Pub Date : 2026-01-01DOI: 10.1016/j.apmr.2025.07.009
Bani Malhotra PhD , Jessica M. Ketchum PhD , Daniel W. Klyce PhD , Jacob A. Finn PhD , Lauren B. Fisher PhD , Kelli G. Talley PhD , Shannon B. Juengst PhD , Elizabeth C. Pasipanodya PhD , Janet P. Niemeier PhD , Paul B. Perrin PhD
Objective
To examine demographic and injury-related predictors of suicide attempt (SA) and suicidal ideation (SI) during the 5 years after traumatic brain injury (TBI) among Veterans and Service Members (V/SMs) enrolled in the Department of Veterans Affairs (VA) Polytrauma Rehabilitation Center (PRC) TBI Model Systems study.
Inpatient rehabilitation at one of the VA’s 5 PRCs.
Participants
A sample of 812 V/SMs with TBI enrolled within 14 months of injury and survived to at least the year 1 data collection.
Main Outcome Measures
Past year SA and past-2-week SI were assessed at follow-ups.
Results
SA prevalence rate across the years varied between 2.2% and 2.5%, with 4.8% of the sample reporting SA at least once. SI rates were higher and varied between 13.2% and 14.3%, with 21.7% reporting SI at least once. After controlling for other predictors, V/SMs aged <30 years had 5.32 times greater odds of SA post-TBI compared with those aged ≥50 years. Those with a preinjury history of mental health treatment or psychiatric hospitalization had 3.89 times greater odds of SA over time. Nonviolent TBI etiologies increased SI odds by 1.94 times. Preinjury history of mental health treatment or psychiatric hospitalization increased SI odds by 1.69 times; and those with a preinjury history of SA had 2.86 times greater SI odds.
Conclusions
These rates, though high, are likely underestimates of 5-year post-TBI suicidality among V/SMs with TBI. V/SMs with TBI should be screened regularly for suicidality—even years after injury. Future research should explore the contributions of the identified risk factors to inform targeted screening and appropriate mental health referral to prevent, assess, monitor, and treat SA and SI.
{"title":"Predicting Suicidality in Veterans/Service Members Over 5 Years After TBI: A VA Model Systems Study","authors":"Bani Malhotra PhD , Jessica M. Ketchum PhD , Daniel W. Klyce PhD , Jacob A. Finn PhD , Lauren B. Fisher PhD , Kelli G. Talley PhD , Shannon B. Juengst PhD , Elizabeth C. Pasipanodya PhD , Janet P. Niemeier PhD , Paul B. Perrin PhD","doi":"10.1016/j.apmr.2025.07.009","DOIUrl":"10.1016/j.apmr.2025.07.009","url":null,"abstract":"<div><h3>Objective</h3><div>To examine demographic and injury-related predictors of suicide attempt (SA) and suicidal ideation (SI) during the 5 years after traumatic brain injury (TBI) among Veterans and Service Members (V/SMs) enrolled in the Department of Veterans Affairs (VA) Polytrauma Rehabilitation Center (PRC) TBI Model Systems study.</div></div><div><h3>Design</h3><div>Multicenter, longitudinal observational cohort study.</div></div><div><h3>Setting</h3><div>Inpatient rehabilitation at one of the VA’s 5 PRCs.</div></div><div><h3>Participants</h3><div>A sample of 812 V/SMs with TBI enrolled within 14 months of injury and survived to at least the year 1 data collection.</div></div><div><h3>Main Outcome Measures</h3><div>Past year SA and past-2-week SI were assessed at follow-ups.</div></div><div><h3>Results</h3><div>SA prevalence rate across the years varied between 2.2% and 2.5%, with 4.8% of the sample reporting SA at least once. SI rates were higher and varied between 13.2% and 14.3%, with 21.7% reporting SI at least once. After controlling for other predictors, V/SMs aged <30 years had 5.32 times greater odds of SA post-TBI compared with those aged ≥50 years. Those with a preinjury history of mental health treatment or psychiatric hospitalization had 3.89 times greater odds of SA over time. Nonviolent TBI etiologies increased SI odds by 1.94 times. Preinjury history of mental health treatment or psychiatric hospitalization increased SI odds by 1.69 times; and those with a preinjury history of SA had 2.86 times greater SI odds.</div></div><div><h3>Conclusions</h3><div>These rates, though high, are likely underestimates of 5-year post-TBI suicidality among V/SMs with TBI. V/SMs with TBI should be screened regularly for suicidality—even years after injury. Future research should explore the contributions of the identified risk factors to inform targeted screening and appropriate mental health referral to prevent, assess, monitor, and treat SA and SI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 59-67"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.apmr.2025.06.018
Flora M. Hammond MD , Kurt Kroenke MD , John D. Corrigan PhD , Angelle M. Sander PhD , Ross Zafonte DO , Robert C. Brunner MD , Joseph T. Giacino PhD , Jeanne M. Hoffman PhD , Dmitry Esterov DO , David X. Cifu MD , Kathleen Bell MD , David C. Mellick PhD
Objective
To examine the use of primary care (PCP) and brain injury physicians in the years after a traumatic brain injury (TBI) and the perceived reasons for lack of utilization.
Design
Prospective, observational cohort study of persons who received inpatient brain injury rehabilitation under the care of a brain injury rehabilitation physician.
Setting
Fifteen TBI Model System centers.
Participants
Participants in the TBI Model Systems (N=1520) cohort who experienced TBI 1-35 years previously.
Interventions
Not applicable.
Main Outcome Measures
The proportion of participants under the care of a PCP and/or a brain injury physician, and if applicable, the reasons not cared for by a physician; and what type of physician the participant would see if they had 8 common brain injury conditions.
Results
Most participants (85%) reported having a PCP, and 35% reported active care from a brain injury physician. More than 90% have visited their physician in the past 1-2 years. Factors independently associated with not having either a PCP or a brain injury physician were being younger, men, black, unmarried, having fewer health conditions, and having a more rapid initial recovery from their TBI. The most frequent reasons for not having a specific type of physician were a lack of perceived need or their physician taking care of most of their health care problems. The PCP was most often the first contact for 8 common health conditions.
Conclusions
Most individuals in this longitudinal cohort of TBI survivors report having a PCP. Demographic and clinical characteristics identified subgroups who may lack regular contact with primary care or brain injury specialty care. While all participants were cared for by a brain injury physician during their initial rehabilitation, only a minority had ongoing care from a brain injury physician years later.
{"title":"Primary Care and Brain Injury Physician Utilization for Individuals Living With Chronic Brain Injury","authors":"Flora M. Hammond MD , Kurt Kroenke MD , John D. Corrigan PhD , Angelle M. Sander PhD , Ross Zafonte DO , Robert C. Brunner MD , Joseph T. Giacino PhD , Jeanne M. Hoffman PhD , Dmitry Esterov DO , David X. Cifu MD , Kathleen Bell MD , David C. Mellick PhD","doi":"10.1016/j.apmr.2025.06.018","DOIUrl":"10.1016/j.apmr.2025.06.018","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the use of primary care (PCP) and brain injury physicians in the years after a traumatic brain injury (TBI) and the perceived reasons for lack of utilization.</div></div><div><h3>Design</h3><div>Prospective, observational cohort study of persons who received inpatient brain injury rehabilitation under the care of a brain injury rehabilitation physician.</div></div><div><h3>Setting</h3><div>Fifteen TBI Model System centers.</div></div><div><h3>Participants</h3><div>Participants in the TBI Model Systems (N=1520) cohort who experienced TBI 1-35 years previously.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The proportion of participants under the care of a PCP and/or a brain injury physician, and if applicable, the reasons not cared for by a physician; and what type of physician the participant would see if they had 8 common brain injury conditions.</div></div><div><h3>Results</h3><div>Most participants (85%) reported having a PCP, and 35% reported active care from a brain injury physician. More than 90% have visited their physician in the past 1-2 years. Factors independently associated with not having either a PCP or a brain injury physician were being younger, men, black, unmarried, having fewer health conditions, and having a more rapid initial recovery from their TBI. The most frequent reasons for not having a specific type of physician were a lack of perceived need or their physician taking care of most of their health care problems. The PCP was most often the first contact for 8 common health conditions.</div></div><div><h3>Conclusions</h3><div>Most individuals in this longitudinal cohort of TBI survivors report having a PCP. Demographic and clinical characteristics identified subgroups who may lack regular contact with primary care or brain injury specialty care. While all participants were cared for by a brain injury physician during their initial rehabilitation, only a minority had ongoing care from a brain injury physician years later.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 42-50"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01DOI: 10.1016/j.apmr.2025.06.010
Nicole M. Gerhardt OTD , Rachel Y. Kim OTD , Maclain Capron MS , M.J. Mulcahey PhD
Objective
The study aimed to describe the development and refinement of a fidelity assessment for a novel performance-based item pool, the Spinal Cord Injury Movement Index (SCI-MovIn), and report on its interrater agreement.
Design
Guidance for the development of intervention fidelity assessments was adapted to create a framework for the development of an assessment fidelity checklist. An initial draft of the SCI-MovIn fidelity checklist was drafted. The set-up and administration fidelity criteria were exposed to iterative modified Delphi surveys with individuals knowledgeable about the SCI-MovIn. Interrater agreement was then assessed through field-testing of the fidelity assessment by fidelity raters who viewed the same video-recorded SCI-MovIn testing sessions.
Setting
Academic institution in an urban area.
Participants
Three individuals participated in the modified Delphi survey (purposeful sample). Three individuals served as fidelity raters for interrater agreement testing.
Interventions
Not applicable.
Main Outcome Measures
The modified Delphi technique was completed iteratively until 100% agreement among respondents was reached that every criterion on the fidelity assessment was relevant, clear, specific, and in alignment with the response scale. Descriptive statistics were used to examine exact percent interrater agreement for the ratings on the SCI-MovIn fidelity assessment across 3 raters.
Results
Four survey rounds were iteratively completed until 100% agreement among respondents was reached that fidelity criteria were relevant, clear, specific, and aligned with the fidelity response scale. Across 21 sessions (394 items), raters’ total absolute exact percent agreement on scores of fidelity was 79.33%. Nine of 13 criteria had >75% agreement.
Conclusions
The SCI-MovIn fidelity assessment was developed using a framework modified from guidance for intervention fidelity assessments. It was refined over 4 rounds of a modified Delphi process and then exposed to field-testing for rater agreement.
{"title":"Development and Preliminary Examination of a Fidelity Assessment for the Spinal Cord Injury Movement Index","authors":"Nicole M. Gerhardt OTD , Rachel Y. Kim OTD , Maclain Capron MS , M.J. Mulcahey PhD","doi":"10.1016/j.apmr.2025.06.010","DOIUrl":"10.1016/j.apmr.2025.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>The study aimed to describe the development and refinement of a fidelity assessment for a novel performance-based item pool, the Spinal Cord Injury Movement Index (SCI-MovIn), and report on its interrater agreement.</div></div><div><h3>Design</h3><div>Guidance for the development of intervention fidelity assessments was adapted to create a framework for the development of an assessment fidelity checklist. An initial draft of the SCI-MovIn fidelity checklist was drafted. The set-up and administration fidelity criteria were exposed to iterative modified Delphi surveys with individuals knowledgeable about the SCI-MovIn. Interrater agreement was then assessed through field-testing of the fidelity assessment by fidelity raters who viewed the same video-recorded SCI-MovIn testing sessions.</div></div><div><h3>Setting</h3><div>Academic institution in an urban area.</div></div><div><h3>Participants</h3><div>Three individuals participated in the modified Delphi survey (purposeful sample). Three individuals served as fidelity raters for interrater agreement testing.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The modified Delphi technique was completed iteratively until 100% agreement among respondents was reached that every criterion on the fidelity assessment was relevant, clear, specific, and in alignment with the response scale. Descriptive statistics were used to examine exact percent interrater agreement for the ratings on the SCI-MovIn fidelity assessment across 3 raters.</div></div><div><h3>Results</h3><div>Four survey rounds were iteratively completed until 100% agreement among respondents was reached that fidelity criteria were relevant, clear, specific, and aligned with the fidelity response scale. Across 21 sessions (394 items), raters’ total absolute exact percent agreement on scores of fidelity was 79.33%. Nine of 13 criteria had >75% agreement.</div></div><div><h3>Conclusions</h3><div>The SCI-MovIn fidelity assessment was developed using a framework modified from guidance for intervention fidelity assessments. It was refined over 4 rounds of a modified Delphi process and then exposed to field-testing for rater agreement.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 1","pages":"Pages 68-76"},"PeriodicalIF":3.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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}
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