Archives of physical medicine and rehabilitation最新文献

{"title":"Letter to the Editor: A Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients","authors":"Chao-Chun Huang MD, Hsuei-Chen Lee PhD","doi":"10.1016/j.apmr.2025.09.008","DOIUrl":"10.1016/j.apmr.2025.09.008","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 140-141"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129956","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}

{"title":"Shoulder rotators isokinetic profile according to instability and/or sport specificity: Implications for rehabilitation: Shoulder rotators isokinetic profile.","authors":"Maryne Cozette, Thierry Weissland, Paul Calmels, Pascal Edouard","doi":"10.1016/j.apmr.2025.12.016","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.12.016","url":null,"abstract":"<p><strong>Objectives: </strong>To (i) describe the shoulder rotator muscle profiles across healthy, unstable, and athletic contexts, and (ii) to compare the usual Peak Torque (PT-method) and the Angular Range (AR-method).</p><p><strong>Design: </strong>Retrospective analysis of data collected cross-sectionally.</p><p><strong>Setting: </strong>Hospital. Each participant participated in isokinetic evaluations of the shoulder rotator muscles at 60°.s^-1 (concentric/eccentric) for both shoulders.</p><p><strong>Participants: </strong>239 participants of 24.7 (7.5) years INTERVENTION: None.</p><p><strong>Main outcome measures: </strong>We recorded the PT and AR mean torque by 10°, and we calculated the antagonist/agonist ratios. We used a two-way repeated measures ANOVA with a correction for multiplicity to compare laterality (i.e., side-to-side) and contexts (i.e., no-overhead sports healthy, no-overhead sports with unstable shoulder, overhead sports healthy and overhead sports with unstable shoulder RESULTS: Concentric PT of external rotators were significantly lower in no-overhead athletes with shoulder instability than healthy no-overhead athletes (p=0.007) and than healthy overhead athletes (p=0.029). The AR highlighted significant (p<0.05) lower concentric external and internal rotator muscles strength: i) in no-overhead athletes with shoulder instability than in healthy no-overhead athletes; ii) in healthy overhead athletes than in healthy no-overhead athletes; iii) in no-overhead athletes with shoulder instability than in healthy overhead athletes. No significant difference was observed in the eccentric modality or in the PT/AR ratios. Significant side-to-side differences (p<0.05) between dominant and non-dominant sides were reported by both PT and AR methods.</p><p><strong>Conclusion: </strong>Only the concentric muscle profiles differed across context groups. The AR allowed for a more precise detection of shoulder muscle adaptations by identifying unique muscle signatures in the moment-angle relationship. These 10° angular range measurements offer complementary information and enhance the clinical utility of isokinetic profiling compared to the traditional PT-method.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896179","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}

{"title":"Post-acute COVID-19 Syndrome: Brain Fog Phenotype, Patient-Centric Understanding, and Biopsychosocial-Oriented Treatment","authors":"Heidi A. Bender PhD ,&nbsp;Natalie A. Williams PhD ,&nbsp;Judith M. Burnfield PhD ,&nbsp;Fofi Constantinidou PhD ,&nbsp;Fransiska M. Bossuyt PhD ,&nbsp;Thomas Bergquist PhD ,&nbsp;Yelena Bogdanova PhD ,&nbsp;Evan Cohen PhD ,&nbsp;Jacob Raber PhD ,&nbsp;Andrew D. Lokai PhD ,&nbsp;Amanda Sacks-Zimmerman PhD","doi":"10.1016/j.apmr.2025.09.002","DOIUrl":"10.1016/j.apmr.2025.09.002","url":null,"abstract":"<div><div>Post-acute COVID-19 syndrome (PACS), a term used to describe ongoing symptoms after SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) (COVID-19) infection, includes prominent neuropsychological sequela, such as a subjective sense of brain fog. Brain fog can be persistent and interfere with quality of life and daily functioning across multiple domains. Rehabilitation professionals can comprehensively address PACS-related brain fog through a biopsychosocial framework of chronic illness. Through emphasizing a patient-centric perspective, rehabilitation practitioners can understand lifestyle protective factors, as well as the reciprocal relationships between emotional processing and behaviors that potentially maintain symptomology manifesting as brain fog. However, current practice models do not fully address the biopsychosocial components for adults suffering from PACS-related brain fog. To address gaps in the literature, we present a biopsychosocial framework for PACS-related brain fog and provide treatment strategies based on evidence from current literature of neuropsychiatric sequela of mild traumatic brain injury. These recommendations will provide practice guidance to rehabilitation professionals in (1) identifying common protective factors that can be optimized in the context of persistent PACS-related brain fog and (2) addressing these symptoms via integrative interventions, considering the biopsychosocial presentation of brain fog.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 134-139"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074234","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}

{"title":"Response to Letter to the Editor: Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients","authors":"Karol Ramírez-Parada PT, MSc, MBA,&nbsp;Cesar Sánchez MD,&nbsp;Irene Cantarero-Villanueva PT, MSc, PhD,&nbsp;Álvaro Reyes PT, MSc, PhD,&nbsp;Mauricio P. Pinto PhD,&nbsp;M. Loreto Bravo PhD,&nbsp;Denise Montt-Blanchard MSc,&nbsp;Francisco Acevedo MD,&nbsp;Benjamín Walbaum MD,&nbsp;Margarita Alfaro-Barra PT,&nbsp;Margarita Barra-Navarro PT,&nbsp;Scarlet Muñoz-Flores PT,&nbsp;Constanza Pinto RM,&nbsp;Sabrina Muñiz RN,&nbsp;Felipe Contreras-Briceño PT, MSc, PhD,&nbsp;Tomás Merino MD,&nbsp;Gina Merino MSc","doi":"10.1016/j.apmr.2025.09.009","DOIUrl":"10.1016/j.apmr.2025.09.009","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 141-142"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181929","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}

{"title":"Effects of a Hybrid Telerehabilitation Model on Mobility and Functional Capacity in Patients With Multiple Sclerosis: A Single-Blind Randomized Controlled Study","authors":"Guzin Kaya Aytutuldu PT, PhD ,&nbsp;Duygu Yalcınkaya PT, MSc ,&nbsp;Buket Akinci PT ,&nbsp;Hikmet Ucgun PT ,&nbsp;Rabia Gokcen Gozubatik Celik MD ,&nbsp;Mesude Tutuncu MD","doi":"10.1016/j.apmr.2025.09.034","DOIUrl":"10.1016/j.apmr.2025.09.034","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of hybrid telerehabilitation (Hybrid TR), telerehabilitation (TR-only), and clinic-based rehabilitation on gait speed (primary outcome: Timed 25-Foot Walk Test), as well as on fatigue, functional capacity, mobility, quality of life, and muscle activation in patients with multiple sclerosis (MS).</div></div><div><h3>Design</h3><div>A single-blind randomized controlled trial with assessments conducted at baseline, mid-treatment (wk 4), and post-treatment (wk 8).</div></div><div><h3>Setting</h3><div>Rehabilitation settings included hybrid (combination of telerehabilitation, clinic-based interventions), only telerehabilitation, and clinic-based environments.</div></div><div><h3>Participants</h3><div>A total of 44 participants (N=44) diagnosed with MS (Expanded Disability Status Scale scores ranging from 0 to 4) were randomly assigned into 3 groups: Hybrid TR (Group A), TR-only (Group B), and clinic-based rehabilitation (Group C). Participants underwent an 8-week intervention program. Selection was based on specific eligibility criteria, and random allocation methods were applied.</div></div><div><h3>Interventions</h3><div>Participants engaged in an 8-week program consisting of breathing exercises, aerobic training, and strengthening exercises delivered through Hybrid TR, TR-only, or clinic-based rehabilitation.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcome was mobility assessed by the Timed 25-Foot Walk. Secondary outcomes included functional capacity assessed by 2-Minute Walk Test, and mobility assessed by timed Up and Go; fatigue assessed by the Modified Fatigue Impact Scale; quality of life assessed by the Multiple Sclerosis International Quality of Life questionnaire; and muscle activation measured by surface electromyography of the rectus femoris muscle.</div></div><div><h3>Results</h3><div>Significant within group improvements in mobility, fatigue, functional capacity, quality of life, and EMG parameters were observed by week 8 across all groups. However, statistically significant between-group differences were not observed, and effect sizes were small to moderate (η²_p=0.01-0.07).</div></div><div><h3>Conclusions</h3><div>Hybrid TR appears to be a feasible and potentially beneficial approach for individuals with MS, with clinical outcomes that may be comparable with those of clinic-based rehabilitation in terms of mobility, fatigue, functional capacity, quality of life, and muscle activation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 11-20"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312322","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}

{"title":"TBI Disability, Health Beliefs, and Workforce Capacity Are Top Barriers to Chronic Pain Guideline-Based Nonpharmacologic Interventions","authors":"Risa Nakase-Richardson PhD ,&nbsp;Jolie Haun PhD ,&nbsp;Mitch Sevigny MS ,&nbsp;Aaron Martin PhD ,&nbsp;Robin Hanks PhD ,&nbsp;Flora Hammond MD ,&nbsp;Georgia Kane MD ,&nbsp;Jessica Ryan PhD ,&nbsp;Natalie Gilmore PhD ,&nbsp;Rebecca Campbell-Montalvo PhD ,&nbsp;Jeanne Hoffman PhD","doi":"10.1016/j.apmr.2025.06.002","DOIUrl":"10.1016/j.apmr.2025.06.002","url":null,"abstract":"<div><h3>Objective</h3><div>To examine determinants of evidence-based, nonpharmacologic treatments for chronic pain among patients with traumatic brain injury (TBI) using an access to care lens.</div></div><div><h3>Design</h3><div>Convenience sample of respondents to an online survey directed to rehabilitation professionals.</div></div><div><h3>Setting</h3><div>Civilian and VA-based centers with TBI providers.</div></div><div><h3>Participants</h3><div>US based providers (N=145) (63% civilian; 34% VA, 3% DOD).</div></div><div><h3>Intervention</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>A 10-item survey examining barriers to nonpharmacologic evidence-based therapies, informed by the robust Levesque Access to Care framework, which includes supply and demand characteristics. Six of the items described patient and community abilities to access care and 4 focused on health care system or infrastructure critical in access. On the basis of their professional experience, participants were asked to separately rate the frequency of the 10 barriers for each of the 3 specific guideline-endorsed interventions for chronic pain: behavioral health therapies, comprehensive chronic pain programs, and substance use disorder treatment.</div></div><div><h3>Results</h3><div>Across all 3 interventions, morbidity associated with TBI (ie, cognitive, physical disabilities), patient lack of understanding, trust, or beliefs about efficacy of intervention, and lack of qualified providers who can deliver the intervention were the most frequently endorsed barriers to delivering NP-EBTs for chronic pain. Subgroup analyses found higher frequency of barriers in civilian versus VA settings particularly related to patient ability to afford (58%-70% difference) and insurance coverage (54%-61%) of interventions.</div></div><div><h3>Conclusions</h3><div>Findings have implication for policy and practice to address health care inequities that persons with TBI-related disability experience in accessing high-quality, evidence-based treatments.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 32-41"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144301020","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}

{"title":"Predicting Suicidality in Veterans/Service Members Over 5 Years After TBI: A VA Model Systems Study","authors":"Bani Malhotra PhD ,&nbsp;Jessica M. Ketchum PhD ,&nbsp;Daniel W. Klyce PhD ,&nbsp;Jacob A. Finn PhD ,&nbsp;Lauren B. Fisher PhD ,&nbsp;Kelli G. Talley PhD ,&nbsp;Shannon B. Juengst PhD ,&nbsp;Elizabeth C. Pasipanodya PhD ,&nbsp;Janet P. Niemeier PhD ,&nbsp;Paul B. Perrin PhD","doi":"10.1016/j.apmr.2025.07.009","DOIUrl":"10.1016/j.apmr.2025.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>To examine demographic and injury-related predictors of suicide attempt (SA) and suicidal ideation (SI) during the 5 years after traumatic brain injury (TBI) among Veterans and Service Members (V/SMs) enrolled in the Department of Veterans Affairs (VA) Polytrauma Rehabilitation Center (PRC) TBI Model Systems study.</div></div><div><h3>Design</h3><div>Multicenter, longitudinal observational cohort study.</div></div><div><h3>Setting</h3><div>Inpatient rehabilitation at one of the VA’s 5 PRCs.</div></div><div><h3>Participants</h3><div>A sample of 812 V/SMs with TBI enrolled within 14 months of injury and survived to at least the year 1 data collection.</div></div><div><h3>Main Outcome Measures</h3><div>Past year SA and past-2-week SI were assessed at follow-ups.</div></div><div><h3>Results</h3><div>SA prevalence rate across the years varied between 2.2% and 2.5%, with 4.8% of the sample reporting SA at least once. SI rates were higher and varied between 13.2% and 14.3%, with 21.7% reporting SI at least once. After controlling for other predictors, V/SMs aged &lt;30 years had 5.32 times greater odds of SA post-TBI compared with those aged ≥50 years. Those with a preinjury history of mental health treatment or psychiatric hospitalization had 3.89 times greater odds of SA over time. Nonviolent TBI etiologies increased SI odds by 1.94 times. Preinjury history of mental health treatment or psychiatric hospitalization increased SI odds by 1.69 times; and those with a preinjury history of SA had 2.86 times greater SI odds.</div></div><div><h3>Conclusions</h3><div>These rates, though high, are likely underestimates of 5-year post-TBI suicidality among V/SMs with TBI. V/SMs with TBI should be screened regularly for suicidality—even years after injury. Future research should explore the contributions of the identified risk factors to inform targeted screening and appropriate mental health referral to prevent, assess, monitor, and treat SA and SI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 59-67"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717351","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}

{"title":"Intimate Partner Violence and Traumatic Brain Injury: A Commentary","authors":"Angela Colantonio PhD, OT Reg. (Ont.),&nbsp;Flora Nikolaou PhD (Clinical Psychology),&nbsp;Denise Gobert PT MEd, PhD,&nbsp;Brooke Holt PhD, CCC-SLP","doi":"10.1016/j.apmr.2025.09.029","DOIUrl":"10.1016/j.apmr.2025.09.029","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 143-144"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312309","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}

{"title":"Primary Care and Brain Injury Physician Utilization for Individuals Living With Chronic Brain Injury","authors":"Flora M. Hammond MD ,&nbsp;Kurt Kroenke MD ,&nbsp;John D. Corrigan PhD ,&nbsp;Angelle M. Sander PhD ,&nbsp;Ross Zafonte DO ,&nbsp;Robert C. Brunner MD ,&nbsp;Joseph T. Giacino PhD ,&nbsp;Jeanne M. Hoffman PhD ,&nbsp;Dmitry Esterov DO ,&nbsp;David X. Cifu MD ,&nbsp;Kathleen Bell MD ,&nbsp;David C. Mellick PhD","doi":"10.1016/j.apmr.2025.06.018","DOIUrl":"10.1016/j.apmr.2025.06.018","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the use of primary care (PCP) and brain injury physicians in the years after a traumatic brain injury (TBI) and the perceived reasons for lack of utilization.</div></div><div><h3>Design</h3><div>Prospective, observational cohort study of persons who received inpatient brain injury rehabilitation under the care of a brain injury rehabilitation physician.</div></div><div><h3>Setting</h3><div>Fifteen TBI Model System centers.</div></div><div><h3>Participants</h3><div>Participants in the TBI Model Systems (N=1520) cohort who experienced TBI 1-35 years previously.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The proportion of participants under the care of a PCP and/or a brain injury physician, and if applicable, the reasons not cared for by a physician; and what type of physician the participant would see if they had 8 common brain injury conditions.</div></div><div><h3>Results</h3><div>Most participants (85%) reported having a PCP, and 35% reported active care from a brain injury physician. More than 90% have visited their physician in the past 1-2 years. Factors independently associated with not having either a PCP or a brain injury physician were being younger, men, black, unmarried, having fewer health conditions, and having a more rapid initial recovery from their TBI. The most frequent reasons for not having a specific type of physician were a lack of perceived need or their physician taking care of most of their health care problems. The PCP was most often the first contact for 8 common health conditions.</div></div><div><h3>Conclusions</h3><div>Most individuals in this longitudinal cohort of TBI survivors report having a PCP. Demographic and clinical characteristics identified subgroups who may lack regular contact with primary care or brain injury specialty care. While all participants were cared for by a brain injury physician during their initial rehabilitation, only a minority had ongoing care from a brain injury physician years later.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 42-50"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590338","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}

{"title":"Development and Preliminary Examination of a Fidelity Assessment for the Spinal Cord Injury Movement Index","authors":"Nicole M. Gerhardt OTD ,&nbsp;Rachel Y. Kim OTD ,&nbsp;Maclain Capron MS ,&nbsp;M.J. Mulcahey PhD","doi":"10.1016/j.apmr.2025.06.010","DOIUrl":"10.1016/j.apmr.2025.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to describe the development and refinement of a fidelity assessment for a novel performance-based item pool, the Spinal Cord Injury Movement Index (SCI-MovIn), and report on its interrater agreement.</div></div><div><h3>Design</h3><div>Guidance for the development of intervention fidelity assessments was adapted to create a framework for the development of an assessment fidelity checklist. An initial draft of the SCI-MovIn fidelity checklist was drafted. The set-up and administration fidelity criteria were exposed to iterative modified Delphi surveys with individuals knowledgeable about the SCI-MovIn. Interrater agreement was then assessed through field-testing of the fidelity assessment by fidelity raters who viewed the same video-recorded SCI-MovIn testing sessions.</div></div><div><h3>Setting</h3><div>Academic institution in an urban area.</div></div><div><h3>Participants</h3><div>Three individuals participated in the modified Delphi survey (purposeful sample). Three individuals served as fidelity raters for interrater agreement testing.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The modified Delphi technique was completed iteratively until 100% agreement among respondents was reached that every criterion on the fidelity assessment was relevant, clear, specific, and in alignment with the response scale. Descriptive statistics were used to examine exact percent interrater agreement for the ratings on the SCI-MovIn fidelity assessment across 3 raters.</div></div><div><h3>Results</h3><div>Four survey rounds were iteratively completed until 100% agreement among respondents was reached that fidelity criteria were relevant, clear, specific, and aligned with the fidelity response scale. Across 21 sessions (394 items), raters’ total absolute exact percent agreement on scores of fidelity was 79.33%. Nine of 13 criteria had &gt;75% agreement.</div></div><div><h3>Conclusions</h3><div>The SCI-MovIn fidelity assessment was developed using a framework modified from guidance for intervention fidelity assessments. It was refined over 4 rounds of a modified Delphi process and then exposed to field-testing for rater agreement.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 68-76"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625304","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}