Archives of rehabilitation research and clinical translation最新文献_第8页

Comparing Dry Needle Therapy and Extracorporeal Shockwave Therapy for Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials 比较干针疗法和体外冲击波疗法治疗腱鞘病：随机对照试验的系统回顾和荟萃分析

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100432

Zonglin Li MD , Yubin Chen MD , Lili Chen MD , Jinshen He MD

Objective

To conduct a systematic review and meta-analysis to assess the effects of extracorporeal shockwave therapy (ESWT) and needling therapy in the treatment of tendinopathy.

Data sources

PubMed (Medline), the Cochrane Library, and Web of Science were searched from August 5, 2024, to August 25, 2024, for comparative studies of needling therapy and ESWT for the treatment of tendinopathy published between January 1, 2000, and August 5, 2024.

Study Selection

Two reviewers independently reviewed randomized controlled trials (RCTs) that reported a comparison of needling therapy and ESWT for tendinopathy for inclusion eligibility.

Data Extraction

Outcomes of interest were the visual analog scale (VAS) score and pressure pain threshold (PPT) score. Two reviewers independently assessed the quality of the included RCTs with the Cochrane risk of bias tool. Effect sizes were estimated using mean differences (MDs), and the significance level was estimated using the P value of the overall effect.

Data Synthesis

Nine RCTs involving 528 patients were deemed suitable for inclusion. Six RCTs involving 318 patients revealed that VAS scores showed no significant difference between ESWT and dry needling in either the immediate (MD, 0.06; 95% CI, −0.30 to 0.43; P=.73) or delayed effects (MD, −0.46; 95% CI, −2.10 to 1.18; P=.59). Two RCTs involving 132 patients revealed that PPT scores showed no significant difference between ESWT and dry needling in delayed effects (MD, −0.08; 95% CI, −0.30 to 0.14; P=.49). Three studies that enrolled 161 subjects concluded that ESWT combined with dry needling therapy was statistically more effective in reducing VAS scores in patients with tendinopathy than pure ESWT for delayed effects (MD, −1.79; 95% CI, −2.60 to −0.97; P<.0001).

Conclusions

This meta-analysis shows that the combination of ESWT with needling therapy is more effective in reducing pain indices in patients with enthesopathy than using ESWT or needling therapy alone. ESWT, combined with needling therapy, should be prioritized for conservative treatment in patients with tendinopathy.

目的通过系统回顾和荟萃分析，评价体外冲击波治疗（ESWT）和针刺治疗腱鞘病的疗效。数据来源：pubmed （Medline）、Cochrane图书馆和Web of Science检索从2024年8月5日至2024年8月25日，检索2000年1月1日至2024年8月5日期间发表的针刺疗法和ESWT治疗肌腱病变的比较研究。研究选择两名评论者独立回顾了随机对照试验（rct），这些试验报道了针刺治疗和ESWT治疗肌腱病变的比较，以确定纳入资格。数据提取感兴趣的结果是视觉模拟量表（VAS）评分和压痛阈值（PPT）评分。两位审稿人使用Cochrane偏倚风险工具独立评估纳入的rct的质量。使用平均差异（md）估计效应量，使用总体效应的P值估计显著性水平。9项随机对照试验纳入528例患者。涉及318例患者的6项随机对照试验显示，VAS评分显示ESWT和干针在即刻(MD, 0.06；95% CI,−0.30 ~ 0.43；P= 0.73)或延迟效应(MD, - 0.46；95% CI,−2.10 ~ 1.18；P = .59)。两项涉及132例患者的随机对照试验显示，ESWT和干针在延迟效应方面PPT评分无显著差异(MD,−0.08；95% CI,−0.30 ~ 0.14；P = 49)。纳入161名受试者的三项研究得出结论，ESWT联合干针治疗在降低肌腱病变患者的VAS评分方面比单纯ESWT在延迟效应方面更有效(MD, - 1.79；95% CI,−2.60 ~−0.97；术;。)。结论本荟萃分析显示，ESWT联合针刺治疗比单独使用ESWT或针刺治疗更能有效地减轻脑瘫患者的疼痛指数。腱鞘病患者保守治疗应优先考虑ESWT联合针刺治疗。

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引用次数: 0

A Systematic Scoping Review of Poststroke Engagement in Physical Activity 卒中后身体活动参与的系统范围综述

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100457

Bettina Pasztor MSc , Avril Drummond PhD , Jennie E. Hancox PhD , Ian M. Taylor PhD

Objective

To synthesize knowledge about physical activity engagement in community living stroke survivors.

Data Sources

Six electronic databases (Scopus, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO/PsycARTICLES, and Web of Science) were searched between April 2023 and March 2024. Search parameters were set from database inception to 2024.

Study Selection

Studies were included if they were randomized controlled trials, (quasi)experimental, cross-sectional, or cohort/longitudinal; published in English; focused on measuring or promoting physical activity during rehabilitation or the postrehabilitation phase; and participants were at least 18 years old, living in the community, and had a clinical diagnosis of stroke.

Data Extraction

Data extracted included general study information; study design; participant characteristics; type of physical activity; program characteristics; type of support provided, type of physical activity engagement measure; and engagement outcomes and rates.

Data Synthesis

Twenty-one studies were included in this review; 6 promoted or measured physical activity as part of formal rehabilitation programs and 15 measured physical activity postrehabilitation. More than half of the studies reported low physical activity engagement. Eleven studies used objective measures of physical activity, whereas 8 used subjective measures and 2 used both. Only the 6 formal rehabilitation programs provided additional support for physical activity engagement, but the support was generally not underpinned by motivational theory or evidence. Walking and walk-related tasks were the most promoted type of physical activity poststroke.

Conclusions

We recommend that future interventions provide additional support for engagement that is underpinned by contemporary motivation theory. The type of support offered should differ depending on whether physical activity is part of a formal rehabilitation program or simply encouraged during postrehabilitation.

目的综合社区生活脑卒中幸存者身体活动参与的相关知识。数据来源检索了2023年4月至2024年3月期间的essix电子数据库（Scopus, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature， PsycINFO/PsycARTICLES和Web of Science）。搜索参数设置从数据库建立到2024年。研究选择纳入随机对照试验、（准）实验、横断面或队列/纵向研究；以英文出版；专注于测量或促进康复期间或康复后阶段的身体活动；参与者至少18岁，住在社区，并且有中风的临床诊断。数据提取提取的数据包括一般研究信息；研究设计;参与者特征;体力活动类型；项目特征;所提供支持的类型、体力活动参与测量的类型；参与的结果和比率。数据综合本综述共纳入21项研究；6个国家促进或测量了身体活动，作为正式康复计划的一部分，15个国家测量了康复后的身体活动。超过一半的研究报告了较低的体育活动参与度。11项研究使用了客观测量方法，8项使用了主观测量方法，2项两者都使用了。只有6个正式的康复项目为体育活动参与提供了额外的支持，但这种支持通常没有动机理论或证据的支持。步行和与步行相关的任务是中风后最受推崇的身体活动类型。我们建议未来的干预措施为当代动机理论所支持的参与提供额外的支持。所提供的支持类型应根据身体活动是正式康复计划的一部分或只是在康复后鼓励而有所不同。

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引用次数: 0

Safety and Effectiveness of Early Rehabilitation in Patients With Stroke and Concomitant Kidney Disease: A Cohort Study With Claims Data 卒中合并肾病患者早期康复的安全性和有效性：一项有索赔数据的队列研究

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100434

Takuaki Tani RPT, PhD , Kiyohide Fushimi MD, PhD , Shinobu Imai RPh, PhD

Objectives

To evaluate the effectiveness and safety of early rehabilitation started within 24 to 48 hours in patients with stroke and chronic kidney disease (CKD).

Design

Database cohort study.

Setting

Acute hospital.

Participants

The study included patients with stroke (n=21,061) and concomitant CKD who were admitted to an acute hospital between April 1, 2018, and March 31, 2020, including those with CKD who underwent early rehabilitation (n=10,129) and usual care (n=2702), as well as those with end-stage kidney disease (ESKD) who underwent early rehabilitation (n=3086) and usual care (n=954). The mean (standard deviation) age of the population was 76.5 (11.1) years, and the sex distribution was 67.3% men and 32.7% women.

Main Outcome Measures

The primary outcome was hospitalization-related mortality, and the secondary outcomes included changes in activities of daily living, measured using the Barthel Index, and length of hospital stay.

Results

Early rehabilitation was no associated with increase in mortality risk (hazard ratio [HR], 0.82; 95% confidence interval (95% CI), 0.67-1.02; P=.070) in patients with CKD, whereas no significant association with mortality risk was observed in patients with ESKD (HR, 0.79; 95% CI, 0.55-1.14; P=.213). The activity of daily living improvement and length of stay did not differ between the early rehabilitation and usual care groups (P=.103 and P=.499, respectively). In the follow-up analysis, patients with CKD undergoing early rehabilitation exhibited a 29% reduction in mortality risk (HR, 0.76; 95% CI, 0.62-0.92; P=.006). In contrast, early rehabilitation did not affect the mortality risk in patients with ESKD (HR, 0.80; 95% CI, 0.56-1.14; P=.217).

Conclusions

This study supports the safety of implementing early rehabilitation in patients with stroke and CKD. Moreover, early rehabilitation may reduce mortality in patients requiring long-term hospitalization.

目的评价脑卒中合并慢性肾脏疾病（CKD）患者在24 ~ 48小时内开始早期康复治疗的有效性和安全性。DesignDatabase队列研究。SettingAcute医院。该研究纳入了2018年4月1日至2020年3月31日期间入院的卒中患者（n= 21061）和合并CKD患者，包括接受早期康复（n= 10129）和常规护理（n=2702）的CKD患者，以及接受早期康复（n=3086）和常规护理（n=954）的终末期肾病（ESKD）患者。人口平均（标准差）年龄为76.5（11.1）岁，性别分布为67.3%的男性和32.7%的女性。主要结局指标主要结局指标是住院相关死亡率，次要结局指标包括日常生活活动的变化（使用Barthel指数测量）和住院时间。结果早期康复与死亡风险增加无相关性(危险比[HR]， 0.82；95%置信区间（95% CI）， 0.67-1.02；P= 0.070)，而ESKD患者与死亡风险无显著相关性(HR, 0.79；95% ci, 0.55-1.14；P = .213)。早期康复组和常规护理组患者的日常生活改善活动度和住院时间差异无统计学意义(P=。103和P=。499年,分别)。在随访分析中，接受早期康复治疗的CKD患者死亡风险降低29% (HR, 0.76；95% ci, 0.62-0.92；P = .006)。相比之下，早期康复对ESKD患者的死亡风险没有影响(HR, 0.80；95% ci, 0.56-1.14；P = .217)。结论本研究支持卒中合并CKD患者早期康复治疗的安全性。此外，早期康复可以降低需要长期住院的患者的死亡率。

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引用次数: 0

Lived Experiences of Older Adults With Chronic Low Back Pain and Implications on Their Daily Life: A Metasynthesis of Qualitative Research 老年人慢性腰痛的生活经历及其对日常生活的影响：一项定性研究的综合分析

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100456

Chelsia K.C. Cheung MSc , Esther T.C. Cheung BSc , Veronika Schoeb PhD , Emmanuelle Opsommer PhD , Doris Y.K. Chong PhD , Janet L.C. Lee PhD , Christine Kumlien PhD , Arnold Y.L. Wong PhD

Objective

To synthesize and conceptualize the lived experiences of older adults with chronic low back pain (CLBP) by systematically reviewing qualitative studies.

Data Sources

CINAHL, PsycINFO, and PubMed were searched from their inception years (1961, 1967, and 1996, respectively) to September 2023 to identify qualitative studies on the lived experiences of older adults with CLBP.

Study Selection

Eligible qualitative studies included published journal article with qualitative design and analysis, and participants aged ≥65 years with chronic nonspecific low back pain (LBP) that lasted for over 3 months. Of 3669 citations screened, 17 studies met the inclusion criteria.

Data Extraction

Findings were analyzed using metasynthesis. Two reviewers independently conducted study selection and data extraction, and the methodological quality of each included study was assessed using the Consolidated Criteria for Reporting Qualitative Research framework.

Data Synthesis

Six themes emerged from the analysis: (1) perceived causes of CLBP; (2) interference with daily living; (3) family dynamics; (4) social life; (5) emotional responses to CLBP; and (6) coping strategies. Collectively, CLBP negatively affected older adults’ personal, family, and social life to varying extents. Suboptimal LBP management could lead to negative emotions (eg, depression) and avoidance behaviors. Accepting and adapting to the presence of CLBP, along with a clear diagnosis of LBP, might promote self-management. Conversely, comorbidities and rumination might hinder self-management efforts.

Conclusions

Given that the acceptance (acknowledging and adapting to the pain) of CLBP improves self-management of pain in older adults, clinicians should pay attention to the concerns of older adults with CLBP, understand the negative effects of CLBP on them, and provide personalized education and management strategies to enhance their self-management and engagement in value-driven actions.

目的通过系统回顾定性研究，对老年人慢性腰痛（CLBP）患者的生活经历进行综合和概念化。数据来源检索cinahl、PsycINFO和PubMed从其成立年份（分别为1961年、1967年和1996年）到2023年9月，以确定老年CLBP患者生活经历的定性研究。研究选择：合格的定性研究包括已发表的具有定性设计和分析的期刊文章，以及年龄≥65岁、慢性非特异性腰痛（LBP）持续3个月以上的参与者。在筛选的3669篇引文中，有17篇研究符合纳入标准。数据提取结果采用元合成法进行分析。两名审稿人独立进行研究选择和数据提取，每个纳入研究的方法学质量使用报告定性研究框架的统一标准进行评估。从分析中得出六个主题：(1)CLBP的感知原因；(2)干扰日常生活的；(3)家庭动态；(4)社会生活；(5)对CLBP的情绪反应；(6)应对策略。总体而言，CLBP不同程度地对老年人的个人、家庭和社会生活产生负面影响。次优的LBP管理可能导致负面情绪（如抑郁）和回避行为。接受和适应CLBP的存在，以及明确的LBP诊断，可能会促进自我管理。相反，合并症和沉思可能会阻碍自我管理的努力。结论接受（承认和适应疼痛）CLBP可提高老年人疼痛自我管理水平，临床医生应关注老年CLBP患者关注的问题，了解CLBP对老年人的负面影响，并提供个性化的教育和管理策略，以增强老年人自我管理和参与价值驱动行动。

{"title":"Lived Experiences of Older Adults With Chronic Low Back Pain and Implications on Their Daily Life: A Metasynthesis of Qualitative Research","authors":"Chelsia K.C. Cheung MSc , Esther T.C. Cheung BSc , Veronika Schoeb PhD , Emmanuelle Opsommer PhD , Doris Y.K. Chong PhD , Janet L.C. Lee PhD , Christine Kumlien PhD , Arnold Y.L. Wong PhD","doi":"10.1016/j.arrct.2025.100456","DOIUrl":"10.1016/j.arrct.2025.100456","url":null,"abstract":"<div><h3>Objective</h3><div>To synthesize and conceptualize the lived experiences of older adults with chronic low back pain (CLBP) by systematically reviewing qualitative studies.</div></div><div><h3>Data Sources</h3><div>CINAHL, PsycINFO, and PubMed were searched from their inception years (1961, 1967, and 1996, respectively) to September 2023 to identify qualitative studies on the lived experiences of older adults with CLBP.</div></div><div><h3>Study Selection</h3><div>Eligible qualitative studies included published journal article with qualitative design and analysis, and participants aged ≥65 years with chronic nonspecific low back pain (LBP) that lasted for over 3 months. Of 3669 citations screened, 17 studies met the inclusion criteria.</div></div><div><h3>Data Extraction</h3><div>Findings were analyzed using metasynthesis. Two reviewers independently conducted study selection and data extraction, and the methodological quality of each included study was assessed using the Consolidated Criteria for Reporting Qualitative Research framework.</div></div><div><h3>Data Synthesis</h3><div>Six themes emerged from the analysis: (1) perceived causes of CLBP; (2) interference with daily living; (3) family dynamics; (4) social life; (5) emotional responses to CLBP; and (6) coping strategies. Collectively, CLBP negatively affected older adults’ personal, family, and social life to varying extents. Suboptimal LBP management could lead to negative emotions (eg, depression) and avoidance behaviors. Accepting and adapting to the presence of CLBP, along with a clear diagnosis of LBP, might promote self-management. Conversely, comorbidities and rumination might hinder self-management efforts.</div></div><div><h3>Conclusions</h3><div>Given that the acceptance (acknowledging and adapting to the pain) of CLBP improves self-management of pain in older adults, clinicians should pay attention to the concerns of older adults with CLBP, understand the negative effects of CLBP on them, and provide personalized education and management strategies to enhance their self-management and engagement in value-driven actions.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100456"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222012","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}

引用次数: 0

Optimizing Pulmonary Health and Quality of Life in Breast Cancer Survivors: A Randomized Controlled Trial Combining Incentive Spirometry and Aerobic Exercise 优化乳腺癌幸存者的肺部健康和生活质量：一项结合激励肺活量测定和有氧运动的随机对照试验

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100449

Dian Marta Sari MD, MSc, PhD , Irma Ruslina Defi MD, PhD , Andre Maharadja MD , Nurvita Trianasari M.Stat, PhD , Laurentia Cindy Gani Wijaya MD , Patricia Helena Christiani Santoso MD , Geraldi Christian Candra MD

Objective

To investigate the combined effect of aerobic and breathing exercises using incentive spirometry on lung function and quality of life (QoL) in patients with breast cancer after radiation therapy (RT).

Design

A single-blind, randomized controlled trial.

Setting

Hasan Sadikin General Hospital Bandung.

Participants

Thirty-seven women aged 40-59 years post-RT breast cancer survivors divided into treatment (18 subjects) and control (19 subjects) groups.

Intervention

The treatment group engaged in thrice-weekly sessions of aerobic and breathing exercises using incentive spirometry, whereas the control group performed only aerobic exercises at the same frequency. Lung function was assessed using spirometry, and QoL was evaluated using the European Organization for Research and Treatment of Cancer QoL Questionnaires-Core30 (EORTC QLQ C30), both conducted before and after the exercise.

Main Outcome Measure(s)

Lung function (assessed using spirometry) and QoL (measured using the EORTC QLQ C30).

Results

Between-group analyses revealed that the treatment group experienced significantly greater improvements than the control group in lung function (forced vital capacity increased by 7.72±3.51 vs. 3.45±1.22, P<.05), physical function (difference of 8.06±5.76 vs. 0.68±2.06, P<.05), dyspnea (difference of −22.22±22.92 vs. 0.00, P<.05), and fatigue (difference of −22.78±20.39 vs. −1.74±5.52, P<.05), with these improvements being clinically meaningful.

Conclusions

The addition of breathing exercises with incentive spirometry to aerobic exercise may improve lung function and QoL in patients with breast cancer who have completed RT.

目的探讨激励性肺活量测定法联合有氧运动和呼吸运动对乳腺癌放疗后患者肺功能和生活质量的影响。设计一项单盲、随机对照试验。万隆哈桑·萨迪金总医院。参与者37名年龄在40-59岁的乳腺癌放疗后幸存者分为治疗组（18名受试者）和对照组（19名受试者）。干预治疗组每周进行三次有氧和呼吸运动，使用刺激肺活量测定法，而对照组只进行相同频率的有氧运动。使用肺活量测定法评估肺功能，使用欧洲癌症研究与治疗组织QoL问卷- core30 （EORTC QLQ C30）评估生活质量，均在运动前后进行。主要观察指标：肺功能（肺活量测定法）和生活质量（EORTC QLQ C30）。结果组间分析显示，治疗组在肺功能（用力肺活量增加7.72±3.51比3.45±1.22,P< 0.05）、身体功能（差异为8.06±5.76比0.68±2.06,P< 0.05）、呼吸困难（差异为- 22.22±22.92比0.00,P< 0.05）、疲劳（差异为- 22.78±20.39比- 1.74±5.52,P< 0.05）方面的改善均显著高于对照组，具有临床意义。结论在有氧运动的基础上加入激励性肺活量测定呼吸运动可改善乳腺癌患者完成RT后的肺功能和生活质量。

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引用次数: 0

Underrepresentation of Participants From Marginalized Racial and Ethnic Groups: A Secondary Analysis of the Cognitive Rehabilitation Literature 来自边缘种族和民族群体的参与者代表性不足：对认知康复文献的二次分析

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100431

Jessica Kersey PhD, OTR/L , Patricia Garcia PsyD, HSPP , Emily Evans PT, PhD , Zaccheus J. Ahonle PhD, CRC , Pooja Jethani OT, OTD, MS, OTR , Juan Carlos Arango-Lasprilla PhD , Devina Kumar PhD, MSc, PT , Anthony H. Lequerica PhD , Gloria M. Morel Valdes PsyD , Paige Salinas MS, MHA, LCSW, CBIST-AP , Devan Parrott PhD

Objective

To examine the inclusion of people with brain injury from racially and ethnically marginalized groups in cognitive rehabilitation clinical trials.

Data Sources

We conducted a secondary analysis of the Cicerone et al (2019) cognitive rehabilitation review.

Study Selection

Of the originally included studies, we excluded those not conducted in the United States, along with case studies and case series studies.

Data Extraction

We extracted data on the racial and ethnic demographics of the study samples, along with eligibility criteria and recruitment and sampling strategies. We examined demographic data descriptively (frequencies and percentages) and examined other study methods thematically.

Data Synthesis

Sixty-five studies met criteria for inclusion in this secondary analysis. Of these, only 27 reported on the racial and ethnic demographics of the study samples. In all but 8, White non-Hispanic participants were overrepresented. We identified several frequently employed recruitment strategies and eligibility criteria that may disproportionately exclude participants from minoritized racial and ethnic groups, including English language, literacy, and baseline education requirements, exclusion based on comorbid conditions, and recruitment of participants from existing clinic patient pools.

Conclusions

We found notable underrepresentation of people with traumatic brain injury (TBI) from racially and ethnically marginalized groups in cognitive rehabilitation clinical trials, which have been used to guide practice and research. This underrepresentation likely exacerbates disparities in rehabilitation access and outcomes among marginalized groups. Further research should seek to comprehensively understand current recruitment and sampling strategies that contribute to this problem and identify opportunities to improve inclusivity in TBI rehabilitation research.

目的探讨种族和边缘民族脑损伤患者在认知康复临床试验中的纳入情况。我们对Cicerone等人（2019）的认知康复综述进行了二次分析。研究选择在最初纳入的研究中，我们排除了那些不在美国进行的研究，以及案例研究和案例系列研究。数据提取我们提取了研究样本的种族和民族人口统计数据，以及资格标准、招募和抽样策略。我们描述性地检查了人口统计数据（频率和百分比），并按主题检查了其他研究方法。65项研究符合纳入本次要分析的标准。其中，只有27个报告了研究样本的种族和民族人口统计数据。除8个外，所有的参与者中，非西班牙裔白人的比例都过高。我们确定了几种常用的招募策略和资格标准，这些策略和标准可能不成比例地排除少数种族和族裔群体的参与者，包括英语语言、读写能力和基线教育要求，基于合并症的排除，以及从现有的临床患者池中招募参与者。结论我们发现在认知康复临床试验中，来自种族和民族边缘群体的创伤性脑损伤（TBI）患者的代表性明显不足，可用于指导实践和研究。这种代表性不足可能会加剧边缘化群体在康复机会和结果方面的差距。进一步的研究应寻求全面了解目前导致这一问题的招募和抽样策略，并确定提高创伤性脑损伤康复研究包容性的机会。

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引用次数: 0

Validation of the Fiberoptic Endoscopy Evaluation of Swallowing in Aspiration Pneumonia: Utility of the Hyodo Dysphagia Score in Predicting the Development of Aspiration Pneumonia 纤维内窥镜对吸入性肺炎吞咽评估的验证：Hyodo吞咽困难评分在预测吸入性肺炎发展中的应用

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100435

Yoko Ibe MD, PhD , Masayuki Tazawa MD, PhD , Hironori Arii MD, PhD , Yumiko Nakao MD, PhD , Risa Toyama MD , Naoki Wada MD, PhD

Objective

To analyze the characteristics of flexible endoscopic evaluation of swallowing (FEES) findings in patients with aspiration pneumonia using the Hyodo dysphagia score and to evaluate the risk of aspiration pneumonia.

Design

Retrospective study.

Setting

Observation in a single primary care institution.

Participants

Inpatients aged ≥20 years who underwent FEES in our hospital between April 2012 and March 2022. A total of 178 patients were eligible to calculate the Hyodo dysphagia score and were enrolled in this study. The mean ± SD age of the subjects was 73.4±13.3 years, and 116 of 178 patients (65.2%) were men.

Intervention

Not applicable.

Main Outcome Measures

The development of aspiration pneumonia.

Results

Eighty-four of 178 patients (47.2%) developed aspiration pneumonia. Age, oral intake status, and serum albumin levels were not significantly different between the pneumonia and nonpneumonia groups. The total and each parameter of the Hyodo dysphagia score were significantly higher in the pneumonia group than in the nonpneumonia group. Logistic regression analysis showed that salivary retention (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.09-1.33; P=.016) and poor cough reflex (OR, 1.88; 95% CI, 1.42-2.49; P<.001) in the Hyodo dysphagia score were risk factors for aspiration pneumonia. The area under the curve of the receiver operating characteristic curve for the onset of pneumonia based on the total Hyodo dysphagia score was 0.75 (95% CI, 0.67-0.82). A cutoff value of 5 for the total Hyodo dysphagia score gave a sensitivity of 0.75 (95% CI, 0.67-0.83) and a specificity of 0.60 (95% CI, 0.49-0.71), with the Youden index having a maximum value of 0.35.

Conclusions

A cutoff value of 5 points for the total Hyodo dysphagia score was optimal in predicting the development of aspiration pneumonia. Salivary retention and poor cough reflex were risk factors for the development of pneumonia.

目的应用Hyodo吞咽困难评分分析吸入性肺炎患者柔性内镜吞咽检查（FEES）的特点，评价吸入性肺炎的发生风险。DesignRetrospective研究。在单一的初级保健机构观察。参与者为2012年4月至2022年3月期间在我院接受FEES治疗的年龄≥20岁的患者。共有178名患者符合计算Hyodo吞咽困难评分的条件，并被纳入本研究。受试者的平均±SD年龄为73.4±13.3岁，178例患者中116例（65.2%）为男性。InterventionNot适用。主要观察指标吸入性肺炎的发生。结果178例患者中84例（47.2%）发生吸入性肺炎。肺炎组和非肺炎组的年龄、口服摄入状况和血清白蛋白水平无显著差异。肺炎组Hyodo吞咽困难总分及各项指标均显著高于非肺炎组。Logistic回归分析显示，唾液潴留(优势比[OR]， 1.60；95%置信区间[CI]， 1.09-1.33；P= 0.016)和咳嗽反射差(OR, 1.88；95% ci, 1.42-2.49；（p < 0.01）是吸入性肺炎的危险因素。基于总Hyodo吞咽困难评分的肺炎发病的受试者工作特征曲线曲线下面积为0.75 （95% CI, 0.67-0.82）。Hyodo吞咽困难总分的临界值为5，灵敏度为0.75 (95% CI, 0.67-0.83)，特异性为0.60 (95% CI, 0.49-0.71)，约登指数的最大值为0.35。结论Hyodo吞咽困难总分5分是预测吸入性肺炎发生的最佳临界值。唾液潴留和咳嗽反射差是发生肺炎的危险因素。

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引用次数: 0

A Systematic Review of the Effects of Therapeutic Exercise With Psychological Interventions on Disability and Personal Outcomes in Older Adults 心理干预治疗性运动对老年人残疾和个人预后影响的系统综述

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100447

Grace A. Rose , Pietra T. Bruni PhD , Mariana Wingood PT, DPT, PhD, MPH , Selmi Kallmi PhD , Elizabeth Finer MA , Patricia M. Bamonti PhD

Objective

To evaluate the effects of therapeutic exercise and psychological interventions on disability and personal outcomes in older adults.

Data Sources

Articles published from January 2013 to February 2025 are available in PubMed, Embase, ProQuest Health & Medical and Psychology, PsycINFO, and PsycArticles.

Study Selection

Inclusion criteria were as follows: (1) intervention included therapeutic exercise combined or integrated with a psychological intervention; (2) randomized controlled trial; (3) sample mean age ≥60 years; (4) primary or secondary outcome(s) of disability. Two authors independently screened trials (n=7391) for inclusion; a third author verified results and resolved discrepancies.

Data Extraction

Data were extracted by a primary reviewer and verified by a second reviewer. The risk of bias assessment was performed using the risk of bias in randomized controlled trials.

Data Synthesis

Thirty-eight trials (n=18,550 participants) were included. Therapeutic exercise included: exercise programs (34%), physical activity counseling and monitoring (37%), rehabilitation (18%), or other (eg, Tai Chi; 13%). Psychological interventions were primarily motivational interviewing (53%) or cognitive-behavioral therapy/strategies (39%). Significant improvement in body functions and structures (n=14, 37%), activity (n=6, 16%), participation (n=20, 53%), and personal factors (n=11, 29%) was observed.

Conclusions

Therapeutic exercise with psychological interventions have a positive effect on disability and personal outcomes, especially in participation. Heterogeneity in the study design, intervention, and population challenged data synthesis. Nonetheless, the current review identified gaps within the literature and directions for future research. Testing the additive effect of these interventions compared to active comparators is a priority for future investigations.

目的评价治疗性运动和心理干预对老年人残疾和个人结局的影响。数据来源2013年1月至2025年2月发表的文章可在PubMed， Embase, ProQuest Health &；医学与心理学，PsycINFO和PsycArticles。研究选择纳入标准如下：(1)干预包括治疗性运动结合或结合心理干预；(2)随机对照试验；(3)样本平均年龄≥60岁；(4)残疾的主要或次要结局。两位作者独立筛选试验（n=7391）纳入；第三位作者验证了结果并解决了差异。数据提取数据由主要审稿人提取，并由第二审稿人验证。偏倚风险评估采用随机对照试验的偏倚风险进行。数据综合纳入38项试验（n=18,550名受试者）。治疗性运动包括：运动计划（34%）、体育活动咨询和监测（37%）、康复（18%）或其他(如太极拳；13%)。心理干预主要是动机性访谈（53%）或认知行为治疗/策略（39%）。观察到身体功能和结构（n=14, 37%）、活动（n=6, 16%）、参与（n=20, 53%）和个人因素（n=11, 29%）的显著改善。结论心理干预治疗性运动对残疾和个人结局有积极影响，尤其是在参与方面。研究设计、干预和人群的异质性对数据合成提出了挑战。尽管如此，目前的综述确定了文献中的空白和未来研究的方向。测试这些干预措施与主动比较物的累加效应是未来研究的重点。

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引用次数: 0

Phantom Limb Pain Assessment Tools: A Literature Review Exploring Strengths and Limitations 幻肢疼痛评估工具：探讨优势和局限性的文献综述

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100453

Alexandra N. Jenson BS , Benjamin Branch DO , Janelle M. Richard BA , Aurora Quaye MD

Objective

To identify and categorize the pain instruments used to evaluate phantom limb pain (PLP), phantom limb sensations (PLSs), and residual limb pain (RLP) stratified by frequency of use, instrument completion time, and inclusion of descriptive terms to distinguish between the 3 phenomena.

Data Sources

MEDLINE/PubMed and Google Scholar from 1986 to 2024.

Study Selection

Cross-sectional, cohort, and case-control studies investigating the prevalence of PLP in adults (18y or older) with surgical and traumatic upper or lower limb amputation.

Data Extraction

Studies were identified and their methods were evaluated for mention of instruments used to assess for PLP. Tools were then evaluated for frequency of usage, completion time, differentiation of pain and sensations after limb amputation, and qualitative assessment using descriptor words associated with PLP and PLSs.

Data Synthesis

The review included 44 studies and identified 25 tools (5 unidimensional and 20 multidimensional). Unidimensional pain scales, particularly the Numeric Rating Scale, were the most frequently used. Of the multidimensional instruments identified, 9 of them were specific to PLP, and 6 distinguished between PLP, PLS, and RLP. Only one multidimensional instrument that was specific to PLP used descriptor words to differentiate between PLP and PLS. No tool was assessed for all 3 conditions and used descriptor words to distinguish between PLP and PLSs.

Conclusions

Based on this systematic review, no PLP-specific instrument is suitable for standardizing the diagnosis of PLP in its current form. Further research is needed to establish a standardized tool that can reliably distinguish between PLP, PLS, and RLP while incorporating qualitative assessments to ensure accurate diagnosis.

目的根据使用频率、器械完成时间和描述术语的包含情况，对用于评估幻肢痛（PLP）、幻肢感觉（pls）和残肢痛（RLP）的疼痛器械进行分类和鉴定，以区分这三种现象。数据来源medline /PubMed和谷歌Scholar 1986 - 2024年。研究选择：横断面、队列和病例对照研究调查手术和创伤性上肢或下肢截肢的成人（18岁或以上）PLP的患病率。数据提取：对研究进行鉴定，并对其方法进行评估，以提及用于评估PLP的工具。然后评估工具的使用频率、完成时间、截肢后疼痛和感觉的区分，并使用与PLP和PLSs相关的描述词进行定性评估。本综述包括44项研究，确定了25种工具（5种一维工具和20种多维工具）。单维疼痛量表，尤其是数字评定量表，是最常用的。在确定的多维工具中，有9个是针对PLP的，6个区分PLP、PLS和RLP。只有一个特定于PLP的多维工具使用描述词来区分PLP和PLS。没有工具对所有3种情况进行评估，并使用描述词来区分PLP和PLS。结论基于本系统综述，目前形式的PLP没有适合于标准化诊断的PLP特异性仪器。需要进一步的研究来建立一个标准化的工具，可以可靠地区分PLP， PLS和RLP，同时结合定性评估以确保准确诊断。

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引用次数: 0

Radiographic Findings in the Lower Extremity Joints of Long-Term Users of Implanted Standing Neuroprostheses with Spinal Cord Injuries 长期使用植入式站立式神经假体伴脊髓损伤患者下肢关节的影像学表现

IF 1.9 Q2 REHABILITATION

Archives of rehabilitation research and clinical translation

Pub Date : 2025-06-01 DOI: 10.1016/j.arrct.2025.100448

H. Alex Hoyen BS , Sean Li BS , Michael Miller MS , Sheeba Joseph MD , Patrick Getty MD , Lisa Lombardo MPT , Gilles Pinault MD , Ronald Triolo PhD

Objective

To assess whether lower extremity degenerative joint changes developed in long-term users of implantable neuromuscular prostheses.

Design

Before-after radiographic assessment.

Setting

Tertiary care center.

Participants

Four individuals (4 men, average age 46.5y, injuries ranging from C7-T11) with spinal cord injury resulting in lower extremity paraplegia were included for analysis. All individuals previously received surgery for the placement of a neuroprosthesis implant system. Individuals were followed with specific spinal cord injury outcome measures and radiographs in a prospective manner. Individual implant usage was also recorded as part of the standard treatment. These individuals were selected because they were in the highest tier for daily use of the implant system.

Interventions

Not applicable.

Main Outcome Measures

Development of degenerative joint pathology, based on analysis of pre- and post-therapy radiographs and grading using the Kellgren and Lawrence and Van Dijk scales.

Results

None of the joints for the individuals that were graded 0-2 (no or mild arthritis) progressed to a grade 3 (moderate arthritis). Further, none of the joints developed an arthritic grade of >3. Only 2 of the 24 total joints had statistically significant (P<.05) degenerative changes: subject 1: right hip; P=.033 (average grade increased from 0.875-1.875); subject 2: right hip; P=.049 (average grade increased from 0.875-1.50).

Conclusions

At an average of 5 years after implantation, regular and independent weight bearing in 4 higher-than-average users of a neuromuscular prosthesis does not appear to promote lower extremity joint degeneration.

目的评估长期使用植入式神经肌肉假体是否会发生下肢退行性关节改变。设计前后放射评估。三级护理中心。4名患者（4名男性，平均年龄46.5岁，损伤范围从C7-T11）因脊髓损伤导致下肢截瘫被纳入分析。所有患者之前都接受了神经假体植入系统的手术。对个体进行前瞻性的脊髓损伤结局测量和x线片随访。个体种植体的使用也被记录为标准治疗的一部分。这些人被选中是因为他们在日常使用植入系统的最高层次。InterventionsNot适用。主要观察指标：基于治疗前和治疗后x线片的分析以及Kellgren、Lawrence和Van Dijk量表的分级，关节退行性病理的发展。结果0-2级（无或轻度关节炎）患者的关节无一进展为3级（中度关节炎）。此外，没有一个关节发展成关节炎等级为3。24个关节中只有2个有统计学意义（P< 0.05）退行性改变：受试者1：右髋关节；P = .033（平均成绩0.875-1.875）；受试者2：右臀部；P = .049（平均成绩从0.875-1.50增加）。结论4例高于平均水平的神经肌肉假体使用者在植入后平均5年的时间里，正常独立负重并没有出现促进下肢关节退行性变的情况。

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引用次数: 0