{"title":"Response to Letter to the Editor: Rehabilitation of Social Communication Skills in Patients With Acquired Brain Injury With Intensive and Standard Group Interactive Structured Treatment: A Randomized Controlled Trial","authors":"Silje Merethe Hansen Ingebretsen PhD, Melanie Kirmess PhD, Jan Stubberud PhD","doi":"10.1016/j.apmr.2024.09.009","DOIUrl":"10.1016/j.apmr.2024.09.009","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 151-152"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340078","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.2024.09.018
Lisa Engel PhD, MSc OS/OT, Wendy Waldman BSW, CBIST, Laurie Rippon MA Ed, HD, Elaheh Keshavarz MSc Rehab
{"title":"Should You Tell Others That You Live With Brain Injury? Things to Consider About Brain Injury and Disclosure","authors":"Lisa Engel PhD, MSc OS/OT, Wendy Waldman BSW, CBIST, Laurie Rippon MA Ed, HD, Elaheh Keshavarz MSc Rehab","doi":"10.1016/j.apmr.2024.09.018","DOIUrl":"10.1016/j.apmr.2024.09.018","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 159-162"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563462","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)01392-3
{"title":"Archives Supplements","authors":"","doi":"10.1016/S0003-9993(24)01392-3","DOIUrl":"10.1016/S0003-9993(24)01392-3","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 163-165"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129949","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.2024.06.005
Meng Zhang PhD , Zhide Liang MD , Liang Tian MD , Yaqi Han MD , Xu Jiang , Yali Li , Zhaoxi Su MD , Tao Liu PhD
Objective
This study aimed to assess the effectiveness of exercise therapy for patients with axial spondyloarthritis (axSpA).
Data Sources
We searched MEDLINE (via PubMed), Cochrane Library, Embase, Web of Science, Scopus, and SPORTDiscus for all relevant publications from database inception to March 2024, without language restriction.
Study Selection
We included randomized controlled trials (RCTs) of patients with axSpA in which ≥1 group received exercise therapy.
Data Extraction
Two independent reviewers assessed the quality of the literature using the Cochrane Collaboration Risk of Bias Tool 2.0. The outcomes were ankylosing spondylitis (AS) disease activity score (ASDAS), Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), Bath AS metrology index (BASMI), 6-minute walk test (6MWT), chest expansion capacity, peak oxygen consumption (VO2peak), pain, fatigue, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR).
Data Synthesis
A total of 20 RCTs, including 1670 patients, were included in this study. Compared with the control group, exercise therapy improved BASFI (weighted mean difference [WMD], −0.49; 95% confidence interval [CI], −0.65 to −0.32; I2=3.4%; P=.414), BASMI (WMD, −0.49; 95% CI, −0.87 to −0.11; I2=71.9%; P=.679), BASDAI (WMD, −0.78; 95% CI, −1.08 to −0.47; I2=55.9%; P=.021), ASDAS (WMD, −0.44; 95% CI, −0.64 to −0.24; I2=0.0%; P=.424), VO2peak (WMD, 3.16; 95% CI, 1.37-4.94; I2=0.0%; P=.873), 6MWT (WMD, 27.64; 95% CI, 12.04-43.24; I2=0.0%, P=.922), pain (standardized mean difference [SMD], −0.47; 95% CI, −0.74 to −0.21; I2=66.0%, P=.046), and fatigue (SMD, −0.49; 95% CI, −0.71 to −0.27; I2=0.0%; P=.446). However, no significant benefit was found in chest expansion, CRP, and ESR outcomes.
Conclusions
Exercise therapy is an effective strategy for improving disease control and symptom relief in patients with axSpA.
{"title":"Effects of Exercise Therapy in Axial Spondyloarthritis: A Systematic Review, Meta-analysis, and Meta-regression of Randomized Trials","authors":"Meng Zhang PhD , Zhide Liang MD , Liang Tian MD , Yaqi Han MD , Xu Jiang , Yali Li , Zhaoxi Su MD , Tao Liu PhD","doi":"10.1016/j.apmr.2024.06.005","DOIUrl":"10.1016/j.apmr.2024.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the effectiveness of exercise therapy for patients with axial spondyloarthritis (axSpA).</div></div><div><h3>Data Sources</h3><div>We searched MEDLINE (via PubMed), Cochrane Library, Embase, Web of Science, Scopus, and SPORTDiscus for all relevant publications from database inception to March 2024, without language restriction.</div></div><div><h3>Study Selection</h3><div>We included randomized controlled trials (RCTs) of patients with axSpA in which ≥1 group received exercise therapy.</div></div><div><h3>Data Extraction</h3><div>Two independent reviewers assessed the quality of the literature using the Cochrane Collaboration Risk of Bias Tool 2.0. The outcomes were ankylosing spondylitis (AS) disease activity score (ASDAS), Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), Bath AS metrology index (BASMI), 6-minute walk test (6MWT), chest expansion capacity, peak oxygen consumption (VO<sub>2</sub>peak), pain, fatigue, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR).</div></div><div><h3>Data Synthesis</h3><div>A total of 20 RCTs, including 1670 patients, were included in this study. Compared with the control group, exercise therapy improved BASFI (weighted mean difference [WMD], −0.49; 95% confidence interval [CI], −0.65 to −0.32; <em>I</em><sup>2</sup>=3.4%; <em>P</em>=.414), BASMI (WMD, −0.49; 95% CI, −0.87 to −0.11; <em>I</em><sup>2</sup>=71.9%; <em>P</em>=.679), BASDAI (WMD, −0.78; 95% CI, −1.08 to −0.47; <em>I</em><sup>2</sup>=55.9%; <em>P</em>=.021), ASDAS (WMD, −0.44; 95% CI, −0.64 to −0.24; <em>I</em><sup>2</sup>=0.0%; <em>P</em>=.424), VO<sub>2</sub>peak (WMD, 3.16; 95% CI, 1.37-4.94; <em>I</em><sup>2</sup>=0.0%; <em>P</em>=.873), 6MWT (WMD, 27.64; 95% CI, 12.04-43.24; <em>I</em><sup>2</sup>=0.0%, <em>P</em>=.922), pain (standardized mean difference [SMD], −0.47; 95% CI, −0.74 to −0.21; <em>I</em><sup>2</sup>=66.0%, <em>P</em>=.046), and fatigue (SMD, −0.49; 95% CI, −0.71 to −0.27; <em>I</em><sup>2</sup>=0.0%; <em>P</em>=.446). However, no significant benefit was found in chest expansion, CRP, and ESR outcomes.</div></div><div><h3>Conclusions</h3><div>Exercise therapy is an effective strategy for improving disease control and symptom relief in patients with axSpA.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 113-123"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465855","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.2024.07.019
M.G. Finco PhD, CPO, MS , Cody L. McDonald PhD, CPO, MPH , Sarah C. Moudy PhD, MSc
Objective
To elicit the preferred terminology among people with limb difference as well as health care and/or research professionals.
Design
Cross-sectional survey.
Setting
Online.
Participants
A convenience sample of N=122 individuals (people with limb difference, n=65; health care and/or research professionals, n=57) completed an online survey. People were included if they (1) were aged ≥18 years; (2) self-identified as having limb difference (regardless of etiology) or as a health care or research professional (with experience working with people with limb difference); and (3) lived in the United States for most of the time in their selected role.
Interventions
Not applicable.
Main Outcome Measures
Importance of terminology, preference toward person-first or identity-first terms, preferred terms, and individual perspectives on terminology preferences.
Results
Most participants identified as White (92.6%). Age significantly differed between groups (people with limb difference, 49.9±15.4y; professionals, 41.0±14.3y; P=.001). Approximately 50% of people with limb difference stated terminology was very or extremely important, compared to 70% of professionals (χ2=16.6, P=.002). While 73.7% of professionals reported a preference for person-first terminology, the sample of people with limb difference were more evenly split, as 42.9% reported a preference for identity-first terminology and 50.8% reported a preference for person-first terminology. The most frequently selected limb and population terms, respectively, were residual limb and individual/person with limb difference; however, many people with limb difference indicated they preferred “amputee” when speaking about a population.
Conclusions
Most of the participants indicated terminology was very or extremely important, and both groups tended to prefer the terms residual limb (limb term) and individual/person with limb difference (population term). However, this study was not intended to recommend terminology, but rather help inform terminology choices that are centered around people with limb difference. Individuality and context should be considered when deciding terminology. Future studies should include more participants from racially/ethnically minoritized groups and people with limb difference who have dysvascular and/or congenital etiologies.
{"title":"Does Terminology Matter? Perspectives From People With Limb Difference, Clinicians, and Researchers","authors":"M.G. Finco PhD, CPO, MS , Cody L. McDonald PhD, CPO, MPH , Sarah C. Moudy PhD, MSc","doi":"10.1016/j.apmr.2024.07.019","DOIUrl":"10.1016/j.apmr.2024.07.019","url":null,"abstract":"<div><h3>Objective</h3><div>To elicit the preferred terminology among people with limb difference as well as health care and/or research professionals.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Setting</h3><div>Online.</div></div><div><h3>Participants</h3><div>A convenience sample of N=122 individuals (people with limb difference, n=65; health care and/or research professionals, n=57) completed an online survey. People were included if they (1) were aged ≥18 years; (2) self-identified as having limb difference (regardless of etiology) or as a health care or research professional (with experience working with people with limb difference); and (3) lived in the United States for most of the time in their selected role.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Importance of terminology, preference toward person-first or identity-first terms, preferred terms, and individual perspectives on terminology preferences.</div></div><div><h3>Results</h3><div>Most participants identified as White (92.6%). Age significantly differed between groups (people with limb difference, 49.9±15.4y; professionals, 41.0±14.3y; <em>P</em>=.001). Approximately 50% of people with limb difference stated terminology was very or extremely important, compared to 70% of professionals (<em>χ<sup>2</sup></em>=16.6, <em>P</em>=.002). While 73.7% of professionals reported a preference for person-first terminology, the sample of people with limb difference were more evenly split, as 42.9% reported a preference for identity-first terminology and 50.8% reported a preference for person-first terminology. The most frequently selected limb and population terms, respectively, were <em>residual limb</em> and <em>individual/person with limb difference</em>; however, many people with limb difference indicated they preferred “amputee” when speaking about a population.</div></div><div><h3>Conclusions</h3><div>Most of the participants indicated terminology was very or extremely important, and both groups tended to prefer the terms residual limb (limb term) and individual/person with limb difference (population term). However, this study was not intended to recommend terminology, but rather help inform terminology choices that are centered around people with limb difference. Individuality and context should be considered when deciding terminology. Future studies should include more participants from racially/ethnically minoritized groups and people with limb difference who have dysvascular and/or congenital etiologies.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 26-36"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987324","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.2024.08.001
John D. Corrigan PhD , Flora M. Hammond MD , Angelle M. Sander PhD , Kurt Kroenke MD
There is growing evidence that long-term outcomes after traumatic brain injury (TBI) are more dynamic than stable. People continue to change, both improving and declining, many years postinjury. Research, practice, and medical education have not yet fully embraced the implications of TBI as a chronic, dynamic condition. In 2020, the National Institute on Disability Independent Living and Rehabilitation Research funded the BeHEALTHY project to develop a model for long-term support of persons with chronic brain injury. Based on initial reviews of the available evidence and expert input from researchers, clinicians, and persons with lived experience, the BeHEALTHY model was proposed. Among existing chronic disease treatment models, Wagner's Chronic Care Model was selected as a starting point, with several critical refinements. The BeHEALTHY model endorses a person-centered approach, recognizing the individual with brain injury, and their social support system, as the primary source of goals in care planning. The model also acknowledges the critical importance of self-management and the need for health care programs to actively promote self-direction by the person using their social supports. The model also recognizes that outcomes are not determined solely by the person and the injury incurred but also by the environment in which a person lives and recovers. The importance of integrating health care with community resources is underscored by embracing environmental influences as a shared responsibility of the community and the health care system. This article recounts the impetus for developing the BeHEALTHY model and describes those it is intended to serve and its structural features and core components.
{"title":"Model of Care for Chronic Brain Injury","authors":"John D. Corrigan PhD , Flora M. Hammond MD , Angelle M. Sander PhD , Kurt Kroenke MD","doi":"10.1016/j.apmr.2024.08.001","DOIUrl":"10.1016/j.apmr.2024.08.001","url":null,"abstract":"<div><div>There is growing evidence that long-term outcomes after traumatic brain injury (TBI) are more dynamic than stable. People continue to change, both improving and declining, many years postinjury. Research, practice, and medical education have not yet fully embraced the implications of TBI as a chronic, dynamic condition. In 2020, the National Institute on Disability Independent Living and Rehabilitation Research funded the BeHEALTHY project to develop a model for long-term support of persons with chronic brain injury. Based on initial reviews of the available evidence and expert input from researchers, clinicians, and persons with lived experience, the BeHEALTHY model was proposed. Among existing chronic disease treatment models, Wagner's Chronic Care Model was selected as a starting point, with several critical refinements. The BeHEALTHY model endorses a person-centered approach, recognizing the individual with brain injury, and their social support system, as the primary source of goals in care planning. The model also acknowledges the critical importance of <em>self</em>-management and the need for health care programs to actively promote self-direction by the person using their social supports. The model also recognizes that outcomes are not determined solely by the person and the injury incurred but also by the environment in which a person lives and recovers. The importance of integrating health care with community resources is underscored by embracing environmental influences as a shared responsibility of the community and the health care system. This article recounts the impetus for developing the BeHEALTHY model and describes those it is intended to serve and its structural features and core components.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 145-149"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999372","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.2024.08.008
Emily Dudek BS , Michael W. Williams PhD , Chung Lin (Novelle) Kew PhD , Annalyn DeMello PhD, MPH, RN , Brittany Wright PhD , Alexandra B. Holland LMSW , Alyssa Day-Gorman MA , Alexa S. Gonzalez MS , Luis Leon Novelo PhD , Xiangyi Liu MS , Shannon B. Juengst PhD, CRC
Objective
To characterize the greatest problem or need among individuals with a history of traumatic brain injury (TBI), as compared with individuals with a history of other neurologic conditions, mental health conditions, and no history of neurologic or mental health conditions.
Design
A directed content analysis of open-text responses to a single online survey question using a framework guided by the Mayo-Portland Adaptability Inventory-4.
Setting
Community.
Participants
A total of 2861 community-dwelling adults (n=274 with TBI; n=289 with other neurologic conditions besides TBI; n=454 with mental health conditions but no neurologic conditions; and n=1844 controls).
Interventions
Not applicable.
Main Outcome Measures
Open-text responses to the survey prompt: “What was your greatest problem or need over the past 2 weeks?”
Results
The Participation index comprised the greatest proportion of responses across all 4 participant groups. A quarter (25.4%) of controls reported None (no problem/need), whereas only 7.9%-10.7% of participants in all other groups reported None. Among all groups, individuals with TBI reported the greatest proportion of problems in the Adjustment and Ability indices. Among people with TBI, Money Management (19.7%), None (10.6%), and Anxiety (7.7%) were the 3 most frequently reported problems. Compared with individuals with mild TBI (mTBI), individuals with moderate-to-severe TBI (msTBI) reported a higher proportion of problems in the Ability and Adjustment indices. Among individuals with msTBI, the Adjustment index accounted for the greatest proportion of problems.
Conclusions
This study employed a person-centered approach to understanding the greatest needs among individuals with TBI. Qualitative differences were observed between individuals with and without TBI, between people with mTBI and msTBI, and across genders among people with TBI. These findings can help guide research and policy toward addressing challenges perceived as highly important by people living in the community with TBI.
{"title":"A Directed Content Analysis for Greatest Problems Among People With and Without Traumatic Brain Injury","authors":"Emily Dudek BS , Michael W. Williams PhD , Chung Lin (Novelle) Kew PhD , Annalyn DeMello PhD, MPH, RN , Brittany Wright PhD , Alexandra B. Holland LMSW , Alyssa Day-Gorman MA , Alexa S. Gonzalez MS , Luis Leon Novelo PhD , Xiangyi Liu MS , Shannon B. Juengst PhD, CRC","doi":"10.1016/j.apmr.2024.08.008","DOIUrl":"10.1016/j.apmr.2024.08.008","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the greatest problem or need among individuals with a history of traumatic brain injury (TBI), as compared with individuals with a history of other neurologic conditions, mental health conditions, and no history of neurologic or mental health conditions.</div></div><div><h3>Design</h3><div>A directed content analysis of open-text responses to a single online survey question using a framework guided by the Mayo-Portland Adaptability Inventory-4.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>A total of 2861 community-dwelling adults (n=274 with TBI; n=289 with other neurologic conditions besides TBI; n=454 with mental health conditions but no neurologic conditions; and n=1844 controls).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Open-text responses to the survey prompt: “<em>What was your greatest problem or need over the past 2 weeks?</em>”</div></div><div><h3>Results</h3><div>The Participation index comprised the greatest proportion of responses across all 4 participant groups. A quarter (25.4%) of controls reported None (no problem/need), whereas only 7.9%-10.7% of participants in all other groups reported None. Among all groups, individuals with TBI reported the greatest proportion of problems in the Adjustment and Ability indices. Among people with TBI, Money Management (19.7%), None (10.6%), and Anxiety (7.7%) were the 3 most frequently reported problems. Compared with individuals with mild TBI (mTBI), individuals with moderate-to-severe TBI (msTBI) reported a higher proportion of problems in the Ability and Adjustment indices. Among individuals with msTBI, the Adjustment index accounted for the greatest proportion of problems.</div></div><div><h3>Conclusions</h3><div>This study employed a person-centered approach to understanding the greatest needs among individuals with TBI. Qualitative differences were observed between individuals with and without TBI, between people with mTBI and msTBI, and across genders among people with TBI. These findings can help guide research and policy toward addressing challenges perceived as highly important by people living in the community with TBI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 42-50"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071882","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.2024.09.006
Lauren A. Hinrichs-Kinney PT, DPT, PhD, OCS , Janell Pisegna PhD, OTR/L, CSRS , Mattie E. Pontiff PT, DPT, PhD, OCS , Emma H. Beisheim-Ryan PT, DPT, PhD , Rebecca Altic PT, DPT , Heather Coats PhD, APRN-BC , Jennifer E. Stevens-Lapsley PT, PhD, FAPTA
Objective
To assess rehabilitation clinicians’ viewpoints regarding a multicomponent implementation program aimed at promoting high-intensity resistance rehabilitation (HIR), as well as practical implications for its use in skilled nursing facility (SNF) rehabilitation.
Design
Prospective convergent mixed-method design.
Setting
Eight rural SNFs within the Department of Veterans Affairs.
Participants
Physical rehabilitation clinicians (physical and occupational therapists, physical and occupational therapy assistants, recreational therapists, and kinesiotherapists) who engaged with the implementation program (n=38).
Interventions
Clinicians engaged with the multicomponent implementation program to promote the use of HIR in clinical practice. The program components included clinician training (i.e., virtual didactic modules with synchronous case discussions), provision of resources (e.g., equipment, job aids), and facilitated implementation (e.g., external implementation facilitator support, distributed tips and tricks).
Main Outcome Measures
Acceptability of Intervention Measure, Training Acceptability Rating Scale, study-specific questionnaires, and qualitative focus groups exploring perceived acceptability, feasibility, and effect on work experience.
Results
Questionnaires revealed high levels of implementation program acceptability and perceived effect, alongside moderate levels of feasibility. Focus group themes supported these findings, explaining high acceptability and effect through differentiation from other trainings and prolonged engagement. Feasibility results were explained qualitatively by facilitatory factors (i.e., team participation, reduced caseloads, training characteristics) and inhibitory factors (i.e., training timing, self-paced scheduling logistics, lack of protected time and space). There was no reported negative effect on clinician work experience.
Conclusions
According to SNF clinician perspectives, a positive HIR implementation experience may be enhanced through implementation programs that provide prolonged engagement and a self-paced structure with built-in accountability. Leadership and organizational support appear important to protect time and space for clinicians who experience competing priorities to successfully facilitate evidence uptake. Future work can evaluate the applicability across various contexts beyond rural VA SNFs.
目的:评估康复临床医生对旨在促进高强度阻力康复(HIR)的多组分实施计划的看法,以及该计划在加护病房(SNF)中使用的实际意义:评估康复临床医生对旨在促进高强度阻力康复(HIR)的多组分实施计划的观点,以及在专业护理机构(SNF)康复中使用该计划的实际意义:设计:前瞻性聚合混合方法设计:环境:退伍军人事务部下属的八家农村专业护理机构:参与实施计划的物理康复临床医生(物理和职业治疗师、物理和职业治疗助理、娱乐治疗师和运动治疗师)(38 人):干预措施: 临床医生参与多成分实施计划,以促进在临床实践中使用 HIR。项目内容包括临床医师培训(即虚拟教学模块与同步病例讨论)、资源提供(如设备、工作辅助工具)和促进实施(如外部实施促进者支持、分发提示和技巧):主要结果测量指标:干预措施可接受性测量、培训可接受性评分量表、特定研究问卷,以及探讨可接受性、影响、可行性和对工作经验的影响的定性焦点小组:调查问卷显示,实施计划的可接受性和可感知的影响程度较高,可行性也处于中等水平。焦点小组的主题支持这些结果,通过与其他培训的差异化和长期参与解释了高可接受性和影响。促进因素(即团队参与、工作量减少、培训特点)和抑制因素(即培训时间、自定进度的后勤安排、缺乏受保护的时间和空间)从质量上解释了可行性结果。没有报告称培训对临床医生的工作经验产生负面影响:根据 SNF 临床医生的观点,通过提供长期参与和自定进度结构以及内置问责制的实施计划,可以增强积极的 HIR 实施体验。领导和组织的支持对于保护临床医生的时间和空间似乎很重要,因为临床医生在成功促进证据吸收的过程中会遇到相互竞争的优先事项。未来的工作可以评估在农村退伍军人社区医疗机构以外的各种环境中的适用性。
{"title":"Mixed-Method Evaluation to Understand Clinician Perspectives of a Program to Implement High-Intensity Resistance Rehabilitation Into Skilled Nursing Facilities","authors":"Lauren A. Hinrichs-Kinney PT, DPT, PhD, OCS , Janell Pisegna PhD, OTR/L, CSRS , Mattie E. Pontiff PT, DPT, PhD, OCS , Emma H. Beisheim-Ryan PT, DPT, PhD , Rebecca Altic PT, DPT , Heather Coats PhD, APRN-BC , Jennifer E. Stevens-Lapsley PT, PhD, FAPTA","doi":"10.1016/j.apmr.2024.09.006","DOIUrl":"10.1016/j.apmr.2024.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>To assess rehabilitation clinicians’ viewpoints regarding a multicomponent implementation program aimed at promoting high-intensity resistance rehabilitation (HIR), as well as practical implications for its use in skilled nursing facility (SNF) rehabilitation.</div></div><div><h3>Design</h3><div>Prospective convergent mixed-method design.</div></div><div><h3>Setting</h3><div>Eight rural SNFs within the Department of Veterans Affairs.</div></div><div><h3>Participants</h3><div>Physical rehabilitation clinicians (physical and occupational therapists, physical and occupational therapy assistants, recreational therapists, and kinesiotherapists) who engaged with the implementation program (n=38).</div></div><div><h3>Interventions</h3><div>Clinicians engaged with the multicomponent implementation program to promote the use of HIR in clinical practice. The program components included clinician training (i.e., virtual didactic modules with synchronous case discussions), provision of resources (e.g., equipment, job aids), and facilitated implementation (e.g., external implementation facilitator support, distributed tips and tricks).</div></div><div><h3>Main Outcome Measures</h3><div>Acceptability of Intervention Measure, Training Acceptability Rating Scale, study-specific questionnaires, and qualitative focus groups exploring perceived acceptability, feasibility, and effect on work experience.</div></div><div><h3>Results</h3><div>Questionnaires revealed high levels of implementation program acceptability and perceived effect, alongside moderate levels of feasibility. Focus group themes supported these findings, explaining high acceptability and effect through differentiation from other trainings and prolonged engagement. Feasibility results were explained qualitatively by facilitatory factors (i.e., team participation, reduced caseloads, training characteristics) and inhibitory factors (i.e., training timing, self-paced scheduling logistics, lack of protected time and space). There was no reported negative effect on clinician work experience.</div></div><div><h3>Conclusions</h3><div>According to SNF clinician perspectives, a positive HIR implementation experience may be enhanced through implementation programs that provide prolonged engagement and a self-paced structure with built-in accountability. Leadership and organizational support appear important to protect time and space for clinicians who experience competing priorities to successfully facilitate evidence uptake. Future work can evaluate the applicability across various contexts beyond rural VA SNFs.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 61-73"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340036","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.2024.09.013
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}