Annals of Physical and Rehabilitation Medicine最新文献

{"title":"Hip strengthening exercise compared to standard rehabilitation after revision hip replacement: a multicenter randomized controlled trial","authors":"Martin G. Stisen ,&nbsp;Alma B. Pedersen ,&nbsp;Troels Kjeldsen ,&nbsp;Frederik N. Foldager ,&nbsp;Martin Lamm ,&nbsp;Anders Assenholt ,&nbsp;Kirstine L. Hvidberg ,&nbsp;Morten K. Rasmussen ,&nbsp;Peter K. Aalund ,&nbsp;Christina F. Frandsen ,&nbsp;Anders Holsgaard-Larsen ,&nbsp;Martin H. Haubro ,&nbsp;Theresa Bieler ,&nbsp;Søren Overgaard ,&nbsp;Torben Beck ,&nbsp;Kim G. Ingwersen ,&nbsp;Erik T. Parner ,&nbsp;Inger Mechlenburg","doi":"10.1016/j.rehab.2025.102076","DOIUrl":"10.1016/j.rehab.2025.102076","url":null,"abstract":"<div><h3>Background</h3><div>People undergoing revision total hip replacement (THR) typically experience slower recovery and greater functional limitations than those undergoing primary procedures. Rehabilitation practices following revision THR are inconsistent and often adapted from protocols for primary THR, despite limited specific evidence supporting their effectiveness.</div></div><div><h3>Objectives</h3><div>To compare the effectiveness of an exercise intervention targeting hip strengthening (NEMEX-STR) on functional performance at 4 months with the standard community-based rehabilitation (Usual care) in participants undergoing revision THR.</div></div><div><h3>Methods</h3><div>This multicenter, randomized, controlled, parallel-group, assessor-blinded superiority trial included participants undergoing revision THR who were randomized to NEMEX-STR or Usual care. The NEMEX-STR group underwent a 16-week intervention targeting hip strengthening, while the Usual care group received standard rehabilitation. The primary outcome was the between-group difference in functional performance assessed by the 30-second Chair Stand Test (30s-CST), from baseline (ie, prior to surgery) to 4 months after the start of the intervention. Secondary outcomes included the Hip Disability and Osteoarthritis Outcome Score (HOOS), the 40-meter Fast-Paced Walk Test (40m-FPWT), the 9-step Timed Stair Climb Test (9-step TSCT), and unilateral leg extensor muscle power.</div></div><div><h3>Results</h3><div>A total of 84 participants were recruited between November 2022 and June 2024 and were allocated to either NEMEX-STR (<em>n</em> = 43) or Usual care (<em>n</em> = 41). The mean changes from baseline to 4-month follow-up in the 30s-CST were 1.9 (95 % CI 0.8 to 3.0) in NEMEX-STR and 1.2 (95 % CI 0.6 to 2.3) chair stands in Usual care, with a between-group difference of 0.7 (95 % CI -0.8 to 2.3). Secondary outcomes showed no clinically relevant between-group differences in change for HOOS subscales, 40m-FPWT, 9-step TSCT, or unilateral leg extensor muscle power.</div></div><div><h3>Conclusion</h3><div>An exercise intervention targeting hip strengthening was not superior to standard community-based rehabilitation for improving functional performance at 4 months in participants undergoing revision THR.</div></div><div><h3>ClinicalTrials.gov</h3><div>NCT05657054.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 4","pages":"Article 102076"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145980816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Singing-based respiratory training in people with post-COVID syndrome: a bicentric randomized feasibility study","authors":"Anke Steinmetz ,&nbsp;Alexander Hönning ,&nbsp;Wiebke Käckenmester ,&nbsp;Ingo Schmehl ,&nbsp;Marc Secara ,&nbsp;Sigrid Biffar ,&nbsp;Ina Kim ,&nbsp;Katja Bahcesular ,&nbsp;Bernhard Lehnert ,&nbsp;Kristin Lehnert ,&nbsp;Marcus Dörr ,&nbsp;Kristina Zappel","doi":"10.1016/j.rehab.2025.102073","DOIUrl":"10.1016/j.rehab.2025.102073","url":null,"abstract":"<div><h3>Background</h3><div>People with post-COVID syndrome (PCS) often suffer from long-term pulmonary consequences. Singing-based respiratory training (SBRT) has proven to be a valuable rehabilitative therapy for people with chronic lung diseases.</div></div><div><h3>Objectives</h3><div>The aim of this study was to investigate the feasibility of SBRT in people with PCS breathing disorders, their compliance and adherence, and to obtain detailed findings on the effect of this training on people with PCS respiratory symptoms.</div></div><div><h3>Methods</h3><div>A randomized controlled, single-blind, bicentric study was conducted with 23 outpatient and 24 inpatient participants undergoing rehabilitation for PCS. Participants either received singing-based respiratory training with the intention of reducing breathing rate or training without the aim of influencing breathing rate. The main outcomes were patient compliance, determination of target parameters for a future efficacy study, and assessment of outcome differences between treatment groups.</div></div><div><h3>Results</h3><div>The 45 study participants were predominantly female (81 %) with a mean age of 51.5 (SD 10.44) years. There was a high level of compliance with SBRT, with 96 % of participants completing all training sessions led by vocal coaches. The overall comparison between baseline and follow-up assessments yielded improvements corresponding to medium effects in the physical component score of the Veterans RAND 12-Item Health Survey (VR-12) with a Cohen’s d of 0.52 (95 % Confidence Interval, CI 0.05 to 0.99]), in the Generalized Anxiety Disorder Scale-7 (GAD-7) with a Cohen’s d of 0.55 (95 % CI 0.11 to 0.9) and in the Patient Health Questionnaire-9 (PHQ-9) with a Cohen’s d of 0.50 (95 % CI 0.06 to 0.93).</div></div><div><h3>Conclusion</h3><div>SBRT was well-tolerated, with high adherence and compliance among participants in our study. Questionnaires assessing health-related quality of life and mental health may be suitable as primary outcomes for a future confirmatory study. The data suggest that SBRT aimed at reducing the respiratory rate does not have a positive effect compared to regular SBRT.</div></div><div><h3>Trial registration</h3><div>German Register of Clinical Trials (DRKS ID DRKS00028275).</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 4","pages":"Article 102073"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145915427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of nonsurgical interventions for the management of adults with cervicogenic headache: a systematic review and meta-analyses","authors":"Laura Martins ,&nbsp;Pablo Collet ,&nbsp;Simon Lafrance ,&nbsp;Anthony Demont","doi":"10.1016/j.rehab.2025.102070","DOIUrl":"10.1016/j.rehab.2025.102070","url":null,"abstract":"<div><h3>Background</h3><div>The efficacy of commonly used medication and physical interventions for cervicogenic headache (CGH) in adults remains insufficiently assessed.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy of nonsurgical interventions for managing adults with CGH.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across 6 databases through September 2025, identifying randomized controlled trials (RCTs) that examined the efficacy of nonsurgical interventions in reducing CGH-related outcomes, including headache frequency, intensity, duration, neck disability, medication intake, and quality of life. 2 reviewers independently extracted data using a standardized form. Risk of bias was assessed with the Cochrane RoB 2.0 tool, and certainty of evidence with the GRADE approach. Meta-analyses were conducted for trials with similar interventions, comparators, and outcomes. Standardized mean differences (SMD) with 95 % confidence intervals were calculated using a random-effects model and the inverse-variance method. Heterogeneity was assessed using χ² and I² statistics. Effect sizes were interpreted according to Cohen’s thresholds. For RCTs not eligible for meta-analysis, a structured narrative synthesis was conducted.</div></div><div><h3>Results</h3><div>29 RCTs were included. Low-certainty evidence suggests that manual therapy reduced headache intensity compared with sham at 0–2 weeks post-intervention (SMD −1.60; 95 %CI −2.40 to −0.79; 5 RCTs; <em>n</em> = 144), but not at 12 months (SMD 0.09; 95 %CI −0.59 to 0,76; 2 RCTs; <em>n</em> = 265). Low-certainty evidence indicates that exercise therapy alone may reduce headache compared with usual care, but the difference was not statistically significant at 1–3 months (SMD −1.30; 95 %CI −2.61 to 0.02; 2 RCTs; <em>n</em> = 116) and at 12 months (SMD −1.25; 95 %CI −2.35 to −0.14; 2 RCTs; <em>n</em> = 116). Evidence is uncertain regarding the efficacy of both manual therapy and the combination of manual therapy and exercise therapy compared with usual care.</div></div><div><h3>Conclusions</h3><div>Manual therapy may offer short-term relief for adults with CGH. However, the long-term effects and added benefits of combined approaches remain unclear.</div></div><div><h3>Trial Registration Prospero</h3><div>#CRD42023390280.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 4","pages":"Article 102070"},"PeriodicalIF":4.6,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145928854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Musculoskeletal deformities in children with spinal muscular atrophy: a multicenter cross-sectional study with longitudinal follow-up","authors":"Xiaoyue Wang ,&nbsp;Yun Zheng ,&nbsp;Jinhua Lu ,&nbsp;Xiaoli Li ,&nbsp;Shujuan Chen ,&nbsp;Yang Xue ,&nbsp;Shuxiang Hu ,&nbsp;Guilan Peng ,&nbsp;Feng Zhang ,&nbsp;Xiuying Zhao ,&nbsp;Yun Liu ,&nbsp;Yabei Fan ,&nbsp;Hongyu Zhou ,&nbsp;Cuili Liang ,&nbsp;Liru Liu ,&nbsp;Lu He ,&nbsp;Jingbo Zhang ,&nbsp;Weizhe Shi ,&nbsp;Jinsheng Tian ,&nbsp;Mingshan Han ,&nbsp;Kaishou Xu","doi":"10.1016/j.rehab.2025.102080","DOIUrl":"10.1016/j.rehab.2025.102080","url":null,"abstract":"<div><h3>Background</h3><div>The administration of Nusinersen has extended the life expectancy of children with spinal muscular atrophy (SMA) Type I, while the prevalence and progression of musculoskeletal deformities remain uncertain.</div></div><div><h3>Objectives</h3><div>To investigate the prevalence of scoliosis, joint contracture, and hip dislocation in children with SMA, and to assess whether Nusinersen combined with rehabilitation can stabilize or improve musculoskeletal conditions.</div></div><div><h3>Methods</h3><div>This multicenter study enrolled 229 children with SMA across nine hospitals in China, with 83 followed longitudinally for 1 to 2 years after Nusinersen initiation. Age, gender, SMA subtype, motor ability, and functional scores were collected. Radiological examinations confirmed scoliosis and hip dislocation, while joint contracture was evaluated through passive range of motion. Spearman’s correlation and logistic regression were used to identify associations and predictors.</div></div><div><h3>Results</h3><div>Overall, 59% of children had scoliosis, 62% had joint contracture, and 21% had hip dislocation. Among children with SMA Type I, 42% presented scoliosis, 46% joint contracture, and 25% hip dislocation. Age was identified as a significant predictor of musculoskeletal deformities, with the odds of scoliosis increasing by 1.379 per year, joint contracture by 1.303, and hip dislocation by 1.305 (<em>P</em> &lt; 0.01). Musculoskeletal deformities correlated positively with age (<em>P</em> &lt; 0.001) but negatively with SMA subtype (<em>P</em> &lt; 0.01), motor ability (<em>P</em> &lt; 0.05), and HFMSE scores (<em>P</em> &lt; 0.01). During follow-up, scoliosis remained stable in 33% of children at 1 year and 42% at 2 years. Knee contracture stability was observed in 12% at 1 year, while ankle contracture remained stable in 25% at 1 and 2 years, with improvement in 25% at 2 years.</div></div><div><h3>Conclusions</h3><div>Musculoskeletal deformities are highly prevalent in children with SMA, particularly among Type I. Age and SMA subtype were significant predictors. Our findings suggest that an integrated approach combining Nusinersen treatment with rehabilitation management may help stabilize or improve musculoskeletal outcomes in this population.</div></div><div><h3>Data registration reference</h3><div>NCT04089566.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102080"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Repetitive transcranial magnetic stimulation for post-stroke aphasia: a meta-analysis of stimulation and hemispheric dynamics","authors":"Kuo-Chang Wei ,&nbsp;Kuan-Yu Chen ,&nbsp;Chenyi Chen ,&nbsp;Yang-Teng Fan ,&nbsp;Yawei Cheng","doi":"10.1016/j.rehab.2026.102107","DOIUrl":"10.1016/j.rehab.2026.102107","url":null,"abstract":"<div><div>Post-stroke aphasia (PSA) is a common and debilitating consequence of stroke. Repetitive transcranial magnetic stimulation (rTMS) has emerged as a promising intervention to support language recovery. In this meta-analysis, we systematically reviewed randomized controlled trials (RCTs) from PubMed, the Cochrane Library, and Embase up to November 1, 2024. A random-effects model was used to calculate pooled standardized mean differences (SMDs) and 95% confidence intervals (CIs). Subgroup analyses examined the effects of protocol type (excitatory vs inhibitory), individualized targeting, stroke chronicity, and stimulation site. Twenty-six RCTs met the inclusion criteria. Across all included studies, the combined sample comprised 419 participants in active rTMS groups and 318 in control or sham groups. The pooled results demonstrated a significant positive effect of rTMS on language recovery in PSA (SMD = 0.80; 95% CI, 0.48–1.11; <em>P</em> &lt; 0.00001). Both inhibitory and excitatory protocols were effective, with the greatest gains observed when inhibitory stimulation targeted the right inferior frontal gyrus (pars triangularis) and was administered during the subacute phase post-stroke. Individualized rTMS did not demonstrate a statistically significant advantage over standard protocols. These findings support rTMS as an effective therapeutic approach for PSA and highlight the importance of optimizing stimulation parameters, timing, and interhemispheric dynamics. Further research is warranted to refine rTMS strategies and identify patient-specific predictors of treatment response.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102107"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147678832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative disability predicts goal attainment failure after selective tibial neurotomy and rehabilitation: a 5-year follow-up study","authors":"Corentin Dauleac ,&nbsp;Jacques Luaute ,&nbsp;Gilles Rode ,&nbsp;Patrick Mertens","doi":"10.1016/j.rehab.2025.102066","DOIUrl":"10.1016/j.rehab.2025.102066","url":null,"abstract":"<div><h3>Background</h3><div>Studies assessing the effectiveness of selective tibial neurotomy (STN) assume that the procedure, combined with a rehabilitation program, reduces foot spasticity and allows the achievement of personal goals. However, few studies have reported failures in goal attainment or recurrence of spasticity, and no predictive factors have been established.</div></div><div><h3>Objectives</h3><div>To identify predictors associated with the failure to achieve personal goals after STN and rehabilitation programs.</div></div><div><h3>Methods</h3><div>Eighty-eight adult participants with spastic foot, irrespective of the etiology, who underwent STN followed by a rehabilitation program were included. Personal goals were assessed using the Goal Attainment Scaling methodology, with T-scores calculated through a 5-year follow-up. Spasticity recurrence was defined as worsening of spasticity on the modified Ashworth scale compared with the clinical status 1 year after STN. Clinical characteristics were analyzed to identify independent predictors, which were subsequently confirmed using logistic regression.</div></div><div><h3>Results</h3><div>At the 5-year follow-up, 10 participants (10/88, 11 %) had a T-score &lt;50. Logistic regression identified the degree of preoperative disability (modified Rankin Scale ≥3, <em>P</em> = 0.003) as the only significant predictor of failure to achieve personal goals. Spasticity-free survival was significantly higher among participants who had achieved their goals at least as expected (<em>P</em> &lt; 0.0005), suggesting a strong relationship between long-term functional gains and sustained spasticity reduction.</div></div><div><h3>Conclusion</h3><div>Failure to achieve personal goals after STN and a rehabilitation program is rare. However, greater preoperative disability was identified as a predictor of goal attainment failure over time.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102066"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of physical exercise on quality of life in women with breast cancer undergoing chemotherapy: a network meta-analysis","authors":"Miguel Contreras Molina ,&nbsp;Susana Priego Jiménez ,&nbsp;Celia Álvarez Bueno ,&nbsp;Beatriz Rodríguez Martín ,&nbsp;Blanca Zuheros Lara ,&nbsp;Marta Carolina Ruiz Grao","doi":"10.1016/j.rehab.2025.102064","DOIUrl":"10.1016/j.rehab.2025.102064","url":null,"abstract":"<div><h3>Background</h3><div>Breast cancer is the most prevalent cancer among women worldwide and poses significant challenges because of its high incidence and treatment-related sequelae. Although the benefits of physical exercise across treatment phases are well documented, evidence specifically assessing its effects during chemotherapy remains limited.</div></div><div><h3>Objective</h3><div>To evaluate the effectiveness of different types of physical exercise in improving overall health-related quality of life (HRQoL) in women with breast cancer undergoing chemotherapy.</div></div><div><h3>Methods</h3><div>A network meta-analysis (NMA) of randomized controlled trials (RCTs) was conducted to compare the impact of various exercise modalities on HRQoL during chemotherapy. Literature searches were conducted through August 2025. The risk of bias was assessed using the Cochrane RoB 2.0 tool, and the evidence quality was rated using GRADE. Pairwise and NMA were conducted via random effects models. Surface under the cumulative ranking curve (SUCRA) values were calculated to rank the interventions.</div></div><div><h3>Results</h3><div>Eighteen RCTs with 1539 participants were included. Compared with the control interventions, the combined and endurance-based exercise interventions had greater effect sizes (ES = 0.41; 95 % CI, 0.15–0.68 for both). These programs significantly improved overall HRQoL in women undergoing chemotherapy.</div></div><div><h3>Conclusions</h3><div>Physical exercise during chemotherapy effectively enhances HRQoL in women with breast cancer. Combined and endurance interventions are the most beneficial.</div></div><div><h3>Implications for practice</h3><div>Findings support the use of structured, supervised exercise, especially combined or endurance-based exercise, in routine care. Programs with relaxation components (eg, yoga) are particularly effective for addressing stress and anxiety. Tailored interventions may optimize adherence and therapeutic outcomes.</div></div><div><h3>PROSPERO registration</h3><div>CRD42024555581</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102064"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcutaneous electrical nerve stimulation improves walking in fatigued persons with multiple sclerosis: A randomized controlled trial","authors":"Nikki Dreijer ,&nbsp;Leda B. Maffei ,&nbsp;Menno P. Veldman ,&nbsp;Elisabeth K. Simmelink ,&nbsp;Dorothea J. Heersema ,&nbsp;Jan F. Meilof ,&nbsp;Inge Zijdewind","doi":"10.1016/j.rehab.2025.102081","DOIUrl":"10.1016/j.rehab.2025.102081","url":null,"abstract":"<div><h3>Background</h3><div>Walking difficulties and fatigue severely limit daily life in persons with multiple sclerosis (pwMS). Sensory stimulation, such as transcutaneous electrical nerve stimulation (TENS), might offer a non-pharmacological strategy to enhance motor function through sensorimotor interactions in the central nervous system.</div></div><div><h3>Objective</h3><div>This randomized, double-blinded, sham-controlled, parallel-group superiority trial investigated the effects of TENS applied to the knee extensors, with and without concurrent exercise, on walking and fatigue in pwMS.</div></div><div><h3>Methods</h3><div>PwMS (<em>n</em> = 80) with fatigue (FSS&gt;4 or MFIS&gt;38) and walking difficulties (MSWS-12&gt;30) were randomized to one of four groups: TENS only (TENS; <em>n</em> = 21), TENS+exercises (COMBINATION; <em>n</em> = 20), sham stimulation (SHAM; <em>n</em> = 20) or sham+exercises (EXERCISE; <em>n</em> = 19) using a computer-generated stratified randomization. Each group performed twelve 10-min sessions over 4 weeks. Participants and outcome assessors were blinded to the stimulation type. Primary outcomes were walking performance (6-minute walk test, 6-MWT), fatigue (FSS, MFIS), and self-reported walking limitations (MSWS-12). Secondary outcomes were knee extensor strength and force steadiness and the 30-second chair-stand test (30-CST). Outcomes were assessed at baseline, immediately post-intervention, and at 2-week follow-up.</div></div><div><h3>Results</h3><div>Intention-to-treat linear mixed-effect models showed a significant time*group interaction for the 6-MWT (<em>p</em> &lt; .05). Relative to SHAM, within-group comparisons indicated significant improvements in the TENS group only (+35 m [95% CI: 23.1–46.5] post-intervention; +35 m [95% CI: 22.4–48.4] at follow-up). Clinically meaningful improvements (&gt;21.6 m) in walking distance were achieved by 74% of the TENS group compared to 44%, 40% and 28% in the COMBINATION, SHAM and EXERCISE group. FSS, MFIS, MSWS-12 and secondary outcomes improved across all groups, with no between-group differences. No important harms were notified.</div></div><div><h3>Conclusions</h3><div>TENS during rest, but not during exercise, improved walking performance in pwMS more than SHAM, but not subjective outcomes such as fatigue or perceived walking limitations. Future studies should investigate underlying neurophysiological mechanisms to optimize therapeutic outcomes.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov (NCT05321927).</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102081"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146173307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specific procedure combinations in a rehabilitation setting define severity clusters of older adults with multiple sclerosis: a cohort study","authors":"Jonathan Levy ,&nbsp;Arnaud Leilaz ,&nbsp;Antoine Léotard ,&nbsp;Charles Joussain ,&nbsp;Marjorie Salga ,&nbsp;John Castro ,&nbsp;Maude Espagnacq ,&nbsp;Olivier Heinzlef ,&nbsp;Djamel Bensmail","doi":"10.1016/j.rehab.2025.102075","DOIUrl":"10.1016/j.rehab.2025.102075","url":null,"abstract":"<div><h3>Introduction</h3><div>People with multiple sclerosis (PwMS) are ageing and exposed to multiple impairments. We described the use of health care procedures in a physical and rehabilitation medicine setting for PwMS ≥70 years and identified specific participant clusters.</div></div><div><h3>Methods</h3><div>In this observational cohort study using a local data hub (2012 to March 2024), PwMS were identified with ICD-10 codes (G35). An age filter (≥70) was applied. Medical procedures were systematically coded according to a specific French classification over time, including dates of occurrence, and then extracted and grouped by impairment domains: upper motor neuron syndrome and orthopedic deformities (UMN-OD), respiratory and sleep disorders (RSD), and neurogenic lower urinary tract dysfunction (NLUTD). Clinical data were retrospectively collected from medical files. We conducted descriptive analyses and multiple-component and clustering analyses to identify and characterize the participants’ profiles.</div></div><div><h3>Results</h3><div>Among 206 participants aged 75.7 (4.3) years, 62% (128) were women, 19% (39) had died, and MS had evolved for 43.3 (12.4) years. The Expanded Disability Status Scale (EDSS) was 7.5 (6.5–8.5), and the Charlson Comorbidity Index (CCI) was 6 (5–7). A total of 2794 procedures were performed for 187 participants, mainly in NLUTD (1424 for 170), which was associated with RSD (<em>P</em> = 0.001), but not UMN-OD (<em>P</em> = 0.262). Three groups were identified (Group 1 = isolated NLUTD, Group 2 = RSD and intrathecal baclofen procedures, and Group 3 = no in-hospital management). People in Group 2 had more severe comorbidities (<em>P</em> &lt; 0.001) than those in the other two groups (<em>P</em> = 0.016).</div></div><div><h3>Conclusions</h3><div>In PwMS ≥70 years, the hospital management of MS-related impairments was directly associated with disease severity and overall comorbidities. Participants who were followed only for NLUTD exhibited severity and comorbidity profiles similar to those of participants who did not require hospital procedures.</div></div><div><h3>Data registration</h3><div>Our institutional health data warehouse and all derived extracted databases within the scope of the health team perimeter are approved by the French Data Protection Authority under the No. 1980120.</div></div>","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102075"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145924797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Successful treatment of hand chronic exertional compartment syndrome with reduced-dose botulinum toxin-A: a case report","authors":"Cédric Cormier,&nbsp;Mathilde Pelletier-Visa,&nbsp;Emmanuel Coudeyre,&nbsp;Maxime Grolier","doi":"10.1016/j.rehab.2025.102055","DOIUrl":"10.1016/j.rehab.2025.102055","url":null,"abstract":"","PeriodicalId":56030,"journal":{"name":"Annals of Physical and Rehabilitation Medicine","volume":"69 3","pages":"Article 102055"},"PeriodicalIF":4.6,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145572092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}