Clinical Rehabilitation最新文献

{"title":"The Vellore Pain Impact Questionnaire (V-PIQ): Initial validation of a tool for assessing the impact of low back pain based on the brief ICF core set.","authors":"Mammen Abijithgeorge, Selvaraj Samuelkamaleshkumar, Suresh Annpatriciacatherine, Ranjan Aruna, Joel Ronaldthomvicmaradona, Maya P Ganesan","doi":"10.1177/02692155251337570","DOIUrl":"https://doi.org/10.1177/02692155251337570","url":null,"abstract":"<p><p>ObjectiveTo develop and validate the Vellore Pain Impact Questionnaire to assess the impact of low back pain in the Indian context.DesignA cross-sectional, quantitative study with two phases: development and validation of the Vellore Pain Impact Questionnaire. Content validity was ensured through a Delphi process involving five occupational therapists, while reliability and criterion validity were assessed.SettingThe study was conducted at the Occupational Therapy outpatient unit of a tertiary care teaching hospital in South India.ParticipantsSixty-five patients aged 18 years and above with nonspecific low back pain persisting for at least 12 weeks were recruited through convenience sampling.InterventionNot applicable.Main MeasuresThe Vellore Pain Impact Questionnaire underwent inter-rater and test-retest reliability using the intraclass correlation coefficient. Criterion validity was evaluated against the Oswestry disability index.ResultsThe Vellore Pain Impact Questionnaire showed excellent content validity (content validity index: 0.96). It demonstrated high reliability, with inter-rater (intraclass correlation coefficient: 0.985) and test-retest (intraclass correlation coefficient: 0.973) scores. The receiver operating characteristic analysis indicated moderate criterion validity (area under the curve: 0.628) compared to the Oswestry disability index. The questionnaire's broader coverage of ICF categories, including psychological and environmental factors, highlights its ability to capture the multidimensional impact of low back pain.ConclusionsThe Vellore Pain Impact Questionnaire shows promise as a reliable and culturally relevant tool for assessing low back pain impact in India, addressing physical, psychological, and social factors. However, further studies are necessary to establish its validity across diverse populations and settings.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251337570"},"PeriodicalIF":2.6,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of cognitive retraining after stroke on everyday living: A systematic review and meta-analysis.","authors":"Jennifer White, Kylee J Lockwood","doi":"10.1177/02692155251336981","DOIUrl":"https://doi.org/10.1177/02692155251336981","url":null,"abstract":"<p><p>ObjectiveTo determine if the addition of cognitive retraining to rehabilitation following stroke results in better everyday living outcomes.Data sourcesElectronic databases MEDLINE, EMBASE, PsycINFO, CINAHL, OT Seeker and Cochrane Library were searched until January 2025.Review methodsRandomised controlled trials were included if they measured change in function and investigated a cognitive retraining intervention aimed at restoration of impaired cognition in one or more specific cognitive domains in the adult stroke population. Papers were excluded if they exclusively provided interventions that were not restorative, such as compensatory approaches or direct task retraining. Two independent reviewers extracted data and assessed study quality.ResultsTwenty-one studies involving 1476 participants were included. There was very low-quality evidence that basic activity of daily living (ADL) was not improved by the addition of cognitive retraining (standardised mean difference (SMD) 0.48, 95% confidence interval (CI) -0.04 to 1.01). There was moderate quality evidence that cognitive retraining had no effect on Instrumental ADL (IADL) (SMD -0.19, 95% CI -0.65 to 0.27) or other measures of functional performance (SMD -0.03, 95% CI -0.31 to 0.24).ConclusionsCognitive retraining focusing on restoration of one or more cognitive domains after stroke did not show an impact in basic ADL performance, IADL performance, or other measures of functional performance. Results were complicated by low-quality evidence and methodological factors including variations in study populations, interventions provided and outcome measures. Further research that includes suitable measures of everyday living is needed to provide more robust evidence and guide clinical practice.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251336981"},"PeriodicalIF":2.6,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intra- and inter-rater reliability of anterior and posterior drawer tests for the assessment of people with shoulder instability.","authors":"Rocio Aldon-Villegas, Gema Chamorro-Moriana, Patricio Lopez-Tarrida, Maria-Luisa Benitez-Lugo","doi":"10.1177/02692155251339380","DOIUrl":"https://doi.org/10.1177/02692155251339380","url":null,"abstract":"<p><p>BackgroundThe well-known drawer tests to assess glenohumeral laxity and instability have shown appropriate reliability, although analysed mainly in healthy subjects.ObjectiveTo evaluate the intra- and inter-rater reliability of anterior and posterior drawer tests in subjects with symptoms of shoulder instability.DesignClinometric study of intra- and inter-rater reliability of drawer tests was carried out following COSMIN recommendations and GRRAS checklist.SettingCentres with equipped facilities for assessments.ParticipantsThere were 105 participants (69 male/36 female) aged 18 to 60 years with instability symptoms in at least one shoulder. Each participant underwent bilateral assessments. The sample consists of 210 shoulders, unstable and healthy.InterventionAnterior and posterior drawer tests.Main measuresHumeral translations were assessed using drawer tests and graded with Hawkins scale, modified Hawkins and dichotomising (positive/negative). Two sessions were performed (seven to fourteen-day washout period): Each patient was evaluated by two examiners in the first session and by one of them in the second. Weighted Kappa analysed the reliability.ResultsThe intra-rater reliability of the anterior and posterior drawer tests was <i>excellent (weighted Kappa</i> = 1) with the Hawkins scale. Inter-rater reliability was <i>good</i> for the anterior drawer: <i>weighted Kappa</i> = 0.76 (95%confidence interval: 0.67-0.85) with the Hawkins scale, <i>weighted Kappa</i> = 0.78 (95%confidence interval: 0.69-0.87) with modified Hawkins, and <i>weighted Kappa</i> = 0.80 (95%confidence interval: 0.71-0.89) dichotomising; and for the posterior drawer: <i>weighted Kappa</i> = 0.62 (95%confidence interval: 0.52-0.72), <i>weighted Kappa</i> = 0.67 (95%confidence interval: 0.57-0.78), and <i>weighted Kappa</i> = 0.70 (95%confidence interval: 0.59-0.80), respectively.ConclusionDrawer tests demonstrated <i>excellent</i> intra-rater and <i>good</i> inter-rater reliability in subjects with symptoms of shoulder instability.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251339380"},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"comments on the article \"physiotherapy-led care versus physician-led care for persons with Low back pain: A systematic review\" by severijns et al. (clin rehabil. 2024 dec;38(12):1571-1589)\".","authors":"Pieter Severijns, Nina Goossens, Wim Dankaerts, Laurent Pitance, Nathalie Roussel, Corentin Denis, Antoine Fourré, Pieter Verschueren, Annick Timmermans, Lotte Janssens","doi":"10.1177/02692155251340671","DOIUrl":"10.1177/02692155251340671","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251340671"},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Modified Ashworth and Modified Tardieu Scales differ in their classification of lower limb spasticity.","authors":"J Beard, G Williams, M Kahn, M Banky","doi":"10.1177/02692155251337306","DOIUrl":"https://doi.org/10.1177/02692155251337306","url":null,"abstract":"<p><p>ObjectiveTo investigate agreement in spasticity classification between the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS) when performed on four lower limb muscles in adults following neurological injury.DesignObservational trial.SettingInpatient and outpatient neurological rehabilitation unit.ParticipantsNinety adults with lower limb spasticity.Main MeasuresNinety participants underwent a spasticity assessment of their hamstrings at 40° and 90° of hip flexion, quadriceps, gastrocnemius and soleus using the MAS and MTS. Assessment findings were dichotomised into spastic (MAS ≥ 1 or MTS X ≥ 2) or not spastic (MAS = 0 or MTS X ≤ 1) categories. To evaluate agreement, 2 × 2 contingency tables were generated to calculate positive, negative and overall agreement. Statistical association was calculated using the Fisher's Exact Test.ResultsThe MAS classified the presence of spasticity more frequently than the MTS. The proportion of trials with agreement in spasticity classifications according to both scales and their Fishers exact test were hamstrings at 90° hip flexion (17.6%; p = 0.009); hamstrings at 40° hip flexion (75.0%; p = 0.166); quadriceps (67.1%; p = 0.020); gastrocnemius (77.9%; p = 0.586); and soleus (67.8%; p = 0.113).ConclusionThe MAS and MTS demonstrated a level of disparity in their classification of lower limb spasticity across all four muscles, particularly the more proximal muscle groups.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251337306"},"PeriodicalIF":2.6,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in mobility after community-based prosthesis fitting and rehabilitation in people with major lower limb amputations: a cohort study.","authors":"Inger Mechlenburg, Lisa Urup Tønning, Rikke Ørholst, Cecilie Iversen, Kajsa Lindberg, Morten Tange Kristensen","doi":"10.1177/02692155251336566","DOIUrl":"https://doi.org/10.1177/02692155251336566","url":null,"abstract":"<p><p>ObjectiveTo investigate changes in mobility in adults with recent major lower limb amputation participating in community-based rehabilitation. Second, to assess the impact of amputation level (transtibial versus transfemoral) on mobility changes.DesignCohort study.SettingRehabilitation Centre in Copenhagen Municipality.SubjectsA total of 265 individuals with recent major lower limb amputations were prospectively recruited into a cohort from 2008 to 2022 as part of routine practice.MethodsFour physiotherapists collected data on age, sex, level of amputation (transtibial/transfemoral) and assessed mobility at start of walking out of parallel handrail (baseline) and at the end (follow-up) of rehabilitation. Mobility was assessed with the Timed-Up-and-Go test, 10-Meter Walk test, and 2-Minute Walk test. The impact of amputation level was analyzed using multivariable linear regression adjusted for age and sex.ResultsA total of 199 individuals (153 men) mean age of 64.9 (standard deviation 12.2) years had baseline and follow-up mobility data and were eligible for the study. Mobility significantly improved on all tests for individuals with both amputation levels after community rehabilitation. Multivariable analysis showed that individuals with transfemoral amputations on average improved with 17.9 seconds more (95% confidence interval: 12.7-23.1) than transtibial completing the Timed-Up-and-Go test. Contrary, transtibial walked 0.11 meter/second faster (95% confidence interval: 0.02-0.20) and 7.2 meters (95% confidence interval: -1.4 to 15.8) longer in the 10-Meter Walk test and 2-Minute Walk test respectively than transfemoral amputees.ConclusionAdults with lower limb amputations improved their mobility significantly from baseline to follow-up. Individuals with transfemoral amputations improved more than transtibial amputations on functional mobility.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251336566"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between frailty and stroke rehabilitation outcomes: A cohort study.","authors":"Tania Yeon Jung Cho, H Carl Hanger, Tim J Wilkinson","doi":"10.1177/02692155251336700","DOIUrl":"https://doi.org/10.1177/02692155251336700","url":null,"abstract":"<p><p>ObjectiveTo assess the independent effect of pre-morbid frailty on stroke rehabilitation outcomes, including mortality, function, and discharge destination.DesignObservational cohort study.SettingInpatient stroke rehabilitation.ParticipantsTwo hundred consecutive stroke patients, 65 years or older, admitted during 2021.Main measuresLogistic regression models analysed binary outcomes (mortality, discharge destination, and significant functional gain), and multiple linear regression models analysed normally distributed continuous outcomes (function, measured by Functional Independence Measure (FIM)). The confounders of age, stroke severity, and pre-morbid dementia/cognitive impairment, were accounted for. Clinical Frailty Scale was the predictor (considered as categorical and dichotomous) for these models.ResultsAfter accounting for the confounders, increased frailty was independently associated with lower discharge FIM (B = -11.32; 95% confidence interval (CI) -14.46-8.18, p < 0.001), smaller FIM change (B = -4.21; 95% CI -6.58-1.84, p < 0.001) and smaller FIM improvements over time (B = -2.36; 95% CI -3.40-1.32, p < 0.001). Frailer patients were less likely to return home (Odds Ratio 0.26; 95% CI 0.17-0.41, p < 0.001). Most patients improved function, at all levels of frailty. Stroke severity (Odds Ratio 1.13; 95% CI 1.06-1.20, p < 0.001), but not frailty, was independently associated with 6-month mortality.ConclusionsPre-morbid frailty was independently associated with lower functional improvement and lower likelihood of discharge back home after stroke rehabilitation, but not with mortality up to 6 months. Measuring both pre-morbid frailty and stroke severity may be useful to provide prognostic information and set realistic expectations.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251336700"},"PeriodicalIF":2.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969373","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recommending 24-hour attendant care: A qualitative study exploring the clinical decision-making process of occupational therapists in Ontario, Canada.","authors":"Bao-Zhu Stephanie Long, Kishana Balakrishnar, Maryna Mazur, Elana Maria, Kathleen Hennessy, Mathew Rose, Behdin Nowrouzi-Kia","doi":"10.1177/02692155251336574","DOIUrl":"https://doi.org/10.1177/02692155251336574","url":null,"abstract":"<p><p>ObjectiveThis study aims to explore how occupational therapists working in private practices in Canada use clinical indicators and tools to determine if clients require 24-hour attendant care.DesignA qualitative research study.SettingThe setting involved semi-structured, one-on-one interviews with occupational therapists in Canada.ParticipantsOccupational therapists were selected through purposive sampling: (1) registered Canadian occupational therapists, (2) with over 10 years of private practice experience, and (3) who have assessed the need for 24-hour attendant care at least once before the study.Main measuresThe interviews were conducted, transcribed, coded, and thematically analyzed by two researchers using Braun and Clarke's protocol. The paper is also reported based on the consolidated criteria for reporting qualitative research guidance.ResultsThe study involved nine occupational therapists (eight women and one man), with 14 to 24 years of private practice experience in Ontario. Three main themes in the decision-making process for 24-hour attendant care were identified: (1) Individualized and Holistic Assessments; (2) Clinical Expertise-Based Decision-making; and (3) Risk Assessment in Decision-Making.ConclusionsThis study provides a greater understanding of the decision-making process of occupational therapists working in Canada when recommending 24-hour attendant care. However, further research and development of guidelines are needed to support occupational therapists in this area.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251336574"},"PeriodicalIF":2.6,"publicationDate":"2025-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Comments on 'Physiotherapy-led Care Versus Physician-led Care for Persons with low Back Pain: A Systematic Review' by Severijns et al.","authors":"Jean-François Kaux, Marc Schiltz, Patrick Linden, Geoffrey Brands, Bruno Schoonejans, Thierry Lejeune","doi":"10.1177/02692155251334282","DOIUrl":"https://doi.org/10.1177/02692155251334282","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251334282"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate effect of extracorporeal shockwave therapy in patients with chronic nonspecific low back pain: A randomized placebo-controlled triple-blind trial.","authors":"Cláudio Gregório Nuernberg Back, Rafaela Peron, Camilla Vitória Rios Lopes, João Victor Estevam de Souza, Richard Eloin Liebano","doi":"10.1177/02692155251333532","DOIUrl":"https://doi.org/10.1177/02692155251333532","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251333532"},"PeriodicalIF":2.6,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}