Archives of rehabilitation research and clinical translation最新文献

{"title":"Home-Based Gait Interventions for Adults with Stroke: A Scoping Review","authors":"Brianne Darcy PT, DPT, DHSc ,&nbsp;Kyle B. Reed PhD ,&nbsp;Stacy J.M. Bamberg ScD ,&nbsp;Donal Murray PhD, CSCS ,&nbsp;Joyce Maring EdD, DPT","doi":"10.1016/j.arrct.2025.100527","DOIUrl":"10.1016/j.arrct.2025.100527","url":null,"abstract":"<div><h3>Objective</h3><div>To map the peer-reviewed literature regarding the methods and outcomes of home-based gait interventions for adults with stroke.</div></div><div><h3>Data Sources</h3><div>PubMed, Cumulative Index To Nursing &amp; Allied Health Literature, Cochrane, Scopus, and Web of Science were searched for relevant studies based on the terms “stroke,” “gait,” “home,” and “treatment,” filtered for 2015 to 2025 publications. Searches occurred on September 12, 2024, and were updated on January 10, 2025.</div></div><div><h3>Study Selection</h3><div>Eligibility screening was performed in 2 stages: title/abstract screening and full-text review. In each stage, articles were screened against the inclusion/exclusion criteria by 2 independent reviewers.</div></div><div><h3>Data Extraction</h3><div>Using a customized spreadsheet, we extracted characteristics of the studies, demographic and clinical participant characteristics, gait treatment and assessment methodologies, and reported outcomes. One author extracted the data, and a second cross-checked for accuracy.</div></div><div><h3>Data Synthesis</h3><div>The titles/abstracts of 1923 articles were screened, and 116 articles underwent full-text review. Sixty-two studies met the eligibility criteria. The studies were conducted in 22 countries and included 3008 adults with chronic or subacute stroke. Home-based rehabilitation was used as a standalone treatment in 61% of studies and paired with or immediately after another rehabilitation intervention in 39% of studies. Gait treatment approaches included technology-integrated home programs (34%), home-use devices (19%), individualized home rehabilitation (15%), self-management or coaching-based programs (13%), home rehabilitation delivered by trained nonclinicians (11%), and task-specific training variations (8%). Gait speed and endurance were the most common assessments. Measurements frequently occurred in clinical settings. At least 60% of studies within each category reported statistically significant or clinically meaningful impacts on specific gait outcomes.</div></div><div><h3>Conclusions</h3><div>Home-based rehabilitation demonstrates global interest. Current evidence related to gait treatment is heterogeneous and shows a prevalence of technology and innovation for the home. A substantial number of preliminary studies suggest emerging treatment methods requiring robust, larger studies to determine the most beneficial treatments and contexts.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100527"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739023","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":"Comparative Efficacy of Different Prehabilitation Strategies in Colorectal Surgery Patients: A Network Meta-Analysis","authors":"Jing-Yi Gao BS ,&nbsp;Jie-Rong Ge BS ,&nbsp;Jing-Yan Cai BS ,&nbsp;Li-Hua Wang MS","doi":"10.1016/j.arrct.2025.100523","DOIUrl":"10.1016/j.arrct.2025.100523","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effect of various prehabilitation strategies on postoperative functional capacity, complication rates, length of hospital stay, and readmission rates in colorectal surgery patients through a network meta-analysis.</div></div><div><h3>Date Sources</h3><div>A systematic search was performed across PubMed, Embase, Cochrane Library, Web of Science, and Scopus from inception to April 2025.</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials comparing different prehabilitation strategies (multimodal prehabilitation, exercise-only, nutrition-only, and postoperative rehabilitation) with standard care or against each other were included<strong>.</strong></div></div><div><h3>Data Extraction</h3><div>Two investigators independently screened titles/abstracts and assessed full texts for eligibility, with discrepancies resolved through consensus or consultation with a third reviewer. The extracted data included the first author’s name, publication year, country, design, sample size, participants’ age, sex, pathology, surgical procedure, intervention type, and reported outcomes.</div></div><div><h3>Data Synthesis</h3><div>Fifteen studies involving 1290 participants were included. Compared with standard care, exercise intervention (mean difference, 62.85m; 95% CI, 9.44-116.12m) and multimodal prehabilitation (mean difference, 29.36m; 95% CI, 1.98-67.01m) significantly improved 6-minute walk test performance. Multimodal prehabilitation demonstrated superior efficacy in reducing postoperative complications (odds ratio, 0.65; 95% CI, 0.40-0.96), whereas other intervention methods showed no significant differences compared with standard care. The results of the network meta-analysis indicated that the best probability of improving the 6-minute walk test results was exercise intervention &gt; multimodal prerehabilitation &gt; nutritional intervention &gt; postoperative rehabilitation &gt; standard care. Heterogeneity across studies was low (I²&lt;30%), with minimal risk of publication bias.</div></div><div><h3>Conclusions</h3><div>Multimodal prehabilitation emerges as the optimal preoperative strategy for colorectal surgery patients, significantly reducing complication risks and enhancing functional capacity. Exercise-only interventions also demonstrate clinically meaningful benefits in functional improvement. Tailored prehabilitation protocols should be implemented based on patient-specific needs and resource availability.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100523"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739022","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":"Enhancing Outpatient Clinic Recruitment: A Quality Improvement Strategy for a Prospective Research Study","authors":"Priya D. Bolikal MD ,&nbsp;Ryan Schuetter BS ,&nbsp;Tess Guzman BS ,&nbsp;Richa Patel MPH ,&nbsp;Paul J. Gubanich MD, MPH ,&nbsp;Shari L. Wade PhD ,&nbsp;Lynn Babcock MD, MS ,&nbsp;Megan Narad PhD ,&nbsp;Sarah M. Eickmeyer MD ,&nbsp;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 (χ²=36.06, <em>P</em>&lt;.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, <em>P</em>&lt;.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}

{"title":"Women Veterans and Mobility Aids","authors":"Pooja Solanki MPH ,&nbsp;Brad E. Dicianno MD ,&nbsp;Alicia M. Koontz PhD ,&nbsp;Kelsey Berryman PhD ,&nbsp;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}

{"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 ,&nbsp;Gholamreza Raissi MD ,&nbsp;Tannaz Ahadi MD ,&nbsp;Seyed Pezhman Madani MD ,&nbsp;Simin Sajadi MD ,&nbsp;Hosna Soleymanzadeh MSc ,&nbsp;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>&lt;.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}

{"title":"Mapping Recovery: The RADAR Scale, Born From a Clinical Round","authors":"Tao He MD, PhD,&nbsp;Yongxiang Yu MB,&nbsp;Kaijie Jiang MB","doi":"10.1016/j.arrct.2025.100528","DOIUrl":"10.1016/j.arrct.2025.100528","url":null,"abstract":"<div><h3>Objective</h3><div>To introduce a novel, patient-centered assessment tool, the RADAR (Reach, Activities, Dexterity, Awareness, Role) scale, designed to quantify functional recovery and facilitate communication in patients with nerve injuries, particularly when functional improvement differs from electrophysiological data.</div></div><div><h3>Design</h3><div>This proof-of-concept study details the development and retrospective application of a new assessment scale derived from a single case observation.</div></div><div><h3>Setting</h3><div>An inpatient ward at an orthopedic center.</div></div><div><h3>Participants</h3><div>A 73-year-old woman who developed complete radial nerve palsy after a humeral shaft fracture.</div></div><div><h3>Interventions</h3><div>The patient underwent open reduction and internal fixation with radial nerve neurolysis, followed by a 7-month rehabilitation program.</div></div><div><h3>Main Outcome Measures</h3><div>The RADAR scale, a 10-item, 50-point tool assessing functional recovery, was retrospectively applied. Scores were compared with serial electromyogram reports of motor nerve amplitude.</div></div><div><h3>Results</h3><div>The patient’s total RADAR score progressively improved from 0 preoperatively to 50 at 28 weeks, closely tracking her observed functional gains. In contrast, electromyogram data showed minimal improvement, with motor nerve amplitude remaining far below normal values, demonstrating a stark function-data dissociation.</div></div><div><h3>Conclusions</h3><div>The RADAR scale can effectively quantify patient-centered functional progress that may be overlooked by standard electrophysiological tests. As a simple tool integrating assessment with shared decision making, it holds potential to improve communication and humanize care in nerve injury rehabilitation. Its validity and reliability warrant investigation in larger prospective studies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100528"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739171","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":"Role of Anxiety in Individuals with Generalized Joint Hypermobility: A Systematic Review","authors":"Janneke E. van Die-de Vries MSc ,&nbsp;Eugene Rameckers PhD ,&nbsp;Patrick Calders PhD ,&nbsp;Raoul H. Engelbert PhD ,&nbsp;Stephan P. Ramaekers PhD ,&nbsp;Marielle E. Goossens PhD ,&nbsp;Jeanine A. Verbunt PhD","doi":"10.1016/j.arrct.2025.100467","DOIUrl":"10.1016/j.arrct.2025.100467","url":null,"abstract":"<div><h3>Objective</h3><div>To present an overview of the existing knowledge of the presence of anxiety in individuals with generalized joint hypermobility (GJH) in different phases of their life.</div></div><div><h3>Data Sources</h3><div>Medline, PsychINFO, and Cochrane were searched from inception to late August 2024.</div></div><div><h3>Study Selection</h3><div>Observational studies that included participants aged &gt;12 years with GJH without comorbidities and psychiatric conditions and provided any information regarding fear or anxiety symptoms.</div></div><div><h3>Data Extraction</h3><div>Extracted data included study and population characteristics and data regarding anxiety and pain.</div></div><div><h3>Data Synthesis</h3><div>Of the 532 identified articles, 32 were included, with a total number of 12,116 subjects. Most studies (n=24) included adults aged &gt;21 years. In total, 11 studies included a population with asymptomatic GJH, and 21 included a sample with symptomatic GJH. Findings on the presence of anxiety were similar in all life phases in individuals with symptomatic GJH whereas in individuals with asymptomatic GJH, people in earlier life phases tended to report less anxiety. Pain complaints were highly frequent in populations with symptomatic GJH. Increased levels of anxiety seemed to be related to higher levels of hypermobility. The highest levels of anxiety were found in individuals with symptomatic GJH followed by those with asymptomatic GJH, who showed slightly increased (but not significant) different levels of anxiety than their peers without GJH.</div></div><div><h3>Conclusions</h3><div>Anxiety may be related to the different stages of the spectrum of GJH, in terms of severity. This review supports the need to screen for anxiety in individuals with GJH in all life phases independent of their complaints.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100467"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739017","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":"Feasibility of a Preoperative Exercise and Nutritional Intervention in Sarcopenic Obese Individuals Undergoing Hip or Knee Arthroplasty: A Pilot Randomized Controlled Trial","authors":"Ellen Oosting PhD ,&nbsp;Mirjam Holverda ,&nbsp;Jordi Elings PhD ,&nbsp;Wouter van Helden MD ,&nbsp;Marco Mensink PhD ,&nbsp;Johannes Zwerver MD, PhD","doi":"10.1016/j.arrct.2025.100524","DOIUrl":"10.1016/j.arrct.2025.100524","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility and preliminary effectiveness of a combined preoperative exercise and nutritional intervention in patients with sarcopenic obesity (SO) scheduled for total hip or knee arthroplasty.</div></div><div><h3>Design</h3><div>A pilot randomized controlled trial was conducted (May 2021 to December 2022).</div></div><div><h3>Setting</h3><div>A regional Dutch hospital.</div></div><div><h3>Participants</h3><div>Patients (N=40) with obesity before total hip arthroplasty or total knee arthroplasty (73% women, age 65±10y, body mass index, 34±3kg/m²). Recruitment achieved a 25% success rate among contacted patients.</div></div><div><h3>Interventions</h3><div>Exercise, a physiotherapist-supervised program of resistance and aerobic training twice weekly for 6 weeks, plus dietitian-guided nutritional advice to reach recommended protein intake within the habitual diet (n=21), compared with a control group receiving usual preoperative care and general dietary guidance (n=19)</div></div><div><h3>Main outcome measures</h3><div>The main outcome was feasibility and acceptability, based on recruitment, adherence, and participant feedback. Secondary outcomes included physical function, self-reported health, body composition, and inflammation markers.</div></div><div><h3>Results</h3><div>Of 40 randomized patients, 25 completed the intervention period, with many dropouts because of scheduling issues related to coronavirus disease 2019. Exercise adherence was 80%, and dietary adherence was high, with participants significantly increasing protein intake. The proportion of patients meeting the recommended protein intake (1.2g/kg) increased from 21% to 93% in the intervention group, whereas it remained at 18% in the control group. Intervention participants improved preoperative functional mobility, with the timed Up and Go test reduced by a clinically relevant difference of 2 seconds. Interviews indicated that participants continued the nutritional advice and exercise on their own initiative after surgery. Postoperative outcomes, measured by length of stay and self-reported physical functioning, were unchanged.</div></div><div><h3>Conclusions</h3><div>Despite recruitment challenges and dropouts, the intervention was feasible and well-received, with short-term functional improvements. The preoperative period offers a valuable window for lifestyle changes, though no postoperative differences were observed. Longer or more personalized interventions may further enhance outcomes.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100524"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739311","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":"Understanding Cannabis Use After Spinal Cord Injury: A Canadian Survey Study","authors":"David J. Allison PhD ,&nbsp;Sanam Ebrahimzadeh PhD ,&nbsp;Alexandria Roa Agudelo cMLA/T ,&nbsp;Arden Lawson BSc ,&nbsp;Daad Kassem BSc ,&nbsp;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}

{"title":"Barriers to Mobility in the ICU: Insights from Severe COVID-19 and Implications for Improving Patient Outcomes","authors":"Irene Kalbian MD ,&nbsp;Andrew Delgado PhD ,&nbsp;Sofia Barchuk DO ,&nbsp;Stacey Cohen MS ,&nbsp;Adel Bassily-Marcus MD ,&nbsp;Laura Tabacof MD ,&nbsp;Lisa Spielman PhD ,&nbsp;Kristen Dams-O’Connor PhD ,&nbsp;Roopa Kohli-Seth MD ,&nbsp;Neha Dangayach MD ,&nbsp;Avniel Shetreat-Klein MD, PhD ,&nbsp;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>&lt;.001), increased sedation (<em>P</em>&lt;.001), fewer ICU physical therapy visits (<em>P</em>=.001), and more frequent proning (<em>P</em>&lt;.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}