PM&R最新文献

{"title":"Correlating autonomic physiology with symptoms of autonomic dysreflexia after spinal cord injury.","authors":"Jennifer Dens Higano, Kathryn Burns, Geoffrey Smith, Ryan Solinsky","doi":"10.1002/pmrj.13295","DOIUrl":"10.1002/pmrj.13295","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury (SCI) commonly have autonomic dysreflexia (AD) with increased sympathetic activity. After SCI, individuals have decreased baroreflex sensitivity and increased vascular responsiveness.</p><p><strong>Objective: </strong>To evaluate the relationship between baroreflex and blood vessel sensitivity with AD symptoms.</p><p><strong>Design: </strong>Case control.</p><p><strong>Setting: </strong>Tertiary academic center.</p><p><strong>Patients: </strong>14 individuals with SCI, 17 matched uninjured controls.</p><p><strong>Interventions: </strong>All participants quantified AD symptoms using the Autonomic Dysfunction Following SCI (ADFSCI)-AD survey. Participants received three intravenous phenylephrine boluses, reproducibly increasing systolic blood pressure (SBP) 15-40 mmHg. Continuous heart rate (R-R interval, ECG), beat-to-beat blood pressures (Finapres), and popliteal artery flow velocity were recorded. Vascular responsiveness (α1 adrenoreceptor sensitivity) and heart rate responsiveness to increased SBP (baroreflex sensitivity) were calculated.</p><p><strong>Main outcome measures: </strong>Baroreflex sensitivity after increased SBP; Vascular responsiveness through quantified mean arterial pressure (MAP) 2-minute area under the curve and change in vascular resistance.</p><p><strong>Results: </strong>SCI and control cohorts were well matched with mean age 31.9 and 29.6 years (p = .41); 21.4% and 17.6% female, respectively. Baseline MAP (p = .83) and R-R interval (p = .39) were similar. ADFSCI-AD scores were higher following SCI (27.9 ± 22.9 vs. 4.2 ± 2.9 in controls, p = .002). To quantify SBP response, MAP area under the curve was normalized to dose/body weight. Individuals with SCI had significantly larger responses (0.26 ± 0.19 mmHg*s/kg*μg) than controls (0.06 ± 0.06 mmHg*s/kg*μg, p = .002). Similarly, leg vascular resistance increased after SCI (24% vs. 6% to a normalized dose, p = .007). Baroreflex sensitivity was significantly lower after SCI (15.0 ± 8.3 vs. 23.7 ± 9.3 ms/mmHg, p = .01). ADFSCI-AD subscore had no meaningful correlation with vascular responsiveness (R² = 0.008) or baroreflex sensitivity (R² = 0.092) after SCI.</p><p><strong>Conclusions: </strong>Although this confirms smaller previous studies suggesting increased α1 adrenoreceptor sensitivity and lower baroreflex sensitivity in individuals with SCI, contrary to our hypothesis these differences lacked correlation to increased symptoms of AD. Further research into physiologic mechanisms is needed to explain why some individuals with SCI develop symptoms.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"478-484"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065649/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143010271","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":"Differences in content of care and outcomes between a clinical practice guideline adherent program and usual care for patellofemoral pain: A retrospective pilot study.","authors":"Shawn Farrokhi, Sara Gorczynski, Emma Beisheim-Ryan, Sara R Piva, Daniel I Rhon, Richard W Willy, Marisa Pontillo","doi":"10.1002/pmrj.13298","DOIUrl":"10.1002/pmrj.13298","url":null,"abstract":"<p><strong>Background: </strong>Patellofemoral pain (PFP) is a common knee condition in young and active individuals that is managed with highly variable treatment strategies.</p><p><strong>Objective: </strong>To determine whether the length, number of visits, and content of physical therapy care for patients with PFP differ between a Clinical Practice Guidelines (CPG) adherent program and usual care. Additionally, the percentage of patients reporting clinically important improvements in patient-reported outcomes in each group was evaluated as an exploratory aim.</p><p><strong>Design: </strong>Retrospective analysis of clinical data.</p><p><strong>Setting: </strong>Military outpatient physical therapy clinics.</p><p><strong>Patients: </strong>Thirty-two patients who received CPG-adherent care and 46 patients who received usual care.</p><p><strong>Interventions: </strong>Patients in the CPG-adherent group were classified into overuse/overload, movement coordination deficits, muscle performance deficits, or mobility impairments subcategories based on CPG-recommended examination procedures and received the CPG-recommended interventions. Patients in the usual care group received interventions based on clinical expertise and organizational practice standards.</p><p><strong>Main outcomes measures: </strong>Length of care, number of visits, and intervention content were used as primary outcomes. The Anterior Knee Pain Scale (AKPS), Defense and Veterans Pain Rating Scale (DVPRS), and Global Rating of Change (GROC) scores were used as secondary outcomes. These scores were extracted from routinely collected health data available in medical records; as a result, not all patients completed these outcomes during the follow-up time points because they were optional.</p><p><strong>Results: </strong>The number of physical therapy visits and percentage of patients receiving knee-targeted exercises, soft tissue mobility interventions, neuromuscular reeducation, patient education, patellar taping, and foot orthoses were greater in the CPG-adherent group compared to usual care (p < .05). Additionally, most patients in the CPG-adherent group reported clinically meaningful improvements in secondary outcomes: AKPS (1 month: 13/23; 3 months: 11/16), DVPRS (1 month: 11/20; 3 months: 8/14), and GROC (1 month: 14/22; 3 months: 11/16). In contrast, fewer than half of the patients in the usual care group reached clinically meaningful thresholds: AKPS (1 month: 1/17; 3 months: 3/8), DVPRS (1 month: 3/15; 3 months: 3/7), and GROC (1 month: 2/12; 3 months: 2/7).</p><p><strong>Conclusion: </strong>The content of the CPG-adherent care was significantly different versus usual care and associated with meaningful changes in outcomes. Several CPG-recommended interventions appeared to be underused in usual care, underscoring the value of further CPG adoption.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"485-495"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922618","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 - May 2025 PM&R.","authors":"","doi":"10.1002/pmrj.13425","DOIUrl":"https://doi.org/10.1002/pmrj.13425","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"17 5","pages":"587-588"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975831","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 mirror therapy on motor and functional recovery of the upper extremity in subacute stroke: Systematic review and meta-analysis.","authors":"Yuan-Lun Hsieh, Tzu-Ying Yang, Zi-You Peng, Ray-Yau Wang, Hui-Ting Shih, Yea-Ru Yang","doi":"10.1002/pmrj.13316","DOIUrl":"10.1002/pmrj.13316","url":null,"abstract":"<p><strong>Objective: </strong>To review and synthesize existing evidence on the effect of mirror therapy (MT) on motor and functional recovery and the effect of unimanual and bimanual MT in individuals with subacute stroke.</p><p><strong>Methodology: </strong>PubMed, Physiotherapy Evidence Database, Cochrane, and Airiti Library were searched for relevant studies. Randomized and pilot randomized controlled trials comparing MT with sham MT or conventional therapy were included. Three researchers independently reviewed eligible studies for study design, participants' characteristics, intervention, and outcome measures and assessed study quality. The Physiotherapy Evidence Database scale was used to evaluate the methodological quality of included studies, and the Cochrane Risk of Bias Tool was used to assess the risk of bias.</p><p><strong>Synthesis: </strong>Fifteen studies with 546 participants were included. An overall effect of MT was found for motor impairment (effect size [95% confidence interval]: 0.473 [0.274-0.673], p < .001), motor function (0.266 [0.059-0.474], p = .012), and activities of daily living (ADL) (0.461 [0.25-0.671], p < .001), compared with controls. There was a significant difference in motor impairment (0.39 [0.134-0.647], p = .003), motor function (0.298 [0.003-0.593], p = .048), and ADL (0.461 [0.157-0.766], p = .003) in favor of bimanual MT compared with controls. No significant effect was found for unimanual MT.</p><p><strong>Conclusion: </strong>MT, specifically bimanual MT, is an effective intervention for improving motor recovery, motor function, and ADL in individuals with subacute stroke, whereas unimanual MT does not show significant benefits in these areas.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"567-581"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033854","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":"Comparison of the treatment efficacy of suprascapular nerve block and intra-articular shoulder injection techniques in patients diagnosed with adhesive capsulitis.","authors":"Muhammet Hüseyin Sarı, Ali Akdağ, Hanife Hale Hekim, Meral Bilgilisoy-Filiz","doi":"10.1002/pmrj.13286","DOIUrl":"10.1002/pmrj.13286","url":null,"abstract":"<p><strong>Background: </strong>Adhesive capsulitis (AC) is a common cause of shoulder disability. Interventional procedures are used along with many other treatment methods. There are insufficient studies directly comparing the superiority of suprascapular nerve block (SSNB) and intra-articular shoulder injection (IAI) techniques, which are frequently used interventional methods in treatment.</p><p><strong>Objective: </strong>To compare the efficacy of ultrasonography-guided SSNB and IAI techniques in terms of pain and functional status in the treatment of AC.</p><p><strong>Design: </strong>A single-center, double-blind randomized study.</p><p><strong>Setting: </strong>The study was conducted at the Physical Therapy and Rehabilitation outpatient clinic of Antalya Training and Research Hospital between March and October 2022.</p><p><strong>Participants: </strong>Eighty-four participants aged 15 to 75 years with a clinical diagnosis of AC were screened for the study, and 60 participants were included in the study after excluding participants who did not meet the criteria.</p><p><strong>Interventions: </strong>Participants were randomized into two groups with 30 participants in each group. Both groups received an injection of 1 mL of 40 mg of triamcinolone acetonide and 9 mL of 0.5% bupivacaine hydrochloride under ultrasonographic guidance.</p><p><strong>Main outcome measures: </strong>The patients' Shoulder Pain and Disability Index (SPADI) scores, shoulder active and passive range of motions (ROM), and visual analog scale (VAS) scores were evaluated before and after the injection in the 1st week, 4th week, and 12th week.</p><p><strong>Results: </strong>Our study found no significant difference in SPADI and ROM between the two groups when comparing pre-injection and post-injection results in 1st week, 4th week, and 12th week. When pre-injection and 1st week, 1st week and 4th week, 4th week and 12th-week measurements were compared, improvement in SPADI-Disability scores, SPADI-Total scores, active flexion, passive flexion, active abduction, passive abduction, and active extension ROM values continued until the 12th week in both groups. In both groups, improvement in SPADI-Pain scores, active external rotation, and passive external rotation ROM values continued until the 4th week. In terms of VAS scores, passive extension, active internal rotation, and passive internal rotation ROM values, there was a statistically significant improvement in both groups after the injection compared to pre-injection.</p><p><strong>Conclusion: </strong>The efficacy of SSNB and IAI techniques in the treatment of adhesive capsulitis was found to be similar. In both methods, significant improvements were observed in SPADI, ROM, and VAS measurements compared to baseline.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"505-512"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142771666","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":"Neuromuscular ultrasound in delayed sciatic neuropathy following hamstring tear.","authors":"Jasmina Solankee, Srivats Srinivasan, Russell Payne, Haibi Cai","doi":"10.1002/pmrj.13294","DOIUrl":"10.1002/pmrj.13294","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"582-584"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065090/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780880","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":"Role of inpatient rehabilitation facility functional measures to predict community discharge after stroke.","authors":"Elizabeth Mangone, Eashan Shahriary, Pamela Bosch","doi":"10.1002/pmrj.13266","DOIUrl":"10.1002/pmrj.13266","url":null,"abstract":"<p><strong>Background: </strong>This study investigated the association between stroke severity, functional status measured by the Inpatient Rehabilitation Facility-Patient Assessment Instrument (IRF-PAI), and community discharge from IRF.</p><p><strong>Objectives: </strong>Aim one examined the association between National Institutes of Health Stroke Scale (NIHSS) scores measured during the acute care stay and IRF admission functional status, measured by the admission IRF-PAI self-care and mobility functional measures, to deduce if functional measures can serve as a proxy for stroke severity. Aim two investigated the ability of the NIHSS and IRF-PAI admission functional measures to predict community discharge from IRF after stroke.</p><p><strong>Design: </strong>Retrospective cohort study using electronic health records and Uniform Data System. Medical Record file data from January 1, 2018, to December 30, 2019.</p><p><strong>Setting: </strong>Academic hospital-based IRF.</p><p><strong>Participants: </strong>Five hundred forty-four patients transferred from acute care hospital to IRF after an ischemic or hemorrhagic stroke. Exclusion criteria included a transient ischemic attack, discharge against medical advice, death during IRF stay, or readmission to acute care within 48 hours of IRF admission.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Admission IRF-PAI self-care and mobility scores and discharge status from IRF.</p><p><strong>Results: </strong>Of the 544 patients, 76.7% had community discharge. NIHSS scores were significantly associated with IRF-PAI admission self-care scores across each NIHSS stroke category. There was no statistically significant association between NIHSS and IRF-PAI admission mobility score. IRF admission self-care and mobility scores were each statistically significant predictors of community discharge (odds ratio [OR] = 1.10, 95% confidence interval [CI]: 1.03-1.17; OR = 1.10, CI: 1.03-1.18, respectively). NIHSS scores were not a statistically significant predictor of community discharge (OR = 0.70, CI: 0.47-1.04) from IRF.</p><p><strong>Conclusions: </strong>IRF-PAI self-care functional measure is associated with the NIHSS and can serve as a proxy for stroke severity. IRF-PAI self-care and mobility measures each predict community discharge.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"522-528"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142352493","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 impact of body mass index on rehabilitation outcomes after lower limb amputation.","authors":"Andrew Dubin, Parisa Zarreii, Sharareh Sharififar, Ryan M Nixon, Rosalynn R Z Conic, Kailash Pendem, Heather K Vincent","doi":"10.1002/pmrj.13292","DOIUrl":"10.1002/pmrj.13292","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effect of obesity on physical function and clinical outcome measures in patients who received inpatient rehabilitation services for lower extremity amputation.</p><p><strong>Methods: </strong>A retrospective review was performed on patients with lower extremity amputation (n = 951). Patients were stratified into five categories adjusted for limb loss mass across different levels of healthy body mass index (BMI), overweight, and obesity. Outcomes included the Inpatient Rehabilitation Facility Patient Assessment Instrument functional scores (GG section), discharge home, length of stay (LOS), therapy time, discharge location, medical complications and acute care readmissions. Deep learning neural networks (DLNNs) were developed to learn the relationships between adjusted BMI and discharge home.</p><p><strong>Results: </strong>The severely obese group (BMI > 40 kg/m²) demonstrated 7%-13% lower toileting hygiene functional scores at discharge compared to the remaining groups (p < .001). The severely obese group also demonstrated 8%-9% lower sit-to-lying and lying-to-sitting bed mobility scores than the other groups (both p < .001). Sit-to-stand scores were 16%-21% worse and toilet transfer scores were 12%-20% worse in the BMI > 40 kg/m² group than the other groups (all p < .001). Walking 50 ft with two turns was most difficult for the BMI > 40 kg/m² group, with mean scores 7%-27% lower than the other BMI groups (p = .011). Wheelchair mobility scores for propelling 150 ft were worst for the severely obese group (4.9 points vs. 5.1-5.5 points for all other groups; p = .021). The LOS was longest in the BMI > 40 group and shortest in the BMI < 25 group (15.0 days vs. 13.3 days; p = .032). Logistic regression analysis indicated that BMI > 40 kg/m² was associated with lower odds risk (OR) of discharge-to-home (OR = 0.504 [0.281-0.904]; p < .022). DLNNs found that adjusted BMI and BMI category were ranked 11th and 12th out of 90 model variables in predicting discharge home.</p><p><strong>Conclusion: </strong>Patients with severe obesity (>40 kg/m²) achieved lower functional independence for several tasks and are less likely to be discharged home despite higher therapy volume than other groups. If a patient is going home, obesity will pose unique demands on the caregivers and resources can be put in place to help reintegrate the patient into life.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"539-547"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829645","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":"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":"563-566"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","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":"Characterization and variability of PROMIS-10 scores with physical therapy in knee osteoarthritis: A retrospective review.","authors":"George R Malik, Jennifer Cheng, Rachel Rothman, Olivia Leupold, Shari Jawetz, Heidi Prather","doi":"10.1002/pmrj.13308","DOIUrl":"10.1002/pmrj.13308","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) and its impairments affect patients' physical and mental health. Radiographically severe knee OA is believed to respond less to conservative treatments including physical therapy (PT) but has not been compared specifically with Patient-Reported Outcomes Measurement Information System (PROMIS)-10.</p><p><strong>Objective: </strong>To correlate baseline PROMIS-10 physical and mental health scores in patients undergoing PT for knee OA, subgrouped by radiographic severity (Kellgren-Lawrence [KL] grade and number of knee compartments involved). Additionally, to describe the relationship between radiographic severity of knee OA and the change in PROMIS-10 scores post-PT.</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Outpatient musculoskeletal clinics at an orthopedic specialty hospital.</p><p><strong>Patients (or participants): </strong>One hundred nine patients (age ≥ 18 years) who presented for evaluation of knee OA from April 1, 2019 to August 1, 2021, had baseline radiographs, underwent PT, and completed PROMIS-10 at baseline and follow-up.</p><p><strong>Interventions: </strong>PT.</p><p><strong>Main outcome measure(s): </strong>PROMIS-10 physical and mental health scores.</p><p><strong>Results: </strong>Participants were 60% female; average age was 66.6 ± 10.0 years. Baseline PROMIS-10 physical and mental health scores averaged 44.4 ± 7.2 and 52.8 ± 9.0. Post-PT PROMIS-10 physical and mental health scores averaged 44.7 ± 6.7 and 52.6 ± 8.7. Physical health scores improved in 39% of patients; mental health scores improved in 36% of patients (no statistical significance). There was no relationship between post-PT PROMIS-10 scores and radiographic severity of knee OA. Females exhibited osteoarthritic changes in all compartments in 72% of cases compared to 55% of males (p = .020). Females demonstrated a higher predisposition for lateral compartment involvement (83% vs. 64%; p = .021) and a higher proportion of severe OA, radiographically, with a KL grade 3-4 (92% vs. 80%; p = .051).</p><p><strong>Conclusions: </strong>More than one third of patients with knee OA reported improved physical and mental health post-PT. The degree of benefit did not relate to radiographic severity. Although OA is characterized by radiographic measurements, there are variables beyond the radiographic imaging that may affect patient outcomes.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"496-504"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142971842","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}