Pub Date : 2025-12-01Epub Date: 2025-12-13DOI: 10.1016/j.arrct.2025.100541
Dian Marta Sari MD, MSc, PhD, Irma Ruslina Defi MD, PhD, Andre Maharadja MD, Nurvita Trianasari MStat, PhD, Laurentia Cindy Gani Wijaya MD, Patricia Helena Christiani Santoso MD, Geraldi Christian Candra MD
{"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, Irma Ruslina Defi MD, PhD, Andre Maharadja MD, Nurvita Trianasari MStat, PhD, Laurentia Cindy Gani Wijaya MD, Patricia Helena Christiani Santoso MD, 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}
Pub Date : 2025-12-01Epub Date: 2025-08-27DOI: 10.1016/j.arrct.2025.100517
James S. Krause PhD , Clara E. Dismuke-Greer PhD , Melinda Jarnecke BS , Brielle D. Grant BS
Objective
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.
Design
Cross-sectional self-report study.
Setting
Medical University.
Participants
Patients (N=1253) with traumatic SCI who averaged 56.7 years of age and 24.1 years since onset.
Interventions
Not applicable.
Main Outcome Measures
Self-reported e-cigarette use, cigarette smoking history.
Results
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 current 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.
Conclusions
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.
{"title":"E-Cigarette Use Among Older Adults with Chronic Spinal Cord Injury: Relationship With History of Cigarette Smoking","authors":"James S. Krause PhD , Clara E. Dismuke-Greer PhD , Melinda Jarnecke BS , 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}
Pub Date : 2025-12-01Epub Date: 2025-09-21DOI: 10.1016/j.arrct.2025.100525
Camille E. Proulx PhD , Manouchka T. Louis Jean MSc , Johanne Higgins PhD , Dany H. Gagnon PhD
Objective
To characterize the dose and content of poststroke upper limb usual care during inpatient occupational therapy (OT) sessions.
Design
Two-week longitudinal observational study.
Setting
Publicly funded inpatient rehabilitation center.
Participants
Eight poststroke inpatients (N=8) receiving OT. No intervention groups were assigned; all participants underwent observation of usual care sessions.
Interventions
No experimental intervention was applied. The OT sessions were filmed and analyzed.
Main Outcome Measures
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.
Results
From 8 participants, 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.
Conclusions
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.
{"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 , Manouchka T. Louis Jean MSc , Johanne Higgins PhD , 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}
Pub Date : 2025-12-01Epub Date: 2025-10-11DOI: 10.1016/j.arrct.2025.100532
Stefan Metzger MA , Boris Polanco MSc , Inge Eriks-Hoogland MD, PhD , Armin Gemperli PhD , Diana Pacheco Barzallo PhD
Objective
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).
Design
Observational cohort study.
Setting
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.
Participants
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.
Interventions
Not applicable. This study used routinely collected clinical and administrative data from the clinic.
Main Outcome Measures
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.
Results
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.
Conclusions
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.
{"title":"Effective and Efficient Rehabilitation. What Works Best for Persons With SCI During (Sub)Acute Phase of Rehabilitation?","authors":"Stefan Metzger MA , Boris Polanco MSc , Inge Eriks-Hoogland MD, PhD , Armin Gemperli PhD , 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}
Pub Date : 2025-12-01Epub Date: 2025-09-18DOI: 10.1016/j.arrct.2025.100526
Kriti Agarwal MPT , Catherine M. Tansey PhD , Amanda K. Rizk PhD , Marla K. Beauchamp PhD , Bryan A. Ross MD , Jean Bourbeau MD , Maria Sedeno MM , Laura Barreto MSc , Rebecca Zucco BSc , Emily Crowley BSc , Tania Janaudis-Ferreira PhD
Objective
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.
Design
Qualitative descriptive study.
Setting
Clinics and research cohorts.
Participants
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.
Interventions
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.
Main Outcome Measures
Semistructured videoconference interviews were conducted and analyzed using deductive thematic analysis.
Results
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.
Conclusions
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.
{"title":"Perspectives of Individuals With Long COVID on Virtual Physical Rehabilitation: A Qualitative Study","authors":"Kriti Agarwal MPT , Catherine M. Tansey PhD , Amanda K. Rizk PhD , Marla K. Beauchamp PhD , Bryan A. Ross MD , Jean Bourbeau MD , Maria Sedeno MM , Laura Barreto MSc , Rebecca Zucco BSc , Emily Crowley BSc , 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}
Pub Date : 2025-09-01Epub Date: 2025-05-27DOI: 10.1016/j.arrct.2025.100464
Ava Hughes BSc , Mahdis Hashemi MD , Laura Schatz BSc , Daniel Gatenby BSc , Paul Winston MD
Cryoneurolysis is a minimally invasive procedure that induces secondary axonotmesis while preserving the nerve’s supportive structures, offering an alternative approach to managing spasticity in multiple sclerosis (MS)—a condition affecting up to 90% of patients with MS and often leading to contractures, pain, and reduced mobility. In this case report, a 48-year-old woman with progressive MS who previously experienced side effects and limited benefits from prior botulinum toxin-A injections underwent ultrasound-guided percutaneous cryoneurolysis on targeted nerves to spastic muscles identified using the response to diagnostic nerve blocks. Range of motion and spasticity were assessed using the Modified Ashworth Scale, Modified Tardieu Scale, and numerical pain ratings. The patient demonstrated marked, sustained improvements in range of motion (shoulder flexion, abduction, and external rotation and elbow extension up to 11mo and knee flexion up to 7mo) and a reduction in spasticity (at 11mo for shoulder and elbow, 4mo for knee). The patient then experienced a progressive MS crisis, and a second treatment was offered at 1 year. There were additional gains after the second round of cryoneurolysis. The procedure showed 15-fold annual cost savings in their jurisdiction compared with botulinum toxin-A, underscoring the potential economic benefits of cryoneurolysis. These findings suggest that cryoneurolysis is a promising treatment for upper and lower limb spasticity in MS, providing significant, sustained improvements in range of motion, pain, and spasticity. Further research with larger cohorts is needed to confirm the long-term efficacy, broader applicability, and fully substantiate the cost-effectiveness of this emerging treatment modality.
{"title":"Cryoneurolysis for Managing Spasticity in Multiple Sclerosis: A Case Report Demonstrating Sustained Functional Gains and Cost-Effectiveness","authors":"Ava Hughes BSc , Mahdis Hashemi MD , Laura Schatz BSc , Daniel Gatenby BSc , Paul Winston MD","doi":"10.1016/j.arrct.2025.100464","DOIUrl":"10.1016/j.arrct.2025.100464","url":null,"abstract":"<div><div>Cryoneurolysis is a minimally invasive procedure that induces secondary axonotmesis while preserving the nerve’s supportive structures, offering an alternative approach to managing spasticity in multiple sclerosis (MS)—a condition affecting up to 90% of patients with MS and often leading to contractures, pain, and reduced mobility. In this case report, a 48-year-old woman with progressive MS who previously experienced side effects and limited benefits from prior botulinum toxin-A injections underwent ultrasound-guided percutaneous cryoneurolysis on targeted nerves to spastic muscles identified using the response to diagnostic nerve blocks. Range of motion and spasticity were assessed using the Modified Ashworth Scale, Modified Tardieu Scale, and numerical pain ratings. The patient demonstrated marked, sustained improvements in range of motion (shoulder flexion, abduction, and external rotation and elbow extension up to 11mo and knee flexion up to 7mo) and a reduction in spasticity (at 11mo for shoulder and elbow, 4mo for knee). The patient then experienced a progressive MS crisis, and a second treatment was offered at 1 year. There were additional gains after the second round of cryoneurolysis. The procedure showed 15-fold annual cost savings in their jurisdiction compared with botulinum toxin-A, underscoring the potential economic benefits of cryoneurolysis. These findings suggest that cryoneurolysis is a promising treatment for upper and lower limb spasticity in MS, providing significant, sustained improvements in range of motion, pain, and spasticity. Further research with larger cohorts is needed to confirm the long-term efficacy, broader applicability, and fully substantiate the cost-effectiveness of this emerging treatment modality.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100464"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-01-13DOI: 10.1016/j.arrct.2025.100427
Kimberly Kontson PhD , Bin Wang PhD , Nicole Leung BA , John M. Miguelez CP, FAAOP(D) , Lauren Trent MOT, OTR/L
Objective
To provide evidence for test–retest reliability, interrater reliability, and convergent validity of the targeted Box and Block Test (tBBT) in the upper limb prosthesis user population.
Design
An observational study was designed to assess various psychometric properties of the novel outcome measure. Participants completed the tBBT across 2 distinct testing sessions to assess test–retest reliability, which was quantified using the intraclass correlation coefficient (ICC) (3,k) and Pearson's correlation coefficient. Multiple raters scored the tBBT to assess interrater reliability, which was quantified using the ICC(2,k) and Pearson's correlation coefficient. Convergent validity was assessed by computing the Pearson's correlation coefficient between specific subtasks of the Capacity Assessment of Prosthesis Performance for the Upper Limb (CAPPFUL) and the tBBT.
Setting
Clinic.
Participants
A convenience sample of 20 transradial, unilateral upper limb prosthesis users.
Interventions
Not applicable.
Main Outcome Measures
tBBT, Box and Block Test (BBT), and CAPPFUL.
Results
Interrater reliability for completion time and identification of unsuccessful transports were found to be excellent for the tBBT with ICC values of 0.97-0.99. Similarly, test–retest reliability was found to be good to excellent with ICC values >0.84. There were strong correlations between the scores obtained by different sessions and the scores given by different raters, with correlation coefficients exceeding 0.75. Moderate to strong correlations were found between the tBBT and BBT and subtasks of the CAPPFUL.
Conclusions
The tBBT is a valid and reliable measure to assess the functional performance of individuals using an upper limb prosthetic device. This novel measure offers benefits of ease and speed of implementation; assessment of repetitive, ecologically representative movements; and quantification of performance using both speed and accuracy.
{"title":"Test–retest Reliability, Interrater Reliability, and Convergent Validity of the Targeted Box and Block Test in an Upper Extremity Prosthesis User Population","authors":"Kimberly Kontson PhD , Bin Wang PhD , Nicole Leung BA , John M. Miguelez CP, FAAOP(D) , Lauren Trent MOT, OTR/L","doi":"10.1016/j.arrct.2025.100427","DOIUrl":"10.1016/j.arrct.2025.100427","url":null,"abstract":"<div><h3>Objective</h3><div>To provide evidence for test–retest reliability, interrater reliability, and convergent validity of the targeted Box and Block Test (tBBT) in the upper limb prosthesis user population.</div></div><div><h3>Design</h3><div>An observational study was designed to assess various psychometric properties of the novel outcome measure. Participants completed the tBBT across 2 distinct testing sessions to assess test–retest reliability, which was quantified using the intraclass correlation coefficient (ICC) (3,k) and Pearson's correlation coefficient. Multiple raters scored the tBBT to assess interrater reliability, which was quantified using the ICC(2,k) and Pearson's correlation coefficient. Convergent validity was assessed by computing the Pearson's correlation coefficient between specific subtasks of the Capacity Assessment of Prosthesis Performance for the Upper Limb (CAPPFUL) and the tBBT.</div></div><div><h3>Setting</h3><div>Clinic.</div></div><div><h3>Participants</h3><div>A convenience sample of 20 transradial, unilateral upper limb prosthesis users.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>tBBT, Box and Block Test (BBT), and CAPPFUL.</div></div><div><h3>Results</h3><div>Interrater reliability for completion time and identification of unsuccessful transports were found to be excellent for the tBBT with ICC values of 0.97-0.99. Similarly, test–retest reliability was found to be good to excellent with ICC values >0.84. There were strong correlations between the scores obtained by different sessions and the scores given by different raters, with correlation coefficients exceeding 0.75. Moderate to strong correlations were found between the tBBT and BBT and subtasks of the CAPPFUL.</div></div><div><h3>Conclusions</h3><div>The tBBT is a valid and reliable measure to assess the functional performance of individuals using an upper limb prosthetic device. This novel measure offers benefits of ease and speed of implementation; assessment of repetitive, ecologically representative movements; and quantification of performance using both speed and accuracy.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100427"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-05-30DOI: 10.1016/j.arrct.2025.100468
Katherine L. McCauley PhD , Tracey Wallace MS, CCC-SLP , Timothy P. Moran PhD , Javier Palacios BS , Dina Forehand MS, CCM , Jacquelyn Breitenstein MS, CTRS, CCM , Shannon C. Miller MD , Russell K. Gore MD
Objective
To explore initial outcomes (treatment entry and completion and staff feedback) for an interdisciplinary military traumatic brain injury (TBI) treatment program with individualized support for co-occurring substance use (SU).
Design
A quality improvement effort was undertaken to develop an integrated model of care for TBI with support for service members and veterans (SM/Vs) with co-occurring SU. We describe treatment entry and completion outcomes, along with staff feedback, collected over 26 months of program implementation.
Setting
An intensive outpatient program (IOP) for SM/Vs with TBI, administered by a not-for-profit hospital
Participants
Three hundred and sixty-four (N=364) SM/Vs applying for TBI treatment (85.2% men, 28.3% active service, median age of 41 (interquartile range, ±12)).
Interventions
An Integrated Care Model for TBI + SU was developed and flexibly applied to support client needs, including modifications to assessment, intervention, and follow-up support related to SU.
Main Outcome Measures
We report on instances of noncompletion because of SU, percentage of admission denials because of SU, demographic and clinical predictors of entering care, and qualitative feedback from treating clinicians.
Results
Over 26 months, 188 individuals entered care, and just 7 who entered the IOP did not complete, with 1 of these instances because of SU. Clinician attitudes indicate optimism about the Integrated Care Model. Predictors of entering care, analyzed using logistic regression with recursive feature elimination, included multiple demographic (sex, race, location, service status) and clinical (SU and psychiatric history, brain injury symptom severity) characteristics.
Conclusions
An interdisciplinary TBI treatment environment holds promise as a setting for incorporating SU-related support to enhance entry and completion for more SM/Vs.
{"title":"Exploring Integration of Support for Co-Occurring Substance Use-Related Needs in Interdisciplinary Traumatic Brain Injury Treatment for Military Service Members and Veterans","authors":"Katherine L. McCauley PhD , Tracey Wallace MS, CCC-SLP , Timothy P. Moran PhD , Javier Palacios BS , Dina Forehand MS, CCM , Jacquelyn Breitenstein MS, CTRS, CCM , Shannon C. Miller MD , Russell K. Gore MD","doi":"10.1016/j.arrct.2025.100468","DOIUrl":"10.1016/j.arrct.2025.100468","url":null,"abstract":"<div><h3>Objective</h3><div>To explore initial outcomes (treatment entry and completion and staff feedback) for an interdisciplinary military traumatic brain injury (TBI) treatment program with individualized support for co-occurring substance use (SU).</div></div><div><h3>Design</h3><div>A quality improvement effort was undertaken to develop an integrated model of care for TBI with support for service members and veterans (SM/Vs) with co-occurring SU. We describe treatment entry and completion outcomes, along with staff feedback, collected over 26 months of program implementation.</div></div><div><h3>Setting</h3><div>An intensive outpatient program (IOP) for SM/Vs with TBI, administered by a not-for-profit hospital</div></div><div><h3>Participants</h3><div>Three hundred and sixty-four (N=364) SM/Vs applying for TBI treatment (85.2% men, 28.3% active service, median age of 41 (interquartile range, ±12)).</div></div><div><h3>Interventions</h3><div>An Integrated Care Model for TBI + SU was developed and flexibly applied to support client needs, including modifications to assessment, intervention, and follow-up support related to SU.</div></div><div><h3>Main Outcome Measures</h3><div>We report on instances of noncompletion because of SU, percentage of admission denials because of SU, demographic and clinical predictors of entering care, and qualitative feedback from treating clinicians.</div></div><div><h3>Results</h3><div>Over 26 months, 188 individuals entered care, and just 7 who entered the IOP did not complete, with 1 of these instances because of SU. Clinician attitudes indicate optimism about the Integrated Care Model. Predictors of entering care, analyzed using logistic regression with recursive feature elimination, included multiple demographic (sex, race, location, service status) and clinical (SU and psychiatric history, brain injury symptom severity) characteristics.</div></div><div><h3>Conclusions</h3><div>An interdisciplinary TBI treatment environment holds promise as a setting for incorporating SU-related support to enhance entry and completion for more SM/Vs.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100468"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To investigate the safety and effectiveness of early cardiopulmonary rehabilitation (ECR) combined with melatonin supplementation on functional capacity and sleep quality during hospitalization in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI).
Design
Single-blinded randomized controlled trial.
Setting
Cardiology inpatient unit where patients were hospitalized after PCI.
Participants
Forty-eight male patients (N=48) with AMI followed by PCI (mean age of 57.1±8.7y) were included and randomized into 3 groups: MELEX (ECR combined with 4 mg of exogenous melatonin), EX (ECR with placebo), and CON (control group with placebo).
Interventions
Patients in the MELEX and EX groups participated in ECR, consisting of walking, passive and active range of motion, moderate-intensity strengthening exercises, and breathing exercises. The MELEX group received a daily 4 mg dose of melatonin, while the EX and CON groups received a placebo. Participants in CON group received usual care without engaging in ECR.
Main Outcomes Measures
Functional capacity was evaluated by the 6-minute walking test (6mwt). Sleep quality was assessed by the Spiegel questionnaire. Rating of perceived exertion was evaluated using the Borg Scale. Assessments were conducted on the first day after PCI and at hospital discharge.
Results
The 6mwt distance was better in the MELEX group than in the other groups exceeding the minimal clinically important differences (P<.001). Sleep quality was improved more in MELEX than EX and CON groups (P<.001). A strong-graded correlation was found between the 6mwt and Spiegel Score (r=0.730; P<.001). No adverse cardiac events related to ECR or melatonin supplementation were recorded during hospitalization.
Conclusions
ECR combined with a daily 4 mg of melatonin supplementation was safe and effective in improving functional capacity and sleep quality in patients with AMI during hospitalization after PCI.
{"title":"Effectiveness of Early Cardiorespiratory Rehabilitation Combined With Melatonin Supplementation During the Inpatient Period After Acute Myocardial Infarction: a Pilot Study","authors":"Mohamed Ali Hbaieb MSc , Salma Charfeddine MD , Tarak Driss PhD , Laurent Bosquet PhD , Benoit Dugué PhD , Leila Abid MD , Omar Hammouda PhD","doi":"10.1016/j.arrct.2025.100454","DOIUrl":"10.1016/j.arrct.2025.100454","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the safety and effectiveness of early cardiopulmonary rehabilitation (ECR) combined with melatonin supplementation on functional capacity and sleep quality during hospitalization in patients with acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (PCI).</div></div><div><h3>Design</h3><div>Single-blinded randomized controlled trial.</div></div><div><h3>Setting</h3><div>Cardiology inpatient unit where patients were hospitalized after PCI.</div></div><div><h3>Participants</h3><div>Forty-eight male patients (N=48) with AMI followed by PCI (mean age of 57.1±8.7y) were included and randomized into 3 groups: MELEX (ECR combined with 4 mg of exogenous melatonin), EX (ECR with placebo), and CON (control group with placebo).</div></div><div><h3>Interventions</h3><div>Patients in the MELEX and EX groups participated in ECR, consisting of walking, passive and active range of motion, moderate-intensity strengthening exercises, and breathing exercises. The MELEX group received a daily 4 mg dose of melatonin, while the EX and CON groups received a placebo. Participants in CON group received usual care without engaging in ECR.</div></div><div><h3>Main Outcomes Measures</h3><div>Functional capacity was evaluated by the 6-minute walking test (6mwt). Sleep quality was assessed by the Spiegel questionnaire. Rating of perceived exertion was evaluated using the Borg Scale. Assessments were conducted on the first day after PCI and at hospital discharge.</div></div><div><h3>Results</h3><div>The 6mwt distance was better in the MELEX group than in the other groups exceeding the minimal clinically important differences (<em>P</em><.001). Sleep quality was improved more in MELEX than EX and CON groups (<em>P</em><.001). A strong-graded correlation was found between the 6mwt and Spiegel Score (<em>r</em>=0.730; <em>P</em><.001). No adverse cardiac events related to ECR or melatonin supplementation were recorded during hospitalization.</div></div><div><h3>Conclusions</h3><div>ECR combined with a daily 4 mg of melatonin supplementation was safe and effective in improving functional capacity and sleep quality in patients with AMI during hospitalization after PCI.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100454"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145009901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-09-01Epub Date: 2025-05-03DOI: 10.1016/j.arrct.2025.100462
Jane T. Hein PT , Sarah Redmond PhD , Lina Daus DPT , Monica Heinemann MOT , Jon Tilburt MD , Andrea Cheville MD, MSCE
Objective
To explore barriers and facilitators experienced by therapists (physical therapists/assistants and occupational therapists/assistants) supporting the implementation of the electronic health record (EHR)-based Healing After Surgery (HAS) initiative, which used clinical decision support (CDS) elements to support therapists in providing perioperative education and support to patients for the use of evidence-based nonpharmacological pain care (NPPC) techniques as part of a health system-wide clinical trial.
Design
A cross-sectional web-based survey.
Setting
Three academic and 3 community-based hospitals from the same health system.
Participants
Therapists (N=236) who delivered the EHR-based HAS initiative.
Interventions
Not applicable.
Main Outcome Measures
Barriers and facilitators that therapists experienced implementing the EHR-based HAS initiative.
Results
We received survey responses from therapists (34.6% response rate). Using a numerical rating scale (1=not at all, 10=a great deal), therapists reported the highest agreement to questions regarding understanding the goal of the initiative (mean ± SD, 7.3±2.4) and alignment of the initiative with therapy practice (mean ± SD, 7.2±2.4), followed by alignment with patient needs (mean ± SD, 6.7±2.4). Ratings were slightly lower for understanding of their role (mean ± SD, 6.5±2.3), leadership support (mean ± SD, 6.3±2.4), and adequacy of training (mean ± SD, 6.2±2.4). Therapists rated the helpfulness of CDS elements at the midpoint of the scale, with mean ratings ranging from 5.0 to 5.1. Only 27% of therapists felt equipped to educate patients on all NPPC techniques.
Conclusions
The EHR-based HAS initiative was perceived to align with standard therapy care. However, many therapists did not feel equipped to support all NPPC techniques. Similar future efforts should address additional training needs and CDS refinement.
{"title":"Evaluating Physical and Occupational Therapists’ and Assistants’ Experiences Implementing an Electronic Health Record-Based Intervention to Support Perioperative Patients’ Use of Nonpharmacological Pain Management Techniques","authors":"Jane T. Hein PT , Sarah Redmond PhD , Lina Daus DPT , Monica Heinemann MOT , Jon Tilburt MD , Andrea Cheville MD, MSCE","doi":"10.1016/j.arrct.2025.100462","DOIUrl":"10.1016/j.arrct.2025.100462","url":null,"abstract":"<div><h3>Objective</h3><div>To explore barriers and facilitators experienced by therapists (physical therapists/assistants and occupational therapists/assistants) supporting the implementation of the electronic health record (EHR)-based Healing After Surgery (HAS) initiative, which used clinical decision support (CDS) elements to support therapists in providing perioperative education and support to patients for the use of evidence-based nonpharmacological pain care (NPPC) techniques as part of a health system-wide clinical trial.</div></div><div><h3>Design</h3><div>A cross-sectional web-based survey.</div></div><div><h3>Setting</h3><div>Three academic and 3 community-based hospitals from the same health system.</div></div><div><h3>Participants</h3><div>Therapists (N=236) who delivered the EHR-based HAS initiative.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Barriers and facilitators that therapists experienced implementing the EHR-based HAS initiative.</div></div><div><h3>Results</h3><div>We received survey responses from therapists (34.6% response rate). Using a numerical rating scale (1=not at all, 10=a great deal), therapists reported the highest agreement to questions regarding understanding the goal of the initiative (mean ± SD, 7.3±2.4) and alignment of the initiative with therapy practice (mean ± SD, 7.2±2.4), followed by alignment with patient needs (mean ± SD, 6.7±2.4). Ratings were slightly lower for understanding of their role (mean ± SD, 6.5±2.3), leadership support (mean ± SD, 6.3±2.4), and adequacy of training (mean ± SD, 6.2±2.4). Therapists rated the helpfulness of CDS elements at the midpoint of the scale, with mean ratings ranging from 5.0 to 5.1. Only 27% of therapists felt equipped to educate patients on all NPPC techniques.</div></div><div><h3>Conclusions</h3><div>The EHR-based HAS initiative was perceived to align with standard therapy care. However, many therapists did not feel equipped to support all NPPC techniques. Similar future efforts should address additional training needs and CDS refinement.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100462"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011267","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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