Clinical Rehabilitation最新文献

{"title":"Understanding the activity and participation limitations in adolescents with cleft lip and palate: A mixed design study using the concept of International Classification of Functioning, Disability and Health Children and Youth Version.","authors":"Guleser Guney Yilmaz, Barkın Köse, Süleyman Yıldızdal, Kübra Ersoy, Yusuf Irmak, Nur Dilay Yumuş, Serkan Pekçetin, Figen Özgür","doi":"10.1177/02692155251327952","DOIUrl":"10.1177/02692155251327952","url":null,"abstract":"<p><p>ObjectiveThe primary objective is to comprehensively examine the activity and participation limitations in adolescents with cleft lip and palate utilizing the ICF-CY (International Classification of Functioning, Disability and Health Children and Youth Version).DesignMixed designed study.</p><p><strong>Setting: </strong>Hacettepe University Plastic and Reconstructive Surgery Department.</p><p><strong>Participants: </strong>264 adolescents with cleft lip and palate and 300 healthy adolescents.</p><p><strong>Main measures: </strong>The Mann-Whitney <i>U</i> test was used to compare occupational balance levels, and qualitative content analysis was used for analyzing interviews. Data were then coded according to the categories of the ICF-CY.ResultsThere was a statistically significant difference between temporality (<i>P</i> = .001), rest and sleep (<i>P</i> = .004), occupational variations and adaptations(<i>P</i> = .001), occupational meaning and value (<i>P</i> = .0001), and A-OBS (Adolescent Occupational Balance Scale<b>)</b> total scores. Participants expressed that they especially had problems in carrying out daily life activities and ensuring social participation. They further stressed that their families tended to provide an overly protective environment. Additionally, adolescents reported improved communication within virtual environments. Adolescents emphasized the impact of the ongoing surgical history on personal development.ConclusionsICF-CY provides an important perspective in examining the activity and participation limitations of children with cleft lip and palate, providing an opportunity to understand the effects of impairments in body structure and function, environmental barriers, and social impacts.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"690-700"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143662433","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 efficacy of gluteal tendinopathy treatments: A systematic review.","authors":"Tobias Bremer, Peter Nicklen, Angie Fearon, Dylan Morrissey","doi":"10.1177/02692155251327298","DOIUrl":"10.1177/02692155251327298","url":null,"abstract":"<p><p>ObjectiveTo guide clinical practice by synthesising robust evidence concerning gluteal tendinopathy management.Data sourcesFive electronic databases were searched from inception to August 2024 for randomised controlled trials (RCTs) of medium or high quality, and low risk of bias, that measured pain and function in adults with clinically diagnosed gluteal tendinopathy.Review methodsSystematic review reporting proof of efficacy. PEDro scale and Cochrane Risk of Bias Tool 2.0 were used to assess internal validity and risk of bias. Efficacy was determined by comparison to minimal intervention. Methodological heterogeneity prevented meta-analysis, but we calculated standardised mean differences (SMD) and 95% confidence intervals (95% CI) for individual study arms to facilitate comparison between interventions.ResultsFour interventions from four RCTs demonstrated efficacy. Exercise and education has moderate strength evidence of a medium effect on pain (SMD = 0.95; 95% CI [0.58, 1.33]) and function (SMD = 0.91; 95% CI [0.53, 1.28]) in the short term with small effects in the medium and long term. Corticosteroid injection has moderate strength evidence of a small effect on pain (SMD = 0.51; 95% CI [0.16, 0.86]) in the short term. Platelet-rich plasma injection was superior in the short term compared to corticosteroid injection for function (SMD = 0.46; 95% CI [0.00, 0.91]). For pain, focused shockwave therapy (f-ESWT) demonstrates superiority in the long term (SMD = 5.77; 95% CI [4.84, 6.71]) compared to corticosteroid injection.ConclusionsExercise and education can be cautiously recommended as the core approach for pain management and function, potentially supplemented by corticosteroid or f-ESWT, while definitive trials of promising interventions are needed to derive robust practice recommendations.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"600-617"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964751","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":"Validation of the Amputee Single Item Mobility Measure (AMPSIMM) and the abbreviated AMPSIMM-4 for amputee mobility.","authors":"Daniel C Norvell, David C Morgenroth, Joseph M Czerniecki, Elizabeth G Halsne, Aaron P Turner, Rhonda M Williams, Alison W Henderson","doi":"10.1177/02692155251327344","DOIUrl":"10.1177/02692155251327344","url":null,"abstract":"<p><p>ObjectiveTo evaluate the criterion and construct validity of the 7-category Amputee Single Item Mobility Measure (AMPSIMM) in a large contemporary dysvascular lower limb amputation population and propose an abbreviated 4-category version (AMPSIMM-4) whose mobility categories parallel the Medicare Functional Classification Levels (K-levels).DesignCohort study retrospectively identifying persons with their first lower limb amputation then prospectively collecting their self-reported mobility.SettingNational cohort identified through a large Veterans' Administration dataset.ParticipantsSix hundred and ninety-two participants aged 30 years and older, undergoing their first diabetes and/or peripheral artery disease-related amputation at the transmetatarsal, transtibial, or transfemoral level, with a subset of 60 consecutive participants with a self-reported K-level.Main measuresAMPSIMM, Locomotor Capability Index-5 (LCI-5), K-levels, and PROMIS Global-10 Physical (PROMIS-P), at one year post amputation.ResultsThe strength of the correlation between AMPSIMM and LCI-5 scores was large (Spearman's rho = .88; <i>p</i> < .0001). The correlation with PROMIS-P scores was 0.67 (<i>p</i> < .0001). The strength of the correlation between the AMPSIMM-4 and self-reported K-levels was large (Spearman's rho = .82; <i>p</i> < .0001).ConclusionsThe AMPSIMM is a clinician-friendly single-item patient-reported measure that can capture a broad range of lower limb amputation mobility, from wheelchair to advanced community ambulation, with or without a prosthesis, and with or without ambulation aids. It demonstrates strong criterion and construct validity. The AMPSIMM-4 can be generated directly from the AMPSIMM with descriptors that are very similar to and are highly correlated with self-reported K-levels.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"646-658"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699634","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":"Facilitators and barriers to physical activity in patients in an acute care hospital setting from an interprofessional perspective: A qualitative study.","authors":"Gesche Gertz, Gesche Ketels, Susanne Gr Klotz","doi":"10.1177/02692155251325614","DOIUrl":"10.1177/02692155251325614","url":null,"abstract":"<p><p>ObjectivePhysical activity levels of patients in hospital are low. The aim of this study was to explore the perceptions of physiotherapists, nurses, and physicians about physical activity of hospitalized patients.DesignQualitative focus group study using phenomenology.SettingUniversity hospital.ParticipantsThirty healthcare professionals (physiotherapists, nurses, and physicians) participated in six focus groups.Main measuresSemi-structured focus groups following an interview guide were conducted. Besides identification of influencing factors and development of ideas for associated interventions, participants should reflect on the roles of different professions. Content analysis of the transcriptions was performed in iterative cycles involving three researchers using inductive coding and redefining based on the literature. Consensus was reached through discussions in the research team.ResultsThree themes of influencing factors on physical activity of patients in hospital with seven codes emerged. In the theme \"patient\" physical and psychosocial factors were mentioned. The theme \"organization\" pooled all factors regarding facilities and processes. The third theme \"health literacy\" has an impact on the two other themes. In this theme self-efficacy, handling of health literacy/knowledge, and communication and cooperation became apparent as codes.ConclusionsHealth literacy plays an important role in the physical activity of patients in hospital. The developed model of influencing factors on physical activity highlights the importance of health literacy for all stakeholders, including patients, staff, and the organization and illustrates the connections to other influencing factors. This model can be helpful in conceptualizing interventions to promote physical activity.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"668-678"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099017/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604230","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":"Exploring the experience of people with shoulder osteoarthritis and their perceptions of non-surgical management: A qualitative study.","authors":"Stacey Lalande, Maria Moffatt, Toby Smith, Chris Littlewood","doi":"10.1177/02692155251325613","DOIUrl":"10.1177/02692155251325613","url":null,"abstract":"<p><p>ObjectiveTo investigate the experience of people with shoulder osteoarthritis and their perception of non-surgical management in the U.K. National Health Service (NHS).DesignQualitative design, using semi-structured telephone interviews. Two authors (SL and MM) performed coding and theme development following principles of reflexive thematic analysis.SettingPhysiotherapy services within three NHS trusts in England. Individual interviews were conducted with patients with a diagnosis of shoulder osteoarthritis.ParticipantsTen participants were recruited (age range 57-86 years; six females; five with bilateral shoulder osteoarthritis).ResultsParticipants reported significant pain, functional limitations, and emotional distress. Non-surgical management experiences varied, with some finding relief from steroid injections, analgesia, and physiotherapy, while others reported limited perceived effectiveness. All participants expressed a desire for more information and support. There were divergent views on the need for surgery.ConclusionThis is the first study to explore the experiences of people with symptomatic shoulder osteoarthritis who have received care within an NHS setting. It highlights the significant impact of shoulder osteoarthritis on daily life and the challenges faced in accessing appropriate care. Findings emphasise the need for patient-centred care, including education, support, information provision and consideration of psychosocial factors. Future research is required to develop an evidence-based guideline for non-surgical management of shoulder osteoarthritis.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"659-667"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656284","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":"Immediate effect of extracorporeal shockwave therapy in patients with chronic nonspecific low back pain: A randomized placebo-controlled triple-blind trial.","authors":"Cláudio Gregório Nuernberg Back, Rafaela Peron, Camilla Vitória Rios Lopes, João Victor Estevam de Souza, Richard Eloin Liebano","doi":"10.1177/02692155251333532","DOIUrl":"10.1177/02692155251333532","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"701-702"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961441","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":"Non-surgical interventions for arthrofibrosis following knee joint replacement: A systematic review.","authors":"Michelle C Hall, Benjamin Smith, Katie J Sheehan, Stefanny Guerra, Bushra Abdunour, Melanie Narayanasamy, Joanne Stocks, Fiona Moffatt, Catherine Sackley","doi":"10.1177/02692155251325624","DOIUrl":"10.1177/02692155251325624","url":null,"abstract":"<p><p>ObjectiveTo evaluate the effectiveness of non-surgical interventions for knee stiffness or arthrofibrosis following knee replacement surgery.Data sourcesOvid MEDLINE, Ovid Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Cumulative Index to Nursing and Allied Health Literature (CINAHL)were searched from database inception to October 2024.Review methodsAll studies of non-surgical interventions (versus any/no comparator) for adults who developed knee stiffness or a diagnosis of arthrofibrosis following knee replacement were included. Selection, quality appraisal and extraction were completed in duplicate. Results were synthesised narratively. The risk of bias was assessed, and GRADE criteria were used to evaluate evidence quality.ResultsSixteen studies were included, comprising two randomised-controlled trials (n = 76), one non-randomised controlled trial (n = 35), seven cohort studies (n = 352) and six case studies (n = seven). Interventions varied widely including exercise, manual therapy, mechanical devices, and education. Improvements in knee range of movement were reported with some demonstrating functional gains >110° of knee flexion, but the evidence was of low quality. Limited reporting of intervention descriptions, patient-relevant outcomes including function and pain, and longer-term follow-up hindered comprehensive evaluation.ConclusionThe review highlights the heterogeneity of interventions, emphasising the need for standardised reporting. While some studies showed promise, the lack of control groups, small sample sizes, and varied follow-up durations limit conclusive findings. There is insufficient evidence to support any specific non-surgical interventions for arthrofibrosis post-arthroplasty. Further research should be a priority.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"580-599"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669292","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":"Changes in mobility after community-based prosthesis fitting and rehabilitation in people with major lower limb amputations: a cohort study.","authors":"Inger Mechlenburg, Lisa Urup Tønning, Rikke Ørholst, Cecilie Iversen, Kajsa Lindberg, Morten Tange Kristensen","doi":"10.1177/02692155251336566","DOIUrl":"https://doi.org/10.1177/02692155251336566","url":null,"abstract":"<p><p>ObjectiveTo investigate changes in mobility in adults with recent major lower limb amputation participating in community-based rehabilitation. Second, to assess the impact of amputation level (transtibial versus transfemoral) on mobility changes.DesignCohort study.SettingRehabilitation Centre in Copenhagen Municipality.SubjectsA total of 265 individuals with recent major lower limb amputations were prospectively recruited into a cohort from 2008 to 2022 as part of routine practice.MethodsFour physiotherapists collected data on age, sex, level of amputation (transtibial/transfemoral) and assessed mobility at start of walking out of parallel handrail (baseline) and at the end (follow-up) of rehabilitation. Mobility was assessed with the Timed-Up-and-Go test, 10-Meter Walk test, and 2-Minute Walk test. The impact of amputation level was analyzed using multivariable linear regression adjusted for age and sex.ResultsA total of 199 individuals (153 men) mean age of 64.9 (standard deviation 12.2) years had baseline and follow-up mobility data and were eligible for the study. Mobility significantly improved on all tests for individuals with both amputation levels after community rehabilitation. Multivariable analysis showed that individuals with transfemoral amputations on average improved with 17.9 seconds more (95% confidence interval: 12.7-23.1) than transtibial completing the Timed-Up-and-Go test. Contrary, transtibial walked 0.11 meter/second faster (95% confidence interval: 0.02-0.20) and 7.2 meters (95% confidence interval: -1.4 to 15.8) longer in the 10-Meter Walk test and 2-Minute Walk test respectively than transfemoral amputees.ConclusionAdults with lower limb amputations improved their mobility significantly from baseline to follow-up. Individuals with transfemoral amputations improved more than transtibial amputations on functional mobility.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251336566"},"PeriodicalIF":2.6,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968401","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":"Physiological and perceptual demand of gait training on inpatient physiotherapists.","authors":"Katelyn D Bosteder, Dannae Arnold, Jaime Gillespie, Neha Chand, Sheridan Merkle, Megan McCorkle, Monica Bennett, Seema Sikka, Rosemary Dubiel, Simon Driver, Chad Swank","doi":"10.1177/02692155251334286","DOIUrl":"https://doi.org/10.1177/02692155251334286","url":null,"abstract":"<p><p>ObjectiveTo describe the physiological and perceptual demand among physiotherapists delivering gait training interventions using usual care and overground robotic exoskeleton approaches for patients with neurological injuries during inpatient rehabilitation.DesignSingle-centre, prospective observational study.SettingInpatient Rehabilitation Hospital.ParticipantsPhysiotherapists trained in neurorehabilitation.InterventionPhysiotherapists conducted two gait training sessions (one usual care and one overground robotic exoskeleton) while physiological and perceptual demand was assessed.Main measuresPhysiological (oxygen consumption, metabolic equivalents and heart rate) and perceptual demand were measured using a wearable metabolic system and the National Aeronautics and Space Administration Task Load Index, respectively.ResultsPhysiotherapists (<i>n</i> = 4) were female, median (min-max) age = 35(34-44) years, non-Hispanic, 50% White, with 11(5-19) years of experience. Physiological demand was lower in overground robotic exoskeleton than usual care in oxygen consumption [13.5(11.3-15.3) versus 16.4(13.5-18.6) millilitres of oxygen/minute/kilogramme of body mass], metabolic equivalents [3.9(3.2-4.4) versus 4.7(3.8-5.3)], average heart rate [111(90-136) versus 119(103-145) beats per minute], peak heart rate [121(101-149) versus 149(116-162) beats per minute] and recovery heart rate [113(88-148) versus 123(105-161) beats per minute]. Perceptual demand was lower in overground robotic exoskeleton than usual care in mental [7(5-16) versus 12(6-17)], physical [10(8-12) versus 16.5(14-21)] and temporal demand [3.5(1-9) versus 12.5(2-16)], performance [5(3-16) versus 11(4-17)], effort [9(6-15) versus 16.5(13-17)] and frustration [3(1-7) versus 5.5(3-8)].ConclusionsDelivery of overground robotic exoskeleton gait training was associated with lower physiological and perceptual demand compared to usual care gait training in patients with neurological injuries during inpatient rehabilitation. Identifying modalities with low demand may reduce physiotherapist burnout and workplace injuries.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155251334286"},"PeriodicalIF":2.6,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991679","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":"10.1177/02692155251321013","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"561-562"},"PeriodicalIF":2.6,"publicationDate":"2025-04-01","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}