American Journal of Physical Medicine & Rehabilitation最新文献

Objective: To systematically evaluate the effects of noninvasive brain stimulation (NIBS) on pain intensity, psychological symptoms, and quality of life in patients with central poststroke pain (CPSP).

Design: A systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted. Databases including PubMed, Embase, Cochrane Library, Web of Science, and CNKI were searched through April 2025. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated, and subgroup analyses were performed by stimulation target and modality.

Results: Thirteen RCTs involving 430 participants were included. Compared with sham stimulation, NIBS significantly reduced pain intensity (SMD = -0.64, 95% CI: -1.24 to -0.05, p = 0.035). Subgroup analyses showed greater pain reduction when stimulation targeted the primary motor cortex (M1) (SMD = -1.07, 95% CI: -1.62 to -0.52) and when using transcranial direct current stimulation (tDCS) (SMD = -1.08, 95% CI: -1.99 to -0.17). However, no significant effects were observed on depression, anxiety, or quality of life.

Conclusion: NIBS, particularly M1 stimulation and tDCS, may provide analgesic benefits for CPSP but appears ineffective for psychosocial outcomes. Larger, well-designed trials are required to validate stimulation-specific efficacy and clarify the broader therapeutic role of NIBS in CPSP.

Objective: To compare the effects of two nutritional supplementation strategies Amendcor® (Creatine, D-ribose, coenzyme Q10, and vitamin E) vs. Ubiquinol+D-ribose, combined with a 12-wk group-based high-intensity aerobic interval training (GB-HIAIT) on functional exercise capacity (FEC), health-related quality of life (HRQoL), left ventricular ejection fraction (LVEF), and perceived exertion (PE), in patients with heart failure with reduced ejection fraction (HFrEF).

Design: 68 patients with HFrEF were randomly assigned to a Creatine + D-ribose + CoQ10 + Vit. E) (n = 35) or a Ubiquinol + D-ribose group (n = 33) and performed GB-HIAIT. The primary outcome was FEC, assessed via the 6-minute walk test (6MWT), peak VO₂, and peak respiratory exchange ratio (RER). Secondary outcomes included HRQoL, LVEF, and PE.

Results: Study participants supplemented with Creatine + D-ribose + CoQ10 + Vit. E demonstrated significantly greater improvements in FEC (6MWT: +19.88%, VO₂ peak: +25.46%, PE: -38.53%), HRQoL: -25.64%, LVEF: +40.94%, compared with subjects supplemented with Ubiquinol + D-ribose (P < 0.05).

Conclusions: Patients with HFrEF who received multi-ingredient supplementation combined with GB-HIAIT demonstrated superior improvements in FEC, HRQoL, LVEF, and PE, compared with those supplemented with Ubiquinol + D-ribose.

Objective: To evaluate the historical trends of sex differences in athletic performance and participation among male and female wheelchair marathon athletes.

Design: This retrospective, observational study utilized secondary, publicly available data of the Boston, Chicago, and New York City marathons within the Wheelchair Division from 1984 to 2023. Athletic performance and participation were evaluated across all marathon events and over time using univariate analysis of variance and Pearson correlations.

Results: Sex differences in athletic performance were observed with males outperforming females in all marathon events over time (p < 0.001). The sex difference among first place finishers was 20% and increased to 33% for tenth place finishers. Though sex differences decreased over time (p < 0.001), large sex differences in performance remain. Female athlete participation in wheelchair marathon events significantly increased over time (p < 0.001) and the ratio of male athletes to female athletes in these events significantly decreased over time (p < 0.001). Overall participation and male athlete participation also generally increased over time.

Conclusion: Significant sex differences were observed in wheelchair marathon performance and participation. These findings highlight the importance of sex as a key biological variable related to human health and performance, especially among wheelchair athletes.

Objectives: Transfers between wheelchairs and beds pose injury risks to users and caregivers, with conventional devices often inefficient and unsafe. The Powered Personal Transfer System (PPTS)-a no-lift solution integrating an Electric Powered Wheelchair (EPW) and hospital bed-aims to improve safety and efficiency. This study evaluated (1) the usability of the PPTS compared with current transfer methods, (2) whether design refinements, including a docking station for EPW positioning, reduced workload, and (3) whether EPW modifications affected indoor mobility functionality.

Design: Cross-sectional usability study.

Setting: Simulated bedroom laboratory.

Intervention: Participants viewed a short instructional video, performed transfers using the PPTS, and completed validated usability measures comparing the PPTS with their usual transfer methods.

Main outcome measures: System Usability Scale (SUS), Usability Scale for Assistive Technology (USAT), NASA Task Load Index (NASA-TLX), and Visual Analog Scale (VAS) for mobility ease.

Results: The PPTS achieved excellent usability. SUS scores were higher than current methods (users: 90 vs 63.4, p < .01; caregivers: 82.5 vs 62.5, p = .013). The docking station reduced mental workload (p < .001). Mobility tasks were rated easy (median VAS >8.5).

Conclusion: PPTS demonstrated excellent usability, and outperformed existing transfer methods, offering a promising, safe, and efficient no-lift transfer solution.

Abstract: Early recovery of arm and trunk function after high cervical spinal cord injury (SCI) is challenging. We report a case of a 42-year-old woman with subacute C3 AIS B SCI treated with cervical and thoracic transcutaneous spinal cord stimulation (tSCS) during acute inpatient rehabilitation. Initiated six weeks post-injury alongside physical therapy, tSCS was associated with improved motor scores (0 to 10), sensory gains, and AIS conversion to C. Functional gains included better trunk control and voluntary upper extremity movement. Treatment was well tolerated without adverse effects. This case supports the feasibility and potential efficacy of early tSCS integration in acute cervical SCI rehabilitation and warrants further study.

Magnetic resonance imaging is the current "gold standard" for measuring cervical muscle volume, but the associated time and cost may be prohibitive in numerous environments. This study sought to develop a novel and accessible model for estimating cervical muscle volume in adolescent athletes. It was hypothesized that cervical muscle volume could be accurately predicted using a combination of clinically-accessible variables. This secondary analysis of clinical trial data utilized 78 sets of biomechanics lab measurements and neck magnetic resonance imaging scans collected in a total of 42 adolescent athletes to develop a multiple linear regression model for predicting total cervical muscle volume. The final regression model was significant (R2 = 0.7644, F = 78.94, p < 0.001) and successfully predicted total cervical muscle volume using body weight, sex, and neck circumference as model inputs. These variables can be easily obtained using simple measurement tools that are available across most clinical and research environments. This model may be used by medical professionals and researchers to estimate total cervical muscle volume when magnetic resonance imaging measurements are unavailable.

Objective: Primary aim was to investigate the effects of upper extremity (UE) robot-assisted training (RAT), applied in addition to conventional rehabilitation program, on cognitive functions after stroke. Secondary aim was to investigate its effects on UE motor functions and activities, hand dexterity, and daily living activities.

Design: 40 post-acute stroke patients were randomized into robotic (n = 20) and control (n = 20) groups. All patients received a conventional rehabilitation program for 6 weeks, total 30 sessions. The robotic group received additional RAT to the affected UE by exoskeleton robotic system at each session. Cognitive functions (Montreal Cognitive Assessment), UE motor functions (Fugl-Meyer Assessment of Upper Extremity), UE activities (Motor Activity Log-28), hand dexterity (Box and Block Test), and daily living activities (Functional Independence Measure) were assessed before and after the treatment, and at 3-month follow-up.

Results: Both groups showed significant improvements regarding primary and secondary outcomes (p < 0,05). However, improvements in all outcome measures did not differ significantly between the groups (p > 0,0167).

Conclusions: UE RAT applied in addition to conventional rehabilitation program in post-acute stroke provided no extra benefit in terms of improvements in cognitive functions, as well as UE extremity motor functions and activities, hand dexterity, and daily living activities.