Pub Date : 2026-01-01DOI: 10.1016/j.apmr.2025.06.007
Flora Nikolaou PhD, Brooke Holt PhD, Iro Michael MSc, Fofi Constantinidou PhD, Eve Valera PhD, Denise Gobert PhD, Angela Colantonio PhD, American Congress of Rehabilitation Medicine Girls and Women with Acquired Brain Injury Task Force
{"title":"Understanding Brain Injury in Intimate Partner Violence: A Guide for Frontline Professionals Working With IPV in Shelters","authors":"Flora Nikolaou PhD, Brooke Holt PhD, Iro Michael MSc, Fofi Constantinidou PhD, Eve Valera PhD, Denise Gobert PhD, Angela Colantonio PhD, American Congress of Rehabilitation Medicine Girls and Women with Acquired Brain Injury Task Force","doi":"10.1016/j.apmr.2025.06.007","DOIUrl":"10.1016/j.apmr.2025.06.007","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 147-149"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641619","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 : 2026-01-01DOI: 10.1016/j.apmr.2025.09.022
{"title":"Correction: Late Breaking Research Poster 2905855","authors":"","doi":"10.1016/j.apmr.2025.09.022","DOIUrl":"10.1016/j.apmr.2025.09.022","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Page 145"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852230","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 : 2026-01-01DOI: 10.1016/j.apmr.2025.07.005
Truls Johansen MPhil, PhD , Martin Matre PhD , Marianne Løvstad PhD , Alexander Olsen PhD , Anne Lund PhD , Anne-Catrine Trægde Martinsen PhD , Frank Becker PhD , Cathrine Brunborg PhD , Albert Rizzo PhD , Jacoba M. Spikman PhD , Dawn Neumann PhD , Jennie Ponsford PhD , Sveinung Tornås PhD
Objective
The study aimed to evaluate the effect of playing a commercially available virtual reality (VR)-game on sustained attention as primary outcome, and processing speed and working memory as secondary outcomes, after traumatic brain injury (TBI).
Design, Setting, and Participants
The study was a parallel-group randomized controlled trial with 1:1 allocation to VR training or an active control condition. One hundred participants aged 18-65 years with complicated mild-to-severe TBI and consequently impaired sustained attention, processing speed, and/or working memory were enrolled. Participants were assessed at baseline, after intervention, and 16 weeks postbaseline.
Intervention
The intervention arm played Beat Saber, a VR game requiring sustained attention and processing speed, 30 minutes per day, 5 days per week for 5 weeks. The control arm received information about everyday activities that might impact cognition.
Outcome Measures
Primary outcome was sustained attention measured by Connors Continuous Performance Test-third edition (CPT-3). Secondary outcomes included processing speed (CPT-3 hit reaction time), working memory (digit span backward and sequencing from Wechsler Adult Intelligence Scale-fourth edition), and self-report measures: Behavior Rating Inventory of Executive Function-Adult Version, Patient Competency Rating Scale, Fatigue Severity Scale, and Quality of Life after BRain Injury.
Results
No statistically significant between-group effect was found for the primary outcome measure, sustained attention (P=.473). However, the VR group demonstrated a significant increase in processing speed (P=.035), which was accompanied by a reduction in the number of errors (P<.001). No differences were observed for working memory. Self-reported executive functioning (P=.017) and quality of life (P=.039) were significantly improved in the VR group.
Conclusion
VR training did not improve sustained attention. However, a combination of prolonged reaction times and a decrease in errors in the VR group may indicate improved attentional control. In addition, the findings suggest that VR training might positively affect executive functioning. VR training may be used for cognitive training after TBI.
{"title":"Virtual Reality in Training of Sustained Attention, Processing Speed, and Working Memory After Traumatic Brain Injury: A Randomized Controlled Trial","authors":"Truls Johansen MPhil, PhD , Martin Matre PhD , Marianne Løvstad PhD , Alexander Olsen PhD , Anne Lund PhD , Anne-Catrine Trægde Martinsen PhD , Frank Becker PhD , Cathrine Brunborg PhD , Albert Rizzo PhD , Jacoba M. Spikman PhD , Dawn Neumann PhD , Jennie Ponsford PhD , Sveinung Tornås PhD","doi":"10.1016/j.apmr.2025.07.005","DOIUrl":"10.1016/j.apmr.2025.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to evaluate the effect of playing a commercially available virtual reality (VR)-game on sustained attention as primary outcome, and processing speed and working memory as secondary outcomes, after traumatic brain injury (TBI).</div></div><div><h3>Design, Setting, and Participants</h3><div>The study was a parallel-group randomized controlled trial with 1:1 allocation to VR training or an active control condition. One hundred participants aged 18-65 years with complicated mild-to-severe TBI and consequently impaired sustained attention, processing speed, and/or working memory were enrolled. Participants were assessed at baseline, after intervention, and 16 weeks postbaseline.</div></div><div><h3>Intervention</h3><div>The intervention arm played Beat Saber, a VR game requiring sustained attention and processing speed, 30 minutes per day, 5 days per week for 5 weeks. The control arm received information about everyday activities that might impact cognition.</div></div><div><h3>Outcome Measures</h3><div>Primary outcome was sustained attention measured by Connors Continuous Performance Test-third edition (CPT-3). Secondary outcomes included processing speed (CPT-3 hit reaction time), working memory (digit span backward and sequencing from Wechsler Adult Intelligence Scale-fourth edition), and self-report measures: Behavior Rating Inventory of Executive Function-Adult Version, Patient Competency Rating Scale, Fatigue Severity Scale, and Quality of Life after BRain Injury.</div></div><div><h3>Results</h3><div>No statistically significant between-group effect was found for the primary outcome measure, sustained attention (<em>P</em>=.473). However, the VR group demonstrated a significant increase in processing speed (<em>P</em>=.035), which was accompanied by a reduction in the number of errors (<em>P</em><.001). No differences were observed for working memory. Self-reported executive functioning (<em>P</em>=.017) and quality of life (<em>P</em>=.039) were significantly improved in the VR group.</div></div><div><h3>Conclusion</h3><div>VR training did not improve sustained attention. However, a combination of prolonged reaction times and a decrease in errors in the VR group may indicate improved attentional control. In addition, the findings suggest that VR training might positively affect executive functioning. VR training may be used for cognitive training after TBI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 21-31"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717274","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 evaluate the effects of a 12-week digital walking exercise program on functional capacity and psychological health in individuals with mild traumatic brain injury (mTBI) and the influence of exercise adherence.
Design
Randomized controlled trial with repeated measures.
Setting
Medical center-based recruitment with home-based intervention.
Participants
Fifty-two adults (N=52) (mean age ± SD, 43.98±14.94y; 57.7% women) diagnosed with mTBI (Glasgow Coma Scale score, 13-15) within 6 months postinjury.
Interventions
Participants were randomly assigned to either a digitally monitored walking program group (structured walking ≥30min/session, ≥3times/wk, supported by a wearable fitness tracker and personalized feedback) or an active control group receiving standard exercise education.
Main Outcome Measures
The primary outcome was functional capacity measured by the 6-minute walk test (6MWT). Secondary outcomes included depressive symptoms (Beck Depression Inventory-II) and quality of life (QoL; World Health Organization QoL-Brief Version). Assessments were conducted at baseline and at 4, 8, and 12 weeks. Generalized estimating equations assessed between-group differences. Subgroup analyses evaluated outcomes in participants with ≥80% adherence to moderate-intensity exercise.
Results
The intervention group demonstrated significantly greater improvements in 6MWT distance at 4 weeks (+41.65m, P=.02), 8 weeks (+61.31m, P=.001), and 12 weeks (+65.29m, P=.003) compared with controls. Between-group differences in depressive symptoms and psychological QoL were not statistically significant. However, in the high adherence subgroup (≥80%), significant improvements were observed in functional capacity, as measured by the 6MWT, as well as in depressive symptoms and overall QoL.
Conclusions
A 12-week digital walking exercise program significantly improved functional capacity in individuals with mTBI. Psychological health benefits were evident among those with high adherence to moderate-intensity walking. These findings support the integration of wearable technologies and remote monitoring tools into structured rehabilitation to promote functional recovery from mTBI.
目的:评价为期12周的数字步行运动对轻度创伤性脑损伤(mTBI)患者功能能力和心理健康的影响,并探讨运动坚持性的影响。设计:随机对照试验,重复测量。环境:以医疗中心为基础的招聘,以家庭为基础的干预。参与者:52名成人(平均年龄43.98±14.94,57.7%为女性)在损伤后6个月内诊断为mTBI(格拉斯哥昏迷评分,13-15)。干预措施:参与者被随机分配到数字监测步行计划组(结构化步行≥30分钟/次,≥3次/周,由可穿戴健身追踪器和个性化反馈支持)或接受标准运动教育的积极对照组。主要结局指标:主要结局指标是通过6分钟步行试验(6MWT)测量功能能力。次要结局包括抑郁症状(贝克抑郁量表- ii)和生活质量(WHOQOL-BREF)。在基线、4周、8周和12周进行评估。评估组间差异的广义估计方程。亚组分析评估≥80%坚持中等强度运动的参与者的结果。结果:干预组4周时6MWT距离明显改善(+41.65 m, p = )。02), 8周(+61.31 m, p = 。001), 12周(+65.29 m, p = )。003)与对照组相比。组间抑郁症状及心理生活质量差异无统计学意义。然而,在高依从性亚组(≥80%)中,通过6分钟步行测试(6MWT)测量的功能能力、抑郁症状和总体生活质量均有显著改善。结论:为期12周的数字行走计划可显著改善mTBI患者的功能能力。在那些坚持中等强度步行的人身上,心理健康的好处是显而易见的。这些发现支持将可穿戴技术和远程监测工具整合到结构化康复中,以促进mTBI的功能恢复。
{"title":"Impact of a Digitally Monitored Walking Program on Functional and Psychological Outcomes in Individuals With Mild Traumatic Brain Injury: A Randomized Controlled Trial","authors":"Hsin-Ya Tzeng MSc , Cheng-Chiang Chang MD , Sy-Jou Chen MD , Dueng-Yuan Hueng MD , Chi-Ming Chu PhD , Hui-Hsun Chiang PhD","doi":"10.1016/j.apmr.2025.08.014","DOIUrl":"10.1016/j.apmr.2025.08.014","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of a 12-week digital walking exercise program on functional capacity and psychological health in individuals with mild traumatic brain injury (mTBI) and the influence of exercise adherence.</div></div><div><h3>Design</h3><div>Randomized controlled trial with repeated measures.</div></div><div><h3>Setting</h3><div>Medical center-based recruitment with home-based intervention.</div></div><div><h3>Participants</h3><div>Fifty-two adults (N=52) (mean age ± SD, 43.98±14.94y; 57.7% women) diagnosed with mTBI (Glasgow Coma Scale score, 13-15) within 6 months postinjury.</div></div><div><h3>Interventions</h3><div>Participants were randomly assigned to either a digitally monitored walking program group (structured walking ≥30min/session, ≥3times/wk, supported by a wearable fitness tracker and personalized feedback) or an active control group receiving standard exercise education.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was functional capacity measured by the 6-minute walk test (6MWT). Secondary outcomes included depressive symptoms (Beck Depression Inventory-II) and quality of life (QoL; World Health Organization QoL-Brief Version). Assessments were conducted at baseline and at 4, 8, and 12 weeks. Generalized estimating equations assessed between-group differences. Subgroup analyses evaluated outcomes in participants with ≥80% adherence to moderate-intensity exercise.</div></div><div><h3>Results</h3><div>The intervention group demonstrated significantly greater improvements in 6MWT distance at 4 weeks (+41.65m, <em>P</em>=.02), 8 weeks (+61.31m, <em>P</em>=.001), and 12 weeks (+65.29m, <em>P</em>=.003) compared with controls. Between-group differences in depressive symptoms and psychological QoL were not statistically significant. However, in the high adherence subgroup (≥80%), significant improvements were observed in functional capacity, as measured by the 6MWT, as well as in depressive symptoms and overall QoL.</div></div><div><h3>Conclusions</h3><div>A 12-week digital walking exercise program significantly improved functional capacity in individuals with mTBI. Psychological health benefits were evident among those with high adherence to moderate-intensity walking. These findings support the integration of wearable technologies and remote monitoring tools into structured rehabilitation to promote functional recovery from mTBI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 1-10"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940354","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 : 2026-01-01DOI: 10.1016/j.apmr.2025.06.009
M.J. Mulcahey PhD , Nicole M. Gerhardt OTD , Rachel Y. Kim OTD , Namrata Grampurohit PhD , Maclain Capron MPH
Objective
The study aimed to describe the development and evaluation of an item pool for a new performance-based clinical outcome assessment (COA), the Spinal Cord Injury Movement Index (SCI-MovIn).
Design
Iterative focus groups, one-on-one consultations and field-testing sessions were used to develop the conceptual model for the SCI-MovIn measurement construct, establish an item pool consisting of candidate items with 5 response categories, and create standardized guidelines for set-up, administration, and scoring. Trained therapists administered 61 items to individuals with spinal cord injury (SCI) for inter- and intrarater reliability testing.
Setting
Academic institution in an urban area.
Participants
Professionals with measurement/SCI expertise participated in focus groups. Individuals with SCI engaged in field-testing and reliability testing sessions.
Main Outcome Measure(s)
Total percent exact agreement between paired raters was calculated. Cronbach’s alpha (α) and intraclass correlation coefficient (ICC) with 95% confidence interval (CI) were used to examine internal consistency. Intra- and interrater reliability were measured using ICCs.
Results
Through iterative focus groups with 18 SCI/measurement professionals and 24 field-testing sessions with 10 individuals with SCI, 226 items were developed, 132 of which were eliminated. The reliability testing sample consisted of 33 adults who sustained SCI an average of 13.2 years before participation. Of the 1215 paired scores from administration of 61 SCI-MovIn items, raters’ scores were identical for 833 (68.6%). Internal consistency was high (α=0.948). Reliability of repeated SCI-MovIn scores was high for both intrarater (ICC=0.992; CI=0.983-0.996) and interrater (ICC=0.887; CI=0.873-0.899) reliability.
Conclusion
The next step is a large-scale study to transform the item pool into a calibrated item bank from which tailored short forms can be developed.
{"title":"Development and Evaluation of an Item Pool of “Movement-Related Body Functions in the Context of Task Performance”","authors":"M.J. Mulcahey PhD , Nicole M. Gerhardt OTD , Rachel Y. Kim OTD , Namrata Grampurohit PhD , Maclain Capron MPH","doi":"10.1016/j.apmr.2025.06.009","DOIUrl":"10.1016/j.apmr.2025.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to describe the development and evaluation of an item pool for a new performance-based clinical outcome assessment (COA), the Spinal Cord Injury Movement Index (SCI-MovIn).</div></div><div><h3>Design</h3><div>Iterative focus groups, one-on-one consultations and field-testing sessions were used to develop the conceptual model for the SCI-MovIn measurement construct, establish an item pool consisting of candidate items with 5 response categories, and create standardized guidelines for set-up, administration, and scoring. Trained therapists administered 61 items to individuals with spinal cord injury (SCI) for inter- and intrarater reliability testing.</div></div><div><h3>Setting</h3><div>Academic institution in an urban area.</div></div><div><h3>Participants</h3><div>Professionals with measurement/SCI expertise participated in focus groups. Individuals with SCI engaged in field-testing and reliability testing sessions.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Total percent exact agreement between paired raters was calculated. Cronbach’s alpha (α) and intraclass correlation coefficient (ICC) with 95% confidence interval (CI) were used to examine internal consistency. Intra- and interrater reliability were measured using ICCs.</div></div><div><h3>Results</h3><div>Through iterative focus groups with 18 SCI/measurement professionals and 24 field-testing sessions with 10 individuals with SCI, 226 items were developed, 132 of which were eliminated. The reliability testing sample consisted of 33 adults who sustained SCI an average of 13.2 years before participation. Of the 1215 paired scores from administration of 61 SCI-MovIn items, raters’ scores were identical for 833 (68.6%). Internal consistency was high (α=0.948). Reliability of repeated SCI-MovIn scores was high for both intrarater (ICC=0.992; CI=0.983-0.996) and interrater (ICC=0.887; CI=0.873-0.899) reliability.</div></div><div><h3>Conclusion</h3><div>The next step is a large-scale study to transform the item pool into a calibrated item bank from which tailored short forms can be developed.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 77-85"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625303","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 : 2026-01-01DOI: 10.1016/S0003-9993(25)01094-9
{"title":"Archives Supplements","authors":"","doi":"10.1016/S0003-9993(25)01094-9","DOIUrl":"10.1016/S0003-9993(25)01094-9","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 150-152"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852231","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 : 2026-01-01DOI: 10.1016/j.apmr.2025.12.024
Hayato Tarumi, Kazuaki Uda, Jun Komiyama, Masahiko Hasegawa, Makiko Tomita, Shu Kobayashi, Nanako Tamiya
Objectives: To examine the association between average weekly minutes of home-visit rehabilitation (HR) and 6-month changes in activities of daily living (ADL) for older adults.
Design: Retrospective cohort study using anonymized electronic health record data SETTING: A total of 1,525 home-visit nursing stations across Japan.
Participants: Adults aged ≥65 years who initiated HR after April 2021 and continued for at least 6 months.
Interventions: HR categorized by average weekly duration: ≤40 min/week, 40 < min/week ≤ 60, 60 < min/week ≤ 80, and 80 < min/week ≤ 120.
Main outcome measure: Change in Barthel index (BI) score from baseline to 6 months.
Results: The analysis included 25,409 participants; the mean (SD) age was 82.9 (7.7) years, and 41.5% were males. The mean (SD) baseline BI was 68.7 (27.1). The proportion of HR duration was: ≤40 min/week (40.2%), >40-60 min/week (25.6%), >60-80 min/week (19.0%), and >80-120 min/week (15.1%). Multivariable linear regression showed significant BI improvements in the >40-60 min/week (0.30; 95% confidence interval [CI], 0.05-0.54), >60-80 min/week (1.05; 95% CI, 0.78-1.32), and >80-120 min/week (1.06; 95% CI, 0.77-1.35) groups than that in the ≤40 min/week group. Among participants with care-need level 1, no significant differences were observed across groups.
Conclusions: Increased average minutes per week of HR at 6 months is associated with an improvement in BI. This result suggests that an HR of 40 min/week may be insufficient to improve ADL.
{"title":"Association between weekly amount of home-visit rehabilitation and changes in activities of daily living: A retrospective cohort study using home-visit nursing station records.","authors":"Hayato Tarumi, Kazuaki Uda, Jun Komiyama, Masahiko Hasegawa, Makiko Tomita, Shu Kobayashi, Nanako Tamiya","doi":"10.1016/j.apmr.2025.12.024","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.12.024","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the association between average weekly minutes of home-visit rehabilitation (HR) and 6-month changes in activities of daily living (ADL) for older adults.</p><p><strong>Design: </strong>Retrospective cohort study using anonymized electronic health record data SETTING: A total of 1,525 home-visit nursing stations across Japan.</p><p><strong>Participants: </strong>Adults aged ≥65 years who initiated HR after April 2021 and continued for at least 6 months.</p><p><strong>Interventions: </strong>HR categorized by average weekly duration: ≤40 min/week, 40 < min/week ≤ 60, 60 < min/week ≤ 80, and 80 < min/week ≤ 120.</p><p><strong>Main outcome measure: </strong>Change in Barthel index (BI) score from baseline to 6 months.</p><p><strong>Results: </strong>The analysis included 25,409 participants; the mean (SD) age was 82.9 (7.7) years, and 41.5% were males. The mean (SD) baseline BI was 68.7 (27.1). The proportion of HR duration was: ≤40 min/week (40.2%), >40-60 min/week (25.6%), >60-80 min/week (19.0%), and >80-120 min/week (15.1%). Multivariable linear regression showed significant BI improvements in the >40-60 min/week (0.30; 95% confidence interval [CI], 0.05-0.54), >60-80 min/week (1.05; 95% CI, 0.78-1.32), and >80-120 min/week (1.06; 95% CI, 0.77-1.35) groups than that in the ≤40 min/week group. Among participants with care-need level 1, no significant differences were observed across groups.</p><p><strong>Conclusions: </strong>Increased average minutes per week of HR at 6 months is associated with an improvement in BI. This result suggests that an HR of 40 min/week may be insufficient to improve ADL.</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":"145896136","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 : 2026-01-01DOI: 10.1016/j.apmr.2025.06.020
Lynda D. Lisabeth PhD , Linda C. Gallo PhD , Janet Prvu Bettger ScD , Madeline Kwicklis MS , Elizabeth M. Almendarez MPH, MSSW , Erin Case BA , Melinda A. Smith DrPH , Lewis B. Morgenstern MD
Objective
To compare physical/mental health in caregivers and noncaregiver family/friends of stroke survivors within a population-based study.
Design
Study is a cohort study design with data from medical records and interviews.
Setting
Population-based stroke study in south Texas.
Participants
Stroke survivors and their informal caregivers and noncaregiver family and friends.
Interventions
Not applicable.
Main Outcome Measures
Physical/mental health measures included Patient Health Questionnaire-8 (PHQ-8; range, 0-24; higher→worse); Patient-Reported Outcomes Measurement Information System-10 physical (range, 16.2-67.7) and mental health (range, 21.2-67.6) summary scores (higher→better) at 90 days poststroke.
Results
Compared with noncaregivers (n=360), caregivers (n=320) had lower socioeconomic status, were more likely women, Mexican American, offspring rather than spouse of care recipient, and to reside with a stroke survivor. Median PHQ-8 scores were worse in caregivers (median=4; IQR, 1-8, mild) than noncaregivers (median=2; IQR, 0-5; no depression). Physical (median=47.7; IQR, 39.8-54.1; median=50.8; IQR, 44.9-57.7) and mental health (median=45.8; IQR, 41.1-50.8; median=50.8; IQR, 45.8-56.0) scores were good to very good in caregivers and noncaregivers, respectively. Caregivers had greater depression symptoms (β=1.5; 95% confidence interval [CI], 0.5-2.5) and worse physical (β=−2.2; 95% CI, −4.0 to −0.4) and mental health (β=−3.2; 95% CI, −5.1 to −1.4) than noncaregivers.
Conclusions
Physical/mental health in caregivers has rarely been compared with those not in the caregiving role. In this study, which controlled for the effect of having a family member or friend with stroke, caregivers had worse physical/mental health than noncaregivers, suggesting that caregiver interventions may improve well-being.
{"title":"Mental and Physical Well-Being of Informal Stroke Caregivers Compared With Noncaregiver Family and Friends","authors":"Lynda D. Lisabeth PhD , Linda C. Gallo PhD , Janet Prvu Bettger ScD , Madeline Kwicklis MS , Elizabeth M. Almendarez MPH, MSSW , Erin Case BA , Melinda A. Smith DrPH , Lewis B. Morgenstern MD","doi":"10.1016/j.apmr.2025.06.020","DOIUrl":"10.1016/j.apmr.2025.06.020","url":null,"abstract":"<div><h3>Objective</h3><div>To compare physical/mental health in caregivers and noncaregiver family/friends of stroke survivors within a population-based study.</div></div><div><h3>Design</h3><div>Study is a cohort study design with data from medical records and interviews.</div></div><div><h3>Setting</h3><div>Population-based stroke study in south Texas.</div></div><div><h3>Participants</h3><div>Stroke survivors and their informal caregivers and noncaregiver family and friends.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Physical/mental health measures included Patient Health Questionnaire-8 (PHQ-8; range, 0-24; higher→worse); Patient-Reported Outcomes Measurement Information System-10 physical (range, 16.2-67.7) and mental health (range, 21.2-67.6) summary scores (higher→better) at 90 days poststroke.</div></div><div><h3>Results</h3><div>Compared with noncaregivers (n=360), caregivers (n=320) had lower socioeconomic status, were more likely women, Mexican American, offspring rather than spouse of care recipient, and to reside with a stroke survivor. Median PHQ-8 scores were worse in caregivers (median=4; IQR, 1-8, mild) than noncaregivers (median=2; IQR, 0-5; no depression). Physical (median=47.7; IQR, 39.8-54.1; median=50.8; IQR, 44.9-57.7) and mental health (median=45.8; IQR, 41.1-50.8; median=50.8; IQR, 45.8-56.0) scores were good to very good in caregivers and noncaregivers, respectively. Caregivers had greater depression symptoms (β=1.5; 95% confidence interval [CI], 0.5-2.5) and worse physical (β=−2.2; 95% CI, −4.0 to −0.4) and mental health (β=−3.2; 95% CI, −5.1 to −1.4) than noncaregivers.</div></div><div><h3>Conclusions</h3><div>Physical/mental health in caregivers has rarely been compared with those not in the caregiving role. In this study, which controlled for the effect of having a family member or friend with stroke, caregivers had worse physical/mental health than noncaregivers, suggesting that caregiver interventions may improve well-being.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 51-58"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673854","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 : 2026-01-01DOI: 10.1016/j.apmr.2025.07.014
Caitlin Courchesne MSc , Medha Amarnath Nair MA , Marc Gelineau BA , Liam McCloskey BA , Josh Faulkner PhD , Molly Cairncross PhD
Objectives
To examine the extent to which psychological transdiagnostic processes have been investigated in relation to mild traumatic brain injury (mTBI) recovery outcomes, summarize methodological approaches, and evaluate consistency among transdiagnostic processes and outcome measures.
Data Sources
Five databases (Ovid MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science) were searched from inception to October 2024. Eleven transdiagnostic processes were identified for inclusion based on a review of existing systematic reviews and meta-analyses establishing transdiagnostic relevance across a range of psychological disorders: attentional bias, avoidance, emotion regulation, flexibility, interpretation bias, intolerance of uncertainty, neuroticism, perfectionism, repetitive negative thinking, self-discrepancy, and shame.
Study Selection
Peer-reviewed, empirical studies published in English were included if they involved human participants with mTBI predominantly aged ≥18 years and reported ≥1 association between a transdiagnostic process and an mTBI recovery outcome.
Data Extraction
Three reviewers extracted data on study design, sample characteristics, transdiagnostic processes and their associated mTBI outcome measures, and analytical approaches using a standardized extraction form.
Data Synthesis
Sixty-seven studies published between 1995 and 2024 were included, yielding 118 transdiagnostic process–outcome associations. Avoidance (29%), flexibility (29%), and interpretation bias (25%) were the most frequently investigated transdiagnostic processes; symptom severity (36%) and disability (18%) were the most frequently reported outcomes. No studies examined associations involving attentional bias, emotion regulation, or perfectionism. Substantial heterogeneity in transdiagnostic processes and outcome measurement was observed. While most studies employed quantitative analysis methods, qualitative approaches uniquely captured less represented transdiagnostic process–outcome associations (eg, intolerance of uncertainty, self-discrepancy, shame).
Conclusions
Although interest in transdiagnostic processes and mTBI recovery is growing, current investigations are centered on a narrow range of psychological constructs. Broader investigation of transdiagnostic processes known to maintain psychopathology and greater methodological consistency are needed.
目的:研究心理跨诊断过程(TPs)与轻度创伤性脑损伤(mTBI)恢复结果的关系,总结方法方法,并评估TP和结果测量之间的一致性。数据来源:检索5个数据库(Ovid MEDLINE、PsycINFO、CINAHL、Scopus和Web of Science),检索时间从成立到2024年10月。通过对现有的系统综述和荟萃分析的回顾,确定了11个tp,并在一系列心理障碍中建立了跨诊断相关性:注意偏差、回避、情绪调节、灵活性、解释偏差、对不确定性的不容忍、神经质、完美主义、重复性消极思维、自我差异和羞耻。研究选择:同行评议的、以英文发表的实证研究被纳入,如果这些研究涉及年龄主要≥18岁的mTBI患者,并且报告TP与mTBI恢复结果之间至少有一种关联。数据提取:三位审稿人使用标准化的提取表格提取研究设计、样本特征、TPs及其相关mTBI结果测量和分析方法的数据。数据综合:纳入了1995年至2024年间发表的67项研究,得出118个tp结局关联。回避(29%)、灵活性(29%)和解释偏差(25%)是最常被调查的TPs;症状严重(36%)和残疾(18%)是最常见的报道结果。没有研究调查了与注意偏差、情绪调节或完美主义有关的关联。观察到TP和结果测量的实质性异质性。虽然大多数研究采用定量分析方法,但定性方法独特地捕获了较少代表性的tp -结果关联(例如,对不确定性的不容忍、自我差异、羞耻)。结论:尽管对TPs和mTBI恢复的兴趣越来越大,但目前的研究主要集中在狭窄的心理结构上。需要对已知维持精神病理的TPs进行更广泛的调查和更大的方法一致性。
{"title":"Psychological Transdiagnostic Processes in Mild Traumatic Brain Injury Recovery: A Scoping Review","authors":"Caitlin Courchesne MSc , Medha Amarnath Nair MA , Marc Gelineau BA , Liam McCloskey BA , Josh Faulkner PhD , Molly Cairncross PhD","doi":"10.1016/j.apmr.2025.07.014","DOIUrl":"10.1016/j.apmr.2025.07.014","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the extent to which psychological transdiagnostic processes have been investigated in relation to mild traumatic brain injury (mTBI) recovery outcomes, summarize methodological approaches, and evaluate consistency among transdiagnostic processes and outcome measures.</div></div><div><h3>Data Sources</h3><div>Five databases (Ovid MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science) were searched from inception to October 2024. Eleven transdiagnostic processes were identified for inclusion based on a review of existing systematic reviews and meta-analyses establishing transdiagnostic relevance across a range of psychological disorders: attentional bias, avoidance, emotion regulation, flexibility, interpretation bias, intolerance of uncertainty, neuroticism, perfectionism, repetitive negative thinking, self-discrepancy, and shame.</div></div><div><h3>Study Selection</h3><div>Peer-reviewed, empirical studies published in English were included if they involved human participants with mTBI predominantly aged ≥18 years and reported ≥1 association between a transdiagnostic process and an mTBI recovery outcome.</div></div><div><h3>Data Extraction</h3><div>Three reviewers extracted data on study design, sample characteristics, transdiagnostic processes and their associated mTBI outcome measures, and analytical approaches using a standardized extraction form.</div></div><div><h3>Data Synthesis</h3><div>Sixty-seven studies published between 1995 and 2024 were included, yielding 118 transdiagnostic process–outcome associations. Avoidance (29%), flexibility (29%), and interpretation bias (25%) were the most frequently investigated transdiagnostic processes; symptom severity (36%) and disability (18%) were the most frequently reported outcomes. No studies examined associations involving attentional bias, emotion regulation, or perfectionism. Substantial heterogeneity in transdiagnostic processes and outcome measurement was observed. While most studies employed quantitative analysis methods, qualitative approaches uniquely captured less represented transdiagnostic process–outcome associations (eg, intolerance of uncertainty, self-discrepancy, shame).</div></div><div><h3>Conclusions</h3><div>Although interest in transdiagnostic processes and mTBI recovery is growing, current investigations are centered on a narrow range of psychological constructs. Broader investigation of transdiagnostic processes known to maintain psychopathology and greater methodological consistency are needed.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 86-104"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798040","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 : 2026-01-01DOI: 10.1016/S0003-9993(25)01078-0
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