (CRF), and secondary outcomes were physical activity (PA) amounts, exercise self-efficacy, sleep quality, and health-related quality of life (HRQOL).</p></div><div><h3>Methods</h3><p>A parallel-group, randomized controlled trial was conducted. Eligible participants with long COVID (<em>n</em> = 182) were randomly assigned in a 1:1 ratio to either the experimental group (EG) or the control group (CG). The EG received 12 weeks of telerehabilitation training with weekly remote monitoring for exercise maintenance and support. The CG received PA counseling only. CRF, PA amounts, exercise self-efficacy, sleep quality, and HRQOL were assessed at baseline and 12 weeks. Generalized estimating equations were used to analyze the intervention effects by examining the interaction between time and group.</p></div><div><h3>Results</h3><p>One hundred twenty-two participants (67 %) completed the study, and 182 were included in the intention-to-treat analysis. The EG had greater walking behavior (β = –763.3, <em>p</em> &lt; 0.001), total amount of PA (β= –711, <em>p</em> = 0.003), exercise self-efficacy (β = –1.19, <em>p</em> &lt; 0.001), and better sleep quality (β = 1.69, <em>p</em> = 0.012) after the 12-weeks of telerehabilitation training than the CG. However, there were no significant differences in any CRF parameters or HRQOL at 12 weeks between the EG and CG.</p></div><div><h3>Conclusion</h3><p>Telerehabilitation training offers a personalized and convenient approach that can increase exercise willingness and PA amounts and improve sleep quality. These findings underscore the potential benefits of telerehabilitation training for promoting healthier lifestyles and improving overall health outcomes.</p></div><div><h3>Clinical Trial Registration</h3><p>The study was registered at ClinicalTrials.gov (NCT05205460) on January 25, 2022.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 5","pages":"Article 101853"},"PeriodicalIF":4.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201204","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
Percutaneous needle tenotomies: indications, procedures, efficacy and safety. A systematic review 经皮穿刺腱切开术:适应症、程序、疗效和安全性。系统综述。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-01 DOI: 10.1016/j.rehab.2024.101839
Hugo Bessaguet , Paul Calmels , Alexis Schnitzler , Flavia Coroian , Pascal Giraux , Florence Angioni , Ahmed Adham , Philippe Denormandie , Romain David , Etienne Ojardias

Background

Percutaneous needle tenotomies constitute a promising approach that enables direct access to tendons through minimally invasive interventions. They can be performed rapidly without need for large incisions or general anaesthesia. However, the reported procedures are heterogeneous and currently conducted without guidelines.

Objectives

We aimed to determine the indications for percutaneous needle tenotomies described in the current literature. Our secondary aim was to identify the different procedures reported, as well as their efficacy and their safety.

Methods

A systematic review following PRISMA guidelines was conducted to identify original articles that mentioned percutaneous needle tenotomy in humans and reported its application, description, effectiveness or adverse events. Non-percutaneous tendinous surgical procedures and ineligible designs were excluded. The Downs and Black checklist was used to assess the risk of bias.

Results

A total of 540 studies were identified from the MEDLINE, Embase, Cochrane Library, and PEDro databases. Fourteen clinical studies met the inclusion criteria and were found to have an acceptable quality (674 individuals, 1664 tenotomies). Our results indicated a wide variety of indications for percutaneous needle tenotomies in children and in adults. We highlighted 24 tendons as eligible targets in the upper and lower limbs. Tenotomies were performed with either 16- or 18-Ga needles, lasted from 1 to 30 min, and were performed using various procedures. Their efficacy was mainly assessed through clinical outcomes highlighting tendon discontinuity on palpation after the procedure. Passive range-of-motion gains after tenotomy were reported for both upper and lower limbs with an estimated 5 % complication rate.

Conclusion

This is the first review to systematically synthesize all the available evidence on the indications, procedures, efficacy and safety of percutaneous tenotomies exclusively performed with needles. Current evidence suggests that procedures are safe and effective for treating various deformities.

PROSPERO registration

CRD42022350571

背景:经皮穿刺针腱切开术是一种很有前途的方法,可通过微创介入直接接触肌腱。这种方法无需大切口或全身麻醉即可快速实施。然而,目前所报道的手术方法不尽相同,而且没有相关指南:我们旨在确定现有文献中描述的经皮穿刺针腱切开术的适应症。我们的第二目的是确定所报道的不同手术方法,以及它们的有效性和安全性:我们按照 PRISMA 指南进行了系统性回顾,以确定提及经皮穿刺针腱切开术并报告其应用、描述、有效性或不良事件的原创文章。非经皮肌腱外科手术和不符合要求的设计均被排除在外。结果:结果:从 MEDLINE、Embase、Cochrane Library 和 PEDro 数据库中共筛选出 540 项研究。有 14 项临床研究符合纳入标准,且质量合格(674 人,1664 次腱鞘切开术)。我们的研究结果表明,儿童和成人经皮穿刺腱切开术的适应症多种多样。我们将 24 条肌腱列为上肢和下肢的合格目标。腱切开术使用16Ga或18Ga针头,持续时间从1分钟到30分钟不等,并采用了不同的手术方法。其疗效主要通过术后触诊肌腱不连续的临床结果进行评估。据报道,腱切开术后上下肢的被动活动范围均有所扩大,并发症发生率约为5%:这是第一篇系统综合了所有可用证据的综述,涉及完全使用针头进行经皮腱鞘切开术的适应症、程序、疗效和安全性。目前的证据表明,经皮腱鞘切开术在治疗各种畸形方面安全有效:CRD42022350571。
{"title":"Percutaneous needle tenotomies: indications, procedures, efficacy and safety. A systematic review","authors":"Hugo Bessaguet ,&nbsp;Paul Calmels ,&nbsp;Alexis Schnitzler ,&nbsp;Flavia Coroian ,&nbsp;Pascal Giraux ,&nbsp;Florence Angioni ,&nbsp;Ahmed Adham ,&nbsp;Philippe Denormandie ,&nbsp;Romain David ,&nbsp;Etienne Ojardias","doi":"10.1016/j.rehab.2024.101839","DOIUrl":"10.1016/j.rehab.2024.101839","url":null,"abstract":"<div><h3>Background</h3><p>Percutaneous needle tenotomies constitute a promising approach that enables direct access to tendons through minimally invasive interventions. They can be performed rapidly without need for large incisions or general anaesthesia. However, the reported procedures are heterogeneous and currently conducted without guidelines.</p></div><div><h3>Objectives</h3><p>We aimed to determine the indications for percutaneous needle tenotomies described in the current literature. Our secondary aim was to identify the different procedures reported, as well as their efficacy and their safety.</p></div><div><h3>Methods</h3><p>A systematic review following PRISMA guidelines was conducted to identify original articles that mentioned percutaneous needle tenotomy in humans and reported its application, description, effectiveness or adverse events. Non-percutaneous tendinous surgical procedures and ineligible designs were excluded. The Downs and Black checklist was used to assess the risk of bias.</p></div><div><h3>Results</h3><p>A total of 540 studies were identified from the MEDLINE, Embase, Cochrane Library, and PEDro databases. Fourteen clinical studies met the inclusion criteria and were found to have an acceptable quality (674 individuals, 1664 tenotomies). Our results indicated a wide variety of indications for percutaneous needle tenotomies in children and in adults. We highlighted 24 tendons as eligible targets in the upper and lower limbs. Tenotomies were performed with either 16- or 18-Ga needles, lasted from 1 to 30 min, and were performed using various procedures. Their efficacy was mainly assessed through clinical outcomes highlighting tendon discontinuity on palpation after the procedure. Passive range-of-motion gains after tenotomy were reported for both upper and lower limbs with an estimated 5 % complication rate.</p></div><div><h3>Conclusion</h3><p>This is the first review to systematically synthesize all the available evidence on the indications, procedures, efficacy and safety of percutaneous tenotomies exclusively performed with needles. Current evidence suggests that procedures are safe and effective for treating various deformities.</p></div><div><h3>PROSPERO registration</h3><p>CRD42022350571</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 5","pages":"Article 101839"},"PeriodicalIF":4.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S187706572400023X/pdfft?md5=9976ccc5bda6621b49faee6dff6c3cef&pid=1-s2.0-S187706572400023X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201260","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Arthro-distension with early and intensive mobilization for shoulder adhesive capsulitis: A randomized controlled trial 肩关节粘连性肩关节囊炎的关节牵张与早期强化活动治疗:随机对照试验
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-01 DOI: 10.1016/j.rehab.2024.101852
Louis Jacob , Sandra Lasbleiz , Katherine Sanchez , Odile Morchoisne , Marie-Martine Lefèvre-Colau , Christelle Nguyen , François Rannou , Antoine Feydy , Jean-Jacques Portal , Alexis Schnitzler , Eric Vicaut , Jean-Denis Laredo , Pascal Richette , Philippe Orcel , Johann Beaudreuil

Background

There are several therapeutic options for the management of shoulder adhesive capsulitis (AC). The superiority of arthro-distension over intra-articular steroid injection (ISI) for AC remains controversial.

Objectives

To evaluate the efficacy of a single arthro-distension procedure combined with early and intensive mobilization (ADM) and physiotherapy, versus ISI and physiotherapy, in people with AC lasting ≥3 months.

Methods

This was a prospective, 2 parallel-group, 2-center, observer-blind randomized controlled trial conducted in tertiary care settings. Adults with AC were randomly assigned to the treatment or control group. Efficacy was assessed using the self-administered Shoulder Pain and Disability Index (SPADI). Total, pain and disability SPADI scores 15 days, 6 weeks, and 3, 6 and 12 months after the procedure (total SPADI at 15 days: primary outcome; other outcomes were secondary) were compared between groups using analysis of covariance (ANCOVA). A post hoc analysis stratified on the initial range of passive glenohumeral abduction, which had not been pre-specified, was conducted.

Results

There were 33 participants in each group. Both groups improved over time. Mean (SD) total SPADI score at 15 days was 33.8 (19.6) in the treatment group and 32.8 (17.5) in the control group, p = 0.393. There were no significant differences for any variables in the overall sample. The post hoc analysis found ADM to be associated with a significant decrease in total SPADI score at 15 days compared with ISI (p = 0.049) in individuals with initial passive glenohumeral abduction >45°.

Conclusions

The effects of ADM on pain and function were not statistically different from those of ISI. However, ADM may be useful in individuals with initial passive glenohumeral abduction >45°.

Database registration

NCT00724113.

背景:治疗肩关节粘连性囊炎(AC)有多种治疗方案。关节拉伸术比关节内注射类固醇(ISI)治疗肩关节粘连性囊炎更有优势,这一点仍存在争议:方法:这是一项前瞻性的研究,采用 2 个平行对照组,分别对肩关节粘连性囊炎(AC)和肩关节内类固醇注射(ISI)患者进行研究:这是一项在三级医疗机构进行的前瞻性、两组平行、两中心、观察者盲法随机对照试验。患有交流障碍的成人被随机分配到治疗组或对照组。疗效采用自编肩部疼痛和残疾指数(SPADI)进行评估。采用协方差分析法(ANCOVA)比较了治疗组和对照组在治疗后15天、6周、3个月、6个月和12个月的SPADI总分、疼痛分和残疾分(15天时的SPADI总分:主要结果;其他结果为次要结果)。此外,还对未预先指定的盂肱外展初始范围进行了分层分析:结果:每组各有 33 名参与者。随着时间的推移,两组均有所改善。治疗组 15 天后的 SPADI 总分平均值(标度)为 33.8(19.6),对照组为 32.8(17.5),P = 0.393。总体样本中的任何变量均无明显差异。事后分析发现,在最初被动盂肱外展角度大于45°的患者中,与ISI相比,ADM与15天后SPADI总分的显著下降相关(p = 0.049):ADM对疼痛和功能的影响与ISI没有统计学差异。结论:ADM 对疼痛和功能的影响与 ISI 相比并无统计学差异,但 ADM 可能对初始被动盂肱外展 >45° 的患者有用:数据库注册:NCT00724113。
{"title":"Arthro-distension with early and intensive mobilization for shoulder adhesive capsulitis: A randomized controlled trial","authors":"Louis Jacob ,&nbsp;Sandra Lasbleiz ,&nbsp;Katherine Sanchez ,&nbsp;Odile Morchoisne ,&nbsp;Marie-Martine Lefèvre-Colau ,&nbsp;Christelle Nguyen ,&nbsp;François Rannou ,&nbsp;Antoine Feydy ,&nbsp;Jean-Jacques Portal ,&nbsp;Alexis Schnitzler ,&nbsp;Eric Vicaut ,&nbsp;Jean-Denis Laredo ,&nbsp;Pascal Richette ,&nbsp;Philippe Orcel ,&nbsp;Johann Beaudreuil","doi":"10.1016/j.rehab.2024.101852","DOIUrl":"10.1016/j.rehab.2024.101852","url":null,"abstract":"<div><h3>Background</h3><p>There are several therapeutic options for the management of shoulder adhesive capsulitis (AC). The superiority of arthro-distension over intra-articular steroid injection (ISI) for AC remains controversial.</p></div><div><h3>Objectives</h3><p>To evaluate the efficacy of a single arthro-distension procedure combined with early and intensive mobilization (ADM) and physiotherapy, versus ISI and physiotherapy, in people with AC lasting ≥3 months.</p></div><div><h3>Methods</h3><p>This was a prospective, 2 parallel-group, 2-center, observer-blind randomized controlled trial conducted in tertiary care settings. Adults with AC were randomly assigned to the treatment or control group. Efficacy was assessed using the self-administered Shoulder Pain and Disability Index (SPADI). Total, pain and disability SPADI scores 15 days, 6 weeks, and 3, 6 and 12 months after the procedure (total SPADI at 15 days: primary outcome; other outcomes were secondary) were compared between groups using analysis of covariance (ANCOVA). A post hoc analysis stratified on the initial range of passive glenohumeral abduction, which had not been pre-specified, was conducted.</p></div><div><h3>Results</h3><p>There were 33 participants in each group. Both groups improved over time. Mean (SD) total SPADI score at 15 days was 33.8 (19.6) in the treatment group and 32.8 (17.5) in the control group, <em>p</em> = 0.393. There were no significant differences for any variables in the overall sample. The post hoc analysis found ADM to be associated with a significant decrease in total SPADI score at 15 days compared with ISI (<em>p</em> = 0.049) in individuals with initial passive glenohumeral abduction &gt;45°.</p></div><div><h3>Conclusions</h3><p>The effects of ADM on pain and function were not statistically different from those of ISI. However, ADM may be useful in individuals with initial passive glenohumeral abduction &gt;45°.</p></div><div><h3>Database registration</h3><p>NCT00724113.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 6","pages":"Article 101852"},"PeriodicalIF":4.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201274","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
Short-term outcomes of early intensive neurorehabilitation for prolonged disorders of consciousness: A prospective cohort study 针对长时间意识障碍的早期强化神经康复的短期疗效:前瞻性队列研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-01 DOI: 10.1016/j.rehab.2024.101838
Danielle M.F. Driessen , Cecile M.A. Utens , Prof Gerard M. Ribbers , Willemijn S. van Erp , Majanka H. Heijenbrok-Kal

Background

Advances in medical care have increased survival in people with severe brain injuries and with that the number of survivors with prolonged disorders of consciousness (PDOC) has increased. In the literature, early intensive neurorehabilitation (EIN) for people with PDOC is recommended to achieve the best possible outcomes.

Objectives

To evaluate the frequency and extent of recovery of consciousness, mortality, complications, pain and discomfort, and medication during a nationwide EIN programme in people with PDOC after acquired brain injury. We hypothesized that level of consciousness would improve in half of people with PDOC.

Methods

Prospective cohort study. People with PDOC aged 16 years and older admitted to the EIN department centralized in a single rehabilitation centre in the Netherlands (Libra Rehabilitation & Audiology) were included. The EIN delivers a subacute medical level of care and rehabilitation for a maximum duration of 14 weeks. The outcome measures were level of consciousness (CRS-R), mortality, number of complications, medication and pain/discomfort (NCS-R).

Results

Of the 104 people included, 68 % emerged to a minimal conscious state with command-following or higher during EIN and 44 % regained consciousness. Mortality during EIN was 6 %, and 50 % of deaths followed a non-treatment decision or withdrawal of life-sustaining treatment. Almost all participants had at least 1 medical complication, leading to hospital readmission for 30 %. 73 % showed no pain or discomfort. During EIN, cardiovascular medication and analgesics were reduced by 15 %.

Conclusions

During the EIN programme, a large percentage of people with PDOC regained at least a minimal conscious state or even consciousness. These outcomes and the frequent medical complications in these people suggest that intensive specialized care should be offered to all people with PDOC. The outcomes of this study might help health professionals to better inform the families of people with PDOC about the short-term prognosis of PDOC.

Protocol registration number

The Dutch Trial Register, NL 8138.

背景:医疗技术的进步提高了严重脑损伤患者的存活率,而随着存活率的提高,患有长时间意识障碍(PDOC)的患者人数也在增加。文献中建议对意识障碍患者进行早期强化神经康复治疗(EIN),以获得最佳治疗效果:目的:评估在全国范围内对后天性脑损伤后意识障碍患者实施强化神经康复治疗计划期间意识恢复的频率和程度、死亡率、并发症、疼痛和不适以及用药情况。我们假设半数 PDOC 患者的意识水平将得到改善:前瞻性队列研究。研究对象包括在荷兰一家康复中心(Libra康复与听力)的EIN部门集中住院的16岁及以上PDOC患者。EIN提供亚急性医疗护理和最长14周的康复治疗。结果测量指标包括意识水平(CRS-R)、死亡率、并发症数量、用药和疼痛/不适(NCS-R):在接受EIN治疗的104人中,有68%的人在EIN治疗期间恢复到最低意识状态,能听从命令或更高水平,44%的人恢复了意识。EIN期间的死亡率为6%,50%的死亡是在做出非治疗决定或撤销维持生命治疗后发生的。几乎所有参与者都至少出现了一种医疗并发症,其中30%导致再次入院。73%的患者没有疼痛或不适感。在EIN期间,心血管药物和镇痛药减少了15%:在EIN过程中,很大比例的PDOC患者至少恢复了最低限度的意识状态,甚至有意识。这些结果以及这些患者经常出现的医疗并发症表明,应该为所有 PDOC 患者提供强化专业护理。这项研究的结果可能有助于医疗专业人员更好地向PDOC患者家属介绍PDOC的短期预后:荷兰试验注册中心,NL 8138。
{"title":"Short-term outcomes of early intensive neurorehabilitation for prolonged disorders of consciousness: A prospective cohort study","authors":"Danielle M.F. Driessen ,&nbsp;Cecile M.A. Utens ,&nbsp;Prof Gerard M. Ribbers ,&nbsp;Willemijn S. van Erp ,&nbsp;Majanka H. Heijenbrok-Kal","doi":"10.1016/j.rehab.2024.101838","DOIUrl":"10.1016/j.rehab.2024.101838","url":null,"abstract":"<div><h3>Background</h3><p>Advances in medical care have increased survival in people with severe brain injuries and with that the number of survivors with prolonged disorders of consciousness (PDOC) has increased. In the literature, early intensive neurorehabilitation (EIN) for people with PDOC is recommended to achieve the best possible outcomes.</p></div><div><h3>Objectives</h3><p>To evaluate the frequency and extent of recovery of consciousness, mortality, complications, pain and discomfort, and medication during a nationwide EIN programme in people with PDOC after acquired brain injury. We hypothesized that level of consciousness would improve in half of people with PDOC.</p></div><div><h3>Methods</h3><p>Prospective cohort study. People with PDOC aged 16 years and older admitted to the EIN department centralized in a single rehabilitation centre in the Netherlands (Libra Rehabilitation &amp; Audiology) were included. The EIN delivers a subacute medical level of care and rehabilitation for a maximum duration of 14 weeks. The outcome measures were level of consciousness (CRS-R), mortality, number of complications, medication and pain/discomfort (NCS-R).</p></div><div><h3>Results</h3><p>Of the 104 people included, 68 % emerged to a minimal conscious state with command-following or higher during EIN and 44 % regained consciousness. Mortality during EIN was 6 %, and 50 % of deaths followed a non-treatment decision or withdrawal of life-sustaining treatment. Almost all participants had at least 1 medical complication, leading to hospital readmission for 30 %. 73 % showed no pain or discomfort. During EIN, cardiovascular medication and analgesics were reduced by 15 %.</p></div><div><h3>Conclusions</h3><p>During the EIN programme, a large percentage of people with PDOC regained at least a minimal conscious state or even consciousness. These outcomes and the frequent medical complications in these people suggest that intensive specialized care should be offered to all people with PDOC. The outcomes of this study might help health professionals to better inform the families of people with PDOC about the short-term prognosis of PDOC.</p></div><div><h3>Protocol registration number</h3><p>The Dutch Trial Register, NL 8138.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 5","pages":"Article 101838"},"PeriodicalIF":4.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877065724000228/pdfft?md5=de5d87e145adac27fce69b1eab0c5a99&pid=1-s2.0-S1877065724000228-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238704","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Factors associated with a prolonged time to return to safe driving following lower extremity injuries 下肢受伤后恢复安全驾驶时间延长的相关因素。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-01 DOI: 10.1016/j.rehab.2024.101850
Andrew L. Alejo, Alexander S. Rascoe, Chang-Yeon Kim, Bryan O. Ren, Matthew T. Hoffa, Isabella M. Heimke, Heather A. Vallier
{"title":"Factors associated with a prolonged time to return to safe driving following lower extremity injuries","authors":"Andrew L. Alejo,&nbsp;Alexander S. Rascoe,&nbsp;Chang-Yeon Kim,&nbsp;Bryan O. Ren,&nbsp;Matthew T. Hoffa,&nbsp;Isabella M. Heimke,&nbsp;Heather A. Vallier","doi":"10.1016/j.rehab.2024.101850","DOIUrl":"10.1016/j.rehab.2024.101850","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 6","pages":"Article 101850"},"PeriodicalIF":4.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201275","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
Knee strength symmetry and reinjury risk after primary anterior cruciate ligament reconstruction: A minimum 2-year follow-up cohort study 膝关节力量对称性与初级前交叉韧带重建术后再次受伤的风险:一项为期至少两年的队列随访研究。
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-06-01 DOI: 10.1016/j.rehab.2024.101848
Joffrey Drigny, Quentin Bouchereau, Henri Guermont, Emmanuel Reboursière, Antoine Gauthier, Clémence Ferrandez, Christophe Hulet
{"title":"Knee strength symmetry and reinjury risk after primary anterior cruciate ligament reconstruction: A minimum 2-year follow-up cohort study","authors":"Joffrey Drigny,&nbsp;Quentin Bouchereau,&nbsp;Henri Guermont,&nbsp;Emmanuel Reboursière,&nbsp;Antoine Gauthier,&nbsp;Clémence Ferrandez,&nbsp;Christophe Hulet","doi":"10.1016/j.rehab.2024.101848","DOIUrl":"10.1016/j.rehab.2024.101848","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 6","pages":"Article 101848"},"PeriodicalIF":4.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141201276","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
A systematic review of rehabilitation programs for cognitive impairment related to breast cancer: Different programs at different times? 针对与乳腺癌相关的认知障碍的康复计划的系统回顾:不同时期的不同计划?
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-03-26 DOI: 10.1016/j.rehab.2024.101832
Marianne Merceur , Karen T. Reilly , Isabelle Bonan , Julie Holé , Emilie Hummel , Mélanie Cogné , Sophie Jacquin-Courtois

Background

“Cancer Related Cognitive Impairment” (CRCI) defines cognitive disorders related to cancer and its treatments. Many people with breast cancer experience signs of CRCI (incidence between 20 and 30 %) and, although several intervention options exist, there is no established standard of care. Our main objective was to provide a detailed description of the methods and results of randomized controlled trials of interventions for CRCI in breast cancer survivors, paying particular attention to the timing of the interventions within the care pathway.

Methods

We conducted a systematic literature review following the PRISMA guidelines from 01 to 01–2019 to 16–07–2023 and included randomized controlled trials of interventions for CRCI after breast cancer with at least one objective cognitive assessment as a primary or secondary outcome.

Results

Among 228 identified studies, 35 (including 2821 participants) were retained for inclusion. The interventions were classified into 4 categories: cognitive rehabilitation, physical activity, complementary therapy and pharmacological treatment. Our analysis revealed that pharmacological interventions have no effect, whereas physical activity interventions proposed in the months following the initial cancer treatment improve Quality of Life and Speed of Information Processing while interventions proposed later improve Memory and Attention (Cognitive Rehabilitation) and Perceived Cognitive Function and Depression/Anxiety/Mood (Complementary Therapies).

Conclusion

CRCI is multifactorial and affected individuals frequently experience high levels of fatigue, pain, anxiety and depression and are most likely to benefit from holistic approaches that include cognition, physical activity, relaxation, psychoeducation, group support and/or psychological counselling. Thus, rehabilitation programs should be designed on multi-modal approaches, using innovative, cost-effective delivery methods that increase access to treatment, and intervention outcomes should be evaluated using measures of participation.

Database registration

The review was recorded on Prospero (01–03–2020), with the registration number 135,627.

背景 "癌症相关认知障碍"(CRCI)是指与癌症及其治疗相关的认知障碍。许多乳腺癌患者都有 CRCI 的症状(发生率在 20% 到 30% 之间),虽然存在多种干预方案,但目前还没有确定的护理标准。我们的主要目的是详细描述乳腺癌幸存者 CRCI 干预措施的随机对照试验的方法和结果,尤其关注干预措施在护理路径中的时间安排。方法我们按照 PRISMA 指南对 2019 年 1 月 1 日至 2023 年 7 月 16 日期间的文献进行了系统性综述,纳入了乳腺癌后 CRCI 干预措施的随机对照试验,并将至少一项客观认知评估作为主要或次要结果。干预措施分为四类:认知康复、体育活动、辅助疗法和药物治疗。我们的分析表明,药物干预没有效果,而在最初癌症治疗后的几个月内提出的体育锻炼干预可提高生活质量和信息处理速度,而随后提出的干预可改善记忆力和注意力(认知康复)以及认知功能感知和抑郁/焦虑/情绪(辅助疗法)。结论CRCI 是一种多因素疾病,患者经常会感到高度疲劳、疼痛、焦虑和抑郁,最有可能从包括认知、体育锻炼、放松、心理教育、团体支持和/或心理咨询在内的综合方法中获益。因此,康复计划的设计应采用多模式方法,使用创新、具有成本效益的提供方法,以增加获得治疗的机会,并应使用参与措施来评估干预结果。数据库注册该综述已在 Prospero(01-03-2020)上登记,登记号为 135,627。
{"title":"A systematic review of rehabilitation programs for cognitive impairment related to breast cancer: Different programs at different times?","authors":"Marianne Merceur ,&nbsp;Karen T. Reilly ,&nbsp;Isabelle Bonan ,&nbsp;Julie Holé ,&nbsp;Emilie Hummel ,&nbsp;Mélanie Cogné ,&nbsp;Sophie Jacquin-Courtois","doi":"10.1016/j.rehab.2024.101832","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101832","url":null,"abstract":"<div><h3>Background</h3><p>“Cancer Related Cognitive Impairment” (CRCI) defines cognitive disorders related to cancer and its treatments. Many people with breast cancer experience signs of CRCI (incidence between 20 and 30 %) and, although several intervention options exist, there is no established standard of care. Our main objective was to provide a detailed description of the methods and results of randomized controlled trials of interventions for CRCI in breast cancer survivors, paying particular attention to the timing of the interventions within the care pathway.</p></div><div><h3>Methods</h3><p>We conducted a systematic literature review following the PRISMA guidelines from 01 to 01–2019 to 16–07–2023 and included randomized controlled trials of interventions for CRCI after breast cancer with at least one objective cognitive assessment as a primary or secondary outcome.</p></div><div><h3>Results</h3><p>Among 228 identified studies, 35 (including 2821 participants) were retained for inclusion. The interventions were classified into 4 categories: cognitive rehabilitation, physical activity, complementary therapy and pharmacological treatment. Our analysis revealed that pharmacological interventions have no effect, whereas physical activity interventions proposed in the months following the initial cancer treatment improve Quality of Life and Speed of Information Processing while interventions proposed later improve Memory and Attention (Cognitive Rehabilitation) and Perceived Cognitive Function and Depression/Anxiety/Mood (Complementary Therapies).</p></div><div><h3>Conclusion</h3><p>CRCI is multifactorial and affected individuals frequently experience high levels of fatigue, pain, anxiety and depression and are most likely to benefit from holistic approaches that include cognition, physical activity, relaxation, psychoeducation, group support and/or psychological counselling. Thus, rehabilitation programs should be designed on multi-modal approaches, using innovative, cost-effective delivery methods that increase access to treatment, and intervention outcomes should be evaluated using measures of participation.</p></div><div><h3>Database registration</h3><p>The review was recorded on Prospero (01–03–2020), with the registration number 135,627.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 5","pages":"Article 101832"},"PeriodicalIF":4.6,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877065724000162/pdfft?md5=d4662c4398d05033f335e59950f52ebb&pid=1-s2.0-S1877065724000162-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The impact of age on outcome 2 years after traumatic brain injury: Case control study 年龄对脑外伤 2 年后疗效的影响:病例对照研究
IF 4.6 3区 医学 Q1 REHABILITATION Pub Date : 2024-03-21 DOI: 10.1016/j.rehab.2024.101834
Marina G. Downing , Meagan Carty , John Olver , Michael Ponsford , Rose Acher , Dean Mckenzie , Jennie L. Ponsford

Background

Age is associated with outcome after traumatic brain injury (TBI). However, there are mixed findings across outcome domains and most studies lack controls.

Objectives

This cross-sectional study examined the association between age group (15–24 years, 25–34 years, 35–44 years, 45–54 years, 55–64 years, and 65 years or more) and outcomes 2 years after TBI in independence in daily activities, driving, public transportation use, employment, leisure activities, social integration, relationships and emotional functioning, relative to healthy controls. It was hypothesized that older individuals with TBI would have significantly poorer outcomes than controls in all domains except anxiety and depression, for which it was expected they would show better outcomes. Global functional outcome (measured using the Glasgow Outcome Scale-Extended) was also examined, and we hypothesized that older adults would have poorer outcomes than younger adults.

Methods

Participants were 1897 individuals with TBI (mean, SD age 36.7, 17.7 years) who completed measures 2 years post-injury and 110 healthy controls (age 38.3, 17.5 years).

Results

Compared to controls, individuals with TBI were less independent in most activities of daily living, participated less in leisure activities and employment, and were more socially isolated, anxious and depressed (p < 0.001). Those who were older in age were disproportionately less likely to be independent in light domestic activities, shopping and driving; and participated less in occupational activities relative to controls. Functional outcome was significantly higher in the youngest age group than in all older age groups (p < 0.001), but the younger groups were more likely to report being socially isolated (p < 0.001), depressed (p = 0.005) and anxious (p = 0.02), and less likely to be married or in a relationship (p < 0.001).

Conclusion

A greater focus is needed on addressing psychosocial issues in younger individuals with TBI, whereas those who are older may require more intensive therapy to maximise independence in activities of daily living and return to employment.

背景年龄与创伤性脑损伤(TBI)后的结果有关。这项横断面研究考察了与健康对照组相比,年龄组(15-24 岁、25-34 岁、35-44 岁、45-54 岁、55-64 岁和 65 岁或以上)与创伤性脑损伤 2 年后在日常活动独立性、驾驶、公共交通使用、就业、休闲活动、社会融合、人际关系和情绪功能方面的结果之间的关系。根据假设,患有创伤性脑损伤的老年人在焦虑和抑郁之外的所有方面的结果都会明显差于对照组,而在焦虑和抑郁方面,预计他们的结果会更好。我们还研究了总体功能结果(使用格拉斯哥结果量表-扩展版进行测量),并假设老年人的结果会比年轻人差。结果与对照组相比,创伤性脑损伤患者在大多数日常生活活动中的独立性较差,参与休闲活动和就业的程度较低,而且更容易被社会孤立、焦虑和抑郁(p <0.001)。与对照组相比,年龄较大者在轻度家务活动、购物和驾驶方面的独立性更差,参与职业活动的程度也更低。最年轻年龄组的功能结果明显高于所有较年长年龄组(p <0.001),但较年轻年龄组更有可能报告被社会孤立(p <0.001)、抑郁(p = 0.005)和焦虑(p = 0.02),已婚或恋爱的可能性较低(p <0.001)。结论 需要更加重视解决年轻创伤性脑损伤患者的社会心理问题,而年龄较大的患者可能需要更深入的治疗,以最大限度地提高日常生活活动的独立性并重返就业岗位。
{"title":"The impact of age on outcome 2 years after traumatic brain injury: Case control study","authors":"Marina G. Downing ,&nbsp;Meagan Carty ,&nbsp;John Olver ,&nbsp;Michael Ponsford ,&nbsp;Rose Acher ,&nbsp;Dean Mckenzie ,&nbsp;Jennie L. Ponsford","doi":"10.1016/j.rehab.2024.101834","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101834","url":null,"abstract":"<div><h3>Background</h3><p>Age is associated with outcome after traumatic brain injury (TBI). However, there are mixed findings across outcome domains and most studies lack controls.</p></div><div><h3>Objectives</h3><p>This cross-sectional study examined the association between age group (15–24 years, 25–34 years, 35–44 years, 45–54 years, 55–64 years, and 65 years or more) and outcomes 2 years after TBI in independence in daily activities, driving, public transportation use, employment, leisure activities, social integration, relationships and emotional functioning, relative to healthy controls. It was hypothesized that older individuals with TBI would have significantly poorer outcomes than controls in all domains except anxiety and depression, for which it was expected they would show better outcomes. Global functional outcome (measured using the Glasgow Outcome Scale-Extended) was also examined, and we hypothesized that older adults would have poorer outcomes than younger adults.</p></div><div><h3>Methods</h3><p>Participants were 1897 individuals with TBI (mean, SD age 36.7, 17.7 years) who completed measures 2 years post-injury and 110 healthy controls (age 38.3, 17.5 years).</p></div><div><h3>Results</h3><p>Compared to controls, individuals with TBI were less independent in most activities of daily living, participated less in leisure activities and employment, and were more socially isolated, anxious and depressed (<em>p</em> &lt; 0.001). Those who were older in age were disproportionately less likely to be independent in light domestic activities, shopping and driving; and participated less in occupational activities relative to controls. Functional outcome was significantly higher in the youngest age group than in all older age groups (<em>p</em> &lt; 0.001), but the younger groups were more likely to report being socially isolated (<em>p</em> &lt; 0.001), depressed (<em>p</em> = 0.005) and anxious (<em>p</em> = 0.02), and less likely to be married or in a relationship (<em>p</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>A greater focus is needed on addressing psychosocial issues in younger individuals with TBI, whereas those who are older may require more intensive therapy to maximise independence in activities of daily living and return to employment.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 5","pages":"Article 101834"},"PeriodicalIF":4.6,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1877065724000186/pdfft?md5=ca499dba63496fb2be178e29ae1429c0&pid=1-s2.0-S1877065724000186-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140180483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Annals of Physical and Rehabilitation Medicine
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1