American Journal of Physical Medicine & Rehabilitation最新文献

Abstract: With increasing use of golf carts and low speed vehicles (LSV) for recreational, work-related, and commuting purposes, the number of related injuries is also on the rise. The body of literature describing these injuries is informative but limited. From this scoping review, we found that, LSV related injuries preferentially affect children, older adults, and males. Common mechanisms of injury include ejection and collision. Associated alcohol consumption is common and typically related to increasing severity of injury. Various injuries may result from LSVs as described in the review, including soft tissue injuries, orthopedic injuries and TBI. Description of trends and classifications of injury will hopefully improve reporting and ability to make recommendations on safe use and regulation.

Objective: The first objective is to examine the age-related trajectory of competitive performance and the age at peak competitive performance in wheelchair rugby players at the Paralympic Games. Another objective is to verify age correlations with performance over the years for each class.

Design: This is a retrospective cohort study.

Results: Data were collected from the official results books of the Paralympic games. The mean age (SD) of the 267 players and 448 analyzed data from all Paralympic games (from Sidney 2004 to Tokyo 2020) across all classes was 32.8 (6.4) yrs, and the age at peak competitive performance was 30.6 (7.4) yrs. Each class had no statistical difference in age at peak competitive performance. In addition, there was no significant correlation between age and performance within classes or across all Paralympic games.

Conclusions: The findings indicate that wheelchair rugby players' age at peak competitive performance is 30.6 yrs, which remains consistent across all classes. There is no statistical correlation between age and performance in wheelchair rugby. These findings significantly affect effective talent identification and athlete development programs. This impact ensures that athletes receive the necessary support to reach their maximum potential while avoiding the pitfalls of underestimating or overestimating their stages of development.

Objective: The aim of the study is to investigate the comparative effects of nonpharmacological therapies for managing global, attention, memory, and execution cognitive functions in stroke patients.

Design: We searched PubMed, Embase, CINAHL, Cochrane Library, Web of Science, PEDro, and Google Scholar for randomized controlled trials that evaluated the effects of nonpharmacological therapies for treating stroke cognitive dysfunctions. We performed a network meta-analysis to estimate the mean treatment effect of 95% credible interval.

Results: Seventy-three randomized controlled trials were included in the network meta-analysis for evidence syntheses. All therapies had significant effects than control on global cognition in stroke patients. Combined therapy was superior to other therapies for global cognition of all patients (vs. cognitive task therapy: 0.71, 95% credible interval = 0.14 to 1.29; vs. exercise: 0.88, 95% credible interval = 0.31 to 1.45, vs. physical modality therapy: 0.77, 95% credible interval = 0.16 to 1.40). Different therapies have effects on specific cognitive domains in stroke patients.

Conclusions: Our findings suggest that nonpharmacological therapies are effective in improving global cognitive function in stroke patients, with cognitive task therapy, exercise therapy, physical modality therapy, and combined therapy being viable options (most optimal approach: combined therapy). Precise selection of therapies based on the time since stroke onset and specific cognitive domains can further enhance treatment outcomes.

Abstract: Despite new effective medications, patients with spinal muscular atrophy types 1-3 can continue to have inadequate cough flows to prevent episodes of acute respiratory failure. Ventilator unweanable intubated patients are thought to require tracheostomy tubes. As a result, potentially beneficial medications may be discontinued and patients die despite receiving these medications. Three cases are presented of medically treated, physically strengthening children, with spinal muscular atrophy type 1. All three subsequently died or underwent tracheotomy. However, there is no evidence of extubation attempts to noninvasive ventilatory support settings or optimal mechanical insufflation-exsufflation despite this option being described to be over 98% successful for extubating unweanable medically untreated children with spinal muscular atrophy 1.