Archives of rehabilitation research and clinical translation最新文献

{"title":"Causes of Adolescent Low Back Pain: A Retrospective Study","authors":"Imana Rhoden MD,&nbsp;Jeremy Simon MD,&nbsp;Adam T. Chrusch MD,&nbsp;David Stolzenberg DO,&nbsp;Christopher Mehallo DO,&nbsp;Grant Thomas BS","doi":"10.1016/j.arrct.2025.100433","DOIUrl":"10.1016/j.arrct.2025.100433","url":null,"abstract":"<div><h3>Objective</h3><div>To add to the body of evidence in the scientific literature with respect to the etiology of adolescent back pain.</div></div><div><h3>Design</h3><div>A retrospective chart review was conducted over a 3 year period. Charts were initially rendered using International Classification of Disease, 10th Revision (ICD-10) diagnosis, and subsequently narrowed down to age range of 10-19 years. Additionally, patients with documented trauma requiring emergent spinal surgery or an alternative diagnosis (eg, hip pain) were excluded.</div></div><div><h3>Setting</h3><div>This study was performed in a large United States based private multispecialty orthopedic practice. This includes 30 different ambulatory office locations in multiple demographic regions.</div></div><div><h3>Participants</h3><div>Patients ages 10 to 19 years old who presented with documented low back pain (LBP) were included. A total of N = 1932 patients were included with a 1.1/1 women to men ratio. The study was conducted over a 3 year period (2015-2018).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Final diagnosis reached by clinician, verified by chart and imaging review.</div></div><div><h3>Results</h3><div>A total of 1932 patients were included: 1010 (52.3%) women and 922 (47.7%) men. Physician reviewers grouped the diagnoses into comprehensive categories. LBP without a specific cause was the most common diagnosis with 827 patients (42.81%). Women accounted for 447 (54.0%) of the patients diagnosed with LBP, whereas men accounted for 380 (46.0%). Disk disease was the second most common diagnosis representing 534 study participants (27.64%). There were more women than men in the overall disk cohort with 304 (30.10%) and 230 (24.95%), respectively. Spondylolysis was the third most common diagnosis with 281 patients (14.54%). The prevalence was higher for men than women, 192 (20.82%) and 89 (8.81%), respectively.</div></div><div><h3>Conclusions</h3><div>A clearer understanding of the various etiologies associated with general LBP was obtained. The findings reveal a higher occurrence of disk-related issues compared with previous data and highlight gender-based differences in the identified pathologies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100433"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222006","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":"Reliability of the Five Step Assessment and Its Coefficients of Impairment in Spastic Paresis","authors":"Marjolaine Baude MD ,&nbsp;Maud Pradines PT, PhD ,&nbsp;Caroline Gault-Colas MD ,&nbsp;Damien Motavasseli MD ,&nbsp;David Simpson MD ,&nbsp;Tymothée Poitou MD ,&nbsp;Violaine Piquet MD ,&nbsp;Pierre-André Natella MD ,&nbsp;Jean-Michel Gracies MD, PhD","doi":"10.1016/j.arrct.2025.100444","DOIUrl":"10.1016/j.arrct.2025.100444","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the intrarater and interrater reliability of the Five Step Assessment (FSA) and its derived coefficients of impairment in chronic spastic paresis.</div></div><div><h3>Design</h3><div>Prospective observational study.</div></div><div><h3>Setting</h3><div>Study of outpatients followed in a rehabilitation department.</div></div><div><h3>Participants</h3><div>In this single-center prospective study, participants (n=18) with chronic hemiparesis (&gt;1y since injury) were evaluated by 4 raters (3 medical doctors, 1 physiotherapist; experience in hemiparesis, 14±9y).</div></div><div><h3>Interventions</h3><div>All raters estimated muscle shortening, spasticity, weakness, and fatigability against the resistance of 8 key antagonists in adults twice, one week apart.</div></div><div><h3>Main Outcome Measures</h3><div>FSA involves measuring 4 angles: angle of arrest at slow speed of stretch (X_V1), angle of catch or clonus at fast speed of stretch (X_V3, Tardieu), angle of match between maximal agonist effort and passive and active antagonist resistances (X_A), residual angle of match after 15 seconds of repeated maximal amplitude active efforts (X_A15), and spasticity grade Y. Four derived coefficients of impairment were studied: coefficients of shortening, C_SH=(X_N−X_V1)/X_N (X_N, normally expected maximal passive joint amplitude); of spasticity, C_SP=(X_V1−X_V3)/X_V1; of weakness, C_W=(X_V1−X_A)/X_V1; and of fatigability, C_F=(X_A−X_A15)/X_A. Both intraclass correlation coefficients and mean differences were calculated for each parameter.</div></div><div><h3>Results</h3><div>Among 18 participants (four women), intrarater reliability was good to excellent (intraclass correlation coefficient &gt;0.75) for all parameters in all muscles. Interrater reliability was good to excellent for all muscles and parameters except for spasticity grade Y and coefficient of fatigability (moderate).</div></div><div><h3>Conclusions</h3><div>The 5 parameters and 4 coefficients of impairment of the FSA have moderate-to-excellent intrarater and interrater reliability in chronic spastic paresis.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100444"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222008","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":"Quantifying At-Home Physiotherapy Participation: SPARS vs Self-Reported Diaries","authors":"Matthew Rezkalla BSc ,&nbsp;Philip Boyer PhD ,&nbsp;David Burns MD, PhD ,&nbsp;Cristian Renteria PT, MPIA ,&nbsp;Cari Whyne PhD","doi":"10.1016/j.arrct.2025.100445","DOIUrl":"10.1016/j.arrct.2025.100445","url":null,"abstract":"<div><div>The completion of at-home physiotherapy exercise is key to many rehabilitation protocols. This study compares at-home upper extremity physiotherapy participation as measured based on data captured with a smart watch to that recorded in self-report diaries. Daily at-home exercise participation (sessions) was recorded for 53 patients with rotator cuff pathology during their first 2 weeks of a 12-week physiotherapy rehabilitation program. Exercise participation was measured using a physical therapy monitoring system that uses smart watch (accelerometer/gyroscope) data analyzed via a convolutional neural network trained on labeled patient-specific in-clinic data and compared to patient reported diaries. A high level of agreement between diary exercise participation and the measurements derived from the smart watch data (ICC=0.72, n=53) was found, with an AUROC=0.99 for binary identification of exercise periods on labeled clinic data. However, overall patient diaries reported more exercise performed (0.96 additional days on average) than measured by the ML algorithm. ML and accelerometer/gyroscope data collected by embedded sensors in a smartwatch represents an accurate and objective alternative to self-reported diaries for monitoring patient at-home participation. Lower levels recorded by the ML algorithm may indicate some limitations in the technology to fully capture participation or potential over-reporting of participation within diaries. As self-reported diary completion decreases over time, physical therapy monitoring technology may represent an acceptable method for longer term assessment of exercise participation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100445"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222047","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":"Reproductive Education and Sexual Abuse Among Individuals With Spina Bifida: A Mixed Methods Study","authors":"Betsy Hopson PhD, MSHA ,&nbsp;Molly Richardson PhD, MPH ,&nbsp;Caroline Caudill BS ,&nbsp;Don Lein PhD ,&nbsp;Courtney Streur MD ,&nbsp;Elizabeth Taylor PhD ,&nbsp;Suzannah Rogers MD ,&nbsp;Victoria Jiminez BS ,&nbsp;Brandon G. Rocque MD, MS ,&nbsp;Jeffrey Blount MD, MPH ,&nbsp;David Joseph MD ,&nbsp;Ching Man Carmen Tong MD","doi":"10.1016/j.arrct.2025.100455","DOIUrl":"10.1016/j.arrct.2025.100455","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate sexual and reproductive health (SRH) knowledge and practices among young adults with spina bifida (SB), with an emphasis on identifying gaps in SRH literacy and barriers to care.</div></div><div><h3>Design</h3><div>Sequential explanatory mixed methods study consisting of a disability-specific survey and follow-up interviews.</div></div><div><h3>Setting</h3><div>Participants were recruited from a multidisciplinary SB clinic.</div></div><div><h3>Participants</h3><div>Eighty young adults (N=80) with SB were surveyed (March 2021-April 2022), and 4 participants from this sample took part in follow-up in-depth qualitative interviews. The sample included both male and female participants who were sexually active or had prior exposure to SRH education.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Primary measures assessed SRH knowledge gaps, relationship barriers, contraception use, pregnancy awareness, and experiences of abuse/coercion. Findings aim to inform educational programs, abuse prevention, and clinical guidelines for individuals with SB.</div></div><div><h3>Results</h3><div>Among the 80 survey participants, 55% of men and 47% of women reported being sexually active. Despite this, 44% of women were unsure about their ability to become pregnant. Sexual abuse or coercion was reported by 25% of women and 10% of men. Key interview themes included challenges and supports related to dating, gaps in SRH education, experiences with sexual intimacy, and the prevalence of sexual abuse. Barriers stemmed from concerns about disclosing SB, misconceptions about independent living, and restricted social opportunities because of family protectiveness. Facilitators included online dating, shared interests, and acceptance from open-minded partners.</div></div><div><h3>Conclusions</h3><div>Among the young adults with SB who participated in this study, many were sexually active but faced significant barriers and gaps in SRH knowledge, increasing their risk of sexual abuse and poor reproductive health outcomes. Determining levels of sexual health literacy and screening for abuse are critical to improving SRH outcomes for this vulnerable population.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100455"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222109","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":"Item-Level Psychometrics for the Functional Gait Assessment in Persons With Stroke","authors":"Bryant A. Seamon PT, DPT, PhD ,&nbsp;Steven A. Kautz PhD ,&nbsp;Mark G. Bowden PT, PhD ,&nbsp;Jesse C. Dean PhD ,&nbsp;Chris M. Gregory PT, PhD ,&nbsp;Richard R. Neptune PhD ,&nbsp;Craig A. Velozo PhD, OTR/L","doi":"10.1016/j.arrct.2025.100452","DOIUrl":"10.1016/j.arrct.2025.100452","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the item-level psychometrics of the Functional Gait Assessment (FGA) for persons with chronic stroke and create a keyform (or score sheet) for clinicians.</div></div><div><h3>Design</h3><div>Retrospective cohort.</div></div><div><h3>Setting</h3><div>Archival item-level data from a research database.</div></div><div><h3>Participants</h3><div>One-hundred-one ambulatory persons (N=101) with chronic stroke (44% women, 58% right hemiparesis, average age 59y, lower extremity Fugl-Meyer 25, and overground self-selected walking speed 0.76 m/s).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>A principal component analysis of the residuals from the Andrich Rating Scale Model (RSM) was used to evaluate unidimensionality and item local dependence. The RSM was also used to examine the rating scale structure, item and person fit, item difficulty hierarchy, and person separation index and to generate a keyform.</div></div><div><h3>Results</h3><div>Principal component analysis of the residuals confirmed the FGA’s unidimensionality and that no items had local dependence. The category rating scale met the criterion and advanced monotonically. The item difficulty hierarchy was similar to that of community-dwelling older adults. The sample’s mean ability level (ie, person measure) was 0.28 logits (SE=0.63). The FGA had high person reliability (0.90) despite 10% of persons misfitting. There were no floor or ceiling effects, and the FGA separated people into 4 strata. The scored FGA keyform visually showed an individual’s response pattern relative to their measure value.</div></div><div><h3>Conclusion</h3><div>Rasch analysis supports the use of the FGA to measure walking balance ability in ambulatory persons with chronic stroke. An FGA keyform can provide instantaneous interval measurement for individuals.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100452"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222110","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":"Amantadine Continuation After Hospital Discharge for Acute Stroke Requiring Inpatient Rehabilitation: A Long-term Follow-up Study","authors":"Haley R. Torr PharmD ,&nbsp;Sara Penrod SLP-CCC ,&nbsp;Jennifer Cote OTR/L ,&nbsp;Sara E. Hanken PT, MPT ,&nbsp;Stephanie C. Chan MD ,&nbsp;Richard R. Riker MD ,&nbsp;Angela Leclerc MSPA, PA-C ,&nbsp;Teresa L. May DO ,&nbsp;David B. Seder MD ,&nbsp;David J. Gagnon PharmD","doi":"10.1016/j.arrct.2025.100459","DOIUrl":"10.1016/j.arrct.2025.100459","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the dosing strategy, safety, and effectiveness of amantadine in patients admitted to inpatient rehabilitation after stroke.</div></div><div><h3>Design</h3><div>Retrospective, single-center, cohort study.</div></div><div><h3>Setting</h3><div>Ninety-bed, inpatient rehabilitation hospital.</div></div><div><h3>Participants</h3><div>Twenty-eight patients (N=28) with amantadine started in a neuro-intensive care unit after stroke and continued after transfer to rehabilitation; the median age was 67 years and 61% were men.</div></div><div><h3>Interventions</h3><div>Oral amantadine.</div></div><div><h3>Main Outcome Measures</h3><div>Amantadine prescribing practices, adverse drug effects, and changes in recovery trajectory relative to dose changes.</div></div><div><h3>Results</h3><div>This cohort included 14 adult patients with intracerebral hemorrhage, 10 with subarachnoid hemorrhage, and 4 with acute ischemic stroke. The most common admitting amantadine dose was 100 mg twice daily. Inpatient rehabilitation lasted 27 (24-35) days, and amantadine was discontinued during rehabilitation in 6 patients (21%). Amantadine was prescribed to 22 patients (79%) at discharge from rehabilitation, most commonly 100 mg daily or twice daily, and was continued for 105 (39-510) days after admission to rehabilitation among the 17 patients with this data available. Twenty-one potential adverse events were identified among 16 (57%) patients, including confusion or delirium, sleeplessness, agitation, fatigue or lethargy, and spasticity; 8 of these (38%) occurred after reductions in amantadine dose.</div></div><div><h3>Conclusions</h3><div>Amantadine dosing was highly variable during inpatient rehabilitation, with trends for longer dosing after acute ischemic stroke and shorter for subarachnoid hemorrhage. Amantadine appeared well tolerated during and after inpatient rehabilitation, and most (22/28) patients were prescribed amantadine at discharge. Strategies to guide long-term use of amantadine after acute stroke require further prospective study.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100459"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222107","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":"Preliminary Study of the Utility of the Menu Task in an Acute Care Setting","authors":"Gordon M. Giles PhD, OTR/L ,&nbsp;Timothy S. Marks PhD ,&nbsp;Terri Flynn MSOT, OTR/L, CLT ,&nbsp;Courtney R. Arganek MSOT, OTR/L, CLT ,&nbsp;Samantha M. Evander Elmore MSOT, OTR/L ,&nbsp;Rebekka Schindler BSOT, OTR/L ,&nbsp;Dorothy F. Edwards PhD","doi":"10.1016/j.arrct.2025.100450","DOIUrl":"10.1016/j.arrct.2025.100450","url":null,"abstract":"<div><h3>Objective</h3><div>To establish the preliminary clinical utility and ecological validity in an acute care setting of a brief functional cognitive screening measure, the Menu Task (MT).</div></div><div><h3>Design</h3><div>Cross-sectional observational study.</div></div><div><h3>Setting</h3><div>Single university-affiliated acute care hospital.</div></div><div><h3>Participants</h3><div>A convenience sample of consecutive general medical patients (N=104) referred to occupational therapy who were not identified as having dementia or delirium and who provided consent.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>MT, Mini-Cog, Activity Measure for Postacute Care (AM-PAC) 6-clicks.</div></div><div><h3>Results</h3><div>The mean age of participants was 70.75 years, and the mean length of stay was 10.17 days. The MT was not significantly correlated with age (<em>r</em>=−.15), education in years (<em>r</em>=.09), the number of chronic health conditions (<em>r</em>=−.18), or length of stay (<em>r</em>=.00). The MT was minimally and not significantly correlated with the AM-PAC Basic Mobility (<em>r</em>=−.06) and Daily Activity (<em>r</em>=−.17) scores. The MT identified more patients as impaired than the Mini-Cog (Χ² =19.69, <em>df</em>=1, N=104; <em>p</em>&lt;.0001). The MT mean scores increased in parallel with increasing scores in the Mini-Cog (F=5.75; <em>df</em>=4.99; <em>p</em>&lt;.0001: ꞃ²=0.19).</div></div><div><h3>Conclusions</h3><div>The mean duration of the MT assessment suggests that routine administration by occupational therapists in an acute care setting is feasible and can add information distinct from the basic mobility and self-care data provided by the AM-PAC measures. This study provides preliminary evidence that the MT is sensitive to functional cognitive deficits in an acutely hospitalized population; however, further research is needed to establish the relationship between the MT and postdischarge independent living skills.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100450"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222108","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":"The Effect of Occupational Therapy Services on Functional Mobility for Patients with Cancer in Acute Care Settings","authors":"Christine C. McNichols PhD, OTR/L ,&nbsp;Alicia K. Peterson PhD ,&nbsp;Stacey Reynolds PhD, OTR/L, FAOTA","doi":"10.1016/j.arrct.2024.100422","DOIUrl":"10.1016/j.arrct.2024.100422","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effect of occupational therapy (OT) services on functional mobility status for patients with cancer in an acute care setting.</div></div><div><h3>Design</h3><div>Secondary data were used in a retrospective, observational study.</div></div><div><h3>Setting</h3><div>The setting was a National Cancer Institute (NCI) hospital in Richmond, Virginia.</div></div><div><h3>Participants</h3><div>Patients aged 18-93 years of age (51.6% female and 48.4% identifying as male) with 6 cancer diagnoses (breast, blood/hematologic, colorectal/gastrointestinal, gynecologic, lung/respiratory, and prostate/genitourinary) admitted to an NCI over 5 years were included for analysis. There were 1949 patients included for analysis in a paired <em>t</em> test, and 448 patients analyzed in an adjusted linear regression based upon complete case analysis.</div></div><div><h3>Intervention</h3><div>The study analyzed the receipt and intensity of OT services.</div></div><div><h3>Main Outcome Measure</h3><div>Activity Measure for Post-Acute Care (AM-PAC) 6-Clicks Basic Mobility scores were analyzed at the time of admission to therapy services and prior to discharge.</div></div><div><h3>Results</h3><div>The patients’ final recorded AM-PAC 6-Clicks Basic Mobility score was statistically significantly higher than the first session's AM-PAC 6-Clicks Basic Mobility score as determined by a paired <em>t</em> test analysis. In a multiple linear regression model adjusted for patient social and demographic factors, we found that for every additional OT service provided, there was an increase in the AM-PAC 6-Clicks Basic Mobility change score; the difference, however, was not statistically significant.</div></div><div><h3>Conclusions</h3><div>There was a statistically significant increase in functional mobility independence for patients with cancer who received OT services in an unadjusted analysis and a non-significant increase in an adjusted analysis of patients’ functional mobility. Findings suggest OT services for patients with cancer may influence functional mobility independence.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 1","pages":"Article 100422"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563397","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterizing Concerns and Stressors During Subacute Spinal Cord Injury: A Thematic Analysis of Psychotherapy Session Notes","authors":"Elizabeth C. Pasipanodya PhD ,&nbsp;Ramya Gopalan MS ,&nbsp;Phuoc Thien Truong BS ,&nbsp;Cria-May Khong BS ,&nbsp;Benjamin Dirlikov MA ,&nbsp;Mark Held PhD ,&nbsp;Janelle Myhre PhD ,&nbsp;Kazuko Shem MD","doi":"10.1016/j.arrct.2024.100410","DOIUrl":"10.1016/j.arrct.2024.100410","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and enumerate the prevalence of concerns and stressors experienced by individuals with spinal cord injury (SCI) during subacute injury.</div></div><div><h3>Design</h3><div>A within-arm (intervention only) qualitative analysis of psychotherapy notes obtained during the 12-week active phase of a randomized controlled trial of tele-cognitive behavioral therapy (tele-CBT). Therapy sessions were conducted between January 2019 and February 2023.</div></div><div><h3>Setting</h3><div>Community setting.</div></div><div><h3>Participants</h3><div>Twenty-two individuals (men: n=14; women: n=8) were included in the analyses; the average age was 44.8 years (SD=18.1) and the mean injury duration was 103.14 days (SD=78.3).</div></div><div><h3>Interventions</h3><div>Participants engaged in 10 (45-60min) CBT sessions with a licensed psychologist; CBT sessions were administered via Apple FaceTime weekly for 8 weeks and then biweekly for 4 weeks, for a total of 10 sessions over 12 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The analyses presented here differ from the main planned analyses to gauge the efficacy of intervention in the study. Psychotherapy notes were qualitatively coded to identify participant endorsements of negative life events, general and SCI-related complaints, and stressors; these inventoried concerns were hierarchically organized into larger subthemes and themes, following Bronfenbrenner's and McLeroy's socioecological framework.</div></div><div><h3>Results</h3><div>Thematically, concerns articulated by individuals with SCI were intrapersonal (cognitive/emotional, somatic, and behavioral), interpersonal (relationships with significant others, with friends and family, with paid caregivers, and with medical providers as well as pet-related concerns), and environmental (access to health care and insurance, accessibility of public spaces, supportive housing, and stigma and discrimination). Compared with research that has enumerated domains of importance among individuals living with SCI, concerns around loss of independence and care burden were more frequently endorsed while bladder/bowel dysfunction and sexual/reproductive concerns were articulated only by a minority of participants. Indeed, across all participants, the most frequently endorsed concerns included pain (n=16; 72.7%), loss of independence (n=12; 54.6%), poor sleep (n=11; 50.0%), and self-perceived care burden (n=11; 50.0%).</div></div><div><h3>Conclusions</h3><div>Individuals with SCI experience a broad range of concerns across multiple ecological levels, some of which are anticipatory (eg, worry about fulfilling duties, once returned to work) and are not SCI-specific (eg, improving health behaviors, managing grief after bereavement). Multimodal and multidisciplinary approaches are needed to provide effective interventions to improve the quality of life.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 1","pages":"Article 100410"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Qualitative Exploration of a Tele-exercise Program to Inform the Design of Adaptive Intervention Strategies for Adults With Multiple Sclerosis","authors":"Yumi Kim PhD ,&nbsp;Elizabeth A. Barstow PhD ,&nbsp;Byron Lai PhD ,&nbsp;Dorothy W. Pekmezi PhD ,&nbsp;Hui-Ju Young PhD ,&nbsp;Jereme Wilroy PhD ,&nbsp;Soumya J. Niranjan PhD ,&nbsp;James H. Rimmer PhD ,&nbsp;Tapan Mehta PhD","doi":"10.1016/j.arrct.2024.100423","DOIUrl":"10.1016/j.arrct.2024.100423","url":null,"abstract":"<div><h3>Objective</h3><div>(1) To examine the experiences and perceptions of people with multiple sclerosis (MS) who previously completed a 3-month tele-exercise program; (2) to identify modifiable factors regarding the program components and implementation procedures that could be used to develop an adaptive tele-exercise intervention.</div></div><div><h3>Design</h3><div>A qualitative study using a semistructured interview guide.</div></div><div><h3>Setting</h3><div>An extension of a comparative effectiveness trial delivered for 761 people with MS between 2016 and 2021. Interviews were conducted over Zoom or phone.</div></div><div><h3>Participants</h3><div>Twenty-two adults with MS who completed the 3-month program (age range, 24-67y, 86% women, 73% Caucasian, 68% relapsing-remitting MS). Participants presented a wide range of mobility disabilities, ranging from no mobility limitation to wheelchair or scooter (n=22).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Thematic analysis of the transcribed interview led to the identification of desirable components and delivery mechanisms of the tele-exercise program.</div></div><div><h3>Results</h3><div>Our analysis indicated the importance of individualized and ongoing modification of exercise program content to accommodate changes in participants’ functional abilities and health status. Participants reported an ideal timepoint of human support, preferably every 3 weeks, via phone or videoconference calls to capture the intervention modification needs (eg, exercise position, intensity, and clarification of exercise instruction). We further identified desirable components for behavioral modifications, such as inclusion of an exercise companion and self-monitoring tool and postintervention resources for sustaining exercise participation during follow-up periods.</div></div><div><h3>Conclusions</h3><div>The findings of this study offer insights into tailoring future adaptive tele-exercise intervention designs aimed at promoting engaging and sustainable exercise participation in people with MS.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 1","pages":"Article 100423"},"PeriodicalIF":1.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143563333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}