Journal of Rehabilitation Medicine最新文献

{"title":"Physical activity levels are low in the days, weeks, and months following dysvascular major lower limb amputation.","authors":"Aniek M Kolen, Leonie A Krops, Harriët Jager-Wittenaar, Herwin Horemans, Johannes B J Bussmann, Martijn L Dijkstra, B. Paul J A Keller, Jacques Oskam, Bastiaan Vierhout, Jean-Paul P M De Vries, Laurens Van Walraven, Wim P Krijnen, Jan H B Geertzen, Rienk Dekker","doi":"10.2340/jrm.v58.44666","DOIUrl":"10.2340/jrm.v58.44666","url":null,"abstract":"<p><strong>Objective: </strong>To determine physical activity levels and their associated factors post-dysvascular major lower limb amputation.</p><p><strong>Design: </strong>Multicentre longitudinal observational study.</p><p><strong>Subjects: </strong>Eighty-one adults with dysvascular major lower limb amputation.</p><p><strong>Method: </strong>Physical activity was assessed via questionnaire (adapted-SQUASH: total min, moderate/vigorous min, MET-min/week), self-reported adherence to Dutch physical activity guidelines, and accelerometer (Activ8: min, bouts, fragmentation) at < 12 days, 5 weeks, 6 months, and 9 months post-amputation. Associated factors were assessed using mixed model analysis.</p><p><strong>Results: </strong>Median [interquartile range] questionnaire-assessed activity increased: 240 [90;600], 525 [245;880], 678 [334;1176], and 885 [525;1733] min/week (p = 0.004). Dutch guideline adherence was 16%, 55%, 47%, and 27%, respectively. Accelerometer-derived activity was 5 [5;9], 26 [13;50], 50 [33;64], and 54 [44;67] min/day. Number of active bouts ranged from 0.0 [0.0;0.0] to 2.0 [1.0;3.0] per day, with fragmentation between 0.0 [0.0;0.0] and 0.4 [0.4;0.5]. Questionnaire-assessed physical activity was negatively associated with age (β = -16 min/week, p = 0.009) and undernutrition (β = -270 min/week, p = 0.013), and positively with grip strength (β = 14 min/week, p = 0.014).</p><p><strong>Conclusion: </strong>Physical activity levels increase but remain low post-lower limb amputation. Age, undernutrition, and grip strength are associated with physical activity. These findings underscore the need for targeted physical activity interventions for individuals post-amputation, to optimize health and clinical outcomes.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm44666"},"PeriodicalIF":2.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13182223/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846393","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":"Effects of incentive spirometer added to standard rehabilitation in previously hospitalized adults with post-COVID-19 condition: a randomized controlled trial.","authors":"Marina Kloni, Alexandros Heraclides, Theognosia Panteli, Alexios Klonis, Panagiotis Rentzias, Christos Karagiannis","doi":"10.2340/jrm.v58.44926","DOIUrl":"10.2340/jrm.v58.44926","url":null,"abstract":"<p><strong>Objective: </strong>Post-COVID-19 condition is associated with persistent respiratory symptoms and impaired functional capacity. This study evaluated the effects of adding an incentive spirometer to standard rehabilitation in adults with post-COVID-19 condition, with peak expiratory flow, dyspnoea, and quality of life as the prespecified primary outcomes.</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Subjects/patients: </strong>Eighty-two previously hospitalized adults diagnosed with post-COVID-19 condition, were randomly assigned to an experimental group (rehabilitation plus incentive spirometer, n = 41) or a control group (rehabilitation alone, n = 41).</p><p><strong>Methods: </strong>Eight outcomes were assessed at baseline and 1 month, including peak expiratory flow, Medical Research Council dyspnoea scale, EQ-5D-5L, and functional performance tests.</p><p><strong>Results: </strong>Both groups improve at 1-month follow-up. The experimental group showed greater improvements in peak expiratory flow (between-group difference = 65.85 L/min; 95% CI: 4.35 to 127.35; p = 0.007), and dyspnoea (MRC difference = -1.08; 95% CI: -1.54 to -0.62; p < 0.001) compared with the control group. No significant between-group differences were observed for quality of life or functional performance measures.</p><p><strong>Conclusion: </strong>Adding incentive spirometry to standard rehabilitation improved peak expiratory flow and reduced dyspnoea in adults with post-COVID-19 condition, supporting its use as a low-cost adjunct for respiratory symptom management.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm44926"},"PeriodicalIF":2.3,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13154367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147846411","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":"Evolution of goal setting and attainment over repeated cycles of botulinum toxin A for upper limb spasticity in real-life clinical practice: longitudinal analyses from the observational ULIS-III cohort study.","authors":"Lynne Turner-Stokes, Klemens Fheodoroff, Jorge Jacinto, Mathieu Beneteau, Pascal Maisonobe, Christian Hannes, Stephen Ashford","doi":"10.2340/jrm.v58.45139","DOIUrl":"10.2340/jrm.v58.45139","url":null,"abstract":"<p><strong>Objective: </strong>This post-hoc analysis evaluated how goal attainment evolved over repeated cycles of botulinum toxin A (BoNT-A) treatment in adults with upper-limb spasticity.</p><p><strong>Methods: </strong>ULIS-III (NCT02454803) was a 2-year observational study involving adults treated with BoNT-A. The analysis included 538 patients who received ≥ 4 BoNT-A injection cycles and had Goal Attainment Scaling (GAS) assessments for each of the first 4 cycles. GAS T-scores were used to measure treatment response. Multivariate models assessed predictors of achieving a GAS T-score ≥ 50 and being in the top tertile (best) of responders.</p><p><strong>Results: </strong>Patients generally maintained consistent goal domains across cycles. Mean change in GAS T-scores remained above the minimal clinically important difference of 10 throughout. The proportion of patients achieving a GAS T-score ≥ 50 increased from 64.5% in Cycle 1 to 75.8% in Cycle 4. Use of injection guidance techniques significantly increased the odds of achieving treatment goals (OR 1.92; 95% CI 1.45-2.55) and being a \"best\" responder (OR 2.44; 95% CI 1.47-4.06). Higher BoNT-A doses were also associated with better outcomes.</p><p><strong>Conclusions: </strong>Repeated BoNT-A treatment supports sustained goal attainment in upper limb spasticity. Success rates improve with each cycle, particularly when guided injection techniques are used.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm45139"},"PeriodicalIF":2.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13135245/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147789504","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":"Effect of inspiratory muscle training on inspiratory muscle strength in adults with post-COVID-19 condition and inspiratory muscle weakness: a randomized controlled trial.","authors":"Anna Törnberg, Anna Svensson-Raskh, Elisabeth Rydwik, Alexandra Halvarsson, Judith Bruchfeld, Malin Nygren-Bonnier","doi":"10.2340/jrm.v58.44931","DOIUrl":"10.2340/jrm.v58.44931","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate the effect of inspiratory muscle training in adults with post-COVID-19 condition (PCC) and inspiratory muscle weakness.</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Subjects/patients: </strong>Adults with PCC and inspiratory muscle weakness.</p><p><strong>Methods: </strong>Participants were randomized to inspiratory muscle training twice daily plus individualized exercise twice weekly or exercise alone, with weekly follow-ups over 8 weeks.</p><p><strong>Primary outcome: </strong>inspiratory muscle strength (Maximal Inspiratory Pressure).</p><p><strong>Secondary outcomes: </strong>expiratory muscle strength (Maximal Expiratory Pressure); functional capacity (Six‑Minute Walk Test; One‑Minute Sit‑to‑Stand); lung function (spirometry); dyspnoea (mMRC); respiratory symptoms (chest tightness, impaired deep breathing, breathing‑related pain); cough frequency (CAAT cough item); fatigue (Fatigue Severity Scale); physical activity (Frändin-Grimby Activity Scale); activity limitations (Patient‑Specific Functional Scale); and health-related quality of life (EQ‑5D‑5L). Intention-to-treat analyses used imputed missing data. Estimated sample size: 90.</p><p><strong>Results: </strong>Forty-four participants were included (median age 47; 82% women; n = 22/group). Between‑group differences favoured the intervention for inspiratory muscle strength (mean difference: 18%; 95% CI: 5-30; OR for clinically meaningful improvement: 7.08, 95% CI: 1.31-38.32) and cough frequency. No other between-group differences were observed.</p><p><strong>Conclusion: </strong>Inspiratory muscle training may improve inspiratory muscle strength and reduce cough frequency, but limited sample size and underrepresentation of the most severely affected warrant cautious interpretation.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm44931"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107392/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730716","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":"Prevalence and biopsychosocial predictors of post-stroke fatigue in patients with minor strokes.","authors":"Anita Kjeverud, Stein Andersson, Anners Lerdal, Anne-Kristine Schanke, Kristin Østlie","doi":"10.2340/jrm.v58.44763","DOIUrl":"10.2340/jrm.v58.44763","url":null,"abstract":"<p><strong>Background: </strong>The majority of stroke patients suffer minor stroke. Little is known about the prevalence of post-stroke fatigue (PSF) and which factors are associated with fatigue in minor stroke patients.</p><p><strong>Objective: </strong>To investigate the prevalence of PSF in a sample of minor stroke patients and to explore associations between biopsychosocial factors and fatigue 12 months post stroke.</p><p><strong>Methods: </strong>In this observational study of 72 minor stroke patients fatigue symptoms were measured in the acute phase and 12 months post stroke using the Fatigue Severity Scale (FSS). At 12 months, data on psychological distress symptoms, coping strategies, balance, cognitive function, and self- report of stroke-related symptoms were collected using standardized questionnaires and tests. To explore the possible associations between fatigue and the different variables the Mann-Whitney U test and Spearman's correlations were used. A multiple regression was conducted to identify which of the factors had the strongest association with fatigue Results: Almost 20% of the sample were fatigue cases 1 year post stroke using a cut off of 5 on the FSS. PSF was strongly associated with having psychological distress symptoms. In univariate analyses, PSF was also associated with fatigue in the acute phase, stroke-related physical impairments, and self-report of symptoms of cognitive impairments.</p><p><strong>Conclusions: </strong>PSF is present in a subgroup of patients with minor stroke. To identify patients at risk of developing chronic PSF, minor stroke patients should be screened for fatigue early after stroke. A short screening of factors associated with fatigue, such as psychological distress and impaired motor, visual, or cognitive function is also advisable. There is a need for further research in larger samples on PSF and associated factors in minor stroke.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm44763"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730691","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":"Sacroiliac joint synostosis as an atypical cause of sports-related groin pain: a case report.","authors":"Lina Van Brabander, Tom Nonneman, Marc Schiltz, Bernard Floré, Samar M Hatem","doi":"10.2340/jrm.v58.45687","DOIUrl":"10.2340/jrm.v58.45687","url":null,"abstract":"","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm45687"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729918","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":"Beyond spasticity reduction: botulinum toxin-a injection is associated with changes in abnormal flexor synergies of the upper limb in chronic stroke.","authors":"Michiyuki Kawakami, Daisuke Ito, Ken Azuma, Takayuki Kamimoto, Arisa Kawabata, Tetsuya Tsuji","doi":"10.2340/jrm.v58.44906","DOIUrl":"10.2340/jrm.v58.44906","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the association between botulinum toxin type A treatment and changes in spasticity and abnormal flexor synergies in patients with chronic stroke.</p><p><strong>Subjects: </strong>Twenty-eight patients with chronic stroke (mean age 56.5 years; mean time since onset 6.3 years) who received botulinum toxin type A injections into upper-arm flexor muscles (biceps brachii, brachialis, or brachioradialis) were enrolled.</p><p><strong>Methods: </strong>This was a retrospective, single-centre cohort study. Assessments were performed before and approximately 2 months after injection. Primary outcomes were changes in spasticity measured by the Modified Ashworth Scale and the abnormal flexor synergy index based on kinematic analysis. Secondary outcomes included changes in voluntary shoulder flexion angle and subgroup analyses according to baseline upper extremity motor severity and responder/non-responder status based on changes in the Modified Ashworth Scale scores of the elbow flexors.</p><p><strong>Results: </strong>Generalized estimating equation analyses showed significant changes in Modified Ashworth Scale elbow flexor scores and the abnormal flexor synergy index after injection. In severity-stratified analyses, significant Time × Severity interactions were observed for Modified Ashworth Scale scores of the elbow and wrist flexors, whereas no significant interaction was found for the abnormal flexor synergy index. In responder/non-responder analyses, a significant Time × Responder-status interaction was observed for the abnormal flexor synergy index. Non-responders showed no significant changes in Modified Ashworth Scale scores or the abnormal flexor synergy index and showed reduced maximum voluntary shoulder flexion angle.</p><p><strong>Conclusion: </strong>This study suggests that botulinum toxin type A treatment was associated with changes in abnormal flexor synergies, in addition to reducing muscle tone. These findings highlight the value of incorporating kinematic assessments such as the abnormal flexor synergy index into the clinical evaluation of botulinum toxin treatment.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm44906"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13107393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730721","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":"Early multidimensional mobility assessments for discriminating discharge-level ambulation and functional independence in subacute stroke inpatients: a retrospective cohort study.","authors":"Seung Heun An, Eun Joo Kim, Jun Min Lee","doi":"10.2340/jrm.v58.45503","DOIUrl":"10.2340/jrm.v58.45503","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether early multidimensional mobility assessments discriminate independent ambulation and functional independence on discharge in subacute stroke inpatients with supervised walking ability.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Subjects/patients: </strong>Fifty subacute stroke inpatients (≤ 5 months post-stroke).</p><p><strong>Methods: </strong>Independent ambulation and functional independence were defined as Functional Ambulation Category ≥ 4 and Modified Barthel Index 75 on discharge, respectively. Discriminative ability of admission assessments was evaluated using univariate binary logistic regression and receiver operating characteristic curve analysis.</p><p><strong>Results: </strong>The Berg Balance Scale and the modified Four Square Step Test demonstrated the highest discriminative performance. For independent ambulation, the Berg Balance Scale (≥ 40.5) yielded an area under the curve of 0.74 (95% confidence interval: 0.60-0.88) with 82% accuracy, and the modified Four Square Step Test (≤ 31.52 s) yielded an area under the curve of 0.78 (0.64-0.91) with 80% accuracy. For functional independence, the Berg Balance Scale (≥ 42.5) yielded an area under the curve of 0.74 (0.60-0.88) with 74% accuracy, and the modified Four Square Step Test (≤ 32.88 s) yielded an area under the curve of 0.71 (0.57-0.86) with 70% accuracy.</p><p><strong>Conclusion: </strong>Early balance and multidirectional stepping performance may be useful for screening to support goal-setting and discharge planning.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm45503"},"PeriodicalIF":2.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13093134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693670","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":"Does aerobic exercise affect memory, attention, working memory, and fatigue after acquired brain injury? A single-blinded, randomized controlled pilot study.","authors":"Eygló Ingólfsdóttir, Ulla Bergfeldt, Märta Berthold Lindstedt, Lennart Bergfeldt, Tie-Qiang Li, Tomas Jonsson, Marika C Möller","doi":"10.2340/jrm.v58.44745","DOIUrl":"10.2340/jrm.v58.44745","url":null,"abstract":"<p><strong>Objective: </strong>To explore potential effects of aerobic exercise on cognitive function, fatigue, and neuroplasticity after stroke or traumatic brain injury.</p><p><strong>Design: </strong>A randomized controlled pilot study.</p><p><strong>Subjects/patients: </strong>Twelve participants, 10 men and 2 women aged 16-65 years diagnosed with acquired brain injury (moderate to severe stroke or traumatic brain injury), enrolled in an outpatient rehabilitation programme at least 3 months post-injury.</p><p><strong>Methods: </strong>The intervention group (n = 6) participated in 30 min of aerobic exercise 3-4 times/week for 8 weeks during their outpatient rehabilitation. The control group (n = 6) received routine physical therapy. In addition, both groups received rehabilitation according to their rehabilitation plan. Neuropsychological and endurance testing was performed before and after the intervention and at a 3-month follow-up. Functional magnetic resonance imaging was performed before and after the intervention.</p><p><strong>Results: </strong>Preliminary findings show no significant difference between the groups regarding cognitive variables, fatigue, or neuroplasticity. However, working memory/executive demanding processing speed, measured with the Paced Auditory Serial Addition Test, improved significantly (p = 0.042) in the aerobic exercise group and there were trends of improvements on several other executive tests in the aerobic exercise group. Automatic visual search speed improved in the control group (p = 0.027).</p><p><strong>Conclusion: </strong>The question of whether aerobic exercise promotes cognition and fatigue after brain injury remains unanswered. This randomized controlled pilot study and its preliminary findings indicate greater improvements in executive processing speed in the aerobic exercise group, while more automatized attention speed improved more in the control group. The experiences from this study might facilitate the design of future studies on this intriguing topic.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT07429526.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm44745"},"PeriodicalIF":2.3,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213536/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693710","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":"Specific components of manual dexterity are affected in patients with writer's cramp: an observational comparative study and preliminary rehabilitation report.","authors":"Jean-Pierre Bleton, Raphael B Takyi, Marion Verneau, Cedric Monchaud, Thierry Peron Magnan, Sophie Sangla, Amélie Yavchitz, Marc A Maier, Påvel G Lindberg","doi":"10.2340/jrm.v58.45215","DOIUrl":"10.2340/jrm.v58.45215","url":null,"abstract":"<p><strong>Objective: </strong>To compare manual dexterity in patients with writer's cramp and healthy controls to determine which components of dexterity are impaired in writer's cramp. In addition, to assess the effects of rehabilitation.</p><p><strong>Design: </strong>Cross-sectional primary study, longitudinal secondary study.</p><p><strong>Subjects/patients: </strong>23 patients with writer's cramp and 20 healthy age- and sex-matched control subjects.</p><p><strong>Methods: </strong>Degree of manual dexterity (through 3 tasks) and handwriting symptoms were assessed, and effects of rehabilitation probed.</p><p><strong>Results: </strong>Patients with writer's cramp showed significantly lower handwriting speed (97 letters/min) and legibility (BFM score = 1.3) compared with control subjects (171 letters/min, p < 0.001; BFM score = 0.15, p < 0.001). Only the task quantifying finger independence showed weaker finger selectivity (median = 0.84) in patients compared with controls (median = 0.89, p = 0.01). The other 2 tasks, maximal finger tapping and visuomotor finger force-tracking, did not reveal significant group differences (all p > 0.44). In patients, automated writing legibility correlated with finger selectivity (r = 0.50, p = 0.02). Rehabilitation improved dexterity (selectivity and force-tracking) and automated writing legibility.</p><p><strong>Conclusion: </strong>In this multi-component analysis of manual dexterity, reduced selectivity of finger movements was identified as the main behavioural mechanism (deficit) in writer's cramp, associated with writing speed. In contrast, force control and tapping speed were unaffected. Selective finger activation can be improved with therapy targeting dextrous finger movements.</p>","PeriodicalId":54768,"journal":{"name":"Journal of Rehabilitation Medicine","volume":"58 ","pages":"jrm45215"},"PeriodicalIF":2.3,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13071796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147640698","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}