PM&R最新文献

{"title":"Effectiveness and efficiency of telerehabilitation on functionality after spinal cord injury: A matched case-control study.","authors":"Alejandro García-Rudolph, Mark Andrew Wright, Carlos Yepes, Narda Murillo, Lucas Conesa, Ignasi Soriano, Raquel Bautista, Eloy Opisso, Josep Maria Tormos, Josep Medina","doi":"10.1002/pmrj.13125","DOIUrl":"10.1002/pmrj.13125","url":null,"abstract":"<p><strong>Background: </strong>Telerehabilitation in spinal cord injury (teleSCI) is a growing field that can improve access to care and health outcomes in patients with spinal cord injury (SCI). The clinical effectiveness of teleSCI is not known.</p><p><strong>Objectives: </strong>To compare independence in activities of daily living and mobility capacity in patients following teleSCI and matched controls undergoing traditional rehabilitation.</p><p><strong>Design: </strong>Matched case-control study.</p><p><strong>Setting: </strong>TeleSCI occurring in home setting (cases) versus traditional rehabilitation on inpatient unit (controls).</p><p><strong>Participants: </strong>Forty-two consecutive patients with SCI followed with teleSCI were compared to 42 historical rehabilitation inpatients (controls) matched for age, time since injury to rehabilitation admission, level of injury (paraplegia/tetraplegia), complete or incomplete injury, and etiology (traumatic/nontraumatic). The teleSCI group (n = 42) was also compared to the complete cohort of historical controls (n = 613).</p><p><strong>Interventions: </strong>The teleSCI group followed home-based telerehabilitation (3.5 h/day, 5 days/week, 67 days average duration) and historical controls followed in-person rehabilitation.</p><p><strong>Main outcome measure(s): </strong>The Functional Independence Measure (FIM), the Spinal Cord Independence Measure (SCIM) and the Walking Index for Spinal Cord Injury (WISCI). We formally compared gains, efficiency and effectiveness. International Standards for Neurological Classification of Spinal Cord Injury and the American Spinal Injury Association Impairment Scale (AIS) were used.</p><p><strong>Results: </strong>The teleSCI group (57.1% nontraumatic, 71.4% paraplegia, 73.8% incomplete, 52.4% AIS grade D) showed no significant differences compared with historical controls in AIS grades, neurological levels, duration, gains, efficiency and effectiveness in FIM, SCIM, or WISCI, although the teleSCI cohort had significantly higher admission FIM scores compared with the complete cohort of historical controls.</p><p><strong>Conclusions: </strong>TeleSCI may provide similar improvements in mobility and functional outcomes as traditional rehabilitation in medically stable patients (predominantly with paraplegia and motor incomplete SCI) when provided with appropriate support and equipment.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058629","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":"Exercise as a behavioral approach to improve mood in persons with traumatic brain injury.","authors":"Carly L A Wender, LaShawnna N Ray, Brian M Sandroff, Denise Krch","doi":"10.1002/pmrj.13091","DOIUrl":"10.1002/pmrj.13091","url":null,"abstract":"<p><p>Mood disturbance is a common, long-term, negative consequence of traumatic brain injury (TBI) that is insufficiently addressed by most traditional treatment modalities. A large body of evidence supports the efficacy of exercise training (ET) to broadly improve mood, as measured most often by the Profile of Mood States (POMS). However, this behavioral approach is not used nearly enough in the TBI population, and when it is, mood is rarely measured. This scoping review will evaluate the use of POMS as a mood measure in TBI research and to establish a rationale for using ET as a behavioral approach to broadly improve mood in persons with TBI.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49692067","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":"Posttraumatic osteoarthritis after athletic knee injury: A narrative review of diagnostic imaging strategies.","authors":"Alexandra E Fogarty, Michael C Chiang, Stephanie Douglas, Lauren H Yaeger, Fabrisia Ambrosio, Christian Lattermann, Cale Jacobs, Joanne Borg-Stein, Adam S Tenforde","doi":"10.1002/pmrj.13217","DOIUrl":"https://doi.org/10.1002/pmrj.13217","url":null,"abstract":"<p><p>Intraarticular knee injuries and subsequent posttraumatic arthritis (PTOA) are common in athletes. Unfortunately, PTOA may significantly affect performance and overall function, but this condition remains difficult to characterize. In this review, we provide an overview of imaging modalities used to evaluate PTOA among athletes and physically active individuals following knee injury, with the goal to discuss the strengths and limitations of their application in this population. A literature search was performed to identify clinical studies focusing of knee injuries in athletes and athletic persons, specifically using imaging for diagnosis or monitoring disease progression. A total of 81 articles were identified, and 23 were included for review. Studies on plain radiographs (n = 8) and magnetic resonance imaging (MRI) assessed arthritic burden (n = 13), with MRI able to depict the earliest cartilage changes. Few studies (n = 2) leveraged ultrasound. Challenges persist, particularly regarding standardization and reliability across different radiographic grading systems. Additionally, further research is needed to establish the clinical significance of techniques to assess cartilage composition on MRI, including ultrashort echo-time enhanced T2*, T1rho and T2 imaging. Addressing these challenges through standardized protocols and intensified research efforts will enhance the diagnostic utility of imaging modalities in musculoskeletal medicine and enable high-quality prospective studies.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856247","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":"Beliefs regarding the use of imaging among patients with low back pain: A cross-sectional study in the context of a middle-income country.","authors":"Leandro M Diniz, Ítalo R Lemes, Ana P C F Freire, Ana F Guimarães, Lucas A C Ferreira, Marcia R Franco, Arianne P Verhagen, Guy Simoneau, Rafael Z Pinto","doi":"10.1002/pmrj.13237","DOIUrl":"https://doi.org/10.1002/pmrj.13237","url":null,"abstract":"<p><strong>Introduction: </strong>Patients with low back pain may play an active role in the prescription of excessive spine imaging.</p><p><strong>Objective: </strong>To determine the proportion of patients with low back pain who have beliefs not aligned with current evidence regarding the use of imaging and to identify factors associated with these beliefs.</p><p><strong>Design: </strong>Secondary analysis of baseline data of a previously published randomized clinical trial.</p><p><strong>Setting: </strong>Outpatient physical therapy clinic in a middle-income country.</p><p><strong>Patients: </strong>Individuals with non-specific low back pain.</p><p><strong>Methods: </strong>Outcome variables were two statements assessing the extent of patient agreement on the need for imaging in the management of low back pain. The predictor variables were age, educational level, duration of symptoms, disability level, pain intensity in the last 24 hours, beliefs about inevitable consequences of low back pain (assessed using the Back Belief Questionnaire), and having received imaging previously. Multivariable logistic models were used for data analysis.</p><p><strong>Main outcome measure(s): </strong>Level of agreement with Statement 1: X-rays or scans are necessary to get the best medical care for low back pain and Statement 2: Everyone with low back pain should have spine imaging.</p><p><strong>Results: </strong>A total of 159 patients were included. Of these, 88.1% believed that imaging was necessary for the best medical care for low back pain and 62.9% believed that everyone with low back pain should obtain imaging. Lower scores on the Back Belief Questionnaire were associated with beliefs that imaging was necessary (odds ratio [OR] = 0.90, 95% confidence interval [CI]: 0.81, 0.99) and low education level was associated with the belief that everyone with low back pain should obtain imaging (OR = 3.03, 95% CI: 1.38, 6.61), after controlling for potential confounders.</p><p><strong>Conclusion: </strong>Nearly 90% of patients believe that spine imaging is necessary for the management of low back pain. Beliefs about the inevitable consequences of low back pain and low education level may be factors that need to be considered when developing new interventions.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141856246","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":"Efficacy of mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions: A systematic review and meta-analysis.","authors":"Chernkhuan Stonsaovapak, Nantawan Koonalinthip, Wasuwat Kitisomprayoonkul","doi":"10.1002/pmrj.13239","DOIUrl":"https://doi.org/10.1002/pmrj.13239","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this systematic review and meta-analysis is to assess the efficacy of mirror neuron system-based therapy for managing pain and improving motor and upper limb function in patients with upper limb orthopedic conditions.</p><p><strong>Literature survey: </strong>Systematic bibliographical searches of the PubMed, SCOPUS, and CENTRAL registries and databases up to September 2023 were conducted to find randomized controlled trials (RCTs) assessing the efficacy of mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions.</p><p><strong>Methodology: </strong>Two reviewers assessed the RCTs using a Cochrane risk-of-bias tool and extracted data from studies with similar outcome measures in the domains of pain, motor function, or functional score, which were pooled into meta-analyses.</p><p><strong>Synthesis: </strong>The review included 13 studies to compare the efficacy of mirror neuron system-based therapy with that of conventional rehabilitation programs. The therapy reduced pain intensity (mean difference [MD] 2.04, 95% confidence interval [CI] 1.46-2.63) and kinesiophobia (MD 8.43, 95% CI 6.98 to 9.88), and increased grip strength (MD 1.86, 95% CI 0.28-3.45). The therapy also improved upper limb functional outcomes as assessed by the 30-item Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire score (MD 13.52, 95% CI 10.63-16.41). However, the outcomes as assessed by the 11-item QuickDASH questionnaire and the Shoulder Pain and Disability Index (SPADI) were not superior to conventional rehabilitation.</p><p><strong>Conclusions: </strong>Mirror neuron system-based therapy for rehabilitation of upper limb orthopedic conditions may reduce pain intensity and kinesophobia, and improve grip strength and DASH scores compared with conventional rehabilitation programs. However, this interpretation is limited by the heterogeneity and various quality of the RCTs included in our meta-analysis.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141760570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of exercise on bone density and physical performance in postmenopausal women: A systematic review and meta-analysis.","authors":"Hsin-Hui Hsu, Ching-Ya Chiu, Wei-Chen Chen, Yea-Ru Yang, Ray-Yau Wang","doi":"10.1002/pmrj.13206","DOIUrl":"https://doi.org/10.1002/pmrj.13206","url":null,"abstract":"<p><strong>Background: </strong>Postmenopausal bone loss and decreased physical performance are commonly presented issues. This study aimed through systematic review and meta-analysis to examine the benefits of adding exercise to medicine/supplements in postmenopausal women.</p><p><strong>Methods: </strong>A systematic search was conducted of four electronic databases for articles published from inception to December 2023. Clinical controlled trials comparing the effect of additional exercise and medicine/supplements alone in postmenopausal women were included. The outcomes studied were bone mineral density (BMD) and physical performance. The quality of evidence was evaluated by the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE).</p><p><strong>Results: </strong>Nineteen articles with 1249 participants were included in this study for systematic review and meta-analysis. The results showed that additional exercise was not associated with significantly improved BMD at the lumbar spine and hip joint compared with medicine/supplements only. However, results of subgroup analysis of exercise types showed a significant improvement in lumbar spine BMD by combining multiple types of exercise training (SMD = 0.37; 95% confidence interval [CI] = 0.01-0.72; p = .04). Furthermore, additional exercise significantly improved lower extremity muscle strength (Standard Mean Difference [SMD] = 1.77; 95% CI = 0.56-2.98; p = .004), Berg's Balance Scale (SMD = 0.72; 95% CI = 0.12-1.32; p = .02), Timed Up and Go (SMD = -1.07; 95% CI = -1.35--0.78; p < .001), fear of falling (SMD = 1.32; 95% CI = 0.89-1.75; p < .001), and the quality of life (SMD = 1.39; 95% CI = 0.74-2.05; p < .001). The quality level of the evidence was between low to very low.</p><p><strong>Conclusions: </strong>The significant value of the exercise was demonstrated through enhancing physical performance and quality of life. Moreover, combining various exercise training programs has shown a positive effect on BMD at the lumbar spine. Therefore, for postmenopausal women, combining exercise with medicine/supplements is recommended to further improve physical function and specific areas of BMD. (PROSPERO: CRD42023390633).</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141731332","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":"Medical schools producing the most physical medicine and rehabilitation residents: An analysis of matriculating residents from 2017 to 2021.","authors":"Devon T Shannon, Paige M Chase, Bailey W Frei, Trevor Anesi, Aaron J Yang","doi":"10.1002/pmrj.13216","DOIUrl":"https://doi.org/10.1002/pmrj.13216","url":null,"abstract":"<p><strong>Background: </strong>Residency choice is often influenced by experiences in medical school. It is unclear what potential factors contribute to medical schools producing higher numbers of physical medicine & rehabilitation (PM&R) residents.</p><p><strong>Objective: </strong>To identify the medical schools producing the most PM&R residents from 2017 to 2021 and potential influencing factors toward this production.</p><p><strong>Design: </strong>Descriptive, cross-sectional study.</p><p><strong>Setting: </strong>Accreditation Council for Graduate Medical Education accredited PM&R programs; allopathic/osteopathic/international medical schools.</p><p><strong>Interventions: </strong>REDCap Survey.</p><p><strong>Participants: </strong>Representatives from medical schools producing the most PM&R residents.</p><p><strong>Methods: </strong>The medical schools that produced the most PM&R residents from 2017 to 2021 were identified using publicly available information on the internet. A subgroup of the highest producing schools were surveyed to determine potential factors that contributed to production of PM&R residents.</p><p><strong>Main outcome measure: </strong>Medical schools with the highest number of matriculated PM&R residents from 2017 to 2021; potential factors influencing matriculating PM&R residents.</p><p><strong>Results: </strong>The medical school that produced the most PM&R residents from 2017 to 2021 was New York Institute of Technology College of Osteopathic Medicine. Nine of the 11 medical schools producing the most PM&R residents were osteopathic. Of osteopathic graduates applying to residency, 2.87% matriculated into PM&R residencies compared to 1.21% of allopathic graduates (p < .001), though a greater number of allopathic graduates overall were represented. Among survey respondents 93.3% (14/15) attributed exposure to PM&R faculty/residents and exposure to PM&R through medical school curriculum as perceived factors contributing to production of PM&R residents.</p><p><strong>Conclusion: </strong>Osteopathic medical schools accounted for most of the schools producing the highest number of PM&R residents. A statistically significant higher percentage of osteopathic graduates were found to pursue PM&R as a career compared to allopathic counterparts although the total number of students entering PM&R was greater from allopathic schools. Potential factors contributing to medical students pursuing PM&R included faculty/resident involvement with medical students, and PM&R exposure through curriculum or interest groups.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634325","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":"Analysis of supply and demand for sports medicine fellowship training: 2012-2022.","authors":"Jason Silvestre, Harris S Slone, John D Kelly","doi":"10.1002/pmrj.13236","DOIUrl":"https://doi.org/10.1002/pmrj.13236","url":null,"abstract":"<p><strong>Background: </strong>The recruitment of high-quality applicants is critical to the vitality of the sports medicine physician workforce.</p><p><strong>Objective: </strong>To analyze changes in the total number of available training positions, applicants, and unfilled training positions in the Sports Medicine Match from 2012 to 2022.</p><p><strong>Design: </strong>This was a retrospective cohort study of sports medicine fellowship applicants.</p><p><strong>Setting: </strong>Accreditation Council for Graduate Medical Education-accredited sports medicine fellowship training programs.</p><p><strong>Participants: </strong>A total of 3763 individuals applying for sports medicine fellowship training from 2012 to 2022.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Annual number of applicants, training positions, and number of unfilled training positions.</p><p><strong>Results: </strong>From 2012 to 2022, the annual number of training positions in sports medicine increased from 177 to 353 (99% increase, p < .001) while the annual number of applicants increased from 256 to 428 (67% increase, p < .001). The annual applicant-to-training position ratio decreased (1.4 to 1.2, p < .001). Annual match rates increased for both U.S. MD graduates (64% to 86%, p < .001) and non-U.S. MD graduates (64% to 77%, p < .001). U.S. MD graduates had higher match rates than non-U.S. MD graduates in 2021 (79% vs 70%, p < .05) and 2022 (86% vs 77%, p < .05). The percentage of applicants who matched at their first (36%-36%, p > .05), second (14%-15%, p > .05), and third (9%-8%, p > .05) ranked programs did not change. The percentage of applicants who did not match decreased (33%-19%, p < .001). The percentage of available fellowship training positions that went unfilled decreased (8%-2%, p < .001).</p><p><strong>Conclusions: </strong>Interest in sports medicine fellowship training is increasing as evidenced by an increasing number of applications and decreasing rate of unfilled training positions. Continued monitoring of future match cycles is important given projected shortages in the physician workforce.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141634324","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":"Weathering the storm: Effect of climate change on acute stroke care and stroke rehabilitation.","authors":"Erica M Jones, Aardhra M Venkatachalam, Nneka L Ifejika","doi":"10.1002/pmrj.13218","DOIUrl":"https://doi.org/10.1002/pmrj.13218","url":null,"abstract":"<p><p>Climate change has deleterious effects on stroke recovery, disproportionately affecting populations with increased stroke incidence. These effects start prior to the acute care hospitalization, precipitated by environmental etiologies and are sustained throughout the life course of stroke survivors. Health care practitioners play a critical role in identifying these concerns and mitigating their impact through effective strategies at the patient level, interventions at the community level, and advocacy at the state and federal level. As the experts on improvement in function, quality of life, and the mitigation of disability, physiatrists have the opportunity to lead efforts in this space for stroke survivors and their caregivers.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141627424","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":"Establishment of regression-based isometric strength reference values for the upper limb in persons with multiple sclerosis.","authors":"Heather M DelMastro, Abigail Robson, Elizabeth S Gromisch, Marc Campo, Laura B Simaitis, Albert C Lo, Zaenab Dhari, Jennifer A Ruiz","doi":"10.1002/pmrj.13234","DOIUrl":"https://doi.org/10.1002/pmrj.13234","url":null,"abstract":"<p><strong>Background: </strong>Muscle weakness is common and significantly affects persons with multiple sclerosis (PwMS), with dysfunction in upper limb (UL) muscle groups occurring in approximately 60% of PwMS.</p><p><strong>Objective: </strong>To develop gender-specific regression-based prediction equations, with 95% confidence intervals for maximal bilateral UL isometric strength (shoulder abduction and adduction, wrist flexion and extension) and hand grip strength in PwMS.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Comprehensive MS center.</p><p><strong>Participants: </strong>256 PwMS.</p><p><strong>Interventions: </strong>Not Applicable.</p><p><strong>Main outcome measures: </strong>Shoulder abduction and adduction and wrist flexion and extension isometric strength (Biodex System 4 Pro Dynamometer) and hand grip strength (Jamar handheld dynamometer) were measured. Disease characteristics (disability and disease duration) and demographics (age, height, and weight) were collected. Regression-based predictive equations were generated for the UL muscle groups for each gender and limb, using age, height, weight, disability, and disease duration as covariates. Variables were compared between genders using the Mann-Whitney U test. Maximal voluntary contraction (MVC) reference values (mean ± SD) were reported based on age (<30, 30-39, 40-49, 50-59, 60-69 years) and disability (mild, moderate, severe ambulant, and severe nonambulant) for each gender and limb.</p><p><strong>Results: </strong>Regression-based equations were developed for both genders' strongest and weakest limb, accounting for age, height, weight, disability, and disease duration. MVC was higher in men than women (p < .001) in all muscle groups. Overall, MVC was significantly related to age in 14, height in 5, weight in 6, disability in 14, and disease duration in none of the 20 models.</p><p><strong>Conclusion: </strong>This is the first study to provide regression-based prediction equations for strongest and weakest MVC of UL muscle groups and demonstrated an inverse relationship between MVC with disability and age. Regression-based reference strength values can help clinicians understand muscular strength along a spectrum of PwMS and can aid in goal setting and education for realistic outcomes.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":null,"pages":null},"PeriodicalIF":2.2,"publicationDate":"2024-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141591187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}