Annals of Rehabilitation Medicine-ARM最新文献

{"title":"Feasibility and Usability of Immersive Virtual Reality Exergames for Patients With Parkinson's Disease: A Pilot Study.","authors":"Seung Hwan Lee, Seo Jung Yun, Minjung Kim, Byung-Mo Oh, Han Gil Seo","doi":"10.5535/arm.260039","DOIUrl":"10.5535/arm.260039","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the feasibility, safety, and usability of a novel fully immersive virtual reality (VR) exergame, designed to incorporate cognitive-motor dual-task training for patients with Parkinson's disease (PD).</p><p><strong>Methods: </strong>We developed a specialized fully immersive VR exergame program, featuring seven cognitive-motor dual-task games. Prior to the pilot study, we refined the system through two successive usability evaluations involving 17 and 15 rehabilitation experts, respectively, to optimize safety and interface design. Subsequently, four patients with idiopathic PD completed a 30-minute VR exergame session using the finalized system under therapist supervision. We assessed cybersickness using the Simulator Sickness Questionnaire (SSQ) and evaluated usability via the User Experience Questionnaire (UEQ) and a self-developed Custom Usability and Satisfaction Survey.</p><p><strong>Results: </strong>All participants completed the session without adverse events. Mean SSQ total scores decreased from 14.75±9.43 to 4.75±1.89 without statistical significance (p>0.05). UEQ demonstrated positive experiences, with Attractiveness (1.167), Efficiency (1.063), and Stimulation (1.500) exceeding benchmarks. Custom Usability and Satisfaction Survey scores for interest (6.00/7) and overall satisfaction (6.25/7) were high; however, physical comfort was rated relatively lower (4.25/7) due to the headset weight and safety harness.</p><p><strong>Conclusion: </strong>The developed fully immersive VR exergame system is feasible, safe, and engaging in patients with PD. Limitations include the small sample size and single-session design. Future research should focus on large-scale randomized controlled trials and hardware improvements to enhance physical comfort for long-term clinical application.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":"50 4","pages":"321-329"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multidomain Response Patterns Following Focused Extracorporeal Shockwave Therapy in Diabetic Adhesive Capsulitis: A Secondary Analysis of a Randomized Controlled Trial.","authors":"Siddharth Rai, Mallikarjun Gunjiganvi, Rupali Awale, Suruchi","doi":"10.5535/arm.260066","DOIUrl":"10.5535/arm.260066","url":null,"abstract":"<p><strong>Objective: </strong>To characterize multidomain response patterns following focused extracorporeal shockwave therapy (fESWT) in patients with diabetic adhesive capsulitis across pain, functional, and mobility domains.</p><p><strong>Methods: </strong>This secondary exploratory analysis included 100 patients with type 2 diabetes mellitus and adhesive capsulitis who received active fESWT in a randomized controlled trial and completed 4-week follow-up. Clinically meaningful improvement was defined as a ≥2-point reduction in Visual Analogue Scale score, a ≥13-point improvement in Shoulder Pain and Disability Index score, and a ≥10° increase in active external rotation. Participants were classified according to combinations of domain-specific responses.</p><p><strong>Results: </strong>Global response, defined as concurrent improvement in pain, function, and mobility, was observed in 52.0% of patients. An additional 34.0% demonstrated improvement in pain and function without corresponding gains in external rotation, while 12.0% were classified as minimal or non-responders. Other discordant response patterns were uncommon (2.0%). Domain-specific response rates were 86.0% for pain, 88.0% for function, and 53.0% for external rotation, indicating that symptomatic and functional improvements occurred more frequently than recovery of shoulder mobility.</p><p><strong>Conclusion: </strong>Short-term response to fESWT in diabetic adhesive capsulitis demonstrates variable concordance across pain, functional, and mobility domains. Recognition of these multidomain response patterns may assist clinicians in interpreting early treatment effects and guiding rehabilitation planning.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":" ","pages":"313-320"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictors of Paid Employment Status Among Individuals With Spinal Cord Injury in South Korea: An Exploratory Study Using Random Forest Analysis.","authors":"Kyungah Song, Jincheol Lim, Onyoo Kim","doi":"10.5535/arm.250179","DOIUrl":"10.5535/arm.250179","url":null,"abstract":"<p><strong>Objective: </strong>To explore factors affecting the paid employment of individuals with spinal cord injury (SCI) in South Korea.</p><p><strong>Methods: </strong>Data collected from previously and currently community-dwelling adults with SCI (n=538) who responded to the 125-item self-reported International Spinal Cord Injury Survey questionnaire were analyzed using random forest and decision tree modeling.</p><p><strong>Results: </strong>In total, 75.1% responders were male, 53.9% were unmarried, 90.1% lived with family, and 84.8% received daily living assistance; the most frequent education level was high school or below (56.1%), and the percentage of participants with paraplegia and complete injuries was 57.2% and 58.7%, respectively. Average age and mean SCI duration were 46.31 and 15.25 years, respectively. Factors with a positive effect on engaging in paid employment included greater total monthly household income, younger age, higher self-efficacy, better quality of life and satisfaction, access to vocational rehabilitation services, absence of disability benefits, no need for daily living assistance, greater independence, no difficulties engaging in activities, absence of sleep disturbances, higher education level, and being unmarried.</p><p><strong>Conclusion: </strong>Employing the random forest method and a large dataset, we identified key predictors of paid employment, corroborating previous findings and establishing a foundation for policy development for employment opportunities.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":"50 4","pages":"290-301"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554921/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Values of Tissue Fluid Accumulation Using Tissue Dielectric Constant and Bioimpedance Analysis in Healthy Volunteers.","authors":"Min Kyung Park, Chang Hyun Lee, Su-Hong Choi, In Joo Kong, Jin A Yoon","doi":"10.5535/arm.250143","DOIUrl":"10.5535/arm.250143","url":null,"abstract":"<p><strong>Objective: </strong>To quantitatively assess short-term, intervention-associated changes in tissue water distribution using tissue dielectric constant (TDC) and bioimpedance analysis (BIA) in healthy volunteers, and to explore correlations between the two modalities.</p><p><strong>Methods: </strong>Thirty-one healthy participants underwent a lymphedema-related intervention on their dominant arm, which included pumping and clearing of the terminus, manual lymphatic drainage, and low-level laser therapy. TDC and BIA were measured before and after the intervention. TDC-derived percentage of water content (PWC) was obtained at nine anatomical sites using a Lymphscanner, while BIA was performed using an InBody S10. Pre- and post-intervention differences were analyzed, and correlations between ΔTDC and ΔBIA parameters were evaluated using Spearman's correlation coefficients.</p><p><strong>Results: </strong>TDC showed small, site-dependent superficial water changes, with significant decreases in PWC at the trunk and breast, and a mild increase at the shoulder on the intervention side. BIA revealed significant increases in R0 and impedance at several frequencies, while extracellular water to total body water ratio and reactance remained unchanged. Correlation analyses identified a few site-specific significant associations between ΔTDC and ΔBIA parameters; however, these correlations were weak-to-moderate and exhibited no consistent pattern across sites or frequencies.</p><p><strong>Conclusion: </strong>Although TDC and BIA both detected small intervention-associated changes in healthy volunteers, the limited correlations between the two modalities suggest that they are not interchangeable. TDC reflects localized superficial tissue water, whereas BIA assesses broader segmental fluid distribution. Therefore, their combined use may provide complementary information by evaluating distinct aspects of tissue water distribution. Further studies involving patients with lymphedema are warranted.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":"50 4","pages":"330-338"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital Health Approaches to Geriatric Rehabilitation: A Narrative Paper.","authors":"Changwon Moon, Pamela Bregasi, Aminreza Khandan, Bijan Najafi","doi":"10.5535/arm.260007","DOIUrl":"10.5535/arm.260007","url":null,"abstract":"<p><p>Rapid population ageing is widening the gap between geriatric rehabilitation needs and constrained care capacity. Digital health offers new ways to deliver rehabilitation beyond traditional settings, but its role and limitations in geriatric practice remain unclear. To provide a narrative synthesis of how digital health can support geriatric rehabilitation, highlighting advances, challenges, and future directions. We conducted a narrative review of digital health approaches in geriatric rehabilitation, informed by the authors' clinical and technical expertise, synthesizing evidence on telemedicine, mobile health, wearable sensors, exergames, extended-reality platforms, and artificial intelligence (AI)-enabled systems across rehabilitation domains. Digital health interventions can support continuous monitoring, motor and cognitive training (including gamified exercise), behavioral self-management, and remote clinician oversight. Studies in selected older populations show feasibility, safety, and short- to medium-term improvements in mobility, frailty, pain, and cardiorespiratory fitness. However, the evidence base is fragmented, often excludes frail older adults and those with cognitive or multisensory impairment, and frequently focuses on surrogate sensor-derived outcomes, with limited long-term data on independence, falls, or quality of life. Persistent challenges include usability and digital-literacy barriers, the \"grey digital divide,\" limited interoperability and workflow integration, and unresolved issues of data governance, privacy, and algorithmic transparency. Digital health has potential to augment geriatric rehabilitation and support healthy ageing, but its benefits are unlikely to be equitably realized without intentional design and implementation. Priorities include human-centered and co-design approaches, pragmatic trials, integration with rehabilitation workflows, and robust ethical and regulatory frameworks for data-driven and AI-enabled care.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":"50 4","pages":"222-243"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"M-Wave and F-Wave Parameters in Relation to Recording Electrode Placement.","authors":"Masataka Kurobe, Naoki Kado, Toshiaki Suzuki","doi":"10.5535/arm.260035","DOIUrl":"10.5535/arm.260035","url":null,"abstract":"<p><strong>Objective: </strong>To clarify the influence of recording electrode placement on F-wave parameters, we investigated F-wave parameters recorded from the abductor pollicis brevis muscle using different recording electrode positions.</p><p><strong>Methods: </strong>Thirteen healthy volunteers participated. Recording electrodes were placed at four locations (20, 30, 40, and 50 mm from the reference electrode). The stimulating electrode was positioned over the median nerve at the wrist, and the reference electrode was placed on the distal tendon of the abductor pollicis brevis muscle. Stimulation intensity was set at 1.2 times that required to elicit the maximal M-wave amplitude. Thirty stimuli were delivered at 0.5 Hz. Outcome measures included M-wave latency and amplitude, F-wave mean latency and amplitude, F/M amplitude ratio, and F-wave persistence. Data were analyzed using one-way repeated-measures analysis of variance, and effect sizes were calculated using partial η².</p><p><strong>Results: </strong>M-wave amplitude varied substantially according to recording electrode position (partial η²=0.50). In contrast, effect sizes were small for most F-wave parameters. The F/M amplitude ratio did not reach statistical significance but demonstrated a moderate-to-large effect size (partial η²=0.24).</p><p><strong>Conclusion: </strong>Recording electrode placement substantially affected M-wave amplitude and may also influence the F/M amplitude ratio. Therefore, consistent electrode placement should be maintained when interpreting these parameters in clinical or research settings. However, given the relatively small sample size, clinically meaningful effects on other F-wave parameters cannot be excluded and should be investigated in larger studies.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":" ","pages":"339-344"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554915/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-Task Exercises for Dynamic Balance, Motor Function, Functional Mobility, and Dual-Tasking in Individuals With Parkinson's Disease: A Meta-Analysis With Meta-Regression.","authors":"Stanley J Winser, Mohammad Jobair Khan, Abu Jor, Priya Kannan","doi":"10.5535/arm.260060","DOIUrl":"10.5535/arm.260060","url":null,"abstract":"<p><p>To evaluate the (1) effectiveness of dual-task (DT) exercise in improving dynamic balance, motor function, functional mobility, dual-tasking, and falls, and (2) influence of DT intervention parameters on treatment effects in individuals with Parkinson's disease (PD). A comprehensive literature search was conducted across 12 electronic databases to identify relevant published articles from inception to September 2025. Risk of bias, methodological rigour, and evidence quality were evaluated using the RoB-2, PEDro, and GRADE tools, respectively. Dynamic balance, motor function, functional mobility, dual-tasking, and falls were assessed. Meta-analysis was performed to estimate intervention effects, and meta-regression evaluated how parameters of DT intervention affected treatment effects. The meta-analysis included 25 studies involving 1,162 individuals with PD. The mean PEDro score was 6.5, RoB-2 indicated a low risk of bias in 11 studies (45%), and GRADE indicated low to high evidence quality. Meta-analysis revealed significant improvements in dynamic balance (mean difference [MD]=4.45, 95% confidence interval [CI]=2.06 to 6.84; p<0.001), motor function (MD=-2.00, 95% CI=-3.32 to -0.67; p<0.001), functional mobility (MD=-1.64, 95% CI=-2.01 to -1.26; p<0.001), and dual-tasking (MD=-3.39, 95% CI=-4.67 to -2.11; p<0.001). Meta-regression revealed that dynamic balance improved with moderately challenging and moderate-intensity DT exercises, practised for 2 hours weekly with ≥90% session adherence. Subgroup meta-analyses revealed that practising for more than 4 weeks significantly improved dynamic balance and functional mobility. Compared with traditional single-task exercises, motor-cognitive DT exercises improved dynamic balance, functional mobility, motor function, and dual-tasking. Further studies examining the effects of DT exercises on falls among individuals with PD are warranted.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":"50 4","pages":"244-264"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Daily Activity Regularity With Functional Recovery in Patients With Stroke and Spinal Cord Injury: A Prospective Actigraphy Study.","authors":"Yu-Hsuan Lin, Chen Lin, Chueh-Hung Wu, Hsiang-Chih Chang, Huey-Wen Liang, Shao-Yu Chen, Kuan-Lin Sung, Wei-Chen Hsu","doi":"10.5535/arm.250170","DOIUrl":"10.5535/arm.250170","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the stability of daily physical activity, quantified by interdaily stability (IS), is associated with activities of daily living (ADL) recovery during inpatient neurorehabilitation, independent of overall activity level, we examined the association between physical activity stability and ADL recovery.</p><p><strong>Methods: </strong>This prospective study recruited 161 patients with stroke or spinal cord injury (mean age: 62.4±14.8 years; 42% female) from two hospitals. Physical activity was assessed using actigraphy for seven days after admission. IS represented activity regularity, and M10 the total activity volume during the most active 10-hour period. ADL was evaluated using the Barthel Index (BI) (baseline BI=32.5±22.9; discharge BI=61.1±28.6). Multiple linear regression analyses examined IS, M10, and ADL recovery, adjusting for baseline BI, age, sex, hospital stay, days from onset to rehabilitation admission, and diagnosis group.</p><p><strong>Results: </strong>Higher IS during the first week after admission was significantly associated with better ADL recovery at discharge after controlling for all covariates (B=30.86, p=0.005). In contrast, total physical activity (M10) was not significantly associated with ADL recovery (B=-0.11, p=0.313). Younger age, lower baseline BI, longer length of stay, and shorter onset-to-admission time were also associated with greater ADL recovery.</p><p><strong>Conclusion: </strong>Greater activity stability was associated with greater ADL improvement in patients with stroke, but not in those with spinal cord injury. IS may be a clinically relevant behavioral marker during inpatient rehabilitation, although its causal role remains to be established.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":"50 4","pages":"302-312"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554917/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immediate Effects of Walking Training With Elastic Ankle Support Devices on Walking and Mobility of Ambulatory Individuals With Stroke.","authors":"Thaksin Chanata, Sugalya Amatachaya, Teerawat Nithiatthawanon, Jirabhorn Wannapakhe, Wannapai Chanwised, Arpassanan Wiyanad, Thiwabhorn Thaweewanakij, Wilairat Namwong","doi":"10.5535/arm.260074","DOIUrl":"10.5535/arm.260074","url":null,"abstract":"<p><strong>Objective: </strong>To compare the immediate effects of walking training without or with an ankle support device (ASD) on spatiotemporal gait parameters, mobility, and satisfaction among 20 ambulatory participants with chronic stroke.</p><p><strong>Methods: </strong>This crossover design required the participants to complete the four 30-minute walking training conditions in a randomized order: without ASD, with ankle-foot orthosis (AFO), with long ankle sling made from 3- to 4-inch elastic bandage, and with elastic ankle support equipment (EASE) developed from elastic bands with buttonholes and plastic rivets, with a 7-day washout period. Gait parameters and Timed Up and Go test (TUG) were measured before and after each training program, and satisfaction with the three ASDs was assessed upon completion.</p><p><strong>Results: </strong>Spatiotemporal parameters (except walking cadence and symmetry) and TUG after training with a long ankle sling and EASE were significantly better than those following training without ASD and with AFO (p<0.001). Participants satisfied with both elastic ASDs in terms of dimensions, weight, safety, comfort, and effectiveness (p<0.001). The EASE was also satisfied for its ease of application and adjustment. The AFO was durable and easy to use but heavy, uncomfortable, and unsafe.</p><p><strong>Conclusion: </strong>The elastic ASDs were designed to assist ankle movements during the stance and swing phases. Thus, they improved walking and mobility of the participants significantly greater than the training with AFO and without ASD. The findings suggest the use of a long ankle sling and EASE as an alternative ASD to promote mobility of ambulatory individuals with chronic stroke.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":" ","pages":"278-289"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13554920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Korean Clinical Practice Guidelines for Rehabilitation in Critically Ill Patients and Post-Intensive Care Syndrome.","authors":"Chi Ryang Chung, Hye Ju Yeo, Jong Geol Do, Yoonju Na, Eunjeong Choi, Jiyeon Kang, Jeong-Yi Kwon, Hyun Jung Kim, Jinyoung Park, Hak-Jae Lee, Myung Hun Jang, Seung-Tak Kang, Kyung Hyup Koo, Young Seok Kim, Won Kim, Tae-Yoon Kim, Jiyoun Park, Jaewon Beom, Kyung Cheon Seo, Hyun-Woo Sun, Woochul Son, Myung-Jun Shin, So Young Ahn, Song I Lee, Min-Hyung Rhee, Yu Hui Won, Myungeun Yoo, Yu Jin Im, Sun Ju Chang, Ye Rim Chang, Mi-Kyeong Jeon, Jin Hee Jung, Yumi Ha, Sung Eun Hyun, Suk-Kyung Hong, Gee Young Suh","doi":"10.5535/arm.260132","DOIUrl":"10.5535/arm.260132","url":null,"abstract":"<p><strong>Objective: </strong>Survivors of critical illness commonly experience persistent physical, cognitive, and psychological impairments, collectively known as post-intensive care syndrome. Although intensive care unit (ICU) rehabilitation is now recognized as an important part of recovery after critical illness, rehabilitation practices remain inconsistent, and clinical practice guidelines adapted to the Korean healthcare context have not been available.</p><p><strong>Methods: </strong>These clinical practice guidelines were developed de novo by a multidisciplinary panel comprising critical care physicians, rehabilitation specialists, nurses, and allied health professionals. The panel prioritized 15 key clinical questions addressing adult, pediatric, and neonatal ICU (NICU) rehabilitation. Systematic literature searches were conducted in Medline via PubMed, Embase, the Cochrane Library, and KoreaMed, and the final searches for all 15 questions were completed by November 30, 2024. The certainty of evidence and strength of recommendations were assessed using the Grading of Recommendations Assessment, Development and Evaluation framework. Final recommendations were approved through a structured consensus process requiring at least 70% panel agreement.</p><p><strong>Results: </strong>The panel issued 15 recommendations across major rehabilitation domains, including early structured rehabilitation, criteria for withholding or discontinuing therapy, adjunctive modalities, rehabilitation frequency, inspiratory muscle training, swallowing rehabilitation, cognitive and occupational therapy, nutritional support, neonatal and pediatric ICU rehabilitation, and post-ICU follow-up care. Thirteen recommendations were conditional, whereas two were strong, mainly because they addressed patient safety.</p><p><strong>Conclusion: </strong>These guidelines provide evidence-informed recommendations for rehabilitation in critically ill patients across adult, pediatric, and NICUs in Korea. They are designed to standardize practice, improve patient safety, support patient-centered functional recovery beyond survival, and identify priorities for future research.</p>","PeriodicalId":47738,"journal":{"name":"Annals of Rehabilitation Medicine-ARM","volume":"50 4","pages":"197-221"},"PeriodicalIF":2.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13563147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}