Archives of physical medicine and rehabilitation最新文献

英文中文

Dropout From Exercise Interventions in Adults With Knee or Hip Osteoarthritis: A Systematic Review and Meta-analysis 膝关节或髋关节骨关节炎成人运动干预的辍学率：系统回顾与荟萃分析

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.02.735

Davy Vancampfort PhD , Tine Van Damme PhD , Ryan L. McGrath PhD , Laura Hemmings PhD , Veerle Gillis MSc , Koen Bernar MSc , Eduarda Bitencourt MSc , Felipe Schuch PhD

Objective

To investigate the prevalence and moderators of dropout rates among adults with knee or hip osteoarthritis participating in exercise randomized controlled trials (RCTs).

Data Sources

Two authors searched Embase, CINAHL, PsycARTICLES, and PubMed up to 01/09/2023.

Study Selection

We included RCTs of exercise interventions in people with knee or hip osteoarthritis that reported dropout rates.

Data Extraction

Dropout rates from exercise and control conditions and exerciser/participant, provider, and design/implementation related moderators.

Data Synthesis

In total, 209 RCTs involving 277 exercise arms in 13,102 participants were included (mean age at study level=64 years; median prevalence of men participants=26.8%). The trim-and-fill-adjusted prevalence of dropout across all RCTs was 17.5% (95% CI=16.7%-18.2%), which is comparable with dropout observed in control conditions (trim-and-fill-adjusted odds ratio=0.89; 95% CI=0.71-1.12, P=.37). Higher prevalence of antidepressant use at study-level predicted higher dropout (R²=0.75, P=.002, N RCTs=6, n exercisers=412). Supervision by an exercise professional was associated with lower dropout rates, with a trim-and-fill-adjusted rate of 13.2% (95% CI=11.7%-14.9%) compared with 20.8% without supervision (95% CI=18.3%-23.5%) (P<.001).

Conclusions

Dropout rates for exercise in RCTs are comparable with control conditions, suggesting that exercise is a generally well-accepted intervention. However, interventions should be supervised by an exercise professional, such as a physiotherapist or exercise physiologist, to further minimize the risk of dropout. Health professionals should consider participants’ use of antidepressants as a risk factor for dropout from exercise.

研究参与运动随机对照试验（RCT）的膝关节或髋关节骨关节炎成人中辍学率的发生率和调节因素。两位作者检索了截至 2023 年 9 月 1 日的 Embase、CINAHL、PsycARTICLES 和 PubMed。我们纳入了针对膝关节或髋关节骨关节炎患者的运动干预RCT，这些RCT报告了辍学率。辍学率与运动和对照条件以及运动者/参与者、提供者和设计/实施相关的调节因素有关。共纳入了 209 项 RCT，涉及 277 个运动臂，13102 名参与者（研究水平的平均年龄=64 岁；男性参与者的中位患病率=26.8%）。所有 RCT 经修剪和填充调整后的辍学率为 17.5%（95%CI=16.7%-18.2%），与对照组中观察到的辍学率相当（经修剪和填充调整后的几率比=0.89；95%CI=0.71-1.12，P=0.37）。在研究水平上，使用抗抑郁药的比例越高，辍学率越高（R²=0.75，P=0.002，RCTs=6，锻炼者人数=412）。由专业人士指导锻炼可降低辍学率，经调整后的辍学率为 13.2%（95%CI=11.7%-14.9%），而无指导的辍学率为 20.8%（95%CI=18.3%-23.5%）（P<0.001）。在研究性试验中，运动的辍学率与对照组的辍学率相当，这表明运动是一种普遍被接受的干预措施。不过，干预措施应在专业运动人员（如物理治疗师或运动生理学家）的指导下进行，以进一步降低辍学风险。医护人员应将参与者使用抗抑郁药物视为运动辍学的风险因素。

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引用次数: 0

Contralaterally Controlled Functional Electrical Stimulation for Improving Motor Function After Acquired Brain Injury: A Systematic Review and Meta-analysis 改善后天性脑损伤后运动功能的对侧控制功能性电刺激：系统回顾与元分析》（Contralaterally Controlled Functional Electrical Stimulation for Improving Motor Function after Acquired Brain Injury: a Systematic Review and Meta-analysis）。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.03.001

Shan Xie MS , Yuqian Zhang MD , Jing Li MS , Zhefan Wu BS , Yulong Bai MD

Objective

To systematically evaluate the effect of contralaterally controlled functional electrical stimulation (CCFES) on motor function after acquired brain injury (ABI).

Data Sources

We searched the PubMed, Embase, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), Web of Science, SinoMed, CNKI, VIP Database for Chinese Technical Periodicals and Wanfang Database, from inception to December 2023.

Study Selection

Studies were included if they were randomized controlled trials assessing the effect of CCFES on motor function compared with routine rehabilitation or routine electrical stimulation after ABI. Two independent reviewers screened 894 articles for inclusion.

Data Extraction

The extracted data included study information, sample size, study population, interventions, measurement evaluated, and the test interval.

Data Synthesis

This study included 24 trials with 28 intervention-control pairs and 1148 participants with stroke. Meta-analysis showed that the CCFES group demonstrated more significant improvement than the control group in the Fugl-Meyer Assessment Scale (FMA) (standardized mean difference [SMD]=0.66, 95% confidence interval [CI]=0.44-0.88, P<.001), active range of motion (AROM) (SMD=0.77, 95% CI=0.54-1.01, P<.001), modified Barthel Index (MBI) (SMD=0.55, 95% CI=0.29-0.81, P<.001), Motricity Index (MI) (SMD=0.60, 95% CI=0.26-0.94, P<.001) surface electromyography (sEMG) (SMD=0.81, 95% CI=0.56-1.06, P<.001), and Functional Ambulation Category (FAC) (SMD=0.53, 95% CI=0.24-0.83, P<.001). The CCFES group showed no significant improvement over the control group in the Action Research Arm Test (ARAT) (SMD=0.24, 95% CI=-0.10-0.58, P=.17).

Conclusions

Our synthesized evidence suggests that CCFES could improve motor function in patients with stroke. More RCTs with other patients with brain injury are required to provide future evidence on the therapy effect of CCFES and make a contribution to the uniform standard of CCFES.

目的系统评估对侧控制功能性电刺激（CCFES）对获得性脑损伤（ABI）后运动功能的影响：数据来源：我们检索了Pubmed、Embase、Cochrane对照试验中央注册、物理治疗证据数据库（PEDro）、Web of Science、SinoMed、CNKI、中国科技期刊VIP数据库和万方数据库，检索时间从开始至2023年12月：如果研究是评估CCFES与常规康复或常规电刺激相比对ABI后运动功能影响的随机对照试验，则纳入研究。两名独立审稿人筛选了894篇文章纳入研究：提取的数据包括研究信息、样本量、研究人群、干预措施、评估的测量方法和测试间隔：本研究共纳入 24 项试验，28 对干预-对照，1148 名中风患者。Meta分析表明，CCFES组在Fugl-Meyer评估量表（FMA）方面比对照组有更显著的改善（标准化平均差（SMD）=0.66，95%置信区间（CI）=0.44-0.88，PC结论）：我们的综合证据表明，CCFES 可改善中风患者的运动功能。未来还需要更多针对其他脑损伤患者的研究实验来证明CCFES的治疗效果，并为CCFES的统一标准做出贡献。

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引用次数: 0

Response to Letter to the Editor: Effect of a Mindfulness and Motivational Interviewing-Oriented Physical-Psychological Integrative Intervention for Community-Dwelling Spinal Cord Injury Survivors: A Mixed-Methods Randomized Controlled Trial 对 "以正念和动机访谈为导向的生理-心理综合干预对社区居住的脊髓损伤幸存者的影响：混合方法随机对照试验 "的回复。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.08.009

Yan Li PhD, Mengqi Li PhD, Daniel Bressington PhD, Kun Li PhD, Arnold Y.L. Wong PhD, Alex Molassiotis PhD, Christina Zong-Hao Ma PhD, Patrick Pui Kin Kor PhD, Wing Fai Yeung PhD

引用次数: 0

Future Directions in Prosthetic Component Research and Clinical Prescription: A Precision Rehabilitation and Patient-Centered Care Approach 假肢部件研究和临床处方的未来方向：精准康复和以患者为中心的护理方法。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.08.016

David C. Morgenroth MD, Elizabeth G. Halsne CPO, PhD, Alison W. Henderson PhD, Daniel C. Norvell PhD

引用次数: 0

Letter to the Editor: Effect of a Mindfulness and Motivational Interviewing-Oriented Physical-Psychological Integrative Intervention for Community-Dwelling Spinal Cord Injury Survivors: A Mixed-Methods Randomized Controlled Trial 致编辑的信，主题为 "以正念和动机访谈为导向的生理-心理综合干预对社区脊髓损伤幸存者的影响：混合方法随机对照试验"。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.07.022

Rongrui Zhao MM, Hong You MM

引用次数: 0

Effect of Exercise on Mental Health and Health-related Quality of Life in Adults With Spinal Cord Injury: A Systematic Review and Meta-analysis 运动对脊髓损伤成人心理健康和健康相关生活质量的影响：系统回顾与元分析》。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.02.737

Matteo Ponzano PhD , Robert Buren MA , Nathan T. Adams MA , Jane Jun MLIS , Arif Jetha PhD , Diane E. Mack PhD , Kathleen A. Martin Ginis PhD

Objectives

To determine the effect of exercise interventions on mental health and health-related quality of life (HRQoL) in individuals with SCI.

Data Sources

We searched Embase, CINAHL, Medline, PsychINFO, and SPORTDiscus from inception to September 2023.

Study Selection

We included randomized controlled trials that (1) involved participants ≥18 years old with a SCI; (2) administered an exercise intervention; and (3) measured subjective well-being, psychological well-being, social well-being, and/or HRQoL as outcomes. We reported standardized means differences (d) with a 95% confidence interval (CI), assessed the risk of bias by using the Revised Cochrane Risk-of-bias Tool for Randomized Trials (RoB 2), and the certainty of the evidence using GRADE.

Data Synthesis

Nineteen studies (797 participants, mean age <65 years in every study) were included. Exercise improved overall well-being (d=0.494; 95% CI 0.268, 0.720; low certainty evidence), subjective well-being (d=0.543; 95% CI 0.270, 0.816; low certainty evidence), psychological well-being (d=0.499; 95% CI 0.193, 0.805; low certainty evidence), social well-being (d=0.452; 95% CI 0.151, 0.752; low certainty evidence), and HRQoL (d=0.323; 95% CI 0.072, 0.574; low certainty evidence). Four serious adverse events probably attributable to the interventions were reported in 3 studies.

Conclusions

Exercise interventions can improve well-being and HRQoL in adults with SCI <65 years of age. Additional research is needed to determine effectiveness in adults ≥65 years of age.

目标：确定运动干预对 SCI 患者心理健康和健康相关生活质量（HRQoL）的影响：确定运动干预对 SCI 患者心理健康和健康相关生活质量 (HRQoL) 的影响：我们检索了从开始到 2023 年 9 月的 Embase、CINAHL、Medline、PsychINFO 和 SPORTDiscus：我们纳入了以下随机对照试验1）涉及年龄大于 18 岁的 SCI 患者；2）实施了运动干预；3）测量了主观幸福感、心理幸福感、社会幸福感和/或 HRQoL 作为结果。我们报告了带有 95% 置信区间 (CI) 的标准化均值差异 (d)，使用修订版 Cochrane 随机试验偏倚风险工具 (RoB 2) 评估了偏倚风险，并使用 GRADE 评估了证据的确定性：共纳入 19 项研究（797 名参与者，每项研究的平均年龄均小于 65 岁）。运动改善了总体幸福感（d = 0.494; 95% CI 0.268, 0.720; 低确定性证据）、主观幸福感（d = 0.543; 95% CI 0.270, 0.816; 低确定性证据）、心理幸福感（d = 0.499；95% CI 0.193，0.805；低确定性证据）、社会福利（d = 0.452；95% CI 0.151，0.752；低确定性证据）和 HRQoL（d = 0.323；95% CI 0.072，0.574；低确定性证据）。三项研究报告了四起可能与干预措施有关的严重不良事件：运动干预可改善患有 SCI 的成年人的福祉和 HRQoL

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引用次数: 0

Menopause and Traumatic Brain Injury: A NIDILRR Collaborative Traumatic Brain Injury Model Systems Study 更年期与创伤性脑损伤：NIDILRR 协作性创伤性脑损伤模型系统研究。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.07.021

Lisa J. Rapport PhD , Claire Z. Kalpakjian PhD , Angelle M. Sander PhD , Anthony H. Lequerica PhD , Tamara Bushnik PhD , Elisabeth H. Quint MD , Robin A. Hanks PhD

Objective

To examine the experience of menopause symptoms in women with traumatic brain injury (TBI).

Design

Cross-sectional descriptive study.

Setting

Five sites of the TBI Model Systems (TBIMS) program.

Participants

Participants were 210 women, aged 40-60 years, who were not taking systemic hormones and did not have both ovaries removed: 61 participants were enrolled in the TBIMS, who were at least 2 years post-TBI and living in the community. One hundred forty-nine participants without TBI were recruited from a research registry and the metropolitan Detroit community.

Interventions

Not applicable.

Main Outcome Measures

A checklist comprised of 21 menopause symptoms assessing 4 symptom clusters (vasomotor, somatic, psychological, and cognitive).

Results

TBI and non-TBI groups did not significantly differ and showed small effect sizes on vasomotor symptoms. On the remaining symptom clusters, women with TBI showed greater presence and severity of symptoms than women without TBI, as well as fewer differences between premenopausal and postmenopausal women on those symptoms. A profile indicating an additive or potentiating effect of TBI on menopause symptoms was not observed.

Conclusions

Findings support a conceptual model of menopause and TBI indicating that symptoms most closely associated with estrogen decline are similar for women with and without TBI, whereas symptoms that overlap with common TBI sequelae are generally more frequent and severe among these women. Likely because of lower baseline of symptoms premenopause, postmenopausal women without TBI reported more numerous and severe symptoms relative to their premenopausal counterparts without TBI. Overall, it may be that women without TBI experience menopause as more of a “change” of life, whereas women with TBI chronically face significantly more of these symptoms than women without TBI.

目的：研究创伤性脑损伤（TBI）女性更年期症状的经历：研究创伤性脑损伤（TBI）女性更年期症状的经历：设计：横断面描述性研究：地点：创伤性脑损伤示范系统（TBIMS）项目的五个地点：参与者：210 名女性，年龄在 40-60 岁之间，未服用系统性荷尔蒙且未切除双侧卵巢：有 61 名参与者参加了 TBIMS 计划，她们在创伤后应激反应后至少 2 年在社区生活。从研究登记处和底特律大都会社区招募了 149 名未患 TBI 的参与者：干预措施：不适用：主要结果测量：由 21 个更年期症状组成的检查表，评估四个症状集群（血管运动、躯体、心理和认知）：结果：创伤性脑损伤组和非创伤性脑损伤组没有明显差异，在血管运动症状方面显示出较小的效应大小。在其余症状群中，有创伤性脑损伤的妇女比没有创伤性脑损伤的妇女表现出更多的症状和更严重的症状，绝经前和绝经后妇女在这些症状上的差异也更小。没有观察到表明创伤性脑损伤对更年期症状有叠加或增效作用的特征：研究结果支持更年期和创伤性脑损伤的概念模型，表明与雌激素下降最密切相关的症状在有创伤性脑损伤和没有创伤性脑损伤的妇女中相似，而与常见创伤性脑损伤后遗症重叠的症状在这些妇女中通常更为频繁和严重。可能是由于绝经前症状基线较低，绝经后无创伤性脑损伤的妇女报告的症状比绝经前无创伤性脑损伤的妇女更多和更严重。总的来说，没有创伤性脑损伤的妇女更年期的经历可能更多的是生活的 "改变"，而有创伤性脑损伤的妇女长期面临的这些症状明显多于没有创伤性脑损伤的妇女。

{"title":"Menopause and Traumatic Brain Injury: A NIDILRR Collaborative Traumatic Brain Injury Model Systems Study","authors":"Lisa J. Rapport PhD , Claire Z. Kalpakjian PhD , Angelle M. Sander PhD , Anthony H. Lequerica PhD , Tamara Bushnik PhD , Elisabeth H. Quint MD , Robin A. Hanks PhD","doi":"10.1016/j.apmr.2024.07.021","DOIUrl":"10.1016/j.apmr.2024.07.021","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the experience of menopause symptoms in women with traumatic brain injury (TBI).</div></div><div><h3>Design</h3><div>Cross-sectional descriptive study.</div></div><div><h3>Setting</h3><div>Five sites of the TBI Model Systems (TBIMS) program.</div></div><div><h3>Participants</h3><div>Participants were 210 women, aged 40-60 years, who were not taking systemic hormones and did not have both ovaries removed: 61 participants were enrolled in the TBIMS, who were at least 2 years post-TBI and living in the community. One hundred forty-nine participants without TBI were recruited from a research registry and the metropolitan Detroit community.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>A checklist comprised of 21 menopause symptoms assessing 4 symptom clusters (vasomotor, somatic, psychological, and cognitive).</div></div><div><h3>Results</h3><div>TBI and non-TBI groups did not significantly differ and showed small effect sizes on vasomotor symptoms. On the remaining symptom clusters, women with TBI showed greater presence and severity of symptoms than women without TBI, as well as fewer differences between premenopausal and postmenopausal women on those symptoms. A profile indicating an additive or potentiating effect of TBI on menopause symptoms was not observed.</div></div><div><h3>Conclusions</h3><div>Findings support a conceptual model of menopause and TBI indicating that symptoms most closely associated with estrogen decline are similar for women with and without TBI, whereas symptoms that overlap with common TBI sequelae are generally more frequent and severe among these women. Likely because of lower baseline of symptoms premenopause, postmenopausal women without TBI reported more numerous and severe symptoms relative to their premenopausal counterparts without TBI. Overall, it may be that women without TBI experience menopause as more of a “change” of life, whereas women with TBI chronically face significantly more of these symptoms than women without TBI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2253-2261"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Increased Auditory Dual Task Cost During Gait Initiation in Adult Patients With Persistent Concussion Symptoms 有持续脑震荡症状的成人患者在步态启动过程中听觉双重任务成本增加。

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/j.apmr.2024.08.007

Kelsey N. Bryk PhD , Scott Passalugo BS , Li- Shan Chou PhD , Darcy S. Reisman PT, PhD , Jocelyn F. Hafer PhD , Jennifer A. Semrau PhD , Thomas A. Buckley EdD

Objective

To compare dual task cost (DTC) during gait initiation (GI) between a population of patients with persistent concussion symptoms (PCS) and age-matched healthy participants.

Design

Cohort study.

Setting

University research center.

Participants

A cohort sample including 15 participants with PCS (43.9±11.7y, 73.3% female) and 23 age-matched healthy participants (42.1±10.3y, 65.2% female) as controls.

Interventions

Participants were tested on a single occasion where they performed 5 trials of single task and 5 trials of dual task GI with 12-camera motion capture and 3 force plates.

Main Outcome Measures

The dependent variables of interest were the DTC for the center of pressure (COP) displacement and velocity during the anticipatory postural adjustment (APA) phase, the COP-center of mass (COP-COM) separation, and the response accuracy during the auditory cognitive tasks.

Results

There were significant group differences with worse DTC for the PCS participants in anterior (A)/posterior (P) displacement (PCS, −37.5±22.1%; Control, −9.7±39.2%; P=.016, d=0.874), APA medial (M)/lateral (L) velocity (PCS, −34.8±28.8%; Control, −17.0±40.21%; P=.041, d=0.866), and the peak COP-COM separation (PCS, −7.3±6.7%; Control, 0.6±6.5%; P=.023, d=1.200). There were no significant group differences in the APA A/P velocity (PCS, −38.8±33.1%; Control, −19.8±43.9%; P=.094), APA M/L displacement (PCS, −34.8±21.8%; Control, −10.6±25.3%; P=.313), or cognitive task performance (PCS, −2.7±10.8%; Control, −0.2±4.3%; P=.321).

Conclusions

PCS participants had greater (worse) DTC during both the planning and execution of the task, with large effect sizes (d>0.80). PCS participants also used a posture-second strategy whereby attentional resources were inappropriately allocated to the cognitive task. These deficits may challenge a patient's ability to complete activities of daily living and limit their functional independence.

目的比较持续性脑震荡症状（PCS）患者与年龄匹配的健康参与者在步态启动（GI）过程中的双重任务成本（DTC）：设计：队列研究：地点：大学研究中心：队列样本包括 15 名 PCS 患者（43.9 ± 11.7 岁，73.3% 为女性）和 23 名年龄匹配的对照组患者（42.1 ± 10.3 岁，65.2% 为女性）：主要结果测量：相关因变量为预期姿势调整（APA）阶段压力中心（COP）位移和速度的DTC、COP-质量中心（COP-COM）分离度以及听觉认知任务中的反应准确性：874）、APA M/L 速度（PCS：-34.8 ± 28.8%，对照组：-17.0 ± 40.21%，P=0.041，d= 0.866）和 COP-COM 分离峰值（PCS：-7.3% ± 6.7%，对照组：0.6 ± 6.5%，P=0.023，d=1.200）。APA的A/P速度（PCS：-38.8 + 33.1%，对照组：-19.8 + 43.9%，P=0.094）、APA的M/L位移（PCS：-34.8 ± 21.8%，对照组：-10.6 ± 25.3%，P=0.313）或认知任务表现（PCS：-2.7 ± 10.8%，对照组：-0.2 ± 4.3%，P=0.321）没有明显的组间差异：结论：PCS 参与者在计划和执行任务过程中的 DTC 均较高（较低），且效应大小较大（d>0.80）。PCS 参与者还采用了 "姿态-秒 "策略，将注意力资源不恰当地分配给了认知任务。这些缺陷可能会影响患者完成日常生活活动的能力，并限制他们的功能独立性。

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引用次数: 0

Ed Board page 教育版面

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/S0003-9993(24)01324-8

引用次数: 0

Archives I/EP Guidelines 档案I/EP指南

IF 3.6 2区医学 Q1 REHABILITATION

Archives of physical medicine and rehabilitation

Pub Date : 2024-12-01 DOI: 10.1016/S0003-9993(24)01340-6

引用次数: 0

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