Clinical Rehabilitation最新文献

{"title":"Physiotherapy of the Trunk Related to Sitting Function After Stroke: A Delphi Study.","authors":"Elizabeth Bell, Kathy Briffa, James McLoughlin, Robyn Fary","doi":"10.1177/02692155251322263","DOIUrl":"https://doi.org/10.1177/02692155251322263","url":null,"abstract":"<p><strong>Objective: </strong>To develop consensus statements from a Delphi panel about physiotherapy of the trunk related to sitting function for people with subacute stroke, with the express aim of facilitating treatment choices by novice physiotherapists.</p><p><strong>Design: </strong>A four-round e-Delphi study using free-text responses and 5-point Likert scales for agreement.</p><p><strong>Participants: </strong>Twenty-six panel members with expertise in clinical and/or research in neurological rehabilitation.</p><p><strong>Main measures: </strong>Round 1 consisted of 5 free-text questions. Subsequent rounds ascertained agreement and consensus on statements formulated from Round 1 responses. Consensus was defined a priori as ≥70% agreement. Round 3 presented an additional two clinical observation queries related to the statements for comment.</p><p><strong>Results: </strong>Twenty participants completed all four rounds. Nineteen of 26 participants (73%) thought physiotherapy of the trunk was important through all stages of recovery after stroke. Different interpretations about what constitutes physiotherapy of the trunk following stroke were identified. Fourteen statements of agreement regarding physiotherapy of the trunk were formulated. The majority of statements involved different activities in sitting such as control of movement over the base of support and reaching with the unaffected arm. In addition to the statements of agreement clinical observations for implementation of the statements were developed.</p><p><strong>Conclusions: </strong>In the absence of detail in clinical guidelines and a wide range of interventions in systematic reviews, this study provides clear and specific options for novice physiotherapists of treatment of the trunk related to functional task practice in sitting and as preparation for sit to stand.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251322263"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522767","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":"Patients' and staffs' experiences of clinical support after a lower limb reconstruction: An interview study.","authors":"Heather Leggett, Jennie Lister, Catherine Hewitt, Hemant Sharma, Catriona McDaid","doi":"10.1177/02692155251317500","DOIUrl":"https://doi.org/10.1177/02692155251317500","url":null,"abstract":"<p><p><b>Objective:</b> To explore patient and healthcare professional perspectives on post-lower limb reconstruction support. <b>Design:</b> A qualitative study<i>.</i> <b>Setting:</b> One-to-one semi-structured interviews undertaken via video conferencing software or over the telephone. <b>Participants:</b> Thirty-two patients (who had undergone reconstructive surgery due to trauma, malunion, non-union, infection or congenital issues treated by internal or external fixation) and 22 orthopaedic healthcare professionals (surgeons, nurses and physiotherapists) were interviewed between November 2020 and June 2021. <b>Results:</b> Thematic analysis was undertaken on data surrounding clinical support. Four themes were generated: being involved and feeling informed, physiotherapy as a motivator for recovery, the importance of timely access to physiotherapy, and mental health support. Patients valued being involved in decisions about their care and feeling informed. Supportive nurses played a key role, with patients appreciating clear communication and empathy. Trust in the clinical team eased anxiety, whilst a lack of information caused stress and dissatisfaction. Post-surgery, information on recovery, access to physiotherapy, and hospital contacts were crucial. Physiotherapy was vital for regaining mobility, providing motivation, and promoting confidence. Access to mental health support was limited, though patients appreciated emotional support from physiotherapists and hospital staff. <b>Conclusion:</b> By providing comprehensive support, healthcare professionals can optimise patient satisfaction with care, enhance psychological well-being, and facilitate the successful rehabilitation and reintegration of patients back into their daily lives.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251317500"},"PeriodicalIF":2.6,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522762","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 Oxford Visual Perception Screen: Development and normative data of a standardised assessment for visual perception difficulties.","authors":"Kathleen Vancleef, Ruby Castellani, Rebecca Shorthose, Catherine Guo, Merak Fulin Cai, Federica Guazzo, Nele Demeyere","doi":"10.1177/02692155251315606","DOIUrl":"https://doi.org/10.1177/02692155251315606","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to develop and standardise a practical systematic screening tool for visual perception impairments after a stroke to replace current subjective methods.</p><p><strong>Design: </strong>A mixed methods study including a cross-sectional study and a case series.</p><p><strong>Setting: </strong>In the community and on stroke rehabilitation units.</p><p><strong>Participants: </strong>Older volunteers without a neurological history contributed to normative data. Patients with ocular conditions or a stroke took part in our case series.</p><p><strong>Instrument: </strong>The Oxford Visual Perception Screen.</p><p><strong>Main measures: </strong>For each task of the Oxford Visual Perception Screen, we determined 5^th centile cut-off scores. We further explored effects of age, visual acuity and gender on visual perception through generalised linear models.</p><p><strong>Results: </strong>Oxford Visual Perception Screen is a 15-min paper-and-pen assessment comprising 10 tasks including picture naming, star counting and reading. Normative data of 107 participants demonstrated persistent high performance with most cut-offs near ceiling. Apart from the Figure Copy (<i>Z</i> = 6.57, <i>p</i> < 0.001) and Global Shape Perception task (<i>Z</i> = 3.32, <i>p</i> < 0.001) we found no evidence for an effect of visual acuity on OxVPS. An effect of age was only observed in the Face Recognition (<i>Z</i> = 3.61, <i>p</i> < 0.001) and Reading task (<i>Z</i> = -3.50, <i>p</i> < 0.001). No effects of gender were observed. A series of eight cases illustrates the interpretation of OxVPS.</p><p><strong>Conclusion: </strong>We present the Oxford Visual Perception Screen, a standardised visual perception screening tool alongside normative data and illustrative cases. The Oxford Visual Perception Screen can potentially change screening for visual perception impairments in clinical practice and is available at https://oxvps.webspace.durham.ac.uk/.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251315606"},"PeriodicalIF":2.6,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514864","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: In radial extracorporeal shock wave therapy, energy matters.","authors":"Christoph Schmitz, Javier Crupnik, Daniel Morgan, Nicola Maffulli, Antoni Morral","doi":"10.1177/02692155251321013","DOIUrl":"https://doi.org/10.1177/02692155251321013","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251321013"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467276","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":"An economic evaluation of pre-discharge home assessment visits following hip fracture: Analysis from a randomised controlled trial.","authors":"Kylee J Lockwood, Nicholas F Taylor, Katherine E Harding, Natasha K Brusco","doi":"10.1177/02692155241312065","DOIUrl":"https://doi.org/10.1177/02692155241312065","url":null,"abstract":"<p><strong>Objective: </strong>To investigate cost-effectiveness of pre-discharge home assessment visits for patients recovering after hip fracture.</p><p><strong>Design: </strong>Cost-effectiveness analysis completed alongside a randomised controlled trial.</p><p><strong>Setting: </strong>Hospital wards and the community.</p><p><strong>Participants: </strong>Adults 50 years and over with hip fractures planning to return home.</p><p><strong>Intervention: </strong>Participants were randomised to either usual-care hospital-based discharge planning or usual-care hospital-based discharge planning with a pre-discharge home assessment visit by an occupational therapist.</p><p><strong>Main measures: </strong>Functional Independence Measure, EQ-5D-3L, and number of falls. Incremental cost-effectiveness ratios were calculated for changes at 30 days and 6 months.</p><p><strong>Results: </strong>Seventy-seven patients participated. Compared to usual care, the home assessment group likely had fewer falls at 30 days (incidence rate ratio = 0.41, 95% confidence interval (CI) 0.15 to 1.11) and increased functional independence at 6 months (11.2 units, 95% CI 4.2 to 18.2) but no difference in quality of life (0.0 units, 95% CI -0.1 to 0.1). The mean cost to provide a home assessment visit was A$135.70. A mean cost saving of A$6182 (95% CI -$6414 to $18,777) favoured the home assessment group. The incremental cost-effectiveness ratio found a saving of A$71,337 (95% CI -$998,930 to $411,409) in achieving clinically important changes in functional independence for the home assessment group at 6 months and a saving of A$34,832 (95% CI -$331,344 to $213,900) per fall avoided in favour of the home assessment group at 30 days.</p><p><strong>Conclusion: </strong>From a health service perspective, pre-discharge home assessments for patients after hip fracture are likely to be cost-effective in restoring functional independence and reducing falls.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155241312065"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467275","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":"Shockwave therapy technique: Concerns around a recent publication.","authors":"Fusun Ardic, Alev Atigan, Meltem Akinci","doi":"10.1177/02692155251318163","DOIUrl":"https://doi.org/10.1177/02692155251318163","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251318163"},"PeriodicalIF":2.6,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467277","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":"Effect of sensorimotor training on stability, mobility, and quality of life after lower extremity thermal burns: A prospective randomised controlled trial.","authors":"Nesma M Allam, Nabil Mahmoud Abdel-Aal, Khadra M Ali, Hadaya Mosaad Eladl","doi":"10.1177/02692155251318560","DOIUrl":"https://doi.org/10.1177/02692155251318560","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of sensorimotor training on stability, balance, mobility, quality of life, and muscle strength after lower extremity and trunk thermal burns.</p><p><strong>Design: </strong>A prospective, randomised controlled trial.</p><p><strong>Setting: </strong>Physiotherapy outpatient setting.</p><p><strong>Participants: </strong>Sixty participants with lower extremity and trunk thermal burns, aged 20-50 years, were randomly allocated to either the Sensorimotor Training group or the Control group.</p><p><strong>Intervention: </strong>The Sensorimotor Training group received both a sensorimotor training programme and a traditional physiotherapy programme, while the Control group received only the traditional physiotherapy programme. The intervention was applied three days per week for eight weeks.</p><p><strong>Outcome measures: </strong>The anteroposterior stability index was the primary outcome, while secondary outcomes included the overall stability index, mediolateral stability index, Timed Up and Go Test, Berg Balance Scale, and the Short Form-36 questionnaire, all measured at baseline and after eight weeks.</p><p><strong>Results: </strong>Significant differences were identified between groups after eight weeks, favouring the Sensorimotor Training group. Mean differences (95% CI) between groups were: -0.89 (-1.23, -0.54) for the anteroposterior stability index; 6.67 (4.48, 8.86) for the Berg Balance Scale; -1.7 (-2.82, -0.59) for the Timed Up and Go Test; 11.22 (7.03, 15.40) for knee extensor torque; and 7.98 (4.62, 11.35) for physical function.</p><p><strong>Conclusion: </strong>Sensorimotor training, when added to a conventional physiotherapy programme, can significantly improve stability, balance, mobility, quality of life, and muscle strength compared to conventional physiotherapy alone in participants with lower extremity and trunk thermal burns.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251318560"},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143390309","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 Fear Avoidance Beliefs Questionnaire thresholds and gender on spatiotemporal parameters during walking in patients with chronic low back pain.","authors":"Yannick Delpierre, Sophie Michaud, Arnaud Brayer","doi":"10.1177/02692155251318572","DOIUrl":"https://doi.org/10.1177/02692155251318572","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the effects of the threshold value of Fear-Avoidance Beliefs Subscales on quantified movement as a function of gender.</p><p><strong>Design study: </strong>Retrospective cohort study.</p><p><strong>Settings: </strong>Single center study.</p><p><strong>Participants: </strong>One hundred forty patients (aged 38.4) with chronic low back pain and referred to functional restauration program.</p><p><strong>Intervention: </strong>Patients participated in a five-week multidisciplinary Functional Restoration Program between 1 April 2013 and 1 April 2019, evaluated with clinical scales, psychosocial care and objective gait analysis. This study was a noninterventional retrospective study.</p><p><strong>Main measures: </strong>Objective gait analysis with the Vicon Motion Systems (Ltd, Oxford, UK), Fear-Avoidance Belief Scale, Visual Analog Scale, the DALLAS Pain Questionnaire, and the Hospital Anxiety and Depression Scale.</p><p><strong>Results: </strong>Data from 131 patients were studied. Patients with significant Fear-Avoidance Beliefs scores walked with significantly higher cadence. Patients with higher work subscale values presented significantly lower cadence, without effects on step length and self-selected speed. Women with significant fear-avoidance belief score walked with higher step length (0.58 m (0.05)) than men with significant fear-avoidance belief score (0.61 m (0.05). Correlations between Fear Avoidance Beliefs Questionnaire and spatiotemporal parameters were gender-dependent but nonsignificant or low.</p><p><strong>Conclusions: </strong>The threshold values depicted in the literature on psychometric analysis reveal low but quantitative effect of fear-avoidance on spatiotemporal parameters. These threshold values can be used by clinicians to evaluate the significance of the clinical scale. Considering gait, cadence should help the clinician to assess the fear-avoidance, particularly for patients are not able to complete all clinical scale items.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251318572"},"PeriodicalIF":2.6,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143255012","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":"Aquatic exercise interventions in the treatment of musculoskeletal upper extremity disorders: A scoping review.","authors":"Lynn Murray, Michelle Kennedy, Michael Malone, Lyn Mair, Lyndsay Alexander","doi":"10.1177/02692155251315078","DOIUrl":"https://doi.org/10.1177/02692155251315078","url":null,"abstract":"<p><strong>Objective: </strong>To identify literature on aquatic exercise therapy used to manage upper extremity musculoskeletal disorders and identify key concepts, intervention components, and gaps in the evidence base.</p><p><strong>Data sources: </strong>The comprehensive search included MEDLINE (Ovid), CINAHL (EBSCOHost), Embase (Ovid), CENTRAL (Cochrane Central Register of Controlled Trials) databases and grey literature sources.</p><p><strong>Review methods: </strong>JBI Scoping review methodology guided this review through protocol development, searching, screening, data extraction and analysis. Study Selection included: Participants - Adults with upper extremity musculoskeletal disorders; Concept - Aquatic based exercise therapy; Context - any setting in any very highly developed nation.</p><p><strong>Results: </strong>The search identified 5045 sources with 68 studies included in the final synthesis. Findings outlined shoulder problems were the most reported upper extremity condition treated (<i>n</i> = 78) especially following rotator cuff repair (<i>n</i> = 17), followed by the hand and wrist (<i>n</i> = 9), and elbow (<i>n</i> = 6). Range of movement (<i>n</i> = 36) and resistance exercises (<i>n</i> = 17) were the most common interventions reported for aquatic therapy, however compliance with reporting guidance across included studies was poor. Sixteen health domains were identified with range of movement (<i>n</i> = 21) and pain (<i>n</i> = 20) the most common, and 62 outcome measures were reported related to the identified domains. Qualitative aspects of aquatic interventions were evaluated in two papers.</p><p><strong>Conclusion: </strong>There is a need for more primary experimental and qualitative studies related to the upper extremity and aquatic therapy. Improved reporting quality of aquatic therapy exercise intervention is required as is the need to establish specific core outcome sets and domains in this area.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251315078"},"PeriodicalIF":2.6,"publicationDate":"2025-02-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143078704","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":"Rehabilitation Patterns After Hospitalization: Results from a Danish Registry.","authors":"Lars Morsø, Mette Birk-Olsen, Søren Bie Bogh","doi":"10.1177/02692155241302720","DOIUrl":"10.1177/02692155241302720","url":null,"abstract":"<p><strong>Objective: </strong>Conditions that could benefit from rehabilitation contribute to 310 million years of life lived with disability. Internationally rehabilitation could be part of the solution to the growing global disease burden. This register based study wanted to explore differences in patterns of rehabilitation among patients discharged from the hospital with a rehabilitation plan, explore rehabilitation initiation, and assess the activation of rehabilitation plans within legal requirements.</p><p><strong>Setting: </strong>The study was conducted at Odense University Hospital in the Region of Southern Denmark.</p><p><strong>Participants: </strong>The study investigated acute contacts by utilising rehabilitation referrals, demographic and municipal data from Odense Municipality residents from 2015 to 2020.</p><p><strong>Main measures: </strong>Descriptive statistics, logistic regressions, cox regression and cumulative incidence rate were used to explore rehabilitation the activation of rehabilitation plans.</p><p><strong>Results: </strong>The cohort consisted of 225,653 hospital contacts. Overall, 10,327 (5%) received a rehabilitation plan. Contacts were more often female or had increased co-morbidity. Prescription increased with age and for ethnical Danes. Initiation of prescribed plans increased within the first weeks, levelling from 30 to 60 days. Delayed initiation of the rehabilitation plan beyond 30 days raised the likelihood of non-initiating altogether.</p><p><strong>Conclusions: </strong>Although evidence acknowledges the benefits of rehabilitation, this study showed that more than 25% of all referred municipality rehabilitation plans were never initiated. If the initiation of a rehabilitation plan was delayed beyond 30 days, it significantly reduced the likelihood of initiation. Therefore, the international community need to keep focus on early rehabilitation and increase the use of rehabilitation in the future.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"249-258"},"PeriodicalIF":2.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142779477","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}