Advances in rehabilitation science and practice最新文献

{"title":"Development and Content Validation of the Questionnaire for Postamputation Pain (Q-PAP): An Expert Delphi Study.","authors":"Max Ortiz-Catalan, Katleho Limakatso","doi":"10.1177/27536351261484074","DOIUrl":"10.1177/27536351261484074","url":null,"abstract":"<p><strong>Introduction: </strong>The questionnaire for postamputation pain (Q-PAP) introduced here has undergone modifications over a decade of research on postamputation pain. It has so far been used as a form of study specific questionnaire. Here, we present the latest attempt to consolidate it as a tool useful for both research and clinical practice by involving experts on postamputation pain worldwide.</p><p><strong>Methods: </strong>A three-round Delphi study was conducted online, utilising email and digital forms as tools for communication and providing feedback. We included a purposive sample of 13 clinicians and researchers with expertise in postamputation pain from eight countries. The experts ranked each questionnaire item for relevance, clarity, and completeness on a 5-point Likert scale. Consensus on each item was considered reached when the level of agreement was above 50%.</p><p><strong>Results: </strong>The preliminary version of the Q-PAP comprised an introduction and sections with questions on phantom limb pain, residual limb pain, neuroma pain, and situational changes. Based on the group's feedback, the section on neuroma pain was removed, as it required clinician-administered tests, which conflicted with the self-report nature of the questionnaire. In addition, individual items on telescoping, prosthesis use, and bone pain were removed, as experts deemed them too specific. The final version of the Q-PAP assesses pain intensity, descriptors, frequency, interference, phantom limb position, phantom limb movements, phantom limb sensation, and situational changes.</p><p><strong>Conclusion: </strong>The findings support content validity of the Q-PAP as a self-report instrument for the multidimensional assessment of postamputation pain, providing a clinically relevant and patient-centred tool for capturing key pain characteristics and experiences. The psychometric validation of the Q-PAP is a crucial part of future work, establishing its reliability, validity, and comparability for use in PAP research and clinical practice.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261484074"},"PeriodicalIF":2.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique Functional Profiles in Deafblindness: Evidence From a Comparative Analysis of ICF Core Sets.","authors":"Lorenzo Billiet, Shirley Dumassais, Sarah Granberg, Walter Wittich","doi":"10.1177/27536351261481978","DOIUrl":"10.1177/27536351261481978","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether the functional implications of deafblindness can be understood as the simple sum of vision loss and hearing loss or whether deafblindness constitutes a distinct sensory disability. By comparing the comprehensive ICF Core Sets for vision loss, hearing loss, and deafblindness, the study aimed to determine the extent to which deafblindness reflects unique patterns of functioning beyond additive single sensory difficulties.</p><p><strong>Method: </strong>A secondary comparative analysis was conducted using all items from the three Core Sets that were classified according to the four ICF components (body functions, body structures, activities and participation, and environmental factors). Items were merged into a single dataset and coded for their presence in each condition. A systematic item-level comparison was performed to identify categories that were common to all three Core Sets, shared by two, or unique to a single sensory condition. No weighting was applied; all items were treated equally. The final output grouped items, reflecting different patterns of overlap and uniqueness.</p><p><strong>Results: </strong>The Core Sets contained 98 items for vision loss, 118 for hearing loss, and 219 for deafblindness. A total of 435 distinct categories were identified. Of these, 53 items appeared in all three conditions. Overlap showed 27 items shared between vision loss and deafblindness, 34 between hearing loss and deafblindness, and 11 between vision and hearing loss. Unique items were most pronounced in the deafblindness Core Set (n = 105), followed by hearing loss (n = 20) and vision loss (n = 7), indicating a substantial condition-specific functional profile for deafblindness.</p><p><strong>Conclusion: </strong>The results demonstrate that deafblindness is not merely the additive coexistence of vision and hearing loss but reflects a distinct and more complex functional profile. These findings support the need for condition-specific clinical approaches, policies, and assessment frameworks tailored to the unique demands of deafblindness.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261481978"},"PeriodicalIF":2.3,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148857896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Clinical Functioning Information Tool (ClinFIT) in Colorectal Surgical Prehabilitation: A Prospective Observational Study.","authors":"Guntitat Rujites, Mengzhe Yang, Bhasker Amatya, Emily Traer, Alaeldin Elmalik, Hilmy Ismail, Fary Khan","doi":"10.1177/27536351261484761","DOIUrl":"10.1177/27536351261484761","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the construct validity and clinical associations of the Clinical Functioning Information Tool (ClinFIT) with routinely collected preoperative risk and functional capacity measures in a colorectal cancer prehabilitation cohort.</p><p><strong>Design: </strong>Prospective observational study of routinely collected prehabilitation clinic data.</p><p><strong>Methods: </strong>Adults with colorectal cancer at a tertiary cancer centre were assessed in the prehabilitation clinic using validated tools and anaesthetic and surgical risk indices, including ClinFIT, Community Integration Questionnaire-Revised (CIQ-R), prehabilitation multidisciplinary risk ratings, functional capacity and cardiopulmonary exercise testing (CPET)-derived risk category, nutrition screening and socioeconomic indices. Associations were examined using Spearman's rank correlations.</p><p><strong>Results: </strong>Participants (n = 64, mean age: 60.8±13.5 years, 54.7% male) had a median acute length of stay (LoS) of 15 days (IQR: 10-20.5). Higher ClinFIT scores moderately correlated with higher American Society of Anesthesiologists physical status (p <0.001), CPET physiological vulnerability/risk (p =0.013), and prehabilitation multidisciplinary risk ratings (p <0.001). ClinFIT showed strong inverse correlations with self-reported functional capacity on the Duke Activity Status Index (p <0.001) and participation (CIQ-R total score) (p <0.001). ClinFIT did not correlate significantly with LoS, procedure-focused surgical risk indices, nutrition screening, or socioeconomic disadvantage.</p><p><strong>Conclusion: </strong>ClinFIT showed strong associations with participation, functional capacity, and selected preoperative vulnerability measures in this colorectal cancer prehabilitation cohort. These findings support its potential role as a multidimensional screening and assessment tool from a rehabilitation perspective. Further work should examine whether ClinFIT provides clinically useful information beyond existing preoperative measures and supports its practical use in preoperative oncology care.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261484761"},"PeriodicalIF":2.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522678/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Admission Thresholds and Outcomes in Inpatient Rehabilitation: A National Analysis.","authors":"Christa Marie Vella, Daniel Cutajar, Andrei Agius Anastasi","doi":"10.1177/27536351261481504","DOIUrl":"10.1177/27536351261481504","url":null,"abstract":"<p><strong>Aim: </strong>To analyse referrals and admissions to Malta's sole inpatient rehabilitation facility, identifying emerging trends and challenges over recent years.</p><p><strong>Design: </strong>A retrospective, population-based analysis was conducted on all in-patient rehabilitation referrals in Malta between July 1, 2022, and December 31, 2023. Referral outcomes, acceptance rates, and primary admission diagnoses were examined. Results were compared to a similar study in 2018. A follow-up questionnaire was designed to look at Rehabilitation outcomes in the 01.07.2022 to 31.12.2023 cohort at 2 years post discharge home.</p><p><strong>Objectives: </strong>1) To identify key shifts in admission process, length of stay and rehabilitation outcomes, thereby providing evidence to enhance in-patient rehabilitation selection and guide international rehabilitation strategies 2) To assess rehabilitation functional outcomes of an inpatient rehabilitation program and 2 years post discharge.</p><p><strong>Results: </strong>407 referrals were placed. Of these, 357 were new referrals, 73.1% (n=261) were accepted-a notable rise from 47% in 2018. Non-acceptance was recorded in 96 cases, while 50 patients were discharged or deceased before review. Both the mean (59 → 92) and median (22 → 59) length of stay increased over the 6-year period, reflecting an increase in both outliers due to social issues but also a shift towards longer length of stays in general. Despite this shift, the number of patients discharged to their own home fell from 90% to 79% with 12.3% being re-admitted to the acute hospital, 8.2% being discharged to a long-term care facility and 1 individual passing away.</p><p><strong>Conclusions: </strong>As a population-based analysis of national in-patient rehabilitation data, this study provides insights into shortcomings in the efficiency and effectiveness of inpatient rehabilitation services. Analysis into the variables that might have contributed to these findings may serve as a framework for rehabilitation policies worldwide. Future research should investigate barriers influencing discharge and long-term rehabilitation success.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261481504"},"PeriodicalIF":2.3,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13498792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Analysis of a Perceptual Hearing Loss Assessment Dataset and the International Classification of Functioning, Disability, and Health Core Sets for Hearing Loss.","authors":"Tahereh Afghah, Kirsten C Wagener","doi":"10.1177/27536351261471149","DOIUrl":"10.1177/27536351261471149","url":null,"abstract":"<p><strong>Objective: </strong>Common hearing assessments often overlook key aspects of hearing loss and its impact on daily-life. This study evaluates a broad dataset of audiological and functional measures by applying the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) Core Sets for Hearing Loss. The aim is to clarify which aspects of hearing loss-related functioning are represented in the dataset and which aspects are not addressed, thereby supporting appropriate interpretation and use of the data in clinical and research contexts.</p><p><strong>Design: </strong>The dataset includes results from otoscopy, pure-tone audiometry, a self-reported hearing and functioning questionnaire (HEAR-COMMAND Tool), speech intelligibility tests (Göttinger Sentence Test, GöSA and Oldenburger Sentence Test, OLSA), listening effort evaluation (Adaptive Categorical Listening Effort Scaling, ACALES), loudness perception assessments (Loudness Validation Method and Adaptive Categorical Loudness Scaling), a multi-talker conversation task (Concurrent Oldenburger Sentence Test, CCOLSA), coupler measurements, in-situ recordings, tone-in-noise perception, and the Dialogue Picture Task (DIAPIX). Using the ICF linking rules, all measures, performed on 76 participants, were systematically mapped to ICF categories.</p><p><strong>Results: </strong>For the brief CSHL, the dataset addressed 92.5% of the categories, missing only brain and inner ear structures. For the comprehensive CSHL, the dataset addressed 50.4% of the categories. This included 81.8% of Body Functions, 40% of Body Structures, 59.5% of Activities and Participation, and 29.1% of Environmental Factors.</p><p><strong>Conclusion: </strong>The results demonstrate that the dataset captures many key aspects of hearing loss and its consequences while also clarifying which areas of functioning are not addressed. By applying the ICF framework as a standardized reference, this study provides guidance for the transparent interpretation and appropriate use of the dataset in clinical and research settings, while enabling the creation of detailed profiles of an individual's hearing loss that are relevant for modeling speech intelligibility and listening effort.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261471149"},"PeriodicalIF":2.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13443246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional and Participation Outcomes of Colorectal Cancer With Peritoneal Metastasis and Pseudomyxoma Peritonei Following Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy (CRS-HIPEC): A Cross-Sectional Survivorship Study.","authors":"Mengzhe Yang, Bhasker Amatya, Alaeldin Elmalik, Krystal Song, Helen Mohan, Alexander Heriot, Fary Khan","doi":"10.1177/27536351261469694","DOIUrl":"10.1177/27536351261469694","url":null,"abstract":"<p><strong>Objective: </strong>To assess the longer-term functional and participation outcomes in survivors with colorectal cancer with peritoneal metastasis (CRCPM) and pseudomyxoma peritonei (PMP) following cytoreductive surgery and hyperthermic intraperitoneal chemotherapy intervention (CRS-HIPEC).</p><p><strong>Method: </strong>Adult CRCPM/PMP in the community following CRS-HIPEC completed validated questionnaires. Descriptive statistics summarized participant characteristics, while multivariate linear regression (p < 0.05) identified predictors of functional and psychosocial outcomes, and a binary logistic regression model identified factors associated with poorer quality of life (QoL).</p><p><strong>Results: </strong>Of 100 participants (59 CRCPM, 41 PMP), mean age: 59.1±12.2 years, 52% male, mean time since CRS-HIPEC: 2.4±2.5 years, overall, many reported persistent issues: fatigue (86%), fear of recurrence (79%), pain (58%), insomnia (52%) and bowel dysfunction (32%). Despite this, overall functional recovery was good (Clinical Functioning Information Tool median [IQR]: 28 [19.3-52.5]), with low perceived psychological impact (Depression Anxiety Stress Scale total: 6 [0-17.5]) and relatively preserved QoL (European Quality of Life VAS score: 78 [60-85]). The CRC-specific QoL was poorer (Functional Assessment of Cancer Therapy-Colorectal: 106 [91-115.6]) and community integration was modest (Community Integration Questionnaire: 20.3 [16-24]). The PMP cohort reported a lower persistent symptom burden and a more favourable QoL. Overall, older age and unemployment were strong predictors of poorer outcomes. Employment status and symptom burden independently predicted longer-term functional and participation outcomes in CRCPM survivorship, with female gender, stoma, and radiotherapy as additional influencing factors.</p><p><strong>Conclusion: </strong>Overall, despite participants being functionally well, many experience substantial longer-term symptom burden and participation-related challenges (especially in CRCPM) following CRS-HIPEC, reflecting significant unmet rehabilitation needs. Systematic integration of rehabilitation across the CRC care continuum is therefore essential to optimise longer-term functional and participation outcomes in this population.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261469694"},"PeriodicalIF":2.3,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148474262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vagus Nerve Stimulation Paired With Rehabilitation in the Home Environment for People With Chronic Post-Stroke Upper Limb Deficits: Preliminary Findings.","authors":"Ruchi Patel, Lisa Spinelli-Guglielmo, Kathleen A Antares, Annie Diedrich, Sarah M Zera","doi":"10.1177/27536351261447473","DOIUrl":"10.1177/27536351261447473","url":null,"abstract":"<p><strong>Background: </strong>Implantable vagus nerve stimulation paired with upper limb (UL) rehabilitation (Paired VNS) is an effective therapy for chronic ischemic stroke currently being implemented in outpatient centers. However, issues such as constraints in transportation, mobility, or caregiver availability may decrease access to in-clinic therapy for some individuals. An alternative approach may be a mobile therapy model in which outpatient rehabilitation services are delivered in the individual's home. The VNS-REHAB At-Home study is a single-arm trial aimed at assessing feasibility of therapist-activated Paired VNS in the home (or mobile Paired VNS) by examining protocol compliance, therapist/patient acceptance, and safety. The goal of this report was to present the preliminary findings from the first participant cohorts.</p><p><strong>Methods: </strong>Participants completed up to 36 hours of therapist-activated mobile Paired VNS within 18 weeks. Therapist-led sessions were supplemented with self-activated VNS during UL functional tasks. The primary feasibility endpoint was the proportion of participants who completed at least 24 hours of mobile Paired VNS. Outcomes included total session hours, therapist/participant acceptance, and safety. While this study was not designed to establish definitive treatment effects, UL impairment/activity, and patient-reported measures were assessed at multiple timepoints as secondary exploratory outcomes.</p><p><strong>Results: </strong>Participants (n = 11) completed a median of 37.8 (32.5-42.4) hours of mobile Paired VNS over 13 (8-18) weeks. All participants met the primary endpoint. Overall, participants and therapists were satisfied (n = 8) or very satisfied (n = 14). Fugl-Meyer Assessment-Upper Extremity scores improved by a median of 7 points. All participants reported improvements in measures of UL use, activities of daily living, and/or participation. Adverse events were reported amongst 3 participants, and there were no serious events related to procedure or device use.</p><p><strong>Conclusions: </strong>Preliminary data from the VNS-REHAB At-Home trial demonstrate that mobile Paired VNS was successfully implemented, well-accepted, and safe in the home setting, with observed meaningful UL improvements. These initial findings support the ongoing evaluation of mobile Paired VNS as an accessible alternative to clinic-based delivery.</p><p><strong>Trial registration: </strong>NCT05691023; https://clinicaltrials.gov/study/NCT05691023.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261447473"},"PeriodicalIF":2.3,"publicationDate":"2026-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13173345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147965801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electronic Patient-Reported Outcome Measure and Decision Support Tool Option for Early Intervention Service Quality: A Pilot Cluster-Randomized Pragmatic Trial.","authors":"Vera C Kaelin, Sabrin Rizk, Yi-Fan Chen, Jodi Dooling-Litfin, Elizabeth Lerner Papautsky, Natalie E Leland, Natalie J Murphy, Beth M McManus, Carla R Lage, Vivian Villegas, Lindsay Kuznicki, Amanda Pedrow, Mary A Khetani","doi":"10.1177/27536351261445239","DOIUrl":"10.1177/27536351261445239","url":null,"abstract":"<p><strong>Introduction: </strong>The Young Children's Participation in Environment Measure (YC-PEM) is an evidence-based and promising electronic patient-reported outcome (e-PRO) option to improve early intervention (EI) service quality, such as when designing the EI service plan.</p><p><strong>Aim: </strong>Establish the preliminary effectiveness of implementing the YC-PEM e-PRO and program-specific shared decision support tool option for EI service quality when designing a service plan.</p><p><strong>Methods: </strong>For this 2-arm pilot pragmatic trial with cluster randomization at the provider level, 76 caregivers enrolled and 57 caregivers (n = 29 intervention group; n = 28 control group) completed pre- and post-intervention measures. Intervention group caregivers completed the YC-PEM e-PRO and program-specific shared decision support tool and were compared to usual care on EI service quality indicators: (1) caregiver perceptions of family-centeredness, (2) caregiver activation for shared decision-making, (3) caregiver engagement in service design and implementation; and (4) service plan quality.</p><p><strong>Results: </strong>No significant group differences at baseline were noted. Pre-post EI service quality revealed no significant differences in the adjusted model (<i>P</i> > .05). However, intervention group families had higher rates participation-focused service plans (69.2%) versus controls (51.4%), most of which met state-level criteria for quality (84%).</p><p><strong>Conclusion: </strong>For EI service quality indicators, this intervention option demonstrated comparable performance to usual care. This finding suggests the intervention promoted high quality, participation-focused service planning despite no overall differences in EI service quality, warranting further testing of implementation factors and effectiveness in various service contexts.<b>Trial Registration Number:</b> NCT04562038.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261445239"},"PeriodicalIF":2.3,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13161632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147935887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inpatient Neurorehabilitation Benefits Patients with Functional Neurological Disorder: A Single Centre Study.","authors":"Weaam Ibraheem, Mathew Jackson, Thomas Palser, Jessica Richmond, Ozlem Erol Durgun, Volker Teweleit, Robert Stephens, Javvad Haider, Manoj Sivan","doi":"10.1177/27536351261441399","DOIUrl":"10.1177/27536351261441399","url":null,"abstract":"<p><strong>Background: </strong>Functional Neurological Disorders (FNDs) are common, comprising 10% to 30% of the Neurology caseload. Emerging evidence suggests that multidisciplinary rehabilitation is effective in FND, but actual gains in daily functioning are not clear from the current literature.</p><p><strong>Aims: </strong>To assess the outcomes of FND patients receiving inpatient rehabilitation in a specialist neurorehabilitation unit.</p><p><strong>Methods: </strong>Multidisciplinary (MDT) rehabilitation was provided by a multidisciplinary professional team led by consultants in Physical and Rehabilitation Medicine (PRM). Functional Outcomes such as Functional Independence Measure /Functional Assessment Measure, including motor and cognitive domains, were measured at 3 timepoints (admission, discharge and during post-discharge telephone appointments). Further data on demographics and disease presentation were collected by retrospective chart review.</p><p><strong>Results: </strong>Eighteen patients with FND were admitted to the unit over a 2-year period. The median length of stay for patients in the rehabilitation unit was 69 days (47-98 days) and the median post-discharge follow-up was 10 months (3,24 months). All outcome measures demonstrated improvement following rehabilitation. In particular, the median (IQR; FIM) score improved by 30 points (IQR 82-120) between admission and discharge, which exceeds the Minimal Clinically Important Difference (MCID) of 22 reported in the literature, indicating a clinically significant improvement. The improvements post-discharge plateaued but were maintained at follow-up. Qualitative feedback indicated high satisfaction with care in the rehabilitation unit and the improvements in daily functioning achieved.</p><p><strong>Conclusion: </strong>FND patients showed clinically significant improvements from inpatient specialist rehabilitation in this cohort. Further multi-site, larger-scale research is needed to determine whether certain types of FND patients have greater improvements than others from inpatient MDT rehabilitation.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261441399"},"PeriodicalIF":2.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13150094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870759","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing the Clinical Skills Training Tool: A Theory-Informed Framework to Strengthen Continuing Professional Development in Low- and Middle-Income Countries.","authors":"Martina Lukin, Shala Cunningham, Angela Patterson, Rachael Lowe","doi":"10.1177/27536351261444263","DOIUrl":"10.1177/27536351261444263","url":null,"abstract":"<p><strong>Background: </strong>Continuing professional development (CPD) is essential for maintaining competency and quality in healthcare practice, yet low- and middle-income countries (LMICs) often lack practical guidance to design, implement, and sustain CPD programs. While implementation science frameworks provide theoretical structure, accessible tools to operationalize these frameworks for rehabilitation workforce development remain limited. This study describes the development and pilot testing of the Clinical Skills Training Tool (CSTT); a theory-informed, planning and evaluation tool to support contextually relevant CPD development for rehabilitation professionals.</p><p><strong>Methods: </strong>The CSTT was developed using implementation science frameworks, including the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework and the Consolidated Framework for Implementation Research (CFIR), and incorporated the Kirkpatrick model to guide CPD evaluation. The tool was piloted between 2021 and 2024 with multidisciplinary rehabilitation stakeholders in Myanmar, Ukraine, Uganda, and Pakistan. Data were collected through stakeholder workshops, structured planning activities, guided reflections, and evaluation of CPD programs developed using the tool. Qualitative framework-informed analysis was used to assess usability, feasibility, contextual adaptation, and implementation factors influencing tool use.</p><p><strong>Results: </strong>A total of 191 stakeholders participated in CSTT pilot implementation across 4 countries. The tool supported systematic identification of workforce training priorities, structured CPD program design, and development of evaluation strategies. CSTT-supported programs demonstrated improvements in stakeholder knowledge, clinical confidence, and adoption of structured evaluation practices. Stakeholders successfully adapted the tool across diverse health system contexts while maintaining fidelity to core planning processes. Iterative refinement improved usability, clarity, and sustainability guidance.</p><p><strong>Conclusions: </strong>The CSTT operationalizes implementation science frameworks into a practical, adaptable tool to support CPD planning and evaluation in LMIC rehabilitation settings. By bridging the gap between implementation theory and workforce development practice, the CSTT provides a scalable approach to strengthening rehabilitation workforce capacity and supporting sustainable CPD systems across diverse global contexts.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"15 ","pages":"27536351261444263"},"PeriodicalIF":2.3,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147790522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}