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Occult presentation of spinal epidural abscess. 脊髓硬膜外脓肿的隐匿表现。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-15 DOI: 10.1002/pmrj.70025
Rotem Hass, Vincenzo Pizzuti, Ashley Petrone, Brett Begley
{"title":"Occult presentation of spinal epidural abscess.","authors":"Rotem Hass, Vincenzo Pizzuti, Ashley Petrone, Brett Begley","doi":"10.1002/pmrj.70025","DOIUrl":"https://doi.org/10.1002/pmrj.70025","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065165","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}
引用次数: 0
Virtual reality glove for home-based hand and arm stroke rehabilitation (vREHAB). 用于家庭手部和手臂中风康复(vREHAB)的虚拟现实手套。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-15 DOI: 10.1002/pmrj.70014
Ling Yan, Julie Muccini, Leonel Lugo, Michael Mlynash, Laura Michiels, Geert Verheyden, Leen Saenen, Benjamin Dirlikov, Arshad Ali, Julie Lanphere, Henry Huie, Robin Lemmens, Maarten G Lansberg
{"title":"Virtual reality glove for home-based hand and arm stroke rehabilitation (vREHAB).","authors":"Ling Yan, Julie Muccini, Leonel Lugo, Michael Mlynash, Laura Michiels, Geert Verheyden, Leen Saenen, Benjamin Dirlikov, Arshad Ali, Julie Lanphere, Henry Huie, Robin Lemmens, Maarten G Lansberg","doi":"10.1002/pmrj.70014","DOIUrl":"https://doi.org/10.1002/pmrj.70014","url":null,"abstract":"<p><strong>Background: </strong>Upper extremity impairment is common after stroke. Virtual-reality rehabilitation systems may help restore hand and arm function.</p><p><strong>Objective: </strong>To assess the feasibility of the Neofect Smart Glove and its effect on functional recovery.</p><p><strong>Design: </strong>Multicenter, prospective, randomized, open-label, blinded-endpoint phase 2 trial consisting of a 12-week active treatment period followed by a 12-week follow-up period.</p><p><strong>Study population: </strong>Patients with subacute and chronic stroke with upper extremity impairment.</p><p><strong>Interventions: </strong>Patients assigned to the intervention group were instructed to use the Smart Glove for a minimum of one session per day for at least 5 days per week during the 12-week active treatment period, in addition to their usual care. Patients in the control group received their usual care only.</p><p><strong>Outcomes: </strong>Feasibility was assessed by the total dose of rehabilitation. The change from baseline to week 12 on the Jebsen-Taylor Hand Function Test (JTHFT) was the primary efficacy outcome and the change on the Upper Extremity Fugl-Meyer Assessment (UE-FMA) was secondary.</p><p><strong>Statistics: </strong>Differences between treatment arms were compared using analysis of covariance in the overall population and, separately, in a post-hoc and exploratory analysis consisting of a subset of patients with mild to moderate upper extremity impairment (baseline JTHFT ≤500).</p><p><strong>Results: </strong>During the 12-week active treatment period, there were no differences between the intervention (n = 18) and control (n = 24) groups in the change in the JTHFT (median -64 vs. -69 seconds, p = .88), the change in the UE-FMA (median 8 vs. 8 points, p = .61), or the total dose of rehabilitation (median 1434 vs. 584 minutes, p = .18). Among the subgroup of patients with mild to moderate symptoms (baseline JTHFT ≤500, n = 31), Smart Glove assignment was associated with a greater improvement on the JTHFT (median -72 vs. -40 seconds, p = .01) and a greater dose of rehabilitation (median 1739 vs. 510 minutes, p = .04) during the active treatment period, but there was no difference in the change in the UE-FMA (median 10 vs. 8 points, p = .15).</p><p><strong>Conclusion: </strong>The addition of the Smart Glove to traditional rehabilitation therapy did not improve hand and arm function in the overall study population but may increase the dose of rehabilitation and improve hand and arm function for patients with mild to moderate upper extremity impairment.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065142","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}
引用次数: 0
How is wakeful rest operationalized and measured in daily life among adults with and without long-term conditions? A systematic scoping review. 在有和没有长期疾病的成年人中,清醒休息是如何在日常生活中运作和测量的?系统的范围审查。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-04 DOI: 10.1002/pmrj.70008
Martin Ackah, Katie L Hackett, Vincent Deary, Florentina Johanna Hettinga, Hosea Boakye, Ulric Sena Abonie
{"title":"How is wakeful rest operationalized and measured in daily life among adults with and without long-term conditions? A systematic scoping review.","authors":"Martin Ackah, Katie L Hackett, Vincent Deary, Florentina Johanna Hettinga, Hosea Boakye, Ulric Sena Abonie","doi":"10.1002/pmrj.70008","DOIUrl":"https://doi.org/10.1002/pmrj.70008","url":null,"abstract":"<p><p>A systematic scoping review was conducted to examine how rest is operationalized and measured in daily life among adults with and without long-term conditions. Searches were performed in PubMed, Cumulative Index to Nursing and Allied Health Literature, and Psych databases for studies from 1990 to 2024. Two independent reviewers screened and selected eligible studies, which included adults with and without long-term conditions. A content analysis was used to synthesize qualitative and quantitative evidence, categorizing rest-related descriptions. Additionally, descriptive and narrative synthesis methods were employed. Of 9393 initial records, 17 studies were included in the review. The findings revealed that rest was operationalized by several key elements, including cessation of activity or engagement in low-energy tasks (n = 9 studies); detachment from activities (n = 4 studies); experiences of peace, joy, and tranquility (n = 5 studies); and time for self-reflection and solitude (n = 2 studies). The operationalization of rest showed both similarities and differences between adults with and without long-term conditions. Although all groups defined rest in physical, emotional, and social terms, mental rest was more prominently emphasized by adults without long-term conditions. The review also identified the effects of rest, including improvements in well-being and psychological functioning (n = 4 studies) and enhanced energy levels that facilitated daily activities (n = 4 studies). However, \"excessive\" rest was linked to negative outcomes, such as increased physical symptoms and disability (n = 3 studies). Notably, only two studies assessed rest measurement tools for adults with long-term conditions. The findings suggest that rest can enhance energy, well-being, and functioning, but excessive rest may worsen physical symptoms and disability. Tailored guidance on optimal rest is essential for maximizing health benefits. The review also highlights the need for further research on comprehensive tools to measure rest.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001362","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}
引用次数: 0
Advancements in large language model accuracy for answering physical medicine and rehabilitation board review questions. 回答物理医学和康复委员会审查问题的大语言模型准确性的进展。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-01 Epub Date: 2025-05-02 DOI: 10.1002/pmrj.13386
Jason Bitterman, Alexander D'Angelo, Alexandra Holachek, James E Eubanks
{"title":"Advancements in large language model accuracy for answering physical medicine and rehabilitation board review questions.","authors":"Jason Bitterman, Alexander D'Angelo, Alexandra Holachek, James E Eubanks","doi":"10.1002/pmrj.13386","DOIUrl":"10.1002/pmrj.13386","url":null,"abstract":"<p><strong>Background: </strong>There have been significant advances in machine learning and artificial intelligence technology over the past few years, leading to the release of large language models (LLMs) such as ChatGPT. There are many potential applications for LLMs in health care, but it is critical to first determine how accurate LLMs are before putting them into practice. No studies have evaluated the accuracy and precision of LLMs in responding to questions related to the field of physical medicine and rehabilitation (PM&R).</p><p><strong>Objective: </strong>To determine the accuracy and precision of two OpenAI LLMs (GPT-3.5, released in November 2022, and GPT-4o, released in May 2024) in answering questions related to PM&R knowledge.</p><p><strong>Design: </strong>Cross-sectional study. Both LLMs were tested on the same 744 PM&R knowledge questions that covered all aspects of the field (general rehabilitation, stroke, traumatic brain injury, spinal cord injury, musculoskeletal medicine, pain medicine, electrodiagnostic medicine, pediatric rehabilitation, prosthetics and orthotics, rheumatology, and pharmacology). Each LLM was tested three times on the same question set to assess for precision.</p><p><strong>Setting: </strong>N/A.</p><p><strong>Patients: </strong>N/A.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measure: </strong>Percentage of correctly answered questions.</p><p><strong>Results: </strong>For three runs of the 744-question set, GPT-3.5 answered 56.3%, 56.5%, and 56.9% of the questions correctly. For three runs of the same question set, GPT-4o answered 83.6%, 84%, and 84.1% of the questions correctly. GPT-4o outperformed GPT-3.5 in all subcategories of PM&R questions.</p><p><strong>Conclusions: </strong>LLM technology is rapidly advancing, with the more recent GPT-4o model performing much better on PM&R knowledge questions compared to GPT-3.5. There is potential for LLMs in augmenting clinical practice, medical training, and patient education. However, the technology has limitations and physicians should remain cautious in using it in practice at this time.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1091-1096"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008745","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}
引用次数: 0
Comparison of baseline PROMIS-10 scores of mental and physical health of patients with low back pain evaluated by physiatrists and orthopedic spine surgeons. 由物理医生和骨科脊柱外科医生评估的腰痛患者的身心健康基线promise -10评分的比较
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-01 Epub Date: 2025-05-07 DOI: 10.1002/pmrj.13378
Rachel Rothman, Glolabo Sokunbi, G Ross Malik, Ellen Casey, Jonathan Kirschner, Carlo Milani, Harvinder Sandhu, Jennifer Cheng, Heidi Prather
{"title":"Comparison of baseline PROMIS-10 scores of mental and physical health of patients with low back pain evaluated by physiatrists and orthopedic spine surgeons.","authors":"Rachel Rothman, Glolabo Sokunbi, G Ross Malik, Ellen Casey, Jonathan Kirschner, Carlo Milani, Harvinder Sandhu, Jennifer Cheng, Heidi Prather","doi":"10.1002/pmrj.13378","DOIUrl":"10.1002/pmrj.13378","url":null,"abstract":"<p><strong>Background: </strong>Enabling spine patients to access appropriate spine providers based on their course of care can enhance care outcomes. Physiatrists are trained to provide care throughout the continuum of low-back pain (LBP) symptoms and structural conditions that do not require urgent/emergent spine structural intervention.</p><p><strong>Objective: </strong>To assess if patients triaged to a physiatrist for LBP based on where they are in their continuum of spine care will report better baseline physical and mental health than patients presenting to a spine surgeon.</p><p><strong>Design: </strong>Retrospective study comparing physical and mental health (Patient-Reported Outcomes Measurement Information System [PROMIS]-10) in patients with LBP who are triaged for initial evaluations with physiatrists or spine surgeons.</p><p><strong>Setting: </strong>Tertiary orthopedic hospital.</p><p><strong>Patients: </strong>Adult patients presenting with chief concerns of nonemergent/nonurgent LBP to physiatry or spine surgery from April 1, 2019 to July 1, 2021.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measures: </strong>Initial-visit PROMIS-10 mental and physical health scores.</p><p><strong>Results: </strong>A total of 2646 new patients presented to physiatrists (n = 1911 [72.2%]) and spine surgeons (n = 735 [27.8%]). Patients evaluated by physiatrists had higher mental health (physiatry 50.1 ± 8.5, spine surgery 46.7 ± 9.0; p < .001) and physical health scores (physiatry 43.7 ± 7.5, spine surgery 39.8 ± 7.2; p < .001) than those presenting to spine surgeons. Furthermore, patients evaluated by physiatrists were more likely to have mental and physical health scores >55 and less likely to have scores <45 (p ≤ .001). Patients with LBP + lower extremity (LE) pain had significantly lower mental and physical health scores than those with LBP alone (mental health 48.5 ± 8.6 [LBP + LE-pain], 49.9 ± 8.9 [LBP-alone]; physical health 41.5 ± 7.3 [LBP + LE-pain], 44.0 ± 7.7 [LBP-alone]; p < .001).</p><p><strong>Conclusions: </strong>Patients directed to spine surgeons via triage had worse PROMIS-10 mental and physical health, suggesting this subgroup of patients may especially need additional resources to address these issues in the course of their care. Physiatrists provided nearly two-thirds of nonurgent LBP evaluations in this tertiary orthopedic center, serving an important role in the initial evaluation and treatment of nonurgent LBP. The impact on patient outcomes, patient satisfaction, and associated health care costs requires further investigation.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1069-1079"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008974","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}
引用次数: 0
Spanish Translated Abstracts. 西班牙语摘要翻译。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-01 DOI: 10.1002/pmrj.70034
{"title":"Spanish Translated Abstracts.","authors":"","doi":"10.1002/pmrj.70034","DOIUrl":"https://doi.org/10.1002/pmrj.70034","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":"17 9","pages":"1126-1133"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065177","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}
引用次数: 0
Comparative efficacy of platelet rich plasma, hyaluronic acid, and corticosteroid injections in adhesive capsulitis management: A meta-analysis. 富血小板血浆、透明质酸和皮质类固醇注射治疗粘连性囊炎的比较疗效:荟萃分析。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-01 Epub Date: 2025-04-24 DOI: 10.1002/pmrj.13376
Robert Valencia, Gowtham Anche, Vivian Cao, Dexter Chen, Vince Song, Akash Dontamsetty, Mikhail Volokitin
{"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":"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 (I<sup>2</sup> > 50) was observed, underscoring the need for future research to standardize methodologies and improve consistency.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1097-1106"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","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}
引用次数: 0
The association between chronic pain and metabolic syndrome: A scoping review. 慢性疼痛和代谢综合征之间的关系:范围综述。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-01 Epub Date: 2025-03-15 DOI: 10.1002/pmrj.13361
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
{"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":"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":"1107-1119"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","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}
引用次数: 0
Importance of muscle health during CAR T therapy: A physiatrist's role during CAR T therapy. 在CAR - T治疗中肌肉健康的重要性:理疗师在CAR - T治疗中的作用。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-01 Epub Date: 2025-02-14 DOI: 10.1002/pmrj.13353
Shannon Strader, Margaret DiGuardo, Toure Barksdale
{"title":"Importance of muscle health during CAR T therapy: A physiatrist's role during CAR T therapy.","authors":"Shannon Strader, Margaret DiGuardo, Toure Barksdale","doi":"10.1002/pmrj.13353","DOIUrl":"10.1002/pmrj.13353","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1122-1123"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415035","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}
引用次数: 0
Developing an intensive aerobic exercise program after stroke: A pilot study. 中风后开展高强度有氧运动:一项初步研究。
IF 2.8 4区 医学
PM&R Pub Date : 2025-09-01 Epub Date: 2025-05-03 DOI: 10.1002/pmrj.13374
Brian Schibler, Michael Spinner, Imama A Naqvi, Joel Stein, Scott Barbuto
{"title":"Developing an intensive aerobic exercise program after stroke: A pilot study.","authors":"Brian Schibler, Michael Spinner, Imama A Naqvi, Joel Stein, Scott Barbuto","doi":"10.1002/pmrj.13374","DOIUrl":"10.1002/pmrj.13374","url":null,"abstract":"<p><strong>Background: </strong>Stroke is a major cause of disability. Exercise is associated with reduced stroke recurrence and improved function. Most interventions have focused on supervised training in clinical settings rather than unsupervised home exercise.</p><p><strong>Objective: </strong>To determine the feasibility of conducting a randomized trial comparing unsupervised, high-intensity home aerobic training to a waitlist control group in survivors of stroke.</p><p><strong>Design: </strong>Assessor blinded randomized controlled pilot study.</p><p><strong>Setting: </strong>Assessments in medical center, home training.</p><p><strong>Participants: </strong>Twenty-three participants who sustained a mild-moderate stroke (National Institutes of Health Stroke Scale score <15) at least 3 months prior were randomized to home aerobic training or waitlist control.</p><p><strong>Intervention: </strong>Aerobic training consisted of 8 weeks of stationary bicycle training, five times per week for 30 minutes with heart rate-guided intensity. Control group maintained their normal activities.</p><p><strong>Outcome measures: </strong>Adherence and retention were the primary focus of this evaluation. Secondary outcomes (aerobic capacity VO<sub>2</sub>max, gait, balance, and functional tests) were included for initial efficacy.</p><p><strong>Results: </strong>Of the 23 participants, only 15 were retained in the study. Dropouts were predominantly in the waitlist control group (3/13 in aerobic group, 5/10 in control group). No serious adverse events occurred. Self-efficacy and adherence to training duration and frequency was high, but only 50% achieved exercise intensity goals. Training benefits were modest with a VO<sub>2</sub>max increase of 1.7 mL/kg/min in the intervention group. The only statistical improvement in outcomes was with box and block testing, likely due to baseline intergroup differences.</p><p><strong>Conclusions: </strong>Before conducting a larger trial, challenges with home aerobic training in the stroke population must be addressed. Despite high exercise self-efficacy, there was high attrition, particularly in the waitlist control group. Future study design should implement an active control. Benefits were limited, likely due to low training intensity, and efforts should be made to improve quality of unsupervised training, such as providing motivational coaching and wearable exercise trackers.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1042-1054"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144027753","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}
引用次数: 0
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