Pub Date : 2024-11-18eCollection Date: 2024-12-01DOI: 10.1097/ph9.0000000000000047
Matthew Rong Jie Tay, Eng Chuan Neoh, Jiayen Wong, Xee Vern Tan, Chien Joo Lim, Kelvin Guoping Tan
Background: Hospital-based outpatient physiotherapy is the standard of care for subacute rehabilitation after total knee arthroplasty (TKA) in Singapore. This study explores the clinical effectiveness of a standardized rehabilitation model at community-based rehabilitation centers to align the appropriate utilization of tertiary and community rehabilitative resources.
Methods: In this pilot study, patients who had undergone TKA were assigned to either control group (n=30) or to intervention group (n=29). The control group received usual hospital-based outpatient physiotherapy, while the intervention group received rehabilitation at a community-based rehabilitation center based on standardized institution protocol. Primary and secondary outcomes were assessed at baseline and at 3 months post TKA.
Results: Baseline characteristics in both groups were not significantly different. All patients completed the study. At 3 months, there were no significant differences in the Time Up and Go test (P<0.853), median 30 s chair rise (P=0.347), knee flexion passive range of motion (P=0.933), knee extension passive range of motion (P=0.409), and presence of knee extension lag (P=0.360). There was a lower pain intensity in the intervention group compared with the control group (P=0.003).
Conclusions: A community-based post-acute TKA rehabilitative model demonstrated improvements in functional outcomes, and reduced pain intensity in study participants, with these findings being similar to that of standard of care hospital-based outpatient physiotherapy. This model of care warrants further evaluation in larger clinical trials.
{"title":"Clinical effectiveness of a standardized community-based supervised post-acute rehabilitation model after total knee arthropathy: A pilot study.","authors":"Matthew Rong Jie Tay, Eng Chuan Neoh, Jiayen Wong, Xee Vern Tan, Chien Joo Lim, Kelvin Guoping Tan","doi":"10.1097/ph9.0000000000000047","DOIUrl":"10.1097/ph9.0000000000000047","url":null,"abstract":"<p><strong>Background: </strong>Hospital-based outpatient physiotherapy is the standard of care for subacute rehabilitation after total knee arthroplasty (TKA) in Singapore. This study explores the clinical effectiveness of a standardized rehabilitation model at community-based rehabilitation centers to align the appropriate utilization of tertiary and community rehabilitative resources.</p><p><strong>Methods: </strong>In this pilot study, patients who had undergone TKA were assigned to either control group (n=30) or to intervention group (n=29). The control group received usual hospital-based outpatient physiotherapy, while the intervention group received rehabilitation at a community-based rehabilitation center based on standardized institution protocol. Primary and secondary outcomes were assessed at baseline and at 3 months post TKA.</p><p><strong>Results: </strong>Baseline characteristics in both groups were not significantly different. All patients completed the study. At 3 months, there were no significant differences in the Time Up and Go test (<i>P</i><0.853), median 30 s chair rise (<i>P</i>=0.347), knee flexion passive range of motion (<i>P</i>=0.933), knee extension passive range of motion (<i>P</i>=0.409), and presence of knee extension lag (<i>P</i>=0.360). There was a lower pain intensity in the intervention group compared with the control group (<i>P</i>=0.003).</p><p><strong>Conclusions: </strong>A community-based post-acute TKA rehabilitative model demonstrated improvements in functional outcomes, and reduced pain intensity in study participants, with these findings being similar to that of standard of care hospital-based outpatient physiotherapy. This model of care warrants further evaluation in larger clinical trials.</p>","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":"7 4","pages":"129-135"},"PeriodicalIF":0.0,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11654452/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142866525","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}
Pub Date : 2024-01-25eCollection Date: 2024-05-01DOI: 10.1097/ph9.0000000000000026
Jeffrey Strakowski, Han Zhang, Millard Reschke, Faye Y Chiou-Tan
Objective: The objective of this paper is to document the feasibility of image acquisition, image optimization, and sonographic appearance of the exposed anatomic windows of cadaveric inner ear dissection for purposes of potential future clinical evaluation as part of the developing area of physical and rehabilitation space medicine.
Methods: Cadaveric dissection of the inner ear was conducted with the goal of exposing areas relevant to vestibular balance. Middle and inner ear structures of 3 human cadavers were imaged with multiple broadband transducers, including emphasis with higher frequency transducers.
Results: The images were best optimized with 17 MHz and 22 MHz small footprint transducers. High-frequency ultrasound (US) images of the semicircular canals, vestibular and facial nerves, and utricles with reflected otoliths (otoconia) were obtained and reported in this article. Detailed visualization of both the vestibular nerve and facial nerve was accomplished, including identification of fascicular architecture. In addition, US reflection from the otoliths contained within the utricle was identified with sufficient clarity to provide surface measurements. Bony acoustic landmarks of the middle ear bones were identified by scanning externally from the tympanic membrane, including the dynamic movement of the bones with manual manipulation.
Conclusion: US visualization has the potential to be an effective imaging modality to monitor potential changes to the otolith's size throughout extended space flight. To our knowledge, no prior study has reported US images of human inner ear structures.
{"title":"Special anatomy series. Imaging inner ear structures with high-frequency ultrasound: Application to physical rehabilitation space medicine.","authors":"Jeffrey Strakowski, Han Zhang, Millard Reschke, Faye Y Chiou-Tan","doi":"10.1097/ph9.0000000000000026","DOIUrl":"10.1097/ph9.0000000000000026","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this paper is to document the feasibility of image acquisition, image optimization, and sonographic appearance of the exposed anatomic windows of cadaveric inner ear dissection for purposes of potential future clinical evaluation as part of the developing area of physical and rehabilitation space medicine.</p><p><strong>Methods: </strong>Cadaveric dissection of the inner ear was conducted with the goal of exposing areas relevant to vestibular balance. Middle and inner ear structures of 3 human cadavers were imaged with multiple broadband transducers, including emphasis with higher frequency transducers.</p><p><strong>Results: </strong>The images were best optimized with 17 MHz and 22 MHz small footprint transducers. High-frequency ultrasound (US) images of the semicircular canals, vestibular and facial nerves, and utricles with reflected otoliths (otoconia) were obtained and reported in this article. Detailed visualization of both the vestibular nerve and facial nerve was accomplished, including identification of fascicular architecture. In addition, US reflection from the otoliths contained within the utricle was identified with sufficient clarity to provide surface measurements. Bony acoustic landmarks of the middle ear bones were identified by scanning externally from the tympanic membrane, including the dynamic movement of the bones with manual manipulation.</p><p><strong>Conclusion: </strong>US visualization has the potential to be an effective imaging modality to monitor potential changes to the otolith's size throughout extended space flight. To our knowledge, no prior study has reported US images of human inner ear structures.</p>","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":"7 1","pages":"33-38"},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11111317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141088920","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}
Pub Date : 2023-12-01DOI: 10.1097/ph9.0000000000000019
{"title":"Keynote Speakers","authors":"","doi":"10.1097/ph9.0000000000000019","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000019","url":null,"abstract":"","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":" 911","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138610696","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 : 2023-12-01DOI: 10.1097/ph9.0000000000000020
{"title":"Oral Presentation 1 and Oral Presentation 2","authors":"","doi":"10.1097/ph9.0000000000000020","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000020","url":null,"abstract":"","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138614317","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 : 2023-12-01DOI: 10.1097/ph9.0000000000000023
Michelle C. Tan, Angela N. Cortez, Faye Y. Chiou-Tan
The objective of this paper is to document sports injuries in premier Highland dancers. Highland dance originated in Scotland and is a relatively unknown sport to physiatrists and sports physicians. It is not the same as Irish dance performed in tap shoes but has some similarities to ballet with regard to the turnout of the leg in the first position. An Institutional Review Board approved, prospective, telephone survey was conducted to document demographics, area, type, and age of injury in premier Highland dancers. A total of 22 premier Highland dancers met the inclusion criteria for the study. In the hip region, injuries included apophysitis at the anterior superior iliac spine. In the knee region, knee effusions, shin splints, and hairline stress fractures of the tibia were reported. In addition, less common injuries in sports, such as tibialis anterior strain and plantaris tendon partial rupture, were noted. In the ankle/foot region, sprains and tears of anterior tibiofibular, calcaneofibular, posterior talofibular ankle ligaments, and plantar fasciitis were observed, as well as fractured metatarsals in the foot and degenerative arthritis. Injuries resulting from improper alignment in “turnout” (external rotation at the hip) and overuse syndromes from intense and long hours of training to reach national and international competitive premier level were observed. Uncommon injuries, such as tibialis anterior strain and plantaris tendon partial rupture, were also noted that were unique to the jumping and heel/toe maneuvers performed in this sport.
{"title":"Premier Highland dancer sports injuries","authors":"Michelle C. Tan, Angela N. Cortez, Faye Y. Chiou-Tan","doi":"10.1097/ph9.0000000000000023","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000023","url":null,"abstract":"\u0000 \u0000 The objective of this paper is to document sports injuries in premier Highland dancers. Highland dance originated in Scotland and is a relatively unknown sport to physiatrists and sports physicians. It is not the same as Irish dance performed in tap shoes but has some similarities to ballet with regard to the turnout of the leg in the first position.\u0000 \u0000 \u0000 \u0000 An Institutional Review Board approved, prospective, telephone survey was conducted to document demographics, area, type, and age of injury in premier Highland dancers.\u0000 \u0000 \u0000 \u0000 A total of 22 premier Highland dancers met the inclusion criteria for the study. In the hip region, injuries included apophysitis at the anterior superior iliac spine. In the knee region, knee effusions, shin splints, and hairline stress fractures of the tibia were reported. In addition, less common injuries in sports, such as tibialis anterior strain and plantaris tendon partial rupture, were noted. In the ankle/foot region, sprains and tears of anterior tibiofibular, calcaneofibular, posterior talofibular ankle ligaments, and plantar fasciitis were observed, as well as fractured metatarsals in the foot and degenerative arthritis.\u0000 \u0000 \u0000 \u0000 Injuries resulting from improper alignment in “turnout” (external rotation at the hip) and overuse syndromes from intense and long hours of training to reach national and international competitive premier level were observed. Uncommon injuries, such as tibialis anterior strain and plantaris tendon partial rupture, were also noted that were unique to the jumping and heel/toe maneuvers performed in this sport.\u0000","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":"148 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139021903","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 : 2023-12-01DOI: 10.1097/ph9.0000000000000022
{"title":"Specialty Development","authors":"","doi":"10.1097/ph9.0000000000000022","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000022","url":null,"abstract":"","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":" 100","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138620547","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 : 2023-12-01DOI: 10.1097/ph9.0000000000000021
{"title":"Poster presentations Part 1, Poster presentations Part 2 and Poster presentations Part 3","authors":"","doi":"10.1097/ph9.0000000000000021","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000021","url":null,"abstract":"","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":"26 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138624838","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 : 2023-12-01DOI: 10.1097/ph9.0000000000000025
Ariné Kuyler, Ensa Johnson, J. Bornman
The main aim of this study was to identify the multidimensional support needs of familiar caregivers and to identify the lessons they had learned throughout the caregiving process. Persons who are minimally responsive require continuous medical care—either at home or at a care facility. The home context is often preferred as it facilitates the care process in a familiar environment and reduces adverse health outcomes, such as mortality. Home care of the person who is minimally responsive is often managed by familiar caregivers who support these individuals in all aspects of daily living. This caregiving experience may be burdensome for the familiar caregiver as increased physical, psychological, emotional, social, and financial requirements, and responsibilities could cause multidimensional stressors. A qualitative descriptive design using 7 semistructured in-depth interviews was used with 7 familiar caregivers of persons who were/are minimally responsive. These participants were obtained from a private care facility and thematic analysis was used to analyze the in-depth interviews. The ecological systems theory was used to identify and link 11 themes with subthemes to the support needs reported by the caregivers. In addition, the results included the lessons learned by these caregivers from their caregiving journey. From the findings of this study, it is clear that caregivers mostly experience challenges within the microsystem and mesosystem with limited challenges in other systems. These systems are, however, integrated and can impact the individual caregiver substantially. Health care practitioners, in particular, should be aware of caregivers’ support needs and give them adequate support at home.
{"title":"Support needs of familiar caregivers caring for persons who are minimally responsive: an ecological system approach","authors":"Ariné Kuyler, Ensa Johnson, J. Bornman","doi":"10.1097/ph9.0000000000000025","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000025","url":null,"abstract":"\u0000 \u0000 The main aim of this study was to identify the multidimensional support needs of familiar caregivers and to identify the lessons they had learned throughout the caregiving process.\u0000 \u0000 \u0000 \u0000 Persons who are minimally responsive require continuous medical care—either at home or at a care facility. The home context is often preferred as it facilitates the care process in a familiar environment and reduces adverse health outcomes, such as mortality. Home care of the person who is minimally responsive is often managed by familiar caregivers who support these individuals in all aspects of daily living. This caregiving experience may be burdensome for the familiar caregiver as increased physical, psychological, emotional, social, and financial requirements, and responsibilities could cause multidimensional stressors.\u0000 \u0000 \u0000 \u0000 A qualitative descriptive design using 7 semistructured in-depth interviews was used with 7 familiar caregivers of persons who were/are minimally responsive. These participants were obtained from a private care facility and thematic analysis was used to analyze the in-depth interviews.\u0000 \u0000 \u0000 \u0000 The ecological systems theory was used to identify and link 11 themes with subthemes to the support needs reported by the caregivers. In addition, the results included the lessons learned by these caregivers from their caregiving journey.\u0000 \u0000 \u0000 \u0000 From the findings of this study, it is clear that caregivers mostly experience challenges within the microsystem and mesosystem with limited challenges in other systems. These systems are, however, integrated and can impact the individual caregiver substantially. Health care practitioners, in particular, should be aware of caregivers’ support needs and give them adequate support at home.\u0000","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":"33 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138987061","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 : 2023-12-01DOI: 10.1097/ph9.0000000000000024
Edwin Luk, Ian J. Baguley, John Olver, Rachael Nunan, John Estell, Senen Gonzalez, Dion Marinkovich, A. Grandoulier, Lynne Turner-Stokes
Primary results from the international upper limb international spasticity-III study provided robust evidence for the benefit of repeated cycles of botulinum toxin-A (BoNT-A) for upper limb spasticity. Internationally, patients with active function goals tended to require more frequent injections, and we hypothesized that reimbursement restrictions in Australia (which typically limited the number of injections received) may have adversely impacted outcomes compared with the international cohort. Upper Limb International Spasticity-III was a prospective, observational study following adults living with spasticity over 2 years of goal-directed upper limb spasticity management including repeated BoNT-A treatment. The Australian subgroup included 115 patients (mean±SD age 53.8±16.9 years, 56% male, 79% stroke etiology), of whom 74% had previously been treated with BoNT-A. Australian participants had fewer injection cycles [2.7 (2.3, 3.0) vs. 4.1 (4.0, 4.3)] with longer injection intervals [330.6 (280.3, 381.0) vs. 200.3 (189.4, 211.1) days] than the international cohort. Across each evaluation cycle, patients in the Australian subgroup showed a change from baseline in Goal Attainment Scaling (GAS) T scores of >10, confirming relevant improvement. At 2 years, cumulated GAS T scores were 47.9 (46.4, 49.4) for the Australian subgroup versus 49.7 (49.3, 50.1) in the international cohort. Active function goals were generally underachieved in the Australian subgroup (mean cumulated GAS-T-score 43.6 (41.6, 45.6) vs. 47.4 (46.5, 48.3) internationally]. As anticipated, the Australian cohort had fewer injection cycles with longer intervals than seen internationally. Their overall goal attainment was lower than for the total cohort, which appeared to be driven by less active function goal attainment. Among other possible factors, these data support the idea that restricted reimbursement may have impacted BoNT-A injection frequency and consequently, patient outcomes.
国际上肢国际痉挛-III研究的初步结果为重复周期注射肉毒杆菌毒素-A（BoNT-A）治疗上肢痉挛提供了有力的证据。 在国际上，以积极功能为目标的患者往往需要更频繁的注射，我们假设，与国际队列相比，澳大利亚的报销限制（通常会限制注射次数）可能会对治疗效果产生不利影响。 上肢国际痉挛-III 是一项前瞻性观察研究，对成年痉挛患者进行了为期两年的目标导向上肢痉挛治疗，包括重复 BoNT-A 治疗。 澳大利亚亚组包括 115 名患者（平均年龄（±SD）为 53.8±16.9 岁，56% 为男性，79% 为中风病因），其中 74% 以前接受过 BoNT-A 治疗。与国际队列相比，澳大利亚参与者的注射周期[2.7 (2.3, 3.0) vs. 4.1 (4.0, 4.3)]更短，注射间隔[330.6 (280.3, 381.0) vs. 200.3 (189.4, 211.1)天]更长。在每个评估周期中，澳大利亚亚组患者的目标达成量表（GAS）T评分与基线相比的变化均大于10分，证实了相关的改善。2 年后，澳大利亚亚组的累计 GAS T 分数为 47.9（46.4，49.4）分，而国际组为 49.7（49.3，50.1）分。澳大利亚亚组的主动功能目标普遍达不到（平均累积 GAS-T 分数为 43.6 (41.6, 45.6) vs. 国际组为 47.4 (46.5, 48.3)]。 正如预期的那样，澳大利亚亚组的注射周期较短，间隔时间较长。他们的总体目标实现率低于总体组群，这似乎是由于较少实现主动功能目标所致。除其他可能的因素外，这些数据还支持这样一种观点，即限制报销可能会影响 BoNT-A 的注射频率，进而影响患者的治疗效果。
{"title":"Goal attainment with integrated upper limb spasticity management including botulinum toxin-A (BoNT-A): Subanalysis of Australian data from the ULIS-III study","authors":"Edwin Luk, Ian J. Baguley, John Olver, Rachael Nunan, John Estell, Senen Gonzalez, Dion Marinkovich, A. Grandoulier, Lynne Turner-Stokes","doi":"10.1097/ph9.0000000000000024","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000024","url":null,"abstract":"\u0000 \u0000 Primary results from the international upper limb international spasticity-III study provided robust evidence for the benefit of repeated cycles of botulinum toxin-A (BoNT-A) for upper limb spasticity.\u0000 \u0000 \u0000 \u0000 Internationally, patients with active function goals tended to require more frequent injections, and we hypothesized that reimbursement restrictions in Australia (which typically limited the number of injections received) may have adversely impacted outcomes compared with the international cohort.\u0000 \u0000 \u0000 \u0000 Upper Limb International Spasticity-III was a prospective, observational study following adults living with spasticity over 2 years of goal-directed upper limb spasticity management including repeated BoNT-A treatment.\u0000 \u0000 \u0000 \u0000 The Australian subgroup included 115 patients (mean±SD age 53.8±16.9 years, 56% male, 79% stroke etiology), of whom 74% had previously been treated with BoNT-A. Australian participants had fewer injection cycles [2.7 (2.3, 3.0) vs. 4.1 (4.0, 4.3)] with longer injection intervals [330.6 (280.3, 381.0) vs. 200.3 (189.4, 211.1) days] than the international cohort. Across each evaluation cycle, patients in the Australian subgroup showed a change from baseline in Goal Attainment Scaling (GAS) T scores of >10, confirming relevant improvement. At 2 years, cumulated GAS T scores were 47.9 (46.4, 49.4) for the Australian subgroup versus 49.7 (49.3, 50.1) in the international cohort. Active function goals were generally underachieved in the Australian subgroup (mean cumulated GAS-T-score 43.6 (41.6, 45.6) vs. 47.4 (46.5, 48.3) internationally].\u0000 \u0000 \u0000 \u0000 As anticipated, the Australian cohort had fewer injection cycles with longer intervals than seen internationally. Their overall goal attainment was lower than for the total cohort, which appeared to be driven by less active function goal attainment. Among other possible factors, these data support the idea that restricted reimbursement may have impacted BoNT-A injection frequency and consequently, patient outcomes.\u0000","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":"316 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138986060","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 : 2023-11-20DOI: 10.1097/ph9.0000000000000018
Ady M. Correa, Diana Molinares, Eduard Tiozzo, Laura Huang
Examine the relationship between obesity and symptom burden (SB) among female oncologic patients evaluated in cancer rehabilitation (CR) clinics. Secondary aims included evaluation of the relationship between obesity and SB among race, types of cancer, comorbid conditions and differences in symptom severity on the Edmonton Symptom Assessment Scale (ESAS) questionnaire across body mass index. Obesity is a risk factor for some types of breast and gynecologic cancers. Studies have shown an increased risk for pain persistence and higher symptom severity experienced by obese female patients who undergo oncologic treatments. The severity of symptom burden (SB), however, has not been studied in obese oncologic patients in the rehabilitation medicine setting. Retrospective chart review study in CR clinics, single institution. All the medical records of female patients (n = 61) who completed ESAS on initial evaluation in CR clinics were evaluated, from August 2020 to January 2022. Obese female patients reported increased SB based on the ESAS questionnaire, specifically three symptom domains: pain, drowsiness, and spiritual distress. Nutrition counseling and lifestyle modifications in CR clinics may positively impact SB.
{"title":"The relation of body mass index and total symptom burden in female oncologic patients","authors":"Ady M. Correa, Diana Molinares, Eduard Tiozzo, Laura Huang","doi":"10.1097/ph9.0000000000000018","DOIUrl":"https://doi.org/10.1097/ph9.0000000000000018","url":null,"abstract":"Examine the relationship between obesity and symptom burden (SB) among female oncologic patients evaluated in cancer rehabilitation (CR) clinics. Secondary aims included evaluation of the relationship between obesity and SB among race, types of cancer, comorbid conditions and differences in symptom severity on the Edmonton Symptom Assessment Scale (ESAS) questionnaire across body mass index. Obesity is a risk factor for some types of breast and gynecologic cancers. Studies have shown an increased risk for pain persistence and higher symptom severity experienced by obese female patients who undergo oncologic treatments. The severity of symptom burden (SB), however, has not been studied in obese oncologic patients in the rehabilitation medicine setting. Retrospective chart review study in CR clinics, single institution. All the medical records of female patients (n = 61) who completed ESAS on initial evaluation in CR clinics were evaluated, from August 2020 to January 2022. Obese female patients reported increased SB based on the ESAS questionnaire, specifically three symptom domains: pain, drowsiness, and spiritual distress. Nutrition counseling and lifestyle modifications in CR clinics may positively impact SB.","PeriodicalId":75125,"journal":{"name":"The journal of the International Society of Physical and Rehabilitation Medicine","volume":"27 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139256092","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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