Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.09.013
Ricardo Augusto Barbieri PhD , Fabio Augusto Barbieri PhD , Nicolle Zelada-Astudillo MSc , Vinicius Christianini Moreno MSc , Carlos Augusto Kalva-Filho PhD , Antonio Roberto Zamunér PhD
Objective
To determine the effects of aerobic training in randomized controlled clinical trials on functional capacity, motor symptoms, and oxygen consumption in individuals with Parkinson disease (PD) through a systematic literature review and meta-analysis.
Data Sources
PUBMED, Web of Science, CINAHL, SciELO, and Medline databases were searched to identify published studies until September 2023.
Study Selection
Randomized controlled clinical trials that evaluated the long-term effect of aerobic exercise in individuals with PD were included.
Data Extraction
Two independent reviewers extracted the data and assessed the risk of bias and the Grading of Recommendation Assessment, Development, and Evaluation. In case of disagreement, a third reviewer was consulted.
Data Synthesis
Thirteen studies were included in the systematic review, and the number of participants was 588 with an average age of 66.2 years (57-73y). The study's exercise intervention lasted between 6 and 70 weeks, with most studies lasting 10-12 weeks, with 3 sessions per week and an average duration of 47 minutes per session. The meta-analysis revealed that aerobic exercise is effective in enhancing maximal oxygen uptake (standardized mean difference, SMD 0.42 [95% CI, 0.18, 0.66; P=.0007]) and functional capacity (SMD 0.48 [95% CI, 0.24−0.71; P<.0001]). In addition, aerobic exercise can reduce the motor-unified Parkinson disease rating scale (mean difference−2.48 [95% CI, −3.16 to −1.81; P<.00001]) score in individuals with PD.
Conclusions
Aerobic exercise training conducted 2-3 times a week, with different intensities (low to high), can be an effective intervention for enhancing functional capacity, maximizing oxygen uptake, and reducing the UPDRS scores in individuals with PD.
{"title":"Influence of Aerobic Exercise on Functional Capacity and Maximal Oxygen Uptake in Patients With Parkinson Disease: A Systematic Review and Meta-analysis","authors":"Ricardo Augusto Barbieri PhD , Fabio Augusto Barbieri PhD , Nicolle Zelada-Astudillo MSc , Vinicius Christianini Moreno MSc , Carlos Augusto Kalva-Filho PhD , Antonio Roberto Zamunér PhD","doi":"10.1016/j.apmr.2024.09.013","DOIUrl":"10.1016/j.apmr.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the effects of aerobic training in randomized controlled clinical trials on functional capacity, motor symptoms, and oxygen consumption in individuals with Parkinson disease (PD) through a systematic literature review and meta-analysis.</div></div><div><h3>Data Sources</h3><div>PUBMED, Web of Science, CINAHL, SciELO, and Medline databases were searched to identify published studies until September 2023.</div></div><div><h3>Study Selection</h3><div>Randomized controlled clinical trials that evaluated the long-term effect of aerobic exercise in individuals with PD were included.</div></div><div><h3>Data Extraction</h3><div>Two independent reviewers extracted the data and assessed the risk of bias and the Grading of Recommendation Assessment, Development, and Evaluation. In case of disagreement, a third reviewer was consulted.</div></div><div><h3>Data Synthesis</h3><div>Thirteen studies were included in the systematic review, and the number of participants was 588 with an average age of 66.2 years (57-73y). The study's exercise intervention lasted between 6 and 70 weeks, with most studies lasting 10-12 weeks, with 3 sessions per week and an average duration of 47 minutes per session. The meta-analysis revealed that aerobic exercise is effective in enhancing maximal oxygen uptake (standardized mean difference, SMD 0.42 [95% CI, 0.18, 0.66; <em>P</em>=.0007]) and functional capacity (SMD 0.48 [95% CI, 0.24−0.71; <em>P<</em>.0001]). In addition, aerobic exercise can reduce the motor-unified Parkinson disease rating scale (mean difference−2.48 [95% CI, −3.16 to −1.81; <em>P<</em>.00001]) score in individuals with PD.</div></div><div><h3>Conclusions</h3><div>Aerobic exercise training conducted 2-3 times a week, with different intensities (low to high), can be an effective intervention for enhancing functional capacity, maximizing oxygen uptake, and reducing the UPDRS scores in individuals with PD.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 134-144"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387471","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}
Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.08.027
Ghazaleh Momeni MSc , Abbas Tabatabaei PhD , Mehrnaz Kajbafvala PhD , Morteza Nakhaei Amroodi , Lincoln Blandford MRes
Objective
To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity, and disability in subjects with chronic subacromial pain syndrome (SAPS).
The participants were randomly allocated to 1 of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for 4 weeks.
Main Outcome Measures
The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).
Results
Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean, 9.17; 95% confidence interval; 0.31-18.03; P=.04), with a large effect size (0.68). The reduction of PAR remained significantly lower in the intervention group than in the control group after 4 months of follow-up (mean, 18.29; 95% confidence intervals [CI], 9.09-27.48; P<.00) with a large effect size (1.27). Disability significantly decreased at 2-month (mean, 14.58, P=.002 on SPADI index; mean, 10.26, P=.006 on DASH index) and 4-month (mean, 19.85, P<.001 on SPADI index; mean, 12.09, P=.001 on DASH index) follow-ups in the intervention group compared to the control group.
Conclusion
Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.
目的评估基于运动过失（MF）控制的个性化锻炼对慢性肩峰下疼痛综合征（SAPS）患者疼痛强度和残疾程度的影响：随机对照试验（IRCT20221126056621N1）：参与者：38名慢性SAPS患者（年龄52.23（8.47）岁，女性占60%）：参与者被随机分配到干预组（根据 MFs 控制测试设计的针对特定运动障碍的个性化练习）或对照组（常用的一般肩胛骨稳定练习）。两组均接受每周两次、为期四周的锻炼：主要结果测量：采用视觉模拟量表测量休息时（PR）和举臂时（PAR）的疼痛强度。残疾评估是主要的次要结果，包括手臂、肩部和手部残疾（DASH）问卷和肩部疼痛与残疾指数（SPADI）：结果：完成所有锻炼课程后，干预组的 PAR 明显低于对照组（平均值 [CI]：9.17 [0.31 至 18.03]，P=0.04），效应大小较大 [0.68]。随访四个月后，干预组的 PAR 减少率仍明显低于对照组（平均值[CI]：18.29 [9.09 至 27.48]，P=0.00），效应量较大[1.27]。与对照组相比，干预组在两个月（SPADI指数平均值=14.58，P=0.002；DASH指数平均值=10.26，P=0.006）和四个月（SPADI指数平均值=19.85，P=0.00；DASH指数平均值=12.09，P=0.001）的随访中残疾程度明显减轻：结论：基于中频运动控制肩部区域的个性化锻炼可降低 SAPS 患者的 PAR 和残疾程度。
{"title":"Individualized Versus General Exercise Therapy in People With Subacromial Pain Syndrome: A Randomized Controlled Trial","authors":"Ghazaleh Momeni MSc , Abbas Tabatabaei PhD , Mehrnaz Kajbafvala PhD , Morteza Nakhaei Amroodi , Lincoln Blandford MRes","doi":"10.1016/j.apmr.2024.08.027","DOIUrl":"10.1016/j.apmr.2024.08.027","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity, and disability in subjects with chronic subacromial pain syndrome (SAPS).</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Rehabilitation clinics.</div></div><div><h3>Participants</h3><div>Thirty-eight participants with chronic SAPS (mean [SD] age, 52.23 (8.47); 60 % women).</div></div><div><h3>Interventions</h3><div>The participants were randomly allocated to 1 of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for 4 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).</div></div><div><h3>Results</h3><div>Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean, 9.17; 95% confidence interval; 0.31-18.03; <em>P</em>=.04), with a large effect size (0.68). The reduction of PAR remained significantly lower in the intervention group than in the control group after 4 months of follow-up (mean, 18.29; 95% confidence intervals [CI], 9.09-27.48; <em>P</em><.00) with a large effect size (1.27). Disability significantly decreased at 2-month (mean, 14.58, <em>P</em>=.002 on SPADI index; mean, 10.26, <em>P</em>=.006 on DASH index) and 4-month (mean, 19.85, <em>P<</em>.001 on SPADI index; mean, 12.09, <em>P</em>=.001 on DASH index) follow-ups in the intervention group compared to the control group.</div></div><div><h3>Conclusion</h3><div>Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 1-13"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/S0003-9993(24)01375-3
{"title":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(24)01375-3","DOIUrl":"10.1016/S0003-9993(24)01375-3","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Page A4"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129759","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}
Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.08.011
Natalie F. Douglas PhD, CCC-SLP , Sarah E. Wallace PhD, CCC-SLP, ASHA Fellow , Chin-I Cheng PhD , Nancy Christensen Mayer MBA/HSA, CCC-SLP , Ellen Hickey PhD, SLP-Reg. (NS), CCC-SLP , Kate Minick PT, DPT, PhD
Objective
To identify risk factors related to falls within the scope of speech-language pathology (SLP) using assessments from the Inpatient Rehabilitation Facility-Patient Assessment Instrument over a 4-month period in 4 inpatient rehabilitation facilities (IRFs).
Design
Observational retrospective cohort study.
Setting
Four IRFs as part of a larger learning health system.
Participants
Adults aged ≥18 years admitted to the IRFs from October 1, 2022 to February 28, 2023 were included.
Intervention
N/A.
Main Outcome Measures
Occurrence of falls.
Results
Analyses of 631 patient records revealed that the odds of falling were almost 3 times greater in people with limited English proficiency than in English speakers (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.09-6.85). People with limited English proficiency who reported poorer health literacy had 4 times higher odds of falling (OR, 3.90; 95% CI, 1.13-13.44) than English speakers who reported adequate health literacy. People with limited English proficiency who reported adequate health literacy had the same risk of falling as English speakers (OR, 0.98; 95% CI, 0.16-6.12), suggesting the protective role of health literacy for people with limited English proficiency.
Conclusions
Language barriers have a significant effect on falls among patients in IRFs. SLPs improving health literacy and providing language support may play a crucial role in mitigating fall risk, thereby enhancing patient safety and outcomes.
目的在四个住院康复机构（IRF）中，使用住院康复机构患者评估工具（IRF-PAI）进行为期四个月的评估，确定与语言病理学（SLP）范围内跌倒相关的风险因素：观察性回顾队列研究 设定： ：四家住院康复机构（IRF），作为大型学习型医疗系统的一部分 参与者： ：2022年1月10日至2023年2月28日期间入住IRF的18岁及以上成人：主要结果测量：结果：：对 631 份病历进行分析后发现，与讲英语者相比，英语水平有限者跌倒的几率几乎是讲英语者的 3 倍（OR = 2.92，95% CI [1.09，6.85]）。与健康知识水平较低的英语使用者相比，英语水平有限且健康知识水平较低的人跌倒的几率要高出 4 倍（OR = 3.90，95% CI [1.13，13.44]）。英语水平有限但健康素养良好的人跌倒的风险与英语使用者相同（OR = .98，95% CI [.16，6.12]），这表明健康素养对英语水平有限的人具有保护作用：结论：语言障碍对 IRF 病人的跌倒有重大影响。提高健康素养和提供语言支持的语言康复师可在降低跌倒风险方面发挥重要作用，从而提高患者的安全和治疗效果。
{"title":"A Role for Health Literacy in Protecting People With Limited English Proficiency Against Falling: A Retrospective, Cohort Study","authors":"Natalie F. Douglas PhD, CCC-SLP , Sarah E. Wallace PhD, CCC-SLP, ASHA Fellow , Chin-I Cheng PhD , Nancy Christensen Mayer MBA/HSA, CCC-SLP , Ellen Hickey PhD, SLP-Reg. (NS), CCC-SLP , Kate Minick PT, DPT, PhD","doi":"10.1016/j.apmr.2024.08.011","DOIUrl":"10.1016/j.apmr.2024.08.011","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors related to falls within the scope of speech-language pathology (SLP) using assessments from the Inpatient Rehabilitation Facility-Patient Assessment Instrument over a 4-month period in 4 inpatient rehabilitation facilities (IRFs).</div></div><div><h3>Design</h3><div>Observational retrospective cohort study.</div></div><div><h3>Setting</h3><div>Four IRFs as part of a larger learning health system.</div></div><div><h3>Participants</h3><div>Adults aged ≥18 years admitted to the IRFs from October 1, 2022 to February 28, 2023 were included.</div></div><div><h3>Intervention</h3><div>N/A.</div></div><div><h3>Main Outcome Measures</h3><div>Occurrence of falls.</div></div><div><h3>Results</h3><div>Analyses of 631 patient records revealed that the odds of falling were almost 3 times greater in people with limited English proficiency than in English speakers (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.09-6.85). People with limited English proficiency who reported poorer health literacy had 4 times higher odds of falling (OR, 3.90; 95% CI, 1.13-13.44) than English speakers who reported adequate health literacy. People with limited English proficiency who reported adequate health literacy had the same risk of falling as English speakers (OR, 0.98; 95% CI, 0.16-6.12), suggesting the protective role of health literacy for people with limited English proficiency.</div></div><div><h3>Conclusions</h3><div>Language barriers have a significant effect on falls among patients in IRFs. SLPs improving health literacy and providing language support may play a crucial role in mitigating fall risk, thereby enhancing patient safety and outcomes.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 37-41"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.08.010
Thaís Marina Pires de Campos Biazon PhD , Henrique Pott Jr. PhD , Flávia Cristina Rossi Caruso PhD , José Carlos Bonjorno Jr. PhD , Viviane Castello-Simões PhD , Maria Thereza Bugalho Lazzarini MD , Mariana Taconelli SD , Audrey Borghi-Silva PhD , Renata Gonçalves Mendes PhD
Objective
To investigate the effects of implementing early multiprofessional mobilization on quality indicators of intensive care in Brazil.
Design
This is a retrospective cohort study.
Setting
A Brazilian educational and research-intensive care unit (ICU).
Participants
A total of 1047 patients were hospitalized from May 2016 to April 2018.
Interventions
Implementation of early multiprofessional mobilization using the MobilizAÇÃO Program (MAP).
Main Outcome Measures
Clinical, ventilation and safety quality indicators, and physical function before (preprogram period) and after (postprogram period) the MAP.
Results
There was a reduction in sedation time (4 vs 1d), hospital stay (21 vs 14d) and ICU stay (14 vs 7d), mechanical ventilation (8 vs 4d), hospital death rate (46% vs 26%) (P<.001), and ICU readmission (21% vs 16%; P=.030) from pre to post MAP. Successful weaning (42% vs 55%) and discharge rate (50% vs 71%) (P<.001) increased after MAP. No differences were found to safety quality indicators between periods. After MAP, complex physical functions assessed using the Manchester Mobility Score (MMS) were more frequent. The in-bed intervention was a predictor for readmission (P=.009; R²=0.689) and death (P=.035; R²=0.217), while walking was a predictor for successful weaning (P=.030; R²=0.907) and discharge (P=.033; R²=0.373). The postprogram period was associated with the MMS at ICU discharge (P<.001; R²=0.40).
Conclusions
Early mobilization implementation through changes in low mobility culture and multiprofessional actions improved quality indicators, including clinical, ventilation, and physical functional quality, without compromising patient safety in the ICU.
{"title":"Effect of Early Multiprofessional Mobilization on Quality Indicators of Intensive Care in a Less Economically Developed Country: An Action on “Rehabilitation 2030” in Brazil","authors":"Thaís Marina Pires de Campos Biazon PhD , Henrique Pott Jr. PhD , Flávia Cristina Rossi Caruso PhD , José Carlos Bonjorno Jr. PhD , Viviane Castello-Simões PhD , Maria Thereza Bugalho Lazzarini MD , Mariana Taconelli SD , Audrey Borghi-Silva PhD , Renata Gonçalves Mendes PhD","doi":"10.1016/j.apmr.2024.08.010","DOIUrl":"10.1016/j.apmr.2024.08.010","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of implementing early multiprofessional mobilization on quality indicators of intensive care in Brazil.</div></div><div><h3>Design</h3><div>This is a retrospective cohort study.</div></div><div><h3>Setting</h3><div>A Brazilian educational and research-intensive care unit (ICU).</div></div><div><h3>Participants</h3><div>A total of 1047 patients were hospitalized from May 2016 to April 2018.</div></div><div><h3>Interventions</h3><div>Implementation of early multiprofessional mobilization using the MobilizAÇÃO Program (MAP).</div></div><div><h3>Main Outcome Measures</h3><div>Clinical, ventilation and safety quality indicators, and physical function before (preprogram period) and after (postprogram period) the MAP.</div></div><div><h3>Results</h3><div>There was a reduction in sedation time (4 vs 1d), hospital stay (21 vs 14d) and ICU stay (14 vs 7d), mechanical ventilation (8 vs 4d), hospital death rate (46% vs 26%) (<em>P<</em>.001), and ICU readmission (21% vs 16%; <em>P=</em>.030) from pre to post MAP. Successful weaning (42% vs 55%) and discharge rate (50% vs 71%) (<em>P</em><.001) increased after MAP. No differences were found to safety quality indicators between periods. After MAP, complex physical functions assessed using the Manchester Mobility Score (MMS) were more frequent. The in-bed intervention was a predictor for readmission (<em>P=</em>.009; <em>R²</em>=0.689) and death (<em>P=</em>.035; <em>R²</em>=0.217), while walking was a predictor for successful weaning (<em>P=</em>.030; <em>R²</em>=0.907) and discharge (<em>P=</em>.033; <em>R²</em>=0.373). The postprogram period was associated with the MMS at ICU discharge (<em>P<</em>.001; <em>R²</em>=0.40).</div></div><div><h3>Conclusions</h3><div>Early mobilization implementation through changes in low mobility culture and multiprofessional actions improved quality indicators, including clinical, ventilation, and physical functional quality, without compromising patient safety in the ICU.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 51-60"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118874","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}
Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.04.013
PeiQiang Peng MM , XuFei Zheng MM , YueTing Wang MM , ShuNing Jiang MM , JiaJu Chen MM , Xin Sui MM , LiJing Zhao MD , Haiyan Xu MD , Yuming Lu MD , Shuang Zhang MD
Objective
To assess near-infrared preirradiation effects on postexercise lower-limb muscle damage and function and determine optimal dosage.
Data Sources
PubMed, Embase, Cochrane Library, EBSCO, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were systematically searched (2009-2023).
Study Selection
Randomized controlled trials of near-infrared preirradiation on lower-limb muscles after fatigue exercise were incorporated into the meta-analysis. Out of 4550 articles screened, 21 met inclusion criteria.
Data Extraction
The included studies’ characteristics were independently extracted by 2 authors, with discrepancies resolved through discussion or by a third author. Quality assessment was performed using the Cochrane risk of bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation System.
Data Synthesis
In 21 studies, near-infrared preirradiation on lower-limb muscles inhibited the decline in peak torque (standardized mean difference [SMD], 1.33; 95% confidence interval [CI], 1.08-1.59; p<.001; increasing 27.97±4.87N·m), reduced blood lactate (SMD, −0.2; 95% CI, −0.37 to −0.03; p=.272; decreasing 0.54±0.42mmol/L), decreased creatine kinase (SMD, −2.11; 95% CI, −2.57 to −1.65; p<.001; decreasing 160.07±27.96U/L), and reduced delayed-onset muscle soreness (SMD, −0.53; 95% CI, −0.81 to 0.24; p<.001). Using a 24-hour cutoff revealed 2 trends: treatment effectiveness depended on power and energy density, with optimal effects at 24.16 J/cm2 and 275 J/cm2 for energy, and 36.81 mW/cm2 and 5495 mW/cm2 for power. Noting that out of 21 studies, 19 are from Brazil, 1 from the United States, and 1 from Australia, and the results exhibit high heterogeneity.
Conclusions
Although we would have preferred a more geographic dispersion of laboratories, our findings indicate that near-infrared preirradiation mitigates peak torque decline in lower-limb muscles. Influenced by energy and power density with a 24-hour threshold, optimal energy and power densities are observed at 24.16 J/cm2, 275 J/cm2, 36.81 mW/cm2, and 5495 mW/cm2, respectively. Laser preirradiation also reduces blood lactate, creatine kinase, and delayed-onset muscle soreness.
{"title":"The Effects of Near-Infrared Phototherapy Preirradiation on Lower-Limb Muscle Strength and Injury After Exercise: A Systematic Review and Meta-analysis","authors":"PeiQiang Peng MM , XuFei Zheng MM , YueTing Wang MM , ShuNing Jiang MM , JiaJu Chen MM , Xin Sui MM , LiJing Zhao MD , Haiyan Xu MD , Yuming Lu MD , Shuang Zhang MD","doi":"10.1016/j.apmr.2024.04.013","DOIUrl":"10.1016/j.apmr.2024.04.013","url":null,"abstract":"<div><h3>Objective</h3><div>To assess near-infrared preirradiation effects on postexercise lower-limb muscle damage and function and determine optimal dosage.</div></div><div><h3>Data Sources</h3><div>PubMed, Embase, Cochrane Library, EBSCO, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were systematically searched (2009-2023).</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials of near-infrared preirradiation on lower-limb muscles after fatigue exercise were incorporated into the meta-analysis. Out of 4550 articles screened, 21 met inclusion criteria.</div></div><div><h3>Data Extraction</h3><div>The included studies’ characteristics were independently extracted by 2 authors, with discrepancies resolved through discussion or by a third author. Quality assessment was performed using the Cochrane risk of bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation System.</div></div><div><h3>Data Synthesis</h3><div>In 21 studies, near-infrared preirradiation on lower-limb muscles inhibited the decline in peak torque (standardized mean difference [SMD], 1.33; 95% confidence interval [CI], 1.08-1.59; <em>p</em><span><.001; increasing 27.97±4.87N·m), reduced blood lactate (SMD, −0.2; 95% CI, −0.37 to −0.03; </span><em>p</em><span>=.272; decreasing 0.54±0.42mmol/L), decreased creatine kinase (SMD, −2.11; 95% CI, −2.57 to −1.65; </span><em>p</em><.001; decreasing 160.07±27.96U/L), and reduced delayed-onset muscle soreness (SMD, −0.53; 95% CI, −0.81 to 0.24; <em>p</em><.001). Using a 24-hour cutoff revealed 2 trends: treatment effectiveness depended on power and energy density, with optimal effects at 24.16 J/cm<sup>2</sup> and 275 J/cm<sup>2</sup> for energy, and 36.81 mW/cm<sup>2</sup> and 5495 mW/cm<sup>2</sup> for power. Noting that out of 21 studies, 19 are from Brazil, 1 from the United States, and 1 from Australia, and the results exhibit high heterogeneity.</div></div><div><h3>Conclusions</h3><div>Although we would have preferred a more geographic dispersion of laboratories, our findings indicate that near-infrared preirradiation mitigates peak torque decline in lower-limb muscles. Influenced by energy and power density with a 24-hour threshold, optimal energy and power densities are observed at 24.16 J/cm<sup>2</sup>, 275 J/cm<sup>2</sup>, 36.81 mW/cm<sup>2</sup>, and 5495 mW/cm<sup>2</sup><span>, respectively. Laser preirradiation also reduces blood lactate, creatine kinase, and delayed-onset muscle soreness.</span></div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 74-90"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847696","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}
To systematically review the literature on the efficacy of addressing glenohumeral internal rotation deficit (GIRD) and risk of upper-extremity injury in overhead athletes.
Data Sources
A search was conducted for relevant studies published in PubMed, Medline, CINAHL, Cochrane, Embase, Ovid, Google Scholar, and Web of Science.
Study Selection
The review focused on randomized controlled trials (RCTSs) and quasi-experiments conducted in English language that assessed the effectiveness of GIRD and the risk of upper-extremity injury in athletes performing overhead movements. The review included 7 RCTs and 2 quasi-experiments out of 5403, which involved a total of 360 participants.
Data Extraction
Two reviewers independently screened the articles, assessed methodological quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews. All studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence Database Scale for RCTs.
Data Synthesis
The efficacy of different types of techniques was evaluated, including joint mobilization, sleeper stretch, cross-body stretch, myofascial release, kinesio taping, and rigid taping. These techniques showed improvement in pain score and range of motion. Furthermore, self-myofascial release tends to improve internal rotation; sleeper stretch and cross-body stretch tend to improve internal rotation with 40 percent decline in pain. However, kinesio taping and rigid taping showed positive results for internal rotation. Acute results determined that the metabolic equivalent (MET) group had significantly more horizontal adduction range of motion posttreatment compared with the control group (P=.04). No significant differences existed between MET and joint mobilizations or between joint mobilizations and the control group for horizontal adduction (P>.16). No significant between-group differences existed acutely for internal rotation (P>.28). There were no significant between-group differences for either horizontal adduction or internal rotation at the 15-minute posttests (P>.70).
Conclusions
The study evaluated the efficacy of various techniques in improving pain score and range of motion in individuals with GIRD. Joint mobilization, sleeper stretch, cross-body stretch, myofascial release, kinesio taping, and rigid taping all showed improvements in pain score and range of motion. However, no significant between-group differences were found for horizontal adduction or internal rotation at the 15-minute posttests. These findings suggest that a combination of these techniques may be effective in treating individuals with GIRD.
目的系统回顾高空运动员盂肱内旋不足与上肢损伤风险的文献资料来源：Medline、CINAHL、Cochrane、Embase、Ovid、谷歌学术和 Web Science：在PubMed、Medline、CINAHL、Cochrane、Embase、Ovid、Google Scholar和Web of Science上搜索已发表的相关研究：综述了用英语进行的随机对照试验和准实验，这些试验和实验评估了盂肱内旋缺损（GIRD）的有效性以及进行高举动作的运动员上肢受伤的风险。在 5403 项随机对照试验和两项准实验中，本研究共纳入了 7 项随机对照试验和两项准实验，涉及 360 名参与者：两名审稿人独立筛选文章，对方法学质量进行评分，并提取数据进行分析。综述按照《系统综述首选报告项目》进行和报告。采用物理治疗证据数据库随机对照试验量表对所有研究进行了一式两份的偏倚风险评估：对不同类型技术的疗效进行了评估。关节活动、卧位拉伸、跨体拉伸、肌面松解、腱鞘贴和硬质绑带疗法对疼痛评分和活动范围均有改善。此外，自我面部肌肉松解术往往能改善内旋；卧位拉伸和跨体拉伸往往能改善内旋，使疼痛减轻 40%。急性结果表明，与对照组相比，MET 组治疗后的水平内收 ROM 明显增加（P=0.04）。在水平内收方面，代谢当量组与关节活动度组或关节活动度组与对照组之间不存在差异（P>0.16）。在急性内旋方面，组间差异不明显（p>.28）。在15分钟的事后测试中，水平内收或内旋的组间差异均不明显（P>0.70）：总之，该研究评估了各种技术在改善盂兰盆型肱骨内旋功能障碍（GIRD）患者疼痛评分和活动范围方面的疗效。关节活动、卧位拉伸、跨体拉伸、肌筋膜松解、肌筋膜绑带和硬质绑带均能改善疼痛评分和活动范围。然而，在 15 分钟后的测试中，水平内收或内旋的组间差异并不明显。总之，这些研究结果表明，综合运用这些技术可能会有效治疗 GIRD 患者。
{"title":"Glenohumeral Internal Rotation Deficit and Risk of Upper Extremity Injury in Overhead Athletes: Systematic Review","authors":"Sabika Minhaj BS-PT, D-DPT, MSc PT , Zahra Khan Afridi DPT , Summaiya Rubab DPT , Zarmina Qazi DPT , Maha Siddiqui DPT","doi":"10.1016/j.apmr.2024.05.027","DOIUrl":"10.1016/j.apmr.2024.05.027","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically review the literature on the efficacy of addressing glenohumeral internal rotation deficit (GIRD) and risk of upper-extremity injury in overhead athletes.</div></div><div><h3>Data Sources</h3><div>A search was conducted for relevant studies published in PubMed, Medline, CINAHL, Cochrane, Embase, Ovid, Google Scholar, and Web of Science.</div></div><div><h3>Study Selection</h3><div>The review focused on randomized controlled trials (RCTSs) and quasi-experiments conducted in English language that assessed the effectiveness of GIRD and the risk of upper-extremity injury in athletes performing overhead movements. The review included 7 RCTs and 2 quasi-experiments out of 5403, which involved a total of 360 participants.</div></div><div><h3>Data Extraction</h3><div>Two reviewers independently screened the articles, assessed methodological quality, and extracted data for analysis. The review was conducted and reported according to the Preferred Reporting Items for Systematic Reviews. All studies were assessed in duplicate for risk of bias using the Physiotherapy Evidence Database Scale for RCTs.</div></div><div><h3>Data Synthesis</h3><div>The efficacy of different types of techniques was evaluated, including joint mobilization, sleeper stretch, cross-body stretch, myofascial release, kinesio taping, and rigid taping. These techniques showed improvement in pain score and range of motion. Furthermore, self-myofascial release tends to improve internal rotation; sleeper stretch and cross-body stretch tend to improve internal rotation with 40 percent decline in pain. However, kinesio taping and rigid taping showed positive results for internal rotation. Acute results determined that the metabolic equivalent (MET) group had significantly more horizontal adduction range of motion posttreatment compared with the control group (<em>P</em>=.04). No significant differences existed between MET and joint mobilizations or between joint mobilizations and the control group for horizontal adduction (<em>P</em>>.16). No significant between-group differences existed acutely for internal rotation (<em>P</em>>.28). There were no significant between-group differences for either horizontal adduction or internal rotation at the 15-minute posttests (<em>P</em>>.70).</div></div><div><h3>Conclusions</h3><div>The study evaluated the efficacy of various techniques in improving pain score and range of motion in individuals with GIRD. Joint mobilization, sleeper stretch, cross-body stretch, myofascial release, kinesio taping, and rigid taping all showed improvements in pain score and range of motion. However, no significant between-group differences were found for horizontal adduction or internal rotation at the 15-minute posttests. These findings suggest that a combination of these techniques may be effective in treating individuals with GIRD.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 91-97"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141426125","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}
Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.05.028
Xiankun Chen PhD , Tong Zhang MM , Xiaoyue Hu GS , Zehuai Wen PhD , Weihui Lu PhD , Wei Jiang PhD
Objective
To explore the effect sizes of different high-intensity interval training (HIIT) protocols on cardiorespiratory parameters when compared with moderate-intensity continuous training (MICT) in different heart failure (HF) subtypes.
Data Sources
Electronic databases were searched from their inception date until January 23, 2023.
Study Selection
Randomized controlled trials (RCTs) were included if they compared HIIT with MICT in patients with HF. The primary outcome was peak oxygen consumption (Vo2peak). Two reviewers independently evaluated 99 initially identified studies, resulting in the selection of 15 RCTs that met the eligibility criteria.
Data Extraction
Data were extracted independently by 2 observers using a data extraction form drafted based on the CONSORT statement and the Template for Intervention Description and Replication; the methodological quality of the studies was analyzed individually based on the Tool for the Assessment of Study Quality in Exercise scale.
Data Synthesis
Fifteen RCTs with 553 patients with HF were included in the systematic review. The included studies had moderate to good overall methodological quality. The results showed that HIIT was generally more effective than MICT at improving Vo2peak in patients with HF (n=541, 15 RCTs; MD: 1.49 mL/kg/min; I2=66%; P<.001). However, the effect size varied depending on the HF subtype and HIIT protocol used. For patients with HF with reduced ejection fraction (HFrEF), the long-interval (high-intensity interval lasting ≥4 min) and high-volume HIIT (high-intensity efforts in total ≥15 min) showed the largest benefits over the MICT (n=261, 6 RCTs; MD: 2.11 mL/kg/min; P<.001); followed by the short-interval (≤1 min) and high-volume HIIT (≥15 min; n=71, 3 RCTs; MD: 0.91 mL/kg/min; P=.12), and the short-interval and low-volume HIIT showed the least superiority over MICT (n=68, 3 RCTs; MD: 0.54 mL/kg/min; P=.05). For patients with HF with perceived ejection fraction, there was a modest beneficial effect from HIIT over MICT (n=141, 3 RCTs; MD: 0.55 mL/kg/min; P=.32).
Conclusions
The long-interval and high-volume HIIT protocol may produce greater benefits than MICT for improving cardiopulmonary fitness in patients with HFrEF. Further research is needed to determine the optimal HIIT protocol for different HF subtypes and to provide definitive recommendations for clinical practice.
{"title":"High-Intensity Interval Training Programs Versus Moderate-Intensity Continuous Training for Individuals With Heart Failure: A Systematic Review and Meta-analysis","authors":"Xiankun Chen PhD , Tong Zhang MM , Xiaoyue Hu GS , Zehuai Wen PhD , Weihui Lu PhD , Wei Jiang PhD","doi":"10.1016/j.apmr.2024.05.028","DOIUrl":"10.1016/j.apmr.2024.05.028","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the effect sizes of different high-intensity interval training (HIIT) protocols on cardiorespiratory parameters when compared with moderate-intensity continuous training (MICT) in different heart failure (HF) subtypes.</div></div><div><h3>Data Sources</h3><div>Electronic databases were searched from their inception date until January 23, 2023.</div></div><div><h3>Study Selection</h3><div><span>Randomized controlled trials (RCTs) were included if they compared HIIT with MICT in patients with HF. The primary outcome was peak oxygen consumption (Vo</span><sub>2</sub>peak). Two reviewers independently evaluated 99 initially identified studies, resulting in the selection of 15 RCTs that met the eligibility criteria.</div></div><div><h3>Data Extraction</h3><div>Data were extracted independently by 2 observers using a data extraction form drafted based on the CONSORT statement and the Template for Intervention Description and Replication; the methodological quality of the studies was analyzed individually based on the Tool for the Assessment of Study Quality in Exercise scale.</div></div><div><h3>Data Synthesis</h3><div><span>Fifteen RCTs with 553 patients with HF were included in the systematic review. The included studies had moderate to good overall methodological quality. The results showed that HIIT was generally more effective than MICT at improving Vo</span><sub>2</sub>peak in patients with HF (n=541, 15 RCTs; MD: 1.49 mL/kg/min; <em>I<sup>2</sup></em>=66%; <em>P</em><span><.001). However, the effect size varied depending on the HF subtype and HIIT protocol used. For patients with HF with reduced ejection fraction (HFrEF), the long-interval (high-intensity interval lasting ≥4 min) and high-volume HIIT (high-intensity efforts in total ≥15 min) showed the largest benefits over the MICT (n=261, 6 RCTs; MD: 2.11 mL/kg/min; </span><em>P</em><.001); followed by the short-interval (≤1 min) and high-volume HIIT (≥15 min; n=71, 3 RCTs; MD: 0.91 mL/kg/min; <em>P</em>=.12), and the short-interval and low-volume HIIT showed the least superiority over MICT (n=68, 3 RCTs; MD: 0.54 mL/kg/min; <em>P</em><span>=.05). For patients with HF with perceived ejection fraction, there was a modest beneficial effect from HIIT over MICT (n=141, 3 RCTs; MD: 0.55 mL/kg/min; </span><em>P</em>=.32).</div></div><div><h3>Conclusions</h3><div>The long-interval and high-volume HIIT protocol may produce greater benefits than MICT for improving cardiopulmonary fitness in patients with HFrEF. Further research is needed to determine the optimal HIIT protocol for different HF subtypes and to provide definitive recommendations for clinical practice.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 98-112"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305251","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}
Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.08.014
Jacob T. Urbina BS, Peter D. Vu MD, Michael V. Nguyen MD, MPH
Objective
To identify and quantify ability bias in generative artificial intelligence large language model chatbots, specifically OpenAI's ChatGPT and Google's Gemini.
Design
Observational study of language usage in generative artificial intelligence models.
Setting
Investigation-only browser profile restricted to ChatGPT and Gemini.
Participants
Each chatbot generated 60 descriptions of people prompted without specified functional status, 30 descriptions of people with a disability, 30 descriptions of patients with a disability, and 30 descriptions of athletes with a disability (N=300).
Interventions
Not applicable.
Main Outcome Measures
Generated descriptions produced by the models were parsed into words that were linguistically analyzed into favorable qualities or limiting qualities.
Results
Both large language models significantly underestimated disability in a population of people, and linguistic analysis showed that descriptions of people, patients, and athletes with a disability were generated as having significantly fewer favorable qualities and significantly more limitations than people without a disability in both ChatGPT and Gemini.
Conclusions
Generative artificial intelligence chatbots demonstrate quantifiable ability bias and often exclude people with disabilities in their responses. Ethical use of these generative large language model chatbots in medical systems should recognize this limitation, and further consideration should be taken in developing equitable artificial intelligence technologies.
{"title":"Disability Ethics and Education in the Age of Artificial Intelligence: Identifying Ability Bias in ChatGPT and Gemini","authors":"Jacob T. Urbina BS, Peter D. Vu MD, Michael V. Nguyen MD, MPH","doi":"10.1016/j.apmr.2024.08.014","DOIUrl":"10.1016/j.apmr.2024.08.014","url":null,"abstract":"<div><h3>Objective</h3><div>To identify and quantify ability bias in generative artificial intelligence large language model chatbots, specifically OpenAI's ChatGPT and Google's Gemini.</div></div><div><h3>Design</h3><div>Observational study of language usage in generative artificial intelligence models.</div></div><div><h3>Setting</h3><div>Investigation-only browser profile restricted to ChatGPT and Gemini.</div></div><div><h3>Participants</h3><div>Each chatbot generated 60 descriptions of people prompted without specified functional status, 30 descriptions of people with a disability, 30 descriptions of patients with a disability, and 30 descriptions of athletes with a disability (N=300).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Generated descriptions produced by the models were parsed into words that were linguistically analyzed into favorable qualities or limiting qualities.</div></div><div><h3>Results</h3><div>Both large language models significantly underestimated disability in a population of people, and linguistic analysis showed that descriptions of people, patients, and athletes with a disability were generated as having significantly fewer favorable qualities and significantly more limitations than people without a disability in both ChatGPT and Gemini.</div></div><div><h3>Conclusions</h3><div>Generative artificial intelligence chatbots demonstrate quantifiable ability bias and often exclude people with disabilities in their responses. Ethical use of these generative large language model chatbots in medical systems should recognize this limitation, and further consideration should be taken in developing equitable artificial intelligence technologies.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 14-19"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103830","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}
Pub Date : 2025-01-01DOI: 10.1016/j.apmr.2024.09.004
Julie A. Adsett PhD , Prue J. McRae MPhil , Alison M. Mudge PhD
Objective
To describe staff-perceived barriers to progressive patient mobilization.
Design
Cross-sectional staff survey.
Setting
Ten internal medicine wards in 4 hospitals in a large health service.
Participants
Nursing, medical, and allied health staff (n=208).
Interventions
Not applicable.
Main Outcome Measures
Patient Mobilization Attitudes and Beliefs Survey. An overall barriers score and subscale scores for knowledge, attitudes, and behaviors were calculated and compared between hospitals, discipline, and years of clinical experience.
Results
The survey was completed by 208 participants (123 nurses, 27 medical, 58 allied health), of whom 104 (50%) had <5 years of experience. The greatest perceived barriers included nursing workload, medical orders not being in place, and patient and family resistance to mobilization. Overall barrier scores differed between hospitals, discipline (mean nursing score ± SD 50±7; mean medical score ± SD, 51±7; mean allied health score ± SD, 43±7), and years of clinical experience (<5y mean score ± SD, 50±7; 5-9y mean score ± SD, 47±7; ≥10y mean score ± SD, 46±8); significant differences by hospital and discipline persisted in multivariate analysis. The behavior subscale had the highest barriers score and knowledge the lowest across all subgroups.
Conclusions
Staff-perceived nursing workload, lack of medical orders, and patient and family resistance to be the greatest barriers to patient mobilization. Barrier scores differed between disciplines, experience levels, and across hospitals within a single health service. Lower scores on the knowledge subscale highlight the need for multicomponent strategies beyond education that address culture and systems; education may particularly benefit medical staff.
{"title":"Staff-Perceived Barriers to Patient Mobilization Vary by Hospital, Discipline, and Experience: A Multisite Cross-Sectional Survey","authors":"Julie A. Adsett PhD , Prue J. McRae MPhil , Alison M. Mudge PhD","doi":"10.1016/j.apmr.2024.09.004","DOIUrl":"10.1016/j.apmr.2024.09.004","url":null,"abstract":"<div><h3>Objective</h3><div>To describe staff-perceived barriers to progressive patient mobilization.</div></div><div><h3>Design</h3><div>Cross-sectional staff survey.</div></div><div><h3>Setting</h3><div>Ten internal medicine wards in 4 hospitals in a large health service.</div></div><div><h3>Participants</h3><div>Nursing, medical, and allied health staff (n=208).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Patient Mobilization Attitudes and Beliefs Survey. An overall barriers score and subscale scores for knowledge, attitudes, and behaviors were calculated and compared between hospitals, discipline, and years of clinical experience.</div></div><div><h3>Results</h3><div>The survey was completed by 208 participants (123 nurses, 27 medical, 58 allied health), of whom 104 (50%) had <5 years of experience. The greatest perceived barriers included nursing workload, medical orders not being in place, and patient and family resistance to mobilization. Overall barrier scores differed between hospitals, discipline (mean nursing score ± SD 50±7; mean medical score ± SD, 51±7; mean allied health score ± SD, 43±7), and years of clinical experience (<5y mean score ± SD, 50±7; 5-9y mean score ± SD, 47±7; ≥10y mean score ± SD, 46±8); significant differences by hospital and discipline persisted in multivariate analysis. The behavior subscale had the highest barriers score and knowledge the lowest across all subgroups.</div></div><div><h3>Conclusions</h3><div>Staff-perceived nursing workload, lack of medical orders, and patient and family resistance to be the greatest barriers to patient mobilization. Barrier scores differed between disciplines, experience levels, and across hospitals within a single health service. Lower scores on the knowledge subscale highlight the need for multicomponent strategies beyond education that address culture and systems; education may particularly benefit medical staff.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 20-25"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340079","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}
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