American Journal of Physical Medicine & Rehabilitation最新文献

Objective: We wanted to identify prevalent symptoms and patterns of long-COVID syndrome, assess the impact on health-related quality of life, and explore factors linked to lower quality of life, including vaccination status and symptom count, in a real-life cohort.

Design: This is an observational retrospective study.

Results: We assessed 133 patients and 85 completed the evaluations. The most common symptoms reported were motor deficit (95.29%) and fatigue (94.12%), while respiratory symptoms, cognitive deficits, and weakness (76.47%) were less frequent. Many patients experienced multiple symptoms, with the majority reporting 5-8 symptoms simultaneously, most associated with fatigue. However, the number of symptoms did not correlate with health-related quality of life as measured by the 12-Item Short Form Survey questionnaire. Finally, vaccination status did not significantly affect 12-Item Short Form Survey scores or the number of reported symptoms.

Conclusions: Our analysis highlighted the presence of diverse multisystemic symptoms in long-COVID patients. Many individuals experienced multiple associated symptoms, negatively affecting their overall quality of life. Neither vaccination status nor the number of symptoms appeared to influence reported quality of life. This emphasizes the need for a comprehensive, early, and multidisciplinary approach to address the syndrome's diverse symptoms.

Objectives: The aims of the study are to describe the incidence of self-reported COVID-19 history in a longitudinal cohort of individuals with complicated mild to severe traumatic brain injury and describe demographic, injury, and functional differences based on history of COVID-19 infection.

Design: Individuals with complicated mild to severe traumatic brain injury aged 16 or older at time of injury who were enrolled in the Traumatic Brain Injury Model Systems longitudinal cohort study, completed a baseline or follow-up interview between October 1, 2021-March 31, 2023, and provided information about COVID-19 history and timing of COVID-19 infection was collected.

Results: Of the 3627 individuals included in the analysis, 29.5% reported a history of COVID-19 infection. Those with reported COVID-19 history tended to be younger, not of a racial/ethnic minority background, and greater functional status at follow-up based on the Glasgow Outcome Scale-Extended Scale compared with those with no reported COVID-19 history ( P < 0.05). Among those with COVID-19 history, 61.8% did not receive medical care, 27.6% received medical care but no hospitalization, and 10.5% were hospitalized. Of those hospitalized, 21.4% required ventilator use.

Conclusions: Incidence of COVID-19 diagnosis and related hospitalization characteristics in persons with complicated mild to severe traumatic brain injury was similar to national incidence between March 2020-2023. Secondary effects of the COVID-19 pandemic on persons with traumatic brain injury require investigation.

Objective: To describe dropout rates, reasons, and factors associated with dropout during rehabilitation programs for patients with Long COVID.

Design: A search was conducted in PubMed, Embase, and Web of Science. Clinical trials were included that involved exercise programs lasting at least 4 weeks and focused on Long COVID patients aged 18 or older of both sexes, reporting on dropouts and their reasons. The TESTEX scale assessed study quality. Data on patients, interventions, and dropout rates were extracted and presented as frequencies.

Results: Twenty-three studies with 1,523 patients (mean age 53.0 ± 6.4 years, 51% female) were included. Overall, 14% (n = 216) of Long COVID patients dropped out. Reasons included health problems (23%), incomplete assessments (19%), loss of interest (16%), lack of adherence (7%), adherence to other interventions (4%), and 31% unreported. The dropout rate was significantly higher in 2020 compared to 2021 (p = 0.039), while no significant associations were observed between the dropout rate and other variables.

Conclusion: Exercise rehabilitation studies for Long COVID patients show a 14% dropout rate, with the most common reasons being health-related issues and incomplete assessments.

Abstract: The COVID-19 pandemic spurred global engagement with continuing medical education (CME). The Canadian Advances in Neuro-Orthopedics for Spasticity Consortium's free online platform offering interdisciplinary expert lectures on spasticity saw parallel growth. We analysed 1733 responses from 41 post-session surveys to assess the learner's perspectives of online CME using a convergent mixed-methods design. The qualitative analysis produced four themes: [1] event value and satisfaction (subthemes: quality and impact of speakers, accessibility of the online format, discussions and interactions, and the benefits of visual learning), [2] increased competence (subthemes: increased knowledge, intent to apply, and increased confidence), [3] inspiring collaboration (subthemes: need for multidisciplinary teams, international collaboration, and effective communication tools), [4] considerations and recommendations (subthemes: relevance to developing countries, technical aspects, and academic level of content). Quantitative analyses supported these findings, showing high levels of satisfaction and perceived gains in knowledge. Notably, 88% of participants indicated intent to apply their knowledge, and 84% stated that it would enhance their competence. These results underscore the importance of interaction in online education and highlights a need for communication skills training to facilitate multidisciplinary teamwork. The findings revealed disparities in perceptions of the academic difficulty of CME, which warrants investigation into participants' CME selection.

Abstract: This study examined preferences in interview type and signals among applicants interviewed by a non-surgical residency program during the 2023-2024 application cycle. A Qualtrics survey was sent to 88 interview applicants of a university-based Physical Medicine and Rehabilitation (PM&R) residency program. Main outcomes included interview type preference the applicants had with our PM&R program only and their interview type preference with multiple PM&R programs, and preferred number of signals. A resulting 38% of applicants completed the survey. The responders (n = 33) had a similar sex and race distribution compared to all interview applicants. Regarding preferred interview type for our single program, 42% favored in-person, while 40% favored virtual. Those geographically closer to our program had similar interview-type preferences compared to participants from other regions. For multiple program interviews, 52% preferred hybrid, 24% virtual, and 15% in-person format. For signal preferences, 70% of the applicants preferred more than five program signals. The program signaling preference was similar between those with more versus less interviews, for which the cut-off of 10 interviews during the 2023-2024 application cycle was used. Overall, respondents did not have a preferred interview format with a single program, strongly preferred the hybrid format when considering multiple programs, and preferred more program signals.

Objectives: Many people with amyotrophic lateral sclerosis (ALS) develop cervical muscle weakness, often managed with cervical collars. Finding supportive and comfortable collars can be challenging. This study aimed to evaluate satisfaction with various collars and their impact on activities of daily living.

Design: This electronic survey study collected demographic information, clinical status, and participant experiences with commonly used cervical collars.

Results: Thirty-four participants (33 with ALS, 1 with primary lateral sclerosis) completed the survey, with 79% reporting neck weakness and 38% experiencing neck pain. Among those who tried cervical collars (65%), many had tried multiple options. The mean satisfaction across all collar types was 5.03 (SD = 2.92) out of 10.

Conclusion: These findings suggest current collars do not fully meet the needs of people living with ALS, emphasizing the importance of improved treatment options. Future research should explore innovative technologies to improve cervical support, function, and quality of life.

Objective: To assess the effects of neuromuscular electrical stimulation combined with lumbar stabilization exercises on lumbar multifidus muscle thickness, disability, pain, depression, anxiety, and fear-avoidance beliefs in patients with chronic low back pain; and to examine the correlation between ultrasound and magnetic resonance imaging of the lumbar multifidus.

Design: Forty patients aged 18-65 years were randomized into two groups: Group 1: exercise and Group 2: exercise + neuromuscular electrical stimulation. The participants underwent 15-session electrical stimulation and/or exercise (3 days/week). All outcome measures assessed at baseline, post-treatment, and 3 months after. Multifidus cross-sectional area on magnetic resonance imaging was measured only at baseline.

Results: Multifidus thickness increased, and pain decreased significantly in both groups, more prominent in Group 2. Disability, depression, and fear-avoidance beliefs scores significantly decreased in both groups, while anxiety decreased only in Group 1. Both magnetic resonance and ultrasound measurements demonstrated excellent inter-rater reliability and statistically significant correlations.

Conclusion: Both groups improved in terms of pain, disability, psychological status and muscle thickness. Neuromuscular electrical stimulation adjunct to lumbar stabilization exercises demonstrated enhanced effectiveness in increasing lumbar multifidus thickness.