European journal of physical and rehabilitation medicine最新文献

{"title":"The effect of blood flow restricted aerobic exercise training on pain, functional status, quality of life and hormonal response to exercise in fibromyalgia patients: a randomized double-blind study.","authors":"Mert Zure, Mahir Topaloğlu, Sina Arman, Ayşegül Ketenci","doi":"10.23736/S1973-9087.25.08817-3","DOIUrl":"10.23736/S1973-9087.25.08817-3","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia is a chronic pain condition with symptoms such as pain, fatigue, and decreased quality of life. Although aerobic exercise is an effective treatment for fibromyalgia, patients often struggle with exercise intolerance due to fatigue, limiting long-term adherence. Research on blood flow-restricted (BFR) exercise suggests it may provide benefits similar to traditional exercise with reduced intensity, but its effects on fibromyalgia-related symptoms remain underexplored.</p><p><strong>Aim: </strong>This study investigated the impact of a BFR aerobic exercise program on pain, functional status, quality of life, and hormonal response in women with fibromyalgia.</p><p><strong>Design: </strong>A prospective, randomized, double-blind, sham-controlled trial.</p><p><strong>Setting: </strong>Outpatient rehabilitation center.</p><p><strong>Population: </strong>Fifty women diagnosed with fibromyalgia were included in this study.</p><p><strong>Methods: </strong>Participants were randomly assigned to two groups receiving supervised aerobic exercise four times weekly for six weeks. The experimental group used blood flow restriction aid with elastic bandages at the groin level, while the control group received a sham restriction. Primary outcomes were assessed with the Fibromyalgia Impact Questionnaire (FIQ). Secondary outcomes included the Central Sensitization Index (CSI), Beck Depression Inventory (BDI), Visual Analogue Scale (VAS) for pain, Chronic Pain Acceptance Questionnaire-8 (CPAQ-8), and 24-hour urine levels of vanillyl mandelic acid (VMA) and 5-hydroxy indole acetic acid (5-HIAA). Evaluations were conducted before, immediately after, and three months post-intervention.</p><p><strong>Results: </strong>The mean age of participants was 43.2±7.2 years, with comparable baseline characteristics between groups. Both groups showed significant improvements across all outcomes, with the BFR group exhibiting superior improvements in FIQ (P<0.001), CSI, and BDI scores, as well as increased urine levels of VMA and 5-HIAA. Although both groups improved in pain and pain acceptance, these changes were not significantly different between groups.</p><p><strong>Conclusions: </strong>Patients with fibromyalgia who have limited exercise tolerance may find that BFR aerobic exercise improves pain, function, central sensitization, mood, and catecholamine-serotonin levels. Additional research is needed to further understand its effects and broaden the scope of this technique in the treatment of fibromyalgia.</p><p><strong>Clinical rehabilitation impact: </strong>BFR aerobic training could improve adherence to exercise therapy in fibromyalgia by offering a lower-intensity alternative with enhanced benefits, potentially leading to better symptom management in clinical settings.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"564-571"},"PeriodicalIF":3.4,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12405945/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156628","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":"Impact of low back and neck pain on the Spanish women-workers' health: effectiveness of a Back School.","authors":"Montserrat Alonso-Sardón, Helena Iglesias-DE-Sena, Antonio J Chamorro, José Ángel Santos-Sánchez, Alberto Benito-Rodríguez, José A Mirón-Canelo","doi":"10.23736/S1973-9087.24.08637-4","DOIUrl":"10.23736/S1973-9087.24.08637-4","url":null,"abstract":"<p><strong>Background: </strong>Neck and back pain pathologies are currently the main cause of absenteeism from work in Spain and in the European Union, and represent a high socio-labor, economic and health cost for the Health Systems.</p><p><strong>Aim: </strong>To assess the effectiveness of a Back School Program of a Spanish mutual insurance company (risk factors, pain and disability scales) in women workers with low back or neck pain.</p><p><strong>Design: </strong>We combined a descriptive study of first-session data collected in the total sample and a prospective multicenter intervention study in those participants who completed the second and third check-up at 6 and 9 months.</p><p><strong>Setting: </strong>Women workers with low back or neck pain, from different sectors and occupations, who participated in a Back School Program of Ibermutua, a Spanish mutual insurance company, during the period from April 1^st, 2009, to March 28^th, 2019.</p><p><strong>Population: </strong>Overall, 1452 women workers participated in the first session, 150 in the second session (6-month review) and 133 in the third session (9-month review).</p><p><strong>Methods: </strong>Different questionnaires and scales were used for data collection, Visual Analog Scale, Neck Disability Index, Oswestry Disability Index, Concept Check Questionnaire and Back School Program Effectiveness Questionnaires.</p><p><strong>Results: </strong>A total of 1095 (75.4%) had low back pain and 742 (51.1%) had neck pain (497 of them had pain in both locations); 42.8% (622) related the pain to their work activity. One in four women workers (390, 26.9%) performed a high-risk work activity (handling, weight transport, mechanical vibrations), 27.4% were prolonged standing and 22.8% were prolonged sitting. The workers participated in the Back School Program for two purposes: therapeutic (1150 women, 79.2%) and preventive (302 women, 20.8%).</p><p><strong>Conclusions: </strong>The Back School is an effective intervention to manage pain and reduce disability in women workers.</p><p><strong>Clinical rehabilitation impact: </strong>This study provided evidence that the Back School Program can be suitable for preventing and improving low back and neck pain and functional disability among women workers. The success of the Back Schools depends on women workers becoming aware of the importance of preventive measures aimed at strengthening the back muscles and collaborating actively, thus significantly reducing the incidence of low back and cervical pain in the workplace.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"285-294"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045996","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":"Acute serum androgen levels and post-rehabilitation functioning in spinal cord injury: findings from SwiSCI.","authors":"Vanessa Seijas, Jivko Stoyanov, Kristen D Brantley, Jsabel Hodel, Peter Francis Raguindin, Jürgen Pannek, Xavier Jordan, Margret Hund-Georgiadis, Inge E Hoogland, Marija Glisic, Stacey A Missmer","doi":"10.23736/S1973-9087.25.08766-0","DOIUrl":"10.23736/S1973-9087.25.08766-0","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) is associated with long-term limitations in daily functioning and secondary complications, including hormonal dysregulation.</p><p><strong>Aim: </strong>The aim of this paper was to investigate the association between serum androgen levels within 30 days post-SCI and functioning during initial inpatient rehabilitation.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Four specialized SCI rehabilitation centers in Switzerland.</p><p><strong>Population: </strong>Individuals with newly diagnosed traumatic or non-traumatic SCI, undergoing specialized initial inpatient rehabilitation in Switzerland.</p><p><strong>Methods: </strong>Nested in the prospective Swiss Spinal Cord Injury Cohort Study (SwiSCI), functioning metrics and serum androgen levels (total testosterone [TT], free testosterone [FT], sex hormone-binding globulin, dehydroepiandrosterone [DHEA], and DHEA sulfate [DHEAS]) were measured at baseline and followed-up until discharge from initial inpatient rehabilitation. Functioning was operationalized with the interval-based Spinal Cord Independence Measure version III (SCIM-III). Multivariable time-varying regression analyses were performed, adjusting for confounders. Missing data were handled by multiple imputations.</p><p><strong>Results: </strong>Participants (N.=80; 15 (19%) female) had a median follow-up of 167 days (IQR:128-224). In males, lower baseline FT was associated with a significantly lower rate of functioning improvement in all models, from baseline to three months after the SCI (e.g., univariable model=-35.9 [95% CI:-79 to -3], P value=0.03) and also from baseline to discharge from inpatient rehabilitation (e.g., in males and age-adjusted model=-49.2 [95% CI:-118 to -2 ], P value=0.04). Similarly, baseline FT levels were positively associated with functioning at discharge (e.g., in the fully-adjusted model, one SD increase in FT was associated with a 26.9% increase in functioning [95% CI: 9 to 42, P=0.01]). Similar trends were observed for TT. DHEA and DHEAS were negatively associated with the improvement in functioning and results were significant only in subgroup analyses. All results for females were null.</p><p><strong>Conclusions: </strong>Our results suggest that low testosterone levels in the acute phase of SCI reduce the rate of functioning improvement and total functioning gained during initial inpatient rehabilitation in males.</p><p><strong>Clinical rehabilitation impact: </strong>Our results underscore the potential role of early androgen assessment and modulation in optimizing rehabilitation outcomes in males with SCI.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"263-274"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810899","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":"Overview of Cochrane Systematic Reviews for rehabilitation interventions in persons with amputation: a mapping synthesis.","authors":"Arne Heyns, Frank-Robbrecht Dusar, Chiara Arienti, Carlotte Kiekens","doi":"10.23736/S1973-9087.25.08664-2","DOIUrl":"10.23736/S1973-9087.25.08664-2","url":null,"abstract":"<p><strong>Introduction: </strong>This review aimed to collect the current evidence from the Cochrane systematic reviews (CSRs) concerning interventions for rehabilitation of people with amputation, in the context of the World Health Organization - Package of Interventions for Rehabilitation.</p><p><strong>Evidence acquisition: </strong>The Cochrane Rehabilitation team led the CSRs' search. Search strings were composed of \"amputation\" and \"rehabilitation\" and run in the Cochrane Library. We used the AMSTAR 2 to assess the methodological quality of the included CSRs. All rehabilitation-relevant data were summarized in an evidence map.</p><p><strong>Evidence synthesis: </strong>Out of the 95 CSRs found, eight related to people with amputation and rehabilitation. We found very low-certainty evidence to support the use of gabapentin in treating phantom limb pain. There was very low-certainty evidence against the use of memantine. Very low-certainty evidence showed faster wound healing, shorter time gaps from amputation to first prosthetic fit, shorter hospital stays and short-term changes in swelling after rigid dressing for people with transtibial amputations. Very low-certainty evidence revealed no difference for mobility assessment or adverse events after different forms of motor rehabilitation after transtibial amputation.</p><p><strong>Conclusions: </strong>Evidence for interventions for rehabilitation after amputation is scarce and the available evidence is of very low certainty. More studies of higher quality are needed to provide evidence to ensure that people with an amputation receive the best rehabilitation possible.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"351-357"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810903","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":"Efficacy of pulmonary rehabilitation on health-related quality of life in patients with interstitial lung disease as assessed by SF-36: a systematic review and meta-analysis.","authors":"Xing He, Jiaqi Ji, Zongmin Pei, Ting Zhou, Hong Fan, Lu Guo","doi":"10.23736/S1973-9087.25.08778-7","DOIUrl":"10.23736/S1973-9087.25.08778-7","url":null,"abstract":"<p><strong>Introduction: </strong>The efficacy of pulmonary rehabilitation (PR) in improving health-related quality of life (HRQoL) in patients with interstitial lung disease (ILD) still have some unresolved issues. This study aimed to identify this gap by using the 36-Item Short Form Survey (SF-36) to assess the advantages and disadvantages of PR in improving the HRQoL of patients with ILD.</p><p><strong>Evidence acquisition: </strong>Self-controlled before-and-after interventional design research related to PR and ILD published in English were retrieved from PubMed, Embase, Web of Science, Scopus, Ovid, and Cochrane Library from inception to May 19, 2024. Data collected from the included studies were general clinical characteristics, study sample size, SF-36 physical component summary (PCS) score, SF-36 mental component summary (MCS) score, scores of the eight domains (physical function, role physical, bodily pain, general health, vitality, social function, role emotional, and mental health), PR time, and main elements of PR. Subgroup analysis was performed based on the PR time and ILD type. Sensitivity analysis was conducted by excluding one study at a time. Publication bias was assessed using Egger's Test, and the reliability of the studies was determined using the funnel plot and trim-and-fill method. Changes in SF-36 domain scores after PR were presented in a radar chart.</p><p><strong>Evidence synthesis: </strong>Pooled analysis of 15 studies involving 1289 patients with ILD who underwent PR showed that the patients had significantly higher PCS scores (weighted mean difference [WMD]=2.07, 95% CI: 1.06, 3.09) and MCS scores (WMD=4.48, 95% CI: 3.21, 5.76) after PR. According to disease types, subgroup analyses showed that patients with idiopathic pulmonary fibrosis had significantly higher PCS scores (WMD=3.15, 95% CI: 0.05, 6.24) but no change in MCS scores after PR (WMD=1.97, 95% CI: -1.91, 5.85). Additionally, subgroup analysis based on PR time revealed that the PCS scores of patients with ILD were significantly increased after <8 weeks of PR (WMD=2.09, 95% CI: 1.02, 3.17) but not after ≥8 weeks of PR (WMD=1.94, 95% CI: -1.05, 4.93, P=0.204). All included studies were of good quality, and the pooled and subgroup results were robust without publication bias.</p><p><strong>Conclusions: </strong>In patients with ILD, PR less than 8 weeks effectively improved the physical and mental HRQoL, but not the social function. Future studies should focus on determining the optimal PR time for enhancing HRQoL in patients with ILD and evaluating the efficacy of PR in different ILD types and other HRQoL domains.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"313-334"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771856","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":"Adaptive sports in Physical and Rehabilitation Medicine across Europe: the forgotten therapeutic ally.","authors":"Louise Declerck, Karol Hornacek, Alvydas Juocevicius, Markos Sgantzos, Gaëtan Stoquart, Nicolas Christodoulou, Jean-François Kaux","doi":"10.23736/S1973-9087.25.08543-0","DOIUrl":"10.23736/S1973-9087.25.08543-0","url":null,"abstract":"<p><strong>Background: </strong>Physical and rehabilitation medicine (PRM) units promote health and autonomy. One way to achieve this is through physical activity (PA), yet research shows that individuals with physical impairments are not physically active. One way to motivate them is through adaptive sports (also named para sports), as this allows for a more enjoyable experience. Yet, it is unknown whether such activities are offered in PRM across Europe. The Special Interest Scientific Committees \"Sports Affairs\" of the European Society of PRM set out to fill this gap of knowledge.</p><p><strong>Aim: </strong>To explore the use of adaptive sports within PRM units in European countries, to collect information on these practices, and to identify any barriers limiting the development of this offer. To investigate how PRM health care professionals view and promote adaptive sports to their patients.</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>European PRM units.</p><p><strong>Population: </strong>PRM health care professionals.</p><p><strong>Methods: </strong>An online questionnaire was developed and disseminated across Europe. Healthcare professionals working in PRM were invited to respond anonymously. Their views on adaptive sports, as well as the actions they undertook to promote it, were scored, and statistical analyses were performed on these scores.</p><p><strong>Results: </strong>A total of 190 health care professionals, from 31 different European countries, participated. Only 8 of the 31 countries seem to have adopted adaptive sports as a tool in PRM. The main barrier which limited the development of this across Europe was lack of infrastructure. Yet, the majority of health care professionals acknowledge that their patients would largely benefit from such activities.</p><p><strong>Conclusions: </strong>The offer of adaptive sports in European PRM is poor. Such activities are not systematically presented to patients with physical impairments. There is a need to improve the situation through structural and legislative changes on one end, but also by providing PRM professionals with adequate tools, resources and networks.</p><p><strong>Clinical rehabilitation impact: </strong>By identifying barriers which limit the use of adaptive sports as a therapeutic tool, this study suggests several strategies to develop this in the European field of PRM, as it may be a way to enhance its effectiveness.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"173-183"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810900","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":"Evidence synthesis of health policy and systems research in rehabilitation: a protocol for Cochrane overviews of systematic reviews on delivery, governance, financial arrangements, and implementation strategies.","authors":"Stefano Negrini, Carlotte Kiekens, Matteo J Del Furia, Silvia Minozzi, Rebecca Ryan, Chiara Arienti, Anne Parkhill, Pierre Côte, Francesca Gimigliano, Carla Sabariego, Paolo Capodaglio, Simon Decary, Wouter DE Groote, Walter R Frontera, Qhayiya Mudau, Melissa Atkinson-Graham, Noora Bakaa, Irene Battel, Olivier K Butzbach, Claudio Cordani, Eshetu H Engeda, Theodore Konstantinidis, Giovanni Iolascon, Sara Liguori, Silvano Mior, Antimo Moretti, Marco Paoletta, Dima Touhami, Jessica Wong, Antony Duttine","doi":"10.23736/S1973-9087.24.08833-6","DOIUrl":"10.23736/S1973-9087.24.08833-6","url":null,"abstract":"<p><p>Cochrane Rehabilitation and the World Health Organization (WHO) Rehabilitation Program are collaborating to produce four Cochrane overviews of systematic reviews that synthesize the current evidence from health policy and systems research (HPSR) in rehabilitation. They will focus on the four pillars of HPSR identified by the Cochrane Effective Practice and Organization of Care (EPOC) taxonomy: delivery arrangements, financial arrangements, governance arrangements, and implementation strategies. The protocol describes why HPSR is currently needed in rehabilitation, provides detailed information on the four EPOC pillars in interaction with rehabilitation and reports the Cochrane methods that will be followed to produce the overviews. 1. Del Furia MJ, Minozzi S, Arienti C, Battel I, Capodaglio P, Côté P, Décary S, De Groote W, Duttine A, Frontera WR, Gimigliano F, Kiekens C, Mudau Q, Ryan R, Sabariego C, Negrini S. Delivery arrangements for rehabilitation services in health systems: an overview of systematic reviews. 2. Gimigliano F, Arienti C, Butzback OK, Capodaglio P, Côté P, Décary S, Del Furia MJ, De Groote W, Duttine A, Frontera WR, Iolascon G, Kiekens C, Liguori S, Minozzi S, Mudau Q, Negrini S, Paoletta M, Ryan R, Sabariego C, Moretti A. Financial arrangements for rehabilitation services in health systems: an overview of systematic reviews. 3. Atkinson-Graham M, Mior S, Bakaa N, Konstantinidis T, Wong J, Arienti C, Capodaglio P, Décary S, De Groote W, Del Furia MJ, Duttine A, Frontera WR, Kiekens C, Minozzi S, Gimigliano F, Mudau Q, Negrini S, Ryan R, Sabariego C, Côté P. Governance arrangements for rehabilitation services in health systems: an overview of systematic reviews. 4. Touhami D, Ryan R, Engeda EH, Arienti C, Capodaglio P, Côté P, Décary S, Del Furia MJ, De Groote W, Duttine A, Frontera WR, Gimigliano F, Kiekens C, Minozzi S, Mudau Q, Negrini S, Sabariego C. Implementation strategies for rehabilitation services in health systems: an overview of systematic reviews. The protocol is largely common to all four overviews. The individual parts of each overview can be identified by the sub-titles delivery arrangements, financial arrangements, governance arrangements, and implementation strategies for overviews 1 to 4.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"335-350"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12184846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045993","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":"International stakeholder consultation on models of rehabilitation service delivery to foster healthy ageing: results of a cross-sectional survey involving 124 countries and all World Health Organization regions.","authors":"Vanessa Seijas, Roxanne Maritz, Patricia Morsch, Pauline Kleinitz, Cathal Morgan, Julia Yee, Beatriz Moreira, Jsabel Hodel, Satish Mishra, Carla Sabariego","doi":"10.23736/S1973-9087.25.08669-1","DOIUrl":"10.23736/S1973-9087.25.08669-1","url":null,"abstract":"<p><strong>Background: </strong>Rehabilitation is an essential service for healthy ageing. Scoping reviews have described how rehabilitation is delivered to older people, however, their evidence is overwhelmingly derived from research published in high-income countries (HICs).</p><p><strong>Aim: </strong>To a) assess whether descriptions of rehabilitation service delivery models derived from the literature reflect real-world practice, and b) gather knowledge about the use of different rehabilitation service delivery models in different settings and countries, including availability and implementation status.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Setting: </strong>International online survey conducted in eight languages.</p><p><strong>Population: </strong>Healthcare workers involved in the provision of rehabilitation for people over 60.</p><p><strong>Methods: </strong>A 33-question questionnaire on the characteristics of rehabilitation service delivery models, their availability and implementation in different regions of the world was distributed globally using a three-layer stakeholder mapping approach. The CHERRIES checklist guided the reporting.</p><p><strong>Results: </strong>The survey was completed by 1285 highly experienced health workers from 124 countries, representing all income levels and all WHO regions. The availability and implementation status of rehabilitation delivery models (inpatient, outpatient, telerehabilitation, home, community, and eldercare) was lower in low- and middle-income countries (LMICs) than in HICs, but none of the models was fully available or implemented nationwide in any region or income level. Physiotherapists, occupational therapists, speech-language therapists, nurses, and rehabilitation physicians are the most common healthcare workers providing rehabilitation in all models and regions. Rehabilitation is often fragmented and multidisciplinary teams are often only available in the inpatient model. Assistive technology is almost always provided in HICs, but only half the time in LMICs, while environmental adaptations are not fully reimbursed by any health system and are not prescribed in some regions.</p><p><strong>Conclusions: </strong>Our findings validate and complement previous reviews by incorporating insights from healthcare workers with real-world experience across income levels and regions. Older people in LMICs have less access to quality rehabilitation services than those in HICs. Globally, rehabilitation services are partially responsive and adequate for supporting healthy ageing.</p><p><strong>Clinical rehabilitation impact: </strong>Rehabilitation stakeholders and policymakers can use this study to (re)design services to better support healthy ageing.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"161-172"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810902","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":"Catastrophizing and fear avoidance beliefs in chronic low back pain: a cross-sectional study.","authors":"Julio Doménech-Fernández, Aida Ezzeddine Angulo, Lourdes Peñalver-Barrios, Eva Del Rio-González, Rocio Herrero, Azucena García-Palacios, Monica Martinez-Diaz, Iago Garreta-Catalá, Máximo A Diez-Ulloa, Rosa M Baños-Rivera","doi":"10.23736/S1973-9087.25.08419-9","DOIUrl":"10.23736/S1973-9087.25.08419-9","url":null,"abstract":"<p><strong>Background: </strong>Chronic low back pain continues to be a challenge in everyday rehabilitation services as improvement keeps being unpredictable.</p><p><strong>Aim: </strong>To evaluate the role of pain coping strategies, fear-avoidance beliefs, anxiety and depression in pain and disability in patients with chronic low back pain.</p><p><strong>Design: </strong>A cross sectional study.</p><p><strong>Setting: </strong>Rehabilitation and Orthopedic departments in four tertiary hospitals in Spain.</p><p><strong>Population: </strong>Overall, 276 patients (200 women) with nonspecific low back pain according COST-B13 guidelines and lasting more than 6 months.</p><p><strong>Methods: </strong>Pain, disability, coping strategies, catastrophizing, anxiety, depression and fear-avoidance beliefs were evaluated with validated questionnaires. Predictive associations of disability and pain were analyzed by Pearson's test and by multivariate regression.</p><p><strong>Results: </strong>Catastrophizing is the pain coping strategy with the highest association with disability (r=0.52, P<0.01). Low back pain and disability showed little correlation in between (r=0.40, P<0.01). The correlation between fear-avoidance ideas and pain and disability was slight (r=0.20, P<0.01). No association was found between anxiety and depression with low back pain and disability. In the regression model, catastrophizing, kinesiophobia and gender explained 35% of the variance in disability. In the subanalysis of patients with surgical indication the influence of catastrophizing was maintained. However, correlation between pain and disability is lower than in patients without surgical indication.</p><p><strong>Conclusions: </strong>The limited correlation between pain and disability suggests that pain alone cannot explain the variability of disability. Catastrophizing and kinesiophobia are predictors of the degree of disability in chronic low back pain and are cognitions potentially modifiable.</p><p><strong>Clinical rehabilitation impact: </strong>These results support the biopsychosocial model in the pathogenesis of chronic low back pain and support the use of cognitive behavioral therapy to modify maladaptive beliefs and attitudes as part of medical or surgical treatment in low back pain.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"305-312"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624052","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":"Mirror therapy reduces excessive variability of motor network in stroke patients: a randomized controlled trial.","authors":"Kexu Zhang, Li Ding, Xu Wang, Jinyang Zhuang, Shanbao Tong, Jie Jia, Xiaoli Guo","doi":"10.23736/S1973-9087.25.08844-6","DOIUrl":"10.23736/S1973-9087.25.08844-6","url":null,"abstract":"<p><strong>Background: </strong>Mirror therapy (MT) has been demonstrated as an effective intervention for promoting motor recovery post-stroke. Existing neuroimaging studies have demonstrated that the efficacy of MT is associated with its effect to increase the strength of brain activity and functional connectivity in the bilateral M1. However, its modulation on brain dynamics, which also hold physiological significance, remains unknown.</p><p><strong>Aim: </strong>To investigate the potential influence of MT on brain dynamics in stroke patients.</p><p><strong>Design: </strong>A randomized, single-blinded, controlled trial.</p><p><strong>Setting: </strong>Inpatient.</p><p><strong>Population: </strong>Fifty first-ever unilateral stroke patients with motor dysfunctions were recruited and randomly assigned to either an MT group (N.=25) or a conventional therapy (CT) group (N.=25) for a 4-week intervention.</p><p><strong>Methods: </strong>Motor function assessments and resting-state fMRI scans were conducted both before and after the intervention. Images from sixteen healthy subjects were used as controls. A dynamic analysis of the fMRI data was performed using measures of the dynamic fractional amplitude of low-frequency fluctuation (dfALFF) and dynamic voxel-mirrored homotopic connectivity (dVMHC).</p><p><strong>Results: </strong>Aberrant dynamics, characterized by increased variability (decreased stability) in spontaneous activity and interhemispheric functional connectivity in sensorimotor networks, were observed in stroke patients. MT but not CT intervention led to reduced variability of spontaneous activity in the ipsilesional primary motor cortex (M1) and interhemispheric M1 functional connectivity, which further exhibited a correlation with motor improvement. Notably, reduced variability of spontaneous activity showed significant mediation effects in the prediction of motor recovery with reduced variability of interhemispheric functional connectivity.</p><p><strong>Conclusions: </strong>MT may reduce the excessive variability of interhemispheric M1 functional connectivity, thereby stabilizing the activity of ipsilesional M1 and then facilitating motor recovery.</p><p><strong>Clinical rehabilitation impact: </strong>This study highlights the unique role of MT in addressing abnormal brain dynamics, emphasizing its addition to standard rehabilitation protocols.</p>","PeriodicalId":12044,"journal":{"name":"European journal of physical and rehabilitation medicine","volume":" ","pages":"184-194"},"PeriodicalIF":3.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105044/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970262","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}