Archives of rehabilitation research and clinical translation最新文献

{"title":"Optimizing Pulmonary Health and Quality of Life in Breast Cancer Survivors: A Randomized Controlled Trial Combining Incentive Spirometry and Aerobic Exercise","authors":"Dian Marta Sari MD, MSc, PhD ,&nbsp;Irma Ruslina Defi MD, PhD ,&nbsp;Andre Maharadja MD ,&nbsp;Nurvita Trianasari M.Stat, PhD ,&nbsp;Laurentia Cindy Gani Wijaya MD ,&nbsp;Patricia Helena Christiani Santoso MD ,&nbsp;Geraldi Christian Candra MD","doi":"10.1016/j.arrct.2025.100449","DOIUrl":"10.1016/j.arrct.2025.100449","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the combined effect of aerobic and breathing exercises using incentive spirometry on lung function and quality of life (QoL) in patients with breast cancer after radiation therapy (RT).</div></div><div><h3>Design</h3><div>A single-blind, randomized controlled trial.</div></div><div><h3>Setting</h3><div>Hasan Sadikin General Hospital Bandung.</div></div><div><h3>Participants</h3><div>Thirty-seven women aged 40-59 years post-RT breast cancer survivors divided into treatment (18 subjects) and control (19 subjects) groups.</div></div><div><h3>Intervention</h3><div>The treatment group engaged in thrice-weekly sessions of aerobic and breathing exercises using incentive spirometry, whereas the control group performed only aerobic exercises at the same frequency. Lung function was assessed using spirometry, and QoL was evaluated using the European Organization for Research and Treatment of Cancer QoL Questionnaires-Core30 (EORTC QLQ C30), both conducted before and after the exercise.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Lung function (assessed using spirometry) and QoL (measured using the EORTC QLQ C30).</div></div><div><h3>Results</h3><div>Between-group analyses revealed that the treatment group experienced significantly greater improvements than the control group in lung function (forced vital capacity increased by 7.72±3.51 vs. 3.45±1.22, <em>P</em>&lt;.05), physical function (difference of 8.06±5.76 vs. 0.68±2.06, <em>P</em>&lt;.05), dyspnea (difference of −22.22±22.92 vs. 0.00, <em>P</em>&lt;.05), and fatigue (difference of −22.78±20.39 vs. −1.74±5.52, <em>P</em>&lt;.05), with these improvements being clinically meaningful.</div></div><div><h3>Conclusions</h3><div>The addition of breathing exercises with incentive spirometry to aerobic exercise may improve lung function and QoL in patients with breast cancer who have completed RT.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100449"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Fiberoptic Endoscopy Evaluation of Swallowing in Aspiration Pneumonia: Utility of the Hyodo Dysphagia Score in Predicting the Development of Aspiration Pneumonia","authors":"Yoko Ibe MD, PhD ,&nbsp;Masayuki Tazawa MD, PhD ,&nbsp;Hironori Arii MD, PhD ,&nbsp;Yumiko Nakao MD, PhD ,&nbsp;Risa Toyama MD ,&nbsp;Naoki Wada MD, PhD","doi":"10.1016/j.arrct.2025.100435","DOIUrl":"10.1016/j.arrct.2025.100435","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the characteristics of flexible endoscopic evaluation of swallowing (FEES) findings in patients with aspiration pneumonia using the Hyodo dysphagia score and to evaluate the risk of aspiration pneumonia.</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Setting</h3><div>Observation in a single primary care institution.</div></div><div><h3>Participants</h3><div>Inpatients aged ≥20 years who underwent FEES in our hospital between April 2012 and March 2022. A total of 178 patients were eligible to calculate the Hyodo dysphagia score and were enrolled in this study. The mean ± SD age of the subjects was 73.4±13.3 years, and 116 of 178 patients (65.2%) were men.</div></div><div><h3>Intervention</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The development of aspiration pneumonia.</div></div><div><h3>Results</h3><div>Eighty-four of 178 patients (47.2%) developed aspiration pneumonia. Age, oral intake status, and serum albumin levels were not significantly different between the pneumonia and nonpneumonia groups. The total and each parameter of the Hyodo dysphagia score were significantly higher in the pneumonia group than in the nonpneumonia group. Logistic regression analysis showed that salivary retention (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.09-1.33; <em>P</em>=.016) and poor cough reflex (OR, 1.88; 95% CI, 1.42-2.49; <em>P</em>&lt;.001) in the Hyodo dysphagia score were risk factors for aspiration pneumonia. The area under the curve of the receiver operating characteristic curve for the onset of pneumonia based on the total Hyodo dysphagia score was 0.75 (95% CI, 0.67-0.82). A cutoff value of 5 for the total Hyodo dysphagia score gave a sensitivity of 0.75 (95% CI, 0.67-0.83) and a specificity of 0.60 (95% CI, 0.49-0.71), with the Youden index having a maximum value of 0.35.</div></div><div><h3>Conclusions</h3><div>A cutoff value of 5 points for the total Hyodo dysphagia score was optimal in predicting the development of aspiration pneumonia. Salivary retention and poor cough reflex were risk factors for the development of pneumonia.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100435"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Effects of Therapeutic Exercise With Psychological Interventions on Disability and Personal Outcomes in Older Adults","authors":"Grace A. Rose ,&nbsp;Pietra T. Bruni PhD ,&nbsp;Mariana Wingood PT, DPT, PhD, MPH ,&nbsp;Selmi Kallmi PhD ,&nbsp;Elizabeth Finer MA ,&nbsp;Patricia M. Bamonti PhD","doi":"10.1016/j.arrct.2025.100447","DOIUrl":"10.1016/j.arrct.2025.100447","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of therapeutic exercise and psychological interventions on disability and personal outcomes in older adults.</div></div><div><h3>Data Sources</h3><div>Articles published from January 2013 to February 2025 are available in PubMed, Embase, ProQuest Health &amp; Medical and Psychology, PsycINFO, and PsycArticles.</div></div><div><h3>Study Selection</h3><div>Inclusion criteria were as follows: (1) intervention included therapeutic exercise combined or integrated with a psychological intervention; (2) randomized controlled trial; (3) sample mean age ≥60 years; (4) primary or secondary outcome(s) of disability. Two authors independently screened trials (n=7391) for inclusion; a third author verified results and resolved discrepancies.</div></div><div><h3>Data Extraction</h3><div>Data were extracted by a primary reviewer and verified by a second reviewer. The risk of bias assessment was performed using the risk of bias in randomized controlled trials.</div></div><div><h3>Data Synthesis</h3><div>Thirty-eight trials (n=18,550 participants) were included. Therapeutic exercise included: exercise programs (34%), physical activity counseling and monitoring (37%), rehabilitation (18%), or other (eg, Tai Chi; 13%). Psychological interventions were primarily motivational interviewing (53%) or cognitive-behavioral therapy/strategies (39%). Significant improvement in body functions and structures (n=14, 37%), activity (n=6, 16%), participation (n=20, 53%), and personal factors (n=11, 29%) was observed.</div></div><div><h3>Conclusions</h3><div>Therapeutic exercise with psychological interventions have a positive effect on disability and personal outcomes, especially in participation. Heterogeneity in the study design, intervention, and population challenged data synthesis. Nonetheless, the current review identified gaps within the literature and directions for future research. Testing the additive effect of these interventions compared to active comparators is a priority for future investigations.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100447"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Findings in the Lower Extremity Joints of Long-Term Users of Implanted Standing Neuroprostheses with Spinal Cord Injuries","authors":"H. Alex Hoyen BS ,&nbsp;Sean Li BS ,&nbsp;Michael Miller MS ,&nbsp;Sheeba Joseph MD ,&nbsp;Patrick Getty MD ,&nbsp;Lisa Lombardo MPT ,&nbsp;Gilles Pinault MD ,&nbsp;Ronald Triolo PhD","doi":"10.1016/j.arrct.2025.100448","DOIUrl":"10.1016/j.arrct.2025.100448","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether lower extremity degenerative joint changes developed in long-term users of implantable neuromuscular prostheses.</div></div><div><h3>Design</h3><div>Before-after radiographic assessment.</div></div><div><h3>Setting</h3><div>Tertiary care center.</div></div><div><h3>Participants</h3><div>Four individuals (4 men, average age 46.5y, injuries ranging from C7-T11) with spinal cord injury resulting in lower extremity paraplegia were included for analysis. All individuals previously received surgery for the placement of a neuroprosthesis implant system. Individuals were followed with specific spinal cord injury outcome measures and radiographs in a prospective manner. Individual implant usage was also recorded as part of the standard treatment. These individuals were selected because they were in the highest tier for daily use of the implant system.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Development of degenerative joint pathology, based on analysis of pre- and post-therapy radiographs and grading using the Kellgren and Lawrence and Van Dijk scales.</div></div><div><h3>Results</h3><div>None of the joints for the individuals that were graded 0-2 (no or mild arthritis) progressed to a grade 3 (moderate arthritis). Further, none of the joints developed an arthritic grade of &gt;3. Only 2 of the 24 total joints had statistically significant (<em>P</em>&lt;.05) degenerative changes: subject 1: right hip; <em>P</em>=.033 (average grade increased from 0.875-1.875); subject 2: right hip; <em>P</em>=.049 (average grade increased from 0.875-1.50).</div></div><div><h3>Conclusions</h3><div>At an average of 5 years after implantation, regular and independent weight bearing in 4 higher-than-average users of a neuromuscular prosthesis does not appear to promote lower extremity joint degeneration.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100448"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phantom Limb Pain Assessment Tools: A Literature Review Exploring Strengths and Limitations","authors":"Alexandra N. Jenson BS ,&nbsp;Benjamin Branch DO ,&nbsp;Janelle M. Richard BA ,&nbsp;Aurora Quaye MD","doi":"10.1016/j.arrct.2025.100453","DOIUrl":"10.1016/j.arrct.2025.100453","url":null,"abstract":"<div><h3>Objective</h3><div>To identify and categorize the pain instruments used to evaluate phantom limb pain (PLP), phantom limb sensations (PLSs), and residual limb pain (RLP) stratified by frequency of use, instrument completion time, and inclusion of descriptive terms to distinguish between the 3 phenomena.</div></div><div><h3>Data Sources</h3><div>MEDLINE/PubMed and Google Scholar from 1986 to 2024.</div></div><div><h3>Study Selection</h3><div>Cross-sectional, cohort, and case-control studies investigating the prevalence of PLP in adults (18y or older) with surgical and traumatic upper or lower limb amputation.</div></div><div><h3>Data Extraction</h3><div>Studies were identified and their methods were evaluated for mention of instruments used to assess for PLP. Tools were then evaluated for frequency of usage, completion time, differentiation of pain and sensations after limb amputation, and qualitative assessment using descriptor words associated with PLP and PLSs.</div></div><div><h3>Data Synthesis</h3><div>The review included 44 studies and identified 25 tools (5 unidimensional and 20 multidimensional). Unidimensional pain scales, particularly the Numeric Rating Scale, were the most frequently used. Of the multidimensional instruments identified, 9 of them were specific to PLP, and 6 distinguished between PLP, PLS, and RLP. Only one multidimensional instrument that was specific to PLP used descriptor words to differentiate between PLP and PLS. No tool was assessed for all 3 conditions and used descriptor words to distinguish between PLP and PLSs.</div></div><div><h3>Conclusions</h3><div>Based on this systematic review, no PLP-specific instrument is suitable for standardizing the diagnosis of PLP in its current form. Further research is needed to establish a standardized tool that can reliably distinguish between PLP, PLS, and RLP while incorporating qualitative assessments to ensure accurate diagnosis.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100453"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causes of Adolescent Low Back Pain: A Retrospective Study","authors":"Imana Rhoden MD,&nbsp;Jeremy Simon MD,&nbsp;Adam T. Chrusch MD,&nbsp;David Stolzenberg DO,&nbsp;Christopher Mehallo DO,&nbsp;Grant Thomas BS","doi":"10.1016/j.arrct.2025.100433","DOIUrl":"10.1016/j.arrct.2025.100433","url":null,"abstract":"<div><h3>Objective</h3><div>To add to the body of evidence in the scientific literature with respect to the etiology of adolescent back pain.</div></div><div><h3>Design</h3><div>A retrospective chart review was conducted over a 3 year period. Charts were initially rendered using International Classification of Disease, 10th Revision (ICD-10) diagnosis, and subsequently narrowed down to age range of 10-19 years. Additionally, patients with documented trauma requiring emergent spinal surgery or an alternative diagnosis (eg, hip pain) were excluded.</div></div><div><h3>Setting</h3><div>This study was performed in a large United States based private multispecialty orthopedic practice. This includes 30 different ambulatory office locations in multiple demographic regions.</div></div><div><h3>Participants</h3><div>Patients ages 10 to 19 years old who presented with documented low back pain (LBP) were included. A total of N = 1932 patients were included with a 1.1/1 women to men ratio. The study was conducted over a 3 year period (2015-2018).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Final diagnosis reached by clinician, verified by chart and imaging review.</div></div><div><h3>Results</h3><div>A total of 1932 patients were included: 1010 (52.3%) women and 922 (47.7%) men. Physician reviewers grouped the diagnoses into comprehensive categories. LBP without a specific cause was the most common diagnosis with 827 patients (42.81%). Women accounted for 447 (54.0%) of the patients diagnosed with LBP, whereas men accounted for 380 (46.0%). Disk disease was the second most common diagnosis representing 534 study participants (27.64%). There were more women than men in the overall disk cohort with 304 (30.10%) and 230 (24.95%), respectively. Spondylolysis was the third most common diagnosis with 281 patients (14.54%). The prevalence was higher for men than women, 192 (20.82%) and 89 (8.81%), respectively.</div></div><div><h3>Conclusions</h3><div>A clearer understanding of the various etiologies associated with general LBP was obtained. The findings reveal a higher occurrence of disk-related issues compared with previous data and highlight gender-based differences in the identified pathologies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100433"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability of the Five Step Assessment and Its Coefficients of Impairment in Spastic Paresis","authors":"Marjolaine Baude MD ,&nbsp;Maud Pradines PT, PhD ,&nbsp;Caroline Gault-Colas MD ,&nbsp;Damien Motavasseli MD ,&nbsp;David Simpson MD ,&nbsp;Tymothée Poitou MD ,&nbsp;Violaine Piquet MD ,&nbsp;Pierre-André Natella MD ,&nbsp;Jean-Michel Gracies MD, PhD","doi":"10.1016/j.arrct.2025.100444","DOIUrl":"10.1016/j.arrct.2025.100444","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the intrarater and interrater reliability of the Five Step Assessment (FSA) and its derived coefficients of impairment in chronic spastic paresis.</div></div><div><h3>Design</h3><div>Prospective observational study.</div></div><div><h3>Setting</h3><div>Study of outpatients followed in a rehabilitation department.</div></div><div><h3>Participants</h3><div>In this single-center prospective study, participants (n=18) with chronic hemiparesis (&gt;1y since injury) were evaluated by 4 raters (3 medical doctors, 1 physiotherapist; experience in hemiparesis, 14±9y).</div></div><div><h3>Interventions</h3><div>All raters estimated muscle shortening, spasticity, weakness, and fatigability against the resistance of 8 key antagonists in adults twice, one week apart.</div></div><div><h3>Main Outcome Measures</h3><div>FSA involves measuring 4 angles: angle of arrest at slow speed of stretch (X_V1), angle of catch or clonus at fast speed of stretch (X_V3, Tardieu), angle of match between maximal agonist effort and passive and active antagonist resistances (X_A), residual angle of match after 15 seconds of repeated maximal amplitude active efforts (X_A15), and spasticity grade Y. Four derived coefficients of impairment were studied: coefficients of shortening, C_SH=(X_N−X_V1)/X_N (X_N, normally expected maximal passive joint amplitude); of spasticity, C_SP=(X_V1−X_V3)/X_V1; of weakness, C_W=(X_V1−X_A)/X_V1; and of fatigability, C_F=(X_A−X_A15)/X_A. Both intraclass correlation coefficients and mean differences were calculated for each parameter.</div></div><div><h3>Results</h3><div>Among 18 participants (four women), intrarater reliability was good to excellent (intraclass correlation coefficient &gt;0.75) for all parameters in all muscles. Interrater reliability was good to excellent for all muscles and parameters except for spasticity grade Y and coefficient of fatigability (moderate).</div></div><div><h3>Conclusions</h3><div>The 5 parameters and 4 coefficients of impairment of the FSA have moderate-to-excellent intrarater and interrater reliability in chronic spastic paresis.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100444"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying At-Home Physiotherapy Participation: SPARS vs Self-Reported Diaries","authors":"Matthew Rezkalla BSc ,&nbsp;Philip Boyer PhD ,&nbsp;David Burns MD, PhD ,&nbsp;Cristian Renteria PT, MPIA ,&nbsp;Cari Whyne PhD","doi":"10.1016/j.arrct.2025.100445","DOIUrl":"10.1016/j.arrct.2025.100445","url":null,"abstract":"<div><div>The completion of at-home physiotherapy exercise is key to many rehabilitation protocols. This study compares at-home upper extremity physiotherapy participation as measured based on data captured with a smart watch to that recorded in self-report diaries. Daily at-home exercise participation (sessions) was recorded for 53 patients with rotator cuff pathology during their first 2 weeks of a 12-week physiotherapy rehabilitation program. Exercise participation was measured using a physical therapy monitoring system that uses smart watch (accelerometer/gyroscope) data analyzed via a convolutional neural network trained on labeled patient-specific in-clinic data and compared to patient reported diaries. A high level of agreement between diary exercise participation and the measurements derived from the smart watch data (ICC=0.72, n=53) was found, with an AUROC=0.99 for binary identification of exercise periods on labeled clinic data. However, overall patient diaries reported more exercise performed (0.96 additional days on average) than measured by the ML algorithm. ML and accelerometer/gyroscope data collected by embedded sensors in a smartwatch represents an accurate and objective alternative to self-reported diaries for monitoring patient at-home participation. Lower levels recorded by the ML algorithm may indicate some limitations in the technology to fully capture participation or potential over-reporting of participation within diaries. As self-reported diary completion decreases over time, physical therapy monitoring technology may represent an acceptable method for longer term assessment of exercise participation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100445"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reproductive Education and Sexual Abuse Among Individuals With Spina Bifida: A Mixed Methods Study","authors":"Betsy Hopson PhD, MSHA ,&nbsp;Molly Richardson PhD, MPH ,&nbsp;Caroline Caudill BS ,&nbsp;Don Lein PhD ,&nbsp;Courtney Streur MD ,&nbsp;Elizabeth Taylor PhD ,&nbsp;Suzannah Rogers MD ,&nbsp;Victoria Jiminez BS ,&nbsp;Brandon G. Rocque MD, MS ,&nbsp;Jeffrey Blount MD, MPH ,&nbsp;David Joseph MD ,&nbsp;Ching Man Carmen Tong MD","doi":"10.1016/j.arrct.2025.100455","DOIUrl":"10.1016/j.arrct.2025.100455","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate sexual and reproductive health (SRH) knowledge and practices among young adults with spina bifida (SB), with an emphasis on identifying gaps in SRH literacy and barriers to care.</div></div><div><h3>Design</h3><div>Sequential explanatory mixed methods study consisting of a disability-specific survey and follow-up interviews.</div></div><div><h3>Setting</h3><div>Participants were recruited from a multidisciplinary SB clinic.</div></div><div><h3>Participants</h3><div>Eighty young adults (N=80) with SB were surveyed (March 2021-April 2022), and 4 participants from this sample took part in follow-up in-depth qualitative interviews. The sample included both male and female participants who were sexually active or had prior exposure to SRH education.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Primary measures assessed SRH knowledge gaps, relationship barriers, contraception use, pregnancy awareness, and experiences of abuse/coercion. Findings aim to inform educational programs, abuse prevention, and clinical guidelines for individuals with SB.</div></div><div><h3>Results</h3><div>Among the 80 survey participants, 55% of men and 47% of women reported being sexually active. Despite this, 44% of women were unsure about their ability to become pregnant. Sexual abuse or coercion was reported by 25% of women and 10% of men. Key interview themes included challenges and supports related to dating, gaps in SRH education, experiences with sexual intimacy, and the prevalence of sexual abuse. Barriers stemmed from concerns about disclosing SB, misconceptions about independent living, and restricted social opportunities because of family protectiveness. Facilitators included online dating, shared interests, and acceptance from open-minded partners.</div></div><div><h3>Conclusions</h3><div>Among the young adults with SB who participated in this study, many were sexually active but faced significant barriers and gaps in SRH knowledge, increasing their risk of sexual abuse and poor reproductive health outcomes. Determining levels of sexual health literacy and screening for abuse are critical to improving SRH outcomes for this vulnerable population.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100455"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Item-Level Psychometrics for the Functional Gait Assessment in Persons With Stroke","authors":"Bryant A. Seamon PT, DPT, PhD ,&nbsp;Steven A. Kautz PhD ,&nbsp;Mark G. Bowden PT, PhD ,&nbsp;Jesse C. Dean PhD ,&nbsp;Chris M. Gregory PT, PhD ,&nbsp;Richard R. Neptune PhD ,&nbsp;Craig A. Velozo PhD, OTR/L","doi":"10.1016/j.arrct.2025.100452","DOIUrl":"10.1016/j.arrct.2025.100452","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the item-level psychometrics of the Functional Gait Assessment (FGA) for persons with chronic stroke and create a keyform (or score sheet) for clinicians.</div></div><div><h3>Design</h3><div>Retrospective cohort.</div></div><div><h3>Setting</h3><div>Archival item-level data from a research database.</div></div><div><h3>Participants</h3><div>One-hundred-one ambulatory persons (N=101) with chronic stroke (44% women, 58% right hemiparesis, average age 59y, lower extremity Fugl-Meyer 25, and overground self-selected walking speed 0.76 m/s).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>A principal component analysis of the residuals from the Andrich Rating Scale Model (RSM) was used to evaluate unidimensionality and item local dependence. The RSM was also used to examine the rating scale structure, item and person fit, item difficulty hierarchy, and person separation index and to generate a keyform.</div></div><div><h3>Results</h3><div>Principal component analysis of the residuals confirmed the FGA’s unidimensionality and that no items had local dependence. The category rating scale met the criterion and advanced monotonically. The item difficulty hierarchy was similar to that of community-dwelling older adults. The sample’s mean ability level (ie, person measure) was 0.28 logits (SE=0.63). The FGA had high person reliability (0.90) despite 10% of persons misfitting. There were no floor or ceiling effects, and the FGA separated people into 4 strata. The scored FGA keyform visually showed an individual’s response pattern relative to their measure value.</div></div><div><h3>Conclusion</h3><div>Rasch analysis supports the use of the FGA to measure walking balance ability in ambulatory persons with chronic stroke. An FGA keyform can provide instantaneous interval measurement for individuals.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100452"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}