Archives of rehabilitation research and clinical translation最新文献

{"title":"Therapeutic Effects of Noninvasive Technology Modalities on Lower-Limb Motor Function in Spinal Cord Injury: A Systematic Review","authors":"Siti Ainun Marufa MSc ,&nbsp;Hung-Yen Chin MD ,&nbsp;Bor-Shing Lin PhD ,&nbsp;Hung-Chou Chen PhD ,&nbsp;Tsung-Hsun Hsieh PhD ,&nbsp;Wei-Lun Lo PhD ,&nbsp;Chun-Wei Wu PhD ,&nbsp;Yu-Ting Li PhD ,&nbsp;Zidni Immanurohmah Lubis MSc ,&nbsp;Nurul Aini Rahmawati MSc ,&nbsp;Kurnia Putri Utami MSc ,&nbsp;Chih-Wei Peng PhD","doi":"10.1016/j.arrct.2025.100536","DOIUrl":"10.1016/j.arrct.2025.100536","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically evaluate the effects of noninvasive technology modalities, defined as externally applied stimulation or feedback devices, on lower-limb motor outcomes in individuals with spinal cord injury (SCI), addressing gaps in generalizability and classification to support evidence-based rehabilitation strategies.</div></div><div><h3>Data Sources</h3><div>We systematically searched PubMed, Web of Science, EMBASE, and the Cochrane Library for English-language articles from database inception to 2023 (initial search conducted in April 2024 and updated in January 2025).</div></div><div><h3>Study Selection</h3><div>We included randomized controlled trials involving adults with SCI that investigated noninvasive technology modalities applied to any body region and reported outcomes related to motor score, muscle performance, or walking ability. Of 2325 records screened, 22 full-text articles were independently evaluated by 2 reviewers, and 11 met the inclusion criteria and were included in the review.</div></div><div><h3>Data Extraction</h3><div>Two reviewers independently extracted data from eligible studies, with disagreements resolved through consensus with a third reviewer. The risk of bias (RoB) was assessed using the Cochrane RoB 2 tool by 2 reviewers.</div></div><div><h3>Data Synthesis</h3><div>Across the included studies (224 participants; mean age=44.9 y), interventions typically consisted of 30-minute sessions, 4 times weekly, over 6 weeks. Four studies applied transcranial stimulation, 4 used transspinal stimulation, and 3 targeted muscle stimulation. Outcomes were evaluated in 4 studies for motor score, 7 for muscle performance, and 7 for walking ability. Most interventions, combined with standard rehabilitation, showed improvements across these outcomes, although only a subset demonstrated statistically significant between-group effects. RoB was low in 6 studies, had some concerns in 3, and was high in 2.</div></div><div><h3>Conclusions</h3><div>Noninvasive modalities appear effective in enhancing lower-limb motor function in individuals with SCI. However, variability in intervention protocols and methodological quality limits the ability to draw definitive conclusions. Further studies should standardize protocols and minimize bias to strengthen the evidence for SCI rehabilitation strategies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100536"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739129","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":"Post-COVID Rehabilitation Outcomes: A Comparative Cohort Study","authors":"Ferdinand Prüfer MSc ,&nbsp;Alexander Kautzky PhD ,&nbsp;Alexandra Unger PhD ,&nbsp;Špela Matko MSc ,&nbsp;Michael J. Fischer PhD ,&nbsp;Ralf Harun Zwick MD ,&nbsp;Vincent Grote PhD","doi":"10.1016/j.arrct.2025.100516","DOIUrl":"10.1016/j.arrct.2025.100516","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate and compare rehabilitation outcomes in patients with post-COVID syndrome (post-COVID) vs those with pulmonary, cardiovascular, metabolic, and orthopedic conditions.</div></div><div><h3>Design</h3><div>Monocentric comparative cohort pre-post study.</div></div><div><h3>Setting</h3><div>Outpatient rehabilitation center.</div></div><div><h3>Participants</h3><div>Consecutive sample of 597 outpatient rehabilitation patients (N=597) (post-COVID, 227; orthopedic disorder, 147; cardiovascular disorder, 84; metabolic disorder, 83; chronic obstructive pulmonary disease [COPD], 35; asthma, 24) aged 50.3±12.7 years, 54.6% women.</div></div><div><h3>Interventions</h3><div>Individualized, multidisciplinary outpatient rehabilitation (6-10wk, total 3.000min, minimum 3sessions/wk, and 2-3h/session) including strength/endurance training, physiotherapy, psychological support, and nutritional counseling.</div></div><div><h3>Main Outcome Measures</h3><div>Physical function was assessed with the 6-minute walking test (6MWT), and quality of life (QOL) with the 5-level EuroQol 5-dimensional questionnaire were measured at admission and discharge of outpatient rehabilitation. Differences within and between groups were analyzed using the analysis of variance, and the effect of baseline values on the outcome’s performance was modeled.</div></div><div><h3>Results</h3><div>The Post-COVID group was younger (44.7±12.6y), and the percentage of women (75.4%) was higher than in other outpatient rehabilitation groups. All groups improved significantly during rehabilitation. Patients with post-COVID showed the lowest baseline and discharge QOL scores. Baseline-adjusted scores demonstrated that, despite overall improvements, the post-COVID group reported significantly lower QOL than other outpatient rehabilitation groups, except the COPD group. In contrast, the post-COVID group achieved the highest physical function gains in 6MWT (+60.4m, <em>P</em>&lt;.001). Baseline-adjusted scores indicated the highest physical function in patients with post-COVID (6MWT, PC = 632.4 m vs ALL = 603.4 m), outperforming all other outpatient rehabilitation groups. Baseline and change scores were negatively correlated, highlighting the need for baseline adjustment.</div></div><div><h3>Conclusions</h3><div>Although outpatient rehabilitation was associated with improvements in physical function in patients with post-COVID, QOL deficits persist, discordant with other common outpatient rehabilitation indications. Targeted rehabilitation strategies addressing mental health and fatigue are needed to optimize post-COVID recovery.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100516"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739179","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 a 2-Month Program of Eccentric Training on Plantar Flexor Structure and Function in Hemiparesis After Stroke","authors":"Maud Pradines PT, PhD ,&nbsp;François Jabouille PT, MSc ,&nbsp;Marjolaine Baude MD, PhD ,&nbsp;Jean-Michel Gracies MD, PhD ,&nbsp;Karine Gros PhD ,&nbsp;Waël Maktouf PhD ,&nbsp;Marina Guihard PhD","doi":"10.1016/j.arrct.2025.100496","DOIUrl":"10.1016/j.arrct.2025.100496","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of isokinetic eccentric training (ECC) in hemiparesis on plantar flexor muscle structure and function.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Neurorehabilitation unit.</div></div><div><h3>Participants</h3><div>Twenty adult (N=20) community-dwelling outpatients with chronic stroke-induced hemiparesis (&gt;6 mo) were recruited (n=10/group); median age: 59 (interquartile range [IQR], 55-64) years, sex: 15 men, 5 women; median time since lesion: 63 (IQR, 50-104) months.</div></div><div><h3>Interventions</h3><div>Subjects were randomized into two 8-week rehabilitation programs: ECC group, involving 3 sessions/wk of plantar flexor ECC training, and a conventional group, with continuation of usual rehabilitation.</div></div><div><h3>Main Outcome Measures</h3><div>(1) Fascicle length and thickness of medial gastrocnemius (MG) and soleus (SOL), knee extended, at 80% maximal clinical extensibility of gastrocnemius in an isokinetic ergometer; (2) The MG and SOL agonist and antagonist electromyographic activity normalized to the amplitude of the maximum motor response during maximal isometric torques in plantar flexion and dorsiflexion; and (3) maximal barefoot 10-m ambulation speed. Parameters were collected by blinded evaluators at day 1 and week 8.</div></div><div><h3>Results</h3><div>At week 8, significant between-group differences were observed for the ECC group, including: SOL fascicle length, +11.1 mm (<em>P</em>=.004, Rank-ANCOVA); SOL thickness: +1.9 mm (<em>P</em>=.007); MG thickness: +1.0 mm (<em>P</em>=.002); increased MG agonist recruitment: +0.015 (<em>P</em>=3 × 10⁻⁴); and decreased MG cocontraction: −0.003 (<em>P</em>=.007). No between-group difference in ambulation speed, maximal torque, or neural command to SOL were observed.</div></div><div><h3>Conclusions</h3><div>In individuals with chronic hemiparesis, ECC training of plantar flexors is feasible and may improve their spastic myopathy, and command to gastrocnemius.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100496"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738924","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":"Efficacy of Home-Based Physical Exercise in Stroke Survivors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Mazen A. Basheikh MD,&nbsp;Adnan A. Badahdah MD","doi":"10.1016/j.arrct.2025.100494","DOIUrl":"10.1016/j.arrct.2025.100494","url":null,"abstract":"<div><h3>Objectives</h3><div>Stroke survivors face a significant burden of disability, necessitating regular activity to improve their functional abilities, well-being, and quality of life. We conducted this systematic review and meta-analysis to assess the feasibility and effectiveness of professionally supervised, home-based rehabilitation in stroke survivors.</div></div><div><h3>Data Sources</h3><div>A comprehensive search of PubMed, Scopus, and Web of Science was carried out from inception until December 2023.</div></div><div><h3>Study Selection</h3><div>We included randomized controlled trials assessing the effectiveness of home-based rehabilitation under professional supervision (intervention) for stroke patients compared with hospital-based, unsupervised home exercise, or no therapy (control).</div></div><div><h3>Data Extraction</h3><div>We extracted and analyzed the mean difference (MD) between groups in improvements using various rehabilitation assessment scales: Fugl-Meyer Assessment (FMA), Barthel Index (BI), Modified Barthel Index, Berg Balance Scale, 6-minute walk test, and Modified Ashworth Scale.</div></div><div><h3>Data Synthesis</h3><div>Seventeen articles were eligible for meta-analysis. The intervention group showed significantly higher BI scores in both early (MD, 2.71; 95% CI, 0.14-5.28; <em>P</em>=.04) and late stages (MD, 4.53; 95% CI, 1.67-7.4; <em>P</em>=.002) compared with controls. The Modified Barthel Index was also significantly higher in the home-based group (MD, 5.12; 95% CI, 1.63-8.62; <em>P</em>=.004). For FMA, significant differences were observed only after 3 months (MD, 3.99; 95% CI, 2.87-5.11; <em>P</em>&lt;.0001) favoring the intervention group. Similarly, the 6-minute walk test results favored the intervention group (MD, 27.5; 95% CI, 14.72-40.29; <em>P</em>&lt;.0001). No significant differences were observed in the Berg Balance Scale and Modified Ashworth Scale between groups. Subgroup analysis confirmed the superior effectiveness of home-based rehabilitation compared with both center-based rehabilitation and unsupervised home exercise in improving BI and FMA scores.</div></div><div><h3>Conclusions</h3><div>This systematic review and meta-analysis of randomized controlled trials suggests that home-based rehabilitation under professional supervision among stroke survivors facilitates more rapid and substantial improvements relative to hospital-based rehabilitation and unsupervised home exercise.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100494"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739019","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":"Relationship between Hospitalization-Associated Disability and Functional Recovery","authors":"Haruka Adachi MSc ,&nbsp;Wataru Kozuki PhD ,&nbsp;Aki Gen PhD ,&nbsp;Ryo Tsujinaka MSc ,&nbsp;Tetsuya Ueda PhD ,&nbsp;Yumi Higuchi PhD","doi":"10.1016/j.arrct.2025.100529","DOIUrl":"10.1016/j.arrct.2025.100529","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the relationship between the timing of functional recovery milestones and hospitalization-associated disability (HAD) in geriatric patients ≥70 years old.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>A general acute care hospital.</div></div><div><h3>Participants</h3><div>A total of 195 patients (N=195) aged ≥70 years (mean age 81.7±7.4y; 48.2% women) who were hospitalized for acute medical conditions. Patients with baseline disability or missing key data were excluded.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The HAD was defined as a ≥5-point decline in the Barthel Index compared to baseline functioning 2 weeks before admission. The relationship between HAD and the number of days to initiation of sitting, wheelchair transfer, and ambulation was examined.</div></div><div><h3>Results</h3><div>The HAD occurred in 34.4% of patients. Those who developed HAD experienced significant delays in the initiation of sitting, wheelchair transfers, and ambulation. Multivariable logistic regression analysis showed that delayed initiation of wheelchair transfer and ambulation were independently associated with HAD, after adjusting for age, Barthel Index at admission, dementia, emergency admission, and total physical therapy time. Notably, the timing of ambulation initiation demonstrated moderate predictive ability for HAD (area under the curve=0.741; 95% CI, 0.656-0.825), with receiver operating characteristic analysis indicating a cut-off value of 1.5 days.</div></div><div><h3>Conclusions</h3><div>Delayed initiation of wheelchair transfer and ambulation was associated with increased risk of HAD in older hospitalized patients. Early initiation of ambulation may serve as a key target for HAD prevention strategies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100529"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739128","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":"Bridging Research and Practice: A Preliminary Detailed Analysis of Current Upper Limb Occupational Therapy Dose and Content in Publicly Funded Poststroke Rehabilitation","authors":"Camille E. Proulx PhD ,&nbsp;Manouchka T. Louis Jean MSc ,&nbsp;Johanne Higgins PhD ,&nbsp;Dany H. Gagnon PhD","doi":"10.1016/j.arrct.2025.100525","DOIUrl":"10.1016/j.arrct.2025.100525","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the dose and content of poststroke upper limb usual care during inpatient occupational therapy (OT) sessions.</div></div><div><h3>Design</h3><div>Two-week longitudinal observational study.</div></div><div><h3>Setting</h3><div>Publicly funded inpatient rehabilitation center.</div></div><div><h3>Participants</h3><div>Eight poststroke inpatients (N=8) receiving OT. No intervention groups were assigned; all participants underwent observation of usual care sessions.</div></div><div><h3>Interventions</h3><div>No experimental intervention was applied. The OT sessions were filmed and analyzed.</div></div><div><h3>Main Outcome Measures</h3><div>Session dose (frequency, time in OT, time allocated to upper-limb rehabilitation, repetition intensity) and content (rehabilitation activity types, upper-limb movement types), analyzed using a video-synchronized observational data collection system.</div></div><div><h3>Results</h3><div>From 8 participants<strong>,</strong> a total of 42 sessions were videotaped, translating into 2250 minutes of OT session dose and content. On average, 28.6±16.1 minutes (53.3% of total session time) was dedicated specifically to upper-limb movements. During this time, participants performed a mean of 209.9±175.7 upper-limb movement repetitions per session, most of which involved reaching movements (mean=111.5±97.7). Additionally, most of the time spent on upper-limb movements (mean=15.8±13.1 minutes) focused on active activities.</div></div><div><h3>Conclusions</h3><div>This study offered valuable insights into the current dose and content of inpatient OT sessions for upper-limb rehabilitation in a publicly funded rehabilitation center. These findings can inform strategies to optimize stroke rehabilitation outcomes, with future research focusing on adapting them to real-world clinical settings.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100525"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739170","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":"E-Cigarette Use Among Older Adults with Chronic Spinal Cord Injury: Relationship With History of Cigarette Smoking","authors":"James S. Krause PhD ,&nbsp;Clara E. Dismuke-Greer PhD ,&nbsp;Melinda Jarnecke BS ,&nbsp;Brielle D. Grant BS","doi":"10.1016/j.arrct.2025.100517","DOIUrl":"10.1016/j.arrct.2025.100517","url":null,"abstract":"<div><h3>Objective</h3><div>To identify self-reported electronic cigarette use and its associations with demographic, spinal cord injury (SCI), socioeconomic, and cigarette smoking history variables among adults with SCI.</div></div><div><h3>Design</h3><div>Cross-sectional self-report study.</div></div><div><h3>Setting</h3><div>Medical University.</div></div><div><h3>Participants</h3><div>Patients (N=1253) with traumatic SCI who averaged 56.7 years of age and 24.1 years since onset.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Self-reported e-cigarette use, cigarette smoking history.</div></div><div><h3>Results</h3><div>16.3% had used e-cigarettes and 4.9% were current users. Both current cigarette smoking (odds ratio [OR], 4.20; confidence interval [CI], 2.45-7.18) and smoking history (OR, 3.55; CI, 2.25-5.60) were related to a history of vaping, as was having some college, but no degree compared with those with no education beyond high school (OR, 1.89; CI, 1.15-3.13). Non-Hispanic Black participants reported lower odds of vaping history than non-Hispanic whites (OR, 0.55; CI, 0.31-0.96). Compared with those under 40, each of 3 age groups reported lower odds of a history of vaping. Odds of <em>current</em> e-cigarette use were higher among those with a smoking history (OR, 5.71; CI, 2.62-12.42); and lower for those between the ages of 51-60 (OR, 0.37, CI, 0.14-0.96) and those 60 and older (OR, 0.11, CI, 0.03-0.38), compared with those under the age of 40.</div></div><div><h3>Conclusions</h3><div>E-cigarette was most strongly related to age and smoking history. It is important to evaluate e-cigarette use and their potential consequences and implement intervention strategies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100517"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739224","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":"Response to 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":"Dian Marta Sari MD, MSc, PhD,&nbsp;Irma Ruslina Defi MD, PhD,&nbsp;Andre Maharadja MD,&nbsp;Nurvita Trianasari MStat, PhD,&nbsp;Laurentia Cindy Gani Wijaya MD,&nbsp;Patricia Helena Christiani Santoso MD,&nbsp;Geraldi Christian Candra MD","doi":"10.1016/j.arrct.2025.100541","DOIUrl":"10.1016/j.arrct.2025.100541","url":null,"abstract":"","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100541"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739226","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":"Effective and Efficient Rehabilitation. What Works Best for Persons With SCI During (Sub)Acute Phase of Rehabilitation?","authors":"Stefan Metzger MA ,&nbsp;Boris Polanco MSc ,&nbsp;Inge Eriks-Hoogland MD, PhD ,&nbsp;Armin Gemperli PhD ,&nbsp;Diana Pacheco Barzallo PhD","doi":"10.1016/j.arrct.2025.100532","DOIUrl":"10.1016/j.arrct.2025.100532","url":null,"abstract":"<div><h3>Objective</h3><div>To estimate the effectiveness and efficiency of comprehensive rehabilitation in improving the score of the spinal cord independence measure III (SCIM) for individuals with spinal cord injury/disease (SCI/D).</div></div><div><h3>Design</h3><div>Observational cohort study.</div></div><div><h3>Setting</h3><div>A specialized spinal cord injury (SCI) rehabilitation clinic in Switzerland that admits patients from across the country and provides (sub)acute rehabilitation following SCI/D.</div></div><div><h3>Participants</h3><div>This study analyzes the clinical data of 383 patients (N=383) who received rehabilitation from a specialized spinal cord injury hospital and rehabilitation center in Switzerland from 2017 to 2020.</div></div><div><h3>Interventions</h3><div>Not applicable. This study used routinely collected clinical and administrative data from the clinic.</div></div><div><h3>Main Outcome Measures</h3><div>We estimated the average effectiveness by computing how the SCIM changed from admission to discharge during the (sub)acute phase of rehabilitation. To compute the efficiency of rehabilitation, we used 2 measures: 1. length of hospital stay and 2. severity of the services a person received. The results were adjusted by patients’ characteristics, using a generalized additive model.</div></div><div><h3>Results</h3><div>Comprehensive (sub)acute rehabilitation for persons with SCI/D is effective, with an average improvement of 35.7 SCIM points. Key factors influencing rehabilitation effectiveness included sex, age, etiology, number of comorbidities, and injury group. Rehabilitation efficiency increases by an average of 0.34 SCIM points per day, or 0.30 SCIM points per Swiss francs (CHF) 1,000.</div></div><div><h3>Conclusions</h3><div>Rehabilitation for persons with SCI/D is shown to be effective. However, there is variability in clinical outcomes and severity across injury groups, emphasizing the need for tailored clinical management strategies. Further research is needed to deepen the understanding of clinical outcome variability and efficiency factors by considering the severity of services.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100532"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739125","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":"Perspectives of Individuals With Long COVID on Virtual Physical Rehabilitation: A Qualitative Study","authors":"Kriti Agarwal MPT ,&nbsp;Catherine M. Tansey PhD ,&nbsp;Amanda K. Rizk PhD ,&nbsp;Marla K. Beauchamp PhD ,&nbsp;Bryan A. Ross MD ,&nbsp;Jean Bourbeau MD ,&nbsp;Maria Sedeno MM ,&nbsp;Laura Barreto MSc ,&nbsp;Rebecca Zucco BSc ,&nbsp;Emily Crowley BSc ,&nbsp;Tania Janaudis-Ferreira PhD","doi":"10.1016/j.arrct.2025.100526","DOIUrl":"10.1016/j.arrct.2025.100526","url":null,"abstract":"<div><h3>Objective</h3><div>Coronavirus disease 2019 is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2, and long COVID is a chronic condition characterized by symptoms persisting for atleast 3 months after infection. To explore the perspectives of individuals with long COVID after an 8-week virtual physical rehabilitation program.</div></div><div><h3>Design</h3><div>Qualitative descriptive study.</div></div><div><h3>Setting</h3><div>Clinics and research cohorts.</div></div><div><h3>Participants</h3><div>Adults (n=132) with confirmed or probable COVID-19 infection and persistent symptoms, including reduced mobility, muscle weakness, dyspnea, and/or fatigue, were recruited in a randomized controlled trial. Thirteen intervention group participants who completed the rehabilitation program were included in this qualitative study.</div></div><div><h3>Interventions</h3><div>The intervention group (n=65) received 8 weeks of tailored, symptom-titrated exercises, weekly educational sessions, and usual care, whereas the control group (n=67) received only usual care.</div></div><div><h3>Main Outcome Measures</h3><div>Semistructured videoconference interviews were conducted and analyzed using deductive thematic analysis.</div></div><div><h3>Results</h3><div>Participants’ age (mean ± SD) was 48.3±15.6 years, 6 had been hospitalized during their COVID-19 infection, and the duration of long COVID (mean ± SD) was 18.8±7.2 months. Four themes were identified: (1) Motivation and confidence: most participants expressed confidence in joining the program, motivated by health goals, scientific contribution, and reassurance from professional support. (2) Program features: the program was praised for its well-organized format, ideal duration, convenient scheduling, supportive kinesiologists, and individualized exercise plans. (3) Health effects: while most reported physical and emotional improvements (eg, increased energy, mobility, and confidence), some noted challenges upon returning to work. (4) Post-program suggestions: participants intended to continue exercising but faced barriers such as fatigue and a lack of motivation, highlighting the need for continued support and resources to maintain progress.</div></div><div><h3>Conclusions</h3><div>This study highlights the positive effects and relevant challenges associated with completing an 8-week personalized, symptom-titrated virtual physical rehabilitation program for individuals with long COVID, emphasizing the need for tailored support and ongoing resources to facilitate sustained recovery.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 4","pages":"Article 100526"},"PeriodicalIF":2.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739310","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}