European journal of physical and rehabilitation medicine最新文献

{"title":"The effect of patients' socioeconomic status in rehabilitation centers on the efficiency and performance.","authors":"Carine Milcent","doi":"10.23736/S1973-9087.24.08046-8","DOIUrl":"10.23736/S1973-9087.24.08046-8","url":null,"abstract":"<p><strong>Background: </strong>Patients' socioeconomic status on hospitals' efficiency in controlling for clinical component characteristics may have a role that has few been studied in rehabilitation centers.</p><p><strong>Design: </strong>Because of the national health insurance system, rehabilitation centers are free of charge. To answer whether a patient's socioeconomic status (SES) is associated with efficiency and performance, we use a counterfactual analysis to get the patient's SES effect \"as if\" the patient's case was identical to whatever hospital. We restrained the data to patients from public acute care units where the decision on rehabilitation sector admission is based on availability, limiting bias by confounding factors. Besides, an analysis of six pathologies led to the same results.</p><p><strong>Setting: </strong>An exhaustive, detailed administrative database on rehabilitation center stays in France. To define the patients' socioeconomic status, we use two sources of data: the information collected at the time of the patient's entry into rehabilitation care and the information collected during the patient's stay in acute care. This double information avoids possible loss of socio-economic details between the two admissions.</p><p><strong>Population: </strong>Patients recruited were exhaustively admitted over the year 2018 for stroke, chronic obstructive pulmonary disease, heart failure, or total hip replacement in France in the acute care unit and then in a rehab center. Mainly the elderly population. Information on patients' demography, comorbidities, and SES are coded due to the reimbursement system. Different dimensions controlling for factors (hospital ownership, patient clinical characteristics, rehabilitation care specificities, medical staff detailed information, and patients' socioeconomic status), were progressively added to control for any differences in baseline data between the two groups.</p><p><strong>Methods: </strong>We assess rehabilitation centers' efficiency by combining selected outcome quality indicators (Physical score improvement, Cognitive score improvement, Mortality, Return-to-home). The specific Providers' Activity Index is used to get the performance index.</p><p><strong>Conclusions: </strong>The performance of healthcare institutions is correlated not only to the case mix of their patients but also to the socioeconomic status of the patients admitted. The performance needs to be seen in light of patients' socioeconomic status.</p><p><strong>Clinical rehabilitation impacts: </strong>The data reveals that patients' socioeconomic status affects rehabilitation care efficiency and performance. In controlling patients' socioeconomic status, for-profit rehabilitation hospitals seemed more efficient than public ones.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"919-928"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497585","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":"Physiotherapy intervention on monosymptomatic nocturnal enuresis: a systematic review.","authors":"Marta Pinto, Lia Jacobsohn, Fátima Florindo-Silva, Lara Costa E Silva","doi":"10.23736/S1973-9087.24.08483-1","DOIUrl":"10.23736/S1973-9087.24.08483-1","url":null,"abstract":"<p><strong>Introduction: </strong>Monosymptomatic nocturnal enuresis is the most common voiding disorder and is associated with a decrease in the well-being and quality of life. Physiotherapy intervention has emerged as a second line treatment, and the treatment strategies that have been most commonly used to treat children and adolescents with monosymptomatic nocturnal enuresis are electrostimulation, magnetotherapy, biofeedback, behavioral therapy and pelvic floor muscle training. Establishing the efficacy of these physiotherapy strategies in children and adolescents up to 16 years is the aim of this Systematic Review.</p><p><strong>Evidence acquisition: </strong>Research was conducted from December 2022 to November 2023 in five databases: PubMed, Web of Science, Academic Search Complete, CINAHL Plus, and PEDro and two independent reviewers assessed titles and abstracts and judged each article for eligibility. Ten randomized-controlled trials written in English remained for analysis. PRISMA guidelines were followed, and the protocol was registered in PROSPERO database.</p><p><strong>Evidence synthesis: </strong>Electrostimulation was the most studied therapeutic modality and the one that showed better results, with significant improvements on bladder volumes and wet nights frequency, especially when used in association with Behavioral Therapy, Biofeedback and Pelvic Floor Muscle Training. Magnetotherapy presented less evidence.</p><p><strong>Conclusions: </strong>The obtained results demonstrated that physiotherapy treatment strategies may be of added value in clinical practice, as they were well tolerated, and provided a safe and effective contribution to second line treatment options for children and adolescents with refractory Monosymptomatic Nocturnal Enuresis to first line treatments.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"1051-1059"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461177","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":"Randomized controlled trials as a source of evidence in rehabilitation: a critical analysis.","authors":"Sandra Schmitz, Thorsten Meyer-Feil","doi":"10.23736/S1973-9087.24.08361-8","DOIUrl":"10.23736/S1973-9087.24.08361-8","url":null,"abstract":"<p><p>The randomized controlled trial (RCT) is the study design with the greatest potential to maximize internal validity when assessing the effectiveness of medical interventions, making it invaluable for evidence-based medicine. Yet, especially in the field of rehabilitation, it is not universally accepted as an unassailable gold standard due to serious problems of its implementation. This paper first examines three factors that limit the applicability of RCTs in rehabilitation practice. The first two factors stem from the nature of rehabilitative treatment itself: the complexity of rehabilitation interventions and the long-term and holistic nature of rehabilitation goals. The third factor relates to the differing functions of RCTs. Interventions vary in their complexity in increasing degree between component, measure, and program interventions. Lower complexity is associated with a greater likelihood of using high rigor efficacy studies. Methodological rigor further depends on the degree to which intervention conditions or contexts can be controlled for. This is particularly the case when examining body-related short-term outcomes. Whether it is reasonable to conduct an RCT also hinges on its function: to gain knowledge or to legitimate the utilization of an intervention in rehabilitation practice. The discussion highlights key challenges to RCT implementation and states questions that should help to identify an RCT as the most appropriate research design. Further empirical and theoretical research is indicated to clarify the distinction between levels of intervention, as this paper is based on theoretical considerations. Additionally, a concise explication of the different functions of an RCT and its meanings for their implementation is needed.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"1078-1087"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142282572","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":"Behavior change theory and behavior change technique use in cancer rehabilitation interventions: a secondary analysis.","authors":"M Lauren Voss, Rachelle Brick, Lynne S Padgett, Stephen Wechsler, Yash Joshi, Genevieve Ammendolia Tomé, Sasha Arbid, Grace Campbell, Kristin L Campbell, Dima El Hassanieh, Caroline Klein, Adrienne Lam, Kathleen D Lyons, Aisha Sabir, Alix G Sleight, Jennifer M Jones","doi":"10.23736/S1973-9087.24.08452-1","DOIUrl":"10.23736/S1973-9087.24.08452-1","url":null,"abstract":"<p><strong>Background: </strong>There is limited evidence depicting ways that behavioral theory and techniques have been incorporated into cancer rehabilitation interventions. Examining their use within cancer rehabilitation interventions may provide insight into the active ingredients that can maximize patient engagement and intervention effectiveness.</p><p><strong>Aim: </strong>This secondary analysis aimed to describe the use of behavior change theory and behavior change techniques (BCTs) in two previously conducted systematic reviews of cancer rehabilitation interventions.</p><p><strong>Design: </strong>Secondary analysis of randomized controlled trials (RCTs) drawn from two systematic reviews examining the effect of cancer rehabilitation interventions on function and disability.</p><p><strong>Setting: </strong>In-person and remotely delivered rehabilitation interventions.</p><p><strong>Population: </strong>Adult cancer survivors.</p><p><strong>Methods: </strong>Data extraction included: behavior change theory use, functional outcome data, and BCTs using the Behavior Change Technique Taxonomy (BCTTv1). Based on their effects on function, interventions were categorized as \"very\", \"quite\" or \"non-promising\". To assess the relative effectiveness of coded BCTs, a BCT promise ratio was calculated (the ratio of promising to non-promising interventions that included the BCT).</p><p><strong>Results: </strong>Of 180 eligible RCTs, 25 (14%) reported using a behavior change theory. Fifty-four (58%) of the 93 BCTs were used in least one intervention (range 0-29). Interventions reporting theory use utilized more BCTs (median=7) compared to those with no theory (median=3.5; U=2827.00, P=0.001). The number of BCTs did not differ between the very, quite, and non-promising intervention groups (H(2)=0.24, P=0.85). 20 BCTs were considered promising (promise ratio >2) with goal setting, graded tasks, and social support (unspecified) having the highest promise ratios.</p><p><strong>Conclusions: </strong>While there was a wide range of BCTs utilized, they were rarely based on theoretically-proposed pathways and the number of BCTs reported was not related to intervention effectiveness.</p><p><strong>Clinical rehabilitation impact: </strong>Clinicians should consider basing new interventions upon a relevant behavior change theory. Intentionally incorporating the BCTs of goal setting, graded tasks, and social support may improve intervention efficacy.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"1036-1050"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497581","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":"Lower peak expiratory flow rate is associated with a higher risk of pneumonia in patients with stroke.","authors":"Wenxiu Wu, Jingjing Lin, Xuezhen Zhou, Suzhen Ye, Mengmeng Shao, Jiangying Yu, Chengye Zhou, Haiyan Li","doi":"10.23736/S1973-9087.24.08475-2","DOIUrl":"10.23736/S1973-9087.24.08475-2","url":null,"abstract":"<p><strong>Background: </strong>Low peak expiratory flow (PEF) rate is common in patients with stroke. Studies on changes in PEF rates in patients with stroke often have small sample sizes, limiting the generalizability of their findings.</p><p><strong>Aim: </strong>This study aimed to compare the PEF rates between patients who were post-stroke with or without pneumonia and age- and sex-matched healthy controls and explore the PEF-pneumonia association among stroke survivors.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Setting: </strong>Department of Rehabilitation, the First Affiliated Hospital of Wenzhou Medical University.</p><p><strong>Population: </strong>Initially, 809 patients with stroke undergoing inpatient rehabilitation were recruited.</p><p><strong>Methods: </strong>Data collected included the demographics, stroke history, the presence of dysphagia, and the PEF rates on admission. Logistic regression analysis was conducted to identify the PEF threshold as predictive of pneumonia after adjusting for confounders.</p><p><strong>Results: </strong>Patients with stroke had a mean PEF rate of 243.89±139.38 L/min, significantly lower than that of the normal control group. The PEF rate was significantly lower in the pneumonia group than in the non-pneumonia group (P<0.001). Within the stroke cohort, the PEF rates were lower than the predicted rates (P<0.001). Older age, lower PEF(%),and dysphagia were associated with a higher pneumonia risk post-stroke per stepwise multivariate logistic regression analysis. Furthermore, the combination of these three significant predictors (PEF(%), swallowing function, and age) yielded an area under the curve of 0.857 .Regarding age, the cut-off point of ≥65.5 years was the optimal level to discriminate the presence of pneumonia among patients with stroke. For PEF%,the cut-off point of <60% was the optimal level to discriminate the presence of pneumonia among patients with stroke. For screening dysphagia, the patients with impaired safety only and those with impaired safety and efficacy faced a higher pneumonia risk.</p><p><strong>Conclusions: </strong>Patients with stroke exhibited significantly lower peak expiratory flow rates compared to healthy controls after adjusting for age and sex and when compared to their reference values. Decreased PEF rates were independently associated with pneumonia development during inpatient rehabilitation in post-stroke patients.</p><p><strong>Clinical rehabilitation impact: </strong>This study suggests that low PEF rates may predict pneumonia and that the prevention of PEF rate decline may prevent pneumonia development.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"929-937"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497583","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":"Clinical presentation of anterior pelvic tilt and trunk muscle endurance among patients with femoroacetabular impingement syndrome: a cross-sectional study.","authors":"Ángel González-DE-LA-Flor, Maríá García-Arrabé, Teresa Fernández-Pardo, Charles Cotteret","doi":"10.23736/S1973-9087.24.08378-3","DOIUrl":"10.23736/S1973-9087.24.08378-3","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome (FAIS) significantly affects the physical function and quality of life of the young and middle-aged population. Pelvic tilt and trunk muscle endurance are physical features poorly studied in FAIS.</p><p><strong>Aim: </strong>This study aimed to compare the anterior pelvic tilt and anterior, lateral, and posterior trunk muscles endurance between people with FAIS and healthy individuals, within FAIS sub types and between the symptomatic and asymptomatic hip in people with FAIS.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Settings: </strong>Participants were recruited and screened for potential eligibility at the Rehabilitation, Sports Medicine, and Physiotherapy Unit between April 2021 and February 2022.</p><p><strong>Population: </strong>Sixty-nine patients with FAIS and 69 controls.</p><p><strong>Methods: </strong>A study adhering to STROBE guidelines recruited 138 participants (69 FAIS, 69 controls). The degree of pelvic tilt was measured by the palpation meter (PALM) tool. To assess trunk musculature endurance, isometric trunk tests described by McGill were performed (extension resistance test, flexion resistance test, and side plank test). Cases were classified based on FAIS subtypes. Differences between groups and subgroups were performed using t-tests and ANCOVA, respectively.</p><p><strong>Results: </strong>Significant differences in anterior pelvic tilt were observed between the control and FAIS groups (P<0.001, d=0.72). Participants with FAIS exhibited greater pelvic tilt (MD=1.57, 95% CI=0.83 to 2.3). Trunk muscle endurance showed statistically significant differences (P<0.001, d=0.72) for posterior muscles. In comparisons between symptomatic and asymptomatic hips, significant differences were found in pelvic tilt (P<0.001, d=0.26) and lateral trunk muscle endurance (P<0.001, d=0.43). FAIS subtypes demonstrated significant differences in lateral trunk muscle endurance (P=0.002, η<inf>p</inf>2=0.209).</p><p><strong>Conclusions: </strong>This study found that patients with FAIS present large anterior pelvic tilt and lower posterior trunk muscle endurance. Although anterior pelvic tilt was comparable for all FAIS subtypes, Pincer-type with or without labral tear exhibited lower lateral trunk muscle endurance compared with Cam-type with or without labral tear. In addition, the symptomatic hip of FAIS patients showed lower lateral trunk muscle endurance compared to the asymptomatic hip.</p><p><strong>Clinical rehabilitation impact: </strong>Incorporating rehabilitation strategies that address pelvic tilt and trunk muscle strengthening in individuals with FAIS might be considered as a potential means to improve these physical impairments, pending careful evaluation of their effectiveness.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"1027-1035"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380370","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 role of single case experimental designs in evidence creation in rehabilitation.","authors":"Wendy Machalicek, Douglas P Gross, Susan Armijo-Olivo, Giorgio Ferriero, Carlotte Kiekens, Rachelle Martin, Margaret Walshe, Stefano Negrini","doi":"10.23736/S1973-9087.24.08713-6","DOIUrl":"10.23736/S1973-9087.24.08713-6","url":null,"abstract":"<p><p>Randomized controlled trials (RCTs) are considered the gold standard of evidence guiding intervention selection in rehabilitation. However, conduct of sufficiently powered RCTs in rehabilitation can be expensive, pose ethical and attrition concerns when participants are assigned to ineffective treatment as usual conditions, and are infeasible with low-incidence populations. Single-case experimental designs (SCEDs), including N-of-1 RCTs are causal inference studies for small numbers of participants and not necessarily one participant as the name implies. These designs are increasingly used to evaluate the effectiveness of rehabilitation interventions in diverse clinical settings and employ design features including but not limited to randomization and each participant serving as their own control. These and other internal validity enhancements can increase the confidence in study results coming from these designs. This manuscript discusses the expanded application of SCEDs in rehabilitation contexts to answer everyday clinical rehabilitation research questions with emphasis on strategies to use: 1) to maximize internal validity of this family of designs; 2) improve utility, effectiveness, and acceptability of these designs for rehabilitation end-users (clinicians, policymakers, and participants); 3) build evidence bases in areas of rehabilitation where RCTs are uncommonly used. Primary considerations for situating SCEDs within the continuum of experimental designs include increasing internal validity within designs, improving transparency in conduct and reporting of these studies, and increasing access to advanced research methods training for rehabilitation professionals.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"1100-1111"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142380373","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 virtual reality on balance impairment in ataxic cerebral palsy children: randomized controlled trial.","authors":"Hanady A Mouhamed, Nehad A Abo-Zaid, Heba A Khalifa, Mohammed E Ali, Noha S Elserty, Mohamed A Behiry, Walaa E Heneidy","doi":"10.23736/S1973-9087.24.08617-9","DOIUrl":"10.23736/S1973-9087.24.08617-9","url":null,"abstract":"<p><strong>Background: </strong>Children with ataxic cerebral palsy have unsteady movements and poor balance. Many therapeutic interventions are used to improve their upper and lower functioning.</p><p><strong>Aim: </strong>To assess the effectiveness of virtual reality (VR) on balance impairment in ataxic cerebral palsy children.</p><p><strong>Design: </strong>RCT.</p><p><strong>Population: </strong>Sixty-four children with ataxic cerebral palsy.</p><p><strong>Methods: </strong>Children were randomly assigned into two equal groups with 32 patients in each group. The control group received a specially developed physical therapy program and the VR group received VR training on a Wii balance board in addition to the control group's program. For three successive months the intervention program was implemented three times a week for both groups. Stability indices (overall, anteroposterior, and mediolateral) were measured using the Biodex balance system and Pediatric Balance Scale (PBS) at baseline and after three months of intervention for both groups.</p><p><strong>Results: </strong>At the beginning of the intervention, there were no statistically significant differences between the two groups (P>0.05). However, following three months of the intervention, there was a statistically significant decline in the stability index scores., as well as a statistically significant improvement in the score of the PBS in both groups with a notable advancement in favor of the VR group (P≤0.05).</p><p><strong>Conclusions: </strong>Adding VR training on a Wii balance board to a designed physical therapy program has a significant impact on improving balance deficits in ataxic cerebral palsy children.</p><p><strong>Clinical rehabilitation impact: </strong>VR has a therapeutic effect on improving balance that may result in better and more efficient rehabilitation program of children with ataxic cerebral palsy.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"949-955"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497582","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":"Navigating Rehabilitation: the General Index of Rehabilitation Knowledge developed by Cochrane rehabilitation through a global interprofessional Delphi process.","authors":"Francesca Gimigliano, Antimo Moretti, Stefano G Lazzarini, Joel Pollet, Chiara Arienti, Maria G Ceravolo, Claudio Cordani, Carlotte Kiekens, Stefano Negrini","doi":"10.23736/S1973-9087.24.08734-3","DOIUrl":"10.23736/S1973-9087.24.08734-3","url":null,"abstract":"","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"1112-1115"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497584","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":"Unveiling the mosaic: comparing demographics and outcomes in traumatic vs. non-traumatic spinal cord injuries.","authors":"Emanuela Lena, Laura Timelli, Sergio DI Fonzo, Angelo Tonini, Valerio Pisani, Caterina Garcovich, Emanuela Covella, Federica Tamburella, Giorgio Scivoletto","doi":"10.23736/S1973-9087.24.08554-X","DOIUrl":"10.23736/S1973-9087.24.08554-X","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;This study analyzed the percentage of patients with nontraumatic spinal cord injury (SCI) which is increasing with the increase of population age. However, little is known about the effect of the etiology of SCI on the outcome of these subjects.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aim: &lt;/strong&gt;The aim of this study was to investigate functional and neurological outcomes in patients with traumatic and nontraumatic spinal cord lesions, with a focus on factors influencing rehabilitation outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Design: &lt;/strong&gt;The design of this study was that of a retrospective analysis of prospectively recorded data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Setting: &lt;/strong&gt;The setting of this analysis was a single Spinal Unit in Italy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Population: &lt;/strong&gt;The population included 1080 subjects, of which 599 (55%) had injuries of traumatic origin and 481 (45%) had nontraumatic injuries.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI), the Spinal Cord Independence Measure (SCIM) and the Walking Index for Spinal Cord Injury (WISCI) were utilized as measurement tools. Multivariate (backwards selection, P=0.20) logistic regression was used to assess the associations of \"complication during hospitalization,\" \"bowel management autonomy,\" \"spontaneous micturition,\" \"home destination\" and \"neurological improvement\" with the following variables: etiology, age, sex, lesion level and severity and length of stay. Multivariate (backwards selection, P=0.20) negative binomial regression was used to assess the relative risks of higher SCIM and WISCI Scores at discharge after adjusting for the abovementioned variables.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our work highlighted several significant differences between the traumatic and nontraumatic groups (including age, sex, lesion severity, and time from lesion onset to admission). Both groups exhibited comparable improvements in neurological and functional status, although some data were in favor of subjects with traumatic lesions. However, the regression analyses demonstrated that the main factors impacting the neurological and functional status at discharge were age, lesion level and severity, rather than the etiology of the lesion.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our study provides valuable insights into the rehabilitation trajectories of traumatic and nontraumatic spinal cord injuries and demonstrates that the cause of SCI has no impact on rehabilitation outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical rehabilitation impact: &lt;/strong&gt;An understanding of neurological and functional recovery after spinal cord lesions is essential for answering patients' questions about their potential functional capabilities. It also assists in determining the necessary resources for inpatient rehabilitation and post discharge care. Moreover, the possession of a thorough grasp of the course and factors influencing the natural recovery of a spinal cord lesion is now a scientif","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"980-988"},"PeriodicalIF":3.3,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142344241","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}