PM&R最新文献

{"title":"Geographic impact on relative locations of interventional spine and musculoskeletal medicine fellowships relative to residency and first job placement.","authors":"Jimmy Wen, Ubaid Ansari, Mouhamad Shehabat, Burhaan Syed, Shannon Dwyer, Denise Nadora, Daniel Razick, Muzammil Akhtar, Joshua Levin","doi":"10.1002/pmrj.13360","DOIUrl":"https://doi.org/10.1002/pmrj.13360","url":null,"abstract":"<p><strong>Background: </strong>Interventional spine and musculoskeletal medicine (ISMM) is a relatively new and rapidly evolving field that utilizes minimally invasive and novel techniques to treat spine and musculoskeletal pain.</p><p><strong>Objective: </strong>To analyze recent geographical trends of ISMM fellows since these fellowships became recognized by the North American Spine Society (NASS) in 2020 (2020 to 2024).</p><p><strong>Methods: </strong>The relative distance from residency to fellowship, residency to first job, and fellowship to first job were analyzed. Relative locations were categorized as within 100 miles, same state, same region, or different region. Odds ratios (ORs) were calculated for the relative locations of each geographical region.</p><p><strong>Results: </strong>A total of 136 fellows from 26 of 28 (93%) NASS ISMM fellowship programs were included. The majority of fellows stayed within the same region from residency to fellowship (63%), residency to first job (67%), and fellowship to first job (65%). Fellows from the Northeast were more likely to stay within 100 miles (OR: 1.8), same state (OR: 2.1), and same region (OR: 2.6) as their residency. From residency/fellowship to first job, Northeast fellows had an increased likelihood of staying within 100 miles (p < .001/p = .021), same state (p < .001/p = .022), and same region (p = .002 for both). Fellows from the West, Midwest, and Southeast had a decreased likelihood of remaining nearby.</p><p><strong>Conclusion: </strong>ISMM fellows were more likely to stay within the same region as their residency and for their first job placement. Fellows from the Northeast had a greater likelihood of staying within 100 miles, same state, and in the same region.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649985","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":"Ultrasound examination following a suboptimal thoracic outlet syndrome surgery.","authors":"Alpaslan Fatih Kaynar, Abdullah Emre Uğur, Beytullah Yazar, Levent Özçakar","doi":"10.1002/pmrj.13375","DOIUrl":"https://doi.org/10.1002/pmrj.13375","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649987","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":"Effects of intermittent pneumatic compression on delayed onset muscle soreness and recovery of muscular fatigue.","authors":"Zhongke Gu, Jiansong Dai, Kai Xu, Gangrui Chen, Xuchen Yang, Ying Shen, Zhifei Yin, Sisi Huang","doi":"10.1002/pmrj.13377","DOIUrl":"https://doi.org/10.1002/pmrj.13377","url":null,"abstract":"<p><strong>Background: </strong>Delayed-onset muscle soreness (DOMS) is a prominent factor that contributes to the decline in athletic performance. However, there is an ongoing debate regarding the efficacy of intermittent pneumatic compression (IPC) in preventing or treating exercise-induced muscle injuries such as DOMS.</p><p><strong>Objective: </strong>To characterize the therapeutic effect of IPC on DOMS induced by plyometric exercise.</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Setting: </strong>Department of Sport and Health Sciences, Nanjing Sport Institute.</p><p><strong>Participants: </strong>Twenty healthy untrained male college students.</p><p><strong>Intervention: </strong>Participants were randomized into an IPC group (n = 10) and a control group (n = 10). DOMS was induced by performing lower limb plyometric exercises. After exercise, the IPC group was treated for 15 minutes with the same built-in protocol of the IPC device immediately and 24, 48, and 72 hours after exercise. Muscle soreness and condition were measured 1 hour before, immediately after, and at intervals of time following exercise: 24, 48, 72, and 96 hours.</p><p><strong>Main outcome measures: </strong>Muscle soreness was measured using the visual analog scale (VAS) and muscle condition was measured using tensiomyography.</p><p><strong>Results: </strong>Compared to control conditions, participants in the IPC group demonstrated significantly improved recovery in muscle soreness (VAS), maximal radial displacement (Dm) and contraction time (Tc) in single muscle contractions of lower limb muscle performance. Compared to the control group, the IPC group showed significant differences in VAS, Dm, and Tc (all p < .05 at 48  and 72 hours post exercise), and sustain time (Ts) (p < .05, 72 hours after exercise). Moreover, 48 hours after exercise, the VAS score was strongly negatively correlated with Dm and positively correlated with Tc, delay time, relaxation time, and Ts.</p><p><strong>Conclusions: </strong>IPC may mitigate exercise-induced DOMS following plyometric exercise. These findings suggest that the peak therapeutic effects appear 48-72 hours after exercise.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649981","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":"Gender composition of spasticity-related clinical practice guideline authorship positions.","authors":"Hannah Uhlig-Reche, Jeremy W Jacobs, Christine S Gaspard, Julie K Silver, Monica Verduzco-Gutierrez","doi":"10.1002/pmrj.13355","DOIUrl":"https://doi.org/10.1002/pmrj.13355","url":null,"abstract":"<p><strong>Background: </strong>The authors of clinical practice guidelines (CPGs) are considered topic experts and specialists. Studies to date have disproportionately found that women are underrepresented in CPG authorship, but no studies have investigated CPGs on spasticity published in the recent literature.</p><p><strong>Objective: </strong>To determine the gender composition of author positions on spasticity-related CPGs published from 2014 to 2023.</p><p><strong>Design: </strong>Retrospective review of literature.</p><p><strong>Setting: </strong>Systematic literature search using PubMed, SCOPUS, and CINAHL databases for spasticity-related CPGs available in English and published between 2014 and 2023.</p><p><strong>Participants: </strong>Authorship positions on spasticity-related CPGs published during the defined study period.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Gender composition of all author positions and physician author positions on spasticity-related CPGs published from 2014 to 2023 were compared with parity and equity benchmarks. The binomial test was used to assess for a difference in the observed versus expected distribution (parity) and the N - 1 χ² test was used to compare the gender proportions of authorship positions with the gender proportions of the equity benchmarks.</p><p><strong>Results: </strong>Six CPGs on spasticity were published during the study period. Most author positions were held by women (54.5%), whereas most physician author positions were held by men physicians (63%). Men physicians held significantly more positions compared with parity (p = .016). Women were overrepresented among all author positions compared with equity using total U.S. academic medicine faculty in neurology/physical medicine and rehabilitation (PM&R) at all benchmark years (95% confidence interval [CI]: 2014: 7.7-23.5; 2018: 4.2-20.0; 2022: 1.4-17.2). There was no difference in the gender composition of physician authors compared with academic medicine physicians in neurology/PM&R for any benchmark year (95% CI: 2014: -8.3 to 11.6; 2018: -2.0 to 7.9; 2022: -4.7 to 5.2).</p><p><strong>Conclusions: </strong>Physician authorship of recent spasticity-related CPGs comprises mostly men, a significant difference from parity but not from equity benchmarks. Women are overrepresented among total authorship positions (including nonphysicians) compared with equity, but not parity. Editorial boards should actively promote authorship diversity of these influential guidelines to minimize gender bias in health care delivery.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649983","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 association between chronic pain and metabolic syndrome: A scoping review.","authors":"Sebastian Encalada, James W Atchison, Cara C Prideaux, Samer Narouze, Johanna Mosquera-Moscoso, Laura Furtado Pessoa de Mendonca, Alejandro Hallo-Carrasco, Larry Prokop, Christine Hunt","doi":"10.1002/pmrj.13361","DOIUrl":"https://doi.org/10.1002/pmrj.13361","url":null,"abstract":"<p><p>Metabolic syndrome (MetS) is a prevalent comorbidity in patients with chronic pain conditions. Emerging evidence suggests that the relationship between MetS and chronic pain is bidirectional. This interplay involves complex mechanisms, including proinflammatory mediators in nociceptive modulation and pain-induced lifestyle changes affecting metabolic function. This scoping review examines the association between MetS and chronic pain. We conducted a scoping review, including 28 studies. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. We included observational studies (cross-sectional, case-control, and cohort studies) from the following databases: Ovid MEDLINE, EMBASE, Cochrane Central, Cochrane Database of Systematic Reviews, and Scopus. We identified studies on migraine (n = 9), spinal pain (n = 8), general chronic pain (n = 4), fibromyalgia syndrome (n = 3), carpal tunnel syndrome (n = 1), osteoarthritis (n = 1), shoulder pain (n = 1), and neuropathic pain (n = 1). Most studies used a cross-sectional design and standard criteria to define MetS, with some exceptions. Individuals with MetS and spinal pain, fibromyalgia, or general chronic pain showed higher pain scores and increased functional limitations. MetS was common in patients with migraine, but its effect on pain severity was inconclusive. The relationship between MetS and other pain conditions requires further investigation to clarify the association and potential mechanisms. MetS is prevalent in patients with chronic pain and is associated with worse pain and functional outcomes. Health care providers should acknowledge the wide spectrum of MetS beyond obesity. This understanding may help identify those at risk for more severe chronic pain.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634217","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":"Manual muscle testing of upper limb muscle strength in persons with tetraplegia undergoing surgical restoration of elbow extension: A scoping review.","authors":"Sabrina Koch-Borner, Ursina Arnet, Ann-Sofi Lamberg, Silvia Schibli, Jennifer Dunn","doi":"10.1002/pmrj.13348","DOIUrl":"https://doi.org/10.1002/pmrj.13348","url":null,"abstract":"<p><p>Tetraplegia often leads to upper limb disability due to triceps paralysis, affecting workspace and mobility. Restoring elbow extension via muscle-tendon or nerve transfer requires preoperative donor muscle strength assessment and postoperative evaluation. Manual muscle testing (MMT) is common, but inconsistencies in grading systems and procedures hinder cross-study comparisons. This study aims to examine how MMT is reported for assessing shoulder and elbow muscle strength in patients with tetraplegia undergoing elbow extension restoration. The review focuses on grading systems, targeted muscles, and testing procedures and positions used in MMT to advocate for standardization. A literature survey was conducted in September 2021 and repeated in September 2023 across five databases: Allied and Complementary Medicine Database, Embase, Medline, CINAHL, and Scopus. The search strategy utilized subject headings and keywords related to \"upper limb reconstructive surgery,\" \"tendon transfer surgery,\" \"nerve transfer surgery,\" and \"tetraplegia.\" Studies describing clinical information about assessment or outcomes of shoulder and elbow muscle strength using MMT in surgical elbow extension restoration in tetraplegia were included. Extracted data included study characteristics, surgical intervention, muscles tested, and description of how MMT is performed. These data were then analyzed to categorize and interpret existing practices. A total of 29 studies met the inclusion criteria. Among these, 66% focused on muscle-tendon, and 34% addressed nerve transfers. Donor strength was assessed preoperatively in 55% and postoperatively in 34%. Elbow extension strength was consistently reported postoperatively but only preoperatively in 83% of studies. Only five studies specified the positions used for muscle testing, but these positions varied. Despite numerous studies on elbow extension restoration outcomes in people with tetraplegia, there is no consistent approach for reporting muscle strength. Consistent reporting of pre- and postoperative muscle strength, including testing positions, is required to obtain standardized MMT positions. Similarly, the adoption of a universal scale could improve outcome reporting and synthesis.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625672","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":"Assessing the beliefs and impacts of strength training in a Division I collegiate gymnastics team.","authors":"Tammy Ng, Tyler Bendrick, Mary Swanstrom, Ellen Casey, Machelle Wilson, Kevin Burnham, Marcia Faustin","doi":"10.1002/pmrj.13350","DOIUrl":"https://doi.org/10.1002/pmrj.13350","url":null,"abstract":"<p><strong>Background: </strong>Traditionally, there has been a reluctance to use weight training with female gymnasts due to concerns that it could cause detrimental increases in muscle mass and impede flexibility. Recent literature has demonstrated that strength training has no significant effect on flexibility and can improve athletic performance.</p><p><strong>Objective: </strong>To assess in a pilot study the perceptions of collegiate gymnasts and coaches toward strength training after starting inaugural strength and conditioning training.</p><p><strong>Design: </strong>Survey-based study.</p><p><strong>Setting: </strong>National Collegiate Athletics Association Division I women's gymnastics program at a public university in California.</p><p><strong>Participants: </strong>Of the 23 gymnasts surveyed, 17 (74%) responded to the survey. Of the two coaches surveyed, both (100%) responded to the survey.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Descriptive statistics characterizing demographics, characteristics of gymnasts' strength and conditioning program, and perceptions regarding the safety of strength training and its impact on performance, body shape, flexibility, and injury rates.</p><p><strong>Results: </strong>Most gymnasts agreed (35%) or strongly agreed (59%) that weight training may improve performance. All gymnasts disagreed (59%) or strongly disagreed (41%) that weight training is not safe; 41% disagreed, 29% strongly disagreed, and 17% agreed that weight training may negatively affect body shape. Most gymnasts disagreed (59%) or strongly disagreed (18%) that weight training decreases flexibility; four (24%) felt neutral. Eighty three percent (59% strongly agree, 24% agree) felt that weight training had a positive impact on performance. More than half of the gymnasts either agreed (24%) or strongly agreed (29%) they had fewer injuries the season after implementing weight training, compared to prior seasons. Both coaches similarly endorsed the safety of strength training and its potential to improve performance.</p><p><strong>Conclusions: </strong>In this pilot study, collegiate gymnasts and coaches expressed generally positive perceptions toward the safety of strength training and its effect on performance. A small number of gymnasts expressed concerns regarding the effects of weight training on body shape and flexibility.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586695","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":"Preoperative muscle weakness is a risk factor for persistent pain 1 year after hip arthroscopy for femoroacetabular impingement syndrome.","authors":"Yuta Nanri, Kohei Nozaki, Takuya Maeda, Hiroyoshi Masuma, Manami Nihei, Takako Uchiya, Masashi Kawabata, Kensuke Fukushima, Michinari Fukuda","doi":"10.1002/pmrj.13352","DOIUrl":"https://doi.org/10.1002/pmrj.13352","url":null,"abstract":"<p><strong>Background: </strong>Femoroacetabular impingement syndrome (FAIS) is a common condition causing hip and groin pain. Hip arthroscopy has been established as a viable treatment option when nonoperative management fails to relieve symptoms of FAIS. Despite the numerous positive hip arthroscopy outcomes for FAIS, some individuals experience persistent postoperative pain. Preoperative muscle strength may be associated with persistent pain and function after arthroscopy in patients with FAIS; however, further investigation is necessary to confirm this theory.</p><p><strong>Objective: </strong>To determine the effect of preoperative muscle strength on persistent pain after arthroscopy in patients with FAIS.</p><p><strong>Design: </strong>Retrospective single-institution cohort study.</p><p><strong>Setting: </strong>Tertiary care university hospital in Japan.</p><p><strong>Participants: </strong>Seventy-eight patients who underwent hip arthroscopy for FAIS between December 2015 and September 2021.</p><p><strong>Methods: </strong>Data were collected on patient demographics, preoperative hip abductor and quadriceps strength, preoperative and postoperative visual analog scale (VAS) for pain, and postoperative patient-reported outcomes (PRO). Hip abductor and quadriceps strength were assessed only on the affected side using a hand-held dynamometer. The VAS uses a 100 mm horizontal line to assess pain intensity, with higher values indicating greater pain. PRO was assessed using the Japanese Orthopaedic Association Hip Disease Evaluation Questionnaire (JHEQ) score.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure: </strong>VAS score for pain 1 year postoperatively.</p><p><strong>Results: </strong>Of the 78 patients, 16 (20.5%) had persistent pain (VAS ≥30) 1 year postoperatively. Low preoperative hip abductor and quadriceps strength were associated with persistent pain after arthroscopy even after adjusting for age, gender, and preoperative VAS score (p = .021 and p = .030, respectively). Low preoperative hip abductor and quadriceps strength were associated with lower JHEQ scores 1 year postoperatively even after adjustments (p = .020 and p = .001, respectively).</p><p><strong>Conclusions: </strong>In these patients, low preoperative muscle strength compared with normal muscle strength was a risk factor for persistent pain and poor PRO scores 1 year postoperatively.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573656","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":"Prevention of concussion and long-term effects of repetitive traumatic brain injury: Unanimous consensus from the Cantu Concussion Summit.","authors":"Robert C Cantu, Allen K Sills, Michael L Alosco, Kristy B Arbogast, Jeffrey J Bazarian, Kevin F Bieniek, Jeff R Crandall, Grant L Iverson, Douglas I Katz, C Dirk Keene, John J Leddy, Christina D Mack, Ann C McKee, William P Meehan, Jesse Mez, Christopher J Nowinski, David O Okonkwo, Gary S Solomon, Thor D Stein, M Carmela Tartaglia, Ross D Zafonte, Daniel H Daneshvar","doi":"10.1002/pmrj.13332","DOIUrl":"https://doi.org/10.1002/pmrj.13332","url":null,"abstract":"<p><strong>Objective: </strong>The Cantu Concussion Summit aimed to gather clinicians and researchers to share findings and identify research gaps in brain injury and long-term cognitive disorders in athletes.</p><p><strong>Design: </strong>The conference concluded with a discussion of ways to best mitigate the risk of concussion and repetitive traumatic brain injury (RTBI).</p><p><strong>Setting and participants: </strong>The summit was supported by an unrestricted educational grant from the National Football League and featured a diverse group of experts from multiple disciplines.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measures: </strong>This discussion resulted in unanimous agreement supporting six consensus statements aimed at enhancing player safety and health.</p><p><strong>Results: </strong>These consensus statements are as follows: (1) Eliminate intentional and avoidable head impacts in sports practices and games. (2) Encourage policies that limit the number, duration, and intensity of head impacts during sports practices and games. (3) Reinforce proper and safer techniques to avoid head contact at all levels of play. (4) Implement rules that reduce and penalize intentional and avoidable contact to the head and neck. (5) Investigate specific clinical signs and symptoms associated with chronic traumatic encephalopathy neuropathology through further research. (6) Improve the criteria for traumatic encephalopathy syndrome through continued research.</p><p><strong>Conclusions: </strong>These consensus statements highlight opportunities to advance the understanding and prevention of concussions and RTBI, by emphasizing the need for ongoing research and policy changes to safeguard athletes' health and well-being. Implementation of these changes would reduce the burden of brain injuries in sports, promoting a safer environment for athletes at all levels.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557800","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":"Incidence of lymphedema among adults with cerebral palsy.","authors":"Christine R Gettys, Sean Smith, Kimberly K Rauch, Daniel G Whitney","doi":"10.1002/pmrj.13277","DOIUrl":"10.1002/pmrj.13277","url":null,"abstract":"<p><strong>Background: </strong>Lymphedema is a chronic and progressive condition but is understudied among adults with cerebral palsy (CP).</p><p><strong>Objective: </strong>To compare the 2-year incidence of lymphedema between adults with versus without CP before and after accounting for multimorbidity, cancer diagnosis/treatment, and lymph node/channel surgery.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Nationwide commercial claims data from January 1, 2011 to December 31, 2017.</p><p><strong>Participants: </strong>Adults ≥18 years old with and without CP with at least 12 months of continuous health plan enrollment, defined as the baseline period, were included for analysis. The 12-month baseline period was used to establish information on preexisting lymphedema (for exclusion), presence of cancer, including radiation treatment and lymph node surgery, and the Whitney Comorbidity Index (WCI).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure: </strong>The 2-year incidence rate (IR) and IR ratio (IRR) of lymphedema were evaluated. Cox regression estimated the hazard ratio (HR) of 2-year lymphedema after adjusting for age, gender, WCI, cancer diagnosis/treatment, and lymph node/channel surgery.</p><p><strong>Results: </strong>The 2-year IR of lymphedema was 5.73 (95% confidence interval [CI] = 4.59-6.88) for adults with CP (n = 9922) and 1.81 (95% CI = 1.79-1.83) for adults without CP (n = 12,932,288); the IRR was 3.17 (95% CI = 2.59-3.87) and the adjusted HR was 2.43 (95% CI = 1.98-2.98). There was evidence of effect modification by gender, age, and WCI score. All HRs were elevated, but men with versus without CP had higher HRs than women with versus without CP; HRs for adults with versus without CP were higher for younger participants and those with lower WCI scores.</p><p><strong>Conclusions: </strong>Adults with CP had a higher 2-year rate of lymphedema compared with those without CP. Men with CP had a disproportionately higher rate than women with CP when compared with their gender-based reference cohorts without CP.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"293-299"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392669","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}