American Journal of Physical Medicine & Rehabilitation最新文献

Objective: The aim of the study is to evaluate whether the application of an interfascial injection with dextrose water could result in reduced pain and improved shoulder function and range of motion.

Design: This is a double-blind randomized controlled trial. Thirty-five patients with chronic shoulder pain were randomly assigned to receive either an interfascial injection of 10 mL of 10% dextrose water guided by ultrasound or a sham injection of 0.5 mL of 10% dextrose water into the subcutaneous layer. All patients received education on a home program of self-massage and self-stretching. Shoulder pain, shoulder range of motion, and neck and shoulder function were measured before injection and at 4 and 12 wks after injection.

Results: Both groups showed significant improvements in visual analog scale scores at 12-wk follow-up. The interfascial injection group exhibited a significant pain reduction compared with the sham group at the 12-wks follow-up. No between-group differences were observed in shoulder range of motion, pain threshold, and neck and shoulder function.

Conclusions: Interfascial injection is effective in decreasing pain in patients with myofascial pain syndrome.

Objective: This study attempts to examine long-term pain medication usage after burn injury and its association with functional and psychosocial outcomes.

Design: This is a multicenter retrospective cohort study utilizing the Burn Model System National Longitudinal Database. Participants injured from 2015 to 2021 were divided into two groups, those taking and not taking prescription pain medication at 12 mos after injury. Regression analyses examined associations between pain medication use and outcomes at 12 mos, adjusting for demographics, burn size, length of hospital stay, and preinjury pain medication use and employment status. Outcomes included VR-12 Physical and Mental Component Summary scores Patient-Reported Outcomes Measurement Information System Anxiety and Depression scores, Satisfaction with Life Scale, and employment status.

Results: Of 358 participants analyzed, prescription pain medication use was associated with worse outcomes at 12 mos: Physical Component Summary (β = -7.11, P < 0.001), Mental Component Summary (β = -6.01, P < 0.001), and Patient-Reported Outcomes Measurement Information System Depression (β = 4.88, P < 0.001) and Anxiety (β = 6.16, P < 0.001). Satisfaction with Life Scale was not significantly associated with pain medication use ( P = 0.069) and those taking pain medication were 52% less likely to be employed at 12 mos ( P = 0.035).

Conclusions: There is a significant association between prescription pain medication use and worse physical, mental, and employment outcomes at 12 mos after burn injury.

Abstract: Although research on sport-related concussion has grown substantially in the last decade, research on concussion in para sports remains limited. The aim of this scoping review is to synthesize and describe the current literature on the incidence, assessment, and management of sport-related concussion in para athletes. The literature search was conducted in CINAHL, Google Scholar, MEDLINE, SPORTDiscus, and Web of Science databases and identified 22 studies that addressed one of our research questions. A majority of studies addressed concussion in elite athletes; youth and collegiate para athletes were largely underrepresented. Fewer studies addressed concussion assessment and management, in part due to limitations in accessibility of current assessment tools for athletes with varying disabilities. Moving forward, there is a need to capture a larger range of incidence data, create modified assessment tools with para-specific normative data, and develop risk prevention strategies for para athletes.

Objective: The aim of the study is to estimate the current nationwide prevalence of falls, injurious falls, concerns about falling, and information on fall prevention among people with multiple sclerosis.

Design: This is a cross-sectional national web-based survey that included 965 adult people with multiple sclerosis. Participants self-reported falls and injurious falls experienced in the past 6 months. Participants also provided information on their concerns about falling and information on fall prevention received.

Results: A total of 56% reported falling in the past 6 months. The prevalence of falls at the population level ranges between 53% and 59%. Most falls occur inside of participants' homes (68%). About 30% of fallers reported an injurious fall. Most respondents, 87% expressed being concerned about falling and 68% reported they had cut down on activities due to their concerns about falling. Among participants who received information about falling (64%), only 9% received a formal fall prevention course.

Conclusions: Despite advances in falls research over the last decades, falling continues to be a highly prevalent problem for people with multiple sclerosis. About one-third of those falls result in injuries. Concerns about falling among fallers and nonfallers affect the performance of daily activities and independence. Few people receive a formal falls prevention education or training.

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: 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 to 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 (SF-12) questionnaire. Finally, vaccination status did not significantly affect SF-12 scores or the number of reported symptoms.

Conclusion: 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 multi-disciplinary approach to address the syndrome's diverse symptoms.

Objective: This study sought to examine the association between inactive time, leisure-time physical activity (LTPA), and mortality in individuals diagnosed with chronic obstructive pulmonary disease (COPD).

Design: This study utilized a nationally representative sample of patients with COPD from National Health and Nutrition Examination Survey (NHANES) survey (n = 1817; weighted population, 23,698,840). Mortality was tracked from the date of interview and examination. LTPA and sedentary time were assessed using a Global Physical Activity Questionnaire.

Results: The study found that only 28% of patients with COPD achieved sufficient LTPA (LTPA ≥150 min/week), while 58% reported no physical activity and 47% sat for over six hours per day. Over a nine-year follow-up period, 501 deaths occurred, with 101 due to heart diseases. Adequate LTPA levels were associated with a decreased risk of mortality from any cause. Moreover, patients who engaged in sufficient LTPA and reduced sitting time had a lower risk of mortality from any cause compared to those who did not engage in sufficient LTPA.

Conclusion: Participating in an adequate amount of LTPA was linked to a reduced risk of death from any cause in patients with COPD. However, irrespective of the extent of the LTPA, there was no significant correlation between sedentary behavior and the risk of mortality.

Objective: To describe and compare adverse event (AE) incidence, type, severity, and preventability in the Canadian inpatient rehabilitation setting.

Design: In this retrospective case series, AEs were identified through chart reviews from two Canadian academic tertiary post-acute care hospitals. AEs were characterized through descriptive statistics and compared using the Mantel-Haenszel and Fisher's exact tests.

Results: During the study period, one site (n = 120) had 28 AEs and an incidence of 9.7 (95% CI 6.1-13.3) per 1000 patient days, and the other (n = 48) had 15 AEs and an incidence of 13.9 (95% CI 6.9-21) per 1000 patient days (p = 0.82). The two sites differed significantly in AE type (p = 0.033) and preventability (p = 0.002) but not severity. The most common AE type was medication/intravenous fluids-related (16/28, 57%) at one site and patient incidents (e.g., falls, pressure ulcers) at the other. Four percent (1/28) of AEs were preventable at one site, and 53% (8/15) at another. Most AEs at both sites were mild in severity.

Conclusions: AEs significantly differed in type and preventability between the two sites. These results suggest the importance of context and the need for an organization-specific and tailored approach when addressing patient safety in inpatient rehabilitation settings.

Objective: The identification of factors associated with successful rehabilitation after hip fractures enables more successful planning of the rehabilitation process and discharge from the hospital. Orthostatic hypotension (OH) and handgrip strength (HGS) have been evaluated in previous studies as potential predictors of rehabilitation outcomes, with inconsistent results.

Design: A retrospective study of patients 65 years of age and above who underwent rehabilitation after surgical repair of hip fracture in the Geriatric Department between July 2020 and October 2023. HGS was measured during the first three days of hospitalization using a digital dynamometer. OH was measured a week after admission to the ward by the tilt table test. Successful rehabilitation was defined as a Montebello Rehabilitation Factor Score Revised (MRFS-R) above 50%.

Results: Data were collected for 253 patients. The mean age was 80.5 ± 7.7 and 32.4% were males. The mean HGS was 17.2 ± 6.6 kg. OH was diagnosed in 32.8%. 193 patients (76.3%) reached the goal of MRFS-R ≥ 50 at the end of the rehabilitation. In a logistic regression analysis HGS, cognitive state, and sex were associated with successful rehabilitation.

Conclusions: Measuring HGS, but not OH, can predict successful rehabilitation.

Objective: This study aimed to apply Classification and Regression Tree (CART) analysis to determine factors associated with glenohumeral osteoarthritis (GH OA) and establish specific cut-off points for risk factors based on this methodology.

Design: The cross-sectional study included 3,383 participants with shoulder pain. Cases were selected for GH OA. Patients with other shoulder pathologies were included as controls. 33 potential risk factors were assessed. The CART analysis was used to determine the highest-ranked risk factors associated with GH OA. Multivariable logistic regression analysis was then performed using the cut-off points obtained from the CART analysis.

Results: The CART analysis showed that age and body mass index (BMI) were the two most significant risk factors for GH OA. Multivariable logistic regression revealed that age categories ≥31- < 58 years (OR = 8.92), ≥58- < 64 years (OR = 20.20), and ≥ 64 years (OR = 42.20), and BMI categories ≥25-30 kg/ m2 (OR = 1.47) and ≥ 30 kg/ m2 (OR = 1.71) had higher odds of developing GH OA compared to age < 31 years and BMI <25 kg/m2.

Conclusion: This was the first study to use CART analysis to evaluate significant risk factors for GH OA and establish cut-off points for increased risk. The findings present age categories that are distinct from the arbitrary age groups used in previous studies.

Objective: This study investigates the global research landscape of prehabilitation, identifying current trends, dominant disciplines, collaborative networks, and prominent articles in the field.

Design: For our analysis, we employed the published prehabilitation literature indexed in the Web of Science Core Collection database, spanning from 2002 to 2022. Additionally, we utilized CiteSpace (version 6.2; Drexel University), a widely used information visualization software to perform bibliometric analysis.

Results: Analyzing 553 research articles, we observe a consistent upward trend in prehabilitation publication and citation activity. Interdisciplinary co-occurrence analysis highlights strong connections with fields such as surgery, rehabilitation, oncology, sports sciences, orthopedics, gastroenterology, and hepatology. Initially centered around postoperative outcomes in major abdominal surgeries, particularly for colorectal, pancreatic, and prostate cancers, prehabilitation research expanded to include thoracic surgeries, focusing on conditions like lung cancer and aortic valve replacement. Preoperative exercise remains a core area, with increasing interest in multimodal prehabilitation and its effectiveness based on patient group characteristics. North America and Western Europe emerge as primary contributors to prehabilitation research.

Conclusion: Current research concentrates on tailoring prehabilitation programs for specific groups, and broadening their geographical scope would enhance the studies, contributing valuable insights for medical practitioners shaping future research efforts.