Archives of physical medicine and rehabilitation最新文献

{"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 ,&nbsp;Cheng-Chiang Chang MD ,&nbsp;Sy-Jou Chen MD ,&nbsp;Dueng-Yuan Hueng MD ,&nbsp;Chi-Ming Chu PhD ,&nbsp;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}

{"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}

{"title":"Development and Evaluation of an Item Pool of “Movement-Related Body Functions in the Context of Task Performance”","authors":"M.J. Mulcahey PhD ,&nbsp;Nicole M. Gerhardt OTD ,&nbsp;Rachel Y. Kim OTD ,&nbsp;Namrata Grampurohit PhD ,&nbsp;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}

{"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}

{"title":"Mental and Physical Well-Being of Informal Stroke Caregivers Compared With Noncaregiver Family and Friends","authors":"Lynda D. Lisabeth PhD ,&nbsp;Linda C. Gallo PhD ,&nbsp;Janet Prvu Bettger ScD ,&nbsp;Madeline Kwicklis MS ,&nbsp;Elizabeth M. Almendarez MPH, MSSW ,&nbsp;Erin Case BA ,&nbsp;Melinda A. Smith DrPH ,&nbsp;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}

{"title":"Psychological Transdiagnostic Processes in Mild Traumatic Brain Injury Recovery: A Scoping Review","authors":"Caitlin Courchesne MSc ,&nbsp;Medha Amarnath Nair MA ,&nbsp;Marc Gelineau BA ,&nbsp;Liam McCloskey BA ,&nbsp;Josh Faulkner PhD ,&nbsp;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}

{"title":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(25)01078-0","DOIUrl":"10.1016/S0003-9993(25)01078-0","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Page A2"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145852367","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":"Guiding Technology Adoption in Rehabilitation: A Framework From the Rehabilitation Technology Implementation for Promising Solutions (Rehab TIPS) Workgroup","authors":"Michelle R. Rauzi DPT, ATC, PhD ,&nbsp;Swapna Balakrishnan DPT ,&nbsp;Sheryl M. Flynn PT, PhD ,&nbsp;Julie J. Keysor PT, PhD ,&nbsp;Helen M. Hoenig MD, MPH","doi":"10.1016/j.apmr.2025.08.008","DOIUrl":"10.1016/j.apmr.2025.08.008","url":null,"abstract":"<div><div>There is an unprecedented growth in health and rehabilitation technologies influencing service delivery. Although adopting emergent or existent technologies may add value to rehabilitation services and outcomes, clinicians face uncertainties on whether and how to adopt new technologies. Because of these challenges, rehabilitation stakeholders need to be active agents in the development, adoption, and ongoing evaluation of a given technology’s effect. This special communication presents the Rehabilitation Technology Implementation for Promising Solutions (Rehab TIPS) Framework. This Framework, designed by the multidisciplinary Rehab TIPS workgroup, integrates established theories toward guiding rehabilitation clinicians in a systematic process of selecting and adopting valuable technologies. This special communication details the underlying models that informed the Rehab TIPS Framework. Then, the 2 components of the Rehab TIPS Framework are outlined: (1) a decision-making process to guide the selection of appropriate technologies for adoption, and (2) the 3 phases of technology adoption by individuals within a socioecological context. Finally, we discuss how the Rehab TIPS Framework can be used in the rehabilitation field, including future directions for advancing the science and practice of technology adoption in rehabilitation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 123-133"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939746","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":"Domains, Trends, and Uptake of Common Data Elements in Intervention Studies Focused on Recovery of Consciousness in Severe Brain Injury From 1986 to 2020: A Scoping Review","authors":"Jennifer A. Weaver PhD, OTR/L ,&nbsp;Alison M. Cogan PhD ,&nbsp;Vera Pertsovskaya MD ,&nbsp;Parie Bhandari MPH ,&nbsp;Bint-e Z. Awan BA ,&nbsp;Sara Lewis MS, OTR/L ,&nbsp;Angela Hartman OTD, OTR/L ,&nbsp;Kristen Maisano OTD, MAEd ,&nbsp;Tom Harrod MLIS ,&nbsp;Theresa L. Bender Pape DrPH ,&nbsp;Trudy Mallinson PhD ,&nbsp;Recovery of Consciousness Study Team","doi":"10.1016/j.apmr.2025.07.021","DOIUrl":"10.1016/j.apmr.2025.07.021","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the range and typology of primary clinical outcome assessments used in intervention studies promoting recovery of consciousness for patients with disorders of consciousness. A secondary aim was to examine the extent to which the introduction of common data elements (CDE) has reduced the heterogeneity of primary clinical outcome assessments in studies that include participants with disorders of consciousness.</div></div><div><h3>Data Sources</h3><div>We searched for articles across 5 databases including Cochrane, Embase, PsycInfo, PubMed, and Scopus.</div></div><div><h3>Study Selection</h3><div>We selected articles that focused on facilitating recovery of consciousness among adults with disorders of consciousness after severe traumatic brain injury.</div></div><div><h3>Data Extraction</h3><div>We extracted the study year, primary clinical outcome assessment, and funding source.</div></div><div><h3>Data Synthesis</h3><div>We classified the primary clinical outcome by International Classification of Functioning, Disability, and Health domain and CDE status. A total of 75 primary clinical outcome assessments were extracted from 306 included articles representing 307 studies; 45 primary clinical outcome assessments (60%) aligned with the International Classification of Functioning, Disability, and Health Body Function domain. The proportion of articles with US federal funding that reported a CDE as the clinical outcome assessment did not differ by year published.</div></div><div><h3>Conclusions</h3><div>Implementation of CDEs in 2010 did not substantively change the utilization of clinical outcome assessments that are CDEs because these were already more likely to be reported than non-CDEs. Overall, the wide variation in primary clinical outcome assessments used in intervention studies facilitating recovery of consciousness limits the ability to conduct meta-analyses, which are needed to increase the strength of evidence for disorders of consciousness interventions.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 105-122"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144940364","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":"Action observation and motor imagery during hand immobilization period accelerate motor and functional recovery in patients with surgical fixation for distal radial fractures: a randomized controlled trial.","authors":"Scandelli Francesco, Temporiti Federico, Vecchi Simona, Manes Niccolò, Pozzi Alessandro, Rajevich Luca, Pivato Giorgio, Gatti Roberto","doi":"10.1016/j.apmr.2025.12.015","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.12.015","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of an action observation (AO) and motor imagery (MI) training compared to standard care pathway on motor and functional recovery in patients with surgical fixation after distal radial fractures (DRF).</p><p><strong>Design: </strong>Two-armed single-blind randomized controlled trial.</p><p><strong>Setting: </strong>Outpatient hand rehabilitation Unit.</p><p><strong>Participants: </strong>Forty right-handed participants who underwent surgical fixation for right DRF.</p><p><strong>Interventions: </strong>Participants allocated to AOMI group performed an AO and MI training during immobilization period, while participants allocated to control group followed a routinary care pathway. Both groups performed a 5-week rehabilitation program after immobilization end.</p><p><strong>Main outcome and measures: </strong>Primary outcome was hand dexterity (Purdue Pegboard Test - PPT). Secondary outcomes were active range-of-motion, pinch and grip strength and hand function (Patient-Rated Wrist/Hand Evaluation - PRWHE). Outcomes were assessed at immobilization end, after a 5-week rehabilitation program and at 6-month follow-up.</p><p><strong>Results: </strong>AOMI group revealed better R-task score of the PPT (mean difference 1.9, CI₉₅ 0.8,3.0), PRWHE-pain (median difference -6.0 CI₉₅ -11.0,-1.0) and PRWHE-specific-activity (median difference -10.0 CI₉₅ -18.0,-2.0) sub-scores and total PRWHE score (median difference -12.8 CI₉₅ -23.8,-4.0) compared to Control group at physiotherapy program end. Moreover, AOMI group revealed higher pinch and grip strength than Control group at immobilization end (median difference: grip 4.6 CI₉₅ 2.0,7.7; pinch 1.9 CI₉₅ 0.3,3.2).</p><p><strong>Conclusions: </strong>AO and MI during the immobilization period accelerated the recovery of hand dexterity and function in patients with surgical fixation for DRF. These findings suggested the incorporation of AO and MI in the care pathway of patients undergoing immobilization after surgery for DRF.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145892018","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}