Journal of Neurologic Physical Therapy最新文献

{"title":"Physical Therapy Provider Continuity Predicts Functional Improvements in Inpatient Rehabilitation.","authors":"Mitchell D Adam,&nbsp;Debra K Ness,&nbsp;John H Hollman","doi":"10.1097/NPT.0000000000000422","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000422","url":null,"abstract":"<p><strong>Background and purpose: </strong>Health care continuity has been linked to improved patient outcomes in a variety of professions and settings. Patients in inpatient rehabilitation receive a consistent dosage of physical therapy (PT) treatment; however, the providing physical therapist may vary. Despite the potential influence of PT provider continuity on functional outcomes in the inpatient rehabilitation setting, this association has not yet been studied.</p><p><strong>Methods: </strong>An observational retrospective chart review was conducted on 555 discharged inpatient rehabilitation patients. The relationship between the number of PT providers from whom a patient received care and Quality Indicator (QI) Mobility discharge scores was examined with Pearson product-moment correlation coefficients, initially with the entire patient group and secondarily with distinct diagnostic groups. Data from subgroups for whom a significant relationship was established were then included in a hierarchical linear regression analysis accounting for relevant covariates.</p><p><strong>Results: </strong>The number of PT providers correlated negatively with QI Mobility discharge scores ( r = -0.41, P ≤ 0.001). When controlling for QI Mobility admission scores, the \"Stroke\" (partial r = -0.17, P = 0.02), \"Spinal Cord Injury\" (partial r = -0.28, P = 0.002), and \"Other Neuromuscular\" (partial r = -0.35, P = 0.03) groups demonstrated significant inverse relationships. A hierarchical linear regression incorporating these 3 diagnostic groups revealed that the number of PT providers remained a significant predictor of QI Mobility discharge scores ( B = -1.50, P ≤ 0.001) when accounting for covariates.</p><p><strong>Discussion and conclusions: </strong>PT provider continuity is related to the functional improvement of neurologically impaired patients in inpatient rehabilitation.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A405 , which discusses the findings of this work in a narrative format).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10398800","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":"Putting on Joy.","authors":"Patricia L Scheets","doi":"10.1097/NPT.0000000000000436","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000436","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033952","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":"The Interplay Between Walking Speed, Economy, and Stability After Stroke.","authors":"Louis N Awad, Brian A Knarr, Pawel Kudzia, Thomas S Buchanan","doi":"10.1097/NPT.0000000000000431","DOIUrl":"10.1097/NPT.0000000000000431","url":null,"abstract":"<p><strong>Background and purpose: </strong>Energy minimization is thought to underlie the naturally selected, preferred walking speed; however, people post-stroke walk slower than their most economical speed, presumably to optimize other objectives, such as stability. The purpose of this study was to examine the interplay between walking speed, economy, and stability.</p><p><strong>Methods: </strong>Seven individuals with chronic hemiparesis walked on a treadmill at 1 of 3 randomized speeds: slow, preferred, and fast. Concurrent measurements of speed-induced changes in walking economy (ie, the energy needed to move 1 kg of bodyweight 1 ml O 2 /kg/m) and stability were made. Stability was quantified as the regularity and divergence of the mediolateral motion of the pelvic center of mass (pCoM) during walking, as well as pCoM motion relative to the base of support.</p><p><strong>Results: </strong>Slower walking speeds were more stable (ie, pCoM motion was 10% ± 5% more regular and 26% ± 16% less divergent) but 12% ± 5% less economical. Conversely, faster walking speeds were 9% ± 8% more economical, but also less stable (ie, pCoM motion was 17% ± 5% more irregular). Individuals with slower walking speeds had an enhanced energetic benefit when walking faster ( rs = 0.96, P < 0.001). Individuals with greater neuromotor impairment had an enhanced stability benefit when walking slower ( rs = 0.86, P = 0.01).</p><p><strong>Discussion and conclusions: </strong>People post-stroke appear to prefer walking speeds that are faster than their most stable speed but slower than their most economical speed. The preferred walking speed after stroke appears to balance stability and economy. To encourage faster and more economical walking, deficits in the stable control of the mediolateral motion of the pCoM may need to be addressed.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A416 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033356/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10033935","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":"Physical Exercise Interventions on Quality of Life in Parkinson Disease: A Network Meta-analysis.","authors":"Patricia Lorenzo-García,&nbsp;Sergio Núñez de Arenas-Arroyo,&nbsp;Iván Cavero-Redondo,&nbsp;María José Guzmán-Pavón,&nbsp;Susana Priego-Jiménez,&nbsp;Celia Álvarez-Bueno","doi":"10.1097/NPT.0000000000000414","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000414","url":null,"abstract":"<p><strong>Background and purpose: </strong>Physical exercise is considered an effective intervention for maintaining or improving quality of life (QoL) in patients with Parkinson disease (PD), but there is no evidence showing which type of physical exercise intervention has more positive effects. This systematic review and meta-analysis aimed to synthesize the evidence regarding the effectiveness of exercise interventions on improving QoL in patients with PD, comparing different types of exercise interventions.</p><p><strong>Methods: </strong>A literature search was conducted through January 2022. The methodological quality of the trials was assessed using the Cochrane risk of bias tool RoB2. For the meta-analysis, physical exercise interventions were classified into 5 training categories: resistance, endurance, alternative exercises, dance, and sensorimotor interventions. A standard meta-analysis and network meta-analysis were carried out to evaluate the efficacy of the different types of physical exercise interventions.</p><p><strong>Results: </strong>The search retrieved 2451 studies, 48 of which were included in this network meta-analysis with a total of 2977 patients with PD. The indirect effects of the network meta-analysis showed positive results for alternative exercises (-0.46; 95% confidence interval [CI]: -0.76, -0.16), dance (-0.63; 95% CI: -1.08, -0.17), and sensorimotor interventions (-0.23; 95% CI: -0.40, -0.07) versus control comparisons.</p><p><strong>Discussion and conclusions: </strong>More research is needed to determine the types of physical exercise interventions that are most beneficial and for which conditions of the disease they have the most positive effects.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A398 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040427","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 Endurance and Oxygen Uptake On-Kinetics in Individuals With Parkinson Disease Following Overground Locomotor Training.","authors":"Andrew E Pechstein,&nbsp;Jared M Gollie,&nbsp;Randall E Keyser,&nbsp;Andrew A Guccione","doi":"10.1097/NPT.0000000000000423","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000423","url":null,"abstract":"Background and Purpose: Poor walking endurance in Parkinson disease (PD) may be attributable to both bioenergetic and biomechanical factors, but locomotor training methods addressing both these factors simultaneously are understudied. Our objective was to examine the effects of overground locomotor training (OLT) on walking endurance in individuals with mild-to-moderate PD, and to further explore potential cardiorespiratory contributions. Methods: A single-arm, longitudinal design was used to examine the effects of 24 biweekly sessions of OLT in people with mild-to-moderate PD (n = 12). Walking endurance was measured as total distance walked during a 10-minute walk test (10minWT). Oxygen uptake (V˙o2) on-kinetic profiles were determined using a monoexponential function. Perceived fatigability was assessed following the 10minWT using a self-report scale. Magnitude of change in primary outcomes was assessed using Cohen's d and adjusted for sample size (Cohen's d(unbiased)). Results: Participants executed 3036 (297) steps and maintained 65.5% (8%) age-predicted heart rate maximum in a typical session lasting 56.9 (2.5) minutes. Medium effects in total distance walked—885.9 (157.2) versus 969.5 (140.9); Cohen's d(unbiased) = 0.54—and phase II time constant of the V˙o2 on-kinetic profile—33.7 (12.3) versus 25.9 (15.3); Cohen's d(unbiased) = 0.54—were observed alongside trivial effects for perceived fatigability—4.7 (1.4) versus 4.8 (1.5); Cohen's d(unbiased) = 0.11—following OLT. Discussion and Conclusions: These preliminary findings may demonstrate the potential for moderate-intensity OLT to improve walking endurance and enhance cardiorespiratory adjustments to walking activity in adults with mild-to-moderate PD. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A407).","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040400","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":"JNPT Congratulates the Members Honored With the 2023 Academy of Neurologic Physical Therapy Awards.","authors":"","doi":"10.1097/NPT.0000000000000433","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000433","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252648","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":"A Hybrid Assessment of Clinical Mobility Test Items for Evaluating Individuals With Mild Traumatic Brain Injury.","authors":"Peter C Fino, Patrick G Michielutti, Ryan Pelo, Lucy Parrington, Leland E Dibble, Carrie W Hoppes, Mark E Lester, Margaret M Weightman, Laurie A King","doi":"10.1097/NPT.0000000000000427","DOIUrl":"10.1097/NPT.0000000000000427","url":null,"abstract":"<p><strong>Background and purpose: </strong>The Functional Gait Assessment (FGA) and High Level Mobility Assessment Tool (HiMAT) are clinical batteries used to assess people with mild traumatic brain injury (mTBI). However, neither assessment was specifically developed for people with mTBI; the FGA was developed to evaluate vestibular deficits, and the HiMAT was developed for individuals with more severe TBI. To maximize the sensitivity and reduce the time burden of these assessments, the purpose of this study was to determine the combination of FGA and HiMAT items that best discriminates persons with persistent symptoms from mTBI from healthy controls.</p><p><strong>Methods: </strong>Fifty-three symptomatic civilians with persistent symptoms from mTBI (21% male, aged 31 (9.5) years, 328 [267] days since concussion) and 57 healthy adults (28% male, aged 32 (9.6) years) participated across 3 sites. The FGA and HiMAT were evaluated sequentially as part of a larger study. To determine the best combination of items, a lasso-based generalized linear model (glm) was fit to all data.</p><p><strong>Results: </strong>The area under the curve (AUC) for FGA and HiMAT total scores was 0.68 and 0.66, respectively. Lasso regression selected 4 items, including FGA Gait with Horizontal Head Turns and with Pivot Turn, and HiMAT Fast Forward and Backward Walk, and yielded an AUC (95% confidence interval) of 0.71 (0.61-0.79) using standard scoring.</p><p><strong>Discussion and conclusions: </strong>The results provide initial evidence supporting a reduced, 4-Item Hybrid Assessment of Mobility for mTBI (HAM-4-mTBI) for monitoring individuals with mTBI. Future work should validate the HAM-4-mTBI and investigate its utility for tracking progression throughout rehabilitation.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A409 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10033306/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10040406","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":"Lessons Learned in Outpatient Physical Therapy for Motor Functional Neurological Disorder.","authors":"Julie Maggio,&nbsp;Kevin Kyle,&nbsp;Christopher D Stephen,&nbsp;David L Perez","doi":"10.1097/NPT.0000000000000415","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000415","url":null,"abstract":"<p><strong>Background and purpose: </strong>Motor functional neurological disorder is a prevalent and costly condition at the intersection of neurology and psychiatry that is diagnosed using positive \"rule-in\" signs. Physical therapy is a first-line treatment and consensus recommendations exist to guide clinical care. Nonetheless, optimal outpatient treatment of adults with functional motor symptoms requires an expanded physical therapy tool kit to effectively guide care.</p><p><strong>Summary of key points: </strong>In this article, lessons learned from a physical therapist practicing in a multidisciplinary and interdisciplinary outpatient functional neurological disorder clinic are highlighted. In doing so, we discuss how use of the biopsychosocial model and neuroscience constructs can inform physical therapy interventions. The importance of team-based care and the delivery of physical therapy through video telehealth services are also outlined.</p><p><strong>Recommendations for clinical practice: </strong>Use of the biopsychosocial formulation to triage clinical challenges and guide longitudinal care, coupled with application of neuroscience to aid intervention selection, allows for patient-centered physical therapy treatment across the spectrum of functional motor symptoms.Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A400 ).</p>","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10690315","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":"2022 Foundation for Physical Therapy Research Awards.","authors":"","doi":"10.1097/NPT.0000000000000424","DOIUrl":"10.1097/NPT.0000000000000424","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49684075","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":"Artificial Intelligence and Neurologic Physical Therapy.","authors":"George Fulk","doi":"10.1097/NPT.0000000000000426","DOIUrl":"https://doi.org/10.1097/NPT.0000000000000426","url":null,"abstract":"","PeriodicalId":49030,"journal":{"name":"Journal of Neurologic Physical Therapy","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10045258","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}