PM&R最新文献

{"title":"Feasibility of a mat-based Pilates program for community dwelling seniors to improve balance and core strength.","authors":"Luigi Gonzales, Katrina Ngo, Perri Kraus, Yueni Zander, Maya N Hatch","doi":"10.1002/pmrj.13358","DOIUrl":"10.1002/pmrj.13358","url":null,"abstract":"<p><strong>Background: </strong>Popular programs to combat the increased rates of falls and improve overall balance and strength in the aging population are limited by accessibility or focus on distal movements, thereby limiting gains from the programs. The use of an age-appropriate, community-based Pilates program focusing on core strengthening for improved balance is proposed.</p><p><strong>Objective: </strong>The primary objective was to test the feasibility, acceptability, and appropriateness of a mat-based, core strengthening Pilates program (aka Pilates Gold). The secondary objective was to investigate changes in balance and core strength for participating seniors.</p><p><strong>Design: </strong>Prospective pre-post, observational study.</p><p><strong>Setting: </strong>Classes were on site at two retirement community centers.</p><p><strong>Participants: </strong>Males and females (65 years old and older) were recruited from two different senior community centers on a first-come first-serve basis. Participants had to be (1) English speaking, (2) an existing resident at one of the retirement communities, and (3) considered healthy by common standards.</p><p><strong>Interventions: </strong>Mat-based Pilates program for 8 consecutive weeks. Movement difficulty and pace were slowly increased over the 8-week program, with a maximum of 17 different movements.</p><p><strong>Main outcome measures: </strong>Primary outcomes for feasibility of the Pilates program were the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure. Secondary outcomes included the Sitting-Rising test, Activities Balance Confidence, and Patient Global Impression of Change.</p><p><strong>Results: </strong>The Pilates program was deemed appropriate, acceptable, and feasible by >80% of senior participants. Over 80% also reported some level of change in overall health due to the program. No significant differences were observed in balance outcomes, although there were individual improvements.</p><p><strong>Conclusions: </strong>Community-based Pilates programs are highly desired, feasible, and acceptable. These results justify further studies, of longer training periods and perhaps increasing difficult levels, to determine if core strengthening mat-based Pilates is truly capable of improving balance, strength, and fall risks in seniors.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"905-916"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical medicine and rehabilitation and interdisciplinary spine clinic referrals are associated with increased conversion to spine surgery.","authors":"Karissa Yamaguchi, Stella Biehl, Murad Alostaz, Aiyush Bansal, Allen Benge, Luke Verst, Spencer Raub, Patricia Lipson, Rakesh Kumar, Venu Nemani, Andrew Friedman, Philip K Louie","doi":"10.1002/pmrj.13390","DOIUrl":"10.1002/pmrj.13390","url":null,"abstract":"<p><strong>Background: </strong>Currently, in the United States, many patients receive immediate referral to a spine surgeon upon concern for any spine pathology, prior to undergoing conservative management. However, research has demonstrated that referrals to spine surgeons for common problems such as low back pain are often not indicated. This situation leads to inefficient care, delayed conservative treatments, and longer wait times for available surgical consultations. Therefore, this highlights an opportunity to improve efficiency in care for patients and clinicians through proper triaging for spine surgery.</p><p><strong>Objective: </strong>To examine whether clinicians from physical medicine and rehabilitation (PM&R) and nonsurgical interdisciplinary spine clinics effectively triaged patients for spine surgeon evaluations.</p><p><strong>Design: </strong>Retrospective study (May 2022-April 2023) of consecutive new patients referred to a spine surgery clinic. Charts were evaluated to determine if surgery was indicated at the initial spine surgeon evaluation. The proportion of patients indicated for surgery was calculated based on the source of referral. An odds ratio (OR) of patients indicated for surgery was calculated to compare different specialty groupings.</p><p><strong>Setting: </strong>All new consecutive patients evaluated between May 2022 and April 2023 on the panels of two fellowship-trained orthopedic spine surgeons at a single outpatient clinic in the Pacific Northwest United States were included. Patients whose symptoms were associated with infections, trauma, and tumors were also excluded as these patients typically have elevated clinical acuity.</p><p><strong>Results: </strong>Of 503 patients, 247 (49.1%) were indicated for and underwent spine surgery within 6 months of initial evaluation. PM&R referrals were more likely to result in surgery compared to primary care physician referrals (OR, 2.88 [95% CI, 1.73-4.79]). Patients referred from interdisciplinary spine clinics were also more likely to undergo surgery compared to those referred by a primary care physician (OR, 2.36 [95% CI, 1.56-3.57]) or generalists (OR, 2.37 [95% CI, 1.58-3.57]).</p><p><strong>Conclusion: </strong>Referrals from PM&R and interdisciplinary spine clinics were significantly associated with increased odds of being indicated for surgery at the time of initial evaluation with a spine surgeon. These findings highlight how interdisciplinary efforts may reduce the nonoperative consultations seen by surgical spine clinicians.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"936-943"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094605","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":"Corticosteroid versus ketorolac injection for treatment of knee osteoarthritis flare.","authors":"Robert Bowers, William Berrigan, Gerardo E Miranda-Comas, Claudia Jimenez, Jennifer Soo Hoo","doi":"10.1002/pmrj.13387","DOIUrl":"10.1002/pmrj.13387","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"970-977"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144161101","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 electrical and magnetic stimulation on upper extremity function after stroke: A systematic review and network meta-analysis.","authors":"Apisara Keesukphan, Monchai Suntipap, Kunlawat Thadanipon, Suparee Boonmanunt, Pawin Numthavaj, Gareth J McKay, John Attia, Ammarin Thakkinstian","doi":"10.1002/pmrj.13356","DOIUrl":"10.1002/pmrj.13356","url":null,"abstract":"<p><strong>Objectives: </strong>To pool and rank the efficacy of various stimulation therapies, including repetitive peripheral magnetic stimulation (rPMS), neuromuscular electrical stimulation (NMES), functional electrical stimulation (FES), transcranial magnetic stimulation (TMS), and combinations of these interventions on upper extremity function, activities of daily living (ADL), and spasticity after stroke relative to sham/conventional rehabilitation.</p><p><strong>Literature survey: </strong>MEDLINE, Scopus, Physiotherapy Evidence Database, Cochrane Central Register of Controlled Clinical Trials, and Google Scholar were searched from inception to July 2022.</p><p><strong>Methodology: </strong>Randomized controlled trials comparing any of the interventions mentioned above (rPMS, NMES, FES, TMS, NMES+rPMS, NMES+TMS, FES+TMS, and conventional rehabilitation) on upper extremity function, ADL, or spasticity from five databases were systematically reviewed and collected. Two-stage network meta-analysis was applied.</p><p><strong>Synthesis: </strong>Thirty-four studies involving 1476 patients reporting upper extremity function with the Fugl-Meyer Assessment were pooled. NMES combined with rPMS, NMES, NMES combined with TMS, TMS, and FES showed significantly higher improvement than conventional rehabilitation, with pooled mean differences (95% confidence intervals) of 14.69 (9.94-19.45), 9.09 (6.01-12.18), 6.10 (2.51-9.69), 4.07 (0.33-7.81), and 3.61 (0.14-7.07) respectively. NMES combined with rPMS had the highest probability for improving upper extremity function. NMES plus TMS had the highest probability for improving ADL, but none of the interventions showed significant differences in spasticity.</p><p><strong>Conclusions: </strong>NMES plus rPMS might be the best intervention to improve upper extremity functions, with NMES plus TMS most likely to lead to improved ADL but the quality of the evidence is low.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"978-993"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144111846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early neurobehavioral outcomes in patients with suspected abusive head trauma receiving inpatient neurorehabilitation.","authors":"Ashley Fournier-Goodnight, Haley Bednarz Holm, Laura Jones, Andrew Jergel","doi":"10.1002/pmrj.13367","DOIUrl":"10.1002/pmrj.13367","url":null,"abstract":"<p><strong>Background: </strong>Patients with suspected abusive head trauma have worse neurobehavioral outcomes than patients with accidental mechanisms of brain injury and at times receive inpatient rehabilitation. However, precise information regarding outcomes among this patient population prior to discharge from an inpatient rehabilitation unit is largely unavailable.</p><p><strong>Objective: </strong>To describe neurobehavioral outcomes using a standardized and norm referenced measure and examine factors related to these outcomes among patients with presumed abusive head trauma who were receiving inpatient rehabilitation.</p><p><strong>Design: </strong>This study involved retrospective review/analysis.</p><p><strong>Setting: </strong>Participants were assessed during their admission to a large inpatient rehabilitation unit housed within an academic medical center.</p><p><strong>Participants: </strong>Participants included 45 pediatric patients admitted and evaluated between 2016 and 2022.</p><p><strong>Interventions: </strong>This study did not investigate intervention(s).</p><p><strong>Main outcome measure(s): </strong>The participants' neurobehavioral outcomes were assessed via the Mullen Scales of Early Learning, American Guidance Service (AGS) Edition.</p><p><strong>Results: </strong>The sample's global neurobehavioral functioning was below average, which was also the case for early visuospatial processing, receptive language, and gross motor abilities. Expressive language and fine motor abilities were comparatively intact. Developmental/age- and time-based variables were the best predictors of global neurobehavioral outcomes. Older age at injury and assessment, lengthier inpatient rehabilitation unit admission, and longer time between injury and assessment were predictive of worse outcomes.</p><p><strong>Conclusions: </strong>These findings are somewhat discrepant from the brain injury literature but may be associated with two, possibly interrelated, factors including age-based performance expectations on assessment and high medical morbidity specific to this patient population. These findings are consistent with the well-documented tendency for infants and toddlers with early brain pathology to exhibit increased neurobehavioral deficits over time.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"886-895"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721126","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":"A case of neuralgic amyotrophy presenting with multiple lower cranial neuropathies with delayed onset of symptoms.","authors":"Takashi Kasahara, Takeshi Kimachi, Mitsuhiko Kodama, Katsuhiro Mizuno","doi":"10.1002/pmrj.13334","DOIUrl":"10.1002/pmrj.13334","url":null,"abstract":"","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"1005-1007"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12345391/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender composition of spasticity-related clinical practice guideline authorship positions.","authors":"Hannah Uhlig-Reche, Jeremy W Jacobs, Christine S Gaspard, Julie K Silver, Monica Verduzco-Gutierrez","doi":"10.1002/pmrj.13355","DOIUrl":"10.1002/pmrj.13355","url":null,"abstract":"<p><strong>Background: </strong>The authors of clinical practice guidelines (CPGs) are considered topic experts and specialists. Studies to date have disproportionately found that women are underrepresented in CPG authorship, but no studies have investigated CPGs on spasticity published in the recent literature.</p><p><strong>Objective: </strong>To determine the gender composition of author positions on spasticity-related CPGs published from 2014 to 2023.</p><p><strong>Design: </strong>Retrospective review of literature.</p><p><strong>Setting: </strong>Systematic literature search using PubMed, SCOPUS, and CINAHL databases for spasticity-related CPGs available in English and published between 2014 and 2023.</p><p><strong>Participants: </strong>Authorship positions on spasticity-related CPGs published during the defined study period.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Gender composition of all author positions and physician author positions on spasticity-related CPGs published from 2014 to 2023 were compared with parity and equity benchmarks. The binomial test was used to assess for a difference in the observed versus expected distribution (parity) and the N - 1 χ² test was used to compare the gender proportions of authorship positions with the gender proportions of the equity benchmarks.</p><p><strong>Results: </strong>Six CPGs on spasticity were published during the study period. Most author positions were held by women (54.5%), whereas most physician author positions were held by men physicians (63%). Men physicians held significantly more positions compared with parity (p = .016). Women were overrepresented among all author positions compared with equity using total U.S. academic medicine faculty in neurology/physical medicine and rehabilitation (PM&R) at all benchmark years (95% confidence interval [CI]: 2014: 7.7-23.5; 2018: 4.2-20.0; 2022: 1.4-17.2). There was no difference in the gender composition of physician authors compared with academic medicine physicians in neurology/PM&R for any benchmark year (95% CI: 2014: -8.3 to 11.6; 2018: -2.0 to 7.9; 2022: -4.7 to 5.2).</p><p><strong>Conclusions: </strong>Physician authorship of recent spasticity-related CPGs comprises mostly men, a significant difference from parity but not from equity benchmarks. Women are overrepresented among total authorship positions (including nonphysicians) compared with equity, but not parity. Editorial boards should actively promote authorship diversity of these influential guidelines to minimize gender bias in health care delivery.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"961-969"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649983","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":"Trajectories of poststroke depression among older adults.","authors":"Roland P Hart, Mark Shuquan Chen, George A Bonanno","doi":"10.1002/pmrj.13365","DOIUrl":"10.1002/pmrj.13365","url":null,"abstract":"<p><strong>Background: </strong>Depression, a common outcome following stroke, has been repeatedly associated with poststroke cognitive deficits and is inversely associated with prestroke cognitive functioning or cognitive reserve. In particular, affected executive functioning has been linked to poststroke depression severity whereas preserved executive functioning is associated with poststroke recovery. Moreover, a growing body of research has demonstrated distinct prototypical trajectories of depression following major medical events. This work has consistently indicated that resilience, or a stable trajectory of healthy adjustment following adverse or potentially traumatic events, is the most common outcome.</p><p><strong>Objective: </strong>To examine trajectories of poststroke depression and their associations with prestroke cognitive functioning.</p><p><strong>Design: </strong>Secondary longitudinal data analysis of a large cohort study.</p><p><strong>Setting: </strong>Institutional; RAND Health and Retirement Study sponsored by the University of Michigan and the National Institute on Aging.</p><p><strong>Participants: </strong>Participants (N = 2298) were drawn from a national, longitudinal dataset of older adults who experienced a stroke and survived for at least 2 years afterward.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Depression was assessed via a modified version of the Center for Epidemiologic Studies Depression Scale Short Form.</p><p><strong>Results: </strong>Results showed that resilience was the most common outcome (65.5% of the sample) following stroke and was associated with greater prestroke working memory (p < .001), age (p < .001), and gender (p < .001).</p><p><strong>Conclusions: </strong>Stroke survivors demonstrate the same depression trajectory patterns as observed following other major medical events. These results help illuminate the longitudinal relationship between working memory and poststroke depression and potentially inform interventions. Additional research is required to understand how these findings may be applied in clinical settings.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"927-935"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711086","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":"Gender/sex differences: Representation of women in lateral ankle sprain research.","authors":"Nicole B Katz, Julie K Silver, Kelly C McInnis","doi":"10.1002/pmrj.13349","DOIUrl":"10.1002/pmrj.13349","url":null,"abstract":"<p><strong>Background: </strong>Women have historically comprised lower percentages of sports science research participants compared to men. Lateral ankle sprains (LAS) are a common musculoskeletal injury that may affect women more than men.</p><p><strong>Objective: </strong>The primary purpose was to assess the representation of women participants in LAS research. The secondary purpose was to analyze the representation of women as authors in this same work.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Setting: </strong>Systematic reviews on LAS in adults published between May 2013 and April 2023.</p><p><strong>Participants: </strong>Eleven systematic reviews on LAS with 77 unique original research studies (10,080 participants, 335 authors) met inclusion criteria.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The main outcomes were the proportion of women as participants and in author roles (primary, senior, and overall).</p><p><strong>Results: </strong>Women were underrepresented as participants (41%, n = 4150). Women were also the minority gender/sex for authors overall (26%, n = 86) as well as primary (32%, n = 23) and senior (29%, n = 19) authors. No clear increase in the inclusion of women as research participants was observed over time (p = .4), nor was there a significant increase in women authors (p = .1). A greater proportion of participants were women when the primary author was a woman (p = .008).</p><p><strong>Conclusion: </strong>Women are underrepresented in LAS research overall, and there is a lack of clear progress in representation over time. Similarly, women are a minority of study authors and data suggest a possible temporal trend of improvement. Efforts should be made to increase the proportion of women included in LAS research in order to support equitable evidence-based care.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":"952-960"},"PeriodicalIF":2.8,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143677083","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":"Epidemiology of traumatic spinal cord injury and traumatic brain injury treated in emergency departments in the United States: 2006 to 2020.","authors":"Axler Jean Paul, Elsa Alvarez, Julian Marcet, McKenna Hamm, Kelly Gartner, Darryl Kaelin, Castillo Camillo, Beatrice Ugiliweneza","doi":"10.1002/pmrj.13440","DOIUrl":"https://doi.org/10.1002/pmrj.13440","url":null,"abstract":"<p><strong>Background: </strong>Traumatic spinal cord injury (TSCI) and traumatic brain injury (TBI) remain health challenges with devastating biopsychological and socioeconomic consequences. The occurrence of dual diagnosis is a significant but poorly reported issue in U.S. emergency departments (EDs).</p><p><strong>Objective: </strong>To evaluate the trend, demographic, and socioeconomic aspects of dual diagnosis compared to isolated TSCI and TBI.</p><p><strong>Design: </strong>Observational cross-sectional study.</p><p><strong>Setting: </strong>Nationwide Emergency Departments Sample, 2006-2020.</p><p><strong>Participants: </strong>Data were extracted on number of ED visits nationwide by patients over 18 years of age with TBI, TSCI, and dual diagnoses based on International Classification of Diseases, Ninth Revision, Clinical Modification and Tenth Revision, Clinical Modification codes. From 2006 to 2020, there were 23,826,719 TBI and TSCI related visits to EDs nationwide. Of these, 68,578 were dual diagnoses (TSCI+TBI), 23,579,060 were isolated TBIs, and 356,562 were isolated TSCIs.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Trend analysis of dual diagnoses, TBI (mild, moderate, severe), and TSCI (cervical, thoracic, lumbar/sacral/cauda equina). Demographics including gender, age, income quartile, comorbidities, and hospital characteristics were compared between TSCI+TBI, TBI alone, and TSCI alone.</p><p><strong>Results: </strong>There was an increase of 201 dual diagnosis ED visits per year from 2012 onwards and an increase of 465 TSCI ED visits per year from 2017. However, TBIs declined from 2014 onwards, following the Centers for Disease Control and Prevention's reclassification of unspecified TBI. Patients with dual diagnosis had a median age of 50 years and were predominantly male. Private insurance (TSCI+TBI: 39%; TBI: 32%; TSCI: 27%) was the most used by patients with dual diagnosis, although 29% (vs. TBI: 27%; TSCI: 32%) were in the lowest income quartiles. Most reported ED visits were in the southern United States, and most were at university hospitals. Importantly, patients treated at level 1 trauma hospitals were primarily dual diagnosis (48%).</p><p><strong>Conclusion: </strong>TSCI alone and dual diagnosis visits are rising nationally in EDs; these patients have higher morbidity rates and may require more specialized care. These patients are among the most vulnerable socioeconomically. The increase in ED visits among these populations underscores the need for adequate and sufficient outpatient care to support their ongoing treatment and recovery.</p>","PeriodicalId":20354,"journal":{"name":"PM&R","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754100","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}