Clinical Rehabilitation最新文献

{"title":"Hospital mobility scale: Measurement properties in neurocritical patients in the intensive care unit (ICU).","authors":"Lucas Lima Ferreira, Roberto Rodrigues Job Júnior, Sandra Regina Alouche, Adriana Claudia Lunardi","doi":"10.1177/02692155261467635","DOIUrl":"https://doi.org/10.1177/02692155261467635","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the measurement properties of the hospital mobility scale (HMS) in neurological patients admitted to the intensive care unit. <b>Design:</b> Measurement properties study. <b>Setting:</b> Neurological intensive care unit. <b>Participants:</b> About 101 neurocritical patients. <b>Intervention:</b> The HMS and the ICU mobility scale were applied at intensive care unit admission. The HMS was reapplied 4 hours later and again at discharge. <b>Main Measures:</b> Inter- and intra-rater reliability were analysed using the intraclass correlation coefficient; measurement error using the standard error of measurement; internal consistency using Cronbach's alpha; construct validity through correlation with the ICU mobility scale total score; floor and ceiling effects using frequency analyses; and responsiveness through effect size (internal), receiver operating characteristic analysis, and correlation with change in ICU mobility scale (external). <b>Results:</b> The HMS demonstrated excellent inter-rater and intra-rater reliability (intraclass correlation coefficient = 0.966 [95%CI 0.946-0.978]; <i>p</i> < 0.001 and 0.955 [95%CI 0.928-0.970]; <i>p</i> < 0.001, respectively), with very good measurement error (standard error of measurement = 5%). Construct validity showed a moderate negative correlation with the ICU mobility scale (<i>r</i> = -0.72; <i>p</i> < 0.001). Internal responsiveness was moderate (effect size = 0.59). External responsiveness showed a moderate correlation with change in ICU mobility scale (<i>r</i> = -0.52; <i>p</i> < 0.001) and a small area under the receiver operating characteristic curve (0.67; 95%CI 0.53-0.81). No floor or ceiling effects were observed. <b>Conclusions:</b> The HMS appears to be a valid and reliable tool for assessing functional mobility in neurological intensive care unit patients; however, its ability to detect short-term changes in mobility over time is limited.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261467635"},"PeriodicalIF":2.9,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148419223","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 effectiveness of cardiovascular rehabilitation for transient ischaemic attack and mild stroke: A randomised controlled trial.","authors":"Lucy Walton, Elisabeth Preston, Allyson Flynn, Rachel Davey, Theophile Niyonsenga, Itismita Mohanty, Shahla Cowans, Christian Lueck, Nicole Freene","doi":"10.1177/02692155261465655","DOIUrl":"https://doi.org/10.1177/02692155261465655","url":null,"abstract":"<p><p>ObjectivesEvaluate the effectiveness of integrated cardiovascular rehabilitation on functional exercise capacity, physical activity, anthropometrics, blood pressure, quality-of-life, anxiety, and depression, for people with transient ischaemic attack (TIA) or mild stroke, over 6 months compared with usual care.DesignRandomised controlled trial.SettingUniversity health centre.ParticipantsAdults (≥18 years) with a TIA or mild stroke in the past 12-months.InterventionOverall, 140 TIA and mild stroke participants were randomised 1:1 to a once-weekly 6-week cardiovascular rehabilitation programme (<i>n</i> = 70), or usual care (<i>n</i> = 70).Main measuresOutcomes assessed at baseline, 6 weeks, and 6 months included 6-min walk test distance (6MWTD), moderate-to-vigorous physical activity, body mass index, waist circumference, blood pressure, Assessment of Quality-Of-Life 6 dimensions (AQoL-6D) and Hospital Anxiety and Depression Scale.ResultsParticipants' median age was 73 years (interquartile range 63-80). Fully-adjusted analyses showed no between-group differences in 6MWTD, while AQoL-6D coping scores improved significantly, favouring cardiovascular rehabilitation at 6 weeks (β:  3.6, 95% CI:  0.07-7.2). There were significant within-group improvements in the intervention group only for AQoL-6D mental health at 6 weeks and coping at 6 months. No other outcomes differed between groups. Subgroup analyses showed small, non-significant 6MWTD gains among TIA intervention participants (Cohen's <i>d</i> = 0.40).ConclusionsCardiovascular rehabilitation was not more effective than usual care in improving exercise capacity, physical activity, anthropometrics, blood pressure, anxiety or depression. Though a short-term quality-of-life improvements suggest psychosocial benefits. Future studies should explore minimum effective programme dosage using sensitive exercise capacity measures, evaluating TIA and mild stroke populations separately.<b>Clinical Trial Registration:</b> Australian New Zealand Clinical Trials Registry: ACTRN12621001586808, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12621001586808.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261465655"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396126","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":"Feasibility of applying the Cognitive Orientation to daily Occupational Performance (CO-OP) approach in a Danish municipal neurorehabilitation context.","authors":"Tove Lise Nielsen, Helene Polatajko, Mette Brandi, Helene Windstrup Holst-Stensborg, Louise Moeldrup Nielsen","doi":"10.1177/02692155261465889","DOIUrl":"https://doi.org/10.1177/02692155261465889","url":null,"abstract":"<p><p>ObjectiveThis feasibility study examined the following aspects of applying Cognitive Orientation to daily Occupational Performance to stroke survivors: recruitment, dose, fidelity, perceived value, benefits, harms and potential outcomes.DesignSingle-group pretest-posttest design.SettingDanish municipal neurorehabilitation centre.SubjectsHome-living stroke survivors aged 45 years or older, with a score of at least 20 on the Montreal Cognitive Assessment, referred from hospital or rehabilitation units. Participants identified at least two occupational performance issues.InterventionsThe Cognitive Orientation to daily Occupational Performance approach aims to improve occupational performance through a therapist-guided process focusing on problem-solving, strategy use, generalisation and transfer. Three occupational therapists delivered the intervention.Main measuresData on participant characteristics and feasibility aspects were collected using surveys, registration forms, interviews and performance-based measures. Occupational performance was assessed using the Canadian Occupational Performance Measure and the Performance Quality Rating Scale.ResultsOf 65 invited stroke survivors, 20 (30.8%) were enrolled. Recruitment took longer than expected due to organisational factors. The intervention was delivered with high fidelity and was perceived as meaningful by both therapists and participants. Significant improvements (<i>p</i> < 0.001) were observed in occupational performance on the Canadian Occupational Performance Measure: performance (mean difference 2.98), satisfaction (mean difference 4.33) and on the Performance Quality Rating Scale (mean difference 2.69).ConclusionThe intervention was feasible in this setting. A full-scale effectiveness study is warranted.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261465889"},"PeriodicalIF":2.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396178","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 botulinum toxin for poststroke lower limb: a systematic review and meta-analysis.","authors":"Carla Sílvia Fernandes, Andreia Maria Novo Lima, Maria Teresa Moreira, Salome Sobral Sousa, Maria Salomé Ferreira","doi":"10.1177/02692155261417499","DOIUrl":"10.1177/02692155261417499","url":null,"abstract":"<p><p>ObjectiveThis review aims to conduct a systematic review and meta-analysis on the effectiveness of botulinum toxin in the treatment of spasticity and the improvement of lower limb function in adult stroke survivors, based on randomized clinical trials.Data sourcesSearches were conducted across multiple databases, including Medline, Scopus, CINAHL, SPORTDiscus, Psychology and Behavioral Sciences Collection, and Cochrane, from inception until September 2025.Review MethodThis systematic review and meta-analysis was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The meta-analysis was performed using Review Manager 5 software, with mean differences pooled using a random-effects model.ResultsThe analysis included 11 studies, with a total of 1740 adult participants. The results confirm that botulinum toxin is effective in reducing spasticity; however, the benefits on other outcomes, namely gait and balance, were limited and inconsistent. Considerable heterogeneity was also observed in intervention protocols, participant characteristics, dosing regimens, and the selection of target muscle groups.ConclusionIt is recommended that future studies prioritize the inclusion of subgroups and medium- and long-term follow-up. Only in this way will it be possible to clarify the true efficacy of botulinum toxin in different patient profiles and to contribute to the optimization of lower limb rehabilitation strategies after stroke.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"893-905"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146177411","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":"The effectiveness of prehabilitation on post-operative recovery from lumbar spinal stenosis surgery - A systematic review and intervention component analysis.","authors":"Peter Heine, Rebecca Hunter, Andrew Booth, Sarah E Lamb, Esther Williamson, Opinder Sahota, Bethan E Phillips, Paul Hendrick, Lianne Wood","doi":"10.1177/02692155261418206","DOIUrl":"10.1177/02692155261418206","url":null,"abstract":"<p><p>ObjectiveTo evaluate prehabilitation interventions evaluated in randomised controlled trials for people undergoing lumbar spinal stenosis surgery and determine which individual intervention components are associated with successful interventions.Data sourcesEnglish language papers from 2011 until December 2025 from PubMed, Cumulative Index of Nursing and Allied Health, Scopus and Web of Science.Review methodsWe searched for randomised controlled trials comparing prehabilitation to other non-active interventions for people undergoing surgery for lumbar spinal stenosis. Two authors independently screened, selected and performed quality assessments of the studies. Relevant study details were extracted, tabulated and synthesised using intervention component analysis.ResultsNine papers describing five randomised control trials involving 466 participants and 28 outcomes measured pre- and/or post-surgery were found. Overall, the interventions consisted of 47 individual components. Fifteen of these components (including psychological/behavioural approaches, and cardiovascular, strength and trunk/core exercise) featured in successful interventions that resulted in greater improvement in 16 outcomes (including back pain, disability, walking and hospital stay) in prehabilitation compared to usual care participants. The results of further evaluation of individual outcomes at each time point was inconsistent and unreliable.PROSPERO registration numberCRD42025645253, https://www.crd.york.ac.uk/PROSPERO/view/CRD42025645253ConclusionOnly five small trials of low-to-moderate quality report common outcomes at similar timepoints. There is high uncertainty regarding the importance of individual intervention components in successful prehabilitation interventions for people undergoing lumbar spinal stenosis surgery.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"906-923"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456143","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":"Validation of the Stroke Drivers' Screening Assessment in people with stroke in the Spanish context.","authors":"Jorge Clavijo-Ruiz, Ana Clara Szot, Lucía Laffarga, Candida Castro, María Rodriguez-Bailón","doi":"10.1177/02692155251414017","DOIUrl":"10.1177/02692155251414017","url":null,"abstract":"<p><p>ObjectiveTo culturally adapt the Stroke Drivers' Screening Assessment (SDSA) and evaluate its construct and predictive validity in a Spanish stroke population.DesignCultural adaptation and validation study.SettingHospitals and neurorehabilitation clinics in Spain.ParticipantsForty-five stroke patients completed the SDSA-Spain, a neuropsychological battery, and a road test.Adaptation processA panel of experts (two occupational therapists, a psychologist specializing in driving, and a driving instructor) adapted the SDSA to the Spanish context.Main measuresThe correlations of the SDSA-Spain with attention and memory tests, its ability to discriminate between fit and unfit drivers according to the instructor's judgment, and its predictive validity for the road test were analyzed.ResultsThe SDSA-Spain correlated significantly with the Useful Field of View subtests 2 and 3, and with the Trail Making Test-part B time. No significant differences were observed in discriminative ability alone between pass and fail participants. A logistic regression was performed selecting Dot Cancellation-time, Dot Cancellation-errors, Road Sign Recognition from the Spanish SDSA, and Useful Field of View-subtest 2. The model achieved an area under the curve of 0.81, accuracy of 0.73, specificity of 0.75, and sensitivity of 0.714.ConclusionsThe SDSA-Spain is an off-road tool that can be useful for assessing fitness to drive in stroke patients, especially when combined with other tests.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"924-934"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145965393","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":"I am not my self: Reconceiving identity in rehabilitation care.","authors":"Lily Gryspeerdt","doi":"10.1177/02692155251415256","DOIUrl":"10.1177/02692155251415256","url":null,"abstract":"<p><p>ProblemHow does someone altered by illness adjust their view of themselves and how could rehabilitation help?BackgroundRehabilitation is expanding its scope to become more holistic, beyond a preoccupation with physical functioning, which requires an understanding of the concept of personal identity. One currently employed approach defines the self as expressed through the physical.PhilosophySuch a view risks reifying the self into something owned. Instead, the change a person experiences with illness or injury is not a shift within themselves but reflects alterations in their interactions with the world. A person is not an internal self, mediated by the form of a body. Instead, a person is a body existing in and experiencing the world, particularly through interactions with others.ApplicationThis revised understanding is significant in rehabilitation because it increases conceptual clarity, removing the perceived challenge associated with defining the self or personal identity. Moreover, by moving towards an integrated view of self, our perspective shifts, such that when a person says, 'I have changed', what we can appreciate is 'things have changed', thus reducing the blame on them. Consequently, there is increased hopefulness and better acknowledgement of patients' social situations.ImplicationsThe purpose of this is not to police colloquial language but to heed against over-interpreting certain common expressions in ways that lead to increased alienation.ConclusionRehabilitation should understand that no self is lost or transformed, but that there is a social identity which changes with altered circumstances and challenges around a person, who remains themselves.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"859-870"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146091778","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":"Prediction for prospective falls via gait evaluation using mobile devices for stroke survivors: A markerless motion analysis study.","authors":"Winnie Wt Lam, Wei Tech Ang, Kenneth Nk Fong","doi":"10.1177/02692155251414356","DOIUrl":"10.1177/02692155251414356","url":null,"abstract":"<p><p>ObjectiveStroke survivors often experience hemiparetic lower extremity impairment, which increases fall risk. This study investigates prospective fall risk prediction using gait kinematic markers analyzed through a markerless motion capture system on mobile devices for participants with chronic stroke.DesignA prospective cohort study.SettingLaboratory setting, with three iPad Pros positioned at the start, end, and lateral points along a 3-meter walkway. Participants: Adults with hemiplegic stroke (Modified Functional Ambulation Classification ≥ III) and age-matched healthy controls, all without a recent fall.Main measuresGait parameters including stride length, cadence, step width, stance/swing time, double support time at baseline, and fall history interview over the 18-month period following the walking experiment.ResultsFifty healthy adults and 46 participants with chronic stroke were recruited. The 18-month prevalence for fallers in participants with stroke was 13%. Participants with stroke demonstrated a slower walking speed, a shorter step width, and a longer standing time than the healthy adults. Cadence, stride length, stance time, and swing time were strong predictors of fallers among participants with chronic stroke. The relative risks for low cadence, low swing phase, and high stance phase were 2.163, 2.002, and 2.142, respectively.ConclusionOur findings support the importance of using gait parameters obtained from the markerless motion capture system on mobile devices to predict prospective fall risk in the stroke population. Future research with larger, diverse cohorts of the stroke population using markerless motion capture is recommended to validate and refine the fall prediction models.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"959-971"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145988145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of oral nutritional supplements on physical functional performance in older patients at nutritional risk discharged with a rehabilitation plan: A randomised controlled trial.","authors":"Alberte Jensen, Elna D Ninh, Barbare B Darlem, Line M Haack, Cecilie M Møller, Anne W Knudsen, Frederikke E Pudselykke, Pelle B Petersen, Anne Marie Beck","doi":"10.1177/02692155261462462","DOIUrl":"10.1177/02692155261462462","url":null,"abstract":"<p><p>ObjectiveTo investigate if post-discharge oral nutritional supplementation improves physical functional performance and other outcomes in older hip fracture patients at nutritional risk.SettingDepartment of Orthopaedic Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.ParticipantsHip fracture patients aged ≥65 years and identified as being at nutritional risk. Of 768 individuals screened, 123 were randomised and 109 (89%) completed the 12-week follow-up.InterventionParticipants were randomised to receive either two cans of high energy, high protein oral nutritional supplementation enriched with vitamin D and omega 3 fatty acids daily for 12 weeks after discharge or standard care.Main measuresThe primary outcome was physical functional performance assessed by the 30-s chair-stand test. Secondary outcomes included muscle mass, hand grip strength, activities of daily living, hydration status, inflammation, appetite, quality of life, energy and protein intake, and omega-3 fatty acid status.ResultsPhysical functional performance improved in both groups, with no significant between-group difference in the number of repetitions performed in the intention-to-treat analysis. Protein intake increased in the intervention group (p = 0.003), while no between-group differences were observed for other outcomes. In the per-protocol analysis, the intervention group showed greater improvement in physical functional performance compared with the control group (p = 0.040). Energy and protein intake were also higher in the intervention group (p = 0.003, p = <.001),ConclusionsPost-discharge oral nutritional supplementation increased protein intake but did not improve physical functional performance. Per-protocol findings suggest that high adherence may be necessary to achieve functional benefits.</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"2692155261462462"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359753","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":"Inspiratory muscle training for people with spinal cord injury: An implementation study.","authors":"Keira E Tranter, Lisa A Harvey, Lydia W Chen, Lynn Blecher, Jacqui White, Jamie Li, Claire L Boswell-Ruys, Marnie Graco, David J Berlowitz, Joanne V Glinsky","doi":"10.1177/02692155261418967","DOIUrl":"10.1177/02692155261418967","url":null,"abstract":"<p><p>ObjectiveAustralian and New Zealand Guidelines for the Physiotherapy Management of People with Spinal Cord Injury recommend the use of inspiratory muscle training for people with spinal cord injury and respiratory muscle weakness. The aim of this study was to evaluate if tailored implementation strategies increased provision of inspiratory muscle training by physiotherapists.DesignA pre-post implementation study with baseline, post and follow-up measures.SettingThree spinal units in Sydney, Australia.ParticipantsTwenty-one physiotherapist-participants and 68 patient-participants across three spinal units.InterventionTailored, evidence-based, multi-faceted implementation strategies to improve physiotherapists' provision of inspiratory muscle training, delivered over a 6-week period (the implementation phase).Main measuresPhysiotherapists' provision of inspiratory muscle training was measured via a standardised audit tool. Medical records were audited at baseline, immediately after the implementation phase and then two months later to determine whether patients had been provided inspiratory muscle training.ResultsNinety-four medical records were audited of 68 patient-participants over the study period. Data at baseline indicated that inspiratory muscle training was only provided to 20% of eligible patient-participants. This improved to 91% immediately post the 6-week implementation phase but reduced to 72% two months later.ConclusionsTailored, evidence-based implementation strategies increased the provision of inspiratory muscle training by physiotherapists. These strategies can be adapted to different health care settings to improve physiotherapists' provision of inspiratory muscle training for the respiratory management of people with spinal cord injury.The study was prospectively registered with the Australian New Zealand Clinical Trials Registry (https://www.anzctr.org.au/. ACTRN: 12623001106628).</p>","PeriodicalId":10441,"journal":{"name":"Clinical Rehabilitation","volume":" ","pages":"972-984"},"PeriodicalIF":2.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13283492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431434","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}