Annals of Physical and Rehabilitation Medicine最新文献

{"title":"Interactive boxing–cycling on frailty and activity limitations in frail and prefrail older adults: A randomized controlled trial","authors":"Yi-Jia Lin ,&nbsp;Wei-Chun Hsu ,&nbsp;Kai Chen Wang ,&nbsp;Wan-Yan Tseng ,&nbsp;Ying-Yi Liao","doi":"10.1016/j.rehab.2024.101819","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101819","url":null,"abstract":"<div><h3>Background</h3><p>Frailty is common among older adults, often associated with activity limitations during physical and walking tasks. The interactive boxing-cycling combination has the potential to be an innovative and efficient training method, and our hypothesis was that interactive boxing-cycling would be superior to stationary cycling in improving frailty and activity limitations in frail and prefrail older adults.</p></div><div><h3>Objective</h3><p>To examine the impact of interactive boxing-cycling on frailty and activity limitations in frail and prefrail older adults compared to stationary cycling.</p></div><div><h3>Materials and methods</h3><p>A single-blinded randomized controlled trial. Forty-five participants who met at least one frailty phenotype criteria were randomly assigned to receive either interactive boxing-cycling (<em>n</em> = 23) or stationary-cycling (<em>n</em> = 22) for 36 sessions over 12 weeks. The interactive boxing-cycling was performed on a cycle boxer bike with an interactive boxing panel fixed in front of the bike. The primary outcomes were frailty status, including score and phenotypes. Secondary outcomes included activity limitations during physical and walking tasks. The pre- and post-intervention data of both groups were analyzed using a repeated measures two-way ANOVA.</p></div><div><h3>Results</h3><p>Both types of cycling significantly improved frailty scores (<em>p</em>&lt;0.001). Interactive boxing-cycling was more effective than stationary cycling in reversing the frailty phenotype of muscle weakness (<em>p</em> = 0.03, odds ratio 9.19) and demonstrated greater improvements than stationary cycling in arm curl (<em>p</em> = 0.002, η²=0.20), functional reach (<em>p</em> = 0.001, η²=0.22), and grip strength (<em>p</em> = 0.02, η²=0.12) tests. Additionally, interactive boxing-cycling exhibited a greater effect on gait speed (<em>p</em> = 0.02, η²=0.13) and gait variability (<em>p</em> = 0.01, η²=0.14) during dual-task walking.</p></div><div><h3>Conclusion</h3><p>In frail and prefrail older adults, interactive boxing-cycling effectively improves frailty but is not superior to stationary cycling. However, it is more effective at improving certain activity limitations.</p></div><div><h3>Registration number</h3><p>TCTR20220328001</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 4","pages":"Article 101819"},"PeriodicalIF":4.6,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anodal tDCS over the motor cortex improves pain but not physical function in chronic chikungunya arthritis: Randomized controlled trial","authors":"Antônio Felipe Lopes Cavalcante ,&nbsp;Joanna Sacha Cunha Brito Holanda ,&nbsp;João Octávio Sales Passos ,&nbsp;Joyce Maria Pereira de Oliveira ,&nbsp;Edgard Morya ,&nbsp;Alexandre H. Okano ,&nbsp;Marom Bikson ,&nbsp;Rodrigo Pegado","doi":"10.1016/j.rehab.2024.101826","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101826","url":null,"abstract":"<div><h3>Background</h3><p>Chikungunya virus (CHIKV) is a globally prevalent pathogen, with outbreaks occurring in tropical regions. Chronic pain is the main symptom reported and is associated with decreased mobility and disability. Transcranial direct current stimulation (tDCS) is emerging as a new therapeutic tool for chronic arthralgia.</p></div><div><h3>Objective</h3><p>To evaluate the effectiveness of 10 consecutive sessions of anodal tDCS on pain (primary outcome) in participants with chronic CHIKV arthralgia. Secondary outcomes included functional status, quality of life, and mood.</p></div><div><h3>Methods</h3><p>In this randomized, double-blind, placebo-controlled trial, 30 participants with chronic CHIKV arthralgia were randomly assigned to receive either active (<em>n</em> = 15) or sham (<em>n</em> = 15) tDCS. The active group received 10 consecutive sessions of tDCS over M1 using the C3/Fp2 montage (2 mA for 20 min). Visual analog scale of pain (VAS), health assessment questionnaire (HAQ), short-form 36 health survey (SF-36), pain catastrophizing scale, Hamilton anxiety scale (HAS), timed up and go (TUG) test, lumbar dynamometry, 30-s arm curl and 2-min step test were assessed at baseline, day 10 and at 2 follow-up visits.</p></div><div><h3>Results</h3><p>There was a significant interaction between group and time on pain (<em>p</em> = 0.03; effect size 95 % CI 0.9 (-1.67 to -0.16), with a significant time interaction (<em>p</em> = 0.0001). There was no interaction between time and group for the 2-minute step test (<em>p</em> = 0.18), but the groups differed significantly at day 10 (<em>p</em> = 0.01), first follow-up (<em>p</em> = 0.01) and second follow-up (<em>p</em> = 0.03). HAQ and SF-36 improved but not significantly. There was no significant improvement in mental health, and physical tests.</p></div><div><h3>Conclusion</h3><p>tDCS appears to be a promising intervention for reducing pain in participants with chronic CHIKV arthralgia, although further research is needed to confirm these findings and explore potential long-term benefits.</p></div><div><h3>Trial Registration</h3><p>Brazilian Registry of Clinical Trials (ReBEC): RBR-245rh7.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 4","pages":"Article 101826"},"PeriodicalIF":4.6,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late-stage rehabilitation after anterior cruciate ligament reconstruction: A multicentre randomised controlled trial (PReP)","authors":"Daniel Niederer ,&nbsp;Matthias Keller ,&nbsp;Karl-Friedrich Schüttler ,&nbsp;Christian Schoepp ,&nbsp;Wolf Petersen ,&nbsp;Raymond Best ,&nbsp;Natalie Mengis ,&nbsp;Julian Mehl ,&nbsp;Matthias Krause ,&nbsp;Sarah Jakob ,&nbsp;Max Wießmeier ,&nbsp;Lutz Vogt ,&nbsp;Lucia Pinggera ,&nbsp;Daniel Guenther ,&nbsp;Andree Ellermann ,&nbsp;Turgay Efe ,&nbsp;David A. Groneberg ,&nbsp;Michael Behringer ,&nbsp;Thomas Stein","doi":"10.1016/j.rehab.2024.101827","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101827","url":null,"abstract":"<div><h3>Background</h3><p>At the completion of formal rehabilitation after anterior cruciate ligament reconstruction, functional capacity is only restored in a small proportion of affected individuals. Therefore, the end of formal rehabilitation is not the end of functional rehabilitation.</p></div><div><h3>Objective</h3><p>To compare adherence to and effectiveness of a late-stage rehabilitation programme with usual care after anterior cruciate ligament (ACL) reconstruction.</p></div><div><h3>Methods</h3><p>This prospective, double-blind, multicentre, parallel group, randomised controlled trial, included people aged 18 to 35 years after formal rehabilitation completion (mean [SD] 241 [92] days post-reconstruction). Participants were block-randomised to a 5-month neuromuscular performance intervention (Stop-X group) or usual care (medically prescribed standard physiotherapy, individual formal rehabilitation, home-exercises). All outcomes were measured once/month. Primary outcome was the normalised knee separation distance on landing after drop jump. Baseline-adjusted linear mixed models were calculated.</p></div><div><h3>Results</h3><p>In total, 112 participants (Stop-X: 57; Usual care: 55,) were analysed. Initially, mean (SD) intervention frequency (units/week) was higher in the Stop-X than the Usual care group: 2.65 (0.96) versus 2.48 (1.14) units/week in the first and 2.28 (1.02) versus 2.14 (1.31) units/week in the second month. No between-group*time(*baseline)-differences were found for the primary outcome. Between-group*time-effects favoured the Stop-X-group at 2 months (fewer self-reported knee problems during sport, KOOS-SPORT) (estimate = 64.3, 95 % CI 24.4–104.3 for the Stop-X), more confidence to return to sport (ACL-RSI) (62.4, 10.7–114.2), fewer pain-associated knee problems (KOOS-PAIN) (82.8, 36.0–129.6), improved everyday activity abilities (KOOS-ADL) (71.1, 6.4–135.7), and improved limb symmetry index in the front hop for distance at 3 and 4 months (0.34, 0.10–0.57; 0.31, 0.08–0.54). No between-group*time-effects occurred for kinesiophobia, symptom-associated knee problems or balance hops performance. At the end of the intervention, 79 % of the Stop-X and 70 % of the Usual care participants (<em>p</em> &lt; 0.05) had successfully returned to their pre-injury sport type and level.</p></div><div><h3>Conclusions</h3><p>The Stop-X intervention was slightly superior to usual care as part of late-stage rehabilitation after ACL-reconstruction. The small benefit might justify its use after formal rehabilitation completion.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 4","pages":"Article 101827"},"PeriodicalIF":4.6,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateropulsion is a predictor of falls during inpatient stroke rehabilitation","authors":"Josie Lewis,&nbsp;Toni Heinemann,&nbsp;Angela Jacques,&nbsp;Kien Chan,&nbsp;Kristie J Harper,&nbsp;Jessica Nolan","doi":"10.1016/j.rehab.2023.101814","DOIUrl":"https://doi.org/10.1016/j.rehab.2023.101814","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 2","pages":"Article 101814"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140179666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home-based exercise program for people with residual disability following hospitalization for COVID-19: Randomized control trial","authors":"Mara Paneroni ,&nbsp;Simonetta Scalvini ,&nbsp;Elisa Perger ,&nbsp;Elisabetta Zampogna ,&nbsp;Simone Govetto ,&nbsp;Federico Mattia Oliva ,&nbsp;Ambra Matrone ,&nbsp;Palmira Bernocchi ,&nbsp;Debora Rosa ,&nbsp;Michele Vitacca","doi":"10.1016/j.rehab.2023.101815","DOIUrl":"https://doi.org/10.1016/j.rehab.2023.101815","url":null,"abstract":"<div><h3>Background</h3><p>The best exercise program for individuals with effort intolerance or hypoxia at rest and/or during exercise post-COVID-19 treatment who have already had in-hospital rehabilitation remains unknown.</p></div><div><h3>Objective</h3><p>We evaluated the efficacy of a home-based rehabilitation exercise program intervention that included teleconsultations with a specialist nurse.</p></div><div><h3>Methods</h3><p>This was a multicenter randomized controlled trial for individuals who had been diagnosed with, and treated for, COVID-19. Despite inpatient rehabilitation they still had effort intolerance; this was defined as being a) only able to walk &lt;70 % of the predicted distance during the six-minute walking test (6MWT) and/or b) oxygen desaturation all day long/during effort. The primary outcome was effort tolerance, as evaluated by the 6MWT. Secondary outcomes were dyspnea, fatigue, spirometry, respiratory muscle evaluations, and oxygenation. The Intervention group performed 4 weeks of a self-directed exercise program with bi-weekly physiotherapist video calls; the Control group participated in physical activity howsoever they wished. Exercises were divided into 4 intensity levels according to disability and oxygen desaturation. The program progressively increased from low (walking, free-body exercise, sit-to-stand, and balance exercises) to high (speed walking with a pedometer, cycle ergometer, and strengthening exercises).</p></div><div><h3>Results</h3><p>We included 79 participants: 40 in the Intervention and 39 in the Control group. Mean (SD) age was 67.1 (10.3) years; 72 % (<em>n</em> = 57) were male. No intergroup differences in effort tolerance were found [Intervention 77.6 (75.4)m vs Control 49.5 (73.3)m (<em>p</em> = 0.109)]. Participants with 6MWT distance results &lt; lower limit of normality values showed best improvements in mean (SD) effort tolerance: Intervention, 120.1 (75.8)m vs Control, 59.1 (75.6)m (<em>p</em> = 0.035). After 2 months, mean (SD) 6MWT distances in the 2 groups were similar: Intervention, 475.9 (82.4)m vs Control, 469.2 (118.9)m (<em>p</em> = 0.807).</p></div><div><h3>Conclusions</h3><p>In individuals with residual disability post-COVID-19 and after inpatient rehabilitation, a home-based exercise program with teleconsultation significantly improves effort tolerance but only for people who had severe effort intolerance at baseline.</p></div><div><h3>Database registration</h3><p>ClinicalTrials.gov number, NCT04821934</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 2","pages":"Article 101815"},"PeriodicalIF":4.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140113031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Our thanks to the individuals who review papers for the Annals of Physical and Rehabilitation Medicine","authors":"Dominic Pérennou","doi":"10.1016/j.rehab.2024.101830","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101830","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101830"},"PeriodicalIF":4.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140103319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of Island Nasolabial Flap for Patients with Oral Cavity Cancer.","authors":"Sharanabasav Hiremath, Sumanjit S Boro, Avadhut Dange","doi":"10.1007/s12070-023-04177-3","DOIUrl":"10.1007/s12070-023-04177-3","url":null,"abstract":"<p><strong>Aim: </strong>To find out the utility of the island nasolabial flap in patients with oral cavity malignancy.</p><p><strong>Materials and methods: </strong>This was an observational study conducted at a super-specialty hospital in Maharashtra from October 2019 to December 2021. Patients with oral malignancy planned for island nasolabial flaps were only considered.</p><p><strong>Results: </strong>A total of 20 patients were operated on, out of which 16 were males and 4 were females. All the patients were followed up for a minimum period of 6 months. The hospital's online reporting system is used for the data collection including the post-operative assessment. Out of the 20 patients, 10 patients were suffering from tongue carcinoma, 6 patients from buccal mucosal carcinoma, two from hard palate carcinoma and one patient each from the floor of the mouth and lip carcinoma. The mean age of the series was 52.3 years, the average duration of the surgery is 169.4 min and the average hospital stay in the series was 4.35 days. The Ryle's tube was removed on an average of 4.35 days. No flap-related complications were noted during the series, and healing of the donor site was uneventful. The functional outcomes after the reconstruction are acceptable in all the cases except in the lip reconstruction patient where there was post-operative drooling.</p><p><strong>Conclusion: </strong>The island nasolabial flap is relatively easy to harvest and less time-consuming. The other advantages include the post-operative surgical scar falls along the nasolabial fold, long pedicle length with preservation of the facial pedicle for future microvascular use, early transfer to the oral feed from the nasogastric feed, and early de-cannulation. In our small study, we observed that the island nasolabial flap is a very useful flap for the small to moderate-sized defects of the oral cavity. We feel, one of the disadvantages of this flap is that it is not an ideal flap for lip reconstruction.</p>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"57 1","pages":"428-436"},"PeriodicalIF":3.9,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10908668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76858153","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}

{"title":"Ten years already, a farewell editorial as associate editors","authors":"Emmanuel Coudeyre,&nbsp;Dominic Pérennou,&nbsp;François Rannou","doi":"10.1016/j.rehab.2024.101829","DOIUrl":"https://doi.org/10.1016/j.rehab.2024.101829","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101829"},"PeriodicalIF":4.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140051882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving orientation with respect to gravity enhances balance and gait recovery after stroke: DOBRAS cohort","authors":"Shenhao Dai ,&nbsp;Céline Piscicelli ,&nbsp;Adélaide Marquer ,&nbsp;Rémi Lafitte ,&nbsp;Emmanuelle Clarac ,&nbsp;Olivier Detante ,&nbsp;Dominic Pérennou","doi":"10.1016/j.rehab.2023.101767","DOIUrl":"10.1016/j.rehab.2023.101767","url":null,"abstract":"<div><h3>Background</h3><p>Lateropulsion is a deficit in body orientation with respect to gravity, frequent after stroke. Although it is a primary factor affecting mobility, the impact of its attenuation on balance and gait recovery has never been investigated. Moreover, most studies on the lateropulsion time-course focus on severe forms suspected to have a poor recovery, which is not proven.</p></div><div><h3>Objectives</h3><p>To investigate lateropulsion attenuation and test 2 hypotheses: 1) lateropulsion attenuation greatly contributes to balance and gait recovery and 2) severe forms of lateropulsion recover slower than moderate forms.</p></div><div><h3>Methods</h3><p>This longitudinal study involved individuals included in the Determinants of Balance Recovery After Stroke (DOBRAS) cohort, after a first-ever hemispheric stroke, with data collected on day 30 (D30), D60 and D90 post-stroke. Body orientation with respect to gravity was assessed using the Scale for Contraversive Pushing (both scores and severity grouping), in parallel with balance (Postural Assessment Scale for Stroke) and gait (modified Fugl-Meyer Gait Assessment).</p></div><div><h3>Results</h3><p>Among the 106 eligible individuals (mean age 66.5 [SD 9.7] years), on D30, 43 (41%) were considered upright and 63 (59%) showed lateropulsion: 30 (28%) moderate and 33 (31%) severe. Most individuals with lateropulsion (73%) improved their body orientation, progressing from severe to moderate lateropulsion, or becoming upright. However, half were still not upright on D90. The improvement in body orientation had a large impact on mobility, especially in individuals with severe lateropulsion, in whom it explained about 50% of balance and gait recovery between D30 and D60, then 20% (D60-D90). For moderate lateropulsion, its attenuation explained about 20% of balance and gait recovery until D90. Lateropulsion attenuation was not slower in individuals with severe forms.</p></div><div><h3>Conclusions</h3><p>Lateropulsion attenuation enhances balance and gait recovery in individuals after stroke suggesting that specific rehabilitation of body orientation with respect to gravity might help to recover mobility.</p></div><div><h3>Registration</h3><p>NCT03203109</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 1","pages":"Article 101767"},"PeriodicalIF":4.6,"publicationDate":"2024-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139547755","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MRI volumetry and diffusion tensor imaging for diagnosis and follow-up of late post-traumatic injuries","authors":"Alice Jacquens ,&nbsp;Pierre-Romain Delmotte ,&nbsp;Claire Gourbeix ,&nbsp;Nicolas Farny ,&nbsp;Bérenger Perret-Liaudet ,&nbsp;Dany Hijazi ,&nbsp;Valentine Batisti ,&nbsp;Grégory Torkomian ,&nbsp;Didier Cassereau ,&nbsp;Clara Debarle ,&nbsp;Eimad Shotar ,&nbsp;Celia Gellman ,&nbsp;Bertrand Mathon ,&nbsp;Eleonor Bayen ,&nbsp;Damien Galanaud ,&nbsp;Vincent Perlbarg ,&nbsp;Louis Puybasset ,&nbsp;Vincent Degos","doi":"10.1016/j.rehab.2023.101783","DOIUrl":"https://doi.org/10.1016/j.rehab.2023.101783","url":null,"abstract":"<div><h3>Background</h3><p>Traumatic Brain Injury (TBI) is a major cause of acquired disability and can cause devastating and progressive post-traumatic encephalopathy. TBI is a dynamic condition that continues to evolve over time. A better understanding of the pathophysiology of these late lesions is important for the development of new therapeutic strategies.</p></div><div><h3>Objectives</h3><p>The primary objective was to compare the ability of fluid-attenuated reversion recovery (FLAIR) and diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) markers to identify participants with a Glasgow outcome scale extended (GOS-E) score of 7–8, up to 10 years after their original TBI. The secondary objective was to study the brain regionalization of DTI markers. Finally, we analyzed the evolution of late-developing brain lesions using repeated MRI images, also taken up to 10 years after the TBI.</p></div><div><h3>Methods</h3><p>In this retrospective study, participants were included from a cohort of people hospitalized following a severe TBI. Following their discharge, they were followed-up and clinically assessed, including a DTI-MRI scan, between 2012 and 2016. We performed a cross-sectional analysis on 97 participants at a median (IQR) of 5 years (3–6) post-TBI, and a further post-TBI longitudinal analysis over 10 years on a subpopulation (<em>n</em> = 17) of the cohort.</p></div><div><h3>Results</h3><p><span>Although the area under the curve (AUC) of FLAIR, fractional anisotropy (FA), and mean diffusivity (MD) were not significantly different, only the AUC of FA was statistically greater than 0.5. In addition, only the FA was correlated with clinical outcomes as assessed by GOS-E score (</span><em>P&lt;</em>10⁻⁴). On the cross-sectional analysis, DTI markers allowed study post-TBI white matter lesions by region. In the longitudinal subpopulation analysis, the observed number of brain lesions increased for the first 5 years post-TBI, before stabilizing over the next 5 years.</p></div><div><h3>Conclusions</h3><p>This study has shown for the first time that post-TBI lesions can present in a two-phase evolution. These results must be confirmed in larger studies. French Data Protection Agency (Commission nationale de l'informatique et des libertés; CNIL) study registration no: 1934708v0.</p></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"67 2","pages":"Article 101783"},"PeriodicalIF":4.6,"publicationDate":"2023-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139038406","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}