Clinical Rehabilitation最新文献

{"title":"Cost consequences analysis of early vocational rehabilitation compared with usual care for stroke survivors.","authors":"Sarah Pyne, Tracey H Sach, Rory Cameron, Helen Risebro, Alexandra Wright-Hughes, Ellen Thompson, Dame Caroline Watkins, Audrey Bowen, Judith Stevens, Amanda J Farrin, Christopher McKevitt, John D Murray, Rory J O'Connor, Julie Phillips, Kate A Radford","doi":"10.1177/02692155241299372","DOIUrl":"https://doi.org/10.1177/02692155241299372","url":null,"abstract":"<p><strong>Objective: </strong>To compare costs and consequences of Early Stroke Specialist Vocational Rehabilitation (ESSVR) with usual care in working age, stroke survivors over 12 months.</p><p><strong>Design: </strong>An economic evaluation nested within the pragmatic, multi-centre, randomised, controlled RETurn to work After stroKE (RETAKE) study.</p><p><strong>Setting: </strong>Twenty-one English and Welsh National Health Service (NHS) hospital-based stroke units. A UK NHS and Personal Social Services perspective was taken in the base-case and a wider perspective (participant, family, employer and other public services) in a secondary analysis.</p><p><strong>Participants: </strong>A total of 583 stroke survivors age ≥18 years (mean 54.0 years, 69% male).</p><p><strong>Interventions: </strong>Participants were randomised to ESSVR, an early, individually tailored (in content, dose, intensity and duration) intervention, plus usual care or usual care alone.</p><p><strong>Main measures: </strong>Disease-specific resource-use data and EQ-5D-5L (health-related quality of life) collected at baseline, 3, 6 and 12 months. Resource-use items were valued using unit costs in UK£ 2021/22. EQ-5D-5L was used to estimate Quality-adjusted life-years (QALYs). If ESSVR was found effective, an incremental cost-utility analysis was planned, otherwise a cost-consequence analysis.</p><p><strong>Results: </strong>The clinical study found no evidence of a between-group difference in the proportion of participants returning to work at 12 months. This, and the level of missing data, means a cost-consequence analysis is reported. Using imputed data, ESSVR plus usual care is estimated to be more expensive with slightly higher QALYs compared with usual care.</p><p><strong>Conclusions: </strong>Early Stroke Specialist Vocational Rehabilitation is unlikely to be considered cost-effective over 12 months, which fits with the clinical finding of no between-group difference in return-to-work rates post-stroke.</p><p><strong>Clinical trial registration information: </strong>The ISRCTN registry: ISRCTN12464275 https://doi.org/10.1186/ISRCTN12464275.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155241299372"},"PeriodicalIF":2.6,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784144","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":"Design and development of an eHealth intervention to support self-management in people with musculoskeletal disorders: 'eHealth: it's TIME'.","authors":"Marie Kelly, Brona M Fullen, Denis Martin, Colin Bradley, Eoghan O'Riain, Joseph G McVeigh","doi":"10.1177/02692155241289097","DOIUrl":"10.1177/02692155241289097","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to co-design and develop a user-centred, theory-based eHealth-mediated self-management support follow-up prototype for adults with musculoskeletal disorders.</p><p><strong>Design: </strong>A three-step system development cycle was employed. Step 1 involved creating intervention features and content, with two focus groups reviewing prioritised eHealth intervention elements based on earlier research. Step 2 involved heuristic testing using Nielsen's 10 heuristic principles. Step 3 incorporated qualitative think-aloud interviews and the System Usability Scale.</p><p><strong>Setting: </strong>Republic of Ireland.</p><p><strong>Participants: </strong>Step 1 included adults with musculoskeletal disorders (<i>n</i> = 12). Step 2 involved five reviewers. Step 3 included people with musculoskeletal disorders (<i>n</i> = 5) and musculoskeletal physiotherapists (<i>n</i> = 5).</p><p><strong>Results: </strong>Participants in step 1 approved four main intervention components, which map to recognised theoretical frameworks, and suggested increased use of visual and interactive elements. Heuristic testing in step 2 identified design and navigation issues. In Step 3, usability testing, additional navigation, content and design recommendations were identified. The overall median system usability score (interquartile range) was 75 (0) out of 100 for adults with musculoskeletal disorders and 77.5 (2.5) out of 100 for musculoskeletal physiotherapists, indicating good usability.</p><p><strong>Conclusion: </strong>A theory-based, user-centred eHealth-mediated follow-up self-management support prototype has been developed for people with musculoskeletal disorders, with the next steps focusing on feasibility testing in clinical practice, with a more diverse population.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1677-1690"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459691","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":"Association between patient-reported frailty and nonhome discharge among older patients with acute stroke: A prospective study.","authors":"Yanli Cui, Cao Meng, Lijun Xiang, Yansi Luo, Xuemei Song, Daihong Cheng, Jiawei Ye, Xiaomei Zhang","doi":"10.1177/02692155241290258","DOIUrl":"10.1177/02692155241290258","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between prestroke frailty and nonhome discharge, prolonged length of stay as well as functional outcomes.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>Single urban teaching hospital in Guangzhou, China.</p><p><strong>Participants: </strong>Consecutive sample of 271 older patients admitted with acute stroke.</p><p><strong>Intervention: </strong>N/A.</p><p><strong>Main measures: </strong>A five-item FRAIL scale (0∼5 points) and the stroke severity at onset were measured. The primary outcome of interest was nonhome discharge, with secondary outcomes including prolonged length of stay and worse short-term prognosis. Multivariable logistic regression adjusting for confounding factors was used to determine the association between patient-reported frailty and nonhome discharge, prolonged length of stay, worse short-term prognosis.</p><p><strong>Results: </strong>The population had a median age of 68 [interquartile range (IQR), 64∼74)]years, with 50 individuals (18.5%) identified as frail. After adjusting for age, sex, Barthel index, National Institutes of Health Stroke Scale, and Mini-Mental Status Exam score at admission, patients with self-reported frailty were significantly likely to experience nonhome discharge (Odds Ratio [<i>OR</i>] = 4.788; 95% confidence interval [CI] = 1.272∼18.017; <i>p</i><i> </i>= .021), prolonged length of stay (<i>OR</i> = 4.76; 95% CI<i> </i>= 1.80∼12.56; <i>p </i>= .002), mRS scores at 30 days (<i>OR</i> = 6.72;95% CI<i> </i>= 1.79∼25.20; <i>p</i> = .005) and three months postdischarge and three-month (<i>OR</i> = 8.94; 95% CI<i> </i>= 2.10∼38.08; <i>p </i>= .003).</p><p><strong>Conclusions: </strong>In older adults with stroke, frailty is associated with nonhome discharge, prolonged length of stay, and worse short-term prognosis, regardless of the stroke severity, cognition, and Barthel index score at admission. FRAIL scale can be used as a practical screening tool in acute care setting by multidisciplinary team in supporting discharge process.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1691-1702"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459679","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":"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":"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":" ","pages":"1658-1676"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","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":"Working towards consensus on the assessment of mood after severe acquired brain injury: Focus groups with UK-based professionals.","authors":"Alexandra E Rose, Breda Cullen, Sarah Crawford, Jonathan J Evans","doi":"10.1177/02692155241287770","DOIUrl":"10.1177/02692155241287770","url":null,"abstract":"<p><strong>Objective: </strong>The assessment of mood after brain injury is more challenging when people have ongoing severe cognitive and receptive communication impairments. There is no gold standard on how these assessments should be undertaken. This study aimed to reach a consensus on this among specialists working with this population.</p><p><strong>Design: </strong>Focus groups were completed using a structured nominal group technique. Groups were compared for overlapping themes and agreed processes.</p><p><strong>Participants: </strong>Five focus groups with a total of 14 participants who work with the population of interest were completed. Participants included 12 clinical psychologists, one psychiatrist and one consultant in rehabilitation medicine.</p><p><strong>Results: </strong>Each of the five groups reached a consensus on a process for assessing mood in this population. Results overlapped and were combined into a proposed circular and iterative model of assessment that includes: (pre) information gathering, (peri) assessment processes, and (post) treatment; with formulation being seen as a vital part of the process. Standardised measures were not recommended for use with this population. Beyond the consensus processes, three implicit themes were identified: (1) depression is different after severe brain injury, (2) overlapping tasks and roles, and (3) looking at the bigger picture.</p><p><strong>Conclusions: </strong>A good level of consensus was achieved across the five groups on processes to follow when assessing mood when people have ongoing cognitive and receptive communication impairments after severe brain injury. We recommend that this formulation-based model be followed when assessing people in this clinical population.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1703-1710"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142388588","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":"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":"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":" ","pages":"1571-1589"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","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 Lymphatic Drainage and Nerve Mobilization Techniques on Nerve Morphology in Mild-to-Moderate Carpal Tunnel Syndrome: A Randomized Controlled Trial.","authors":"Emine Cihan, Merve Akdeniz Leblebicier, Cansu Sahbaz Pirincci, Fatima Yaman, Arzu Ture, Busra Ari, Berra Yamuc","doi":"10.1177/02692155241289101","DOIUrl":"10.1177/02692155241289101","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether nerve mobilization related to nerve mobility or the removal of edema using lymphatic drainage affects the cross-sectional area of the nerve, hand function, and symptom severity in carpal tunnel syndrome.</p><p><strong>Design: </strong>The study is a prospective randomized controlled trial. Data were analyzed between groups using ANOVA, Chi-squared test, and Kruskal-Wallis test.</p><p><strong>Setting: </strong>Treatment lasted 4 weeks. Splint group wore the splint daily. Splint+manual lymphatic drainage received lymphatic drainage 5 days a week. Splint+nerve mobilization performed neuromobilization exercises as home exercises 5 days a week. Evaluations were conducted before and after 4 weeks of treatment.</p><p><strong>Participants: </strong>The study included 80 patients with mild-to-moderate carpal tunnel syndrome.</p><p><strong>Interventions: </strong>The patients were randomly divided into three groups: splint (<i>n</i> = 27), splint+manual lymphatic drainage (<i>n</i> = 27), or the splint+nerve mobilization (<i>n</i> = 26).</p><p><strong>Main outcome measures: </strong>The main outcome measures were ultrasound assessments and the Boston Carpal Tunnel Questionnaire (Symptom Severity Scale and Boston Functional Status Scale).</p><p><strong>Results: </strong>Compared to the other groups, the nerve cross-sectional area decreased at both the carpal tunnel (<i>p</i> = 0.003) and mid-forearm (<i>p</i> = 0.014) levels in the drainage group. Nerve mobilization did not result in a significant change in the nerve cross-sectional area. All groups showed significant improvements in both symptom severity and functional status scores (<i>p</i> < 0.001).</p><p><strong>Conclusion: </strong>The reduction of edema through lymphatic drainage contributes to a decrease in the cross-sectional area of the median nerve. Additionally, all three methods appear to positively impact the functional capacity of the hand and alleviate symptoms.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1633-1644"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142459692","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":"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":" ","pages":"1590-1608"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","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":"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":"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":" ","pages":"1609-1621"},"PeriodicalIF":2.6,"publicationDate":"2024-12-01","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, safety of and adherence to adjustable compression wraps in the control phase of breast cancer-related lymphedema: A randomized controlled trial.","authors":"Jéssica Malena Pedro da Silva, Raul Denner Duarte Araújo, Suzana Sales de Aguiar, Erica Alves Nogueira Fabro, Marcus Vinicius de Mello Pinto, Luiz Claudio Santos Thuler, Anke Bergmann","doi":"10.1177/02692155241270921","DOIUrl":"10.1177/02692155241270921","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate efficacy, safety, and adherence to using adjustable compression wraps (ACWs) for upper limb volume control in women with breast cancer-related lymphedema.</p><p><strong>Design and setting: </strong>Randomized controlled trial at a reference hospital for breast cancer treatment in Brazil.</p><p><strong>Participants: </strong>Women in control phase of the breast cancer-related lymphedema.</p><p><strong>Interventions: </strong>Compared use of ACWs versus compressive mesh.</p><p><strong>Main measures: </strong>Evaluated before treatment, at 30 days, and 6 months after initiating therapy. The primary outcome was the change in excess limb volume. Secondary outcomes included adherence, incidence of adverse events, functionality, quality of life, and hand grip. Statistical analysis involved calculating the effect size (ES) with a 95% confidence interval.</p><p><strong>Results: </strong>Were included 71 women with mean excess limb volume of 321.79 mL (±194.98). In the 30-day analysis (Time 1), a reduction of 37.6 mL in volume was observed only in the ACW group (<i>p</i> = .041, ES 0.20), with improved functionality (<i>p</i> = .013, ES 0.22). In the six months analysis (Time 2), the compressive mesh group increased by 2.48% in volume (<i>p</i> = .023, ES 0.26) and demonstrated improvement functionality (<i>p</i> = .036, ES 0.27). Mild adverse events and satisfactory adherence were observed. However, in the intergroup comparison, no statistically significant difference was observed for any evaluated outcome-excess volume, incidence of adverse events, adherence, hand grip, quality of life, and functionality between the groups (<i>p</i> > .05) at both times.</p><p><strong>Conclusions: </strong>Both compression therapies achieved satisfactory adherence, were safe, effective and equivalent for controlling limb volume in breast cancer-related lymphedema.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1481-1494"},"PeriodicalIF":2.6,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906116","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}