Advances in rehabilitation science and practice最新文献

{"title":"Cryoneurolysis: A Novel Treatment for Management of Spasticity. Presentation of a Case Series.","authors":"Anton Pick, Rachel Dye, Melanie K Fleming","doi":"10.1177/27536351251340216","DOIUrl":"10.1177/27536351251340216","url":null,"abstract":"<p><strong>Background: </strong>Spasticity is a motor phenomenon occurring in disorders of the central nervous system that impacts on active and passive function, and quality of life. Pharmacological, physical and surgical management options are available, each of which have limitations. Cryoneurolysis is a technique developed for the treatment of pain which involves the controlled freezing and thawing of peripheral nerves. Recent case reports and series have suggested it may offer a novel treatment approach for pain associated with spasticity.</p><p><strong>Objectives: </strong>To report on the evaluation of cryoneurolysis in the first cohort of patients treated in a UK spasticity clinic.</p><p><strong>Methods: </strong>Eight patients with a variety of neurological conditions (aged 25-75 years) underwent cryoneurolysis. Each had been receiving regular botulinum toxin injections and had ongoing treatment goals. All patients first underwent diagnostic nerve blocks with local anaesthetic to determine their appropriateness for the treatment. Cryoneurolysis was then performed with ultrasound and nerve stimulator guidance. Assessments included goal attainment, Modified Ashworth Scale (MAS), ArmA, LegA and the patient reported impact of spasticity scale (PRISM), alongside patient satisfaction and side effect questionnaires. Assessments were at baseline and at regular intervals over 9 to 12 months.</p><p><strong>Results: </strong>All patients attained at least one of their goals, with sustained effect for more than 6 months. MAS demonstrated mixed or modest improvements. Functional outcome measures (ArmA/LegA) showed several meaningful improvements, particularly in passive function. There was an indication of an improvement in PRISM across domains, which plateaued at 6 months. Post-procedure pain was the most common side effect but subsided in all affected patients by 3 months. Patient satisfaction was positive.</p><p><strong>Conclusions: </strong>Our findings contribute to a growing base of case reports and series suggesting that cryoneurolysis could be a potentially useful treatment modality for spasticity. Future controlled studies should aim to evaluate cost-effectiveness and compare with existing treatments.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251340216"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264415/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651372","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":"Synergistic integration of epidural spinal cord stimulation with robotic therapy and neurorehabilitation to facilitate functional recovery in chronic sensorimotor complete spinal cord injury: A case series.","authors":"Seng Kwee Wee, Zhi Yan Ng Valerie, Min Wee Phua, Wen Li Lui, Fatimah Misbaah, Rui Xin Justin Ker, Wai Hoe Ng, Kai Rui Wan","doi":"10.1177/27536351251343738","DOIUrl":"10.1177/27536351251343738","url":null,"abstract":"<p><strong>Objective: </strong>To present the rehabilitation considerations in prehabilitation and the rehabilitation phase post spinal cord stimulator implantation; and to evaluate the efficacy of synergistic combination of epidural spinal cord stimulation (SCS) with motor imagery, trunk rehabilitation, robotic and overground gait training in improving mobility in persons with sensorimotor complete spinal cord injury (SCI).</p><p><strong>Design: </strong>A non-controlled before-after clinical trial.</p><p><strong>Methods: </strong>Epidural spinal cord stimulators were implanted into 3 participants with complete thoracic SCI (Thoracic 4, Thoracic 2 and Thoracic 10 respectively). They underwent 1 month of prehabilitation, followed by 7 months of daily rehabilitation post-implantation, consisting of SCS, motor imagery, trunk rehabilitation, robotic therapy and overground gait training. Pre-post assessments include the American Spinal Injury Association Impairment Scale (AIS) examination, Spinal Cord Independence Measure version III (Mobility subscale) (SCIM-III), Walking Index for Spinal Cord Injury II (WISCI-II), Trunk Assessment Scale for Spinal Cord Injury (TASS), Five Times Sit-to-Stand (5×STS) and 2-minute Walk Test (2mWT).</p><p><strong>Results: </strong>Post rehabilitation, there were improvements in WISCI-II, TASS, 5×STS and 2mWT in all 3 participants; and no change in AIS sensory scores. Only participants 2 and 3 exhibited slight improvement in SCIM-III. The WISCI-II of all participants improved, ranging from 3 levels to 9 levels, which was considered a clinically meaningful change. Furthermore, the change in TASS exceeded the minimal clinically important difference (MCID) of 4 points for two participants. The change in 5×STS exceeded the MCID of 2.27 seconds for all participants. These significant improvements translated into the participants' ability to perform sit-to-stand independently and ambulate with a rollator frame under supervision of a carer.</p><p><strong>Conclusion: </strong>This clinical trial demonstrated proof-of-concept and promising findings that support our rehabilitation protocol in improving functional mobility of people with sensorimotor complete SCI, which may be replicated in future studies.*The study protocol was registered with Clinical-trials.gov (NCT05644171; Registered 13 November 2022. https://clinicaltrials.gov/ct2/show/NCT05644171).</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251343738"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144499590","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":"Meta-Analysis of Goal Setting and Physical Treatment Categorisation for Focal Spasticity Following Stroke or Other Acquired Brain Injury.","authors":"Stephen Ashford, Jorge Jacinto, Klemens Fheodoroff, Lynne Turner-Stokes","doi":"10.1177/27536351251343520","DOIUrl":"10.1177/27536351251343520","url":null,"abstract":"<p><strong>Background: </strong>Setting goals and planning treatment to attain those goals is often integral to rehabilitation practice, particularly when managing spasticity following stroke or other brain injury. Optimal treatment planning and provision using an algorithm based on mapping goals and treatments, may improve outcome.</p><p><strong>Methods: </strong>We analysed goal setting and treatment interventions through secondary analysis of goals and related treatments from (a) the Leg Activity measure study, (b) Ankle Contracture data set and (c) the Upper Limb International Spasticity-III study. Total 1207 participants. Goal categories were defined and identified based on a previously published framework: Pain, Involuntary Movement, Contracture Prevention, Active Function (self-performance of tasks), passive function (secondary performance of tasks or personal care). Treatment intervention was then identified per goal category.</p><p><strong>Results: </strong><i>Arm spasticity goal categorisation</i>: Pain 302 (22%), Involuntary Movement 166 (12%), Contracture Prevention 208 (15%), Active Function 174 (13%), passive function 501 (37%). <i>Primary interventions identified per category</i>: Pain (Positioning the limb, serial casting), Involuntary Movement (Position the limb, Splinting), Contracture Prevention (Positioning the limb, serial casting, Shoulder support and slings, Splinting), Active Function (Positioning the limb, serial casting, shoulder supports and splinting), passive function (Positioning the limb, serial casting, shoulder supports and splinting). <i>Leg spasticity goal categorisation</i>: Pain 117 (15%), Involuntary Movement 10 (1%), Contracture Prevention 139 (17%), Active Function 356 (44%), passive function 181 (22%). <i>Primary interventions identified per category</i>: Pain (Passive stretch, positioning), Involuntary Movement (Splinting), Contracture Prevention (Positioning, Orthotics, Task Practice), Active Function (Task Practice, Orthotics), passive function (Orthotics, Positioning).</p><p><strong>Conclusions: </strong>Commonalities in goal categorisation were found in arm and leg. In these cohorts' task-practice interventions to improve active function (walking and transferring) were reported for leg but were not frequently reported for arm rehabilitation. It is suggested that improved treatment planning may result in greater and faster treatment goal attainment and better outcomes.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251343520"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12179447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478029","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":"Psychometric Validation of the Arabic Version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) in Libya.","authors":"Alhadi M Jahan, Aymen M Elgoneti","doi":"10.1177/27536351251348750","DOIUrl":"10.1177/27536351251348750","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to adapt and validate the Arabic version of the American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment Form for assessing shoulder disabilities in the Libyan-Arab population.</p><p><strong>Methods: </strong>A cross-sectional study design was employed, involving 108 participants with shoulder conditions from rehabilitation centers in Misrata, Libya. The ASES form underwent translation and cultural adaptation following established guidelines, including forward translation, synthesis, back-translation, expert review, and pilot testing. Psychometric validation included assessments of reliability, convergent and discriminant validity, and agreement using Cronbach's α, Intraclass Correlation Coefficient (ICC), and Bland-Altman analysis.</p><p><strong>Results: </strong>The Arabic ASES form demonstrated excellent internal consistency (Cronbach's α = .90) and high test-retest reliability (ICC = 0.95). Convergent validity was confirmed by significant correlations with the DASH (<i>r</i> = -.867, <i>P</i> < .001), ADL (<i>r</i> = .522, <i>P</i> < .001), VAS (<i>r</i> = -.480, <i>P</i> < .001), and SF-MPQ (<i>r</i> = -.554, <i>P</i> < .001). Discriminant validity was supported by weak, non-significant correlations with unrelated constructs such as self-efficacy, sleep quality, and stress. Bland-Altman analysis indicated minimal systematic bias between repeated measurements.</p><p><strong>Conclusion: </strong>The Arabic ASES form is a reliable, valid, and culturally appropriate tool for evaluating shoulder disabilities in Arabic-speaking populations, particularly in Libya. Its cross-cultural validation supports broader applicability across diverse Arabic-speaking contexts, enhancing clinical and research utility.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251348750"},"PeriodicalIF":0.0,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144303786","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":"Outcomes and Complications Following Tracheostomy in Neurocritical Care Unit: A Prospective Longitudinal Study.","authors":"Amin Mohamed Abu Baker, Sachin Watve, Sabrina Arabel Eltringham, Amanda Forrester, Vikrant Devgire, Krishnan Padmakumari Sivaraman Nair","doi":"10.1177/27536351251341566","DOIUrl":"10.1177/27536351251341566","url":null,"abstract":"<p><strong>Background: </strong>Patients admitted to neurological critical care unit (NCCU) frequently require ventilator support and tracheostomy. This prospective longitudinal observational study collated outcomes following tracheostomy amongst patients admitted to NCCU.</p><p><strong>Methods: </strong>In this prospective longitudinal observational study, we collected a predetermined set of clinical data for all patients admitted to the NCCU who underwent tracheostomy, until they were discharged from the unit. Exploratory data analysis of the tracheostomy outcomes was performed to identify the clinical parameters influencing decannulation.</p><p><strong>Results: </strong>Fifty four (5.4%) of 999 consecutive patients admitted to NCCU required tracheostomy. The mortality among people who had tracheostomy was 11.1% (n = 6) and decannulation rate was 59.3% (n = 32). Tracheostomies were more commonly done in men, those admitted with GCS of 3.0 and had cerebrovascular accidents. Thirty (55.6%) patients had sialorrhea during their NCCU admission which demonstrated significant associations with the total length of NCCU admission, time taken for decannulation, admission GCS, Fiberoptic Endoscopic Evaluation of Swallowing (FEES) referrals, need to recannulate following decannulation, pulmonary infections, and oral candidiasis. Incidence of chest infections was higher prior to the institution of pharmacological management of oral secretions. Prevalence of oral candidiasis was higher among patients who received pharmacotherapies for oral secretion.</p><p><strong>Conclusion: </strong>Oral secretion issues increase incidences of pulmonary infections, delay decannulation, increase the need for recannulation, and prolong the stay of patients in NCCU. Pharmacological management of oral secretions was associated with a reduced incidence of chest infections and a shorter duration to achieve decannulation.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251341566"},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12144365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144251070","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":"Integration of Wearables Into a Cardiac Rehabilitation Program and Its Impact on Physical Activity and Exercise Capacity in Older Patients With Cardiovascular Disease.","authors":"Eijiro Yagi, Koichiro Matsumura, Yuki Uchigashima, Jun Shiroyama, Mitsuki Hase, Tomoya Nanba, Nobuhiro Yamada, Yohei Funauchi, Masafumi Ueno, Kiyonori Togi, Manabu Shirotani, Gaku Nakazawa","doi":"10.1177/27536351251343538","DOIUrl":"10.1177/27536351251343538","url":null,"abstract":"<p><strong>Background: </strong>Cardiac rehabilitation using mobile health is increasingly being described as effective in improving exercise habits and physical function. However, the effectiveness of combined mobile health and hospital-based cardiac rehabilitation in older patients with cardiovascular disease is unknown.</p><p><strong>Objective: </strong>To investigate the effect of a wearable watch device combined with hospital-based cardiac rehabilitation in older patients with cardiovascular disease compared with those with usual care.</p><p><strong>Methods: </strong>A randomized, controlled trial was conducted in patients with cardiovascular disease aged ⩾60 years who underwent hospital-based cardiac rehabilitation. The patients were randomized 1:1 in those with a wearable watch (Fitbit Versa 3) or usual care. During out-of-hospital cardiac rehabilitation, patients with a wearable watch were advised to check their heart rate with a wearable watch and to target their physical activity at the heart rate determined by cardiopulmonary exercise testing. The primary endpoint was a change in physical activity obtained from the International Physical Activity Questionnaire (metabolic equivalents [METs]-minute/week) between the 2 groups during 12 weeks.</p><p><strong>Results: </strong>Among 39 patients (median age = 73 years, 82% men), the change in physical activity was significantly greater in patients with a wearable watch than in those with usual care (median: 2073 [1155-4400] vs 148 [-1261-899] METs-minute/week; analysis of covariance; <i>P</i> < .001). In patients with a wearable watch, 6-minute walk distance, the peak oxygen uptake, peak METs, and anaerobic threshold were significantly improved, whereas no significant increase was observed in patients with usual care from baseline to 12 weeks.</p><p><strong>Conclusions: </strong>In older patients with cardiovascular disease, a wearable watch device combined with hospital-based cardiac rehabilitation increases physical activity and improves exercise capacity outside of hospital.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251343538"},"PeriodicalIF":0.0,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144200957","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":"Refilling Intrathecal Drug Delivery Pumps Outside the Clinic: Survey of Practice in the United Kingdom.","authors":"Stephen G B Kirker","doi":"10.1177/27536351251341016","DOIUrl":"10.1177/27536351251341016","url":null,"abstract":"<p><strong>Introduction: </strong>Many people with spasticity or pain managed with intrathecal drug delivery pumps have very impaired mobility and are at high risk of developing pressure sores, which may prevent them from travelling to a clinic in their wheelchair. Some patients may be transported by stretcher, but some will be bedbound at home. Routinely refilling all pumps at home is established practice in several parts of Europe and USA.</p><p><strong>Method: </strong>Freedom of information requests were emailed to trusts and health boards hosting intrathecal drug delivery services in the UK and Ireland, asking about frequency of home visits for pump refills, how many staff travelled, use of prefilled syringes and how they would manage a patient's long-term inability to attend clinic.</p><p><strong>Results: </strong>Detailed data was received from all but 1 of 54 active clinics in the UK, but Irish legislation did not allow this data to be returned. Two thousand one hundred forty-five patients were managed with intrathecal pumps in the UK. Eleven services had less than 10 patients and 5 had more than 100. Twenty-one services did less than 1 home refill/year and 9 did more than 12/year. Twenty had travelled to patients more than 50 miles from the clinic, or to an island. Twenty-two services would send 2 clinicians and 10 would bring prefilled sterile syringes, rather than aspirate from bottles at the bedside.</p><p><strong>Conclusion: </strong>FoI requests can generate a very high response rate in the UK. Many services manage a small number of patients, which would make it difficult to provide cover when a single-handed clinician is unavailable or to train a second clinician.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251341016"},"PeriodicalIF":0.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144180348","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":"Heart Rate Variability as a Possible Biomarker of Cognitive-Motor Integration in Post-Stroke Patients.","authors":"Rachele Penati, Alessandro Robustelli, Giulio Gasperini, Alessandro Specchia, Valeria Paleari, Eleonora Guanziroli, Franco Molteni","doi":"10.1177/27536351251335133","DOIUrl":"https://doi.org/10.1177/27536351251335133","url":null,"abstract":"<p><p>Heart Rate Variability (HRV) refers to variation in time intervals between consecutive heartbeats, indicating autonomic nervous system's control over the heart. Time and frequency analysis of HRV could serve as predictors for severity and functional outcome in stroke. Aim of this study is to verify if HRV, measured during cognitive and sensorimotor upper limb (UL) tasks, can be used as a biomarker of cognitive-motor interaction in post-stroke patients. Forty-six patients with unilateral brain injury following stroke were enrolled: 27 (58.7%) ischemic, 19 hemorrhagic, 24 (52.2%) subacute (<6 months), and 22 chronic. Mean age at evaluation was 61 years. Right side was affected in 16 subjects (34.8%). Each patient underwent HRV recording in the following conditions: (1) Rest (5 minutes); (2) Visuomotor simulation training of the affected upper limb (UL) using Dessintey IVS3 (DE, 5 minutes); (3) Motor Imagery of the affected UL (MI, 5 minutes). UL functional outcome measures were collected for both affected and less affected sides. All patients showed reduced HRV in time and frequency domains and sympathetic tone predominance at rest. During DE and MI, a significant reduction in time domain was observed. In frequency domains, low frequency decreases during DE, with parasympathetic tone predominance. In the subgroup analyses for lesion side, only right hemiparetic patients showed parasympathetic predominance during mental tasks of the upper limb (DE and MI. No correlation was found between HRV parameters and UL functional scales. Different HRV response in time and frequency domains to mental task was observed between right and left hemiparetic subjects. This could be explained by different anatomical-functional substrates between right and left hemisphere and could reflect different behaviors during UL cognitive-motor tasks. HRV parameters were not correlated with clinical functional assessment scales, likely meaning that they possible exploring different domains.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251335133"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053056/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144056650","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 Community Reintegration Model for Persons With Traumatic Spinal Cord Injury in South Africa: Process and Outcomes.","authors":"Eugene Nizeyimana, Quinette Louw, Conran Joseph","doi":"10.1177/27536351251326797","DOIUrl":"10.1177/27536351251326797","url":null,"abstract":"<p><strong>Background: </strong>Traumatic spinal cord injury impacts physical functioning, independence, and quality of life. The high incidence rate of 75.6 per million in South Africa indicate the crucial role of successful community reintegration. Despite South African's policy emphasizing comprehensive rehabilitation of persons with disabilities, community reintegration following spinal cord injury remains inadequate.</p><p><strong>Objective: </strong>To develop a multidimensional model to improve community reintegration for individuals with traumatic spinal cord injuries in South Africa.</p><p><strong>Methods: </strong>A 4-phase mixed methods study was employed. Phase 1 used a cross-sectional survey of 108 individuals with spinal cord injuries to investigate levels and factors influencing psychosocial and community reintegration. Phase 2 involved 28 qualitative interviews with different content experts, including individuals with spinal cord injuries, caregivers, rehabilitation professionals, and persons representing people with disabilities in the communities. Phase 3 reviewed existing community reintegration programs, while Phase 4 used a Delphi technique with 10 experts to design and refine program components and strategies.</p><p><strong>Results: </strong>The study revealed low levels of psychosocial and community reintegration, influenced by employment and housing factors. Content experts highlighted barriers such as inaccessible environments, transportation challenges, and negative societal attitudes. Program components included technological support, employment assistance, mentorship, and recreational activities. The first 3 phases informed a development of a 3-level model addressing client, community, and legislative domains. In the fourth phase, experts reached consensus on components and strategies to achieve this multi-level community reintegration model.</p><p><strong>Conclusion: </strong>The evidence-based community reintegration model offers a structured, multi-level framework to address reintegration challenges in South Africa. It emphasizes coordinated interventions at individual, community, and policy levels to improve outcomes for individuals with traumatic spinal cord injuries.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351251326797"},"PeriodicalIF":0.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143782151","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":"Unsupervised Assessment of Frailty Status Using Wearable Sensors: A Feasibility Study among Community-Dwelling Older Adults.","authors":"Oonagh Mary Giggins, Grainne Vavasour, Julie Doyle","doi":"10.1177/27536351241311845","DOIUrl":"10.1177/27536351241311845","url":null,"abstract":"<p><strong>Objectives: </strong>This study examined whether community-dwelling older adults can independently capture wearable sensor data that can be used to classify frailty status.</p><p><strong>Methods: </strong>Fifty-one older adults (age 77.5 ± 8.4 years, height 163.6 77.5 ± 8.4, weight 72.0 ± 13.5 kg, female 76%) took part in this investigation. Participants independently captured physical activity and physical function data at home using a smartwatch and a research-grade inertial sensor system for 48-hours. Machine learning classifiers were used to determine whether the data obtained can discriminate between frailty levels.</p><p><strong>Results: </strong>Models incorporating variables from both the smartwatch and inertial sensor system were successful in the prediction of frailty status.</p><p><strong>Discussion: </strong>This study has demonstrated the ability of older adults to collect data which can be used to indicate their frailty risk. This may enable earlier intervention and lessen the impact of frailty on the individual and society as a whole.</p>","PeriodicalId":72107,"journal":{"name":"Advances in rehabilitation science and practice","volume":"14 ","pages":"27536351241311845"},"PeriodicalIF":0.0,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434460","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}