PM&R最新文献

{"title":"Characteristics, proficiency profile, and specialty perceptions of Peruvian physiatrists: A survey study.","authors":"Roger De la Cerna-Luna, Daniel Fernandez-Guzman, Nives Santayana-Calisaya, Analia Velez de Villa-Velarde, Fernando Ylaquita-Chicata, Nataly Casas-Flores, Carol Valladolid-Evaristo","doi":"10.1002/pmrj.13331","DOIUrl":"https://doi.org/10.1002/pmrj.13331","url":null,"abstract":"<p><strong>Background: </strong>Despite the growth of physical medicine and rehabilitation (PM&R) in recent years, the same cannot be said for its workforce conditions. Although various issues regarding the reality of the physiatry workforce have been reported, no studies were found that have evaluated it in Peru.</p><p><strong>Objective: </strong>To assess characteristics, proficiency profile, and specialty perceptions of Peruvian physiatrists.</p><p><strong>Design: </strong>Cross-sectional survey, designed and validated by the Peruvian Society of PM&R.</p><p><strong>Setting: </strong>Online anonymous and voluntary questionnaire.</p><p><strong>Participants: </strong>One hundred five Peruvian physiatrists.</p><p><strong>Interventions: </strong>During August 2023, after approval from the ethics committee, a Google Forms questionnaire was shared with the participants via WhatsApp, providing information about study details. Responses were monitored through direct communication with each participant.</p><p><strong>Main outcome measures: </strong>Twenty-four questions covering sociodemographic data, training-related characteristics, work-related characteristics, proficiency perceptions, and specialty perceptions.</p><p><strong>Results: </strong>Most surveyed physiatrists were females (80%) and completed residency between 2017 and 2022 (46.7%). Only 2.8% had pursued a subspecialty fellowship; 41.9% were involved in teaching and easily found employment after residency. Most worked in the public sector (82.9%) and had a permanent employment status under the 728 regime (33.3%). Most reported having much proficiency (Level 3) in all competency domains. Mastery in ultrasound (US) (10.2%) and electrodiagnostic medicine (EDX) (4.1%) was reported mainly by those completing residency between 2017 and 2022. Only 2.9% reported ability to conduct scientific research. Overall satisfaction with the specialty was high (75.2%).</p><p><strong>Conclusions: </strong>The survey found that most of surveyed Peruvian physiatrists worked in the public sector, had permanent employment status, considered themselves highly proficient in all evaluated domains, reported low mastery in US and EDX, and were very satisfied with the specialty. Given the lack of literature, these findings provide valuable insights for policymakers and educators, highlighting key areas for improving conditions for the physiatry workforce.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449792","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 conservative intervention for kinesiophobia in individuals with a history of ankle sprain: A systematic review.","authors":"Takumi Kobayashi, Yuta Koshino","doi":"10.1002/pmrj.13328","DOIUrl":"https://doi.org/10.1002/pmrj.13328","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effect of conservative interventions on kinesiophobia, a fear-avoidance belief regarding exercise, in individuals who have had a lateral ankle sprain.</p><p><strong>Literature survey: </strong>Systematic computerized literature search was performed using PubMed, CINAHL, Web of Sciences, and Cochrane Library databases. Randomized controlled trials investigating the effects of conservative interventions on kinesiophobia in individuals with a history of lateral ankle sprain, including chronic ankle instability, compared to those of control, sham, or different conservative interventions were included. They were written in English and published prior to December 2023.</p><p><strong>Methodology: </strong>Two independent reviewers screened the studies using specific eligibility criteria. Study characteristics, patients, intervention and comparator, and outcome were extracted. Outcomes were defined as kinesiophobia observed using a questionnaire (eg, Tampa Scale for Kinesiophobia-11) or other means. The risk of bias was assessed using the Revised Cochrane risk of bias tool for randomized trials.</p><p><strong>Synthesis: </strong>Five randomized controlled trials were included. These studies examined the effects of transcranial direct current stimulation, joint mobilization, balance and strength training, visual biofeedback during multimodal training, and low-friction patches attached to the outside of shoes, respectively. Limited evidence from single studies showed that the visual biofeedback during walking and low-friction patches attached on the outside of shoes were significantly more effective than the control and other treatments for kinesiophobia in individuals with a history of a lateral ankle sprain. Because the intervention and control groups differed between studies, data synthesis through meta-analysis was not performed.</p><p><strong>Conclusions: </strong>Visual biofeedback during walking and low-friction patches attached on the outside of shoes may improve kinesiophobia in patients with a history of lateral ankle sprains. An approach to sensory-perceptual impairment in individuals with a history of lateral ankle sprains may be more effective in improving kinesiophobia. These conservative interventions may have an effect on kinesiophobia, but the evidence is limited.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449810","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":"Flipping the script: Conservative management of a flipped intrathecal baclofen pump.","authors":"Katherine Archibold, P Daniel McNeely, Alexander Whelan","doi":"10.1002/pmrj.13354","DOIUrl":"https://doi.org/10.1002/pmrj.13354","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441769","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":"Patients' real-world engagement with movement pattern modifications for nonarthritic hip-related pain.","authors":"Abby L Cheng, Austin J Hannemann, Brian K Brady, Madeline M Pashos, Julia B Huecker, Karen Steger-May, Heidi Prather, John C Clohisy, Marcie Harris-Hayes","doi":"10.1002/pmrj.13343","DOIUrl":"https://doi.org/10.1002/pmrj.13343","url":null,"abstract":"<p><strong>Background: </strong>Nonarthritic hip-related pain can cause chronic pain and disability. Movement pattern training is an effective nonoperative treatment when delivered via formal physical therapy, but some patients have limited access to physical therapy. Discussion of movement pattern training during a patient's initial visit to a medical provider could be a valuable addition to first-line management of hip pain. However, the general acceptability of movement pattern related activity modification is not yet known.</p><p><strong>Objective: </strong>To understand the real-world willingness of patients with nonarthritic hip-related pain to implement movement pattern modifications. A secondary goal was to explore adherence to movement pattern related activity modification after a single instructional session.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>Outpatient clinics of two U.S. tertiary care academic medical centers.</p><p><strong>Participants: </strong>Eighty-eight 15-40-year-old patients who were diagnosed by a musculoskeletal clinician with nonarthritic hip-related pain and advised to pursue nonoperative management.</p><p><strong>Interventions: </strong>Participants received a single instructional session of movement pattern training principles, in addition to usual nonoperative care.</p><p><strong>Main outcome measures: </strong>The primary outcome was the proportion of participants who reported implementing one or more movement pattern related activity modifications during the 12-week follow-up period. The secondary outcome was participants' self-reported proportion of time that movement pattern related activity modifications were implemented.</p><p><strong>Results: </strong>Eighty-eight participants enrolled (mean 27 [SD 8] years old, 81% (n = 71) female). By 12-week follow-up, 100% of the 80 retained participants implemented one or more movement pattern related activity modifications. Participants incorporated movement pattern modifications a median of 73% (interquartile range 50%-85%) of the time.</p><p><strong>Conclusions: </strong>Participants with nonarthritic hip-related pain demonstrated high willingness to engage in movement pattern related activity modification, even after a single instructional session. Instruction in movement pattern training principles during an initial medical visit for nonarthritic hip-related pain may be a valuable, well-received addition to traditional first-line management.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425951","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":"Advances in musculoskeletal ultrasound-Chronicle of a 25-year live witness.","authors":"Levent Özçakar","doi":"10.1002/pmrj.13341","DOIUrl":"https://doi.org/10.1002/pmrj.13341","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415032","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":"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":"https://doi.org/10.1002/pmrj.13353","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","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}

{"title":"Impact of animal-assisted intervention on therapy engagement in hospitalized children with traumatic brain injuries.","authors":"Miranda Yelvington, Beverly Spray, Frank Bregy, Amy Ramick, Austin Lovenstein, Marlene Walden","doi":"10.1002/pmrj.13335","DOIUrl":"https://doi.org/10.1002/pmrj.13335","url":null,"abstract":"<p><strong>Background: </strong>Individuals who sustained traumatic brain injuries in childhood may experience global challenges including disorders of consciousness, motor dysfunctions, and sensory impairments. Occupational and physical therapy are important parts of recovery from an acute brain injury, addressing deficits that directly affect functional recovery and return to age-appropriate activities of daily living. Difficulty with active engagement in therapy tasks can limit the effectiveness of therapeutic interventions. Therapists search for methods to increase patient engagement to bolster patient progress.</p><p><strong>Objective: </strong>To examine the effect of animal-assisted interventions on patient engagement and therapy participation in children with traumatic brain injuries.</p><p><strong>Design: </strong>Prospective, crossover design observational study with each patient serving as their own control.</p><p><strong>Setting: </strong>This study was conducted in a pediatric acute rehabilitation unit.</p><p><strong>Participants: </strong>Nine participants completed all study sessions.</p><p><strong>Intervention: </strong>Study participants completed four visits, two with animal-assisted intervention and two without animal-assisted intervention.</p><p><strong>Outcomes and measures: </strong>The Pediatric Rehabilitation Intervention Measure of Engagement, length of session, breaks needed.</p><p><strong>Results: </strong>The use of animal-assisted intervention resulted in significantly greater mean engagement scores and significantly greater affective and behavioral engagement scores. No significant differences were found with cognitive engagement score, length of session tolerated, or number of breaks required. No participants had decreased engagement when animal-assisted intervention was used.</p><p><strong>Conclusions: </strong>Animal-assisted intervention has the potential to increase therapy engagement in acute rehabilitation with children recovering from traumatic brain injuries.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415034","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":"Identifying malaligned knee screw during ultrasound examination.","authors":"Pelin Türkekul, Jakub Jačisko, Filip Jevič, Alena Kobesova, Levent Özçakar","doi":"10.1002/pmrj.13344","DOIUrl":"https://doi.org/10.1002/pmrj.13344","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415033","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":"Prevalence and treatment outcomes of persistent postural-perceptual dizziness after traumatic brain injury.","authors":"Brandon Johnson, Nathaniel Johnson, Jeffrey Staab, Dmitry Esterov","doi":"10.1002/pmrj.13339","DOIUrl":"https://doi.org/10.1002/pmrj.13339","url":null,"abstract":"<p><strong>Background: </strong>Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder that is a potential sequela of traumatic brain injury (TBI). Currently, little is known about how patients with TBI associated PPPD respond to typical PPPD treatment modalities.</p><p><strong>Objective: </strong>To investigate the prevalence of TBI as a precipitant for PPPD and assess outcomes of usual treatment.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Electronic medical records from a tertiary care center.</p><p><strong>Participants: </strong>Patients ≥18 years of age diagnosed with PPPD secondary to TBI between January 2015 and December 2022 who underwent 6 months of treatment with at least one return clinic visit.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure(s): </strong>Patients' best clinical global impression-improvement scale (CGI-I) score following 6 months of treatment were collected and then compared with previously published literature, with CGI-I scores of 1or 2 (indicating the patient was \"very much\" or \"much\" improved, respectively) considered treatment responders.</p><p><strong>Results: </strong>In total, 134 (8.9%) of 1503 patients had a TBI as the triggering event for PPPD. The mean age of this cohort was 47.6 years with most of these cases occurring after a mild TBI (85.8%). The proportion of females with post-TBI PPPD (58.2%) was significantly lower than the proportion with PPPD due to all causes (p < .037). The most common treatment prescribed was vestibular therapy (82.2%), and 53.3% of patients were considered treatment responders after 6 months. Patients with TBI-induced PPPD had a significantly worse mean CGI-I score (2.49 ± 1.1) when compared to prior literature (1.71 ± 0.83) (p < .001).</p><p><strong>Conclusions: </strong>This study found a 9% prevalence of PPPD following TBI in the largest cohort studied to date. Patients who developed PPPD following TBI did not respond as well to standard treatments as patients with other causes of the disorder, and thus may require closer clinical follow-up to assess treatment efficacy.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415036","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":"Telerehabilitation of patients with stroke: Initial program theories for successful implementation.","authors":"Mohamed M Hasan, Miriam R Rafferty, Elliot Roth, Sarah Abunaser, Justin D Smith, Lisa R Hirschhorn, Donna Woods","doi":"10.1002/pmrj.13322","DOIUrl":"https://doi.org/10.1002/pmrj.13322","url":null,"abstract":"<p><strong>Purpose: </strong>Telerehabilitation has proven effective for stroke survivors, yet it is slowly implemented. We developed Initial Program Theories (IPTs) that focus on the telerehabilitation of stroke survivors in the United States to uncover the possible causal relationship between implementation strategies and outcomes.</p><p><strong>Methods: </strong>We created a conceptual framework to steer the development of IPTs. Then, we extracted concepts from theoretical frameworks reported in telemedicine implementation literature combined with feedback meetings with stakeholders with relevant experience.</p><p><strong>Results: </strong>We developed a framework for implementing telerehabilitation that includes implementation levels, contextual domains, telerehabilitation technology, implementation phases, actors, targets, mechanisms, and outcomes. We created 27 IPTs that specify telerehabilitation interventions, implementation strategies, actors, targets, context, implementation mechanisms, and outcomes. The IPTs were refined and validated through feedback meetings.</p><p><strong>Conclusions: </strong>This study adds to the relatively scarce literature on IPT development. For each IPT, we elaborated on the implementation mechanism and how it could facilitate or hinder telerehabilitation implementation, an essential insight for researchers and professionals to plan successful implementation strategies. Understanding causal mechanisms helps identify implementation strategies that will work in the U.S. context and improve weak implementation strategies that are potentially significant or commonly used.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374659","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}