Archives of rehabilitation research and clinical translation最新文献

{"title":"Temporal Relationships Between Depression, Self-Efficacy, and Physical Activity in Individuals With Stroke","authors":"Grace C. Bellinger PhD, MPH ,&nbsp;Ryan T. Roemmich PhD ,&nbsp;Kevin J. Psoter PhD, MPA ,&nbsp;Stephen T. Wegener PhD ,&nbsp;Eva Keatley PhD ,&nbsp;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>&gt;.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>&lt;.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}

{"title":"Screening, Diagnosis, and Treatment of Cardiometabolic Risk in Persons With Spinal Cord Injury/Disease: A Scoping Review","authors":"Luxshmi Nageswaran MSc ,&nbsp;Sarah Rosenbaum ,&nbsp;Athena Ma ,&nbsp;Nita Chan BSc ,&nbsp;Dalton L. Wolfe PhD ,&nbsp;Laura J. Graham MPT, PhD ,&nbsp;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}

{"title":"Evaluating Goal Attainment Scaling for Individuals With Mild Cognitive Impairment or Dementia in Rehabilitation Settings","authors":"Praneeta Jogie MClinRehab ,&nbsp;Miia Rahja PhD ,&nbsp;Maayken van den Berg PhD ,&nbsp;Jacqui Salway BOccTherapy ,&nbsp;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}

{"title":"Effect of Menthol on Dyspnea During Exercise in Individuals With COPD","authors":"Pauline Smondack PT ,&nbsp;Tristan Bonnevie PT, PhD ,&nbsp;Francis-Edouard Gravier PT, PhD ,&nbsp;Rimeh Ayari MD ,&nbsp;Armand Bonne MD ,&nbsp;Fairuz Boujibar PT, PhD ,&nbsp;Yann Combret PT, PhD ,&nbsp;Guillaume Prieur PT, PhD ,&nbsp;Virgil Rolland MD ,&nbsp;Grégoire Prum MD, PhD ,&nbsp;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":"Age Is Not the Limit—Functional Outcomes and Discharge Predictors in a Neurorehabilitation Cohort of Mixed Ages","authors":"Mauro Silva MD ,&nbsp;Armin Schnider MD, PhD ,&nbsp;François Herrmann MD, PhD ,&nbsp;Christophe Graf MD","doi":"10.1016/j.arrct.2025.100545","DOIUrl":"10.1016/j.arrct.2025.100545","url":null,"abstract":"<div><h3>Objective</h3><div>To identify predictors of functional improvement and home discharge across a wide age spectrum in a real-world inpatient neurorehabilitation cohort, and to assess whether age independently influences rehabilitation outcomes.</div></div><div><h3>Design</h3><div>Retrospective observational cohort study.</div></div><div><h3>Setting</h3><div>Two inpatient neurorehabilitation units within a university hospital: a high-intensity program (Neurorehabilitation Unit A) and a geriatric-adapted, less intensive program (Neurorehabilitation Unit B).</div></div><div><h3>Participants</h3><div>A total of 694 patients (N=694) admitted for neurorehabilitation between January 2018 and April 2020. Mean age was 66.6±17.5 years; 47.1% were women, and 60.1% were admitted poststroke.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Home discharge; functional improvement defined as ΔFIM≥10 and Montebello Rehabilitation Factor Score (MRFS)≥0.5.</div></div><div><h3>Results</h3><div>At discharge, 74.9% of patients returned home. Functional improvement was achieved in 32.5% (ΔFIM≥10) and 18.3% (MRFS≥0.5). In multivariable models, age was not independently associated with any outcome. Positive predictors of home discharge included higher FIM score at discharge (odds ratio, 1.05; 95% CI, 1.03-1.07), lower FIM score at admission, and greater therapy intensity. Functional improvement was associated with longer length of stay and lower comorbidity burden. Use of antipsychotics (home discharge) and antidepressants (MRFS) were negatively associated with outcomes. Hospitalization in the geriatric unit (Neurorehabilitation Unit B) was associated with lower odds of recovery and discharge home, likely reflecting increased frailty and complexity.</div></div><div><h3>Conclusions</h3><div>Chronological age was not an independent predictor of home discharge or functional improvement in this mixed-age cohort; generalization to the oldest-old and markedly frail populations should be cautious. Functional status, comorbidities, and therapy factors were more relevant for prognosis. These findings support individualized, age-inclusive rehabilitation strategies that focus on clinical complexity rather than age alone.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100545"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739018","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,&nbsp;Shashank Dokania BHMS,&nbsp;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}

{"title":"Impact of Percutaneous Intercostal Nerve Stimulation Combined With Diaphragm Pacing on Respiratory Function in Cervical Spinal Cord Injury: A Case Report","authors":"Run Peng MSc ,&nbsp;Huiming Gong MD ,&nbsp;Xiaoxin Wang MD ,&nbsp;Liang Zhang MD ,&nbsp;Zitong Liu MSc ,&nbsp;Yongqi Xie MSc ,&nbsp;Shuang Guo MSc ,&nbsp;Xinqi Cao MSc ,&nbsp;Xinyue Pang MSc ,&nbsp;Mingliang Yang MD","doi":"10.1016/j.arrct.2025.100530","DOIUrl":"10.1016/j.arrct.2025.100530","url":null,"abstract":"<div><div>In the treatment of respiratory impairment because of cervical spinal cord injury, bilateral implantation of a diaphragmatic pacemaker is considered to be the most effective way to enable patients to achieve independent breathing. However, in patients who can only use unilateral diaphragmatic pacemakers, especially adolescent children, the use of unilateral diaphragmatic pacemakers may have an effect on the productive development of such patients, which can lead to thoracic deformities and a decrease in the efficiency of pacing. This study presents a case of a pediatric patient with high cervical spinal cord injury who underwent unilateral implanted diaphragm pacing (IDP) combined with bilateral percutaneous intercostal nerve stimulation. The results demonstrated that intercostal nerve stimulation led to an increase in tidal volume. After 14 days of treatment and follow-up, a further increase in tidal volume was observed. These findings suggest that percutaneous intercostal nerve stimulation may serve as a viable adjunctive therapy for respiratory rehabilitation in patients with cervical spinal cord injury.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100530"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739176","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":"Early Feasibility and Efficacy of a Novel Skill-Based Training Program for Poststroke Dysphagia","authors":"Mariana M. Bahia PhD, CCC-SLP ,&nbsp;Julia Carpenter MA, CCC-SLP ,&nbsp;Kelly Rogers MA, CCC-SLP ,&nbsp;Leora R. Cherney PhD, CCC-SLP","doi":"10.1016/j.arrct.2025.100535","DOIUrl":"10.1016/j.arrct.2025.100535","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To develop a skill-based swallowing training program for poststroke survivors with dysphagia, to examine the acceptability, appropriateness, and feasibility of the program from the perspective of clinicians and researchers, and to investigate the early efficacy of the program.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;The Plan-Do-Study-Act framework was used to conduct a clinician survey and to measure within-subject changes pre and posttreatment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Inpatient rehabilitation hospital.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Fifteen swallowing clinicians and 7 researchers with a background in speech-language pathology responded to a survey about the intervention’s acceptability, appropriateness, and feasibility (n = 22). Two patients (a 56y woman and a 33y man) with moderate-severe dysphagia secondary to poststroke received the swallowing intervention during inpatient rehabilitation (n = 2).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;The Effort Accuracy Timing-Skill Training Applied to Rehabilitation in Swallowing (EAT-STARS) program is a novel, systematic, and progressive skill-based training program designed to improve swallowing function in poststroke dysphagia. The program consists of up to 8 treatment sessions, spanning 2 weeks, and incorporates principles of motor learning and neuroplasticity to enhance participants’ ability to recognize correct/incorrect motor patterns, thereby promoting skill acquisition and mastery. It requires patients to generate different levels of swallowing effort (ie, regular swallow, effortful swallow) and control the timing of swallowing (ie, prompt swallow, swallow with bolus hold) using real-time surface electromyography visual biofeedback.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Clinicians and researchers answered a survey that included the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measurequestionnaires. The early efficacy of the EAT-STARS program was assessed through standardized pre- and postswallowing measurements, including the Mann Assessment of Swallowing Ability, the Modified Barium Swallowing Impairment Profile, the Eating Assessment Tool, and a visual analog scale to indicate patient-perceived swallowing difficulty.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The EAT-STARS program met preestablished cutoff scores for the Acceptability of Intervention Measure (90%), Intervention Appropriateness Measure (87.5%), and Feasibility of Intervention Measure (83.4%) measures, indicating excellent acceptability, appropriateness, and feasibility, respectively. The early efficacy measures indicated that patients demonstrated improvements in both clinical swallowing ability and swallowing physiologyposttreatment. Moreover, patients reported perceived improvements in swallowing (visual analog scale and Eating Assessment Tool).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The novel EAT-STARS pr","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100535"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739126","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":"Changes in Gait After Training for Individuals With Cerebellar Ataxia","authors":"Affan Smani ,&nbsp;Seonjoo Lee PhD ,&nbsp;Michael Spinner MS ,&nbsp;Scott Barbuto MD, PhD","doi":"10.1016/j.arrct.2025.100540","DOIUrl":"10.1016/j.arrct.2025.100540","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate gait changes for individuals who performed either home aerobic or balance training.</div></div><div><h3>Design</h3><div>Single-blind randomized clinical trial.</div></div><div><h3>Setting</h3><div>Home training and outcome assessments at large, tertiary, urban hospital.</div></div><div><h3>Participants</h3><div>Individuals with cerebellar ataxia (N=52).</div></div><div><h3>Interventions</h3><div>Individuals in the aerobic group trained 30 minutes per session, 5 times per week at up to 85% predicted maximum heart rate. Individuals in the balance group (control) performed 30 minutes of balance exercises of varying difficulty 5 times per week. Participants in both groups were expected to train for 1 year.</div></div><div><h3>Main Outcome Measures</h3><div>Gait parameters (step length, step variability, stride width, gait velocity) were determined at 0, 6, and 12 months.</div></div><div><h3>Results</h3><div>Of the 52 individuals who agreed to participate, 24 individuals in each group had gait analysis performed. At 12 months, 20 and 19 participants had gait analysis performed in the balance and aerobic groups, respectively. Linear mixed effect model analysis was used to determine difference between individuals in the balance versus the aerobic group. Step length was the only parameter that showed statistically significant improvement with aerobic training over balance training (6mo: <span><math><mi>β</mi></math></span>, 4.1 cm; 95% CI, 0.76-7.42; <em>P</em>=.03; 12mo: <span><math><mi>β</mi></math></span>, 4.1 cm; 95% CI, 0.33-7.82; <em>P</em>=.04). We also found that individuals who hit training goals (either balance or aerobic) had statistically significant improvements in step length (6mo: <span><math><mi>β</mi></math></span>, 7.15 cm; 95% CI, 3.87-10.42; <em>P</em>&lt;.001; 12mo: <span><math><mi>β</mi></math></span>, 7.16 cm; 95% CI, 4.20-10.13; <em>P</em>&lt;.001), stride width (6mo: <span><math><mi>β</mi></math></span>, −2.72 cm; 95% CI, −4.33 to −1.11; <em>P</em>=.001; 12mo: <span><math><mi>β</mi></math></span>, −2.29 cm; 95% CI, −3.72 to −0.86; <em>P</em>=.002), and gait speed (6mo: <span><math><mi>β</mi></math></span>, 15.26 cm/s; 95% CI, 5.16-25.36; <em>P</em>=.004; 12mo: <span><math><mi>β</mi></math></span>, 16.85 cm/s; 95% CI, 7.89-25.80; <em>P</em>&lt;.001) compared to those who did not hit training goals. Step variability was not improved with either training.</div></div><div><h3>Conclusions</h3><div>There was a minor improvement of increased step length in individuals with ataxia who performed home aerobic training compared to home balance training. However, individuals with ataxia who regularly performed either type of home training had statistically significant improvements in multiple gait parameters compared to those who did not train regularly.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100540"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739123","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":"Rehabilitation of High-Level Dynamic Balance Skills in an Individual With Significant Nonprogressive Cerebellar Atrophy: Case Report","authors":"Earllaine Croarkin PT, MPT ,&nbsp;Joseph A. Shrader PT ,&nbsp;Pashtun Shahim MD, PhD ,&nbsp;Simge Yonter MD ,&nbsp;Camilo Toro MD ,&nbsp;Cris Zampieri PT, PhD","doi":"10.1016/j.arrct.2025.100500","DOIUrl":"10.1016/j.arrct.2025.100500","url":null,"abstract":"<div><div>A 46-year-old man received a course of quinolone-family antibiotics for puncture wound-related cellulitis. Cerebellar symptoms developed within 3 weeks of treatment, progressed over 6 months, and then became static. Seven years later, he received an individualized 12-week-long course of physical therapy to challenge his balance with high-level fall-inducing but safe dynamic activities. Outcome measures included the International Cooperative Ataxia Rating Scale, modified Dynamic Gait Index, instrumented gait analysis, and posturography. The total modified dynamic gait index score improved 4 points. Gait velocity increased and reached a meaningful clinically important difference threshold. Step length increased, and step width and toeing out decreased. Reaction times, movement velocities, and center of gravity excursions improved on the limits of stability test. He increased frontal and sagittal speed on the rhythmic weight shift test and became able to jump vertically and run with hand support on a treadmill. The results highlight the benefits of an individualized physical therapy program for a patient with chronic nonprogressive cerebellar deficits years after the original insult. Factors that may have contributed to the success of this case are the nonprogressive nature of the disorder, a harness system that allowed for sufficiently challenging repetitions, and the patient’s physically fit and disciplined characteristics.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100500"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739228","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}