Clinical Rehabilitation最新文献

{"title":"Recommending 24-hour attendant care: A qualitative study exploring the clinical decision-making process of occupational therapists in Ontario, Canada.","authors":"Bao-Zhu Stephanie Long, Kishana Balakrishnar, Maryna Mazur, Elana Maria, Kathleen Hennessy, Mathew Rose, Behdin Nowrouzi-Kia","doi":"10.1177/02692155251336574","DOIUrl":"10.1177/02692155251336574","url":null,"abstract":"<p><p>ObjectiveThis study aims to explore how occupational therapists working in private practices in Canada use clinical indicators and tools to determine if clients require 24-hour attendant care.DesignA qualitative research study.SettingThe setting involved semi-structured, one-on-one interviews with occupational therapists in Canada.ParticipantsOccupational therapists were selected through purposive sampling: (1) registered Canadian occupational therapists, (2) with over 10 years of private practice experience, and (3) who have assessed the need for 24-hour attendant care at least once before the study.Main measuresThe interviews were conducted, transcribed, coded, and thematically analyzed by two researchers using Braun and Clarke's protocol. The paper is also reported based on the consolidated criteria for reporting qualitative research guidance.ResultsThe study involved nine occupational therapists (eight women and one man), with 14 to 24 years of private practice experience in Ontario. Three main themes in the decision-making process for 24-hour attendant care were identified: (1) Individualized and Holistic Assessments; (2) Clinical Expertise-Based Decision-making; and (3) Risk Assessment in Decision-Making.ConclusionsThis study provides a greater understanding of the decision-making process of occupational therapists working in Canada when recommending 24-hour attendant care. However, further research and development of guidelines are needed to support occupational therapists in this area.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"819-829"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141767/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Comments on 'Physiotherapy-led Care Versus Physician-led Care for Persons with low Back Pain: A Systematic Review' by Severijns et al.","authors":"Jean-François Kaux, Marc Schiltz, Patrick Linden, Geoffrey Brands, Bruno Schoonejans, Thierry Lejeune","doi":"10.1177/02692155251334282","DOIUrl":"10.1177/02692155251334282","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"842-843"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do some people with a prolonged disorder of consciousness experience pain? A clinically focused narrative review and synthesis.","authors":"Derick T Wade, Andrew Hanrahan","doi":"10.1177/02692155251333540","DOIUrl":"10.1177/02692155251333540","url":null,"abstract":"<p><p>ObjectiveTo investigate the hypothesis that people with a prolonged disorder of consciousness experience nociceptive pain.MethodA non-systematic literature review into the nature and neurophysiological basis of consciousness and pain likely function when someone has severe thalamocortical dysfunction; the behavioural manifestations of pain in people who cannot communicate; and how they relate to the experience.FindingsConsciousness depends on thalamocortical integrity and is judged clinically by establishing the person's behaviour depends on extracting or using meaning. The experience of pain is also deduced from a person's behaviour, including increased purposeless motor movements, facial expressions, non-verbal vocal expressions and physiological (autonomic) changes such as tachycardia and tear production. Extensive brainstem and midbrain networks are activated by pain, including autonomic networks. Given their early evolution and location, they likely resist damage. The networks appear intrinsically resilient, functioning when damaged unless the damage is severe.SynthesisSomeone with a prolonged disorder of consciousness usually has intransitive consciousness (arousal) that is not dependent on cortical cognitive processes and may have retained occurrent consciousness of mental states when aroused. Nociceptive stimuli elicit automatic but purposeless behaviours typically associated with pain. These behaviours are likely to be responses to this unpleasant mental state of occurrent consciousness that is limited to the time they show pain behaviours, with no memory of it.ConclusionThe unconscious person with a prolonged disorder of consciousness exhibiting pain behaviours in response to nociceptive stimuli likely experiences pain without analysing its significance; they are unlikely to anticipate or remember it.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"796-807"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955693","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":"What is the level of work and societal participation in patients with pelvic ring injuries? A two-year prospective cohort study.","authors":"Camryn C Therrien, Kaj Ten Duis, Hester Banierink, N M Trouwborst, Jean-Paul Pm de Vries, Frank Fa IJpma, Inge Hf Reininga","doi":"10.1177/02692155251333535","DOIUrl":"10.1177/02692155251333535","url":null,"abstract":"<p><p>ObjectiveTo provide insight into the impact of pelvic ring injuries on patients' work and school activities and participation in society.DesignProspective-cohort study.SettingA level-1 trauma center in the Netherlands.Participants195 patients with a pelvic ring injury.Main measuresThe work or school activities and participation in society domains of the World Health Organization Disability Assessment Score II (WHO-DAS II) were administered at admission (pre-injury score), 3 months, 6 months, 1 year and 2 years following the injury.ResultsBefore the injury, the median scores were 80 for both work or school activities and participation in society. The scores 3 months after the injury were 40 and 60, respectively, but both improved to 75 after 2 years. The percentage of non-recovered patients decreased over time, from 45% to 35% for work or school activities and from 34% to 18% for participation in society between 6 months and 2 years. At work or school, patients struggled to complete daily tasks and important activities as efficiently and effectively as needed. Regarding participation in society, patients struggled with the amount of time spent managing their injuries, joining community activities, and doing things for relaxation. No relationships between patients or injury characteristics and recovery were identified one year following the injury.ConclusionsPelvic ring injuries greatly impact patients' work or school activities and participation in society. However, these domains greatly improve within the first two years, with many individuals regaining their pre-injury capabilities. Still, some continue to experience long-term difficulties in participation.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"808-818"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141768/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986852","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":"The Vellore Pain Impact Questionnaire (V-PIQ): Initial validation of a tool for assessing the impact of low back pain based on the brief ICF core set.","authors":"Mammen Abijithgeorge, Selvaraj Samuelkamaleshkumar, Suresh Annpatriciacatherine, Ranjan Aruna, Joel Ronaldthomvicmaradona, Maya P Ganesan","doi":"10.1177/02692155251337570","DOIUrl":"10.1177/02692155251337570","url":null,"abstract":"<p><p>ObjectiveTo develop and validate the Vellore Pain Impact Questionnaire to assess the impact of low back pain in the Indian context.DesignA cross-sectional, quantitative study with two phases: development and validation of the Vellore Pain Impact Questionnaire. Content validity was ensured through a Delphi process involving five occupational therapists, while reliability and criterion validity were assessed.SettingThe study was conducted at the Occupational Therapy outpatient unit of a tertiary care teaching hospital in South India.ParticipantsSixty-five patients aged 18 years and above with nonspecific low back pain persisting for at least 12 weeks were recruited through convenience sampling.InterventionNot applicable.Main MeasuresThe Vellore Pain Impact Questionnaire underwent inter-rater and test-retest reliability using the intraclass correlation coefficient. Criterion validity was evaluated against the Oswestry disability index.ResultsThe Vellore Pain Impact Questionnaire showed excellent content validity (content validity index: 0.96). It demonstrated high reliability, with inter-rater (intraclass correlation coefficient: 0.985) and test-retest (intraclass correlation coefficient: 0.973) scores. The receiver operating characteristic analysis indicated moderate criterion validity (area under the curve: 0.628) compared to the Oswestry disability index. The questionnaire's broader coverage of ICF categories, including psychological and environmental factors, highlights its ability to capture the multidimensional impact of low back pain.ConclusionsThe Vellore Pain Impact Questionnaire shows promise as a reliable and culturally relevant tool for assessing low back pain impact in India, addressing physical, psychological, and social factors. However, further studies are necessary to establish its validity across diverse populations and settings.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"750-760"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to \"comments on the article \"physiotherapy-led care versus physician-led care for persons with Low back pain: A systematic review\" by severijns et al. (clin rehabil. 2024 dec;38(12):1571-1589)\".","authors":"Pieter Severijns, Nina Goossens, Wim Dankaerts, Laurent Pitance, Nathalie Roussel, Corentin Denis, Antoine Fourré, Pieter Verschueren, Annick Timmermans, Lotte Janssens","doi":"10.1177/02692155251340671","DOIUrl":"10.1177/02692155251340671","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"844-845"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retraction notice: \"Acceptance and commitment therapy for the treatment of depression in persons with physical disability: A randomized controlled trial\".","authors":"","doi":"10.1177/02692155251345412","DOIUrl":"https://doi.org/10.1177/02692155251345412","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":"39 6","pages":"846"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233391","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":"Inter-individual differences in early post-operative pain, cognitions, and emotions after total hip arthroplasty: A longitudinal cohort study.","authors":"Abner Sergooris, Jonas Verbrugghe, Bruno Bonnechère, Thomas Matheve, Kristoff Corten, Katleen Bogaerts, Annick Timmermans","doi":"10.1177/02692155251333537","DOIUrl":"10.1177/02692155251333537","url":null,"abstract":"<p><p>ObjectiveTo identify (1) pre- to early post-operative changes in pain and related cognitions and emotions, (2) early post-operative pain trajectories and their covariates, and (3) predictors of early post-operative cognitions and emotions.DesignLongitudinal cohort study.SettingSecondary care setting at Hospital East-Limburg and the European Hip Center (Belgium).ParticipantsOne hundred thirty-three individuals with hip osteoarthritis undergoing total hip arthroplasty.InterventionData were collected before total hip arthroplasty and during the first post-operative week.Main measuresSociodemographic information, traumatic experiences, anxiety, depression, perceived injustice, fear-avoidance, self-efficacy, and pain-related variables were assessed. Statistical analyses included Friedman tests to evaluate pre- to post-operative changes in pain and related cognitions and emotions, Latent Class Growth Analysis and multinomial logistic regression to identify pain trajectories and their covariates, and Least Absolute Shrinkage and Selection Operator regression to identify predictors of early post-operative cognitions and emotions.ResultsFour early post-operative pain trajectories were identified. Two trajectories (36%, <i>n</i> = 48) demonstrated no reduction in pain intensity one week after surgery. Higher levels of self-efficacy (odds ratio = 0.83) and pre- to post-operative reductions in perceived injustice (odds ratio = 0.86) were associated with lower odds of being classified in the unremitting pain trajectory. Between 38% and 64% in the variance of early post-operative cognitions and emotions could be predicted. Pre-operative perceived injustice showed a positive association with fear-avoidance (ß = 1.96) and anxiety symptoms (ß = 0.80).ConclusionsInter-individual differences exist in early post-operative pain after total hip arthroplasty but are poorly associated with cognitions or emotions. Pre-operative perceived injustice may influence early post-operative cognitions and emotions.<b>Registration:</b> ClinicalTrials.gov, NCT05265858 (https://classic.clinicaltrials.gov/ct2/show/NCT05265858).</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"784-795"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981935","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 influence of hearing loss and hearing aid use on experienced emotion in everyday listening situations.","authors":"Jack A Holman, Graham Naylor","doi":"10.1177/02692155251326830","DOIUrl":"10.1177/02692155251326830","url":null,"abstract":"<p><p>ObjectiveTo address the extent to which the emotional experience of everyday listening situations is impacted by hearing loss and hearing aid use.DesignAn exploratory prospective study with an observation arm and an intervention arm utilising smartphone-based ecological momentary assessment over 10 days. A hearing loss group was asked to wear and not wear their hearing aids on alternate days. A normal hearing group completed the surveys without hearing aids.SettingRemote study gathering data during daily life.ParticipantsTwenty-six experienced hearing aid users with hearing loss and twenty participants with normal hearing thresholds.InterventionRotating hearing aid use on alternate days in the hearing loss group.Main measuresParticipants reported on experienced emotions (valence, arousal and discrete emotion) in listening activities at random points throughout the day, as well as at baseline for related socioemotional variables.ResultsParticipants with hearing loss reported similar valence and arousal to the normal hearing group when wearing their hearing aids, but significantly lower when not wearing hearing aids. Wearing (versus not wearing) hearing aids showed a significant beneficial effect on valence and arousal. Discrete emotions were more negative when not wearing hearing aids. End-of-day reports of valence were also more negative. There was no significant effect of listening situation type.ConclusionsUnaided hearing loss was associated with a negative impact on emotions in listening situations. Hearing aids can restore the emotions experienced in everyday listening situations. The results highlight the importance of socioemotional well-being as a factor and outcome in audiological rehabilitation.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"770-783"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12141770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604182","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":"The impact of the number of sessions and stimulation parameters on repetitive transcranial magnetic stimulation efficacy for post-stroke upper extremity recovery: A systematic review and meta-analysis.","authors":"Gabriel Barreto, Paz Sánchez, Rebeca Dias, Adriana Baltar, Lívia Shirahige, Rodrigo Fragoso de Andrade, Kelly Sukar Cavalcanti de Oliveira, Carlos Alberto Santana, Daniele Piscitelli, Kátia Monte-Silva","doi":"10.1177/02692155251328945","DOIUrl":"10.1177/02692155251328945","url":null,"abstract":"<p><p>ObjectiveTo identify the optimal number of sessions and parameters of repetitive transcranial magnetic stimulation frequency, stimulation intensity, number of pulses per session/treatment that promotes a greater effect on post-stroke upper extremity function.Data sourcesMEDLINE (PubMed), Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Latin American and Caribbean Health Science Literature, Scientific Electronic Library Online, and Scopus up to November 2024.Review methodsWe conducted a meta-analysis on randomized controlled trials of repetitive transcranial magnetic stimulation combined with other therapies for post-stroke upper extremity function, assessed risk-of-bias using the Physiotherapy Evidence Database scale, calculated standard mean differences (SMD) with 95% confidence intervals (CI), and determined parameter cutoff points using a receiver operating characteristic curve.ResultsThirty-five randomized clinical trials involving 897 patients were included. Compared to control groups, repetitive transcranial magnetic stimulation combined with other therapies improved upper extremity motor function with a higher effect size for: ≥ 15 sessions (SMD 0.72 95% CI, 0.37 to 1.08; p < 0.0001]), > 1 Hz frequencies (0.98 [95% CI, 0.48 to 1.48; p = 0001]), intensities of <100% of resting motor threshold (SMD 0.52 [95% CI, 0.29 to 0.75; p < 0.00001]), ≥ 1000 pulses per session (SMD 0.61 [95% CI, 0.40 to 0.82; p < 0.00001]), and ≥12,000 pulses per treatment (SMD 0.64 [95% CI, 0.36 to 0.93; p < 0.0001]).ConclusionTo enhance post-stroke upper extremity function, the optimal repetitive transcranial magnetic stimulation protocol involves at least 15 sessions, frequencies above 1 Hz, intensities below 100% of resting motor threshold, at least 1000 pulses per session, and 12,000 pulses per treatment.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"707-727"},"PeriodicalIF":2.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143974411","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}