PM&R最新文献

{"title":"Predictors of improvement in community adolescents with chronic neck pain: A secondary analysis using different improvement criteria.","authors":"Rosa Andias, Mário Rodrigues, Anabela G Silva","doi":"10.1002/pmrj.13131","DOIUrl":"10.1002/pmrj.13131","url":null,"abstract":"<p><strong>Background: </strong>Interventions based on pain neuroscience education and exercise have emerged as effective in the management of chronic neck pain in adolescents. No studies have explored factors that might be associated with recovery in adolescents with neck pain.</p><p><strong>Objective: </strong>To explore predictors of improvement after an intervention based on exercise and pain neuroscience education.</p><p><strong>Design: </strong>Secondary analysis of a randomized trial.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>127 community adolescents with neck pain.</p><p><strong>Interventions: </strong>Blended-learning intervention based on exercise and pain neuroscience education.</p><p><strong>Main outcome measures: </strong>A set of variables including sociodemographic data, pain characteristics, physical activity, disability, sleep, catastrophizing, fear of movement, self-efficacy, symptoms of central sensitization, knowledge of pain neuroscience, pressure pain thresholds, and neck muscles endurance were used to predict a clinical response at 1 week after intervention and at 6-month follow-up.</p><p><strong>Results: </strong>Different predictors of improvement and non-improvement to intervention were found, but common predictors were not found for all the improvement criteria explored and time points.</p><p><strong>Conclusions: </strong>These findings suggest that using different criteria to characterize adolescents with neck pain as improved and non-improved after pain neuroscience education and exercise have an effect on the variables associated with a response to the intervention.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"981-991"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983610","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":"Factors associated with medial meniscal extrusion in non-osteoarthritic knees with medial meniscus tears: A cross-sectional study.","authors":"Xinguang Liu, Bin Yang, Chen Liu, Xing Xin","doi":"10.1002/pmrj.13134","DOIUrl":"10.1002/pmrj.13134","url":null,"abstract":"<p><strong>Background: </strong>Medial meniscal extrusion (MME) plays an important role in the progression of knee osteoarthritis. Exploring the factors associated with MME in non-osteoarthritic knees may assist in the prevention of osteoarthritis.</p><p><strong>Objective: </strong>To identify the factors associated with pathologic MME in non-osteoarthritic knees with medial meniscus tears (MMTs).</p><p><strong>Design: </strong>A cross-sectional study.</p><p><strong>Participants: </strong>One hundred fifty patients with non-osteoarthritic knees who underwent arthroscopic surgery for MMT. Patients were divided into a pathologic MME group (n = 54) and a control group (n = 96) based on whether a pathologic MME was present on magnetic resonance (MR) images.</p><p><strong>Setting: </strong>Tertiary medical institution.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The MME distance was measured on a coronal MR image obtained at the midpoint of the medial femoral condyle. An MME distance ≥3 mm was considered to indicate pathologic MME. Demographic and clinical data were collected as variables. Multivariable logistic regression analysis was performed to identify factors associated with pathologic MME.</p><p><strong>Results: </strong>After multivariable adjustment, body mass index (BMI) and the type of MMT were associated significantly with pathologic MME in the multivariable logistic regression model. Each unit higher in BMI was associated with a 13% higher risk of pathologic MME (odds ratio [OR] 1.13, 95% confidence interval [CI] 1.01-1.28, p = .04). The odds of pathologic MME were approximately four times and three times higher for radial tears (OR 4.34, 95% CI 1.25-15.03, p = .02) and complex tears (OR 3.07, 95% CI 1.17-8.05, p = .02) than for horizontal and longitudinal tears.</p><p><strong>Conclusions: </strong>BMI and the type of MMT were independent factors associated with pathologic MME in non-osteoarthritic knees with MMT. A higher BMI, radial tears, and complex tears were predisposed to pathologic MME.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"959-965"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176117","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":"Social determinants of health and COVID-19 recovery after inpatient rehabilitation.","authors":"Hannah Martin, Christopher Lewis, Sean Dreyer, Juliana Couri, Sanchita Sen, Prakash Jayabalan","doi":"10.1002/pmrj.13141","DOIUrl":"10.1002/pmrj.13141","url":null,"abstract":"<p><strong>Background: </strong>Neighborhoods with more social determinants of health (SDOH) risk factors have higher rates of infectivity, morbidity, and mortality from COVID-19. Patients with severe COVID-19 infection can have long-term functional deficits leading to lower quality of life (QoL) and independence measures. Research shows that these patients benefit greatly from inpatient rehabilitation facilities (IRF) admission, but there remains a lack of studies investigating long-term benefits of rehabilitation once patients are returned to their home environment.</p><p><strong>Objective: </strong>To determine SDOH factors related to long-term independence and QoL of COVID-19 patients after IRF stay.</p><p><strong>Design: </strong>Multisite cross-sectional survey.</p><p><strong>Setting: </strong>Two urban IRFs.</p><p><strong>Main outcome measures: </strong>Primary outcome measures were Post-COVID Functional Status Scale (PCFS) and Short Form-36 (SF-36) scores. Secondary outcomes were quality indicator (QI) scores while at IRF and a health care access questionnaire. Results were analyzed using analysis of variance and multivariate logistic regression analyses.</p><p><strong>Results: </strong>Participants (n = 48) who were greater than 1 year post-IRF stay for severe COVID-19 were enrolled in the study. Higher SF-36 scores were associated with male gender (p = .002), higher income (≥$70,000, p = .004), and living in the city (p = .046). Similarly, patients who were of the male gender (p = .004) and had higher income (≥$70,000, p = .04) had a greater odds of a 0 or 1 on the PCFS. Age was not associated with differences. Women were more likely to seek follow-up care (p = .014). Those who sought follow-up care reported lower SF-36 overall and emotional wellness scores, p = .041 and p = .007, respectively. Commonly reported barriers to health care access were financial and time constraints.</p><p><strong>Conclusions: </strong>Patients with SDOH risk factors need to be supported in the outpatient setting to maintain functional gains made during IRF stays. Female gender, income, and urban setting are potential predictors for long-term QoL and independence deficits after rehabilitation for COVID-19 infection. Low emotional wellness is an indicator for patients to seek out care as far out as 1 year from their rehabilitation stay.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"966-972"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194408","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":"Postinjection protocols following platelet-rich plasma administration for knee osteoarthritis: A systematic review.","authors":"Oscar Paul Levine, Koushik Kondapi, Vehniah Kristin Tjong, Chetan Gohal","doi":"10.1002/pmrj.13139","DOIUrl":"10.1002/pmrj.13139","url":null,"abstract":"<p><strong>Objective: </strong>Platelet-rich plasma (PRP) use in treating orthopedic conditions has increased, yet evidence of its clinical efficacy is inconsistent and limited by heterogeneity in osteoarthritis (OA) severity, PRP preparations and protocols, and clinical outcome measurement. This review aims to characterize the variations in postinjection protocols in studies assessing the clinical efficacy of PRP for knee OA.</p><p><strong>Literature survey: </strong>A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search from database inception to February 2023 of CINAHL, MEDLINE, and EMBASE was conducted.</p><p><strong>Methodology: </strong>Article screening, data extraction, and risk of bias assessments were completed in duplicate by two reviewers. Primary outcomes were presence/absence and timing of the following postinjection protocol components: nonsteroidal anti-inflammatory drug (NSAID) restrictions, non-NSAID analgesic and cryotherapy use, immediate knee flexion/extension, immediate rest, activity restriction, return-to-activity guidelines, and rehabilitation protocols. A descriptive analysis was used to analyze the data. Given study heterogeneity, a meta-analysis was not performed.</p><p><strong>Synthesis: </strong>A total of 187 studies were included for analysis. Half of all studies (51.9%) excluded patients due to preinjection NSAID use, most often within 5 days of blood sampling or injection. Postinjection NSAID restriction was included in 42.8% of studies, ranging from 1 to 1800 days. Few studies (19.4%) that permitted non-NSAID analgesia restricted their use prior to clinical assessments. Postinjection immediate flexion, extension, and immobilization were rarely (8.6%) mentioned. Activity restriction was included in a third of studies (35.3%), with the most frequent length of restriction being 1 day. Postinjection return-to-activity protocols were less common (20.3%), usually with a \"gradual\" and/or \"as tolerated\" recommendation. A minority of studies (16.0%) reported physical therapy protocols and the vast majority (93.3%) were home based.</p><p><strong>Conclusion: </strong>Significant heterogeneity remains in post-PRP injection protocols, with unclear consensus regarding optimal recommendations and limited rationale for the protocols outlined. Further study is necessary to compare protocols directly and to determine which pre- and postinjection recommendations can result in optimal outcomes.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1023-1029"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207442","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":"Cervical polyradiculopathy after varicella zoster virus reactivation.","authors":"Edmond Benedetti, Rebecca Liu, Steven Gershon","doi":"10.1002/pmrj.13124","DOIUrl":"10.1002/pmrj.13124","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1049-1051"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139741854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the risk of lumbar degenerative disc disease associated with swimming: A systematic review.","authors":"Connie Hsu, Timothy Genovese, Kelly C McInnis","doi":"10.1002/pmrj.13138","DOIUrl":"10.1002/pmrj.13138","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of the current study is to synthesize the outcomes of investigations reporting the odds of lumbar degenerative disc disease (DDD) in competitive swimmers compared to controls.</p><p><strong>Literature survey: </strong>PubMed, Embase, and Web of Science databases were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from inception until March 2023 to identify relevant studies evaluating the risk for lumbar DDD associated with swimming.</p><p><strong>Methods: </strong>Data in the current literature were synthesized for positive imaging findings of DDD at one or more lumbar level in swimmers compared to nonswimmers. Additionally, data regarding prevalence of lumbar disc degeneration and back pain in competitive swimmers were synthesized.</p><p><strong>Synthesis: </strong>Four studies were included in the final analysis. Study quality and risk of bias were deemed adequate. There was significant heterogeneity among studies (I² = 0.74) regarding data collected, population of swimmers, sample size, and methods. Therefore, a meta-analysis was not conducted. Three of the four studies included in this review reported that swimmers have increased odds of developing lumbar DDD. Additionally, secondary outcome analysis indicated that swimmers have a higher probability of developing moderate-to-severe back pain.</p><p><strong>Conclusion: </strong>Competitive swimming appears to be associated with the presence of DDD on advanced imaging and moderate-to-severe back pain. These findings are limited by significant differences in study methodology in the included studies. Although swimming is conventionally considered a low-impact sport, elite swimmers risk developing lower back pain and disc pathology, possibly because training involves unique biomechanics with repetitive rotational and hyperextension/flexion of the spine. Further research investigating risk factors involving biomechanics of swimming on the spine may have important implications for stroke technique, injury prevention, and rehabilitation for swimmers.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1012-1022"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158792","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":"Answering the Rehabilitation 2030 Call.","authors":"Emily Hillaker, Michael Bova, Jina Libby, Maria Tricarico, Patrick Andrews, Rebecca Scharf","doi":"10.1002/pmrj.13160","DOIUrl":"10.1002/pmrj.13160","url":null,"abstract":"<p><p>In 2017, the World Health Organization initiated a global effort to improve rehabilitative services by 2030, with the overall goal of helping individuals with disabilities achieve maximal independence and improved well-being. Though more than 1 billion people worldwide live with a disability, a significant portion do not have access to appropriate rehabilitative services. In low-income countries, such as Zambia, where rehabilitative services are greatly lacking, disability can further exacerbate economic disparities in the context of personal, cultural, and environmental factors that limit participation in society. Therefore, expansion of rehabilitative services in low-income countries is a pressing global need, and such efforts must be tailored to the societal and cultural framework in which they are implemented. Community-based rehabilitation programs are uniquely poised to provide services in similar low-to-middle-income countries as they eliminate travel barriers to care, allow for regular follow-up, and address the societal determinants of disability by encouraging greater community engagement and by decreasing cultural stigma around disability. Special Hope Network (SHN), a community-based rehabilitation organization in Lusaka, Zambia that serves families caring for children with physical and cognitive disabilities, represents a cost-effective, sustainable, and culturally practical model to provide rehabilitative care. We propose this organization's model as one that can be reproduced and expanded upon in other low-to-middle-income countries to answer the World Health Organization's call to action.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1030-1033"},"PeriodicalIF":2.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306687","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":"Lipohemarthrosis in the detection of intraarticular fractures: Looking beyond the tibial plateau.","authors":"Jack Porrino, Colby Shreve, Eric Marten, Hyojeong Lee, Andrew Haims","doi":"10.1002/pmrj.13220","DOIUrl":"10.1002/pmrj.13220","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1041-1048"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141564142","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":"Impact of the COVID-19 pandemic on the rate of lower limb amputation in Veterans.","authors":"Kierra J Falbo, Nicole R Walker, Amber L Wacek, Juan E Cave, Matthew D Sauerbrey, Amy A Gravely, Mary E Matsumoto, John M Looft","doi":"10.1002/pmrj.13130","DOIUrl":"10.1002/pmrj.13130","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic led to changes in health care, including postponement of nonurgent appointments. These changes, combined with overall decreased activity levels, may have placed individuals with vascular disease at increased risk for skin ulceration and amputation.</p><p><strong>Objective: </strong>To determine the rates of lower limb amputation in Veterans due to complications of diabetes and/or vascular disease in the year following onset of the COVID-19 pandemic (March 2020-March 2021) compared to the previous 3 years (March 2017-March 2020).</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Setting: </strong>Minneapolis Veterans Affairs Health Care System.</p><p><strong>Participants: </strong>Veterans with a vascular consult appointment note between March 1, 2017, and February 28, 2021.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Primary outcome was lower limb amputation rate in the year following onset of the COVID-19 pandemic compared to the previous 3 years. Secondary outcome was the rate of lower limb wounds in the same time frame. We hypothesized that rates of lower limb amputation and wounds increased during the pandemic.</p><p><strong>Results: </strong>Vascular consult appointments (n = 4183) were reviewed between March 1, 2017, and February 28, 2021. Significantly higher rates of amputation (7.52% vs. 5.19%; p = .006) and wound presence (16.77% vs. 11.66%; p < .001) were found 1 year postpandemic compared to the previous 3 years. Amputation and wound rates did not significantly increase between pairs of consecutive years prior to the pandemic but significantly increased between the year preceding the pandemic and the first year of the pandemic (amputation p = .047; wound p = .004).</p><p><strong>Conclusions: </strong>Increased rates of amputation and wounds in Veterans following the onset of the COVID-19 pandemic are likely due to disruption of care, lifestyle changes, and other pandemic-related factors. Awareness of COVID-19-related negative health effects is imperative for health care providers to ensure appropriate allocation of resources and alternate models for care delivery for amputation and preventative care as part of disaster response.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"973-980"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140120426","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":"Comparing apples to oranges: Bringing basic physics to the bedside.","authors":"Sammy Wu, Kristen De Vries, Iñigo San Millán, Grigory Syrkin","doi":"10.1002/pmrj.13135","DOIUrl":"10.1002/pmrj.13135","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1052-1055"},"PeriodicalIF":4.6,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139983609","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}