Journal of Neurologic Physical Therapy最新文献

{"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}

{"title":"Commentary on: \"Walking as a Mediator Between Strength and Health-Related Quality of Life in Multiple Sclerosis\".","authors":"Prudence Plummer, Anne McCarthy Jacobson, Annie B Fox","doi":"10.1097/NPT.0000000000000527","DOIUrl":"10.1097/NPT.0000000000000527","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"145-146"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175439","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":"Walking as a Mediator Between Strength and Health-Related Quality of Life in Multiple Sclerosis.","authors":"Laura B Simaitis, Elizabeth S Gromisch, Alyssa Demeule, Rhiannon Murphy, Corinne Palumbo, Heather M DelMastro","doi":"10.1097/NPT.0000000000000505","DOIUrl":"10.1097/NPT.0000000000000505","url":null,"abstract":"<p><p>Background and Purpose: Lower limb (LL) weakness and gait impairment are prevalent among persons with multiple sclerosis (PwMS) and can impede functional independence and impact health-related quality of life (HR-QoL). The purpose of this study was to examine the mediation effect of walking speed and perceived walking ability on the relationship between LL weakness and HR-QoL in ambulatory PwMS.</p><p><strong>Methods: </strong>Participants (n = 175) were PwMS in this secondary analysis of a cross-sectional study. Demographics, pain (visual analog scale), fatigue (5-item Modified Fatigue Impact Scale), LL strength (hip extensors [HE] and flexors [HF], knee extensors [KE] and flexors [KF], and ankle plantarflexors [APF] and dorsiflexors [ADF]), Timed 25-Foot Walk, 12-item MS Walking Scale, and HR-QoL (MS Impact Scale-Physical [MSIS-29-Phys] and Psychological [MSIS-29-Psych]) were collected. Bivariate and mediation analyses using Hayes' PROCESS were performed to determine if LL strength had an indirect effect through walking speed or perceived walking ability on physical and psychological HR-QoL while controlling for fatigue and pain.</p><p><strong>Results: </strong>There were significant ( P < 0.01) correlations for all strength measures with the MSIS-29-Phys and for HF, KE, KF, and APF with the MSIS-29-Psych. In the mediation analyses, LL strength indirectly influenced PwMS' MSIS-29-Phys through walking speed and perceived walking ability. There was only partial mediation between HE, HF, KF, ADF, and MSIS-29-Phy when walking speed was in the model. LL strength did not influence MSIS-29-Psych.</p><p><strong>Discussion and conclusions: </strong>LL strength impacts physical HR-QoL through walking but does not indirectly affect PwMS' perceived psychological HR-QoL. These findings may prompt physical therapists to create individualized care plans that address LL weakness and walking impairments with the goal of promoting optimal outcomes and improving HR-QoL.</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/A504 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"137-144"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717511","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":"Walking Forward: Advances in Mobility for People with Neurological Disorders.","authors":"George Fulk, Merrill Landers, Michelle Ploughman, Dorian Rose, Gavin Williams","doi":"10.1097/NPT.0000000000000521","DOIUrl":"10.1097/NPT.0000000000000521","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"117-118"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053024","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":"Proximal Muscle Resistance Training to Improve Walking in People With Multiple Sclerosis: A Pilot Study.","authors":"Mark M Mañago, Jeri E Forster, Eliza Biondi, Margaret Schenkman, Michelle H Cameron, Cory L Christiansen","doi":"10.1097/NPT.0000000000000504","DOIUrl":"10.1097/NPT.0000000000000504","url":null,"abstract":"<p><strong>Background and purpose: </strong>This pilot study examined the feasibility of a proximal muscle resistance training program to improve walking in people with multiple sclerosis using a combination of in-person, virtual, and independent exercise sessions.</p><p><strong>Methods: </strong>People with multiple sclerosis (Expanded Disability Status Scale Score is <6.0) were recruited to a study of resistance training exercises targeting hip abduction and trunk muscles for 10 weeks. Feasibility criteria were: enrolling 40 participants, retaining ≥80%, ≥80% visit adherence, no serious intervention-related adverse events, and ≥80% satisfaction. The 6-Minute Walk Test, Timed 25-Foot Walk Test, muscle performance (hip abduction and lateral trunk flexion strength, and trunk flexion endurance), patient-reported outcomes, daily step count, and pelvis and trunk kinematics were measured before and after intervention. Patient-reported outcomes and step count were measured again 12 weeks after intervention.</p><p><strong>Results: </strong>Twenty-eight people (median Expanded Disability Status Scale is 3.5) enrolled and 92.8% were retained. Visit adherence was 86.5% (96% for virtual visits, 74% for in-person visits), and 48% of participants preferred virtual visits, while 20% preferred in-person visits. There were no serious intervention-related adverse events, and there was 100% satisfaction. Following intervention, 6-Minute Walk Test distance increased 29.6 m (95% confidence interval [CI], 12.2-47.0), Timed 25-Foot Walk Test decreased by 0.57 seconds (95% CI, -0.85 to -0.29), and all muscle performance outcomes improved. Patient-reported outcomes also improved immediately following intervention. There were no changes in average daily step count or trunk and pelvis kinematics.</p><p><strong>Discussion and conclusions: </strong>This proximal muscle resistance training program was feasible, with benefits in walking and muscle strength, warranting a future efficacy study.</p><p><p>Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A499 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":"119-127"},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12103630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717510","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":"Letter to the Editor \"Comment on Tilson JK, Martinez C, Mickan S, Et Al. Understanding Behavior Change in Clinical Practice Guideline Implementation: A Qualitative Study\" [J Neurol Phys Ther. 2025;49(1):13-23].","authors":"Annie Tapp","doi":"10.1097/NPT.0000000000000525","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000525","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286853","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":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235683","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":"Physical Therapy and Deep Brain Stimulation in Parkinson Disease: Safety, Feasibility, and Preliminary Efficacy.","authors":"Lauren E Tueth, Kerri S Rawson, Linda R Van Dillen, Gammon M Earhart, Joel S Perlmutter, Ryan P Duncan","doi":"10.1097/NPT.0000000000000519","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000519","url":null,"abstract":"<p><strong>Background and purpose: </strong>Subthalamic nucleus deep brain stimulation (STN-DBS) effectively treats some of the motor manifestations of Parkinson disease (PD). However, previous work suggests STN-DBS may lead to worsening of balance and gait in some people with PD. Physical therapy (PT) is often used to improve balance and gait in PD, but its safety, feasibility, and efficacy have not been tested in people with STN-DBS. The purpose of this study was to test the safety, feasibility, and preliminary efficacy of PT for improving gait and balance in persons with PD and STN-DBS.</p><p><strong>Methods: </strong>This randomized pilot study compared the effects of an 8-week PT intervention (n = 15) on balance and gait to a usual care control group (n = 14) among people with PD with STN-DBS. Individuals were evaluated in the on medication/on stimulation state as well as off medication/off stimulation state.</p><p><strong>Results: </strong>PT was safe as there were no serious adverse events during treatment. PT was feasible as the average percentage of session attendance was 93%. PT significantly improved balance as measured by the Balance Evaluation Systems Test (BESTest) in the on medication/on stimulation state but did not significantly improve gait. No significant differences between groups were found in the off medication/off stimulation state.</p><p><strong>Discussion and conclusions: </strong>PT was safe, feasible, and may improve balance for individuals with PD with STN-DBS. Further work is needed to understand how modifying the frequency and intensity of PT interventions may impact balance and gait in individuals with STN-DBS.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004125","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":"Measurement Properties of a Virtually Administered 30-Second Chair Stand Test in People With Stroke.","authors":"Kenneth S Noguchi, Allison Liang, Elise Wiley, Sarah Park, Brodie M Sakakibara, Ada Tang","doi":"10.1097/NPT.0000000000000520","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000520","url":null,"abstract":"<p><strong>Background and purpose: </strong>Muscle strength is important for functional independence after a stroke. Given the rise in telerehabilitation, there is a need to study the measurement properties of virtually administered performance-based measures. The purpose of this study was to assess the validity and responsiveness of a virtually administered 30-second chair stand test (30sCST-Virtual) in people with stroke.</p><p><strong>Methods: </strong>Thirty-two hypotheses were generated about construct validity and responsiveness using several outcome measures (Stroke Impact Scale, strength domain [SIS-S], Timed Up and Go [TUG], Activities-Specific Balance Confidence Scale, Fugl-Meyer Lower Extremity Assessment, Functional Reach Test, and SIS cognition domain). Hypotheses were tested using Spearman's correlations. Scores on the 30sCST-Virtual were compared between higher- and lower-functioning participants using the modified Rankin Scale (mRS) and NIH Stroke Scale (NIHSS) with Wilcoxon rank-sum tests to assess known-groups validity.</p><p><strong>Results: </strong>Sixty-seven participants (n = 19 female, 9.3 months post-stroke) with mild to moderate stroke were included. The 30sCST-Virtual demonstrated acceptable construct validity and responsiveness, as 14 (82%) and 12 (80%) hypotheses were confirmed, respectively. Its baseline scores were most highly correlated with the TUG (r = - 0.64) and change scores with the SIS-S (r = 0.35). The 30sCST-Virtual scores were also lower in those with lower function using the mRS (median difference [MD] = 4.0 repetitions, P < 0.001) and NIHSS (MD = 3.5 repetitions, P = 0.003), meeting our hypotheses for known-groups validity.</p><p><strong>Discussion and conclusions: </strong>The 30sCST-Virtual demonstrated acceptable construct validity and responsiveness, as well as adequate known-groups validity. It was also moderately correlated with other measures of physical function, indicating that the 30sCST-Virtual may measure the construct of functional strength.</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/A526).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056346","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":"Moving Sounds Increase Postural Visual Dependence in Adults With Chronic Traumatic Brain Injury.","authors":"Daniel Humphrey, Jennifer Kelly, Emily R Rosario, Tammie Keller Johnson, Anat V Lubetzky","doi":"10.1097/NPT.0000000000000515","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000515","url":null,"abstract":"<p><strong>Background and purpose: </strong>This cross-sectional study aimed to (1) establish the safety and tolerability of head-mounted display (HMD) assessment of sensory integration for postural control in participants with chronic traumatic brain injury (TBI); (2) investigate whether responses to visual and auditory cues differ between persons with TBI and healthy controls; and (3) evaluate the relationship between postural responses, postural visual dependence, and self-reported perception of disability.</p><p><strong>Methods: </strong>20 healthy adults and 19 participants with TBI completed an HMD assessment of with visual and auditory perturbations. Head sway was quantified as a directional path in the anteroposterior and mediolateral directions. Participants also completed the Simulator Sickness Questionnaire (SSQ) and the Dizziness Handicap Inventory (DHI).</p><p><strong>Results: </strong>All participants completed testing. The average change in SSQ scores from pre to post postural control assessment was 0.8 points for healthy controls and 3.2 points for participants with TBI. Head sway in the TBI group was consistently higher in both directions, especially with dynamic visuals. In addition, a significant sound by visual by group interaction in the mediolateral direction indicates that participants with TBI responded more to the visual perturbations when sounds were present. Under the most challenging conditions, people with mild-to-moderate dizziness handicap showed little head sway, while those with severe symptoms were more variable.</p><p><strong>Discussion and conclusions: </strong>HMD assessment of participants with TBI is feasible and provides a clinic-based assessment of postural visual dependence in this population. This assessment carries the potential to evaluate postural control and monitor progress of participants with TBI.</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038904","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}