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Impact of Pneumonia on Rehabilitation Outcomes: A Large Observational Study 肺炎对康复结果的影响:一项大型观察性研究
IF 2 Q2 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-12-10 DOI: 10.1016/j.arrct.2025.100569
Van Giap Vu PhD , Thi Linh Tran MMed , Viet Phuong Dao PhD , Xuan Trien Vu MSc , Le Huyen Mai MMed , Thi Thu Ha Bui MSc , Thi Minh Thanh Vu MD , Dao Quang Do BPT , Thi Thanh Huyen Tran PhD , Dao Vu Do PhD

Objective

To evaluate the effect of poststroke pneumonia on rehabilitation outcomes in patients with acute stroke.

Design

A prospective observational cohort study.

Setting

Rehabilitation services for patients with stroke across 3 hospitals in a low and middle-income country.

Participants

A total of 922 patients with stroke (N=922) were enrolled (median age: 67y; 63.7% men) and classified into poststroke pneumonia (PSP; n=296) and nonpneumonia (PSNP; n=626) groups. The patients with PSP were further divided into 2 subgroups based on onset timing including stroke-associated pneumonia (SAP; n=157), defined as diagnosis within 7 days of stroke onset, and hospital-acquired pneumonia (HAP; n=139), defined as pneumonia diagnosed after 7 days.

Interventions

Not applicable.

Main Outcome Measures

Primary outcome analysis focused on functional outcomes (modified Rankin Scale [mRS]), hospital length of stay (LOS), and mortality were assessed at discharge, 3 months, and 6 months after stroke. Secondary analysis explored predictors of functional outcomes.

Results

Patients with PSP demonstrated significantly poorer functional outcomes, with higher mRS scores (≥3) at discharge, 3 months, and 6 months (P<.001). However, HAP showed stronger association with poor outcomes (odds ratio [OR]≥3) than SAP. Mortality was higher in the PSP group compared with the PSNP group at 3 months (OR=4.98; 95% CI, 2.1-11.7, P<.001) and 6 months after stroke (OR=5.4; 95% CI, 2.3-12.6, P<.001). HAP also associated with a longer LOS (24.18±7.81d) than SAP (19.5±8.26d; P<.001). Stroke severity remained a strong predictor of outcomes in this study.

Conclusions

Poststroke pneumonia worsens rehabilitation outcomes, prolongs LOS, and increases mortality. Early pneumonia prevention and multidisciplinary integrated rehabilitation, aligned with World Health Organization (WHO) standards, are essential to improve stroke recovery and reduce complications in low- and middle-income countries.
目的探讨脑卒中后肺炎对急性脑卒中患者康复预后的影响。设计一项前瞻性观察队列研究。在一个低收入和中等收入国家的3家医院为中风患者提供康复服务。共纳入922例脑卒中患者(N=922)(中位年龄:67岁,男性63.7%),分为脑卒中后肺炎(PSP, N= 296)和非肺炎(PSNP, N= 626)组。根据发病时间将PSP患者进一步分为卒中相关性肺炎(SAP, n=157)和医院获得性肺炎(HAP, n=139) 2个亚组,SAP定义为卒中发病7天内确诊,HAP定义为7天后确诊。InterventionsNot适用。主要结局指标主要结局分析侧重于功能结局(改良Rankin量表[mRS]),住院时间(LOS)和死亡率分别在出院时、中风后3个月和6个月进行评估。二次分析探讨了功能结局的预测因素。结果PSP患者的功能预后明显较差,出院时、3个月时和6个月时mRS评分均较高(≥3)(P<.001)。然而,与SAP相比,HAP与不良预后的相关性更强(比值比[OR]≥3)。卒中后3个月(OR=4.98; 95% CI, 2.1-11.7, P<.001)和6个月时,PSP组的死亡率高于PSNP组(OR=5.4; 95% CI, 2.3-12.6, P<.001)。HAP的LOS(24.18±7.81d)也比SAP(19.5±8.26d; P<.001)更长。在这项研究中,中风严重程度仍然是预测结果的重要指标。结论脑卒中后肺炎恶化康复预后,延长LOS,增加病死率。根据世界卫生组织(世卫组织)的标准,早期预防肺炎和多学科综合康复对于改善中低收入国家的中风康复和减少并发症至关重要。
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引用次数: 0
Use of the AM-PAC 6 Clicks Basic Mobility Short Forms as a Measure of Functional Change in the Pediatric Heart Failure Population 使用AM-PAC 6 click基本活动能力短表作为儿童心力衰竭人群功能变化的测量
IF 2 Q2 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-12-20 DOI: 10.1016/j.arrct.2025.100575
Amanda Waples PT, DPT, Samuel R. Pierce PT, PhD, Julie Orlando PT, DPT, PhD

Objectives

To evaluate the responsiveness of the 6 Clicks Basic Mobility Short Form (BMSF) and Basic Mobility Short Form – Low Function (BMSF-LF) in children with heart failure (HF) and to assess the correlations of the BMSF with the 6-Minute Walk Test (6MWT) and the 60-Second Sit-to-Stand (60sSTS) test.

Design

Retrospective cohort study.

Setting

Inpatient acute cardiac center in a large, urban children’s hospital.

Participants

Sixty-six participants (N=66) between 1 and 21 years of age with a diagnosis of pediatric HF and at least 2 documented BMSF and/or BMSF-LF in the electronic medical record. Chart reviews were completed for each participant to determine if change was a result of functional improvement or a change in medical status resulting in functional decline. Data for the 60sSTS and 6MWT were included if completed within 48 hours of a documented BMSF. Thirty participants completed a 60sSTS and 21 participants completed a 6MWT.

Interventions

Not applicable.

Main Outcome Measures

BMSF, BMSF-LF, 6MWT, and 60sSTS.

Results

Large effect sizes as measured by standardized response mean (SRM) were found for both the BMSF (SRM=0.96) and BMSF-LF (SRM=1.07) for functional improvement as well as for functional decline with the BMSF (SRM=-1.35) and BMSF-LF (SRM=-1.34). There was a significant, moderate positive correlation between the BMSF and the 6MWT distance (ρ=0.47, P=.048) and a moderate correlation between the BMSF and 60sSTS repetitions that did not reach significance (ρ=0.35, P=.070).

Conclusions

The 6 Clicks BMSF and BMSF-LF demonstrate excellent responsiveness to both functional improvement and functional decline in pediatric patients with HF. The moderate correlation between the BMSF and the 6MWT suggests a positive association between performance-based endurance testing and functional status.
目的评价心力衰竭(HF)患儿6次基本活动能力短表(BMSF)和基本活动能力短表-低功能(BMSF- lf)的反应性,并评价BMSF与6分钟步行测试(6MWT)和60秒坐立测试(60sSTS)的相关性。设计回顾性队列研究。在大型城市儿童医院设置急性心脏病住院中心。参与者66名(N=66)年龄在1 - 21岁之间,诊断为小儿心衰,电子病历中至少有2例BMSF和/或BMSF- lf记录。每个参与者都完成了图表审查,以确定变化是功能改善的结果,还是医疗状况的变化导致功能下降。如果在记录BMSF后48小时内完成,则包括60sSTS和6MWT的数据。30名参与者完成了60sSTS, 21名参与者完成了6MWT。InterventionsNot适用。主要观察指标bmsf、BMSF-LF、6MWT和60sSTS。结果BMSF (SRM=0.96)和BMSF- lf (SRM=1.07)对功能改善和功能下降均有较大的效应,其中BMSF (SRM=-1.35)和BMSF- lf (SRM=-1.34)。BMSF与6MWT距离呈正相关(ρ=0.47, P= 0.048),与60sSTS重复数呈正相关(ρ=0.35, P= 0.070)。结论6 click BMSF和BMSF- lf对小儿心衰患者的功能改善和功能下降均表现出良好的反应性。BMSF和6MWT之间的中度相关性表明,基于性能的耐力测试与功能状态之间存在正相关。
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引用次数: 0
Neural Effects of Low-Frequency Acupoint Electrical Stimulation Therapy on Patients With Poststroke Motor Dysfunction: A Resting-State Functional Magnetic Resonance Imaging Study 低频穴位电刺激治疗脑卒中后运动功能障碍的神经效应:静息状态功能磁共振成像研究
IF 2 Q2 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-12-18 DOI: 10.1016/j.arrct.2025.100574
Dongxia Li MD , Hong Huo MD , Yihao Zhou MD , Siyu Yang MD , Wenqiang Li MM , Jingyi Li MD , Yue Liu MD , Dongyan Wang MD

Objective

To investigate differences in brain functional activity between patients with poststroke motor dysfunction and healthy individuals, and to examine the effects of low-frequency acupoint electrical stimulation on brain regional homogeneity (ReHo) in patients.

Design

This was a case-control study.

Setting

The study was conducted in a local tertiary hospital.

Participants

Twenty-eight patients with poststroke motor dysfunction (infarcts in the right basal ganglia region; 19 men, 9 women; mean age 59.07±9.03y) were recruited to form the Treatment group (Tx). Concurrently, 20 age- and gender-matched healthy controls (HCs) were recruited (14 men and 6 women, with an average age of 57.60±8.36y).

Interventions

The Tx received low-frequency acupoint electrical stimulation. Scalp Acupoint Selection: motor area on the affected hemisphere. Limb Acupoint Selection: acupoints on the affected limb, forming the following pairs: Shousanli (LI10) – Waiguan (SJ5); Ximen (PC4) – Neiguan (PC6); Zusanli (ST36) – Shangjuxu (ST37); and Heyang (BL55) – Chengshan (BL57). Head: frequency 2 Hz, pulse width 100 µs, and intensity 1.5 mA. Upper limb: frequency 35 Hz, pulse width 200 µs, and intensity 40 mA. Lower limb: frequency 50 Hz, pulse width 400 µs, and intensity 40 mA. Each session lasted 30 minutes, administered once daily for 6 sessions per week over 3 weeks.

Main Outcome Measures

The primary endpoint was the improvement from baseline in ReHo for patients with stroke at 3 weeks.

Results

Compared with HCs, patients with stroke showed increased ReHo in the bilateral parahippocampal gyrus, bilateral cerebellum, and cerebellar vermis, whereas ReHo decreased in sensorimotor network (SMN)-related brain regions (false discovery rate [FDR]-corrected, P<.05). After intervention, ReHo increased in the right SMN-related brain regions, whereas ReHo decreased in the left cerebellum and left angular gyrus (FDR-corrected, P<.05). Right precentral gyrus ReHo changes positively correlated with Fugl-Meyer Assessment improvement. Left cerebellum ReHo changes positively correlated with Modified Barthel Index improvement but negatively with National Institute of Health Stroke Scale improvement. Other regions showed no significant correlation.

Conclusions

Abnormal synchrony between SMN and cerebellum may be a key pathologic feature in poststroke motor dysfunction. Lateralized SMN functional remodeling is a potential neural mechanism for motor recovery via low-frequency acupoint electrical stimulation.
目的探讨脑卒中后运动功能障碍患者与正常人脑功能活动的差异,探讨低频穴位电刺激对脑区域均匀性(ReHo)的影响。本研究为病例对照研究。本研究在当地一家三级医院进行。参与者:28例脑卒中后运动功能障碍患者(右侧基底节区梗死,男性19例,女性9例,平均年龄59.07±9.03岁)被纳入治疗组(Tx)。同时,招募年龄和性别匹配的健康对照(hc) 20例(男性14例,女性6例,平均年龄57.60±8.36岁)。干预措施:Tx接受低频穴位电刺激。头皮取穴:患处半球运动区。肢体取穴:患肢取穴,形成以下对:寿三里(LI10) -外关(SJ5);西门(PC4) -内关(PC6);足三里(ST36) -上居绪(ST37);和阳(BL55) -城山(BL57)。头:频率2hz,脉冲宽度100µs,强度1.5 mA。上肢:频率35 Hz,脉宽200µs,强度40 mA。下肢:频率50 Hz,脉宽400µs,强度40 mA。每个疗程持续30分钟,每天一次,每周6次,持续3周。主要终点是卒中患者3周时ReHo较基线的改善。结果与hc相比,卒中患者双侧海马旁回、双侧小脑和小脑蚓部的ReHo升高,而感觉运动网络(SMN)相关脑区ReHo降低(错误发现率[FDR]校正,P< 0.05)。干预后,右侧smn相关脑区ReHo升高,而左侧小脑和左侧角回ReHo降低(fdr校正,P< 0.05)。右侧中央前回ReHo变化与Fugl-Meyer评估改善呈正相关。左小脑ReHo变化与改良Barthel指数改善呈正相关,与国立卫生研究院卒中量表改善负相关。其他地区无显著相关性。结论SMN与小脑的异常同步可能是脑卒中后运动功能障碍的一个重要病理特征。侧化SMN功能重构是低频穴位电刺激下运动恢复的潜在神经机制。
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引用次数: 0
Safety and Benefits of Moderate to High Intensity Aerobic Exercise During the Subacute Phase of Stroke: A Systematic Review and Meta-analysis 中高强度有氧运动在脑卒中亚急性期的安全性和益处:一项系统综述和荟萃分析
IF 2 Q2 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-11-27 DOI: 10.1016/j.arrct.2025.100551
Erin Y. Harmon PhD , Mel Melewski DPT, NCS , Dana Provost DPT, NCS , Matthew B. Sonagere DO

Objective

To determine the safety and efficacy of moderate to high intensity exercise for patients in the subacute phase of stroke recovery.

Data Sources

Embase, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, ClinicalTrials.gov, Google Scholar, and previous meta-analyses published between January 1994 and October 2024.

Study Selection

Title and abstract screening required consensus by 2 reviewers. A total of 27 randomized controlled trials met inclusion criteria. Studies were included if they enrolled participants <6 months post stroke. Interventions were eligible if they were of moderate or high cardiovascular intensity as defined by the American College of Sports Medicine. Acceptable comparator groups included sham, low intensity interventions, no exercise, relaxation, or cognitive interventions.

Data Extraction

Three reviewers independently extracted data using the COVIDENCE platform, with each article reviewed by at least 2 individuals. Random effect meta-analyses were employed to generate pooled estimates of effects. Primary outcomes included severe cardiac and cerebral adverse events, measures of endurance, and gait speed. Secondary outcomes included death, blood pressure, balance, quality of life, and functional independence.

Data Synthesis

Several measures of endurance and gait speed were significantly improved with moderate to high intensity interventions (change in 6-minute walk test, mean difference (MD): 33.11 m; 95% CI, 23.24-42.98; P<.001, k=15; change in peak work rate, MD: 9.28 watts; 95% CI, 5.20-13.37; P=.002; and change in fastest gait speed, MD: 0.12 m/s; 95% CI: 0.05-0.19; P=.003, k=10). Severe adverse cardiac/cerebral events (SAE), peak volume of oxygen, comfortable gait speed, and secondary outcomes did not significantly differ between groups (SAE incidence rate ratio: 1.45; 95% CI, 0.74-2.82; P=.245, k=11).

Conclusions

Moderate to high intensity exercise should be considered within acute rehabilitation facilities, skilled nursing facilities, and outpatient settings for patients in the subacute phase of post stroke rehabilitation and screened as appropriate. Physician collaboration for patient selection and continued active monitoring for SAEs is recommended.
目的探讨中高强度运动对脑卒中亚急性期恢复期患者的安全性和有效性。数据来源embase, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, ClinicalTrials.gov,谷歌Scholar,以及1994年1月至2024年10月间发表的meta分析。研究选择题目和摘要筛选需要2位审稿人的一致意见。共有27项随机对照试验符合纳入标准。纳入中风后6个月的研究。根据美国运动医学学院的定义,如果干预措施是中度或高心血管强度,则符合条件。可接受的比较组包括假手术、低强度干预、无运动、放松或认知干预。数据提取:三名审稿人使用covid - ence平台独立提取数据,每篇文章至少由2人审稿。随机效应荟萃分析用于产生效应的汇总估计。主要结局包括严重的心脏和大脑不良事件、耐力测量和步态速度。次要结局包括死亡、血压、平衡、生活质量和功能独立性。中至高强度干预显著改善了耐力和步态速度(6分钟步行测试的变化,平均差异(MD): 33.11 m;95% ci, 23.24-42.98;术;措施,k = 15;峰值工作速率变化量,MD: 9.28瓦;95% ci, 5.20-13.37;P = .002;最快步速变化,MD: 0.12 m/s;95% ci: 0.05-0.19;P = .003, k = 10)。严重不良心/脑事件(SAE)、峰值氧气量、舒适步态速度和次要结局在两组间无显著差异(SAE发生率比:1.45;95% CI, 0.74-2.82; P= 0.245, k=11)。结论中高强度运动应考虑在急性康复设施、熟练护理设施和门诊环境中进行,并在适当时进行筛选。建议医生合作选择患者并继续积极监测SAEs。
{"title":"Safety and Benefits of Moderate to High Intensity Aerobic Exercise During the Subacute Phase of Stroke: A Systematic Review and Meta-analysis","authors":"Erin Y. Harmon PhD ,&nbsp;Mel Melewski DPT, NCS ,&nbsp;Dana Provost DPT, NCS ,&nbsp;Matthew B. Sonagere DO","doi":"10.1016/j.arrct.2025.100551","DOIUrl":"10.1016/j.arrct.2025.100551","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the safety and efficacy of moderate to high intensity exercise for patients in the subacute phase of stroke recovery.</div></div><div><h3>Data Sources</h3><div>Embase, PubMed, Cochrane Central Register of Controlled Trials, CINAHL, ClinicalTrials.gov, Google Scholar, and previous meta-analyses published between January 1994 and October 2024.</div></div><div><h3>Study Selection</h3><div>Title and abstract screening required consensus by 2 reviewers. A total of 27 randomized controlled trials met inclusion criteria. Studies were included if they enrolled participants &lt;6 months post stroke. Interventions were eligible if they were of moderate or high cardiovascular intensity as defined by the American College of Sports Medicine. Acceptable comparator groups included sham, low intensity interventions, no exercise, relaxation, or cognitive interventions.</div></div><div><h3>Data Extraction</h3><div>Three reviewers independently extracted data using the COVIDENCE platform, with each article reviewed by at least 2 individuals. Random effect meta-analyses were employed to generate pooled estimates of effects. Primary outcomes included severe cardiac and cerebral adverse events, measures of endurance, and gait speed. Secondary outcomes included death, blood pressure, balance, quality of life, and functional independence.</div></div><div><h3>Data Synthesis</h3><div>Several measures of endurance and gait speed were significantly improved with moderate to high intensity interventions (change in 6-minute walk test, mean difference (MD): 33.11 m; 95% CI, 23.24-42.98; <em>P&lt;</em>.001, <em>k</em>=15; change in peak work rate, MD: 9.28 watts; 95% CI, 5.20-13.37; <em>P</em>=.002; and change in fastest gait speed, MD: 0.12 m/s; 95% CI: 0.05-0.19; <em>P</em>=.003, <em>k</em>=10). Severe adverse cardiac/cerebral events (SAE), peak volume of oxygen, comfortable gait speed, and secondary outcomes did not significantly differ between groups (SAE incidence rate ratio: 1.45; 95% CI, 0.74-2.82; <em>P</em>=.245, <em>k</em>=11).</div></div><div><h3>Conclusions</h3><div>Moderate to high intensity exercise should be considered within acute rehabilitation facilities, skilled nursing facilities, and outpatient settings for patients in the subacute phase of post stroke rehabilitation and screened as appropriate. Physician collaboration for patient selection and continued active monitoring for SAEs is recommended.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100551"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428610","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}
引用次数: 0
Variations in Head-Neck Posture and Hyoid Kinematics in Patients With Stroke and Aspiration Risk: A Cross-Sectional Observational Study 卒中和误吸风险患者头颈姿势和舌骨运动学的变化:一项横断面观察研究
IF 2 Q2 REHABILITATION Pub Date : 2026-03-01 Epub Date: 2025-12-08 DOI: 10.1016/j.arrct.2025.100570
Haipeng Jin MD , Yanli Huang MS , Weihong Xiao MS , Li Ding MD , Ling Gao MS , Huijuan Zheng MS , Rongrong Ye MS

Objective

To observe alterations in head-neck posture and hyoid kinematics in patients with stroke and aspiration risk.

Design

A prospective observational study.

Setting

Hospital inpatient unit.

Participants

A total of 24 patients (N=24) with stroke were included in this study: 12 patients with high aspiration risk (7 men and 5 women) aged 62-77 years (median=72.50; IQR, 64.00-74.00) and 12 patients with low aspiration risk (8 men and 4 women) aged 50-80 years (median=66.00; IQR, 58.25-71.25).

Interventions

Not applicable.

Main Outcome Measures

Head-neck posture was assessed by craniovertebral angle (CVA), coronal C2-C7 Cobb angle, and cervical range of motion (CROM). Hyoid kinematics were evaluated via anterior horizontal displacement, superior horizontal displacement, and motion duration.

Results

Compared with the low aspiration risk group, the high aspiration risk group exhibited a significantly smaller CVA and reduced CROM, along with diminished hyoid displacement (P<.05). Additionally, CROM for active extension was significantly greater than that for passive extension in the high aspiration risk group (z=−2.937, P=.003). Correlation analysis showed that there were significant positive correlations between head-neck posture (CVA and CROM for active and passive extension) and hyoid displacement (superior- horizontal displacement and anterior- horizontal displacement) (P<.001).

Conclusions

This study observed variations in head-neck posture and hyoid kinematics in patients with stroke and aspiration risk and found positive correlations between them. Our results suggest that abnormal head-neck posture may be a relevant factor influencing swallowing function, and indicate new strategies and insights for patients with stroke.
目的观察脑卒中和误吸危险患者头颈部姿势和舌骨运动的改变。设计前瞻性观察性研究。医院住院病房。本研究共纳入24例脑卒中患者(N=24): 12例高误吸风险患者(7男5女),年龄62-77岁(IQR为64.00-74.00),12例低误吸风险患者(8男4女),年龄50-80岁(中位数为66.00,IQR为58.25-71.25)。InterventionsNot适用。主要观察指标通过颅椎角(CVA)、冠状C2-C7 Cobb角和颈椎活动度(CROM)来评估头颈部姿势。舌骨运动学通过前水平位移、后水平位移和运动持续时间来评估。结果与低误吸风险组相比,高误吸风险组CVA明显减小,CROM降低,舌骨移位减少(P< 0.05)。此外,在高误吸风险组中,主动伸展术的CROM显著大于被动伸展术(z=−2.937,P= 0.003)。相关分析显示头颈体位(主动和被动伸展时的CVA和CROM)与舌骨移位(上水平移位和前水平移位)之间存在显著正相关(P<.001)。结论本研究观察到卒中患者头颈姿势和舌骨运动学的变化与误吸风险之间存在正相关。我们的研究结果表明,异常的头颈姿势可能是影响吞咽功能的相关因素,并为脑卒中患者提供新的策略和见解。
{"title":"Variations in Head-Neck Posture and Hyoid Kinematics in Patients With Stroke and Aspiration Risk: A Cross-Sectional Observational Study","authors":"Haipeng Jin MD ,&nbsp;Yanli Huang MS ,&nbsp;Weihong Xiao MS ,&nbsp;Li Ding MD ,&nbsp;Ling Gao MS ,&nbsp;Huijuan Zheng MS ,&nbsp;Rongrong Ye MS","doi":"10.1016/j.arrct.2025.100570","DOIUrl":"10.1016/j.arrct.2025.100570","url":null,"abstract":"<div><h3>Objective</h3><div>To observe alterations in head-neck posture and hyoid kinematics in patients with stroke and aspiration risk.</div></div><div><h3>Design</h3><div>A prospective observational study.</div></div><div><h3>Setting</h3><div>Hospital inpatient unit.</div></div><div><h3>Participants</h3><div>A total of 24 patients (N=24) with stroke were included in this study: 12 patients with high aspiration risk (7 men and 5 women) aged 62-77 years (median=72.50; IQR, 64.00-74.00) and 12 patients with low aspiration risk (8 men and 4 women) aged 50-80 years (median=66.00; IQR, 58.25-71.25).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Head-neck posture was assessed by craniovertebral angle (CVA), coronal C2-C7 Cobb angle, and cervical range of motion (CROM). Hyoid kinematics were evaluated via anterior horizontal displacement, superior horizontal displacement, and motion duration.</div></div><div><h3>Results</h3><div>Compared with the low aspiration risk group, the high aspiration risk group exhibited a significantly smaller CVA and reduced CROM, along with diminished hyoid displacement (<em>P</em>&lt;.05). Additionally, CROM for active extension was significantly greater than that for passive extension in the high aspiration risk group (<em>z</em>=−2.937, <em>P</em>=.003). Correlation analysis showed that there were significant positive correlations between head-neck posture (CVA and CROM for active and passive extension) and hyoid displacement (superior- horizontal displacement and anterior- horizontal displacement) (<em>P&lt;</em>.001).</div></div><div><h3>Conclusions</h3><div>This study observed variations in head-neck posture and hyoid kinematics in patients with stroke and aspiration risk and found positive correlations between them. Our results suggest that abnormal head-neck posture may be a relevant factor influencing swallowing function, and indicate new strategies and insights for patients with stroke.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100570"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428872","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}
引用次数: 0
Efficacy of Acupuncture Combined With Robotic Therapy in the Treatment of Limb Dysfunction After Stroke: A Systematic Review and Meta-Analysis 针刺联合机器人治疗脑卒中后肢体功能障碍的疗效:系统回顾和荟萃分析
IF 2 Q2 REHABILITATION Pub Date : 2025-12-01 Epub Date: 2025-08-20 DOI: 10.1016/j.arrct.2025.100504
Tao Zhu MS , Kaiyang Xue MS , Ming Li MS , Dan Yang BS , Mingxi Yan MS , Jin Cui PhD

Objective

To conduct a meta-analysis investigating the effect of acupuncture combined with robotic therapy on limb dysfunction after a stroke.

Data Sources

Electronic searches of 8 databases were conducted from database establishment to September 20, 2024.

Study Selection

Randomized controlled trials comparing acupuncture combined with robot therapy versus monotherapy for poststroke limb dysfunction.

Data Extraction

Data extraction was independently performed by 2 authors, with any discrepancies resolved through discussion with a third investigator. The extracted dataset included the first author’s name, publication year, characteristics of the study population, sample size, intervention protocols, motor function scores, and other relevant outcome measures.

Data Synthesis

A total of 19 randomized controlled studies were included, encompassing 1353 patients, with a maximum sample size of 120 patients and a minimum sample size of 40 patients. Our findings revealed that the combined therapy group exhibited significantly higher scores on the Fugl-Meyer Assessment (FMA) for limb motor function and the Modified Barthel Index (MBI) for activities of daily living compared with the robot group: (standard mean difference [MD], 4.89; 95% CI, 2.66-7.12; P<.001) and (MD, 7.17; 95% CI, 4.20-10.14; P<.001), respectively. Similarly, the results indicated that the combined therapy group achieved significantly higher scores on both the FMA and MBI compared with the acupuncture-only group: (MD, 4.68, 95% CI, 3.32-6.04, P<.001) and (MD, 11.66; 95% CI, 7.92-15.39; P<.001), respectively. Furthermore, the FMA score was higher in the combined therapy group than in the conventional treatment group (MD, 5.98; 95% CI, 3.11-8.84; P<.001).

Conclusions

Acupuncture combined with robotic therapy appears to enhance limb motor function and improve quality of life, with the clinical efficacy of this combined intervention exceeding that of either therapy administered individually. However, considering the moderate to low quality of the included studies and their frequent absence of blinding, future clinical research should focus on high-quality randomized double-blind controlled trials for validation.
目的探讨针刺联合机器人治疗对脑卒中后肢体功能障碍的影响。数据来源从建库到2024年9月20日,对8个数据库进行了电子检索。研究选择:比较针灸联合机器人疗法与单一疗法治疗中风后肢体功能障碍的随机对照试验。数据提取数据提取由2位作者独立完成,任何差异通过与第三位研究者讨论解决。提取的数据集包括第一作者姓名、出版年份、研究人群特征、样本量、干预方案、运动功能评分和其他相关结果测量。共纳入19项随机对照研究,共1353例患者,最大样本量为120例,最小样本量为40例。我们的研究结果显示,与机器人组相比,联合治疗组在肢体运动功能的Fugl-Meyer评估(FMA)和日常生活活动的改良Barthel指数(MBI)上的得分明显更高:(标准平均差[MD], 4.89; 95% CI, 2.66-7.12; P<.001)和(MD, 7.17; 95% CI, 4.20-10.14; P<.001)。同样,结果表明,联合治疗组在FMA和MBI上的得分均明显高于单独针灸组:(MD, 4.68, 95% CI, 3.32-6.04, P<.001)和(MD, 11.66, 95% CI, 7.92-15.39; P<.001)。此外,联合治疗组的FMA评分高于常规治疗组(MD, 5.98; 95% CI, 3.11-8.84; P<.001)。结论针刺联合机器人治疗可增强肢体运动功能,改善生活质量,其临床疗效优于单独治疗。然而,考虑到纳入的研究质量中低,且经常缺乏盲法,未来的临床研究应侧重于高质量的随机双盲对照试验进行验证。
{"title":"Efficacy of Acupuncture Combined With Robotic Therapy in the Treatment of Limb Dysfunction After Stroke: A Systematic Review and Meta-Analysis","authors":"Tao Zhu MS ,&nbsp;Kaiyang Xue MS ,&nbsp;Ming Li MS ,&nbsp;Dan Yang BS ,&nbsp;Mingxi Yan MS ,&nbsp;Jin Cui PhD","doi":"10.1016/j.arrct.2025.100504","DOIUrl":"10.1016/j.arrct.2025.100504","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct a meta-analysis investigating the effect of acupuncture combined with robotic therapy on limb dysfunction after a stroke.</div></div><div><h3>Data Sources</h3><div>Electronic searches of 8 databases were conducted from database establishment to September 20, 2024.</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials comparing acupuncture combined with robot therapy versus monotherapy for poststroke limb dysfunction.</div></div><div><h3>Data Extraction</h3><div>Data extraction was independently performed by 2 authors, with any discrepancies resolved through discussion with a third investigator. The extracted dataset included the first author’s name, publication year, characteristics of the study population, sample size, intervention protocols, motor function scores, and other relevant outcome measures.</div></div><div><h3>Data Synthesis</h3><div>A total of 19 randomized controlled studies were included, encompassing 1353 patients, with a maximum sample size of 120 patients and a minimum sample size of 40 patients. Our findings revealed that the combined therapy group exhibited significantly higher scores on the Fugl-Meyer Assessment (FMA) for limb motor function and the Modified Barthel Index (MBI) for activities of daily living compared with the robot group: (standard mean difference [MD], 4.89; 95% CI, 2.66-7.12; <em>P</em>&lt;.001) and (MD, 7.17; 95% CI, 4.20-10.14; <em>P</em>&lt;.001), respectively. Similarly, the results indicated that the combined therapy group achieved significantly higher scores on both the FMA and MBI compared with the acupuncture-only group: (MD, 4.68, 95% CI, 3.32-6.04, <em>P</em>&lt;.001) and (MD, 11.66; 95% CI, 7.92-15.39; <em>P</em>&lt;.001), respectively. Furthermore, the FMA score was higher in the combined therapy group than in the conventional treatment group (MD, 5.98; 95% CI, 3.11-8.84; <em>P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>Acupuncture combined with robotic therapy appears to enhance limb motor function and improve quality of life, with the clinical efficacy of this combined intervention exceeding that of either therapy administered individually. However, considering the moderate to low quality of the included studies and their frequent absence of blinding, future clinical research should focus on high-quality randomized double-blind controlled trials for validation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100504"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739021","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}
引用次数: 0
Functional Trajectory of Childhood Stroke in the Inpatient Rehabilitation Setting 住院康复环境下儿童脑卒中的功能轨迹
IF 2 Q2 REHABILITATION Pub Date : 2025-12-01 Epub Date: 2025-08-23 DOI: 10.1016/j.arrct.2025.100505
Jennifer Wu MD, PhD , Deena S. Godfrey MD , Patricia Orme MD , Brian D. Wishart DO, MMS

Objective

To examine the functional outcomes of a group of infants, children, and adolescents admitted to acute inpatient rehabilitation for neurologic impairments caused by a new childhood stroke.

Design

Retrospective cross-sectional cohort study.

Setting

A pediatric inpatient rehabilitation program in a stand-alone inpatient rehabilitation facility (IRF) located within an academic medical center.

Participants

A total of 91 patients (N=91) aged 6 months to 17.8 years were admitted to a pediatric inpatient rehabilitation program with a new diagnosis of childhood stroke.

Interventions

Standard of care pediatric inpatient rehabilitation treatment.

Main Outcome Measures

Change in the functional independence measure in children (WeeFIM) score across inpatient rehabilitation treatment.

Results

The 51 boys/39 girls/and 1 transgender patient were 9.6±5.7 years old with ischemic stroke (n=53) or hemorrhagic stroke (n=38). At admission, they had moderate-to-severe functional impairments (WeeFIM total score=46.5±25.5 points). Inpatient rehabilitation length of stay was 33.7±28.5 (range, 3-134) days. WeeFIM total score improved to 71.2±31.6 points at IRF discharge. Hemorrhagic (compared with ischemic) stroke was associated with higher rates of craniectomy (X2=4.6, P=.03) and older age at IRF admission (Z=1.98, P<.05). Older age was associated with higher age-corrected WeeFIM total scores at admission (F=7.9, P=.0007) and discharge (F=18.1, P<.001), but age did not affect change in WeeFIM score.

Conclusions

Pediatric inpatient rehabilitation results in functional improvements for new neurologic impairments caused by childhood stroke.
目的探讨一组新生儿、儿童和青少年因新发儿童脑卒中引起的神经功能损伤而接受急性住院康复治疗的功能结局。设计:回顾性横断面队列研究。在学术医疗中心内的独立住院康复设施(IRF)进行儿科住院康复计划。共有91名患者(N=91),年龄在6个月至17.8岁之间,因新诊断为儿童卒中而进入儿科住院康复计划。干预措施:儿科住院康复治疗的护理标准。主要观察指标:住院康复治疗期间儿童功能独立测量(WeeFIM)评分的变化。结果男51例,女39例,变性者1例,年龄9.6±5.7岁,缺血性脑卒中53例,出血性脑卒中38例。入院时,患者有中度至重度功能障碍(WeeFIM总分=46.5±25.5分)。住院康复时间为33.7±28.5天(范围:3 ~ 134)d。IRF放电时WeeFIM总分提高至71.2±31.6分。出血性卒中(与缺血性卒中相比)与较高的颅骨切除术发生率(X2=4.6, P= 0.03)和IRF入院时年龄较大(Z=1.98, P< 0.05)相关。年龄越大,入院时(F=7.9, P= 0.0007)和出院时(F=18.1, P= 0.001)年龄校正后WeeFIM总分越高,但年龄不影响WeeFIM评分的变化。结论儿科住院康复治疗可改善儿童脑卒中新发神经功能损害。
{"title":"Functional Trajectory of Childhood Stroke in the Inpatient Rehabilitation Setting","authors":"Jennifer Wu MD, PhD ,&nbsp;Deena S. Godfrey MD ,&nbsp;Patricia Orme MD ,&nbsp;Brian D. Wishart DO, MMS","doi":"10.1016/j.arrct.2025.100505","DOIUrl":"10.1016/j.arrct.2025.100505","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the functional outcomes of a group of infants, children, and adolescents admitted to acute inpatient rehabilitation for neurologic impairments caused by a new childhood stroke.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional cohort study.</div></div><div><h3>Setting</h3><div>A pediatric inpatient rehabilitation program in a stand-alone inpatient rehabilitation facility (IRF) located within an academic medical center.</div></div><div><h3>Participants</h3><div>A total of 91 patients (N=91) aged 6 months to 17.8 years were admitted to a pediatric inpatient rehabilitation program with a new diagnosis of childhood stroke.</div></div><div><h3>Interventions</h3><div>Standard of care pediatric inpatient rehabilitation treatment.</div></div><div><h3>Main Outcome Measures</h3><div>Change in the functional independence measure in children (WeeFIM) score across inpatient rehabilitation treatment.</div></div><div><h3>Results</h3><div>The 51 boys/39 girls/and 1 transgender patient were 9.6±5.7 years old with ischemic stroke (n=53) or hemorrhagic stroke (n=38). At admission, they had moderate-to-severe functional impairments (WeeFIM total score=46.5±25.5 points). Inpatient rehabilitation length of stay was 33.7±28.5 (range, 3-134) days. WeeFIM total score improved to 71.2±31.6 points at IRF discharge. Hemorrhagic (compared with ischemic) stroke was associated with higher rates of craniectomy (X<sup>2</sup>=4.6, <em>P</em>=.03) and older age at IRF admission (Z=1.98, <em>P</em>&lt;.05). Older age was associated with higher age-corrected WeeFIM total scores at admission (F=7.9, <em>P</em>=.0007) and discharge (F=18.1, <em>P</em>&lt;.001), but age did not affect change in WeeFIM score.</div></div><div><h3>Conclusions</h3><div>Pediatric inpatient rehabilitation results in functional improvements for new neurologic impairments caused by childhood stroke.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100505"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739225","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}
引用次数: 0
Health-Related Quality of Life in Survivors of Stroke Post Inpatient Rehabilitation Discharged to a Home Setting 卒中患者住院康复出院后与健康相关的生活质量
IF 2 Q2 REHABILITATION Pub Date : 2025-12-01 Epub Date: 2025-09-07 DOI: 10.1016/j.arrct.2025.100521
Siqi Xiang OT , Bradley Smith BS , Margaret A. French PT, DPT, PhD , Heather A. Hayes DPT, PhD

Objective

To examine if personal factors, stroke severity, social determinants of health, and functional status are associated with health-related quality of life (HRQOL) in individuals poststroke who have completed their inpatient rehabilitation facility (IRF) stay and have returned home. We hypothesized that functional status would explain a significant portion of variability in HRQOL after accounting for covariates, including personal factors, stroke severity, and metrics of social determinants of health.

Design

This study was a secondary analysis of data from a prospective, longitudinal cohort study.

Setting

The IRF to the community.

Participants

Individuals (N=72) poststroke (mean age ± SD, 64.1±14.4y, 58.3% men) who returned home after completing rehabilitation in an IRF.

Interventions

Not applicable.

Main Outcome Measures

The HRQOL in Stroke Patients-26 (HRQOLISP-26) was captured after individuals were discharged to the home setting.

Results

Functional status explained an additional 40% of the variance in HRQOLISP-26 after controlling for personal factors, stroke severity, and metrics of social determinants of health (R2=0.63, ΔR2=0.40, F=6.21, p<.001). The specific functional measures that were significantly associated with HRQOLISP-26 were basic mobility (β=0.38, p=.01), applied cognition (β=0.56, p<.001), and depression (β=−4.58, p=.03).

Conclusions

We found that functional status, including mobility, cognition, and depression, is implicated in affecting HRQOL in individuals with subacute stroke who have completed their IRF stay and have returned home. Thus, underlying the importance of rehabilitation is the consideration of not only the progression of physical and cognitive function but also mood.
目的探讨脑卒中后完成住院康复设施(IRF)并返回家中的患者的健康相关生活质量(HRQOL)是否与个人因素、脑卒中严重程度、健康的社会决定因素和功能状态相关。我们假设,在考虑了协变量(包括个人因素、中风严重程度和健康的社会决定因素指标)后,功能状态可以解释HRQOL变异的重要部分。本研究是对前瞻性纵向队列研究数据的二次分析。设置IRF到社区。参与者:在IRF中完成康复后回家的脑卒中后个体(N=72)(平均年龄±SD, 64.1±14.4岁,58.3%男性)。InterventionsNot适用。主要观察指标脑卒中患者-26的HRQOL (HRQOLISP-26)在个体出院后被捕获。结果在控制了个人因素、中风严重程度和健康社会决定因素指标后,功能状态解释了hrqolsp -26中另外40%的方差(R2=0.63, ΔR2=0.40, F=6.21, p< 0.001)。与HRQOLISP-26显著相关的具体功能指标为基本活动能力(β=0.38, p= 0.01)、应用认知(β=0.56, p= 0.01)和抑郁(β= - 4.58, p= 0.03)。结论:我们发现功能状态,包括活动能力、认知和抑郁,与完成IRF住院并返回家的亚急性卒中患者的HRQOL有关。因此,康复的重要性在于不仅要考虑身体和认知功能的发展,还要考虑情绪的发展。
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引用次数: 0
Electromyographic Prediction of Walking Independence in Patients With Incomplete Spinal Cord Injury 不完全性脊髓损伤患者步行独立性的肌电图预测
IF 2 Q2 REHABILITATION Pub Date : 2025-12-01 Epub Date: 2025-10-13 DOI: 10.1016/j.arrct.2025.100533
Tatsuya Sugimoto PhD , Yuma Sonoda PhD , Nobuhito Taniguchi M.Eng , Hiroshi Kawaguchi PhD , Shintaro Izumi PhD

Objective

To predict walking independence in patients with incomplete cervical cord injury (ICCI) using electromyography of the trunk and lower extremity during straight-leg raising (SLR).

Design

Prospective cohort study. Prediction model using logistic regression.

Setting

Single acute-care hospital.

Participants

Forty patients equally split between walking dependent and walking independent groups (mean ages: 70.7±14.4 and 63.7±15.4 years; male-to-female ratios: 18:2 and 16:4; total length of stay: 31.2±20.9 and 25.7±16.5 days).

Interventions

Not applicable.

Main Outcome Measures

Trunk and lower extremity acceleration and surface electromyography data measured during nondominant SLR and basic information were used to predict the level of walking independence at discharge or transfer from the acute-care hospital.

Results

The results showed that the model with the lower extremity motor score (LEMS) and the root mean square (RMS) of the contralateral external oblique (EO) had the lowest Akaike information criterion of 22.24, and both were significant factors in predicting walking independence at discharge or transfer from the acute-care hospital (P=.019 and .034). The predictive accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve were 0.875, 0.850, 0.900, and 0.975 (95% confidence interval: 0.939-1.000), respectively.

Conclusions

A higher LEMS and lower RMS of the contralateral EO during nondominant SLR are significant predictors of walking independence at discharge or transfer from an acute-care hospital in patients with ICCI.
目的利用直腿抬高(SLR)时躯干及下肢肌电图预测不完全性颈髓损伤(ICCI)患者的行走独立性。前瞻性队列研究。使用逻辑回归的预测模型。单一急症护理医院。40例患者平均分为步行依赖组和步行独立组(平均年龄:70.7±14.4岁和63.7±15.4岁;男女比例:18:2和16:4;总住院时间:31.2±20.9和25.7±16.5天)。InterventionsNot适用。主要观察指标:在非优势SLR期间测量的下肢加速度和表面肌电图数据以及基本信息用于预测出院或从急性护理医院转移时的行走独立水平。结果下肢运动评分(LEMS)和对侧外斜肌(EO)均方根(RMS)模型的赤井信息标准最低(22.24),两者均是预测出院或转院时患者行走独立性的显著因素(P= 0.019和0.034)。预测准确度为0.875,灵敏度为0.850,特异度为0.900,受试者工作特征曲线下面积为0.975(95%可信区间:0.939 ~ 1.000)。结论非显性SLR期间对侧EO LEMS升高和RMS降低是ICCI患者出院或转院时行走独立性的重要预测因素。
{"title":"Electromyographic Prediction of Walking Independence in Patients With Incomplete Spinal Cord Injury","authors":"Tatsuya Sugimoto PhD ,&nbsp;Yuma Sonoda PhD ,&nbsp;Nobuhito Taniguchi M.Eng ,&nbsp;Hiroshi Kawaguchi PhD ,&nbsp;Shintaro Izumi PhD","doi":"10.1016/j.arrct.2025.100533","DOIUrl":"10.1016/j.arrct.2025.100533","url":null,"abstract":"<div><h3>Objective</h3><div>To predict walking independence in patients with incomplete cervical cord injury (ICCI) using electromyography of the trunk and lower extremity during straight-leg raising (SLR).</div></div><div><h3>Design</h3><div>Prospective cohort study. Prediction model using logistic regression.</div></div><div><h3>Setting</h3><div>Single acute-care hospital.</div></div><div><h3>Participants</h3><div>Forty patients equally split between walking dependent and walking independent groups (mean ages: 70.7±14.4 and 63.7±15.4 years; male-to-female ratios: 18:2 and 16:4; total length of stay: 31.2±20.9 and 25.7±16.5 days).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Trunk and lower extremity acceleration and surface electromyography data measured during nondominant SLR and basic information were used to predict the level of walking independence at discharge or transfer from the acute-care hospital.</div></div><div><h3>Results</h3><div>The results showed that the model with the lower extremity motor score (LEMS) and the root mean square (RMS) of the contralateral external oblique (EO) had the lowest Akaike information criterion of 22.24, and both were significant factors in predicting walking independence at discharge or transfer from the acute-care hospital (<em>P</em>=.019 and .034). The predictive accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve were 0.875, 0.850, 0.900, and 0.975 (95% confidence interval: 0.939-1.000), respectively.</div></div><div><h3>Conclusions</h3><div>A higher LEMS and lower RMS of the contralateral EO during nondominant SLR are significant predictors of walking independence at discharge or transfer from an acute-care hospital in patients with ICCI.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100533"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739127","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}
引用次数: 0
Prospective Randomized Controlled Trial of the Impact of Olfactory Training on Cognitive and Emotional Function in Individuals with Parkinson Disease 嗅觉训练对帕金森病患者认知和情绪功能影响的前瞻性随机对照试验
IF 2 Q2 REHABILITATION Pub Date : 2025-12-01 Epub Date: 2025-07-24 DOI: 10.1016/j.arrct.2025.100497
Yunxiao Dou MD , Siyu Qian MM , Yichen Zhao MD , Yan Tan MD , Yanxin Zhao MD

Objective

To investigate the clinical effects of olfactory training (OT) on olfactory function and related nonmotor symptoms in patients with Parkinson disease (PD).

Design

Randomized controlled trial with a duration of 6 months of follow-up.

Setting

A tertiary hospital providing neurology rehabilitation services in China.

Participants

Of 81 initially recruited PD patients, 70 completed the study (N=70, 35 per group after randomization: OT group n=35, control n=35). All participants met inclusion criteria and received standard medical care. No dropouts were because of adverse effects.

Interventions

The intervention group received OT using a standardized protocol. The training involved daily exposure to specific odorants for 6 months. The control group did not receive OT.

Main Outcome Measures

Primary outcomes included changes in olfactory test scores, memory and cognition scores (assessed using neuropsychological tests), and depressive and anxiety scale scores. These were measured before and after the 6-month intervention.

Results

After 6 months, the intervention group exhibited significant improvements in olfactory test scores (threshold-discrimination-identification score: t=3.839, P<.01, Cohen’s d=0.649), memory (memory quotient: t=2.597, P<.05, Cohen’s d=0.439) and cognition scores (Mini-Mental State Examination: z=−2.791, P<.01, rank-biserial correlation (r)=−0.330 and Montreal Cognitive Assessment: t=2.626, P<.05, Cohen’s d=0.444), depressive (Hamilton Depression Scale: z=−3.601, P<.001, r=−0.425 and Patient Health Questionnaire-9: z=−2.396, P<.05, r=−0.29) and anxiety (Hamilton Anxiety Scale: z=−3.049, P<.01, r=−0.36 and Generalized Anxiety Disorder-7: z=−2.849, P<.01, r=0.336) scale scores compared to the control group, showing moderate effects, respectively. The increase in memory scale scores was positively correlated with the increase in olfactory scores (Spearman r=0.415, P<.05). Statistical analysis was performed using SPSS 27.0 software, with P values indicating significance.

Conclusions

The OT has beneficial effects on olfactory function and related nonmotor symptoms in patients with PD. The 6-month training led to significant improvements in memory, cognition, depression, and anxiety. Further studies are needed to determine the long-term effects and optimal duration of OT for patients with PD.
目的探讨嗅觉训练(OT)对帕金森病(PD)患者嗅觉功能及相关非运动症状的影响。随机对照试验,随访6个月。设置国内一家提供神经康复服务的三级医院。参与者:81名初始招募的PD患者,70名完成了研究(N=70,随机分组后每组35名:OT组N= 35,对照组N= 35)。所有参与者均符合纳入标准并接受标准医疗护理。没有人因为不良反应而退学。干预组采用标准化方案接受OT治疗。这项训练包括在6个月内每天接触特定的气味。对照组不接受OT治疗。主要结果测量主要结果包括嗅觉测试分数、记忆和认知分数(使用神经心理学测试评估)以及抑郁和焦虑量表分数的变化。这些是在6个月干预前后测量的。结果6个月后,干预组在嗅觉测试得分(阈值-辨别-识别得分:t=3.839, P< 0.01, Cohen’s d=0.649)、记忆(记忆商:t=2.597, P< 0.05, Cohen’s d=0.439)、认知得分(Mini-Mental State Examination: z= - 2.791, P< 0.01,秩双序列相关(r)= - 0.330,蒙特利尔认知评估:t=2.626, P< 0.05, Cohen’s d=0.444)、抑郁(Hamilton抑郁量表:患者健康问卷-9:z= - 2.396, p - lt; 0.05, r= - 0.29)和焦虑(汉密尔顿焦虑量表:z= - 3.049, p - lt; 0.01, r= - 0.36)量表得分与对照组相比,分别表现为中度影响。记忆量表得分的增加与嗅觉得分的增加呈正相关(Spearman r=0.415, P< 0.05)。采用SPSS 27.0软件进行统计学分析,P值为显著性。结论OT对PD患者的嗅觉功能及相关非运动症状有改善作用。6个月的训练在记忆、认知、抑郁和焦虑方面有了显著的改善。需要进一步的研究来确定OT对PD患者的长期影响和最佳持续时间。
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引用次数: 0
期刊
Archives of rehabilitation research and clinical translation
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