Clinical Rehabilitation最新文献

{"title":"Emergent motion capture technology for upper extremity assessment in stroke: A systematic scoping review.","authors":"Jarrad Fisher, Kate Makroglou, Justine Tinker, Christine T Shiner, Alexandra Hurden, Jack Weston, Lorraine Li, Ceyaan Rauniyar, Natasha A Lannin, Craig S Anderson, Xiaoying Chen","doi":"10.1177/02692155261420748","DOIUrl":"10.1177/02692155261420748","url":null,"abstract":"<p><p>ObjectiveTo systematically appraise motion capture technologies used for clinical assessment of upper limb function in adults post stroke, focusing on applicability, strengths, limitations, and research gaps.Data SourcesA systematic scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed, MEDLINE, CINAHL, CENTRAL, and IEEE Xplore were searched for studies published between January 2014 and December 2025.Review MethodsEligible studies quantitatively evaluated motion capture systems in adult stroke populations. Data extracted included technology type, technical specifications, outcomes, and reported strengths and limitations.ResultsFrom 3217 screened studies, 204 were included. Inertial measurement units were most common (71) followed by markerless optical motion capture (43), electromyography (39), marker-based optical motion capture (33), fusion systems (10), and smart devices (8). Marker-based systems provided high precision but were costly and complex. Markerless systems reduced setup requirements and supported clinical use but were prone to tracking errors. Inertial measurement units enabled portable monitoring, though accuracy decreased for slow or fine movements. Electromyography offered insights into neuromuscular activity but was expensive and sensitive to placement. Fusion systems allowed multidimensional assessment but were resource intensive. Smart devices provided accessible options but lacked precision. Most studies focused on chronic stroke, with limited evaluation in acute or home contexts. Reporting of stroke severity was inconsistent, and protocols were rarely standardised.ConclusionMotion capture technologies show promise for upper limb assessment after stroke but face challenges of cost, accessibility, and standardisation. Research in acute and home settings, along with predictive modelling, is needed to support clinical translation.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1195-1215"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147282600","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":"Optimizing exercise interventions for motor skills enhancement in attention deficit hyperactivity disorder: Evidence from meta-analysis.","authors":"Yuxuan Zhang, Xiaoman Che, Zhenghao Dong, Jiaxing Shen, Ye Tao, Bo Cui, Feilong Zhu","doi":"10.1177/02692155261428944","DOIUrl":"10.1177/02692155261428944","url":null,"abstract":"<p><p>ObjectiveThis meta-analysis aimed to evaluate effects of physical exercises on gross and fine motor skills in children and adolescents with attention deficit hyperactivity disorder (ADHD), and to explore the influencing factors and dose-response relationships for optimizing exercise parameters.Data sourcesSix electronic databases were searched from inception to 20 June 2025, with an updated search performed on 27 January 2026.MethodsThe effect sizes were estimated using Hedge's <i>g</i> within three-level random-effects modeling frameworks. Subgroup analyses were performed to examine potential moderators, while restricted cubic splines were employed to characterize dose-response relationships.ResultsTwenty-one studies with 850 participants were included. Physical exercises showed moderate positive effects on both gross motor skills (Hedge's <i>g</i> = 0.62, 95% CI: 0.48-0.76) and fine motor skills (Hedge's <i>g</i> = 0.72, 95% CI: 0.54-0.90). Significant improvements were observed in subcomponents of gross motor skills (locomotion, object control, body coordination, and strength) and fine motor skills (manual dexterity, hand-eye coordination, and handwriting). Moderator analyses indicated that longer session durations (>45 min) and higher frequencies (≥3 sessions/week) were associated with greater benefits. Fine motor skills (∼1350 min) appeared to require greater cumulative exercise exposure than gross motor skills (∼810 min) to achieve substantial gains.ConclusionPhysical exercise is an effective intervention for improving motor skills in children and adolescents with ADHD. However, the effectiveness of interventions appears to be moderated by motor subcomponents and dose parameters. Tailored programs, specific motor skill targets and dose parameters, should be integrated into clinical and educational practices to maximize outcomes.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1177-1194"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364334","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 interventions for the management of treatment-induced trismus in people with head and neck cancer: A scoping review.","authors":"Ernesto Anarte-Lazo, Ana Bravo-Vazquez, Carlos Bernal-Utrera, Daniel Torres-Lagares, Cleofas Rodriguez-Blanco, Deborah Falla","doi":"10.1177/02692155261426637","DOIUrl":"10.1177/02692155261426637","url":null,"abstract":"<p><p>ObjectiveTrismus is a common and debilitating complication following head and neck cancer treatment, with significant consequences for quality of life, nutrition and oral function. Although several rehabilitation strategies have been proposed, their design and effectiveness remain poorly systematized. This review aimed to summarize evidence from randomized controlled trials on rehabilitation interventions for treatment-induced trismus in HNC.Data sourcesA scoping review was performed using PubMed, PEDro, Web of Science, Scopus and EMBASE, covering publications up to May 2025.Review methodsWe included randomized controlled trials in English or Spanish evaluating any rehabilitation intervention in adults with trismus following HNC treatment. One author conducted the search, and two authors independently screened articles for inclusion.ResultsFrom 2215 records identified, 25 randomized controlled trials met the inclusion criteria. Twelve investigated preventions during or shortly after cancer treatment, while 13 addressed established trismus. Most interventions were based on exercise therapy, delivered in hospitals, private clinics or at home. Only a minority incorporated manual therapy or physical agents. Devices such as TheraBite or JawTrainer were evaluated in several studies. While most trials reported improvements in maximal mouth opening, few assessed condition-specific patient-reported outcomes. Rehabilitation interventions were predominantly implemented by physiotherapists.ConclusionExercise therapy, often combined with devices, is the most frequently studied approach for treatment-induced trismus. Evidence for manual therapy and physical modalities remains limited. Considerable heterogeneity across studies hinders comparison and replication, underlining the need for standardized protocols and outcomes in future trials.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1160-1176"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147289249","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":"Post-stroke cognitive impairment is associated with poorer return-to-work outcomes in working-aged stroke survivors: A systematic review.","authors":"Libby J Cunningham, Tadhg Stapleton, Killian Walsh, Frances Horgan","doi":"10.1177/02692155261420770","DOIUrl":"10.1177/02692155261420770","url":null,"abstract":"<p><p>ObjectivesTo examine the relationship between post-stroke cognitive impairment and return-to-work outcomes in working-aged stroke survivors and evaluate cognitive assessment methods used in included studies.Data sourcesMEDLINE, EMBASE, CINAHL, and APA PsycINFO databases were searched from 2003 to October 2025 according to PRISMA guidelines.Review methodsTwo reviewers independently screened titles and abstracts for inclusion. Data extraction and quality appraisal was completed by two reviewers. Narrative synthesis was completed due to substantial heterogeneity across studies.ResultsThirty-nine studies met inclusion criteria (observational studies (<i>n</i> = 33), qualitative (<i>n</i> = 5) and randomised control trial (<i>n</i> = 1)). Stroke severity was predominantly mild. Post-stroke cognitive impairment prevalence across study cohorts ranged from 17.5% at 28 days to 89% at 7 years with considerable variance in assessments and timing (range 2 days to 7 years). Concentration, memory and processing speed impairments were most frequently reported. Return-to-work rates ranged from 7.5% to 100%, with no clear trends for time post-stroke or stroke sub-type. Cognition was the most commonly associated variable influencing return-to-work outcomes followed by stroke severity, mood and functional status. The invisible nature of post-stroke cognitive impairment and limited awareness among employers and clinicians was highlighted.ConclusionPost-stroke cognitive impairment is commonly associated with poorer return-to-work outcomes even following milder stroke. Despite high detection, post-stroke cognitive impairment often remains hidden. This review highlights the substantial variation in post-stroke cognitive assessment practices and lack of intervention studies. Findings emphasise the need for consistent assessment and management of post-stroke cognitive impairment and increased awareness of its considerable negative impact on employment outcomes.PROSPERO: CRD42023462322.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"1216-1253"},"PeriodicalIF":2.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146156340","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 short-term compression in people with knee osteoarthritis: A sham-controlled randomised trial.","authors":"Angelica Viana Ferrari, Hugo Jario Almeida Silva, Glauko A F Dantas, Julya P M Perea, Gabriel M Ferretti, Tarcísio F De Campos, Francisco Alburquerque-Sendín, Tania F Salvini","doi":"10.1177/02692155261479928","DOIUrl":"https://doi.org/10.1177/02692155261479928","url":null,"abstract":"<p><p>ObjectiveTo evaluate the effects of knee compression using elastic bandages on pain intensity and physical function in individuals with knee osteoarthritis in the short term.DesignThree-arm, randomised controlled trial.SettingIndividuals with knee osteoarthritis received compression, sham compression, or no bandaging.Main measuresNinety participants were assessed at baseline (Day 1), Day 6 after intervention, and 12 and 24 weeks post-intervention. The primary outcomes were pain intensity assessed using the Visual Analogue Scale and the pain subscale of the Western Ontario and McMaster Universities Osteoarthritis Index. Secondary outcomes included the Western Ontario and McMaster Universities Osteoarthritis Index, physical function tests, and global rating of change.InterventionsThe experimental group received knee compression with elastic bandages for 20 min per day over four consecutive days; sham group used elastic bandages without compression; and the control group received no bandaging.ResultsNo between-group differences reached the minimal clinically important difference for pain measured by the Visual Analogue Scale or Western Ontario and McMaster Universities Osteoarthritis Index pain subscale at any follow-up. Likewise, not clinically important between-group differences were found for Western Ontario and McMaster Universities Osteoarthritis Index or physical function tests. On Day 6, global rating of change favored the experimental versus sham group (-1.5; 95% confidence interval -2.6 to -0.3) and the sham versus control group (-1.4; 95% confidence interval -2.5 to -0.3).ConclusionKnee compression using elastic bandages was not superior to sham or control conditions in reducing pain or improving physical function in individuals with knee osteoarthritis.Level of evidence1b.<b>Trial registration:</b> NCT04724902.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261479928"},"PeriodicalIF":2.9,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148839364","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":"Reliability and validity of the Upper Limb Performance Assessment for functional prehension tasks in adults with stroke: A prospective study.","authors":"Julie Lacombe, Solène Piagno, Benoit Lepage, Margot Morin, Judy Ranka, Camille Cormier, David Gasq, Claire Villepinte","doi":"10.1177/02692155261474839","DOIUrl":"https://doi.org/10.1177/02692155261474839","url":null,"abstract":"<p><p>BackgroundManaging upper limb motor performance in daily living is a challenge for adults with stroke. Current assessments demonstrate limitations for evaluation of personalised activity performance in real environments.ObjectiveTo examine the reliability, validity, clinical utility and interpretability of a standardised ecologically task-based assessment of upper limb motor performance in post-stroke adults using the Upper Limb Performance Assessment.DesignA prospective validation study.SettingA neurorehabilitation centre.Participants100 adults with chronic post-stroke upper limb deficit. Performance was rated by three trained occupational therapists.Main measuresUpper limb movement was analysed through Upper Limb Performance Assessment on a video-recorded prehension drinking task. Prehension was rated for reliability and measurement error with the intra-class correlation coefficient and the minimal difference. Validity was examined with the Fugl-Meyer Assessment for Upper Extremity, the Wolf Motor Function Test, the Motor Activity Log and the Functional Independence Measure according to Spearman's rank correlation coefficient.ResultsReliability demonstrated adequate reliability metrics (intra-class correlation coefficient: 0.87-0.97) and measurement error (12.56%-15.99%) without systematic bias. Convergent validity was strong with the Fugl-Meyer Assessment (Spearman's rank correlation coefficient (ρ)= .76, <i>p</i> < .01), Wolf Motor Function Test (ρ= .72, <i>p</i> < .01), Motor Activity Log (ρ=.67, <i>p</i> < .05) and Functional Independence Measure (ρ=.58, <i>p</i> < .01). Clinical utility for administration time and costs was demonstrated.ConclusionThe Upper Limb Performance Assessment demonstrated excellent reliability among trained raters, adequate convergent validity and interpretability in adults with stroke, demonstrating moderate clinical utility. It presents an interest as an observer-rated performance-based measure of functional prehension in real-life settings.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261474839"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817875","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":"Biofeedback in Parkinson's disease: A systematic review with meta-analysis.","authors":"Arielle Baumgart, Elisabeth Preston, Louise Ada, Maria Tereza M Alvarenga, Juliana Fb de Mondença, Allyson Flynn","doi":"10.1177/02692155261474067","DOIUrl":"https://doi.org/10.1177/02692155261474067","url":null,"abstract":"<p><p>ObjectivesThe objective was to examine whether the addition of biofeedback to practice is effective in improving lower limb activity compared with practice alone for people with Parkinson's disease.Data sourcesFour databases were searched for randomised trials of adults with idiopathic Parkinson's disease. Trials included biofeedback delivered concurrently during practice of sitting, standing up, standing and/or walking compared with the same amount of practice without biofeedback. Outcomes were measures of activity congruent with the activity trained, such as Berg Balance Scale, Timed Up and Go test, and walking speed.Review methodSystematic review with meta-analyses of randomised trials following PRISMA guidelines, using the PEDro scale for risk of bias and GRADE to determine quality of evidence.ResultsTwenty trials were included, involving 814 participants. Biofeedback during the practice of sitting and standing increased Berg Balance Scale score by 1.5 out of 56 (95% CI 0.7 to 2.3), biofeedback during the practice of standing and walking decreased Timed Up and Go time by 0.2 s (95% CI -1.4 to 1.8), and biofeedback during the practice of walking increased walking speed by 0.02 m/s (95% CI -0.06 to 0.1). The quality of the evidence was high for balance, moderate for mobility, and low for walking.ConclusionThis systematic review provides evidence that the addition of biofeedback to the practice of lower limb activities is no more effective than practice alone in people with Parkinson's disease.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261474067"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817828","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":"Predictive validity and clinical relevance of DriveSafe DriveAware as a cognitive assessment of fitness to drive in medically at-risk drivers.","authors":"Belinda Joy Johnston, Joan Margaret O'Donnell, Vanita Parekh, Jacqueline Wesson, Lynette Mackenzie","doi":"10.1177/02692155261471411","DOIUrl":"https://doi.org/10.1177/02692155261471411","url":null,"abstract":"<p><p>ObjectiveTo evaluate the predictive validity and potential clinical relevance of the DriveSafe DriveAware assessment for predicting on-road driving outcomes in medically at-risk drivers.DesignProspective cohort study.SettingFitness-to-drive assessment pathway involving a driver licensing authority, medical review clinic, and occupational therapy driver assessors in the Australian Capital Territory, Australia.ParticipantsA convenience sample of 138 drivers referred for occupational therapy driving assessment because of medical fitness-to-drive concerns.MethodsParticipants completed the DriveSafe DriveAware, comprising DriveSafe and DriveAware subtests, before an on-road driving assessment. On-road outcomes were dichotomised as pass (unrestricted licence) or fail (conditional licence, reassessment, or licence cancellation). Receiver operating characteristic analyses, Youden's Index, and classification accuracy metrics were calculated.ResultsDriveSafe DriveAware demonstrated strong classification performance, with 86% sensitivity, 100% specificity, 100% positive predictive value, and 93% overall accuracy. Eighty-seven percent of participants were classified as <i>Likely to Pass</i> or <i>Likely to Fail</i>, with 13% classified as <i>Further Testing</i>. No participants classified as <i>Further Testing</i> achieved an unconditional pass. DriveSafe and DriveAware subtests showed excellent discrimination (area under the curve = 0.96 and 0.95, respectively). Optimal cut-offs were broadly consistent with previously proposed thresholds. Drivers who failed the on-road assessment were older and had lower DriveSafe and DriveAware subtest scores than those who passed.ConclusionDriveSafe DriveAware showed strong predictive validity in this sample and may support triage and clinical decision-making within fitness-to-drive assessment pathways.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261471411"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817823","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":"Towards global standards in stroke rehabilitation and recovery: An international evaluation of practice alignment.","authors":"Thoshenthri Kandasamy, Rachel C Stockley, Jeroen M Hendriks, Shamala Thilarajah, Noorazah Azah Abd Aziz, Erin Godecke, Jie Jia, Margit Alt Murphy, Elizabeth A Lynch","doi":"10.1177/02692155261478023","DOIUrl":"https://doi.org/10.1177/02692155261478023","url":null,"abstract":"<p><p>ObjectiveTo evaluate how Centres of Clinical Excellence criteria align with routine clinical practice in international stroke rehabilitation centres and explore the factors influencing practices across diverse health systems.DesignMixed-methods study.SettingInternational stroke rehabilitation centres across diverse geographic and economic contexts.ParticipantsClinicians and service leaders representing 15 centres from 10 countries (two lower-middle-income, two upper-middle-income, and six high-income).InterventionEvaluation of how international stroke rehabilitation centres demonstrate performance that aligns with the multidimensional Centre of Clinical Excellence criteria, and exploration of the contextual factors influencing practices across diverse health systems.Main measuresSurvey responses and semi-structured interview data examining patient-centred care, interprofessional practice, workforce development, research, mentorship and organisational structures supporting clinical excellence.ResultsStrong alignment was observed for patient-centred outcomes, interprofessional teamwork, and staff education, supported by established clinical pathways and outcome measurement processes. High-income and metropolitan centres more frequently reported protected time, funding, and formal workforce development structures. Centres in low- and middle-income and regional settings relied more on informal processes due to resource constraints. Across all contexts, leadership development, mentorship, advocacy, research engagement, and continuity of care were inconsistently implemented and documented.ConclusionsCore domains of stroke rehabilitation are well established internationally; however, system-level supports that sustain evidence-based practice vary considerably. Embedding structured leadership, workforce development, research engagement, and advocacy mechanisms alongside routine care may strengthen sustainability, improve consistency of evidence-based practice, and reduce inequities in rehabilitation outcomes.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261478023"},"PeriodicalIF":2.9,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817813","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":"Development and external validation of quality indicators for Neurorehabilitation Units: The REHABest Delphi study.","authors":"Jacobo Formigo-Couceiro, Clara Pérez-Esteve, José María Climent-Barberá, Carlos Cordero-García, Raquel Cutillas-Ruiz, Esther Duarte, Francisco Javier Juan-García, María Lourdes López De Munaín, Rosa Martín-Mourelle, Antonio Montoto-Marqués, Serafín Rodríguez-Palero, Pedro Ignacio Tejada-Ezquerro, Emilio Ignacio-García, Helena Bascuñana-Ambrós","doi":"10.1177/02692155261470080","DOIUrl":"https://doi.org/10.1177/02692155261470080","url":null,"abstract":"<p><p>ObjectiveTo develop a consensus-based framework of quality indicators for Neurorehabilitation Units.DesignDelphi consensus study with two-phase external validation.SettingExpert consultation and external validation were conducted through online questionnaires.ParticipantsTwelve neurorehabilitation experts participated in the Delphi process. External validation involved 63 independent specialists and a multidisciplinary panel of nine professionals.InterventionDevelopment of quality indicators through a three-round Delphi process following Conducting and REporting DElphi Studies (CREDES) recommendations.Main measuresExpert agreement on candidate indicators, with consensus defined a priori as ≥75%.ResultsAn initial qualitative expert-generation phase produced 38 candidate indicators. These were subsequently refined through three Delphi rounds, during which indicators were retained, merged, reformulated, added, or disaggregated according to expert consensus and accreditation level. The final framework comprised 50 indicators categorized into structure (21), process (13), and outcome (16) domains. External validation confirmed the relevance and clarity of the framework, although implementation challenges were identified in centres with heterogeneous resources.ConclusionsThe proposed framework provides a structured set of quality indicators that may support quality assessment, accreditation, and continuous improvement in neurorehabilitation services.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261470080"},"PeriodicalIF":2.9,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148789144","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}