Journal of Rehabilitation Research and Development最新文献

{"title":"Foot clearance and variability in mono- and multifocal intraocular lens users during stair navigation.","authors":"Erik Renz,&nbsp;Madeleine Hackney,&nbsp;Courtney Hall","doi":"10.1682/JRRD.2015.02.0030","DOIUrl":"https://doi.org/10.1682/JRRD.2015.02.0030","url":null,"abstract":"<p><p>Intraocular lenses (IOLs) provide distance and near refraction and are becoming the standard for cataract surgery. Multifocal glasses increase variability of toe clearance in older adults navigating stairs and increase fall risk; however, little is known about the biomechanics of stair navigation in individuals with multifocal IOLs. This study compared clearance while ascending and descending stairs in individuals with monofocal versus multifocal IOLs. Eight participants with multifocal IOLs (4 men, 4 women; mean age = 66.5 yr, standard deviation [SD] = 6.26) and fifteen male participants with monofocal IOLs (mean age = 69.9 yr, SD = 6.9) underwent vision and mobility testing. Motion analysis recorded kinematic and custom software-calculated clearances in three-dimensional space. No significant differences were found between groups on minimum clearance or variability. Clearance differed for ascending versus descending stairs: the first step onto the stair had the greatest toe clearance during ascent, whereas the final step to the floor had the greatest heel clearance during descent. This preliminary study indicates that multifocal IOLs have similar biomechanic characteristics to monofocal IOLs. Given that step characteristics are related to fall risk, we can tentatively speculate that multifocal IOLs may carry no additional fall risk.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.02.0030","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34971395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of a multimodal neurophysiologic assessment tool in distinguishing between individuals with and without a history of mild traumatic brain injury.","authors":"Martin Baruch,&nbsp;Jeffrey T Barth,&nbsp;David Cifu,&nbsp;Martin Leibman","doi":"10.1682/JRRD.2015.06.0120","DOIUrl":"https://doi.org/10.1682/JRRD.2015.06.0120","url":null,"abstract":"<p><p>This was a preliminary validation study of a multimodal concussion assessment battery incorporating eye-tracking, balance, and neurocognitive tests on a new hardware platform, the Computerized Brain Injury Assessment System. Using receiver-operating characteristics analyses, (1) we identified a subset of the most discriminating neurophysiological assessment tests involving smooth pursuit eye movement tracking errors, corrective saccade counts, a balance score ratio sensitive to vestibular balance performance, and two neurocognitive tests of response speed and memory/incidental learning; (2) we demonstrated the enhancement in discriminatory capability of detecting concussion-related deficits through the combination of the identified subset of assessments; and (3) we demonstrated the effectiveness of a robust and readily implemented global scoring approach was demonstrated for both eye track and balance assessment tests. These results are significant in introducing a comprehensive solution for concussion assessment that incorporates an economical, compact, and mobile hardware system and an assessment battery that is multimodal and time efficient and whose efficacy has been demonstrated on a preliminary basis. This represents a significant step toward the goal of a system capable of making a dependable return-to-play/duty determination based on concussion likelihood.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.06.0120","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34971401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential neurobiological benefits of exercise in chronic pain and posttraumatic stress disorder: Pilot study.","authors":"E. Scioli-Salter, D. Forman, J. Otis, C. Tun, K. Allsup, C. Marx, R. Hauger, J. Shipherd, D. Higgins, A. Tyzik, A. Rasmusson","doi":"10.1682/JRRD.2014.10.0267","DOIUrl":"https://doi.org/10.1682/JRRD.2014.10.0267","url":null,"abstract":"This pilot study assessed the effects of cardiopulmonary exercise testing and cardiorespiratory fitness on plasma neuropeptide Y (NPY), allopregnanolone and pregnanolone (ALLO), cortisol, and dehydroepiandrosterone (DHEA), and their association with pain sensitivity. Medication-free trauma-exposed participants were either healthy (n = 7) or experiencing comorbid chronic pain/posttraumatic stress disorder (PTSD) (n = 5). Peak oxygen consumption (VO2) during exercise testing was used to characterize cardiorespiratory fitness. Peak VO2 correlated with baseline and peak NPY levels (r = 0.66, p < 0.05 and r = 0.69, p < 0.05, respectively), as well as exercise-induced changes in ALLO (r = 0.89, p < 0.001) and peak ALLO levels (r = 0.71, p < 0.01). NPY levels at the peak of exercise correlated with pain threshold 30 min after exercise (r = 0.65, p < 0.05), while exercise-induced increases in ALLO correlated with pain tolerance 30 min after exercise (r = 0.64, p < 0.05). In contrast, exercise-induced changes in cortisol and DHEA levels were inversely correlated with pain tolerance after exercise (r = -0.69, p < 0.05 and r = -0.58, p < 0.05, respectively). These data suggest that cardiorespiratory fitness is associated with higher plasma NPY levels and increased ALLO responses to exercise, which in turn relate to pain sensitivity. Future work will examine whether progressive exercise training increases cardiorespiratory fitness in association with increases in NPY and ALLO and reductions in pain sensitivity in chronic pain patients with PTSD.","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2014.10.0267","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67551377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Department of Veterans Affairs Office of Research and Development's pain portfolio.","authors":"A. Kusiak","doi":"10.1682/JRRD.2015.08.0149","DOIUrl":"https://doi.org/10.1682/JRRD.2015.08.0149","url":null,"abstract":"It is an exciting time for pain research at the Department of Veterans Affairs (VA). In the seven years that I have been a Scientific Program Manager in the Rehabilitation Research and Development Service in the Office of Research and Development (ORD), I have witnessed an increase in the number of projects and funded investigators within VA's pain portfolio. In 2009, there were approximately 57 projects on pain research. In July 2015, the number of projects was 109, and importantly, the investment in pain research almost tripled within this time span. This change can be attributed to the increased interest in pain research within VA's scientific and clinical communities brought about by the unique chronic pain management needs of Veterans returning from Iraq and Afghanistan and the collaborative effort between VA's pain research community and ORD to spotlight pain research. Pain research in ORD appropriately spans the translational research spectrum and includes basic/foundational research mainly in animal models, epidemiology to determine the distribution of various painful conditions in the VA, pain diagnosis, management and treatment of pain, underlying causes of chronic pain including the transition from the acute to chronic state, adverse events associated with pain management, and health services-level research. This editorial covers a fraction of the innovative and unique areas of pain research being conducted at the VA and the important role VA researchers play in the pain community, as evidenced by VA participation in the Interagency Pain Research Coordinating Committee (IPRCC) National Pain Strategy (NPS). * Pain management: The challenge of treating Veterans with chronic pain and coexisting conditions has sparked an interest in how to care for these individuals effectively. Team-based integrative approaches play up to VA's strengths as a healthcare system and include the clinicians who see Veterans in the clinic, who also conduct basic up to health services research. This is reflected in the high number of treatment-related projects (n = 46) examining the effectiveness of exercise and activity; complementary approaches, including electroceuticals (e.g., transcranial magnetic stimulation) and yoga; and testing different formulations of drug therapies focused not only on pain but also on coexisting conditions, including posttraumatic stress disorder (PTSD), depression, sleep, and substance use disorders. The emphasis of treatment includes reduced dependence on opioids as \"go to\" drugs and examining alternate forms of pain management, putting the Veteran in the driver's seat in managing the painful condition. * Comparative-effectiveness research: Comparative-effectiveness studies emphasize the importance of \"evidence-based practice\" and \"practice-based evidence\" results and are reality checks as to what treatments should be effective and what treatments actually are effective. These types of studies are unique to healthcare systems and a","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67551982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping with tinnitus.","authors":"E. Martz, J. Henry","doi":"10.1682/JRRD.2015.09.0176","DOIUrl":"https://doi.org/10.1682/JRRD.2015.09.0176","url":null,"abstract":"This narrative article on coping with tinnitus has four primary objectives. First, theoretical perspectives about defining and categorizing coping are discussed. Second, an overview of the empirical research on coping with tinnitus is provided, focusing on how coping with tinnitus has been measured and on the trends that were found in research on coping with tinnitus. Third, the problems related to the current state of research on coping with tinnitus are highlighted. Fourth, suggestions are provided on ways that researchers can improve research on coping with tinnitus.","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.09.0176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67552054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of other integrative health therapies by Veterans with pain who are receiving massage.","authors":"Carol Elizabeth Fletcher, Allison R Mitchinson, Erika L Trumble, Daniel B Hinshaw, Jeffery A Dusek","doi":"10.1682/JRRD.2015.01.0015","DOIUrl":"10.1682/JRRD.2015.01.0015","url":null,"abstract":"<p><p>Veterans are increasingly using complementary and integrative health (CIH) therapies to manage chronic pain and other troubling symptoms that significantly impair health and quality of life. The Department of Veterans Affairs (VA) is exploring ways to meet the demand for access to CIH, but little is known about Veterans' perceptions of the VA's efforts. To address this knowledge gap, we conducted interviews of 15 inpatients, 8 receiving palliative care, and 15 outpatients receiving CIH in the VA. Pain was the precipitating factor in all participants' experience. Participants were asked about their experience in the VA and their opinions about which therapies would most benefit other Veterans. Participants reported that massage was well-received and resulted in decreased pain, increased mobility, and decreased opioid use. Major challenges were the high ratio of patients to CIH providers, the difficulty in receiving CIH from fee-based CIH providers outside of the VA, cost issues, and the role of administrative decisions in the uneven deployment of CIH across the VA. If the VA is to meet its goal of offering personalized, proactive, patient-centered care nationwide then it must receive support from Congress while considering Veterans' goals and concerns to ensure that the expanded provision of CIH improves outcomes. </p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.01.0015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67552089","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":"Reliability and validity of the inertial sensor-based Timed \"Up and Go\" test in individuals affected by stroke.","authors":"S. Wüest, F. Massé, K. Aminian, R. Gonzenbach, E. D. de Bruin","doi":"10.1682/JRRD.2015.04.0065","DOIUrl":"https://doi.org/10.1682/JRRD.2015.04.0065","url":null,"abstract":"The instrumented Timed \"Up and Go\" test (iTUG) has the potential for playing an important role in providing clinically useful information regarding an individual's balance and mobility that cannot be derived from the original single-outcome Timed \"Up and Go\" test protocol. The purpose of this study was to determine the reliability and validity of the iTUG using body-fixed inertial sensors in people affected by stroke. For test-retest reliability analysis, 14 individuals with stroke and 25 nondisabled elderly patients were assessed. For validity analysis, an age-matched comparison of 12 patients with stroke and 12 nondisabled controls was performed. Out of the 14 computed iTUG metrics, the majority showed excellent test-retest reliability expressed by high intraclass correlation coefficients (range 0.431-0.994) together with low standard error of measurement and smallest detectable difference values. Bland-Altman plots demonstrated good agreement between two repeated measurements. Significant differences between patients with stroke and nondisabled controls were found in 9 of 14 iTUG parameters analyzed. Consequently, these results warrant the future application of the inertial sensor-based iTUG test for the assessment of physical deficits poststroke in longitudinal study designs.","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.04.0065","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67552204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postconcussive symptom overreporting in Iraq/Afghanistan Veterans with mild traumatic brain injury.","authors":"S. Jurick, E. Twamley, L. D. Crocker, Chelsea C. Hays, H. Orff, S. Golshan, A. Jak","doi":"10.1682/JRRD.2015.05.0094","DOIUrl":"https://doi.org/10.1682/JRRD.2015.05.0094","url":null,"abstract":"A comprehensive evaluation, including the assessment of neurobehavioral symptoms, has been instituted at the Department of Veterans Affairs (VA) healthcare system to address the large number of Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) Veterans returning with mild traumatic brain injuries (mTBIs). The Validity-10 is measure of symptom overreporting embedded within the Neurobehavioral Symptom Inventory, a component of the comprehensive evaluation that assesses postconcussive symptom severity. The Validity-10 is composed of 10 unlikely/low-frequency items and a validated cutoff score to identify postconcussive symptom overreporting. We examined the items and cutoff used in the initial development and validation study of the Validity-10 through retrospective chart reviews of 331 treatment-seeking Veterans who sustained an mTBI. The Validity-10 exhibited significant relationships with psychiatric variables, VA service connection, and neuropsychological performance validity (all p < 0.01), but nonsignificant relationships with demographic and injury variables (all p > 0.05). Furthermore, the Validity-10 modestly predicted neuropsychological performance validity test failure over and above psychiatric comorbidities and VA service connection. The present study supports the use of the Validity-10 to assess symptom validity in treatment-seeking OIF/OEF Veterans with a history of mTBI.","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.05.0094","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67552244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity, ambulation, and comorbidities in people with diabetes and lower-limb amputation.","authors":"Roger J Paxton, Amanda M Murray, Jennifer E Stevens-Lapsley, Kyle A Sherk, Cory L Christiansen","doi":"10.1682/JRRD.2015.08.0161","DOIUrl":"10.1682/JRRD.2015.08.0161","url":null,"abstract":"<p><p>We characterized physical activity (PA) and its relation to physical function and number of comorbidities in people with diabetes and transtibial amputation (AMP), people with diabetes without AMP, and nondisabled adults without diabetes or AMP. Twenty-two individuals with type 2 diabetes mellitus (DM) and transtibial amputation (DM+AMP), 11 people with DM, and 13 nondisabled participants were recruited for this cross-sectional cohort study. Measures included PA volume and intensity, a Timed Up and Go test, a 2-min walk test, and number of comorbidities. The nondisabled group performed greater amounts of PA than the DM group, who performed greater amounts of PA than the DM+AMP group. PA was related to physical function in the DM group and in the DM+AMP group, whereas no such relationship existed in the nondisabled group. PA was not related to number of comorbidities in any group. These findings suggest the ability to walk may affect overall performance of PA. Alternately, PA may alleviate walking problems. This possibility is of interest because issues with walking may be modifiable by improved levels and intensity of PA. PA's lack of relation to number of comorbidities suggests that factors beyond multiple morbidities account for group differences in PA.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5474964/pdf/nihms862953.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34864757","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":"Preliminary findings of a novel measure of driving behaviors in Veterans with comorbid TBI and PTSD.","authors":"Elizabeth K Whipple,&nbsp;Maria T Schultheis,&nbsp;Keith M Robinson","doi":"10.1682/JRRD.2015.09.0172","DOIUrl":"https://doi.org/10.1682/JRRD.2015.09.0172","url":null,"abstract":"<p><p>Veterans of the military operations in Iraq and Afghanistan are at an elevated risk of driving-related accidents and fatalities compared with civilians. Combat exposure, military driving training, risk-seeking, traumatic brain injury (TBI), and posttraumatic stress disorder (PTSD) are all factors associated with driving-related risk. However, few empirical studies have observed driving patterns in this population, and the influence of these contributing factors remains unclear. This study utilized a novel self-report measure to assess driving behaviors, subjective driving-related anxiety, and the emotional experiences of military Veterans who have returned to civilian driving. This questionnaire was completed by 23 combat Veterans diagnosed with comorbid TBI and PTSD and 10 nondisabled combat Veterans. Drivers with TBI and PTSD reported more frequent high-risk driving behaviors and higher levels of anxiety while driving in certain situations than nondisabled combat Veterans. These preliminary findings highlight the importance of studying on-the-road situations and cues that produce anxiety in Veterans, particularly those with TBI and PTSD. A greater understanding of driving-related anxiety is needed to inform targeted and effective interventions for unsafe driving in Veterans.</p>","PeriodicalId":50065,"journal":{"name":"Journal of Rehabilitation Research and Development","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1682/JRRD.2015.09.0172","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34794548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}