PM&R最新文献

{"title":"Establishment of regression-based isometric strength reference values for the upper limb in persons with multiple sclerosis.","authors":"Heather M DelMastro, Abigail Robson, Elizabeth S Gromisch, Marc Campo, Laura B Simaitis, Albert C Lo, Zaenab Dhari, Jennifer A Ruiz","doi":"10.1002/pmrj.13234","DOIUrl":"10.1002/pmrj.13234","url":null,"abstract":"<p><strong>Background: </strong>Muscle weakness is common and significantly affects persons with multiple sclerosis (PwMS), with dysfunction in upper limb (UL) muscle groups occurring in approximately 60% of PwMS.</p><p><strong>Objective: </strong>To develop gender-specific regression-based prediction equations, with 95% confidence intervals for maximal bilateral UL isometric strength (shoulder abduction and adduction, wrist flexion and extension) and hand grip strength in PwMS.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Comprehensive MS center.</p><p><strong>Participants: </strong>256 PwMS.</p><p><strong>Interventions: </strong>Not Applicable.</p><p><strong>Main outcome measures: </strong>Shoulder abduction and adduction and wrist flexion and extension isometric strength (Biodex System 4 Pro Dynamometer) and hand grip strength (Jamar handheld dynamometer) were measured. Disease characteristics (disability and disease duration) and demographics (age, height, and weight) were collected. Regression-based predictive equations were generated for the UL muscle groups for each gender and limb, using age, height, weight, disability, and disease duration as covariates. Variables were compared between genders using the Mann-Whitney U test. Maximal voluntary contraction (MVC) reference values (mean ± SD) were reported based on age (<30, 30-39, 40-49, 50-59, 60-69 years) and disability (mild, moderate, severe ambulant, and severe nonambulant) for each gender and limb.</p><p><strong>Results: </strong>Regression-based equations were developed for both genders' strongest and weakest limb, accounting for age, height, weight, disability, and disease duration. MVC was higher in men than women (p < .001) in all muscle groups. Overall, MVC was significantly related to age in 14, height in 5, weight in 6, disability in 14, and disease duration in none of the 20 models.</p><p><strong>Conclusion: </strong>This is the first study to provide regression-based prediction equations for strongest and weakest MVC of UL muscle groups and demonstrated an inverse relationship between MVC with disability and age. Regression-based reference strength values can help clinicians understand muscular strength along a spectrum of PwMS and can aid in goal setting and education for realistic outcomes.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"45-53"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Narrative review and call to action on reporting and representation in orthobiologics research for knee osteoarthritis.","authors":"Alexander Sin, William Hollabaugh, Lauren Porras","doi":"10.1002/pmrj.13214","DOIUrl":"10.1002/pmrj.13214","url":null,"abstract":"<p><p>Osteoarthritis affects a significant portion of U.S. adults, and knee osteoarthritis contributes to 80% of disease burden. Previous data have shown that non-White patient populations often report worse symptoms and less favorable outcomes following arthroplasty, a definitive treatment for knee osteoarthritis. There is a lack of demographics data on race/ethnicity, as well as socioeconomic status (SES) and social determinants of health (SDOH), in knee osteoarthritis treatment guidelines and knee arthroplasty research. In addition, there is underrepresentation of non-White patient populations in the existing treatment guidelines for knee osteoarthritis. Over the past decade, orthobiologics have emerged as an alternative to surgical intervention. Our hypothesis is that there would be a similar lack of reporting of demographics data and underrepresentation of non-White populations in studies pertaining to orthobiologics, including evaluating differences in outcomes. This study reviewed U.S.-based research in orthobiologics as a treatment option for knee osteoarthritis. We identified a lack of demographics reporting in terms of race/ethnicity, and none of the studies reported SES or SDOH. Non-White populations were underrepresented; White patients contributed to 80% or more of all study populations that reported race/ethnicity. None studied the correlation between symptoms and outcome measures, and the race/ethnicity, SES, and SDOH of the patients. Based on a review of existing literature, we strongly advocate for ongoing research encompassing patients of all races/ethnicities, SES, and SDOH, and an exploration into potential variations in symptoms and outcomes among distinct population subgroups. Furthermore, SES barriers may influence health care delivery on orthobiologics for disadvantaged populations.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"88-95"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-perceived preparedness for practice among graduating physical medicine & rehabilitation residents.","authors":"Nathan A Wasserman, Laura Y Huang, Diana M Molinares, Timothy Tiu","doi":"10.1002/pmrj.13246","DOIUrl":"10.1002/pmrj.13246","url":null,"abstract":"<p><strong>Background: </strong>There is little research regarding the self-perceived preparedness of residents to enter independent practice after training. Given the vast breadth of physical medicine & rehabilitation (PM&R) and the increasingly complex and wide-ranging responsibilities and roles of physiatrists, this study is necessary to evaluate residents' perspectives of how programs are preparing them in the face of the changing practice environment.</p><p><strong>Objective: </strong>To identify how graduating PM&R residents perceived their training to prepare them for future practice. The researchers assessed perceived preparedness in six domains: (1) evaluation and management of conditions, (2) settings and responsibilities of practice, (3) familiarity with administrative processes, (4) physiatric-specific prescriptions, (5) performing procedures, and (6) interpretation of diagnostic studies.</p><p><strong>Design: </strong>Survey.</p><p><strong>Setting: </strong>Virtual.</p><p><strong>Participants: </strong>Graduating PM&R residents in their final year of training in the United States were invited to complete the survey. Of 415 graduating residents, 54 accessed the survey, and 40 (9.6%) fully completed questions relating to preparation by residency.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure: </strong>Self-perceived preparedness for practice among graduating residents across 70 subdomains of practice.</p><p><strong>Results: </strong>Mean preparedness was highest in the domain of physiatric prescription (3.45/5), and preparedness for administrative processes was significantly lower than all other domains (mean 2.25/5, p < .001). Across subdomains, the highest preparedness was in performing electromyography (4.48/5). Medical skills rated less than 2.50/5 included interpreting urodynamics (1.93/5), performing osteopathic manipulative therapy (1.57/5), and performing unguided peripheral nerve injections (2.25/5).</p><p><strong>Conclusions: </strong>Ultimately, residency programs should increase administrative training and identify internal strengths and weaknesses by polling their residents.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"24-31"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142666693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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 mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions: A systematic review and meta-analysis.","authors":"Chernkhuan Stonsaovapak, Nantawan Koonalinthip, Wasuwat Kitisomprayoonkul","doi":"10.1002/pmrj.13239","DOIUrl":"10.1002/pmrj.13239","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this systematic review and meta-analysis is to assess the efficacy of mirror neuron system-based therapy for managing pain and improving motor and upper limb function in patients with upper limb orthopedic conditions.</p><p><strong>Literature survey: </strong>Systematic bibliographical searches of the PubMed, SCOPUS, and CENTRAL registries and databases up to September 2023 were conducted to find randomized controlled trials (RCTs) assessing the efficacy of mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions.</p><p><strong>Methodology: </strong>Two reviewers assessed the RCTs using a Cochrane risk-of-bias tool and extracted data from studies with similar outcome measures in the domains of pain, motor function, or functional score, which were pooled into meta-analyses.</p><p><strong>Synthesis: </strong>The review included 13 studies to compare the efficacy of mirror neuron system-based therapy with that of conventional rehabilitation programs. The therapy reduced pain intensity (mean difference [MD] 2.04, 95% confidence interval [CI] 1.46-2.63) and kinesiophobia (MD 8.43, 95% CI 6.98 to 9.88), and increased grip strength (MD 1.86, 95% CI 0.28-3.45). The therapy also improved upper limb functional outcomes as assessed by the 30-item Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score (MD 13.52, 95% CI 10.63-16.41). However, the outcomes as assessed by the 11-item QuickDASH questionnaire and the Shoulder Pain and Disability Index (SPADI) were not superior to conventional rehabilitation.</p><p><strong>Conclusions: </strong>Mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions may reduce pain intensity and kinesophobia, and improve grip strength and DASH scores compared with conventional rehabilitation programs. However, this interpretation is limited by the heterogeneity and various quality of the RCTs included in our meta-analysis.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"59-75"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the editor regarding \"Hydrodilatation versus corticosteroid injection in treatment for adhesive capsulitis\" by Latzka et al.","authors":"Rick Schneider, Jennifer Cheng, Jo Hannafin, James Wyss","doi":"10.1002/pmrj.13244","DOIUrl":"10.1002/pmrj.13244","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"112-113"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142293739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latzka and Cali reply.","authors":"Erek Latzka, Malia Cali","doi":"10.1002/pmrj.13302","DOIUrl":"10.1002/pmrj.13302","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"114-115"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Departments.","authors":"","doi":"10.1002/pmrj.13338","DOIUrl":"https://doi.org/10.1002/pmrj.13338","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"17 1","pages":"E1-E9"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2023-2024 Reviewer Thank You.","authors":"","doi":"10.1002/pmrj.13346","DOIUrl":"https://doi.org/10.1002/pmrj.13346","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"17 1","pages":"117-119"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academy News - January 2025 PM&R.","authors":"","doi":"10.1002/pmrj.13337","DOIUrl":"https://doi.org/10.1002/pmrj.13337","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"17 1","pages":"116"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142984461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The importance of language in describing concussions: A qualitative analysis.","authors":"Peter Knowles, Katherine Schneider, Amy K Bugwadia, Piya Sorcar, Roy D Pea, Daniel H Daneshvar, Christine M Baugh","doi":"10.1002/pmrj.13256","DOIUrl":"10.1002/pmrj.13256","url":null,"abstract":"<p><strong>Background: </strong>Concussions are mild traumatic brain injuries that are often undiagnosed due to difficulties in identifying symptoms. To minimize the negative sequelae associated with undiagnosed concussion, efforts have targeted improving concussion reporting. However, knowing more about concussions does not indicate how likely an athlete is to report their concussion. Alternatively, the attitudes and beliefs of athletes and surrounding stakeholders have shown to be a better indication of whether an athlete intends to report their concussion. Prior research has shown that athletes report concussions less often when the injury is described using language that minimizes their severity, such as when it is referred to as a \"ding.\" This study evaluated whether describing concussions using the word \"brain\" was associated with individuals' underlying attitudes and beliefs about the injury's severity.</p><p><strong>Objective: </strong>To measure the relationship between perceived concussion severity and the language used to describe concussions, specifically whether participants used the word \"brain\" in describing the injury.</p><p><strong>Methods: </strong>One-on-one semi-structured telephone interviews were conducted, and a cross sectional secondary qualitative analysis was performed to assess participants' perceived concussion severity and their use of the word \"brain\" to describe concussions.</p><p><strong>Design: </strong>Cross-sectional secondary qualitative analysis.</p><p><strong>Setting: </strong>One-on-one semistructured telephone interviews.</p><p><strong>Participants: </strong>In 2017, 94 individuals involved in high school sports, including athletes, coaches, educators, parents of athletes, and athletic directors were recruited via convenience sampling.</p><p><strong>Main outcome measures: </strong>Respondents' perceived severity of concussions.</p><p><strong>Results: </strong>Individuals who used a brain phrase to describe concussion also perceived concussions as more severe (p < .001). Specifically, those who described concussions with maximum severity had higher odds of using brain phrases than those who described concussions as having minimum (odds ratio [OR] = 0.05, 95% confidence interval [CI] = 0.002-0.299, p < .001) or moderate severity (OR = 0.24, 95% CI = 0.086-0.647, p = .003), with the most significant relationship found among coaches.</p><p><strong>Conclusions: </strong>These findings demonstrate the relationship between medical terminology and perceived severity of concussions. This relationship may play a role in concussion reporting behavior for coaches, athletes, and parents. Education programs using similar medical terminology may promote concussion reporting behaviors.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"6-13"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142073699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}