PM&R最新文献

{"title":"The relationship between falls and hip bone mineral density of paretic and nonparetic limbs after stroke.","authors":"Tugba Atan, Umay Ekinci, Ayca Uran San, Yasin Demir, Umut Guzelkucuk, Serdar Kesikburun, Sinem Uyar Koylu, Arif Kenan Tan","doi":"10.1002/pmrj.13290","DOIUrl":"10.1002/pmrj.13290","url":null,"abstract":"<p><strong>Background: </strong>Poststroke osteoporosis, particularly of the hip, and an increased risk of fractures due to accidental falls are well known in people with stroke. Only a few of the current stroke guidelines recommend bone mineral density (BMD) measurements during follow-up in this population and measurements are often performed unilaterally.</p><p><strong>Objectives: </strong>To compare femoral hip BMD between fallers and nonfallers among patients with stroke, while also assessing differences in balance, mobility, fear of falling, and exploring discrepancies between paretic and nonparetic sides within each group.</p><p><strong>Design: </strong>Cross-sectional.</p><p><strong>Setting: </strong>Inpatient stroke rehabilitation unit of a tertiary university hospital.</p><p><strong>Patients: </strong>Patients with unilateral hemiplegia hospitalized as a result of stroke.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The primary outcome was the femoral neck BMD measurement. Dual-energy x-ray absorptiometry was used to measure BMD. Secondary outcomes included Berg balance scale (BBS), timed up-and-go test (TUGT), functional ambulation classification (FAC), and falls efficacy scale-international (FES-I).</p><p><strong>Results: </strong>A total of 44 patients were enrolled. Twenty-two participants (50%) reported falling. There were no statistically significant differences in BMD (p = .504, p = .197, p = .667, respectively) and T-scores (p = .457, p = .194, p = .693, respectively) of paretic, nonparetic femoral neck, and lumbar spine between nonfallers and fallers. The BBS (p = .033, 95% confidence interval [CI] 0.17-19.05) was significantly lower in the fallers. The FES-I was statistically significantly higher in the fallers (p = .001, 95% CI -22.40 to -6.50). The BMD and T-scores of femoral neck between the paretic and the nonparetic limbs did not differ significantly in the nonfallers (n = 22) (p = .908, 95% CI -0.03-0.03; p = .886, 95% CI -0.27-0.24) but did differ in the fallers (n = 22) (p = .007, 95% CI -0.06 to -0.01; p = .006, 95% CI -0.51 to -0.09).</p><p><strong>Conclusions: </strong>This study emphasizes that hip BMD may differ on paretic and nonparetic sides, especially in patients with stroke and a history of falls and balance problems. Fall-related self-efficacy and balance may be determinants of falls in these patients.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"529-538"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740258","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":"Self-reported physical activity more than 1 year after stroke and its determinants in relation to the WHO recommendations.","authors":"Maria Kähler, Hanna M Nilsson, Lina Rosengren, Lars Jacobsson, Jan Lexell","doi":"10.1002/pmrj.13297","DOIUrl":"10.1002/pmrj.13297","url":null,"abstract":"<p><strong>Background: </strong>Physical activity (PA) after stroke has significant health benefits if it is conducted regularly, with sufficient intensity and duration. Because of the health benefits, it is important to identify those below the World Health Organization (WHO) recommended level of PA. However, few studies have assessed the level of PA after stroke in relation to the WHO recommendations and which sociodemographic factors and stroke characteristics are associated with those below the WHO recommendations.</p><p><strong>Objective: </strong>To assess survivors of stroke at least 1 year after onset and (1) describe their self-reported level of PA; (2) explore the association between PA, sociodemographics, and stroke characteristics, and (3) determine the characteristics of those below the WHO recommended level of PA.</p><p><strong>Design: </strong>Cross-sectional descriptive survey.</p><p><strong>Setting: </strong>Community settings.</p><p><strong>Participants: </strong>Data were collected from 160 survivors of stroke (mean age 73 years, 46% women, mean time since stroke onset 35 months).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The Swedish National Board of Health and Welfare Physical Activity Questionnaire and the following sociodemographics and stroke characteristics: gender, age, marital status, vocational situation, need for home help, use of mobility devices, time since stroke onset, first-time stroke, type of stroke, location of stroke, and stroke treatment.</p><p><strong>Results: </strong>Two thirds (66.3%) of the participants were below the WHO recommendations. The hierarchical regression analysis explained 13% of the variance in PA with need for home help as a single significant contributor. Those who did not meet the WHO recommendations were significantly older, more likely to live alone, and in need of home help and mobility devices.</p><p><strong>Conclusions: </strong>A majority of survivors of stroke do not meet the WHO recommended level of PA. Future studies should assess how other factors characterize those who are physically inactive. This knowledge could help rehabilitation professionals to target interventions and self-management programs to promote PA among survivors of stroke.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"513-521"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12065089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142922551","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":"Re: Autonomic dysreflexia: Current pharmacologic management.","authors":"Isaac Hernandez Jimenez, Andréane Richard-Denis","doi":"10.1002/pmrj.13296","DOIUrl":"10.1002/pmrj.13296","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"585-586"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142780928","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 role of rehabilitation across the continuum of liver disease from cirrhosis to transplantation and beyond: A narrative review.","authors":"Laura Malmut, Sarah Eickmeyer, Leslie Rydberg, Jacqueline Neal, Julie Lanphere, Kim Barker","doi":"10.1002/pmrj.13384","DOIUrl":"https://doi.org/10.1002/pmrj.13384","url":null,"abstract":"<p><strong>Objective: </strong>The authors' objective with this narrative review is to explore the impact of rehabilitative interventions at each stage of liver disease. TYPE: Narrative review.</p><p><strong>Literature survey: </strong>Literature search conducted in Medline, Embase, and Google Scholar databases.</p><p><strong>Methodology: </strong>Articles were included if they were identified in one of the three database, written in English, peer-reviewed, and involved human participants without any restrictions on the publication date. Reference lists of these publications were also scrutinized for other articles that might be relevant. Elibigle articles were reviewed to determine whether they met inclusion crtieria.</p><p><strong>Synthesis: </strong>Authors synthesized findings in the eligible articles to create a narrative summary.</p><p><strong>Conclusions: </strong>Chronic liver disease is a major cause of morbidity and mortality across the globe. Cirrhosis causes alterations in metabolic and circulatory functions that negatively affect nutritional status and exercise capacity. Frailty is identified in nearly half of patients with advanced liver disease and bears a poor prognosis. Exercise and nutritional interventions improve key components of physical frailty and quality of life in chronic liver disease and after liver transplantation. Early mobility is generally recommended following liver transplantation and deemed to be safe and feasible. Inpatient rehabilitation may be considered in patients who require ongoing daily medical management by a physician, demonstrate a significant functional decline from their baseline, tolerate intensive rehabilitation, and have functional goals that can be addressed by at least two skilled therapies. Rehabilitation is safe and improves outcomes at every stage of liver disease from cirrhosis to following transplantation. This literature review explores the impact of rehabilitative interventions at each stage of liver disease from cirrhosis to transplantation and beyond.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994739","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":"Frequency, characteristics, and reasons for termination of cerebral palsy clinical trials.","authors":"Michael J Gouzoulis, Dennis L Caruana, Ally Ae Lim Yang, Anthony E Seddio, Jonathan N Grauer, David B Frumberg","doi":"10.1002/pmrj.13398","DOIUrl":"https://doi.org/10.1002/pmrj.13398","url":null,"abstract":"<p><strong>Background: </strong>Cerebral palsy is a common neurodevelopmental disease. Clinical trials are essential to improve care for these patients, and trial termination can have a significant effect on progress.</p><p><strong>Objective: </strong>To investigate the frequency, characteristics, and reasons for termination for cerebral palsy clinical trials.</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Setting: </strong>Database.</p><p><strong>Main outcome measures: </strong>The ClinicialTrials.gov database was queried for all completed and terminated studies surrounding cerebral palsy. Trial characteristics and the reasons for termination were determined. Univariable and multivariable analysis was performed to determine independent predictive factors for termination of these clinical trials.</p><p><strong>Results: </strong>A total of 717 clinical trials were identified, of which 49 (6.8%) were terminated. The most common reasons for termination were recruitment/retention issues (26.5% of terminated trials), administrative/conduct reasons (20.4% of terminated trials), and scientific data from the trial (12.2% of terminate trials). On multivariable analysis, industry sponsorship was independently associated with termination (odds ratio, 3.25; p = .047). No other factors were associated with trial termination.</p><p><strong>Conclusions: </strong>Cerebral palsy clinical trials are terminated at a rate of 6.8%. The primary reason for trial termination was related to recruitment/retention issues, and the only factor that was predictive of termination was industry sponsorship. These reasons and factors should be considered when starting a clinical trial to minimize potential risk of premature termination.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041338","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":"Comparative efficacy of platelet rich plasma, hyaluronic acid, and corticosteroid injections in adhesive capsulitis management: A meta-analysis.","authors":"Robert Valencia, Gowtham Anche, Vivian Cao, Dexter Chen, Vince Song, Akash Dontamsetty, Mikhail Volokitin","doi":"10.1002/pmrj.13376","DOIUrl":"https://doi.org/10.1002/pmrj.13376","url":null,"abstract":"<p><strong>Objective: </strong>To compare the efficacy of platelet-rich plasma (PRP) and hyaluronic acid (HA) against corticosteroid injections in adult patients with adhesive capsulitis (AC), in impacting pain relief and range of motion (ROM).</p><p><strong>Literature survey: </strong>A systematic review was conducted between January and February 2024 through PubMed and Google Scholar using the following keywords: \"PRP,\" \"Hyaluronic Acid,\" \"Bone Marrow Aspirate,\" \"Frozen Shoulder,\" \"Periarthritis,\" \"Adhesive Capsulitis,\" and \"Corticosteroid Injections.\" Inclusion criteria were studies published between January 2019 and February 2024 and used corticosteroids as a comparison for orthobiologic treatment. The initial search yielded 47 studies, refined to 21 after applying eligibility criteria. Ultimately, six studies were selected.</p><p><strong>Methodology: </strong>Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, a Cochrane Risk of Bias analysis was performed, and data were independently extracted by multiple authors. A meta-analysis was conducted to compare the efficacy of PRP and HA against corticosteroids measured by visual analog scale (VAS), Shoulder Pain and Disability Index (SPADI), Disabilities of the Arm, Shoulder, and Hand (DASH), and UCLA Shoulder scores.</p><p><strong>Synthesis: </strong>Qualitatively, studies with 3 months or longer patient follow-ups demonstrated better long-term efficacy in pain reduction and ROM improvement with PRP or HA injections. A 6-month improvement in pain as measured by VAS had a significant standardized mean difference (SMD) of -1.31 (95% confidence interval [CI], -1.56 to 1.04). There were significant improvements in functional outcomes at 6 months in DASH (SMD of -1.23 [95% CI, -1.71 to -0.74]) and UCLA Shoulder scores (SMD of 0.74 [95% CI, 0.47-1.00]): No significant differences were observed in 3-month outcomes: DASH (SMD of -0.12 [95% CI, -0.54 to 0.30]) and SPADI scores (SMD of -0.34 [95% CI, -0.78 to 0.10]). Cochrane analysis identified one study with high risk of bias.</p><p><strong>Conclusions: </strong>The review highlights orthobiologics as a promising alternative to corticosteroid injections in managing AC, with PRP providing more long-term pain relief compared to corticosteroid injections. Improvements in shoulder ROM were also seen but require further studies to determine their significance. However, substantial heterogeneity (I² > 50) was observed, underscoring the need for future research to standardize methodologies and improve consistency.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050484","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":"Multidisciplinary collaborative guidance on the assessment and treatment of patients with Long COVID: A compendium statement.","authors":"Abby L Cheng, Eric Herman, Benjamin Abramoff, Jordan R Anderson, Alba Azola, John M Baratta, Matthew N Bartels, Ratna Bhavaraju-Sanka, Svetlana Blitshteyn, Jeffrey S Fine, Talya K Fleming, Monica Verduzco-Gutierrez, Joseph E Herrera, Rasika Karnik, Monica Kurylo, Michele T Longo, Mark D McCauley, Esther Melamed, Mitchell G Miglis, Jacqueline D Neal, Christina V Oleson, David Putrino, Leslie Rydberg, Julie K Silver, Carmen M Terzic, Jonathan H Whiteson, William N Niehaus","doi":"10.1002/pmrj.13397","DOIUrl":"https://doi.org/10.1002/pmrj.13397","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In 2021, the American Academy of Physical Medicine and Rehabilitation established the Multi-Disciplinary Post-Acute Sequelae of SARS-CoV-2 Infection Collaborative to provide guidance from established Long COVID clinics for the evaluation and management of Long COVID. The collaborative previously published eight Long COVID consensus guidance statements using a primarily symptom-based approach. However, Long COVID symptoms most often do not occur in isolation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Aims: &lt;/strong&gt;This compendium aims to equip clinicians with an efficient, up-to-date clinical resource for evaluating and managing adults experiencing Long COVID symptoms. The primary intended audience includes physiatrists, primary care physicians, and other clinicians who provide first-line assessment and management of Long COVID symptoms, especially in settings where subspecialty care is not readily available. This compendium provides a holistic framework for assessment and management, symptom-specific considerations, and updates on prevalence, health equity, disability considerations, pathophysiology, and emerging evidence regarding treatments under investigation. Because Long COVID closely resembles other infection-associated chronic conditions (IACCs) such as myalgic encephalomyelitis/chronic fatigue syndrome, the guidance in this compendium may also be helpful for clinicians managing these related conditions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Guidance in this compendium was developed by the collaborative's established modified Delphi approach. The collaborative is a multidisciplinary group whose members include physiatrists, primary care physicians, pulmonologists, cardiologists, psychiatrists, neuropsychologists, neurologists, occupational therapists, physical therapists, speech and language pathologists, patients, and government representatives. Over 40 Long COVID centers are represented in the collaborative.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Long COVID is defined by the National Academies of Sciences, Engineering, and Medicine as \"an IACC that occurs after SARS-CoV-2 infection and is present for at least 3 months as a continuous, relapsing and remitting, or progressive disease state that affects one or more organ systems.\" The current global prevalence of Long COVID is estimated to be 6%. Higher prevalence has been identified among female gender, certain racial and ethnic groups, and individuals who live in nonurban areas. However, anyone can develop Long COVID after being infected with the SARS-CoV-2 virus. Long COVID can present as a wide variety of symptom clusters. The most common symptoms include exaggerated fatigue and diminished energy windows, postexertional malaise (PEM)/postexertional symptom exacerbation (PESE), cognitive impairment (brain fog), dysautonomia, pain/myalgias, and smell and taste alterations. Holistic assessment should include a traditional history, physical examination, and additional diagnostic testing, as indicat","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143989898","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 spinal education for lumbar spinal stenosis (POSE-LSS): A qualitative analysis of patient experiences.","authors":"James E Eubanks, Jordan A Gliedt, Zachary A Cupler, Geronimo Bejarano, Esther R C Janssen, Richard L Skolasky, Rob J E M Smeets, Michael J Schneider","doi":"10.1002/pmrj.13388","DOIUrl":"https://doi.org/10.1002/pmrj.13388","url":null,"abstract":"<p><strong>Background: </strong>Surgical intervention for lumbar spinal stenosis (LSS) is common and associated with high rates of postoperative side effects or complications. Prehabilitation programs aim to reduce postoperative complications and enhance outcomes. However, the clinical effectiveness of prehabilitation programs for patients undergoing LSS surgery has yet to be fully investigated. A key part of this investigation is to gain insight into how to design these programs through an iterative process that includes feedback from patients' experiences.</p><p><strong>Objective: </strong>To explore patients' experiences with a novel prehabilitation program: Pre-Operative Spinal Education for Lumbar Spinal Stenosis (POSE-LSS).</p><p><strong>Design: </strong>Individual structured telephone interviews with pragmatic qualitative analysis.</p><p><strong>Setting: </strong>Academic medical center.</p><p><strong>Participants: </strong>Patients (n = 10) who underwent lumbar spinal stenosis surgery and completed the POSE-LSS program prior to their surgery were included (six women; four men, mean age: 62.3 years).</p><p><strong>Interventions: </strong>POSE-LSS is a novel multimodal, education-focused, time-efficient prehabilitation program for patients undergoing LSS surgery. Participants received the following: (1) educational booklet and video, (2) in-person physical therapy (PT) session, and (3) telemedicine visit with a physiatrist.</p><p><strong>Outcome measures: </strong>One-on-one structured interviews to understand patients' experiences with a LSS prehabilitation program.</p><p><strong>Results: </strong>Participants in this qualitative study described a favorable, unique, and feasible experience associated with participation in the POSE-LSS program. Three main themes were developed from these interviews about POSE-LSS: (1) it helped patients to better prepare for their surgery and improved postoperative expectations, (2) it addressed modifiable psychological factors associated with the surgical intervention, and (3) it fits into a larger support system necessary to meet patients' needs.</p><p><strong>Conclusions: </strong>The perspectives gained from this qualitative study can inform improved design and evaluation of LSS prehabilitation programs.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027757","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":"Clinical impact of a poststroke depression screening program.","authors":"Lai Gwen Chan, Matthew Hok Shan Ng, Olivia Harmony Chan, Juan Lih Eu, Ram Bajpai","doi":"10.1002/pmrj.13372","DOIUrl":"https://doi.org/10.1002/pmrj.13372","url":null,"abstract":"<p><strong>Background: </strong>The potential clinical impact of routine proactive detection and early intervention for poststroke depression (PSD) is currently unknown, despite broad evidence of the adverse impact of PSD on stroke outcomes.</p><p><strong>Objective: </strong>To measure the impact of a clinical service for routine poststroke depression (PSD) screening and intervention (Effective Mood Management After Stroke [EMMAS]) on the long-term outcomes of survivors of stroke.</p><p><strong>Design: </strong>Cross-sectional case-control comparison of propensity-score matched samples of patients with stroke.</p><p><strong>Setting: </strong>Tertiary hospital inpatient rehabilitation setting.</p><p><strong>Patients: </strong>A sample of patients with a diagnosis of stroke from preimplementation and a sample from postimplementation of EMMAS.</p><p><strong>Outcome measure: </strong>Poor long-term outcome was defined as a composite of death, institutionalization, requiring a full-time caregiver, or screening positive for depression at >5 years after stroke.</p><p><strong>Results: </strong>Matched samples (n=115) were identified and matched on demographics and stroke characteristics including severity. In the fully adjusted logistic regression for poor outcomes, patients from the EMMAS program were found to have a significantly lower odds of developing poor outcomes in the long term (odds ratio [OR], 0.37 [95% CI, 0.203-0.654], p < .001).</p><p><strong>Conclusion: </strong>Routine in-hospital screening and early intervention for PSD has the potential to improve long-term outcomes of survivors of stroke regardless of PSD diagnosis. All patients with stroke can potentially benefit from such an integrated model of care. Further cost-effectiveness analyses are required.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995016","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":"Exploring concordance between face-to-face and tele-assessment of upper limb functionality in people with multiple sclerosis.","authors":"Alba Navas-Otero, Irene Calles-Plata, Araceli Ortiz-Rubio, Sheila de Gómez-de-Castro, Alejandro Heredia-Ciuró, Marie Carmen Valenza, Irene Cabrera-Martos","doi":"10.1002/pmrj.13382","DOIUrl":"https://doi.org/10.1002/pmrj.13382","url":null,"abstract":"<p><strong>Background: </strong>People with multiple sclerosis (PwMS) experience fatigue, pain, and sensory-motor disturbances that limit fundamental daily activities. The development of techniques for remotely assessing upper limb functionality is crucial for advancing telemedicine as an integral part of the continuum of care for PwMS.</p><p><strong>Objective: </strong>To assess the agreement between face-to-face assessment and tele-assessment of upper limb functionality in PwMS.</p><p><strong>Method: </strong>A descriptive study was conducted to investigate the concordance. Participants were evaluated twice: once physically and once remotely. Upper limb functionality (Manual Ability Measure), upper limb extremity muscle strength and endurance (30-second Arm Curl Test), and range of motion (Range of Movement) were assessed.</p><p><strong>Results: </strong>A total of 42 PwMS were included in this study. The participants were included in a face-to-face assessment and tele-assessment of upper limb functionality. Concordance between both methods for upper limb extremity muscle strength and endurance, manual dexterity, motor speed, precision, and range of motion was assessed as high. Moreover, most confidence intervals were narrow and excluded 0.8.</p><p><strong>Conclusion: </strong>Tele-assessment of upper limb functionality showed high concordance with face-to-face assessment in PwMS. Tele-assessment of upper limb functionality through a video call system could serve as a complementary or alternative method to meet the increasing demand for monitoring multiple sclerosis disease progression.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143976448","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}