Clinical Rehabilitation最新文献

{"title":"The experiences and perceptions of social prescribing: A qualitative study with people with long-term conditions, link workers and healthcare practitioners.","authors":"Declan J O'Sullivan, Lindsay M Bearne, Janas M Harrington, Joseph G McVeigh","doi":"10.1177/02692155261444570","DOIUrl":"https://doi.org/10.1177/02692155261444570","url":null,"abstract":"<p><p>ObjectiveTo explore the experiences and perceptions of key stakeholders regarding social prescribing interventions.DesignQualitative study incorporating focus groups and semi-structured interviews. Data was analysed thematically to identify themes and sub-themes. The Consolidated Criteria for Reporting Qualitative Research was used.SettingUrban communities in The Republic of Ireland.ParticipantsParticipants included people with long-term conditions (n = 12), link workers (n = 9), healthcare practitioners (n = 17), and community service representatives (n = 6).InterventionSocial prescribing interventions using community link workersMain measuresFace-to-face focus groups were conducted with individuals with long-term conditions and online focus groups with link workers, healthcare practitioners, and community service representatives. Online semi-structured interviews were conducted with General practitioner.ResultsTranscripts were analysed using reflexive thematic analysis, using an inductive approach to develop codes, categories and themes. One overarching theme, three themes and six sub-themes were identified. The overarching theme 'Between Promise and Precarity' reflected the opportunities for growth, connection and sustainability alongside the challenges of implementing social prescribing. Theme 1 Promise had one sub-theme of empowerment and growth. Theme 2 was Fragmentation with two sub-themes of awareness and understanding. Theme 3 was Precarity with three sub-themes of workforce and resource insecurity, information gaps and evaluation shortfalls.ConclusionSocial prescribing has the potential to improve health and well-being by empowering individuals to grow through social connection. However, poor stakeholder understanding and collaboration coupled with unclear link worker roles and resource constraints threaten its sustainability. Streamlined workflows, clear guidelines and robust stakeholder partnerships are required to ensure social prescribing succeeds.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261444570"},"PeriodicalIF":2.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834627","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":"Costs and cost effectiveness of the use of telerehabilitation training for upper limb function in people after stroke: A systematic review.","authors":"Daim Syukriyah, Jemma Perks, Phil McBride, Philip Clatworthy, Helen Dawes, Maedeh Mansoubi, Tristan Snowsill, Gordon Taylor, Claire Hulme","doi":"10.1177/02692155261441561","DOIUrl":"https://doi.org/10.1177/02692155261441561","url":null,"abstract":"<p><p>ObjectiveTo review the costs and cost-effectiveness of telerehabilitation training for upper limb function in people after stroke.Data SourcesMEDLINE, EconLit, and EMBASE databases were searched for studies published between 2013 and 16 March 2026.MethodsThe review included studies of technology-based rehabilitation programmes for individuals after stroke that evaluated costs or cost-effectiveness. Titles and abstracts were screened, and data were independently extracted by two researchers. Study quality was appraised using the Critical Appraisal Skills Programme (CASP) checklist. Findings were synthesised narratively.ResultsFifteen studies including 963 participants were included. Two studies conducted cost-effectiveness analyses, eight reported cost analyses, and six reported the use of a preference-based measure recommended for cost-effectiveness studies (all used the EQ-5D), with some studies contributing to more than one category. Evidence on costs and cost-effectiveness was mixed, but several studies suggested potential cost savings. Reporting of EQ-5D outcomes was inconsistent across studies.ConclusionsEvidence on the costs of telerehabilitation training for upper limb function primarily focused on therapist time and equipment costs. Few studies included costs associated with equipment maintenance, depreciation, or the need for internet-enabled devices. Reductions in therapist time could offset or exceed technology costs. Further research is needed to evaluate the longer-term costs and cost-effectiveness of telerehabilitation in this population.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261441561"},"PeriodicalIF":2.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811872","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":"Goal setting in stroke rehabilitation: A systematic review and qualitative synthesis of the experiences and perspectives of healthcare professionals.","authors":"Anna Fišerová, Šarlota Duchoňová, Hannah Hafiz, Martina Hagarová, Brodie Morton, Helena Tessmann, Christopher D Graham, Nils Rickardsson","doi":"10.1177/02692155261446313","DOIUrl":"https://doi.org/10.1177/02692155261446313","url":null,"abstract":"<p><p>ObjectiveTo synthesise and analyse qualitative evidence relevant to the question: What are the experiences and perspectives of healthcare professionals on goal setting in stroke rehabilitation?Data sourcesPubMed, PsycINFO, MEDLINE and CINAHL were systematically searched in May 2025, supplemented by backward and forward citation searching.Review methodsThis systematic review was pre-registered on PROSPERO (CRD420251038210). Eligibility criteria included peer-reviewed qualitative or mixed methods studies with qualitative data from healthcare professionals outlining experiences of goal setting in stroke rehabilitation. Non-English publications were excluded. The Critical Appraisal Skills Programme (CASP) checklist was used to appraise quality. Data were analysed using thematic synthesis.ResultsEight studies, published between 1999 and 2020, were included. These comprised 108 clinicians of various rehabilitation disciplines, from multiple countries, working across acute, inpatient and community settings. Most data were collected via semi-structured interviews. Methodological rigour of identified studies was generally high. Nine descriptive themes emerged from the thematic synthesis. From these descriptive themes, three analytical themes were derived: (1) Who leads, who follows?, (2) Between hope and reality, (3) Starting with the person, not the problem. Eight of the descriptive themes were directly related to analytical themes, whereas one theme was a stand-alone theme. Confidence in the thematic synthesis findings was assessed as moderate.ConclusionThis synthesis of qualitative studies from various rehabilitation settings in stroke found that experiences of goal setting from the perspective of healthcare professionals describe directive and collaborative approaches, emotional aspects of goal setting in time-limited contexts and a commitment to person-centred care.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261446313"},"PeriodicalIF":2.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147811891","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":"Reliability and concurrent validity of the Courage Kenny-Fibrosis Grading Scale for breast or head and neck cancer-related fibrosis.","authors":"Laura Gilchrist, Laura Franco, Monica Heinen, Carolyn Holm, Margaret Weightman","doi":"10.1177/02692155251403994","DOIUrl":"10.1177/02692155251403994","url":null,"abstract":"<p><p>ObjectiveFibrosis can develop after surgical or radiation treatments for cancer and is often seen in rehabilitation settings, yet few measures exist for standardized assessment. The aims of this study are to describe the validity and reliability of a new measure for cancer treatment-related fibrosis in survivors of breast or head/neck cancer.DesignFace validity of the Courage Kenny-Fibrosis Grading Scale was established using an iterative survey process. Reliability and concurrent validity were assessed using repeated measures by blinded raters and concurrent assessment with the Common Terminology Criteria for Adverse Events, Late Effects Normal Tissue-Subjective, Objective, Management, Analytic scales, and adheremeter rating of skin mobility.SettingOutpatient rehabilitation clinic.ParticipantsQuestionnaires were completed by 43 clinicians and researchers in the first round of face validation and 21 in the second. For reliability and concurrent validity, 41 cancer survivors, including 26 post-breast cancer and 15 post-head/neck cancer, were assessed by four physical therapists.ResultsAdequate face validity of the final version was established using responses from 21 clinicians. Inter-rater and intra-rater reliability of the final scale was adequate at ICC = 0.810 and 0.941, respectively. Associations between the Fibrosis Grading Scale and the Common Terminology Criteria for Adverse Events and Late Effects Normal Tissue scales were moderately significant (r_S = 0.290-0.574, p < 0.05), indicating concurrent validity.ConclusionAfter development of the Fibrosis Grading Scale using an iterative survey process, sufficient reliability and validity was established to use as an assessment in breast and head/neck cancer survivors.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"603-613"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707692","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":"Defining the content of interdisciplinary rehabilitation for people with chronic low back pain: An international Delphi study.","authors":"Dries Ceulemans, Lisa Goudman, Michiel Reneman, Maarten Moens, Ann De Smedt, Lode Godderis, Jonas Callens, Olivia Lavreysen, Hubert Van Puyenbroeck, Dominique Van De Velde","doi":"10.1177/02692155251413189","DOIUrl":"10.1177/02692155251413189","url":null,"abstract":"<p><p>ObjectiveInterdisciplinary interventions for chronic low back pain are diverse, and there is a need to reach consensus on the content of rehabilitation.DesignA three-round Delphi survey was conducted across international networks, a world physiotherapy specialty group, and the research team. The first round contained a checklist, based on previous research on interdisciplinary rehabilitation for people with chronic low back pain. Participants rated all items, subitems, clarifications, and questions on three content-validity indicators: (a) clarity and comprehensibility, (b) unique value, and (c) alignment with the goal. General questions were asked, together with qualitative feedback and missing items. A sensitivity analysis was conducted in anticipation of a possible overrepresentation of participants from a specific region.SettingClinical practice and research.ParticipantsClinicians or researchers with knowledge and/or experience in the field of chronic low back pain and/or rehabilitation.Main measuresConsensus scores and qualitative feedback.ResultsAfter three rounds, consensus was reached on all subitems. There was an overrepresentation of Belgian participants. The sensitivity analysis, removing Belgian responses, showed no or little differences in consensus scores. Consensus was reached on a comprehensive checklist comprising 11 items essential to rehabilitation for people with chronic low back pain. Additionally, 32 subitems with corresponding questions were identified, ensuring coverage of all aspects of rehabilitation for people with chronic low back pain.ConclusionThis study developed an evidence- and consensus-based checklist for interdisciplinary rehabilitation in people with chronic low back pain. Future work should assess implementation and uptake in research and clinical practice.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"663-675"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145984327","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 letter to the editor regarding 'transcranial direct current stimulation for upper extremity motor dysfunction in poststroke patients: A systematic review and meta-analysis'.","authors":"Xian Tang, Yuan Xing, Nan Zhang, Zhiyuan Shen, Xin Guo, Jun Xing, Shujuan Tian","doi":"10.1177/02692155251413216","DOIUrl":"10.1177/02692155251413216","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"711-714"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040665","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":"Perspectives of early mobility in the cardiac surgery intensive care unit: an interpretive description study.","authors":"Emily K Phillips, Amy Abegglen, Jacqueline L Hay, April Gregora, Kathy Smith, Carly Shaski, Gavin Bozek, Sarah Gilchrist, Andrew Fagan, Anna M Chudyk, Maureen C Ashe, Annette S H Schultz, Sheila O'Keefe-McCarthy, Rakesh C Arora, Todd A Duhamel","doi":"10.1177/02692155251405747","DOIUrl":"10.1177/02692155251405747","url":null,"abstract":"<p><p>ObjectiveEarly mobility after cardiac surgery in the intensive care unit improves patient outcomes, yet implementation by clinicians remains inconsistent. To inform interventions to increase adoption, this study sought to explore clinicians' perspectives on the definition of early mobility in the cardiac surgery intensive care unit and describe perceived barriers and facilitators to implementation.DesignThis qualitative study was guided by interpretive description.SettingA tertiary hospital that performs 1000 cardiac surgeries annually.ParticipantsA total of 26 clinicians, including nurses, physicians, healthcare aides, respiratory therapists, and physiotherapists, participated.Main MeasuresThe nine focus groups and four individual interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.ResultsThree themes and 13 categories were created from the data: (1) Incongruent operationalization and conceptualization (across micro, meso, and macro levels), (2) uncertainty, and (3) inconsistency in mobilization practices. Themes were rooted in ambiguous definitions of \"early\" and \"mobility,\" discrepancy between conceptualization and implementation of timing, varied interpretations of success, and perceived safety concerns. In addition, 4 barriers and 4 facilitators were identified and categorized into patient-care and clinician-related.ConclusionDeveloping early mobility protocols and education informed by clinicians may enhance its implementation in the cardiac surgery intensive care unit. Incorporating the perspectives of clinicians into early mobility protocol development is essential to support behaviour change and provide this beneficial care.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"699-708"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13121822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145833296","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":"Evaluating the benefit of performing two 6-min walk tests after pulmonary rehabilitation to improve assessment of functional capacity.","authors":"Manon Pirou, Marc Beaumont","doi":"10.1177/02692155251407319","DOIUrl":"10.1177/02692155251407319","url":null,"abstract":"<p><p>ObjectiveThe 6-min walk test (6MWT) is an essential test during pulmonary rehabilitation. The significant learning effect of the 6MWT involves performing two tests. However, when tests are repeated three months later, the learning effect appears smaller in magnitude. Consequently, in clinical practice, only one test is performed after a pulmonary rehabilitation program. The aim of this study was to determine whether there is a benefit of performing two 6MWTs after pulmonary rehabilitation.DesignProspective, single center, noninterventional study.SettingPulmonary Rehabilitation Unit of the Centre Hospitalier des Pays de Morlaix (Morlaix, France) from 24 March 2023 to 19 March 2024.ParticipantsPatients aged 18 and older with moderate to very severe chronic obstructive pulmonary disease (COPD), admitted to a four-week pulmonary rehabilitation program.InterventionSubjects performed two 6MWTs at the end of the program.Main measuresThe primary outcome was the distance covered during the walk test. Secondary outcomes included oxygen saturation, heart rate, and lower limb fatigue.ResultsOne hundred seventy-six patients were included. Results revealed a significant difference (<i>p</i> < .05) in distance walked between the two 6MWT. Seventy-eight percent of patients (<i>n</i> = 135) walked further on the second test with a mean improvement of 14 m. The second test allowed an additional 15% (<i>n</i> = 26) to be classified as \"responders\" to the program regarding exercise capacity.ConclusionThe significant improvement in distance on the second test supports the value of performing two 6MWTs at the end of pulmonary rehabilitation in patients with COPD. Research is needed to extend findings to populations other than COPD.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"614-621"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146149324","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 on a recent paper on transcranial Direct Current Stimulation and clinical practice guidelines.","authors":"Kathryn S Hayward, Lauren Christie, Natasha A Lannin","doi":"10.1177/02692155251413194","DOIUrl":"10.1177/02692155251413194","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"709-710"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040514","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":"Do people with preoperative mental health diagnoses experience poorer pain and functional outcomes after total knee replacement? A systematic review and meta-analysis.","authors":"Saurabh P Mehta, Craig A Wassinger, Mostafa Zahed, Emily W Blevins, Summer B Calloway, Joshua Bunner, Lauren E Johnson, Montana Riddle, Victoria Kailand Moaf","doi":"10.1177/02692155251411902","DOIUrl":"10.1177/02692155251411902","url":null,"abstract":"<p><p>ObjectiveThis systematic review explored whether individuals with preoperative mental health diagnoses undergoing total knee replacement experience worse outcomes compared to patients without such diagnoses.Data SourcesMEDLINE, CINAHL, PSYCINFO, SPORT Discus, and PEDro databases were searched from inception to October 2025 to identify relevant articles.Review MethodsTwo independent reviewers screened and extracted data from relevant studies. The risk of bias for each study was assessed using the Quality in Prognostic Studies Tool. Meta-analysis using the standardized mean differences was employed to analyse associations between preoperative mental health diagnoses and pain and function at six months and ≥one year after total knee replacement. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool.ResultsThe literature search yielded 53 articles eligible for the review, of which 13 were rated as low risk of bias. Preoperative mental health diagnoses were not associated with worse pain at six months (standardized mean differences = -0.68, <i>P</i>  =  .21) or ≥ one year (standardized mean differences = -0.48, <i>P</i> = .08) post-total knee replacement. Similarly, preoperative mental health diagnoses were also not associated with functional outcomes at six months (standardized mean differences = -0.34, <i>P</i> = .07) or ≥one year (standardized mean differences = -0.56, <i>P</i> = .32). Considerable heterogeneity and imprecise estimates limited the certainty of these findings.ConclusionFindings suggest that preoperative mental health conditions alone may not predict poor pain and function outcomes post-total knee replacement. Given the heterogeneity and low certainty of evidence, further research should explore associations between mental health and other risk factors to guide personalized preoperative interventions.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"647-662"},"PeriodicalIF":2.9,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965335","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}