Clinical RehabilitationPub Date : 2024-06-01Epub Date: 2024-02-05DOI: 10.1177/02692155241229398
Xue-Qiang Wang, Yu-Ling Wang, Jeremy Witchalls, Jia Han, Zhi-Jie Zhang, Phillip Page, Yi Zhu, Carla Stecco, Jian-Hua Lin, Doa El-Ansary, Quan-Sheng Ma, Qi Qi, Jae-Seop Oh, Wei-Ming Zhang, Adrian Pranata, Li Wan, Kui Li, Ming Ma, Lin-Rong Liao, Yu-Lian Zhu, Jing-Wei Guo, Pei-Jie Chen
{"title":"Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus.","authors":"Xue-Qiang Wang, Yu-Ling Wang, Jeremy Witchalls, Jia Han, Zhi-Jie Zhang, Phillip Page, Yi Zhu, Carla Stecco, Jian-Hua Lin, Doa El-Ansary, Quan-Sheng Ma, Qi Qi, Jae-Seop Oh, Wei-Ming Zhang, Adrian Pranata, Li Wan, Kui Li, Ming Ma, Lin-Rong Liao, Yu-Lian Zhu, Jing-Wei Guo, Pei-Jie Chen","doi":"10.1177/02692155241229398","DOIUrl":"10.1177/02692155241229398","url":null,"abstract":"<p><strong>Objective: </strong>To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions.</p><p><strong>Data sources: </strong>A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years.</p><p><strong>Review methods: </strong>Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts.</p><p><strong>Results: </strong>Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain.</p><p><strong>Conclusions: </strong>The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5-10 years.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"715-731"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139691402","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}
Clinical RehabilitationPub Date : 2024-06-01Epub Date: 2024-03-01DOI: 10.1177/02692155241235336
Xian Tang, Nan Zhang, Zhiyuan Shen, Xin Guo, Jun Xing, Shujuan Tian, Yuan Xing
{"title":"Transcranial direct current stimulation for upper extremity motor dysfunction in poststroke patients: A systematic review and meta-analysis.","authors":"Xian Tang, Nan Zhang, Zhiyuan Shen, Xin Guo, Jun Xing, Shujuan Tian, Yuan Xing","doi":"10.1177/02692155241235336","DOIUrl":"10.1177/02692155241235336","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of transcranial direct current stimulation in poststroke patients with upper extremity motor dysfunction using a systematic review and meta-analysis.</p><p><strong>Data sources: </strong>We searched the Web of Science, Cochrane Library, EMBASE, and PubMed for randomized controlled trials investigating the effects of both active and sham stimulation up until January 27, 2024.</p><p><strong>Review methods: </strong>Efficacy, including the upper extremity Fugl-Meyer Assessment, Action Research Arm Test, Barthel Index, and safety, were assessed. The risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the Physiotherapy Evidence Database Scale. Meta-analysis was performed using the RevMan 5.4 software.</p><p><strong>Results: </strong>Forty-four studies with 1555 participants were included. Transcranial direct current stimulation proved effective in improving upper extremity motor function (standardized mean difference = 0.22, 95% confidence interval: 0.12-0.32, <i>P</i> < 0.001) and Barthel Index (mean difference = 4.65, 95% confidence interval: 2.82-6.49, <i>P</i> < 0.001). Subgroup analysis revealed the highest transcranial direct current stimulation efficacy in patients with subacute stroke. Both anodal and cathodal stimulation were effective against upper extremity motor dysfunction. C3/C4 was the most effective stimulus target. Optimal stimulation parameters included stimulus current densities <0.057 mA/cm<sup>2</sup> for 20-30 min and <30 sessions. Adverse effects and dropouts during follow-up showed that transcranial direct current stimulation is safe and feasible.</p><p><strong>Conclusions: </strong>Our findings suggest that both anodal and cathodal stimulation were significantly effective in subacute stroke patients, particularly when preceding other treatments and when C3/C4 is targeted.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"749-769"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139995800","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}
Clinical RehabilitationPub Date : 2024-06-01Epub Date: 2024-02-19DOI: 10.1177/02692155241231929
Claire Mitchell, Kate Woodward-Nutt, Annette Dancer, Stephen Taylor, Joe Bugler, Audrey Bowen, Paul Conroy, Brooke-Mai Whelan, Sarah J Wallace, Sabrina El Kouaissi, Jamie Kirkham
{"title":"Towards a core outcome set for dysarthria after stroke: What should we measure?","authors":"Claire Mitchell, Kate Woodward-Nutt, Annette Dancer, Stephen Taylor, Joe Bugler, Audrey Bowen, Paul Conroy, Brooke-Mai Whelan, Sarah J Wallace, Sabrina El Kouaissi, Jamie Kirkham","doi":"10.1177/02692155241231929","DOIUrl":"10.1177/02692155241231929","url":null,"abstract":"<p><strong>Objective: </strong>To identify and agree on what outcome domains should be measured in research and clinical practice when working with stroke survivors who have dysarthria.</p><p><strong>Design: </strong>Delphi process, two rounds of an online survey followed by two online consensus meetings.</p><p><strong>Setting: </strong>UK and Australia.</p><p><strong>Participants: </strong>Stroke survivors with experience of dysarthria, speech and language therapists/pathologists working in stroke and communication researchers.</p><p><strong>Methods: </strong>Initial list of outcome domains generated from existing literature and with our patient and public involvement group to develop the survey. Participants completed two rounds of this survey to rate importance. Outcomes were identified as 'in', 'unclear' or 'out' from the second survey. All participants were invited to two consensus meetings to discuss these results followed by voting to identify critically important outcome domains for a future Core Outcome Set. All outcomes were voted on in the consensus meetings and included if 70% of meeting participants voted 'yes' for critically important.</p><p><strong>Results: </strong>In total, 148 surveys were fully completed, and 28 participants attended the consensus meetings. A core outcome set for dysarthria after stroke should include four outcome domains: (a) intelligibility of speech, (b) ability to participate in conversations, (c) living well with dysarthria, (d) skills and knowledge of communication partners (where relevant).</p><p><strong>Conclusions: </strong>We describe the consensus of 'what' speech outcomes after stroke are valued by all stakeholders including those with lived experience. We share these findings to encourage the measurement of these domains in clinical practice and research and for future research to identify 'how' best to measure these outcomes.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"802-810"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11059832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905226","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}
Clinical RehabilitationPub Date : 2024-06-01Epub Date: 2024-01-30DOI: 10.1177/02692155241228832
S Rute-Pérez, C Rodríguez-Domínguez, E M Sánchez-Lara, M Pérez-García, A Caracuel
{"title":"Does Including Facebook Training Improve the Effectiveness of Computerized Cognitive Training? A Randomized Controlled Trial.","authors":"S Rute-Pérez, C Rodríguez-Domínguez, E M Sánchez-Lara, M Pérez-García, A Caracuel","doi":"10.1177/02692155241228832","DOIUrl":"10.1177/02692155241228832","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether implementing a Facebook training program improves the effectiveness of computerized cognitive training (CCT) in older adults.</p><p><strong>Design: </strong>Randomized, controlled, double single-blind trial with parallel groups.</p><p><strong>Setting: </strong>Community centers.</p><p><strong>Subjects: </strong>Eighty-six adults between 60 and 90 years old.</p><p><strong>Interventions: </strong>Nine face-to-face 60-min sessions of CCT with VIRTRAEL for all participants. The experimental group received an additional 30 min of Facebook training per session.</p><p><strong>Main measures: </strong>Attention (d2 Test of Attention); learning and verbal memory (Hopkins Verbal Learning Test-Revised); working memory (Letter-Number Sequencing test), semantic and abstract reasoning (Similarities and Matrix Reasoning tests); and planning (Key Search test).</p><p><strong>Results: </strong>There was a significant Group*Time interaction in the Hopkins Verbal Learning Test-Revised-Trial 3, Letter-Number sequencing, and Matrix tests. Between groups, post-hoc analyses showed a difference in Matrix reasoning (<i>p</i> < .001; <i>d</i> = 0.893) at post-intervention in favor of the experimental group. Significant main effects of time were found in the CCT group between baseline and 3-month follow-up for Concentration (F = 26.431, <i>p</i> ≤ .001), Letters and Numbers (F = 30.549, <i>p</i> ≤ .001), Learning (F = 38.678, <i>p</i> ≤ .001), Similarities (F = 69.885, <i>p</i> ≤ .001), Matrix (F = 90.342, <i>p</i> ≤ .001), and Key Search (F = 7.904, <i>p</i> = .006) tests.</p><p><strong>Conclusions: </strong>The utilization of CCT with VIRTRAEL, a freely accessible tool with broad applicability, resulted in enhanced attention, verbal learning, working memory, abstract and semantic reasoning, and planning among older adults. These improvements were sustained for at least three months post-training. Additional training in Facebook did not enhance the effectiveness of CCT.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"783-792"},"PeriodicalIF":2.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139641691","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}
Clinical RehabilitationPub Date : 2024-06-01Epub Date: 2024-02-06DOI: 10.1177/02692155241230894
Edmund C Ickert, David Griswold, Omar Ross, Shannon Dudash, Colleen Duchon, Ken Learman
{"title":"Effects of kinesiotaping during early post-operative rehabilitation in individuals who underwent a total knee arthroplasty: A systematic review and meta-analysis of randomized control trials.","authors":"Edmund C Ickert, David Griswold, Omar Ross, Shannon Dudash, Colleen Duchon, Ken Learman","doi":"10.1177/02692155241230894","DOIUrl":"10.1177/02692155241230894","url":null,"abstract":"<p><strong>Objective: </strong>To report the treatment effects of early use kinesiotaping on pain, range of motion, mobility, and edema outcomes following total knee arthroplasty.</p><p><strong>Data sources: </strong>Cochrane Central Register of Controlled Trials, PubMED, SPORTDiscus, Biosis Citation Index, and the Cumulative Index to Nursing and Allied Health Literature were searched for potential randomized control trials from inception to 8 January 2024.</p><p><strong>Review methods: </strong>Randomized control trials evaluating the effect of kinesiotaping published in English were included. Reference lists for relevant reviews were searched. Study quality was assessed using the Cochrane Risk of Bias 2 tool. Certainty of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation approach.</p><p><strong>Results: </strong>Seven articles totaling 534 participants were included for meta-analysis. Kinesiotaping with standard rehabilitation when compared to standard rehabilitation alone had very low certainty of evidence in pain and knee flexion range of motion. Kinesiotaping was favored at post-operative days two to four for pain (<i>P</i> = 0.03, standard mean difference = -0.77 [-1.45, -0.09]) and range of motion (<i>P</i> = 0.002, standard mean difference = -0.24 [-0.44, -0.03]). Kinesiotaping was favored at post-operative days six to eight for pain (<i>P</i> = 0.02, standard mean difference = -0.76 [-1.41, -0.12]) and range of motion (<i>P</i> = 0.04, standard mean difference = -0.63 [-1.22, -0.04]). Edema and mobility could not be meta-analyzed.</p><p><strong>Conclusion: </strong>The use of kinesiotaping early in post-operative rehabilitation could be a useful modality for reducing pain and increasing the range of knee flexion, however, the certainty of evidence is very low.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"732-748"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697073","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}
Clinical RehabilitationPub Date : 2024-06-01Epub Date: 2024-02-28DOI: 10.1177/02692155241235338
Kathryn Fahy, Rose Galvin, Jeremy Lewis, Karen McCreesh
{"title":"'If he thought that I was going to go and hurt myself, he had another thing coming': Treatment experiences of those with large to massive rotator cuff tears and the perspectives of healthcare practitioners.","authors":"Kathryn Fahy, Rose Galvin, Jeremy Lewis, Karen McCreesh","doi":"10.1177/02692155241235338","DOIUrl":"10.1177/02692155241235338","url":null,"abstract":"<p><strong>Objective: </strong>To explore the treatment experiences of those diagnosed with large to massive rotator cuff tears and the perspectives of healthcare practitioners providing their care.</p><p><strong>Design: </strong>A qualitative descriptive study using reflexive thematic analysis.</p><p><strong>Setting: </strong>In-person focus groups were undertaken in a clinical setting (private practice [<i>n</i> = 1]; public outpatient [<i>n</i> = 2]). Semi-structured interviews were conducted online via Microsoft Teams.</p><p><strong>Participants: </strong>Patients diagnosed with these tears (<i>n</i> = 12) and healthcare practitioners (<i>n</i> = 11).</p><p><strong>Results: </strong>Two interlinking themes were identified based on the care received and provided for patients with symptomatic large to massive rotator cuff tears:1) <i>Positive treatment experiences and management:</i> Education, clear communication and reassurance around prognosis were the foundation of positive patient-clinician care. Sub-themes of pain relief, exercise prescription and confidence in their pathway underpinned this experience. This proficiency in care was affirmed by some <i>healthcare practitioners</i> who spoke about the importance of confidence and experience in their management plan even in times of poor progress.2) <i>Negative treatment experiences and management:</i> Uncertainty, delays and exacerbation of pain flawed the patient-clinician care. Sub-themes of inappropriate pain relief, inappropriate exercise prescription and uncertainty impacted their care. Some <i>healthcare practitioners</i> acknowledged knowledge gaps led to uncertainty especially when choosing the next step of care and were quick to escalate care to deflect this uncertainty.</p><p><strong>Conclusions: </strong>The findings suggest discordance exists between the patient's experiences and expectations when the delivery of care was by less experienced and confident healthcare practitioners in the management of this condition. This highlights the need for improved education and support for healthcare practitioners.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"824-836"},"PeriodicalIF":3.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11059833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139989544","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}
Anne Ribeiro Streb, Carolina Graef Vieira, Larissa dos Santos Leonel, Cecília Bertuol, Willen Remon Tozetto, Jucemar Benedet, Giovani Firpo Del Duca
{"title":"Effects of linear periodized and non-periodized combined training on body image perception of adults with obesity: A randomized clinical trial","authors":"Anne Ribeiro Streb, Carolina Graef Vieira, Larissa dos Santos Leonel, Cecília Bertuol, Willen Remon Tozetto, Jucemar Benedet, Giovani Firpo Del Duca","doi":"10.1177/02692155241249670","DOIUrl":"https://doi.org/10.1177/02692155241249670","url":null,"abstract":"ObjectiveVerify the effect of non-periodized and linear periodized combined training on body image perception and body dissatisfaction in adults with obesity.DesignA randomized clinical trial on the effect of two types of combined training periodization was carried out on people with grade I and II obesity.SettingParticipants were allocated into three groups: non-periodized periodization group, linear periodization group, and control group, with 23 participants in each.SubjectsAdults with obesity, with a body mass index between 30 kg/m² and 40 kg/m².InterventionsThe intervention lasted 16 weeks (separated into three mesocycles of 4 weeks and 1 week of familiarization), in 3 weekly sessions of 1 hour each, composed of aerobic (30 min) and muscle strength exercises (six exercises) in the same session. The group with non-periodized model maintained uniform intensity, volume, and workload throughout the mesocycles. The group with the linear periodization model started with low initial intensity, subsequently introducing a gradual increase of intensity in the mesocycles.Main measuresBody image perception (current and ideal silhouette) and body dissatisfaction were assessed using the Stunkard silhouette scale.ResultsThe perception of the current silhouette increased only in the control group (Δ = 1.16; p = 0.04). There was a significant reduction in the ideal silhouette over time ( p = 0.001), especially in non-periodized group (Δ = −1.26). Body dissatisfaction increased significantly only over time ( p = 0.001), especially for control group (Δ = 1.47).ConclusionsRegardless of periodization, combined training effectively maintained the perception of the current silhouette and reduced the ideal silhouette in adults with obesity.Trial registrationBrazilian Registry of Clinical Trials (RBR-3c7rt3).","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":"43 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830872","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":"Clinical validation of automated depth camera-based measurement of the Fugl-Meyer assessment for upper extremity","authors":"Zhaoyang Wang, Tao Zhang, Jingyuan Fan, Fanbin Gu, Qiuhua Yu, Honggang Wang, Jiantao Yang, Qingtang Zhu","doi":"10.1177/02692155241251434","DOIUrl":"https://doi.org/10.1177/02692155241251434","url":null,"abstract":"ObjectiveDepth camera-based measurement has demonstrated efficacy in automated assessment of upper limb Fugl-Meyer Assessment for paralysis rehabilitation. However, there is a lack of adequately sized studies to provide clinical support. Thus, we developed an automated system utilizing depth camera and machine learning, and assessed its feasibility and validity in a clinical setting.DesignValidation and feasibility study of a measurement instrument based on single cross-sectional data.SettingRehabilitation unit in a general hospitalParticipantsNinety-five patients with hemiparesis admitted for inpatient rehabilitation unit (2021–2023).Main measuresScores for each item, excluding those related to reflexes, were computed utilizing machine learning models trained on participant videos and readouts from force test devices, while the remaining reflex scores were derived through regression algorithms. Concurrent criterion validity was evaluated using sensitivity, specificity, percent agreement and Cohen's Kappa coefficient for ordinal scores of individual items, as well as correlations and intraclass correlation coefficients for total scores. Video-based manual assessment was also conducted and compared to the automated tools.ResultThe majority of patients completed the assessment without therapist intervention. The automated scoring models demonstrated superior validity compared to video-based manual assessment across most items. The total scores derived from the automated assessment exhibited a high coefficient of 0.960. However, the validity of force test items utilizing force sensing resistors was relatively low.ConclusionThe integration of depth camera technology and machine learning models for automated Fugl-Meyer Assessment demonstrated acceptable validity and feasibility, suggesting its potential as a valuable tool in rehabilitation assessment.","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":"45 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140830803","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}
Clinical RehabilitationPub Date : 2024-05-01Epub Date: 2024-02-20DOI: 10.1177/02692155241233348
Meredith Harrison-Brown, Corey Scholes, Milad Ebrahimi, Christopher Bell, Garry Kirwan
{"title":"Applying models of care for total hip and knee arthroplasty: External validation of a published predictive model to identify extended stay risk prior to lower-limb arthroplasty.","authors":"Meredith Harrison-Brown, Corey Scholes, Milad Ebrahimi, Christopher Bell, Garry Kirwan","doi":"10.1177/02692155241233348","DOIUrl":"10.1177/02692155241233348","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to externally validate a reported model for identifying patients requiring extended stay following lower limb arthroplasty in a new setting.</p><p><strong>Design: </strong>External validation of a previously reported prognostic model, using retrospective data.</p><p><strong>Setting: </strong>Medium-sized hospital orthopaedic department, Australia.</p><p><strong>Participants: </strong>Electronic medical records were accessed for data collection between Sep-2019 and Feb-2020 and retrospective data extracted from 200 randomly selected total hip or knee arthroplasty patients.</p><p><strong>Intervention: </strong>Participants received total hip or knee replacement between 2-Feb-16 and 4-Apr-19. This study was a non-interventional retrospective study.</p><p><strong>Main measures: </strong>Model validation was assessed with discrimination, calibration on both original and adjusted forms of the candidate model. Decision curve analysis was conducted on the outputs of the adjusted model to determine net benefit at a predetermined decision threshold (0.5).</p><p><strong>Results: </strong>The original model performed poorly, grossly overestimating length of stay with mean calibration of -3.6 (95% confidence interval -3.9 to -3.2) and calibration slope of 0.52. Performance improved following adjustment of the model intercept and model coefficients (mean calibration 0.48, 95% confidence interval 0.16 to 0.80 and slope of 1.0), but remained poorly calibrated at low and medium risk threshold and net benefit was modest (three additional patients per hundred identified as at-risk) at the a-priori risk threshold.</p><p><strong>Conclusions: </strong>External validation demonstrated poor performance when applied to a new patient population and would provide limited benefit for our institution. Implementation of predictive models for arthroplasty should include practical assessment of discrimination, calibration and net benefit at a clinically acceptable threshold.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"700-712"},"PeriodicalIF":3.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139912193","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}
Clinical RehabilitationPub Date : 2024-05-01Epub Date: 2024-01-18DOI: 10.1177/02692155231225705
Ilaria Catellani, Pasquale Arcuri, Fabio Vita, Daniela Platano, Paolo Boccolari, Elena Lanfranchi, Tracy Fairplay, Roberto Tedeschi
{"title":"An overview of rehabilitation approaches for focal hand dystonia in musicians: A scoping review.","authors":"Ilaria Catellani, Pasquale Arcuri, Fabio Vita, Daniela Platano, Paolo Boccolari, Elena Lanfranchi, Tracy Fairplay, Roberto Tedeschi","doi":"10.1177/02692155231225705","DOIUrl":"10.1177/02692155231225705","url":null,"abstract":"<p><strong>Objective: </strong>To provide a comprehensive overview of rehabilitation treatment strategies for focal hand dystonia (FHD) in musicians, examining their evolution and effectiveness.</p><p><strong>Data sources: </strong>A systematic search of five databases, PubMed, PEDro, Cochrane Library, Trip, and Google Scholar, to identify relevant articles on FHD rehabilitation. The last search was performed on 20 December 2023.</p><p><strong>Methods: </strong>Inclusion criteria were applied to 190 initially identified articles, resulting in 17 articles for review. Exclusions were made for duplicates, irrelevant titles, abstracts, and non-rehabilitation interventions.</p><p><strong>Results: </strong>Ten different rehabilitation approaches were identified over 20 years. While no definitive intervention protocol exists, a multimodal approach is commonly recommended.</p><p><strong>Conclusions: </strong>This scoping review underscores the diversity of rehabilitation strategies for FHD. It suggests the potential of multimodal approaches, emphasizing the need for further large-scale clinical efficacy studies.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"589-599"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139490901","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}