Clinical Rehabilitation最新文献

{"title":"Prognostic factors of pain, disability, and poor outcomes in persons with neck pain - an umbrella review.","authors":"Thomas Gerard, Florian Naye, Simon Decary, Pierre Langevin, Chad Cook, Nathan Hutting, Marylie Martel, Yannick Tousignant-Laflamme","doi":"10.1177/02692155241268373","DOIUrl":"https://doi.org/10.1177/02692155241268373","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was to identify prognostic factors pertaining to neck pain from systematic reviews.</p><p><strong>Data sources: </strong>A search on PubMed, Scopus, and CINAHL was performed on June 27, 2024. Additional grey literature searches were performed.</p><p><strong>Review methods: </strong>We conducted an umbrella review and included systematic reviews reporting the prognostic factors associated with non-specific or trauma-related neck pain and cervical radiculopathy. Prognostic factors were sorted according to the outcome predicted, the direction of the predicted outcome (worse, better, inconsistent), and the grade of evidence (Oxford Center of Evidence). The predicted outcomes were regrouped into five categories: pain, disability, work-related outcomes, quality of life, and poor outcomes (as \"recovery\"). Risk of bias analysis was performed with the ROBIS tool.</p><p><strong>Results: </strong>We retrieved 884 citations from three databases, read 39 full texts, and included 16 studies that met all selection criteria. From these studies, we extracted 44 prognostic factors restricted to non-specific neck pain, 47 for trauma-related neck pain, and one for cervical radiculopathy. We observed that among the prognostic factors, most were associated with characteristics of the condition, cognitive-emotional factors, or socio-environmental and lifestyle factors.</p><p><strong>Conclusion: </strong>This study identified over 40 prognostic factors associated mainly with non-specific neck pain or trauma-related neck pain. We found that a majority were associated with worse outcomes and pertained to domains mainly involving cognitive-emotional factors, socio-environmental and lifestyle factors, and the characteristics of the condition to predict outcomes and potentially guide clinicians to tailor their interventions for people living with neck pain.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371151","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":"Effects of osteopathic manipulative treatment associated with transcranial direct current stimulation in individuals with chronic low back pain: A double-blind, randomised placebo-controlled trial.","authors":"Danilo Armbrust, Guilherme Peixoto Tinoco Arêas, Carlos Luques Fonseca, Fernando Zanela da Silva Arêas, Natália de Almeida Carvalho Duarte, Silvia Ataíde Alves Santana, Arislander Jonathan Lopes Dumont, Hugo Pasin Neto, Claudia Santos Oliveira","doi":"10.1177/02692155241274718","DOIUrl":"https://doi.org/10.1177/02692155241274718","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of osteopathic manipulative treatment (OMT) associated with transcranial direct current stimulation (tDCS) in reducing pain, disability, and improving quality of life in participants with non-specific chronic low back pain.</p><p><strong>Design: </strong>A randomised double-blind clinical trial.</p><p><strong>Setting: </strong>Clinical outpatient unit.</p><p><strong>Subjects: </strong>72 participants with non-specific chronic low back pain were randomised into three groups: active tDCS + OMT (<i>n</i> = 24), sham tDCS + sham OMT (<i>n</i> = 24), and sham tDCS + OMT (<i>n</i> = 24).</p><p><strong>Interventions: </strong>Evaluations were performed before, after the intervention, and one month post-intervention. tDCS consisted of ten 20-minute sessions over two weeks (five sessions per week). OMT was administered once per week, with two sessions conducted before the first and sixth tDCS sessions.</p><p><strong>Main measures: </strong>Pain, disability, and quality of life were assessed at baseline, after two weeks, and at one month of follow-up.</p><p><strong>Results: </strong>The visual analogue scale showed a significant decrease in all groups (<i>p</i> < 0.001). However, tDCS + OMT and sham tDCS + OMT demonstrated a clinically significant reduction compared to the sham combination (effect size <i>n</i>² = 0.315). Roland-Morris scores decreased across all groups without specific group effects. EuroQoL 5-Dimension 3-Level improvement was observed only in the tDCS + OMT and sham tDCS + OMT groups (significant difference between T2 and T0, <i>p</i> = 0.002).</p><p><strong>Conclusion: </strong>The combination of OMT and tDCS did not provide clinically significant improvement over OMT alone in participants with non-specific chronic low back pain.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142364693","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":"Efficacy of pelvic floor muscle training with physical therapy for low back pain: A systematic review and meta-analysis.","authors":"Youngeun Lim, Yerim Do, Seon Heui Lee, Haneul Lee","doi":"10.1177/02692155241287766","DOIUrl":"https://doi.org/10.1177/02692155241287766","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of pelvic floor muscle training and physical therapy interventions in patients with low back pain.</p><p><strong>Data sources: </strong>The Ovid-Medline, Ovid-Embase, Cochrane Library, CINAHL, Web of Science, and PEDro databases were searched for randomised, controlled trials published in English or Korean between database inception and September 2024.</p><p><strong>Review methods: </strong>Studies providing pelvic floor muscle training in individuals with low back pain were included. The risk of bias using the Cochrane Risk of Bias 2 tool and the grading of recommendation, assessment, development, and evaluation (GRADE) system was used to evaluate the quality of evidence. The meta-analysis was performed using Review Manager software 5.4.</p><p><strong>Results: </strong>Nineteen studies were included in this review. Pelvic floor muscle training showed low certainty evidence for improving pain (standardised mean difference = -0.73, 95% CI [-1.10, -0.36]) and reflected a clinically meaningful reduction in pain. The evidence for disability improvement had a low certainty (mean difference = -5.21, 95% CI [-7.15, -3.26]) due to high heterogeneity. Substantial improvements in pain and disability were observed when pelvic floor muscle training was added to standard physical therapy, with low certainty of evidence supporting these findings. Whereas pelvic floor muscle training substantially improved pain compared to other interventions, there was no marked improvement in disability.</p><p><strong>Conclusion: </strong>Pelvic floor muscle training is potentially beneficial in addition to physical therapy for reducing low back pain, particularly in pregnancy-related cases. However, the evidence should be interpreted considering the quality and risk of bias.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142371150","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":"Physiotherapy-led care versus physician-led care for persons with low back pain: A systematic review.","authors":"Pieter Severijns, Nina Goossens, Wim Dankaerts, Laurent Pitance, Nathalie Roussel, Corentin Denis, Antoine Fourré, Pieter Verschueren, Annick Timmermans, Lotte Janssens","doi":"10.1177/02692155241282987","DOIUrl":"https://doi.org/10.1177/02692155241282987","url":null,"abstract":"<p><strong>Objective: </strong>To summarise the evidence on the effect of physiotherapy-led versus physician-led care on clinical outcomes, healthcare use, and costs in persons with low back pain.</p><p><strong>Data sources: </strong>PubMed, Web of Science, CINAHL, Embase, and PEDro were systematically searched with the latest search performed in July 2024. Reference lists of articles were hand-searched.</p><p><strong>Review methods: </strong>Studies comparing clinical outcomes, healthcare use, or costs between adults with low back pain first consulting a physiotherapist and those first consulting a physician were included. Methodological quality was assessed with the Newcastle-Ottawa Scale. Study design, clinical setting, patient characteristics, and group effects were extracted. Findings on outcomes assessed in two or more studies were synthesised narratively. Certainty of evidence was determined using the GRADE approach.</p><p><strong>Results: </strong>Eighteen studies comprising 1,481,980 persons with low back pain were included. Most studies were non-randomised retrospective or prospective cohort studies. In primary care (15 studies), consistent evidence, though of mostly very low certainty, indicated that physiotherapy-led care leads to higher patient satisfaction, less use of medication, injections and imaging, fewer physician's visits, lower total healthcare costs, and less sick leave compared to physician-led care, without increased harm. In emergency care (three studies), evidence of very low certainty showed that physiotherapy-led care leads to shorter waiting and treatment times, and fewer hospital admissions.</p><p><strong>Conclusion: </strong>Physiotherapy-led care is a clinically, time- and cost-effective care pathway for low back pain, although the certainty of evidence was overall very low. Further high-quality research with a greater focus on clinical outcomes is warranted.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342922","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 impact of delays in transfer to specialist rehabilitation on outcomes in patients with acquired brain injury.","authors":"Lloyd Bradley, Sally Wheelwright","doi":"10.1177/02692155241284866","DOIUrl":"https://doi.org/10.1177/02692155241284866","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of time waiting for admission to inpatient neurorehabilitation following acquired brain injury on rehabilitation outcomes.</p><p><strong>Design: </strong>A retrospective observational case series.</p><p><strong>Setting: </strong>A specialist brain injury inpatient rehabilitation service.</p><p><strong>Subjects: </strong>Consecutive 235 admissions to specialist brain injury rehabilitation following acutely-acquired brain injury between 2019 and 2022.</p><p><strong>Main measures: </strong>Waiting time from the point of injury to admission, diagnostic category, admission complexity (patient categorisation tool), functional status (functional independence measure/functional attainment measure), care needs (Northwick Park Care Needs Assessment), change in functional status and care needs over duration of admission (efficiency). Subgroup analysis was performed for patients with a tracheostomy, enteral feeding, anticonvulsant treatment and prior neurosurgery.</p><p><strong>Results: </strong>There was no relationship between admission wait and initial complexity (<i>r</i>_s= 0.006; <i>p</i> = 0.923), functional status (<i>r</i>_s= -0.070; <i>p</i> = 0.284) or care needs (<i>r</i>_s= 0.019; <i>p</i> = 0.768). Longer waiting times were significantly associated with reduced efficiency of rehabilitation (<i>r</i>_s= -0.240; <i>p</i> = 0.0002) and change of care needs (<i>r</i>_s= -0.246; <i>p</i> = 0.0001). Longer waits were associated with reduced rehabilitation efficiency for patients prescribed anticonvulsants (<i>n</i> = 115; <i>r</i>_s= -0.243; <i>p</i> = 0.009), with a tracheostomy (<i>n</i> = 46; <i>r</i>_s= -0.362; <i>p</i> = 0.013), requiring enteral nutrition (<i>n</i> = 137; <i>r</i>_s= -0.237; <i>p</i> = 0.005) or having had intracranial surgery (<i>n</i> = 97; <i>r</i>_s= -0.344; <i>p</i> = 0.0006). There was a negative association between waiting times and reduction in care needs for patients admitted on anticonvulsants (<i>r</i>_s= -0.319; <i>p</i> = 0.0005) and requiring enteral nutrition (<i>r</i>_s= -0.269; <i>p</i> = 0.001).</p><p><strong>Conclusion: </strong>Longer wait for transfer to rehabilitation following brain injury is associated with reduced improvement in functional status and care needs over time. Attention should be given to ensuring rapid transfer into inpatient rehabilitation services.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342924","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":"Providing Emotional Support During the Process of Multiple Sclerosis Diagnosis (PrEliMS): A Feasibility Randomised Controlled Trial.","authors":"Roshan das Nair, Jacqueline R Mhizha-Murira, Gogem Topcu, Tierney Tindall, Clare Bale, Nima Moghaddam, Grit Scheffler-Ansari, Avril Drummond, Deborah Fitzsimmons, Nikos Evangelou","doi":"10.1177/02692155241284781","DOIUrl":"https://doi.org/10.1177/02692155241284781","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the feasibility and acceptability of an emotional support programme for newly diagnosed people with multiple sclerosis.</p><p><strong>Design: </strong>Three-arm, mixed methods, randomised controlled trial comparing usual care, versus usual care plus nurse-specialist support, versus usual care plus nurse-specialist support plus peer support.</p><p><strong>Participants: </strong>Community-dwelling adults within two years of diagnosis <i>or</i> undergoing diagnosis.</p><p><strong>Interventions: </strong>PrEliMS involves information provision, emotional support, and strategies and techniques based on psychoeducation, Acceptance and Commitment Therapy principles, supportive listening. One version of the intervention was provided by nurse-specialists alone and the other was provided by nurse-specialists plus peer support.</p><p><strong>Main measures: </strong>The main outcome of interest was the feasibility of proceeding to a definitive trial, exploring recruitment rate, acceptability, completion of outcome measures (perceived stress, mood, self-efficacy, psychological impact, and service use), and signal of efficacy.</p><p><strong>Results: </strong>Of 40 participants randomised (mean age 36.2 years (SD = 14.8); 54% women; 85% with relapsing-remitting MS), 36 and 38 returned 3- and 6-month questionnaires, respectively. Participant interviews suggested the trial was largely feasible, and the intervention acceptable, with some amendments to trial procedures and intervention delivery noted. There were, however, no statistically significant differences between groups at followup for any measures, and effect-size estimates were small.</p><p><strong>Conclusion: </strong>A definitive trial combining nurse-specialist and peer support adjustment to diagnosis intervention is warranted, but more work exploring the delivery and fidelity of the intervention is needed before this is pursued.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.6,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342923","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":"Effectiveness of Pilates compared with home-based exercises in individuals with chronic non-specific low back pain: Randomised controlled trial","authors":"Caroline Ribeiro Tottoli, Ângela Jornada Ben, Everton Nunes da Silva, Judith E Bosmans, Maurits van Tulder, Rodrigo Luiz Carregaro","doi":"10.1177/02692155241277041","DOIUrl":"https://doi.org/10.1177/02692155241277041","url":null,"abstract":"ObjectiveTo investigate the effectiveness of a Pilates exercise program compared with home-based exercises in individuals with chronic non-specific low back pain.DesignA randomised controlled trial with a six-month follow-up.SettingRehabilitation clinic.ParticipantsOne hundred and forty-five individuals (18–50 years of age) with low back pain for ≥ 12 consecutive weeks were enrolled and randomly allocated to either Pilates ( n = 72) or home-based exercise groups ( n = 73).InterventionsMethod Pilates (Mat Pilates exercises using accessories) versus home-based exercise (postural exercises, muscle stretching and strengthening, and spine stabilisation/mobilisation), twice a week, for 6 weeks.Main measuresAssessments were performed at baseline, post-intervention, and six months follow-up. Outcomes were pain intensity, disability, and health-related quality of life.ResultsAt post-intervention, the Pilates group had significantly lower pain intensity (mean difference = −1.14; 95% CI −2.05; −0.23), less disability (mean difference = −6.7; 95% CI −11.3; −2.0), and higher health-related quality of life (mean difference = 0.102; 95% CI 0.054; 0151) compared to the home-based exercise group. At follow-up, the Pilates group had a significantly higher health-related quality of life (mean difference = 0.055; 95% CI 0.003; 0.106) compared with the home-based exercise group but there were no significant differences in pain and disability. A significant overall effect of Pilates compared to home-based exercise was found for disability (mean difference = −4.4; 95% CI −7.6; −1.1), and health-related quality of life (mean difference = 0.049; 95% CI 0.022; 0.076), but not for pain.ConclusionAlthough Pilates was significantly superior to home exercise for pain and disability, the differences were not considered clinically relevant. However, Pilates did provide significant and clinically relevant differences in utility.","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265743","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":"Rasch Analysis of the Chinese Version of the Nociception Coma Scale–Revised in Patients with Prolonged Disorders of Consciousness","authors":"Yuhang Zheng, Xinyou Lin, Yuehong Huang, Steven Laureys, Haibo Di","doi":"10.1177/02692155241280524","DOIUrl":"https://doi.org/10.1177/02692155241280524","url":null,"abstract":"ObjectivesThe aim of this study was to analyze the Chinese version of the Nociception Coma Scale–Revised in patients with prolonged disorders of consciousness within the framework of Rasch modeling, including investigating the invariance of total scores across different etiologies of disorders of consciousness.DesignProspective psychometric study.ParticipantsPatients with prolonged disorders of consciousness from the Rehabilitation and Neurology units in hospital.InterventionsNone.Main Outcome MeasureThe Nociception Coma Scale–Revised was undertaken by trained raters and the Coma Recovery Scale-Revised was used to assess patients’ consciousness. The psychometric properties within the Rasch model including item-person targeting, reliability and separation, item fit, unidimensionality, and differential item functioning were assessed.Results84 patients with prolonged disorders of consciousness (mean age 53 years; mean injury 5 months; 42 with Minimally Conscious State and 42 with Unresponsive Wakefulness Syndrome) of 252 observations were enrolled in the study. Through the procedure of repeated assessment and differential item function, a lower item bias Rasch set was purified. The Rasch model assumptions were examined and met, with item reliability and validity meeting the recommended threshold.ConclusionsThe Chinese version of the Nociception Coma Scale–Revised demonstrated unidimensionality, good reliability and separation, and good item fit, but dissatisfied person fit and item-person targeting. The verbal subscale showed a notable discrepancy between person responses and the difficulty of the items, suggesting limited clinical significance.","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265907","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":"Efficacy of interferential current therapy plus exercise compared to sham interferential current plus exercise for pain relief in patients with knee osteoarthritis: A randomised controlled trial","authors":"Chalida Varapirom, Vilai Kuptniratsaikul, Rungsima Yamthed, Ananya Srisomnuek","doi":"10.1177/02692155241278949","DOIUrl":"https://doi.org/10.1177/02692155241278949","url":null,"abstract":"ObjectiveTo compare the efficacy of interferential current (IFC) therapy combined with quadriceps strengthening exercise versus sham IFC plus exercise for pain relief and functional improvement in patients with knee osteoarthritis.Study DesignDouble-blind randomised controlled trial.SettingOutpatient rehabilitation clinic.SubjectsKnee osteoarthritis patients aged 50–85 years with a pain score ≥4/10.MethodsOne hundred forty-four participants were randomly allocated into the study and control groups. The study group received 20 min of IFC therapy (carrier frequency: 4000 Hz, beat frequency: 100 Hz) five times per week for three weeks, while the control group received sham IFC following the same protocol, followed by 10 min of exercise in both groups. Outcome measures included Numeric Rating Scale for Pain, Western Ontario and McMaster Universities Index (WOMAC) score, gait speed, and EuroQol-Five Dimensions-Five Levels questionnaire assessed at baseline, Week 3, and Week 6. Adverse events and patient satisfaction were evaluated at Week 3.ResultsAt Week 3, the study group demonstrated statistical improvement compared to the control group for Numeric Rating Scale for Pain, WOMAC Total, WOMAC Pain, and WOMAC Stiffness. The mean difference (95% confidence interval) between groups was 0.76 (0.21–1.30), 0.49 (0.03–0.95), 0.63 (0.13–1.13), and 0.62 (0.04–1.20), respectively. However, the mean differences between groups were below the Minimally Clinically Important Difference values for each outcome. Additionally, there were no significant differences between groups at Week 6 for any outcome measure.ConclusionIFC had no effect on pain reduction and functional improvement in patients with mild to moderate knee osteoarthritis.","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142176621","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":"Assessment of mood after severe acquired brain injury: Interviews with UK clinical psychologists and medical professionals","authors":"Alexandra E Rose, Breda Cullen, Sarah Crawford, Jonathan J Evans","doi":"10.1177/02692155241278289","DOIUrl":"https://doi.org/10.1177/02692155241278289","url":null,"abstract":"ObjectiveMood assessment is challenging when people have cognitive and receptive communication impairments after severe brain injury. This study explored how UK-based medical and psychology professionals working with people with severe cognitive and communication impairments after brain injury assess mood in this population.DesignFollowing their participation in an online survey, professionals were invited to participate in individual semi-structured interviews. Interviews were analysed using thematic analysis to label explicit data (semantic themes) and implicit data (latent themes).ParticipantsTwenty-three clinical psychologists and nine medical professionals participated in online or in-person interviews.ResultsBoth groups explicitly reported using a combination of collateral information, history, observations, and patient interviews when assessing mood in this population. Medical professionals did not routinely use standardised measures and clinical psychologists often adjusted them when they used them. The respondents discussed difficulties conceptualising depression after brain injury, the experience needed by the assessor, and the need for an individualised approach for this population. Clinical psychologists discussed the pressures of working in healthcare systems and medical professionals discussed how symptoms may influence prescription choices. Seven latent themes were labelled which highlighted additional challenges and complexities experienced by those assessing mood, beyond the actual assessment process itself.ConclusionsNo ‘gold standard’ approach to assessing mood in those with cognitive and communication difficulties after severe brain injury was identified. There was overlap in assessment approaches but no clear consensus. Interviewees felt that mood assessment must be approached differently in this population and that self-report measures are not useful.","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142176572","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}