Journal of Rehabilitation Medicine最新文献

{"title":"Effectiveness of rehabilitation interventions in patients with colorectal cancer: an overview of systematic reviews.","authors":"Mengzhe Yang, Bhasker Amatya, Sana Malik, Krystal Song, Stefanie Marcella, Catherine Voutier, Fary Khan","doi":"10.2340/jrm.v57.40021","DOIUrl":"10.2340/jrm.v57.40021","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate existing evidence from published systematic reviews for the effectiveness and safety of rehabilitation interventions in adult patients with colorectal cancer.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted using medical/health science databases up to October 2024. Bibliographies of pertinent articles, journals, and grey literature were searched. Three reviewers independently selected potential reviews, assessed methodological quality, and graded the quality of evidence for outcomes using validated tools.</p><p><strong>Results: </strong>Sixty systematic reviews (761 randomized controlled trials) evaluated 5 categories of rehabilitation interventions. Over half of the included reviews (n = 31) were of moderate-high quality. The findings suggest: moderate-quality evidence for exercise interventions for improving physical fitness and quality of life; high-quality evidence for nutritional interventions in reducing postoperative infections; high-quality evidence for multimodal prehabilitation for improved preoperative functional capacity; moderate-quality evidence for nutritional interventions for improving humoral immunity, reducing inflammation, and length of stay; moderate-quality evidence for acupuncture in improving gastrointestinal functional recovery; psychosocial interventions in improving short-term quality of life and mental health, and lifestyle interventions for improved quality of life.</p><p><strong>Conclusion: </strong>Rehabilitation interventions yielded positive effects across multiple outcomes. However, high-quality evidence is still needed to determine the most effective rehabilitation approaches for patients with colorectal cancer.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm40021"},"PeriodicalIF":2.5,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11780671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outdoor experiences and outdoor-based activities and interventions for individuals with spinal cord injury: a systematic scoping review.","authors":"Anders O Aaby, Samuel D Williamson, Louise S Madsen, Thomas Maribo, Sophie L Ravn","doi":"10.2340/jrm.v57.40705","DOIUrl":"10.2340/jrm.v57.40705","url":null,"abstract":"<p><strong>Study design: </strong>Systematic scoping review.</p><p><strong>Objectives: </strong>The aim was to identify and synthesize empirical studies exploring outdoor experiences, activities, and interventions in people with spinal cord injury (SCI).</p><p><strong>Methods: </strong>Systematic searches were performed in 7 bibliometric databases. Unique records were independently screened by 2 authors. Peer-reviewed studies on outdoor experiences, activities, or interventions in adults with SCI were included. This was supplemented by Google Scholar searches and citation tracking. Data from included studies were extracted and analysed in a narrative synthesis.</p><p><strong>Results: </strong>A total of 89 studies were included. Study findings were catalogued into 9 categories and grouped into 3 themes. Theme 1 covered findings related to the experiences and outcomes of outdoor recreational activities and nature exposure. Theme 2 covered findings on facilitators and barriers related to outdoor recreational activities and nature exposure. Theme 3 covered findings related to outdoor testing of equipment and tools.</p><p><strong>Conclusion: </strong>People with SCI mainly report positive experiences from engaging with the natural environment and pursuing outdoor activities, but also experienced a range of barriers that need to be considered in both research and clinical practice. Future studies need to explore the effects of outdoor-based rehabilitation, also employing high-quality methods.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm40705"},"PeriodicalIF":2.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11770228/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual limb neuropathic pain association with neuroma, prosthetic, function, and participation outcomes in individuals living with a transtibial amputation: an exploratory study.","authors":"Camille Fournier-Farley, Mathieu Boudier-Revéret, Dany H Gagnon","doi":"10.2340/jrm.v57.40551","DOIUrl":"10.2340/jrm.v57.40551","url":null,"abstract":"<p><strong>Objective: </strong>To determine the strength of the association between residual limb neuropathic pain intensity and the number of neuromas, prosthetic, functional, and participation outcomes, and assess whether ultrasound (US) biomarkers of neuromas differ between pain intensities.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Subjects: </strong>Twenty-two participants with a transtibial amputation for more than 12 months, with and without residual limb neuropathic pain.</p><p><strong>Methods: </strong>Participants completed questionnaires (Numerical Pain Rating Scale, Pain Disability Index (PDI), Prosthetic Profile of the Amputee-Locomotor Capabilities Index), and had their residual limbs examined by US. Whenever a neuroma was diagnosed during US, images of the neuroma(s) were recorded and US biomarkers were computed.</p><p><strong>Results: </strong>Of the 27 neuromas diagnosed, pain intensity was associated with no use of walking aid, less daily prosthesis wearing time, a higher PDI score, and a neuroma at the common fibular nerve. The cross-sectional area, the thickness ratio, or the thickness of the overlying tissues was not associated with pain intensity.</p><p><strong>Conclusion: </strong>Though the results enrich currently available evidence on clinical variables potentially associated with the intensity of neuropathic pain in individuals living with a transtibial amputation, and on the limited value of US biomarkers studied to determine the association between neuroma(s) and pain intensity, future studies providing higher quality evidence remain needed.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm40551"},"PeriodicalIF":2.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776252/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stakeholder perspectives on implementation of internet-delivered cognitive behaviour therapy in physical medicine rehabilitation setting using the Consolidated Framework for Implementation Research.","authors":"Swati Mehta, Ujjoyinee Barua, Marcie Nugent, Kevin Hansen, Luvish Sondhi, Randy Upper, Dalton Wolfe, Eldon Roh, Keith Sequeira, Robert Teasell, Heather D Hadjistavropoulos","doi":"10.2340/jrm.v57.40898","DOIUrl":"10.2340/jrm.v57.40898","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the growing evidence for the effects of tailored internet-delivered cognitive behaviour therapy (ICBT) programmes for those receiving physical rehabilitation, there is a lack of implementation of these programmes in a clinical or community setting. The aim of the current study was to evaluate barriers and facilitators of implementing an ICBT programme into a physical medicine rehabilitation setting.</p><p><strong>Methods: </strong>Stakeholders with expertise in physical medicine rehabilitation were recruited (n = 25) including: 16 clinicians, 4 administrators, 3 persons with lived experience, and 2 care partners. Individual semi-structured interviews were conducted based on the domains of the Consolidated Framework for Implementation Research (CFIR). Transcripts were analysed using a positivist approach, using deductive thematic content analysis. Themes were coded based on the domains of CFIR.</p><p><strong>Results: </strong>Facilitators for implementation primarily fell under intervention characteristics including relative advantage, strong evidence and quality, and design quality. Perceived barriers for implementation were identified in the inner setting including leadership engagement, culture, and available resources.</p><p><strong>Conclusions: </strong>The results from the current study provide insight on the factors that may contribute towards successful implementation of an ICBT programme in a physical medicine setting.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm40898"},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An exploratory qualitative assessment of patient and clinician perspectives on patient-reported outcome measures and disease-modifying therapies in adults with spinal muscular atrophy.","authors":"Jeremy Slayter, Lauren Casey, Shane McCullum, Dorothy Drost, Allison Banks, Colleen O'Connell","doi":"10.2340/jrm.v57.41254","DOIUrl":"10.2340/jrm.v57.41254","url":null,"abstract":"<p><strong>Objective: </strong>To understand patient, caregiver, and clinician perspectives on patient-reported outcome measures, critical functional domains, and disease-modifying therapies in adult spinal muscular atrophy.</p><p><strong>Design: </strong>An exploratory qualitative single-site study.</p><p><strong>Patients: </strong>Ten adults with spinal muscular atrophy and two clinicians participated in semi-structured interviews.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted virtually or in person with participants after they completed outcome measures at a routine clinic visit. Two researchers analysed transcripts concurrently using a thematic approach to determine themes.</p><p><strong>Results: </strong>Ten themes were identified among partici-pants. Patient-reported outcome measure preference varied between functional groups and was under-responsive, although it captured meaningful data. Motor stability was most frequently expected with disease-modifying therapy, but participants also reported improved fatigue and respiratory status.</p><p><strong>Conclusion: </strong>After considering patient goals, functional status, and preferences, patient-reported outcome measures represent a valuable adjunct to standard clinical and research tools. Optimal selection of patient-reported outcome measures requires careful consideration of multiple patient factors. Collaborative development of modified patient-reported outcome measures may yield a responsive, meaningful, and acceptable tool that can be used across a broad functional spectrum.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm41254"},"PeriodicalIF":2.5,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11748171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142985416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between physical activity and depressive symptoms in stroke survivors: a cross-sectional study of 1,140 individuals.","authors":"Yihao Wang, Jiali Chen, Yanwei Zou, Mengshu Yang, Xiaoyun Kong, Ling Wang, Jingyuan Xue, Ci Dong","doi":"10.2340/jrm.v57.41272","DOIUrl":"10.2340/jrm.v57.41272","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the relationship between physical activity and depressive symptoms in stroke survivors.</p><p><strong>Design: </strong>A cross-sectional study utilizing National Health and Nutrition Examination Survey (NHANES) 2007-2018 data, employing propensity score matching to control for confounders.</p><p><strong>Patients: </strong>1,140 stroke survivors from NHANES, assessing depressive symptoms through the Patient Health Questionnaire-9 (PHQ-9) conducted via family interview or a mobile examination centre examination.</p><p><strong>Methods: </strong>PA was surveyed concurrently with the PHQ-9, categorized into vigorous, moderate, and moderate-to-vigorous intensities. Propensity score matching was used to match participants based on their activity levels, and the relationship between physical activity and depressive symptoms was analysed by logistic regression.</p><p><strong>Results: </strong>Among all the subjects, 225 individuals had significant depressive symptoms. If vigorous-intensity PA duration is longer than 75 min (odds ratio [OR] = 0.41, 95% CI 0.21-0.75) or longer than 150 min (OR = 0.42, 95% CI 0.19-0.85), and moderate-intensity physical activity duration is longer than 150 min (OR = 0.59, 95% CI 0.38-0.90) or between 150 and 300 min (OR = 0.36, 95% CI 0.15-0.77), and moderate-to-vigorous PA duration is greater than 150 min (OR = 0.61, 95% CI 0.40-0.91) or exceeding 300 min (OR = 0.50, 95% CI 0.31-0.78), this might be associated with lower depressive symptoms.</p><p><strong>Conclusion: </strong>Regular physical activity, particularly of moderate or higher intensity, is associated with milder depressive symptoms in stroke survivors, suggesting the potential for non-pharmacological intervention.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm41272"},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The presence of unknown polio engagement confirmed by electromyography and muscle testing.","authors":"Waleed Al-Najjar, David Krabbe, Joakim Strandberg, Katharina S Sunnerhagen","doi":"10.2340/jrm.v57.40718","DOIUrl":"10.2340/jrm.v57.40718","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the usefulness of electromyography at a polio clinic in identifying unperceived muscle denervation. Second, to compare people who perceived themselves as weak in 1 or both legs with those who did not.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Subjects: </strong>The study included 542 persons with late effects of polio in Sweden. Mean age 58 at the first visit, 312 were female. Data used are from a clinical quality registry.</p><p><strong>Methods: </strong>At the first visit patients answered sent-out questionnaires. They underwent an electromyography test, walk test, and muscle strength assessment.</p><p><strong>Results: </strong>Electromyography identified signs of chronic neurogenic changes in lower limb muscles (n = 260) where the patient reported no previous involvement, comprising 239 of the participants. Significant differences in values shows that the group who did not perceive themselves as weak exhibited better performance, demonstrating greater speed, strength, and reduced reliance on wheelchairs.</p><p><strong>Conclusion: </strong>Electromyography can identify signs of muscle denervation in association with weakness in people with late effects of polio who perceived themselves as healthy. This comparison suggests that those that do not perceive weakness may unknowingly overuse their muscles. These findings contribute to our understanding of the late effects of polio and importance of early detection and rehabilitation.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm40718"},"PeriodicalIF":2.5,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening and outcomes of co-occurring traumatic brain injury among people with spinal cord injury: a scoping review.","authors":"Deborah L Snell, Phoebe Wynands, Jennifer Dunn, Joanne Nunnerley, Alice Theadom","doi":"10.2340/jrm.v57.41897","DOIUrl":"10.2340/jrm.v57.41897","url":null,"abstract":"<p><strong>Objective: </strong>To map existing knowledge on screening and rehabilitation outcomes for co-occurring traumatic brain injury among people with traumatic spinal cord injury (SCI).</p><p><strong>Methods: </strong>Articles focusing on screening and rehabilitation outcomes in participants sustaining co-occurring traumatic brain injury and traumatic spinal cord injury (all ages) were identified in Ovid, Scopus, Web of Science, CINAHL, and ProQuest Dissertations and Theses electronic databases. There were no limitations on study design, date, or geographical location. Articles were excluded if they were not available in English. Data were extracted into the Rayyan online collaboration platform and summarized descriptively.</p><p><strong>Results: </strong>Twenty-five studies were included, with a mix of retrospective, case-control, and prospective cohort designs. Screening under-estimated traumatic brain injury incidence when approaches relied on inconsistently collected traumatic brain injury indicators, especially for mild traumatic brain injury. Rehabilitation outcomes included length of stay, functional outcomes, cognitive functioning, complication rates, and employment. Although mixed, outcomes among persons with moderate to severe co-occurring traumatic brain injury especially, appeared poorer than those with spinal cord injury alone.</p><p><strong>Conclusions: </strong>Multivariable approaches to traumatic brain injury ascertainment and greater consistency in documenting acute traumatic brain injury indicators may improve reliability of capturing traumatic brain injury and traumatic brain injury severity among persons with traumatic spinal cord injury. Impacts of co-occurring traumatic brain injury appear greater relative to SCI alone but few studies analysed outcomes based on traumatic brain injury severity.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm41897"},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why we need a representative organization of academic PRM in Europe, and why we need it now.","authors":"Gerold Stucki, Henk J Stam, Francesca Gimigliano, Stefano Negrini","doi":"10.2340/jrm.v57.42369","DOIUrl":"10.2340/jrm.v57.42369","url":null,"abstract":"<p><p>The growing relevance of rehabilitation in healthcare to address increasing patient needs necessitates robust Physical and Rehabilitation Medicine (PRM) integration into medical education and practice. Academic PRM, rooted in medical faculties, is vital for developing the medical speciality as an academic discipline across Europe, where it faces challenges, including limited representation in medical schools and competition for resources with established disciplines. This commentary advocates establishing a representative organization for academic PRM in Europe. Currently, no organization adequately represents academic PRM at the European level. The lack of academic chairs and departments in some countries undermines PRM's credibility and visibility, making it less attractive to students and prospective academics. An organized effort could provide a platform for knowledge exchange, policy formulation, and advocacy, ultimately strengthening the discipline's presence in medical faculties. Immediate action is crucial, particularly in light of the WHO's call for action 2030 and its 2023 resolution emphasizing the need for rehabilitation within health systems. A representative European academic PRM organization could advocate for education on rehabilitation across all medical specialities and enhance the understanding of functioning as a health indicator. It would also support the development of national academic organizations across Europe and facilitate collaboration with other stakeholders, including patient organizations, rehabilitation professionals, and funding agencies. Critical considerations for creating this organization include defining core activities, establishing governance principles focused on representativity and inclusion, and fostering relationships with existing national, European, and international organizations of PRM and academic medicine. By leveraging successful models like the Association of Academic Physiatrists in the United States, Europe can develop a robust and credible voice for academic PRM. This initiative is timely and necessary to capitalize on the current momentum and ensure the future of academic PRM in Europe.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm42369"},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11680898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized controlled trial of cognitive behavioral therapy versus health education for sleep disturbance and fatigue following stroke and traumatic brain injury.","authors":"Lucy Ymer, Adam McKay, Dana Wong, Kate Frencham, Natalie Grima, Monique Roper, Sylvia Nguyen, Jade Murray, Gershon Spitz, Jennie Ponsford","doi":"10.2340/jrm.v57.41302","DOIUrl":"10.2340/jrm.v57.41302","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate efficacy of cognitive behavioural therapy for sleep and fatigue adapted for brain injury relative to health education control in alleviating sleep disturbance and fatigue after acquired brain injury.</p><p><strong>Design: </strong>Parallel groups randomized controlled trial.</p><p><strong>Subjects: </strong>126 community dwelling adults with stroke or traumatic brain injury.</p><p><strong>Methods: </strong>Participants were randomized 2:1 to receive 8-weeks of cognitive behavioural therapy for sleep and fatigue (n = 86) or health education (n = 40). The Pittsburgh Sleep Quality Index was assessed pre- and post-treatment, and 2 and 4-months post-treatment, with secondary measures of insomnia, fatigue, sleepiness, mood, quality of life, activity levels, self-efficacy, and actigraphy.</p><p><strong>Results: </strong>Both groups showed improved sleep by 4-month follow-up. However, cognitive behavioural therapy for sleep and fatigue had significantly larger and more rapid improvements than health education immediately post-treatment (β = -1.50, p < 0.001, 95% confidence interval -2.35 to -0.64). There were no significant between-groups differences in fatigue; however, cognitive behavioural therapy for sleep and fatigue showed within-group gains on both fatigue measures immediately post-treatment and over time (β = -0.29, p = 0.047, 95% confidence interval -0.58 to -0.01). Health education had delayed improvements at 4-month follow-up on 1 fatigue measure.</p><p><strong>Conclusions: </strong>Both cognitive behavioural therapy for sleep and fatigue and health education led to improvement in sleep and fatigue; however, effects were larger and more rapid for cognitive behavioural therapy for sleep and fatigue immediately post-treatment. This supports the efficacy of cognitive behavioural therapy for sleep and fatigue in acquired brain injury but also highlights that health education may result in delayed improvements in symptoms. ANZCTR Trial registration numbers: 1261700087830; 12617000879369.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"57 ","pages":"jrm41302"},"PeriodicalIF":2.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11681142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142924026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}