Pub Date : 2025-12-01DOI: 10.1016/j.arrct.2025.100503
Pooja Solanki MPH , Brad E. Dicianno MD , Alicia M. Koontz PhD , Kelsey Berryman PhD , Frances M. Weaver PhD
Objective
To conduct a needs assessment to learn about women Veterans’ needs, priorities, preferences, and experiences with mobility assistive technology (MAT).
Design
Cross-sectional survey study.
Setting
National survey.
Participants
Women veterans (age, ≥18y) receiving care from the Veterans Health Administration who received MAT in the last 5 years participated in an online survey (N=700).
Interventions
None.
Main Outcome Measures
The survey included questions regarding demographics, experiences with procurement, evaluation, and follow-up for MAT, and ability to participate in various activities.
Results
Seven hundred women veterans responded to the online survey but due to missing responses only 593 surveys were analyzed. The most commonly used MAT included canes (26%), walkers (24%), and manual or power wheelchairs (29%). Activities for which their assistive mobility device did not meet their needs included housework (26%), leisure (22%), and social activities (19%). Some women veterans identified challenges with their device related to the design and lack of options when choosing a device. Although a majority of veterans reported positive feedback in procuring their MAT, there were opportunities for improvement in follow-up.
Conclusions
Approximately 1 out of 5 women indicated that their devices did not meet some of their needs. The unique needs of women veterans should be considered during the design and provision of MAT, and education should be provided on maintenance of the MAT. Future research is warranted to develop possible solutions for these gaps with the goal of improving women veterans’ experiences and function related to MAT.
{"title":"Women Veterans and Mobility Aids","authors":"Pooja Solanki MPH , Brad E. Dicianno MD , Alicia M. Koontz PhD , Kelsey Berryman PhD , Frances M. Weaver PhD","doi":"10.1016/j.arrct.2025.100503","DOIUrl":"10.1016/j.arrct.2025.100503","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct a needs assessment to learn about women Veterans’ needs, priorities, preferences, and experiences with mobility assistive technology (MAT).</div></div><div><h3>Design</h3><div>Cross-sectional survey study.</div></div><div><h3>Setting</h3><div>National survey.</div></div><div><h3>Participants</h3><div>Women veterans (age, ≥18y) receiving care from the Veterans Health Administration who received MAT in the last 5 years participated in an online survey (N=700).</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>The survey included questions regarding demographics, experiences with procurement, evaluation, and follow-up for MAT, and ability to participate in various activities.</div></div><div><h3>Results</h3><div>Seven hundred women veterans responded to the online survey but due to missing responses only 593 surveys were analyzed. The most commonly used MAT included canes (26%), walkers (24%), and manual or power wheelchairs (29%). Activities for which their assistive mobility device did not meet their needs included housework (26%), leisure (22%), and social activities (19%). Some women veterans identified challenges with their device related to the design and lack of options when choosing a device. Although a majority of veterans reported positive feedback in procuring their MAT, there were opportunities for improvement in follow-up.</div></div><div><h3>Conclusions</h3><div>Approximately 1 out of 5 women indicated that their devices did not meet some of their needs. The unique needs of women veterans should be considered during the design and provision of MAT, and education should be provided on maintenance of the MAT. Future research is warranted to develop possible solutions for these gaps with the goal of improving women veterans’ experiences and function related to MAT.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100503"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739229","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}
To evaluate the efficacy of clemastine in improving clinical and electrophysiological outcomes in patients with carpal tunnel syndrome (CTS) when combined with standard splint therapy.
Design
A double-blind, randomized, placebo-controlled trial with follow-up assessments at 1 and 3 months.
Setting
A physical medicine and rehabilitation outpatient clinic.
Participants
Adult patients (N=27) (mean age=46.4y; sex ratio, 29.2% men and 70.8% women), enrolled with electrodiagnostically confirmed mild to moderate CTS, were randomized into clemastine (n=14) and placebo (n=13) groups.
Interventions
The treatment group received 1 mg oral clemastine nightly plus a wrist splint, while the control group received a placebo plus an identical wrist splint, with both interventions maintained for 3 months.
Main Outcome Measures
Primary endpoints included Boston Carpal Tunnel Questionnaire Symptom Severity (BQ-SS) and Functional Status (BQ-FS) scores, nerve conduction study parameters (median nerve sensory and motor distal latency), and ultrasonographic median nerve cross-sectional area.
Results
The case group showed a significant difference in follow-up mean BQ-FS and BQ-SS scores (ANOVA, p<.01) at 1 month and 3 months compared with the control. No significant differences were found in the nerve conduction study or ultrasonographic cross-sectional area between groups.
Conclusions
Clemastine, combined with wrist splinting, may provide further clinical benefits in patients with CTS, particularly in improving BQ-SS and BQ-FS outcomes. Further research is necessary to confirm these findings and explore appropriate dosing options.
{"title":"Evaluation of Clemastine’s Effects on Clinical and Electrodiagnostic Parameters in Individuals With CTS: A Preliminary Placebo-Controlled Double-Blind RCT","authors":"Kamyar Kazemi MD , Gholamreza Raissi MD , Tannaz Ahadi MD , Seyed Pezhman Madani MD , Simin Sajadi MD , Hosna Soleymanzadeh MSc , Negar Kariznoee PharmD","doi":"10.1016/j.arrct.2025.100502","DOIUrl":"10.1016/j.arrct.2025.100502","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of clemastine in improving clinical and electrophysiological outcomes in patients with carpal tunnel syndrome (CTS) when combined with standard splint therapy.</div></div><div><h3>Design</h3><div>A double-blind, randomized, placebo-controlled trial with follow-up assessments at 1 and 3 months.</div></div><div><h3>Setting</h3><div>A physical medicine and rehabilitation outpatient clinic.</div></div><div><h3>Participants</h3><div>Adult patients (N=27) (mean age=46.4y; sex ratio, 29.2% men and 70.8% women), enrolled with electrodiagnostically confirmed mild to moderate CTS, were randomized into clemastine (n=14) and placebo (n=13) groups.</div></div><div><h3>Interventions</h3><div>The treatment group received 1 mg oral clemastine nightly plus a wrist splint, while the control group received a placebo plus an identical wrist splint, with both interventions maintained for 3 months.</div></div><div><h3>Main Outcome Measures</h3><div>Primary endpoints included Boston Carpal Tunnel Questionnaire Symptom Severity (BQ-SS) and Functional Status (BQ-FS) scores, nerve conduction study parameters (median nerve sensory and motor distal latency), and ultrasonographic median nerve cross-sectional area.</div></div><div><h3>Results</h3><div>The case group showed a significant difference in follow-up mean BQ-FS and BQ-SS scores (ANOVA, <em>p</em><.01) at 1 month and 3 months compared with the control. No significant differences were found in the nerve conduction study or ultrasonographic cross-sectional area between groups.</div></div><div><h3>Conclusions</h3><div>Clemastine, combined with wrist splinting, may provide further clinical benefits in patients with CTS, particularly in improving BQ-SS and BQ-FS outcomes. Further research is necessary to confirm these findings and explore appropriate dosing options.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100502"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739230","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}
Pub Date : 2025-12-01DOI: 10.1016/j.arrct.2025.100539
Priya D. Bolikal MD , Ryan Schuetter BS , Tess Guzman BS , Richa Patel MPH , Paul J. Gubanich MD, MPH , Shari L. Wade PhD , Lynn Babcock MD, MS , Megan Narad PhD , Sarah M. Eickmeyer MD , Brad G. Kurowski MD, MS
Objective
To improve study recruitment by increasing the number of eligible participants who receive study information during their outpatient clinical care.
Design
Quality improvement study.
Setting
Outpatient clinics from July 2024 to January 2025.
Participants
Eligible patients across 16 outpatient clinics (N=231, mean age=14.1 ± 2.0 y, women=46%, White=74%).
Interventions
Using quality improvement methodology, the team identified barriers and key drivers for recruitment from clinics. The initial interventions included designating and engaging a clinical staff member in each clinic to distribute study information (recruitment champion), notifying them of potentially eligible patients, tracking progress, and incentivizing recruitment with small rewards. Recruitment was tracked and reviewed monthly to assess progress and identify interventions for ongoing iterations.
Main Outcome Measures
Primary: Percentage of eligible patients who received study information during their clinic visit. Secondary: Study enrollment rates.
Results
During this period, 58.9% of eligible patients received study information during their clinic visits (baseline rate from prior similar study=32.6%). Enrollment from clinic contact averaged 59% (baseline rate from prior similar study=21.8%). Chi-square test indicated a significantly higher proportion of patients received information about the study from clinic staff compared with the prior similar study (χ2=36.06, P<.001), and those receiving information about the study in clinic corresponded with a higher rate of enrollment compared with the group that did not receive information in clinic (χ2=21.33, P<.001).
Conclusions
This project demonstrates the successful application of quality improvement methodology toward optimizing clinical recruitment. Approaches used in this study can potentially be generalized to other outpatient clinical populations and research studies.
目的通过增加在门诊临床护理期间接受研究信息的合格参与者的数量来改善研究招募。设计质量改进研究。门诊门诊从2024年7月到2025年1月。16家门诊诊所的合格患者（N=231，平均年龄=14.1±2.0 y，女性=46%，白人=74%）。干预措施使用质量改进方法，团队确定了从诊所招募的障碍和关键驱动因素。最初的干预措施包括在每个诊所指定并聘请一名临床工作人员分发研究信息（招募冠军），通知他们潜在的合格患者，跟踪进展，并以小额奖励激励招募。每月对招聘进行跟踪和审查，以评估进展并确定正在进行的迭代的干预措施。主要结果测量：在临床访问期间接受研究信息的合格患者的百分比。第二：学习入学率。结果在此期间，58.9%的符合条件的患者在就诊期间获得了研究信息（先前类似研究的基线率=32.6%）。临床接触入组率平均为59%（先前类似研究的基线率为21.8%）。卡方检验显示，从临床工作人员处获得研究信息的患者比例明显高于既往类似研究（χ2=36.06, p < 0.01），从临床工作人员处获得研究信息的患者入组率明显高于未从临床工作人员处获得研究信息的患者（χ2=21.33, p < 0.01）。结论本项目展示了质量改进方法在优化临床招募中的成功应用。本研究中使用的方法有可能推广到其他门诊临床人群和研究。
{"title":"Enhancing Outpatient Clinic Recruitment: A Quality Improvement Strategy for a Prospective Research Study","authors":"Priya D. Bolikal MD , Ryan Schuetter BS , Tess Guzman BS , Richa Patel MPH , Paul J. Gubanich MD, MPH , Shari L. Wade PhD , Lynn Babcock MD, MS , Megan Narad PhD , Sarah M. Eickmeyer MD , Brad G. Kurowski MD, MS","doi":"10.1016/j.arrct.2025.100539","DOIUrl":"10.1016/j.arrct.2025.100539","url":null,"abstract":"<div><h3>Objective</h3><div>To improve study recruitment by increasing the number of eligible participants who receive study information during their outpatient clinical care.</div></div><div><h3>Design</h3><div>Quality improvement study.</div></div><div><h3>Setting</h3><div>Outpatient clinics from July 2024 to January 2025.</div></div><div><h3>Participants</h3><div>Eligible patients across 16 outpatient clinics (N=231, mean age=14.1 ± 2.0 y, women=46%, White=74%).</div></div><div><h3>Interventions</h3><div>Using quality improvement methodology, the team identified barriers and key drivers for recruitment from clinics. The initial interventions included designating and engaging a clinical staff member in each clinic to distribute study information (recruitment champion), notifying them of potentially eligible patients, tracking progress, and incentivizing recruitment with small rewards. Recruitment was tracked and reviewed monthly to assess progress and identify interventions for ongoing iterations.</div></div><div><h3>Main Outcome Measures</h3><div>Primary: Percentage of eligible patients who received study information during their clinic visit. Secondary: Study enrollment rates.</div></div><div><h3>Results</h3><div>During this period, 58.9% of eligible patients received study information during their clinic visits (baseline rate from prior similar study=32.6%). Enrollment from clinic contact averaged 59% (baseline rate from prior similar study=21.8%). Chi-square test indicated a significantly higher proportion of patients received information about the study from clinic staff compared with the prior similar study (χ<sup>2</sup>=36.06, <em>P</em><.001), and those receiving information about the study in clinic corresponded with a higher rate of enrollment compared with the group that did not receive information in clinic (χ<sup>2</sup>=21.33, <em>P</em><.001).</div></div><div><h3>Conclusions</h3><div>This project demonstrates the successful application of quality improvement methodology toward optimizing clinical recruitment. Approaches used in this study can potentially be generalized to other outpatient clinical populations and research studies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100539"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739231","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}
To describe the prevalence and characteristics of cannabis use among Canadians with spinal cord injury (SCI).
Design
Observational study.
Setting
Online survey.
Participants
Canadian adults with any level or severity of SCI (N=80). In total, 136 individuals were screened for participation, of which 80 (61.2% men; mean age: 57.7y) completed the survey.
Interventions
Not applicable.
Main Outcome Measures
Prevalence and frequency of cannabis use; reasons for and against use; perceived effectiveness; adverse events; and modality of cannabis consumption.
Results
Overall, 42.5% of participants reported cannabis use postinjury, and 37.5% were current users, exceeding the general Canadian population’s usage rate (25%). Postinjury, the primary reasons for cannabis use shifted from recreation (25%) to alleviating pain (36.3%) and improving sleep (30%), with users perceiving moderate effectiveness. Reported adverse events were generally mild and infrequent, with fatigue being the most common (11.3%). Edibles replaced smoking as the most common modality of cannabis consumption postinjury. No significant associations were found between cannabis use and demographic variables, including sex, education, or employment status.
Conclusions
This small survey highlights the prevalence and therapeutic motivations for cannabis use among Canadians with SCI, with a shift toward medicinal applications postinjury. With moderate perceived effectiveness and a low prevalence of only mild side effects, future research is warranted to evaluate cannabis’ efficacy and safety in this population and to address barriers to its use, including stigma and health concerns.
{"title":"Understanding Cannabis Use After Spinal Cord Injury: A Canadian Survey Study","authors":"David J. Allison PhD , Sanam Ebrahimzadeh PhD , Alexandria Roa Agudelo cMLA/T , Arden Lawson BSc , Daad Kassem BSc , Eldon Loh MD","doi":"10.1016/j.arrct.2025.100498","DOIUrl":"10.1016/j.arrct.2025.100498","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the prevalence and characteristics of cannabis use among Canadians with spinal cord injury (SCI).</div></div><div><h3>Design</h3><div>Observational study.</div></div><div><h3>Setting</h3><div>Online survey.</div></div><div><h3>Participants</h3><div>Canadian adults with any level or severity of SCI (N=80). In total, 136 individuals were screened for participation, of which 80 (61.2% men; mean age: 57.7y) completed the survey.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Prevalence and frequency of cannabis use; reasons for and against use; perceived effectiveness; adverse events; and modality of cannabis consumption.</div></div><div><h3>Results</h3><div>Overall, 42.5% of participants reported cannabis use postinjury, and 37.5% were current users, exceeding the general Canadian population’s usage rate (25%). Postinjury, the primary reasons for cannabis use shifted from recreation (25%) to alleviating pain (36.3%) and improving sleep (30%), with users perceiving moderate effectiveness. Reported adverse events were generally mild and infrequent, with fatigue being the most common (11.3%). Edibles replaced smoking as the most common modality of cannabis consumption postinjury. No significant associations were found between cannabis use and demographic variables, including sex, education, or employment status.</div></div><div><h3>Conclusions</h3><div>This small survey highlights the prevalence and therapeutic motivations for cannabis use among Canadians with SCI, with a shift toward medicinal applications postinjury. With moderate perceived effectiveness and a low prevalence of only mild side effects, future research is warranted to evaluate cannabis’ efficacy and safety in this population and to address barriers to its use, including stigma and health concerns.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100498"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739024","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}
Pub Date : 2025-12-01DOI: 10.1016/j.arrct.2025.100537
Irene Kalbian MD , Andrew Delgado PhD , Sofia Barchuk DO , Stacey Cohen MS , Adel Bassily-Marcus MD , Laura Tabacof MD , Lisa Spielman PhD , Kristen Dams-O’Connor PhD , Roopa Kohli-Seth MD , Neha Dangayach MD , Avniel Shetreat-Klein MD, PhD , Miguel X. Escalon MD, MPH
Objective
To evaluate mobility outcomes of patients with severe COVID-19 during their intensive care unit (ICU) stay compared to non-COVID-19 critically ill counterparts and assess factors impacting mobility status.
Design
A retrospective, single-center case–control study.
Setting
This investigation was conducted at a large tertiary care center at the epicenter of the COVID-19 pandemic between April 2019 and July 2020 to capture a prepandemic baseline and the initial surge.
Participants
A total of 3275 ICU cases were analyzed. Analysis was conducted at the ICU visit level rather than the patient level. Eligible visits included adults ≥18 years. The COVID-19 cohort (COVID vs non-COVID) was defined by confirmed infection (polymerase chain reaction or equivalent testing). ICU visits with missing data were excluded and subsequently matched via coarsened exact matching.
Interventions
Not applicable.
Main Outcome Measures
Primary outcome measure was an ICU visit’s highest ICU mobility status (Immobile, Nonambulatory, Ambulatory) at any time during their stay. Secondary outcomes included age, sex, body mass index, APACHE-III score, Richmond Agitation Sedation Scale, patient expired, tracheostomy status, percutaneous endoscopic gastrostomy status, hospital length of stay, prone status, and physical therapy status.
Results
The COVID visits were overwhelmingly categorized as immobile, whereas non-COVID visits were more likely to be ambulatory. Multinomial regression showed that COVID patients were 60% less likely to be Nonambulatory and 93% less likely to be Ambulatory versus immobile. COVID-19 visits were also associated with higher final APACHE-III scores (P=.001), longer hospital stays (P<.001), increased sedation (P<.001), fewer ICU physical therapy visits (P=.001), and more frequent proning (P<.001) compared to non-COVID visits.
Conclusions
Severe COVID-19 significantly affects ICU mobility, with COVID visits experiencing reduced mobility compared to non-COVID visits. These findings underscore the urgent need for innovative sedation protocols and ICU mobilization strategies to mitigate risks of ICU-acquired weakness, postintensive care syndrome, and other long-term disabilities. Addressing these challenges is critical to improving outcomes for all ICU patients facing barriers to traditional mobilization strategies and preparing for future pandemics.
{"title":"Barriers to Mobility in the ICU: Insights from Severe COVID-19 and Implications for Improving Patient Outcomes","authors":"Irene Kalbian MD , Andrew Delgado PhD , Sofia Barchuk DO , Stacey Cohen MS , Adel Bassily-Marcus MD , Laura Tabacof MD , Lisa Spielman PhD , Kristen Dams-O’Connor PhD , Roopa Kohli-Seth MD , Neha Dangayach MD , Avniel Shetreat-Klein MD, PhD , Miguel X. Escalon MD, MPH","doi":"10.1016/j.arrct.2025.100537","DOIUrl":"10.1016/j.arrct.2025.100537","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate mobility outcomes of patients with severe COVID-19 during their intensive care unit (ICU) stay compared to non-COVID-19 critically ill counterparts and assess factors impacting mobility status.</div></div><div><h3>Design</h3><div>A retrospective, single-center case–control study.</div></div><div><h3>Setting</h3><div>This investigation was conducted at a large tertiary care center at the epicenter of the COVID-19 pandemic between April 2019 and July 2020 to capture a prepandemic baseline and the initial surge.</div></div><div><h3>Participants</h3><div>A total of 3275 ICU cases were analyzed. Analysis was conducted at the ICU visit level rather than the patient level. Eligible visits included adults ≥18 years. The COVID-19 cohort (COVID vs non-COVID) was defined by confirmed infection (polymerase chain reaction or equivalent testing). ICU visits with missing data were excluded and subsequently matched via coarsened exact matching.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcome measure was an ICU visit’s highest ICU mobility status (Immobile, Nonambulatory, Ambulatory) at any time during their stay. Secondary outcomes included age, sex, body mass index, APACHE-III score, Richmond Agitation Sedation Scale, patient expired, tracheostomy status, percutaneous endoscopic gastrostomy status, hospital length of stay, prone status, and physical therapy status.</div></div><div><h3>Results</h3><div>The COVID visits were overwhelmingly categorized as immobile, whereas non-COVID visits were more likely to be ambulatory. Multinomial regression showed that COVID patients were 60% less likely to be Nonambulatory and 93% less likely to be Ambulatory versus immobile. COVID-19 visits were also associated with higher final APACHE-III scores (<em>P</em>=.001), longer hospital stays (<em>P</em><.001), increased sedation (<em>P</em><.001), fewer ICU physical therapy visits (<em>P</em>=.001), and more frequent proning (<em>P</em><.001) compared to non-COVID visits.</div></div><div><h3>Conclusions</h3><div>Severe COVID-19 significantly affects ICU mobility, with COVID visits experiencing reduced mobility compared to non-COVID visits. These findings underscore the urgent need for innovative sedation protocols and ICU mobilization strategies to mitigate risks of ICU-acquired weakness, postintensive care syndrome, and other long-term disabilities. Addressing these challenges is critical to improving outcomes for all ICU patients facing barriers to traditional mobilization strategies and preparing for future pandemics.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100537"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739122","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}
Pub Date : 2025-12-01DOI: 10.1016/j.arrct.2025.100501
Praneeta Jogie MClinRehab , Miia Rahja PhD , Maayken van den Berg PhD , Jacqui Salway BOccTherapy , Kate Laver PhD
Objective
To examine the validity and acceptability of goal attainment scaling for people with mild cognitive impairment or dementia, and to compare the responsiveness of goal attainment scaling with other measures of rehabilitation outcome.
Design
The Goal Attainment Scale and the Functional independence measure (FIM) were completed on admission and discharge. Agreement between participants’ and health professionals’ ratings of goal attainment was used to examine validity. Acceptability was measured using the Bland-Altman method, with a maximum allowed difference of +10 and −10. Responsiveness was measured using the Pearson r to assess the relationship between goal attainment change scores and FIM change scores.
Setting
Subacute hospital.
Participants
Older adults (N=21) with a diagnosis of cognitive impairment or dementia.
Agreement between the health professionals’ and participants’ ratings of goal attainment was considered acceptable. There was no statistically significant correlation between goal attainment and changes in FIM (p=.054).
Conclusions
The findings suggest that people with mild cognitive impairment or dementia participating in rehabilitation programs can engage in goal setting using goal attainment scaling.
{"title":"Evaluating Goal Attainment Scaling for Individuals With Mild Cognitive Impairment or Dementia in Rehabilitation Settings","authors":"Praneeta Jogie MClinRehab , Miia Rahja PhD , Maayken van den Berg PhD , Jacqui Salway BOccTherapy , Kate Laver PhD","doi":"10.1016/j.arrct.2025.100501","DOIUrl":"10.1016/j.arrct.2025.100501","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the validity and acceptability of goal attainment scaling for people with mild cognitive impairment or dementia, and to compare the responsiveness of goal attainment scaling with other measures of rehabilitation outcome.</div></div><div><h3>Design</h3><div>The Goal Attainment Scale and the Functional independence measure (FIM) were completed on admission and discharge. Agreement between participants’ and health professionals’ ratings of goal attainment was used to examine validity. Acceptability was measured using the Bland-Altman method, with a maximum allowed difference of +10 and −10. Responsiveness was measured using the Pearson <em>r</em> to assess the relationship between goal attainment change scores and FIM change scores.</div></div><div><h3>Setting</h3><div>Subacute hospital.</div></div><div><h3>Participants</h3><div>Older adults (N=21) with a diagnosis of cognitive impairment or dementia.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Goal Attainment Scale, Functional independence measure.</div></div><div><h3>Results</h3><div>Agreement between the health professionals’ and participants’ ratings of goal attainment was considered acceptable. There was no statistically significant correlation between goal attainment and changes in FIM (<em>p</em>=.054).</div></div><div><h3>Conclusions</h3><div>The findings suggest that people with mild cognitive impairment or dementia participating in rehabilitation programs can engage in goal setting using goal attainment scaling.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100501"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739172","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}
Pub Date : 2025-12-01DOI: 10.1016/j.arrct.2025.100543
Luxshmi Nageswaran MSc , Sarah Rosenbaum , Athena Ma , Nita Chan BSc , Dalton L. Wolfe PhD , Laura J. Graham MPT, PhD , Emma A. Bateman MSc, MD
Objectives
To map and categorize evidence related to cardiometabolic disease (CMD) risk in persons with spinal cord injury/disease (SCI/D) and to assess the proportion of studies reporting on sociodemographic variables.
Data Sources
A scoping review of scientific evidence was conducted. MEDLINE, CINAHL, and EMBASE databases were searched using primary constructs (SCI/D, CMD) from inception to July 1, 2024.
Study Selection
Articles must meet the following criteria: (1) full-length article, (2) available in English, (3) SCI/D population aged ≥18 years, and (4) diagnosed CMD and/or evaluated CMD strategies/interventions.
Data Extraction
The following information was extracted from the included articles: title, country in which the study was conducted, participant characteristics, sociodemographic variables reported, objective/purpose statement, study design, study type, intervention type, CMD risk factors evaluated, assessment time point(s), additional non-CMD outcome measures, use of clinical practice guidelines for risk stratification, summary of results, and report of clinical implications.
Data Synthesis
Of the 1726 studies screened, 120 met the inclusion criteria. Definitions from the Users’ Guide to the Medical Literature were used to categorize studies under Diagnosis (n=75; 62.5%), Therapy (n=27; 22.5%), Prognosis (n=14; 11.7%), and Harm (n=4; 3.3%). Diagnosis studies commonly assessed the presence/absence of CMD using screening tools or biomarkers, although only 25 (20.7%) reported on sociodemographic variables, of which race (24.0%), ethnicity (17.3%), and education (13.3%) were most frequently reported. Positive findings for reducing the risk of obesity, hypertension, dyslipidemia, and diabetes mellitus were found across Therapy studies. Most (85.2%) incorporated health-promoting behaviors such as physical activity, nutritional counseling, and behavior change interventions. Four studies (14.8%) evaluated different pharmacologic treatments (atorvastatin, fenofibrate, α-lipoic acid, semaglutide) to target CMD risk factors.
Conclusions
Most of the literature on CMD in persons with SCI/D pertains to Diagnosis, reinforcing the increased prevalence and risk compared with the general population. Physical activity was the most studied therapeutic intervention to manage CMD after SCI/D; however, the limited number of therapy studies demonstrates a need to explore the efficacy of tailored interventions and multipronged approaches. Sociodemographic reporting was poor across all study types, highlighting a gap in understanding subgroup risk. Future research should prioritize addressing these gaps to improve CMD care.
{"title":"Screening, Diagnosis, and Treatment of Cardiometabolic Risk in Persons With Spinal Cord Injury/Disease: A Scoping Review","authors":"Luxshmi Nageswaran MSc , Sarah Rosenbaum , Athena Ma , Nita Chan BSc , Dalton L. Wolfe PhD , Laura J. Graham MPT, PhD , Emma A. Bateman MSc, MD","doi":"10.1016/j.arrct.2025.100543","DOIUrl":"10.1016/j.arrct.2025.100543","url":null,"abstract":"<div><h3>Objectives</h3><div>To map and categorize evidence related to cardiometabolic disease (CMD) risk in persons with spinal cord injury/disease (SCI/D) and to assess the proportion of studies reporting on sociodemographic variables.</div></div><div><h3>Data Sources</h3><div>A scoping review of scientific evidence was conducted. MEDLINE, CINAHL, and EMBASE databases were searched using primary constructs (SCI/D, CMD) from inception to July 1, 2024.</div></div><div><h3>Study Selection</h3><div>Articles must meet the following criteria: (1) full-length article, (2) available in English, (3) SCI/D population aged ≥18 years, and (4) diagnosed CMD and/or evaluated CMD strategies/interventions.</div></div><div><h3>Data Extraction</h3><div>The following information was extracted from the included articles: title, country in which the study was conducted, participant characteristics, sociodemographic variables reported, objective/purpose statement, study design, study type, intervention type, CMD risk factors evaluated, assessment time point(s), additional non-CMD outcome measures, use of clinical practice guidelines for risk stratification, summary of results, and report of clinical implications.</div></div><div><h3>Data Synthesis</h3><div>Of the 1726 studies screened, 120 met the inclusion criteria. Definitions from the Users’ Guide to the Medical Literature were used to categorize studies under Diagnosis (n=75; 62.5%), Therapy (n=27; 22.5%), Prognosis (n=14; 11.7%), and Harm (n=4; 3.3%). Diagnosis studies commonly assessed the presence/absence of CMD using screening tools or biomarkers, although only 25 (20.7%) reported on sociodemographic variables, of which race (24.0%), ethnicity (17.3%), and education (13.3%) were most frequently reported. Positive findings for reducing the risk of obesity, hypertension, dyslipidemia, and diabetes mellitus were found across Therapy studies. Most (85.2%) incorporated health-promoting behaviors such as physical activity, nutritional counseling, and behavior change interventions. Four studies (14.8%) evaluated different pharmacologic treatments (atorvastatin, fenofibrate, α-lipoic acid, semaglutide) to target CMD risk factors.</div></div><div><h3>Conclusions</h3><div>Most of the literature on CMD in persons with SCI/D pertains to Diagnosis, reinforcing the increased prevalence and risk compared with the general population. Physical activity was the most studied therapeutic intervention to manage CMD after SCI/D; however, the limited number of therapy studies demonstrates a need to explore the efficacy of tailored interventions and multipronged approaches. Sociodemographic reporting was poor across all study types, highlighting a gap in understanding subgroup risk. Future research should prioritize addressing these gaps to improve CMD care.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100543"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739175","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}
Pub Date : 2025-12-01DOI: 10.1016/j.arrct.2025.100522
Grace C. Bellinger PhD, MPH , Ryan T. Roemmich PhD , Kevin J. Psoter PhD, MPA , Stephen T. Wegener PhD , Eva Keatley PhD , Margaret A. French PT, DPT, PhD
Objective
To investigate the temporal relationships between depressive symptoms, physical activity, and self-efficacy in individuals with stroke.
Design
Six-month prospective observational cohort study. Three separate lagged linear mixed effects models were constructed (1 with each functional domain as the dependent variable). Each model included the measure of the targeted functional domain as the dependent variable, measurements from the previous month of the 2 other functional domains and their interaction as fixed effects, participant as a random effect, and demographics and stroke characteristics as covariates.
Setting
General community.
Participants
Seventy-three individuals (N=73) with stroke (42 male; 61.9±12.3y).
Interventions
Not applicable.
Main Outcome Measures
Three functional domains were the primary outcomes: physical activity was defined by average steps per day as measured by a Fitbit device; depressive symptoms and self-efficacy were measured by Patient-Reported Outcomes Measurement Information System short forms. These outcome measures were collected at study enrollment and monthly thereafter for 6 months, resulting in a maximum of 7 timepoints.
Results
The depressive symptoms by self-efficacy interaction was associated with future physical activity (β=−4.67, P=.01), suggesting that higher self-efficacy positively impacts the following month’s physical activity only when depressive symptoms are low. Depressive symptoms were not associated with self-efficacy, steps per day, or their interaction in the prior month (P>.05), indicating that the relationship between depressive symptoms and physical activity is unidirectional. Finally, depressive symptoms were associated with self-efficacy in the subsequent month (β=−0.26, P<.01).
Conclusions
The longitudinal study provides evidence that (1) mitigating depressive symptoms and promoting self-efficacy may improve future physical activity; (2) addressing depressive symptoms first may lead to more effective treatment of depression, low self-efficacy, and low physical activity; and (3) treating depression may improve future self-efficacy. Together the results provide additional knowledge about the complex relationships between mobility, mood, and self-efficacy that must be carefully managed during poststroke rehabilitation.
{"title":"Temporal Relationships Between Depression, Self-Efficacy, and Physical Activity in Individuals With Stroke","authors":"Grace C. Bellinger PhD, MPH , Ryan T. Roemmich PhD , Kevin J. Psoter PhD, MPA , Stephen T. Wegener PhD , Eva Keatley PhD , Margaret A. French PT, DPT, PhD","doi":"10.1016/j.arrct.2025.100522","DOIUrl":"10.1016/j.arrct.2025.100522","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the temporal relationships between depressive symptoms, physical activity, and self-efficacy in individuals with stroke.</div></div><div><h3>Design</h3><div>Six-month prospective observational cohort study. Three separate lagged linear mixed effects models were constructed (1 with each functional domain as the dependent variable). Each model included the measure of the targeted functional domain as the dependent variable, measurements from the previous month of the 2 other functional domains and their interaction as fixed effects, participant as a random effect, and demographics and stroke characteristics as covariates.</div></div><div><h3>Setting</h3><div>General community.</div></div><div><h3>Participants</h3><div>Seventy-three individuals (N=73) with stroke (42 male; 61.9±12.3y).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Three functional domains were the primary outcomes: physical activity was defined by average steps per day as measured by a Fitbit device; depressive symptoms and self-efficacy were measured by Patient-Reported Outcomes Measurement Information System short forms. These outcome measures were collected at study enrollment and monthly thereafter for 6 months, resulting in a maximum of 7 timepoints.</div></div><div><h3>Results</h3><div>The depressive symptoms by self-efficacy interaction was associated with future physical activity (β=−4.67, <em>P</em>=.01), suggesting that higher self-efficacy positively impacts the following month’s physical activity only when depressive symptoms are low. Depressive symptoms were not associated with self-efficacy, steps per day, or their interaction in the prior month (<em>P</em>>.05), indicating that the relationship between depressive symptoms and physical activity is unidirectional. Finally, depressive symptoms were associated with self-efficacy in the subsequent month (β=−0.26, <em>P</em><.01).</div></div><div><h3>Conclusions</h3><div>The longitudinal study provides evidence that (1) mitigating depressive symptoms and promoting self-efficacy may improve future physical activity; (2) addressing depressive symptoms first may lead to more effective treatment of depression, low self-efficacy, and low physical activity; and (3) treating depression may improve future self-efficacy. Together the results provide additional knowledge about the complex relationships between mobility, mood, and self-efficacy that must be carefully managed during poststroke rehabilitation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100522"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739222","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}
To investigate the effects of olfactory stimulation with menthol on exertional dyspnea and physiological data during cycling exercise in patients with chronic obstructive pulmonary disease (COPD).
Design
Controlled trial. Patients with COPD hospitalized for pulmonary rehabilitation performed endurance exercise training using a cycle ergometer and resistance training with and without menthol to decrease respiratory sensations.
Setting
Three exercise sessions on a cycle ergometer.
Participants
Twenty-one adult patients (N=21; women; mean age ± SD, 64±8y; Global Initiative for Chronic Obstructive Lung Disease (GOLD) score IV) referred for pulmonary rehabilitation with functional chronic dyspnea (rated ≥2 on the modified Medical Research Council scale) were included.
Interventions
Session 1 without menthol, session 2 with menthol, and session 3 without menthol.
Main Outcome Measures
The primary evaluation criterion was the maximum dyspnea experienced during the sessions on a cycle ergometer. Several parameters were recorded and analyzed, including oxygen saturation, heart rate, muscle fatigue (assessed using the modified Borg scale), and dyspnea, as well as the duration of exercise, power output, and distance covered on the cycle ergometer. After completing the sessions, patients were asked about their preference regarding the use of menthol (with or without).
Results
Three types of patients were identified based on dyspnea during exercise: responders (n=7; 33%), partial responders (n=7; 33%), and nonresponders (n=7; 33%). The comparison between responders and nonresponders showed a significant difference regarding the oxygen flow rate during effort (2.5 [0.0-3.0] vs 0.0 [0.0-0.8] l/min; P=.04). No significant differences were found in the other parameters, even with the MDP questionnaire.
Conclusions
Menthol could be an adjuvant to exercise rehabilitation, improving exercise-induced dyspnea in patients with chronic dyspnea, particularly in patients with high oxygen flow during exercise.
{"title":"Effect of Menthol on Dyspnea During Exercise in Individuals With COPD","authors":"Pauline Smondack PT , Tristan Bonnevie PT, PhD , Francis-Edouard Gravier PT, PhD , Rimeh Ayari MD , Armand Bonne MD , Fairuz Boujibar PT, PhD , Yann Combret PT, PhD , Guillaume Prieur PT, PhD , Virgil Rolland MD , Grégoire Prum MD, PhD , Eric Verin MD, PhD","doi":"10.1016/j.arrct.2025.100482","DOIUrl":"10.1016/j.arrct.2025.100482","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of olfactory stimulation with menthol on exertional dyspnea and physiological data during cycling exercise in patients with chronic obstructive pulmonary disease (COPD).</div></div><div><h3>Design</h3><div>Controlled trial. Patients with COPD hospitalized for pulmonary rehabilitation performed endurance exercise training using a cycle ergometer and resistance training with and without menthol to decrease respiratory sensations.</div></div><div><h3>Setting</h3><div>Three exercise sessions on a cycle ergometer.</div></div><div><h3>Participants</h3><div>Twenty-one adult patients (N=21; women; mean age ± SD, 64±8y; Global Initiative for Chronic Obstructive Lung Disease (GOLD) score IV) referred for pulmonary rehabilitation with functional chronic dyspnea (rated ≥2 on the modified Medical Research Council scale) were included.</div></div><div><h3>Interventions</h3><div>Session 1 without menthol, session 2 with menthol, and session 3 without menthol.</div></div><div><h3>Main Outcome Measures</h3><div>The primary evaluation criterion was the maximum dyspnea experienced during the sessions on a cycle ergometer. Several parameters were recorded and analyzed, including oxygen saturation, heart rate, muscle fatigue (assessed using the modified Borg scale), and dyspnea, as well as the duration of exercise, power output, and distance covered on the cycle ergometer. After completing the sessions, patients were asked about their preference regarding the use of menthol (with or without).</div></div><div><h3>Results</h3><div>Three types of patients were identified based on dyspnea during exercise: responders (n=7; 33%), partial responders (n=7; 33%), and nonresponders (n=7; 33%). The comparison between responders and nonresponders showed a significant difference regarding the oxygen flow rate during effort (2.5 [0.0-3.0] vs 0.0 [0.0-0.8] l/min; <em>P</em>=.04). No significant differences were found in the other parameters, even with the MDP questionnaire.</div></div><div><h3>Conclusions</h3><div>Menthol could be an adjuvant to exercise rehabilitation, improving exercise-induced dyspnea in patients with chronic dyspnea, particularly in patients with high oxygen flow during exercise.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100482"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739020","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":"Letter to the Editor: Optimizing Pulmonary Health and Quality of Life in Breast Cancer Survivors: A Randomized Controlled Trial Combining Incentive Spirometry and Aerobic Exercise","authors":"Parth Aphale Ph.D, Shashank Dokania BHMS, Himanshu Shekhar BHMS","doi":"10.1016/j.arrct.2025.100538","DOIUrl":"10.1016/j.arrct.2025.100538","url":null,"abstract":"","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100538"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739177","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}
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