Clinical Rehabilitation最新文献

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Wrist Stabilising Exercise Versus Hand Orthotic Intervention for Persons with Hypermobility - A Randomised Clinical Trial. 针对多动症患者的腕部稳定运动与手部矫形器干预--随机临床试验。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-10-29 DOI: 10.1177/02692155241293265
Lindholm Susanne, Claesson Lisbeth
{"title":"Wrist Stabilising Exercise Versus Hand Orthotic Intervention for Persons with Hypermobility - A Randomised Clinical Trial.","authors":"Lindholm Susanne, Claesson Lisbeth","doi":"10.1177/02692155241293265","DOIUrl":"10.1177/02692155241293265","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effectiveness of wrist stabilisation exercises compared to conventional intervention, whether it reduces pain and/or paraesthesia in the hand, as well as how the interventions affected activity ability, health-related quality of life and effects on hand function and grip strength in people with Hypermobility Diagnosis.</p><p><strong>Design: </strong>A randomised controlled trial.<b>Setting</b>: Units of Occupational therapy in Primary Care, Kalmar County Council, SwedenParticipants: The study included 169 participants' data randomised to the Exercise group (n = 83) or the Control group (n = 86). The samples consisted of adults in diagnosed Hypermobility Spectrum Disorders or hypermobility Ehlers Danlos Syndrome with symptoms of pain and/or paraesthesia in the hands in the last three years.<b>Interventions</b>: The Exercise group trained according to structured progressive exercises and weights programme. The Control group used the hand orthosis during selected activities. Both groups performed randomised intervention for 12 weeks.<b>Main measures</b>: The primary outcome was the Disabilities of Arm, Shoulder, and Hand questionnaire. Secondary outcomes were the Grip Ability Test, the Jamar dynamometer and the EuroQol EQ-5D.</p><p><strong>Results: </strong>There were 116 subjects who completed the intervention. There were no statistically significant difference between the wrist stabilisation exercise and the conventional intervention in terms of activity ability, health-related quality of life, hand function, grip strength, pain or paraesthesia in people with Hypermobility Spectrum Disorders or hypermobility Ehlers Danlos Syndrome.</p><p><strong>Conclusion: </strong>There is no statistically significant difference between the Exercise group and the Control group regarding activity ability after 12 weeks intervention period.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"47-57"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521209","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}
引用次数: 0
Outcomes after inpatient rehabilitation for older adults with hip fractures: A cross-sectional study. 髋部骨折老年人住院康复后的疗效:横断面研究。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-11-25 DOI: 10.1177/02692155241300647
Se Won Lee, Carol Elsakr, Keong M Joung, Napatkamon Ayutyanont
{"title":"Outcomes after inpatient rehabilitation for older adults with hip fractures: A cross-sectional study.","authors":"Se Won Lee, Carol Elsakr, Keong M Joung, Napatkamon Ayutyanont","doi":"10.1177/02692155241300647","DOIUrl":"10.1177/02692155241300647","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics of older adults undergoing inpatient rehabilitation after hip fractures and to find factors associated with discharge location.</p><p><strong>Design: </strong>Cross-sectional analysis.</p><p><strong>Setting: </strong>Inpatient rehabilitation units in the United States.</p><p><strong>Participants: </strong>≥65 years old patients with hip fractures.</p><p><strong>Intervention: </strong>Inpatient rehabilitation with ≥1 hour of physical and occupational therapy per weekday.</p><p><strong>Main measures: </strong>Home versus nonhome discharges.</p><p><strong>Results: </strong>79% of 7439 (<i>n</i> = 5,908) patients were discharged to home after a median stay of 14 days, while 13% (<i>n</i> = 990) were discharged to skilled nursing facilities. 6% (<i>n</i> = 423) were transferred to acute care during rehabilitation stay. Functional mobility levels for bed-to-chair transfer and sit-to-stand at admission were significantly lower in patients discharged to facilities than in patients discharged to home. Older age (OR 0.97 per 1 year, CI 0.96-0.98); comorbidities of dementia (OR 0.68, CI 0.56-0.83) and cerebrovascular disease (OR 0.53, CI 0.36-0.78); and the use of opioid analgesics (OR 0.71, CI 0.56-0.91), antipsychotics (OR 0.73, CI 0.58-0.92), and anticonvulsants (OR 0.81, CI 0.67-0.96), and lower initial functional levels in bed-to-chair transfers (OR 0.08, CI 0.05-0.12) for dependent level; OR 0.16, CI 0.10-0.25 for level requiring maximal assistance; OR 0.38, CI 0.24-0.60 for level requiring partial, moderate assistance), were associated with a decreased likelihood of discharge to home after inpatient rehabilitation.</p><p><strong>Conclusion: </strong>Older adults with dementia, cerebrovascular disorders, and lower bed-to-chair transfer mobility levels at admission after hip fractures may benefit from additional targeted rehabilitation to improve the chances of a successful community discharge.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"35-46"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142709251","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}
引用次数: 0
The Oswestry Disability Index is not a good measure for low back pain in adolescents: A Rasch analysis of data from 200 people. 奥斯韦特里残疾指数(Oswestry Disability Index)并不能很好地衡量青少年的腰背痛:对 200 人数据的 Rasch 分析。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-11-08 DOI: 10.1177/02692155241296802
Mitchell Selhorst, Todd Degenhart, Michael Jackowski, Samuel Meyer, Alexander Rospert
{"title":"The Oswestry Disability Index is not a good measure for low back pain in adolescents: A Rasch analysis of data from 200 people.","authors":"Mitchell Selhorst, Todd Degenhart, Michael Jackowski, Samuel Meyer, Alexander Rospert","doi":"10.1177/02692155241296802","DOIUrl":"10.1177/02692155241296802","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the psychometric properties of the modified Oswestry Disability Index in adolescents with low back pain through Rasch analysis.</p><p><strong>Design: </strong>This is a psychometric study.</p><p><strong>Setting: </strong>Physical therapy clinics of a large pediatric hospital in Columbus, Ohio (United States).</p><p><strong>Subjects: </strong>Two hundred adolescent patients with low back pain (112 female, 15.4 ± 1.9 years old).</p><p><strong>Main measure: </strong>The modified Oswestry Disability Index.</p><p><strong>Results: </strong>The mean modified Oswestry Disability Index score was 17.1 ± 12.1, with scores ranging from 0 to 56 on the 100-point scale. The Rasch person reliability for the Oswestry Disability Index was 0.70, representing minimal acceptable person reliability. The Oswestry Disability Index demonstrated poor item spacing, hierarchy, and targeting of the adolescents' disability level (>1 logit between person mean and item mean). A significant misfit was observed in three of 10 items. There were significant issues with the functioning of responses on all items of the Oswestry Disability Index. Principal component analysis of residuals revealed a ratio of 5.3:1, demonstrating acceptable unidimensionality.</p><p><strong>Conclusion: </strong>Due to multiple psychometric issues, the Oswestry Disability should not be used to assess disability in adolescents with low back pain. The Oswestry Disability Index significantly mistargets adolescent ability and only provides an acceptable assessment of the most disabled adolescents.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"58-66"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142603596","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}
引用次数: 0
Validation of the World Health Organization Rehabilitation Competency Framework: An illustration using physiotherapy. 世界卫生组织康复能力框架的验证:使用物理疗法的说明。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-12-10 DOI: 10.1177/02692155241300271
Marieke Mocke, Marianne Unger, Susan Hanekom
{"title":"Validation of the World Health Organization Rehabilitation Competency Framework: An illustration using physiotherapy.","authors":"Marieke Mocke, Marianne Unger, Susan Hanekom","doi":"10.1177/02692155241300271","DOIUrl":"10.1177/02692155241300271","url":null,"abstract":"<p><strong>Objective: </strong>The World Health Organization's Rehabilitation 2030 initiative represents a new strategic direction for the worldwide rehabilitation community and their Rehabilitation Competency Framework (RCF) was designed to describe the requirements of a rehabilitation workforce. This study aimed to identify and review global physiotherapy competencies and explore their congruence with the WHO-RCF.</p><p><strong>Design: </strong>A document review and thematic analysis were conducted on competency documents sourced from World Physiotherapy member countries.</p><p><strong>Methods: </strong>A three-pronged search strategy was used to identify physiotherapy competencies in all World Physiotherapy members that were listed on their website at the time of the study. All competency statements identified were sorted using the definitions of the five domains of the WHO-RCF. A desktop inductive thematic analysis of competencies was conducted to derive a conceptual framework for future competency framework development.</p><p><strong>Results: </strong>Two thousand and one competency statements were extracted from 20 documents, all accommodated within the WHO-RCF. From the dataset, a conceptual framework was developed consisting of 17 themes and 59 sub-themes across five domains. Technological competence, entrepreneurship and broader competencies to advance the social justice agenda were identified as gaps.</p><p><strong>Conclusion: </strong>To promote homogeneity, it is recommended that all rehabilitation professionals utilise a similar methodology using the WHO-RCF to develop future frameworks that are contextually relevant. Competencies needed for change in support of equitable access and better health for all should be included.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"88-98"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776352/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799642","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}
引用次数: 0
Letter to the Editor Concerning the Article: 'Effect of a Transitional Tele-Rehabilitation Programme on Quality of Life of Adult Burn Survivors: A Randomised Controlled Trial'. 就文章致编辑的信:过渡性远程康复计划对成年烧伤幸存者生活质量的影响:随机对照试验"。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-10-29 DOI: 10.1177/02692155241295975
Özden Özkal
{"title":"Letter to the Editor Concerning the Article: 'Effect of a Transitional Tele-Rehabilitation Programme on Quality of Life of Adult Burn Survivors: A Randomised Controlled Trial'.","authors":"Özden Özkal","doi":"10.1177/02692155241295975","DOIUrl":"10.1177/02692155241295975","url":null,"abstract":"","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"132-133"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521208","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}
引用次数: 0
Effects of mirror therapy on upper limb motor function of patients with stroke: A systematic review and meta-analysis of randomized controlled trials. 镜像疗法对中风患者上肢运动功能的影响:随机对照试验的系统回顾和荟萃分析。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2025-01-21 DOI: 10.1177/02692155241299211
Ita Daryanti Saragih, Ratna Puji Priyanti, Sakti Oktaria Batubara, Bih-O Lee
{"title":"Effects of mirror therapy on upper limb motor function of patients with stroke: A systematic review and meta-analysis of randomized controlled trials.","authors":"Ita Daryanti Saragih, Ratna Puji Priyanti, Sakti Oktaria Batubara, Bih-O Lee","doi":"10.1177/02692155241299211","DOIUrl":"10.1177/02692155241299211","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to investigate and review the effects of mirror therapy on upper limb function, including improvements in shoulder, elbow, forearm, wrist, and hand function, as well as coordination between the upper extremities, in patients with stroke.</p><p><strong>Data sources: </strong>Six databases, CINAHL Plus with Full Text, Cochrane Central Register of Controlled Trials, Embase, Medline Complete, PubMed, and Web of Science, were searched from database inception to 15 October 2024, as well as manual searching of Google Scholar, for relevant trials.</p><p><strong>Review methods: </strong>The methodological quality of the trials was assessed using version 2 of the Cochrane risk-of-bias tool with five domains. A random-effects model was applied to calculate the pooled mean difference of dichotomous variables using the 95% confidence interval. The variance in effect estimation in a forest plot for each trial was then quantified using <i>I</i><sup>2</sup>.</p><p><strong>Results: </strong>Eighteen studies, representing 633 patients with stroke, were included in this study. Mirror therapy significantly improved upper limb motor function (mean difference [MD] = 1.79; 95% CI = 0.04-3.54; <i>p</i> = 0.04) and hand function (MD = 1.48; 95% CI = 0.17-2.78; <i>p</i> = 0.03) in patients with stroke. Subgroup analyses of overall upper limb function showed that mirror therapy was effective in improving function when delivered more than 5 times a week (MD = 2.75; 95% CI = 1.02-4.48) over a period of ≤ 4 weeks (MD = 3.26; 95% CI = 1.19-5.33). The results of the methodology assessment using RoB-2 on all the trials included in the analysis showed that 16 trials were considered to have some concerns.</p><p><strong>Conclusion: </strong>Mirror therapy appears to be beneficial for improving upper limb motor function after stroke. More trials are needed to determine the effects of mirror therapy on shoulder/elbow/forearm, wrist, and hand function and coordination between upper extremities after stroke.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"23-34"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001328","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}
引用次数: 0
Influences on the physical activity behaviour of inpatients after stroke outside of staff-led rehabilitation sessions: a systematic review. 中风后住院病人在工作人员指导的康复课程之外进行体育锻炼的影响因素:系统综述。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-11-10 DOI: 10.1177/02692155241293269
Peter Hartley, Katie Bond, Rachel Dance, Isla Kuhn, Joanne McPeake, Faye Forsyth
{"title":"Influences on the physical activity behaviour of inpatients after stroke outside of staff-led rehabilitation sessions: a systematic review.","authors":"Peter Hartley, Katie Bond, Rachel Dance, Isla Kuhn, Joanne McPeake, Faye Forsyth","doi":"10.1177/02692155241293269","DOIUrl":"10.1177/02692155241293269","url":null,"abstract":"<p><strong>Objective: </strong>To use behavioural science frameworks to synthesise evidence on the factors influencing physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions.</p><p><strong>Data sources: </strong>A systematic review of qualitative and mixed-methods studies. MEDLINE, PsycINFO, CINAHL, and AMED were searched from inception to October 2024 for studies that explored influences on the physical activity of patients hospitalised after stroke.</p><p><strong>Review methods: </strong>Data were coded with reference to the Theoretical Domains Framework and the COM-B ('capability', 'opportunity', 'motivation' and 'behaviour') model. Thematic analysis was used to group data extracts into themes within each Theoretical Domains Framework domain. Risk of bias was assessed using the Mixed Methods Appraisal Tool.</p><p><strong>Results: </strong>We identified 17 studies. There was no significant risk of bias concerns. We identified 19 themes across eight Theoretical Domains Framework domains and all COM-B model categories. The most frequently recognised themes were found in three Theoretical Domains Framework domains: Environmental Context and Resources (themes: 1 -- availability of sufficient skilled staff to facilitate physical activity; 2 - design and use of the physical environment; 3 - lack of opportunities or incentives; 4 - passivity and institutionalisation; 5 - perceived and actual rules and culture of the ward); Skills (theme: physical impairments); and Social Influences (theme: activity influenced by family and friends).</p><p><strong>Conclusions: </strong>The review highlights the complexity of the influences on the physical activity of patients hospitalised after stroke outside of staff-led rehabilitation sessions. It is likely multi-component interventions addressing a number of influences will be required to effectively improve physical activity. PROSPERO ID: CRD42022383506.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"109-127"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615870","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}
引用次数: 0
Reliability, validity and usability of the K-force® grip dynamometer to evaluate handgrip-strength in patients with intensive care unit-acquired weakness. 用 K-force® 握力器评估重症监护室乏力患者手握强度的可靠性、有效性和可用性。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-11-10 DOI: 10.1177/02692155241295979
Ingrid D van Iperen, Daphne Stegink, Barbara L Tempert-de Haan, Marleen Flim, Robert van der Stoep, Peter E Spronk
{"title":"Reliability, validity and usability of the K-force<sup>®</sup> grip dynamometer to evaluate handgrip-strength in patients with intensive care unit-acquired weakness.","authors":"Ingrid D van Iperen, Daphne Stegink, Barbara L Tempert-de Haan, Marleen Flim, Robert van der Stoep, Peter E Spronk","doi":"10.1177/02692155241295979","DOIUrl":"10.1177/02692155241295979","url":null,"abstract":"<p><strong>Objective: </strong>Handgrip dynamometry is recognised as a method for evaluating volitional muscle strength in the intensive care, but conventional handgrip dynamometers cannot accurately measure grip strength in very weak patients. The aim of this study was to determine the reliability, validity and usability of the K-force<sup>®</sup> grip in patients with intensive care unit-acquired weakness.</p><p><strong>Design: </strong>Evaluation of measurement properties of the K-force<sup>®</sup> grip.</p><p><strong>Setting: </strong>Two Intensive Care Units in The Netherlands.</p><p><strong>Participants: </strong>Patients diagnosed with intensive care unit-acquired weakness according to a Medical Research Council sum score <48.</p><p><strong>Intervention & main measures: </strong>Intra- and inter-rater reliability of the K-force<sup>®</sup> grip were assessed using the intraclass correlation coefficient. Concurrent validity was examined using calibration weights. The usability was evaluated with the System Usability Scale.</p><p><strong>Results: </strong>Intra-rater reliability showed an intraclass correlation coefficient of 0.987 for the dominant hand and 0.972 for the non-dominant hand. Inter-rater reliability showed coefficients of 0.944 for the dominant hand and 0.942 for the non-dominant hand. There was a perfect correlation (<i>r</i> = 1) between the K-force® grip and the calibration weights. The usability of the K-force® grip was rated excellent by 11 healthcare professionals with a System Usability Scale score of 86.</p><p><strong>Conclusions: </strong>The K-force<sup>®</sup> grip is a promising new tool for the evaluation of muscle strength in intensive care unit-acquired weakness patients who are too weak to use conventional hand dynamometers.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"67-77"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142615883","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}
引用次数: 0
Exploring physiotherapy staff's perceptions of physiotherapy delivery in acute stroke rehabilitation. 探索物理治疗人员对急性中风康复中物理治疗服务的看法。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-11-21 DOI: 10.1177/02692155241300091
Jimmy James, Damian Purcell, Mark P McGlinchey
{"title":"Exploring physiotherapy staff's perceptions of physiotherapy delivery in acute stroke rehabilitation.","authors":"Jimmy James, Damian Purcell, Mark P McGlinchey","doi":"10.1177/02692155241300091","DOIUrl":"10.1177/02692155241300091","url":null,"abstract":"<p><strong>Objective: </strong>To explore physiotherapists' perspectives on current and alternative models of physiotherapy delivery in acute stroke rehabilitation.</p><p><strong>Design: </strong>Qualitative service evaluation.</p><p><strong>Setting: </strong>An acute stroke rehabilitation unit within a London teaching hospital in the UK.</p><p><strong>Participants: </strong>A purposive sample of 17 physiotherapy staff (qualified physiotherapists and physiotherapy support staff) working in the acute stroke rehabilitation unit at the time of, or in the previous 3 months of the study were recruited to participate.</p><p><strong>Results: </strong>Three themes were identified: barriers to effective physiotherapy delivery, enablers of effective physiotherapy delivery, and alternative models of physiotherapy delivery. Themes were framed by the concept of providing effective and efficient physiotherapy guided by reflection. Main barriers included patients not being ready for and underutilisation of time within physiotherapy sessions. Use of timetabling and access to senior therapy support enabled more effective and efficient physiotherapy delivery. Alternative models to optimise physiotherapy delivery included different staff to patient ratios, group therapy, opportunistic physiotherapy delivery and self-management.</p><p><strong>Conclusions: </strong>Several enablers of and barriers to providing effective and efficient physiotherapy post-stroke exist. Physiotherapists should consider implementing alternative models of physiotherapy delivery to increase the amount of physiotherapy provided to patients' post-stroke, thereby facilitating post-stroke functional recovery.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"99-108"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681013","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}
引用次数: 0
Several components of postural control are affected by benign paroxysmal positional vertigo but improve after particle-repositioning maneuvers: A systematic review and meta-analysis. 良性阵发性位置性眩晕会影响姿势控制的几个组成部分,但在进行粒子定位操作后会有所改善:系统回顾和荟萃分析。
IF 2.6 3区 医学
Clinical Rehabilitation Pub Date : 2025-01-01 Epub Date: 2024-11-05 DOI: 10.1177/02692155241292662
Sara Pauwels, Laura Casters, Pieter Meyns, Nele Lemkens, Winde Lemmens, Kenneth Meijer, Raymond van de Berg, Joke Spildooren
{"title":"Several components of postural control are affected by benign paroxysmal positional vertigo but improve after particle-repositioning maneuvers: A systematic review and meta-analysis.","authors":"Sara Pauwels, Laura Casters, Pieter Meyns, Nele Lemkens, Winde Lemmens, Kenneth Meijer, Raymond van de Berg, Joke Spildooren","doi":"10.1177/02692155241292662","DOIUrl":"10.1177/02692155241292662","url":null,"abstract":"<p><strong>Objective: </strong>Benign Paroxysmal Positional Vertigo is a vestibular disorder causing vertigo and imbalance. This systematic review and meta-analysis aims to explore the impact of benign paroxysmal positioning vertigo and repositioning maneuvers on postural control.</p><p><strong>Data sources: </strong>In September 2024, PubMed, Web of Science, Scopus and reference lists of included studies were systematically searched. Articles comparing measures of postural control between patients and controls, and/or pre- and posttreatment were considered relevant.</p><p><strong>Methods: </strong>Study selection, data extraction and identification of risk of bias were done by two researchers. If possible, meta-analysis was performed with Review Manager version 5.4.1 and standardized mean differences were calculated with a random-effects model.</p><p><strong>Results: </strong>Twenty-one of the 37 included studies were useful for meta-analyses. Meta-analyses revealed that benign paroxysmal positional vertigo negatively affects perception of verticality (p < .001; SMD = 0.73; 95% CI = [0.39;1.08]) and sensory orientation (p < .001; SMD = -1.66; 95% CI = [-2.08, -1.23]). The perception of verticality (p < .001; SMD = 0.99; 95% CI = [0.76;1.21]) and sensory orientation (p < .001; SMD = -0.77; 95% CI = [-1.11, -0.44]) improved after treatment with repositioning maneuvers. Results of systematic review indicate stability in gait was impaired, vertigo but improve after repositioning maneuvers. Limits of stability were impaired in older patients, but did not improved after repositioning maneuvers.</p><p><strong>Conclusion: </strong>Benign paroxysmal positioning vertigo affects several underlying components of postural control. Repositioning maneuvers can significantly improve the related postural control impairments. This may partly explain the increased odds of falling in these patients, and the positive treatment effect of repositioning maneuvers on falls and fear of falling.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"3-22"},"PeriodicalIF":2.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582413","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}
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