medRxiv - Rehabilitation Medicine and Physical Therapy最新文献

{"title":"Are specific, measurable, action-oriented, realistic, and time-bound (SMART) goals associated with improved walking outcomes for stroke survivors undergoing outpatient stroke rehabilitation? An observational cross-sectional retrospective cohort study","authors":"Helia Mohammadi-Ghayeghchi, Nidhi Bhagat, Mackenzie Campbell, Madi Mayhew, Rheall Dufresne, Levi Ewald, Augustine J. Devasahayam, Avril Mansfield","doi":"10.1101/2024.09.05.24313054","DOIUrl":"https://doi.org/10.1101/2024.09.05.24313054","url":null,"abstract":"<strong>Background</strong> Goal-setting is a core principle used in clinical practice to guide treatment. Setting goals improves adherence to rehabilitation treatments and may lead to better outcomes in people with neurological disorders. However, there is a lack of research into the prevalence of goals using a Specific, Measurable, Action-Oriented, Realistic, and Time-Bound (SMART) framework. Additionally, it is currently unclear if the SMART framework improves ambulatory outcomes in outpatient stroke rehabilitation.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217328","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":"Research report CERITER Clinical study - Stride One","authors":"Sarah Meyer, Jan Limet, Piet Stevens, Marc Michielsen","doi":"10.1101/2024.09.04.24312478","DOIUrl":"https://doi.org/10.1101/2024.09.04.24312478","url":null,"abstract":"<strong>Objective</strong> This study investigates the short-term impact of the use of Ceriter Stride One on the quality of gait in patients rehabilitating after a cerebrovascular accident (CVA). Stride One is a smart insole that provides real-time audio feedback (cues) to the patient when performing a certain exercise. The goal of Stride One is to allow patients to practice walking more intensively and with higher quality during rehabilitation.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217352","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":"Understanding Bilateral Motor Coordination in Stroke Using the Towel Folding Task: An Exploratory Biomechanical Study","authors":"Jingyi Wu, Patrick Wai-Hang Kwong, Ananda Sidarta, Jack Jiaqi Zhang, Jingwen Zhuang, Yining Li, Kenneth NK Fong","doi":"10.1101/2024.09.03.24313027","DOIUrl":"https://doi.org/10.1101/2024.09.03.24313027","url":null,"abstract":"<strong>Objectives</strong> Coordination deficits in bilateral upper limbs make daily activities more difficult for stroke survivors. Previous studies showed worse kinematics during unilateral tasks compared to healthy individuals, but this was unclear for bimanual tasks. We aim to assess the potential of the towel folding task from the Wolf Motor Function Assessment as a measure of bimanual control by examining kinematic differences between stroke survivors and healthy individuals and correlating these differences with clinical parameters in the stroke group.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217365","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":"Red flags useful to screen for suspect cancer in patients with low back pain: a scoping review protocol","authors":"Gianluca Notarangelo, Giuseppe Giovannico, Francesco Bruno, Claudia Milella, Firas Mourad, Filippo Maselli","doi":"10.1101/2024.09.01.24311072","DOIUrl":"https://doi.org/10.1101/2024.09.01.24311072","url":null,"abstract":"Low back pain (LBP) is defined as pain and discomfort occurring under the costal arch and above the inferior gluteal folds, with or without leg pain. The most common type of low back pain is “non-specific low back pain”. It is defined as such because there is no specific pathology that can be the cause. Instead, “specific low back pain” is caused by diseases such as infections, tumors, osteoporosis, ankylosing spondylitis, fractures, inflammatory processes, radicular syndromes, cauda equina syndrome, etc. It is the most common musculoskeletal disorder in the world and the most cause of disability.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"37 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217330","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":"Priority Setting for Multicenter Research Among Adults with Cerebral Palsy: A Qualitative Study","authors":"Cristina A. Sarmiento, Mary Gannotti, Jocelyn Cohen, Edward Hurvitz","doi":"10.1101/2024.08.28.24312747","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312747","url":null,"abstract":"<strong>Purpose</strong> Identify priorities for adult cerebral palsy (CP) research by engaging individuals with lived experience, clinical investigators, and community leaders.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217354","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":"Effects of maximal speed locomotor training on spatiotemporal gait changes in individuals with chronic stroke: A secondary analysis of a randomized controlled trial","authors":"Daria Pressler, Sarah M. Schwab-Farrell, Darcy S. Reisman, Sandra A. Billinger, Pierce Boyne","doi":"10.1101/2024.08.27.24312508","DOIUrl":"https://doi.org/10.1101/2024.08.27.24312508","url":null,"abstract":"<strong>Objective</strong> To investigate longitudinal changes in spatiotemporal gait parameters after maximal versus moderate speed locomotor training in chronic stroke, by comparing short-burst high-intensity interval training (HIIT) versus moderate-intensity aerobic training (MAT). Compared to MAT, short-burst HIIT was hypothesized to exhibit greater improvement in non-paretic step length.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142227164","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":"Gait Adaptations to Walking Speeds in Individuals with Myotonic Dystrophy Type 1","authors":"Hoerter Barthelemy, Laurent Ballaz, Yosra Cherni","doi":"10.1101/2024.08.28.24312607","DOIUrl":"https://doi.org/10.1101/2024.08.28.24312607","url":null,"abstract":"Background\u0000Myotonic dystrophy type 1 (DM1) is a prevalent inherited muscular dystrophy in adults, affecting distal muscles such as the gastrocnemius, soleus, and tibialis anterior. This leads to significant gait deviations and reduced walking speed, impacting overall well-being and increasing fall risk.\u0000Objective\u0000This study aimed to assess how walking speed affects gait kinematics in individuals with DM1. Methods\u0000Eighteen individuals with genetically confirmed DM1 (4 women, age: 41.0 [35.5; 47.8] years, mass: 76.8 [67.1; 94.6] kg, height: 166.0 [156.7; 173.3] cm) participated in this study. Each participant walked barefoot along a 13-meter walkway at comfortable and fast speeds. Subsequently, spatiotemporal parameters and joint kinematics were assessed. Results\u0000The step length (p &lt; 0.001), cycle speed (p &lt; 0.001), and cadence (p &lt; 0.001) increased significantly, leading to a higher walking speed. Moreover, the vertical amplitude of the center of mass (CoM) increased significantly (p = 0.015), while the mediolateral amplitude decreased (p = 0.001) at fast walking condition. In addition, significant kinematic changes included increased trunk tilt (p &lt; 0.001), greater anterior pelvic tilt (p &lt; 0.001), increased hip flexion at initial contact, and enhanced knee flexion during both stance and swing phases. Ankle dorsiflexion showed a trend towards increase during stance phase (p = 0.055) at fast walking condition.\u0000Conclusions\u0000Fast walking speed in individuals with DM1 lead to significant gait adaptations. These adaptations reflect compensatory mechanisms to manage muscle weakness. The present study revealed significant changes in spatiotemporal parameters related to walking speed. Fast walking also highlighted kinematic adaptations in trunk, pelvis and lower limb joints. These findings enhance our understanding of gait deviation in individuals with DM1 and suggest the potential benefits of targeted fast walking training in this population.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217331","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":"Predicting Walking Capacity Outcomes After Moderate to High Intensity Locomotor Training in Chronic Stroke","authors":"Christina Garrity, Darcy S Reisman, Sandra A Billinger, Katie A Butera, Pierce Boyne","doi":"10.1101/2024.08.24.24312537","DOIUrl":"https://doi.org/10.1101/2024.08.24.24312537","url":null,"abstract":"Purpose: Moderate-to-high intensity locomotor training (M-HIT) is strongly recommended in stroke rehabilitation but outcomes are variable. This study aimed to identify baseline clinical characteristics that predict change in walking capacity following M-HIT in chronic stroke.\u0000Methods: This analysis used data from the HIT-Stroke Trial (N=55), which involved up to 36 sessions of either moderate or high intensity locomotor training. A prespecified model assessed how well baseline motor impairment (Fugl-Meyer lower limb motor scale [FM-LL]), comfortable gait speed (CGS), and balance confidence (Activities Balance Confidence scale [ABC]), independently explain changes in 6-minute walk distance (Δ6MWD), while controlling for treatment group. Exploratory analysis tested additional baseline covariates using the all-possible regressions procedure. The prognostic value of each potential covariate was assessed by its average contribution to the explained variance in Δ6MWD (Δ pseudo-R²). Results: With the prespecified model, 8-week Δ6MWD was significantly associated with baseline FM-LL (β=5.0 [95% CI: 1.4, 8.6]) and ABC (β=0.7 [0.0, 1.4]), but not CGS (β=-44.6 [-104.7, 15.6]). The exploratory analysis revealed the top 7 covariates with the highest mean Δ pseudo-R² were: FM-LL, pain-limited walking duration, ABC, the use of an assistive device, fatigue, depression, and recent walking exercise history &gt;2 days per week.\u0000Conclusions: On average, participants with less motor impairment and higher balance confidence have greater walking capacity improvements after M-HIT in chronic stroke. Additional negative prognostic factors may include pain-limited walking duration, use of an assistive device, fatigue, depression, and recent walking exercise but these exploratory findings need to be confirmed in future studies.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"420 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217349","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":"A low-cost virtual reality stroke rehabilitation system: breaking down barriers to treatment","authors":"Aidan Fisk, Summer Fox, Jenna Floyd, Daniel H Blustein","doi":"10.1101/2024.08.23.24312233","DOIUrl":"https://doi.org/10.1101/2024.08.23.24312233","url":null,"abstract":"Stroke is a leading cause of disability worldwide. Following a stroke, high doses of intensive motor rehabilitation provide maximal benefit. Barriers to realizing recommended levels of rehabilitation therapy include cost, physical access, and clinical resource availability. Virtual Reality (VR) offers a potential solution to overcome these challenges and enable home-based, self-directed therapy. Here we present a low-cost system utilizing the off-the-shelf Meta Quest 2 headset running custom software to deliver immersive rehabilitation exercises. The system employs movement amplification to partially reduce motor deficits and enable more engaging task completion. It leverages recent advances in VR technology, including hand tracking, voice recognition, and an AI-driven virtual coach, to create a more accessible environment for users with no prior VR experience. We tested the system in 60 able-bodied participants to assess feasibility for eventual clinical use. Participants completed three VR tasks with 30 participants receiving motor amplification. We measured motion sickness levels and attitudes towards the technology, while generating a set of normative motor performance data. Results showed no significant effect of amplification on motor performance, indicating that the small amplification factors applied in this healthy sample did not markedly impact task outcomes. User attitudes towards VR improved after the experience and minimal motion sickness was reported. This study suggests that low-cost VR systems may serve as a feasible option to increase post-stroke motor rehabilitation. Further study is needed to test the system in older adults and in stroke patients to determine feasibility in a more representative clinical setting.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217350","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":"Comparison of Peripheral Nerve Injury Outcomes Between COVID-19 Survivors and Non-COVID Rehabilitation Inpatients: A Retrospective Study","authors":"Antonio Mondriguez-Gonzalez, Brian M Rothemich, Manasi N Sheth, Kevin N Swong, Colin K. Franz","doi":"10.1101/2024.08.22.24312439","DOIUrl":"https://doi.org/10.1101/2024.08.22.24312439","url":null,"abstract":"Introduction: Peripheral nerve injury (PNI) is associated with severe Coronavirus disease 2019 (COVID-19) survivorship. The diagnosis of PNI is often made by a physiatrist during a detailed functional assessment during an inpatient rehabilitation stay. COVID-19 patients have elevated rates of medical comorbidities, including risk factors for acquired PNI, such as diabetes mellitus and obesity. It is not known if the functional prognosis from PNI in COVID-19 survivors differs substantially from PNI in other inpatient rehabilitation populations.\u0000Objective: To determine the prognosis of PNI associated with severe COVID-19 survivorship and compare it to PNI associated with other inpatient rehabilitation populations.\u0000Design: Retrospective chart review study.\u0000Setting: Single-center inpatient rehabilitation hospital in a large urban city. Patients: Adult patients admitted to an inpatient rehabilitation hospital with PNI(s).\u0000Interventions: Not applicable.\u0000Main Outcome Measures: The primary outcome was the change in manual muscle testing (MMT) over time. Secondary outcomes included the rate of peripheral nerve surgery and the number of distinct PNI sites per patient. Results: The analysis consisted of 60 subjects with PNI. We identified 30 subjects who had PNI associated with COVID-19 and were matched with 30 subjects with PNI not associated with COVID-19 who were diagnosed during their inpatient rehabilitation admission. The data collected included basic demographics, COVID-19 status immediately before inpatient rehabilitation admission, medical comorbidities, acute rehabilitation inpatient diagnosis, nerve injury location and mechanism of injury, muscles affected, and change in serial MMT, plus documentation of any surgical intervention. No significant difference was found between the improvement of MMT, surgery rate, or number of nerve injuries and COVID-19 status.\u0000Conclusion: PNIs associated with severe COVID-19 survivorship have similar recovery patterns as those of other etiologies. This data is reassuring that PNI associated with COVID-19 may be managed similarly to other types of PNI.","PeriodicalId":501453,"journal":{"name":"medRxiv - Rehabilitation Medicine and Physical Therapy","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217358","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}