Journal of Neurologic Physical Therapy最新文献

{"title":"Examining Loneliness in People With Parkinson Disease Participating in Community-based Exercise.","authors":"L A Swink, D Diprinzio, J Brown, D Novak, C L Christiansen, M M Mañago","doi":"10.1097/NPT.0000000000000532","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000532","url":null,"abstract":"<p><strong>Background and purpose: </strong>This study determined the prevalence of loneliness in a regional community-based exercise class program for people with Parkinson disease (PwPD) and examined relationships with demographic characteristics, functional independence, functional mobility, and quality of life (QOL).</p><p><strong>Methods: </strong>This study was a cross-sectional analysis of 231 PwPD, all of whom were participating in community-based exercise class programs. Participants completed questionnaires on loneliness (UCLA 3-Item Loneliness Scale [UTILS]), functional independence (Schwab & England Scale), performance-based measures of functional mobility (Timed Up & Go, 10 Meter Walk Test, 30 Second Sit-to-Stand), and QOL (Parkinson's Disease Questionnaire-8). UTILS scores of ≤ 4 were classified as \"non-lonely,\" and scores > 4 were classified as \"lonely.\"</p><p><strong>Results: </strong>Participants were, on average, 71.9 (±7.5) years old, 5.4 (±5.4) years since their Parkinson disease diagnosis, had been participating in group exercise classes for 2.3 (±2.4) years, and almost one-third of participants (n = 76/231, 32.9%) scored in the \"lonely\" range on the UTILS. There were significant differences between the lonely and non-lonely groups in sex distribution, functional independence, Timed Up & Go, and QOL. Age, functional independence, and loneliness scores accounted for 55.8% of the variance in QOL scores.</p><p><strong>Discussion and conclusion: </strong>In this study, loneliness was present even in PwPD actively engaged with an exercise community. Loneliness among PwPD was also related to functional independence, functional mobility, and QOL. While further study is needed, having rehabilitation clinicians and exercise class instructors screen for loneliness in PwPD may help inform plans of care and recommendations to address loneliness.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Structural and Functional Changes With 8 Weeks of Backward Walking Training in Multiple Sclerosis: A Case Series.","authors":"Maryam M Abbawi, Michael VanNostrand, Patrick G Monaghan, Taylor N Takla, Biaohua Yu, Ana M Daugherty, Jeffrey A Stanley, Nora E Fritz","doi":"10.1097/NPT.0000000000000529","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000529","url":null,"abstract":"<p><strong>Background and purpose: </strong>Individuals with multiple sclerosis (MS) experience mobility declines and an increased risk of falls. Studies in MS have suggested backward walking (BW) as a promising intervention to improve mobility, yet the impact of BW on reactive balance, physical activity, prospective falls, and brain structure has not been explored. The purpose of this case series was to examine feasibility, acceptability, and impact of 8 weeks of BW training (BWT) on gait speed, static and reactive balance, fall incidence, physical activity, and white matter microstructure. A secondary aim was to explore concurrent changes in structure and function with BWT.</p><p><strong>Case description: </strong>Eight ambulatory individuals with relapsing-remitting MS performed forward walking (FW) and BW, static and reactive balance tests, and underwent myelin water imaging (MWI) pre- (baseline) and post-intervention. MWI metrics were extracted from the body of the corpus callosum, superior cerebellar peduncle, and corticospinal tract. Physical activity was measured for 1 week before and after the intervention, and falls were monitored prospectively for 6 months.</p><p><strong>Intervention: </strong>Eight weeks of laboratory (1×/week) and home-based (2×/week) BWT; in the laboratory, individuals performed treadmill and overground BW followed by functional exercises incorporating backward stepping. At home, participants performed overground BW and the same functional exercises.</p><p><strong>Outcomes: </strong>BWT was feasible (100%) and acceptable (96.9%). All participants exhibited increased microstructural changes on the MWI metrics in at least 1 region of interest. Participants demonstrated decreases in sway area during static balance tasks (7/8), decreases in postural latency during reactive stepping (7/8), increases in BW velocity (6/8), and increases in FW velocity (4/8). There was a decrease in fall rate from baseline to 6 months post-intervention (4/7).</p><p><strong>Discussion: </strong>Eight weeks of BWT resulted in structural and functional changes; however, a larger sample size is needed to determine the clinical significance and generalizability of these findings.</p><p><strong>Video abstract available: </strong>for more insights from the authors (see the Video, Supplemental Digital Content available at: http://links.lww.com/JNPT/A536.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Approaching Significance: Statistical Guidance for Authors and Reviewers.","authors":"Keith R Lohse, Stephanie Kliethermes","doi":"10.1097/NPT.0000000000000526","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000526","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144643954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Individual Factors on Exercise Dose During a Walking Intervention in People With Stroke.","authors":"Kiersten M McCartney, Ryan T Pohlig, Duncan Thibodeau Tulimieri, Pierce Boyne, Susanne M Morton, Darcy S Reisman","doi":"10.1097/NPT.0000000000000517","DOIUrl":"10.1097/NPT.0000000000000517","url":null,"abstract":"<p><strong>Background and objective: </strong>There has been a substantial increase in the number of studies demonstrating improvements in walking capacity in people with chronic stroke following moderate-to-high intensity walking exercise interventions. Yet, there is significant variability in response to these interventions. This is likely due to the heterogeneity in this population and the variability in the exercise dose parameters actually attained within these walking interventions. Exercise prescription can be optimized by understanding how individual variables impact walking exercise dose. This study leveraged a large, clinical dataset to classify people with chronic stroke into homogeneous groups (called classes) and compare classes on the walking exercise dose achieved in a walking intervention.</p><p><strong>Methods: </strong>One hundred sixty-nine people with chronic (>6-Months) stroke completed clinical evaluations and a 12-week high-intensity treadmill intervention. Baseline measures of walking capacity, physical health, and psychosocial factors were used in a latent variable mixture model to assess if latent, homogeneous classes existed within the dataset. Objective criteria determined the optimal number of classes, which were compared to the walking exercise dose attained across the intervention.</p><p><strong>Results: </strong>Four homogeneous classes were distinguished by differences in baseline walking capacity, steps-per-day, comorbidity burden, and balance self-efficacy. Despite clear \"clinical profiles\" of people with chronic stroke, these classes did not differ on the walking exercise dose attained.</p><p><strong>Discussion and conclusions: </strong>Prior literature and clinical intuition suggest individuals with lower baseline walking capacity, physical health, and self-efficacy are less likely to tolerate high-intensity exercise, however our results demonstrate this is not true for people with chronic stroke.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1 available at: http://links.lww.com/JNPT/A524 .</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"153-161"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Personalized Auditory Rhythmic Cues to Optimize Gait in Older Adults and People With Parkinson Disease.","authors":"Elinor C Harrison, Lauren E Tueth, Allison M Haussler, Kerri S Rawson, Gammon M Earhart","doi":"10.1097/NPT.0000000000000508","DOIUrl":"10.1097/NPT.0000000000000508","url":null,"abstract":"<p><strong>Background and purpose: </strong>Gait dysfunction in people with Parkinson disease (PwPD) is common and debilitating. Internal cues (ie, mental singing) may provide a useful alternative to external cueing (ie, listening to music) to improve walking for PwPD. In this study, we individually tailored cues to each participant by allowing them to choose their own cue song and by selecting the cue rate that elicited the longest strides.</p><p><strong>Methods: </strong>Fifty-six participants (28 controls and 28 PwPD) performed walking trials in a single-session, cross-sectional study. Initially, uncued trials were compared with cued conditions in which participants walked to music or while they mentally sang at 4 randomized cue rates (90%, 100%, 110%, and 120% of uncued walking cadence). Participants chose their songs from a curated catalog. Cues were optimized according to longest stride lengths as measured by APDM wearable sensors. Repeated measures Analysis of Variance assessed differences between gait characteristics (velocity, cadence, and stride length) and gait variabilities (coefficients of variations) across conditions and groups.</p><p><strong>Results: </strong>Both cue types improved velocity, cadence, and stride length as compared to uncued walking. Internal cues were most beneficial to gait variability. The majority of participants exhibited the longest strides and fastest velocities at the highest cue rate of 120%, though a cue rate of 110% was most beneficial to gait variability.</p><p><strong>Discussion and conclusions: </strong>This study shows how internal and external cues personalized by song choice and cue rate may be tailored to individuals. The information gained may help tailor cues to optimize gait performance for older adults and PwPD.</p><p><strong>Video abstract available: </strong>for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A518 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"162-170"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188473/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143366325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examination of Proprioceptive Reliance During Backward Walking in Individuals With Multiple Sclerosis.","authors":"Michael VanNostrand, Patrick G Monaghan, Nora E Fritz","doi":"10.1097/NPT.0000000000000497","DOIUrl":"10.1097/NPT.0000000000000497","url":null,"abstract":"<p><strong>Background: </strong>Slowed somatosensory conduction in multiple sclerosis (MS) increases postural instability and decreases proprioception. Despite these delays, individuals with MS rely more on proprioception for balance compared to controls. This heightened reliance, combined with slowed signal transduction, increases fall risk. Backward walking (BW) increases proprioceptive reliance by reducing visual cues. However, no study has conclusively linked proprioception to BW. This study aims to assess proprioception's role in BW compared to forward walking (FW) in MS and to compare differences in proprioception between MS fallers and non-fallers.</p><p><strong>Methods: </strong>Fifty participants (average age: 50.34 ± 11.84, median Patient Determined Disease Steps [PDDS]: 2) completed the study. Participants completed BW and FW at comfortable and fast speeds. We have previously established vibration sensation as a proxy measure for proprioception. Vibration thresholds were quantified at the great toe bilaterally using a 2-alternative forced-choice procedure.</p><p><strong>Results: </strong>Significant correlations were seen for vibration sensation and FW comfortable ( ρ  = 0.35), FW fast ( ρ  = 0.34), BW comfortable ( ρ  = 0.46), and BW fast ( ρ  = 0.46). After controlling for age, sex, and PDDS, vibration sensation significantly predicted performance during all walking tasks, with larger beta coefficients seen during BW (comfortable β  = 0.57; fast β  = 0.58) compared to FW (comfortable β  = 0.41; fast β  = 0.45). Fallers performed significantly worse than non-fallers for vibration sensation ( P = 0.04).</p><p><strong>Discussion and conclusions: </strong>Considering the notable decrease in proprioception in participants with MS and the clear distinction between fallers and non-fallers, it is crucial to conduct fall risk assessments and interventions focusing on proprioception. With its heightened reliance on proprioception, BW offers a promising method for assessing fall risk and could be an effective exercise intervention.</p><p><p>Video Abstract available for more insights from the authors (see the Supplemental Digital Content available at: http://links.lww.com/JNPT/A490 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"147-152"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"State of the Academy.","authors":"Nancy Fell","doi":"10.1097/NPT.0000000000000522","DOIUrl":"10.1097/NPT.0000000000000522","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"175-176"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Academy of Neurologic Physical Therapy 2025 Election Results.","authors":"","doi":"10.1097/NPT.0000000000000524","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000524","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":"49 3","pages":"177"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fusing GPS, Activity Monitors, and Self-Report to Improve Assessment of Walking Activity and Community Participation After Stroke.","authors":"George D Fulk, Karen Klingman, Emily N Peterson","doi":"10.1097/NPT.0000000000000518","DOIUrl":"10.1097/NPT.0000000000000518","url":null,"abstract":"<p><strong>Background and purpose: </strong>Walking and participation in the community are important goals for people post-stroke (PPS). These constructs are challenging to measure given limitations in current data collection methodologies. The purpose of this study was to (1) develop a data fusion approach that combined data from global positioning system (GPS), activity monitor (AM), and daily trip log to identify walking activity and participation in the community, and (2) to examine the construct validity of the data fusion method.</p><p><strong>Methods: </strong>At 60 days post-stroke, PPS wore a GPS and AM and completed a daily trip log for 7 days. Using a combination of a density-based spatial clustering algorithm and geocoding GPS, AM, and daily trip log data were time synched and fused to identify total trips taken outside the home; locations visited per trip; number of steps taken in the home, in the community, at each location visited, and in total. Associations between stroke outcomes and the data fusion metrics were determined to support the construct validity of the data fusion method.</p><p><strong>Results: </strong>Forty-four PPS took a mean of 2,541 steps/day, of which 56% were in the community, and took a mean of 0.39 trips/day outside the home and visited a mean of 0.42 locations. A social visit was the most common reason for going into the community. There were fair associations between number of trips outside the home and gait speed (GS), r = 0.49, Berg Balance Scale (BBS), r = 0.48, modified Rankin Scale (mRS), r = -0.47, and Stroke Impact Scale participation subscale (SIS-P) (0.45). There were moderate associations between steps taken in the community and GS, r = 0.63, BBS, r = 0.51, mRS, r = -0.61, and SIS-P, r = 0.43.</p><p><strong>Discussion and conclusions: </strong>Participants did not often access their community. Fusing GPS, AM, and trip log data may provide a comprehensive method to identify walking activity and community participation in PPS.</p><p><strong>Video abstract available: </strong>for more insights from the authors (see the Video, Supplemental Digital Content, available at: http://links.lww.com/JNPT/A529 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"128-136"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From Research to the Clinic: Using Technology to Measure Gait in Neurorehabilitation.","authors":"Amelia R Cain, Kristan A Leech","doi":"10.1097/NPT.0000000000000523","DOIUrl":"10.1097/NPT.0000000000000523","url":null,"abstract":"<p><strong>Background and purpose: </strong>Neurorehabilitation research utilizes wearable technology (WT) and mobile phone apps (MPA) to measure gait and walking activity in people with various neurological conditions. Despite physical therapists' perceptions that WT is useful, the reported use of WT in clinical practice remains low. The purpose of this brief review is to discuss the advantages of WT and MPA for gait assessment in the clinical setting, highlight WT and MPA that are available for clinical use, and acknowledge the limitations and future potential of these technologies in patient care.</p><p><strong>Summary of key points: </strong>WT and MPA provide objective assessments of gait characteristics or physical activity that is low-cost, easy to use, and a beneficial adjunct to traditional clinical methods. There are several WT and MPA that have been validated in persons with neurological conditions and help identify gait impairments and discriminate fallers from non-fallers. Although additional research is needed to overcome continued barriers to use in clinical practice, WT and MPA have potential as tools to provide objective feedback to patients and influence clinical decision making.</p><p><strong>Recommendations for clinical practice: </strong>There are many advantages to using WT or MPA to measure gait and walking activity in persons with neurologic conditions. We anticipate that these technologies will only become more pervasive in research and practice and recommend that clinicians consider applying these technologies in their own practice.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"171-174"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}