Clinical Rehabilitation最新文献

{"title":"A scoping review: POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder and Skin Changes), physical recovery, and rehabilitation.","authors":"Lucy Johnson, Shirley D'Sa, Gita Ramdharry, Jackie Walumbe, Michael Lunn, Oliver Tomkins, Jonathan Sive, Orla McCourt","doi":"10.1177/02692155251355091","DOIUrl":"https://doi.org/10.1177/02692155251355091","url":null,"abstract":"<p><p>ObjectivePOEMS syndrome is a rare and treatable plasma cell disorder. Although medical advances have improved survival, polyneuropathy - which impairs both sensory and motor function in the limbs - continues to be the predominant contributor to reduced mobility and quality of life. Multidisciplinary teams can offer rehabilitation during the disease progression and recovery, but there is limited guidance on appropriate types, intensity, and timing of intervention. This scoping review aims to answer the question: \"What is known about physical recovery and rehabilitation in POEMS syndrome?\"Data sourcesMEDLINE, CINAHL, EMBASE, PEDRO and EMCARE databases. Additional studies were identified from grey literature and handsearching of citations.Review methodsA scoping review was conducted. Included papers focused on POEMS syndrome with details on physical outcomes pre and post treatment and rehabilitation intervention. Data was extracted into tables, and a narrative summary was produced for each paper.ResultsIn total 21 papers were included and analysed through narrative summaries across three themes: 1) physical and functional deficits, 2) physical recovery and 3) rehabilitation interventions. There were no studies evaluating rehabilitation intervention and limited detail on intervention specifics and timings. Most studies focused on the outcome of medical intervention on physical impairments, with little attention to disability, function and quality of life.ConclusionsThere is a need for expert-led recommendations, standardised rehabilitation guidelines and further research into effective interventions including timing, intensity and the patient's preferences.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251355091"},"PeriodicalIF":2.6,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144559420","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":"Home-based self-training: A qualitative exploration of the experiences of individuals with chronic-stroke.","authors":"Khawla Loubani, Yishai Bachar Kirshenboim, Ruth Maman, Chedva Levin, Debbie Rand","doi":"10.1177/02692155251344850","DOIUrl":"10.1177/02692155251344850","url":null,"abstract":"<p><p>ObjectiveTo explore how individuals with chronic-stroke experience and engage in home-based self-training, aiming to highlight factors related to their adherence and overall experience of self-training.DesignA qualitative study.SettingCommunity.SubjectsIndividuals with chronic-stroke.InterventionsParticipants underwent a structured 5-week home-based upper-extremity self-training via videogames or the Graded Repetitive Arm Supplementary Intervention which includes activities using everyday objects.Main measuresParticipants were interviewed following their participation in the self-training intervention, using a semi-structured interview. Interviews were transcribed verbatim and then analyzed using thematic analysis. Findings were validated through author discussions.ResultsTwenty-two participants (63% men) were included, aged 33 to 80, 6-36 months post-stroke. Participants had preserved cognitive ability, were mostly independent in daily living, and had a moderate upper-extremity motor ability (median (interquartile range (IQR)) Fugl-Meyer Motor Assessment score: 41 (29-47)/66 points). Three main themes were identified: 1) personal factors (e.g. devotion to perform self-training, commitment to the study, and personal roles), 2) self-training factors (e.g. experience and its influence on general condition), 3) environment-related factors (e.g. training equipment, home environment, and family support). The structured intervention and family support led to motivation and commitment. Challenges included time constraints, pain, and fatigue.ConclusionsThis qualitative study deepens understanding of home-based self-training experiences among individuals with chronic-stroke, highlighting how motivational, environmental, and self-training factors interact to shape long-term adherence. These insights can guide clinicians tailor interventions to promote long-term adherence and engagement by addressing individual, environmental, and task-related factors, and by identifying participants who may require additional support.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"923-933"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical utility, validity and reliability of the IPad application for goal-setting: The aid for decision-making in occupation choice-2.","authors":"Kounosuke Tomori, Tatsunori Sawada, Yuho Okita, William Wmm Levack","doi":"10.1177/02692155251344860","DOIUrl":"10.1177/02692155251344860","url":null,"abstract":"<p><p>ObjectiveTo evaluate the clinical utility, reliability, and validity of the second-generation aid for decision-making in occupation choice-2 (ADOC2), an iPad application designed for client-centred and occupation-centred goal setting.DesignThis study consisted of two components: (1) The development and refinement of the ADOC2 application, focusing on user interface design and structured goal-setting functionality; and (2) the clinical evaluation of its utility, validity, and reliability.SettingEleven rehabilitation facilities in Japan (10 hospitals, 1 home-based setting).ParticipantsA total of 116 occupational therapy clients and 56 occupational therapists participated in the study.Main measuresClinical utility was assessed using a structured questionnaire previously validated for the original ADOC. Validity was examined through correlations with the Canadian Occupational Performance Measure (COPM) and the EuroQol 5-Dimension 5-Level (EQ-5D-5L). Test-retest reliability of satisfaction and performance scores was analysed using weighted kappa coefficients.ResultsOver 90% of participants reported positive experiences with ADOC2 during the goal-setting process. The COPM scores showed strong correlations with ADOC2 ratings, while EQ-5D-5L scores showed weaker but expected correlations. Weighted kappa analyses indicated substantial to almost perfect agreement for test-retest reliability.ConclusionsADOC2 is a clinically useful, valid, and reliable tool for facilitating client-centred goal setting in occupational therapy practice.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"934-944"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207850","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":"Conceptualisation of financial capability in adults with acquired cognitive impairment: A qualitative evidence synthesis.","authors":"Sarah Swan, Freyr Patterson, Terra M Bredy, Jennifer Fleming","doi":"10.1177/02692155251347766","DOIUrl":"10.1177/02692155251347766","url":null,"abstract":"<p><p>ObjectiveTo explore definitions, theoretical models and conceptual frameworks related to financial capability in adults with acquired cognitive impairment from acquired brain injury or other neurological disease, including dementia.Data sourcesA systematic search of PubMed (inclusive of Medline), CINAHL, EMBASE, PsycINFO, ABI-inform, SCOPUS and the Cochrane database for papers published until May 2025.Review methodsA qualitative evidence synthesis approach was utilised in conjunction with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Eligible papers articulated an original comprehensive definition and/or theoretical model or conceptual framework focused on financial capability in the target population. Papers were screened by two researchers, with methodological quality of included papers critically appraised. Data were extracted for tabulation and thematic synthesis, which was completed via coding and categorisation into descriptive and analytical themes.ResultsThe final analysis included 21 papers from the initial screening of 6516 papers. Fifteen discrete models were identified, with results indicating inconsistency in terminology use and meanings. Models that consider real-world performance within an individual's contextual environment are increasingly utilising economics related terminology such as financial capability. The majority of papers related to people with dementia and were multidisciplinary in authorship, or from the psychology literature. Themes found in the literature include the multi-dimensionality of financial capability, financial decision-making ability and exploitation risk for legal capacity, and the neuropathological cause of declining financial capability.ConclusionFurther research with the inclusion of the consumer lived experience is recommended to inform models of care for this complex area of practice.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"849-871"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"914-922"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198465/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physiological and perceptual demand of gait training on inpatient physiotherapists.","authors":"Katelyn D Bosteder, Dannae Arnold, Jaime Gillespie, Neha Chand, Sheridan Merkle, Megan McCorkle, Monica Bennett, Seema Sikka, Rosemary Dubiel, Simon Driver, Chad Swank","doi":"10.1177/02692155251334286","DOIUrl":"10.1177/02692155251334286","url":null,"abstract":"<p><p>ObjectiveTo describe the physiological and perceptual demand among physiotherapists delivering gait training interventions using usual care and overground robotic exoskeleton approaches for patients with neurological injuries during inpatient rehabilitation.DesignSingle-centre, prospective observational study.SettingInpatient Rehabilitation Hospital.ParticipantsPhysiotherapists trained in neurorehabilitation.InterventionPhysiotherapists conducted two gait training sessions (one usual care and one overground robotic exoskeleton) while physiological and perceptual demand was assessed.Main measuresPhysiological (oxygen consumption, metabolic equivalents and heart rate) and perceptual demand were measured using a wearable metabolic system and the National Aeronautics and Space Administration Task Load Index, respectively.ResultsPhysiotherapists (<i>n</i> = 4) were female, median (min-max) age = 35(34-44) years, non-Hispanic, 50% White, with 11(5-19) years of experience. Physiological demand was lower in overground robotic exoskeleton than usual care in oxygen consumption [13.5(11.3-15.3) versus 16.4(13.5-18.6) millilitres of oxygen/minute/kilogramme of body mass], metabolic equivalents [3.9(3.2-4.4) versus 4.7(3.8-5.3)], average heart rate [111(90-136) versus 119(103-145) beats per minute], peak heart rate [121(101-149) versus 149(116-162) beats per minute] and recovery heart rate [113(88-148) versus 123(105-161) beats per minute]. Perceptual demand was lower in overground robotic exoskeleton than usual care in mental [7(5-16) versus 12(6-17)], physical [10(8-12) versus 16.5(14-21)] and temporal demand [3.5(1-9) versus 12.5(2-16)], performance [5(3-16) versus 11(4-17)], effort [9(6-15) versus 16.5(13-17)] and frustration [3(1-7) versus 5.5(3-8)].ConclusionsDelivery of overground robotic exoskeleton gait training was associated with lower physiological and perceptual demand compared to usual care gait training in patients with neurological injuries during inpatient rehabilitation. Identifying modalities with low demand may reduce physiotherapist burnout and workplace injuries.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"976-988"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991679","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":"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":"872-889"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","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":"Cost-effectiveness of the My Therapy self-directed therapy program for rehabilitation patients: A stepped wedge cluster randomised trial.","authors":"Natasha K Brusco, Sara L Whittaker, Christina L Ekegren, Meg E Morris, Nicholas F Taylor, Annemarie L Lee, Lisa Somerville, Natasha A Lannin, Rania Abdelmotaleb, Libby Callaway, Keith D Hill","doi":"10.1177/02692155251347756","DOIUrl":"10.1177/02692155251347756","url":null,"abstract":"<p><p>ObjectiveTo determine if the My Therapy self-management program could be implemented without increasing the rehabilitation admission cost, from a health service perspective.DesignEconomic evaluation, including a cost-effectiveness analysis.SettingAustralian rehabilitation wards (<i>n</i> = 9).ParticipantsRehabilitation inpatients with any diagnosis.InterventionMy Therapy: a self-directed therapy program shown to increase daily inpatient rehabilitation participation dosage time by 38%.Main MeasuresOutcomes included cost (rehabilitation admission and all-cause 30-day readmissions), and effect (minimal clinically important difference in functional independence (FIM^TM), and quality-adjusted life years (EQ-5D-5L)), to estimate incremental cost-effectiveness ratios (ICERs).ResultsThere were 2363 participants, with a mean age of 77 (SD 13) years, 62% female, and 27% with cognitive impairment. My Therapy costs $5 (SD $2) per patient/day to implement, excluding opportunity costs. Estimated differences in effect were non-significant for the proportion of participants achieving a minimal clinically important difference in function (control 31%, intervention 36%; OR: 1.08, 95% CI: 0.77, 1.53), and quality-adjusted life years (mean difference -0.01, 95% CI: -0.04 to 0.02). Estimated differences in cost were also non-significant (OR: 1.06, 95% CI: 0.97, 1.16). ICERs were also non-significant. Post hoc, it was determined that the cost/minute of daily therapy participation was $14/minute for control and $11/minute for intervention conditions.ConclusionsThe My Therapy self-management program was implemented without increasing rehabilitation admission and all-cause 30-day readmission costs. However, clinical differences were not detected. There may have been a small reduction in cost/minute for daily therapy participation.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"890-901"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144282727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","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":"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":"967-975"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","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":"Expert consensus on the application of dry needling in stroke patients: A modified delphi method.","authors":"Jorge Velázquez-Saornil, Vanesa Abuín-Porras, Raúl Frutos-Llanes, José Manuel Barragan-Casas, Angélica Campón-Chekroun, Zacarías Sánchez-Milá","doi":"10.1177/02692155251342071","DOIUrl":"10.1177/02692155251342071","url":null,"abstract":"<p><p>ObjectiveThis study aimed to establish an expert consensus on the use of dry needling for treating spasticity in stroke patients via the Delphi method.DesignA modified Delphi technique was conducted over four rounds.SettingThe study was guided by the NEUMUSK Group Research, Department of Physiotherapy, Faculty of Health Sciences. Ávila Catholic University, following the Checklist for Reporting of Survey Studies (CROSS).ParticipantsA total of 102 international experts in stroke rehabilitation and dry needling collaborated on this consensus study.InterventionPanellists rated 35 key questions across rounds via a 6-point Likert scale. Questions that failed to reach 70% consensus were eliminated.Main measurementsValidated Likert scale responses to carry out the expert consensus.ResultsThere was a high level of consensus regarding the use of dry needling in the early spasticity and hypertonia phases of stroke rehabilitation (early spasticity defined as the first few weeks after stroke when increased muscle tone begins to appear), with 87% and 91% agreement, respectively. However, less consensus has been reached for its application in hypotonia. Local twitch responses have been identified as critical indicators of treatment success, and ultrasound-guided dry needling has been widely endorsed for its precision. The effects of dry needling were reported to last between 48 and 72 h.ConclusionThis study provides clear recommendations for the use of dry needling in stroke patients, particularly during the early stages of spasticity. While the short-term benefits are evident, further research is needed to optimize the treatment frequency and explore its role in different stages of recovery, such as hypotonia. This consensus will aid healthcare professionals in integrating dry needling into comprehensive stroke rehabilitation programmes.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"955-966"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109980","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}