Archives of rehabilitation research and clinical translation最新文献

{"title":"Outcomes and Preferences for Decision-Making for Upper Limb Prosthetic Care: The Patient Journey: A Scoping Literature Review","authors":"Leslie Wilson PhD ,&nbsp;Mark Gutin PharmD ,&nbsp;Timothy Banh PhD ,&nbsp;Elizabeth Gress MPA ,&nbsp;Todd Castleberry PhD ,&nbsp;Siya Asatkar BS ,&nbsp;Peggy Tahir MLIS ,&nbsp;Michael P. Douglas MS ,&nbsp;Shane R. Wurdeman PhD","doi":"10.1016/j.arrct.2025.100460","DOIUrl":"10.1016/j.arrct.2025.100460","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify key concepts or themes and map the breadth of evidence describing the current decision-making process for prostheses between individuals with upper limb loss/difference (ULL/D) and prosthetists using a scoping review.</div></div><div><h3>Data Sources</h3><div>We searched PubMed, Web of Science, Embase, and Cumulative index to Nursing and Allied Health Literuature (CINAHL) databases to identify studies using PRISMA guidelines.</div></div><div><h3>Study Selection</h3><div>Qualitative, quantitative, quasi-experimental, randomized controlled studies or mixed methods studies in the English language with adults ≥18 years involving ULL/D from any cause were included. Studies were required to provide outcome measures, decision aids, discrete choice or other preference measurement methods, patient satisfaction, quality of life, cost, and choice characteristics of prostheses.</div></div><div><h3>Data Extraction</h3><div>Characteristics were extracted from each study including study aim, author, publication year, country, sampling strategy, sample size, data collection methods, analysis, outcome or survey type, approach or discussion of prosthetic preference or choice, model or description of the prosthetic, results, and attributes or factors of decision-making. Two individuals assessed study quality using the 2018 validated Critical Appraisal Skills Program qualitative studies checklist.</div></div><div><h3>Data Synthesis</h3><div>Of the 1388 studies, 67 were included. Our findings reveal a variety of study types and purposes that together describe factors important to a complex decision-making process. We conceptualized 5 main themes to create our literature landscape: (1) adequacy of outcomes/measures used, (2) extent of preference research, (3) prosthesis type comparisons, (4) factors critical to decision-making, and (5) the prescription process. A personalized approach to decision-making was stressed but there were only 5 prosthetic preference studies. We identified a list of the major factors or attributes important when choosing a prosthetic to be used in preference research; functionality, appearance, grip characteristics, durability, weight, and cost. We suggest a “user complexity” construct to integrate the studies on technology and users’ choices.</div></div><div><h3>Conclusions</h3><div>To the best of our knowledge, this is the first literature review to focus on preference measurements. Despite this lack of preference studies, there was consensus on the importance of including the patient’s voice into the prosthetic choice through the prescription process. Our findings synthesize a body of literature that is not well organized or generalizable enough to help individuals and prosthetists make prosthesis decisions. Our insights can guide shared decision-making and improve prosthetic prescription.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100460"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing Dry Needle Therapy and Extracorporeal Shockwave Therapy for Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Zonglin Li MD ,&nbsp;Yubin Chen MD ,&nbsp;Lili Chen MD ,&nbsp;Jinshen He MD","doi":"10.1016/j.arrct.2025.100432","DOIUrl":"10.1016/j.arrct.2025.100432","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct a systematic review and meta-analysis to assess the effects of extracorporeal shockwave therapy (ESWT) and needling therapy in the treatment of tendinopathy.</div></div><div><h3>Data sources</h3><div>PubMed (Medline), the Cochrane Library, and Web of Science were searched from August 5, 2024, to August 25, 2024, for comparative studies of needling therapy and ESWT for the treatment of tendinopathy published between January 1, 2000, and August 5, 2024.</div></div><div><h3>Study Selection</h3><div>Two reviewers independently reviewed randomized controlled trials (RCTs) that reported a comparison of needling therapy and ESWT for tendinopathy for inclusion eligibility.</div></div><div><h3>Data Extraction</h3><div>Outcomes of interest were the visual analog scale (VAS) score and pressure pain threshold (PPT) score. Two reviewers independently assessed the quality of the included RCTs with the Cochrane risk of bias tool. Effect sizes were estimated using mean differences (MDs), and the significance level was estimated using the <em>P</em> value of the overall effect.</div></div><div><h3>Data Synthesis</h3><div>Nine RCTs involving 528 patients were deemed suitable for inclusion. Six RCTs involving 318 patients revealed that VAS scores showed no significant difference between ESWT and dry needling in either the immediate (MD, 0.06; 95% CI, −0.30 to 0.43; <em>P</em>=.73) or delayed effects (MD, −0.46; 95% CI, −2.10 to 1.18; <em>P</em>=.59). Two RCTs involving 132 patients revealed that PPT scores showed no significant difference between ESWT and dry needling in delayed effects (MD, −0.08; 95% CI, −0.30 to 0.14; <em>P</em>=.49). Three studies that enrolled 161 subjects concluded that ESWT combined with dry needling therapy was statistically more effective in reducing VAS scores in patients with tendinopathy than pure ESWT for delayed effects (MD, −1.79; 95% CI, −2.60 to −0.97; <em>P</em>&lt;.0001).</div></div><div><h3>Conclusions</h3><div>This meta-analysis shows that the combination of ESWT with needling therapy is more effective in reducing pain indices in patients with enthesopathy than using ESWT or needling therapy alone. ESWT, combined with needling therapy, should be prioritized for conservative treatment in patients with tendinopathy.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100432"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222046","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Scoping Review of Poststroke Engagement in Physical Activity","authors":"Bettina Pasztor MSc ,&nbsp;Avril Drummond PhD ,&nbsp;Jennie E. Hancox PhD ,&nbsp;Ian M. Taylor PhD","doi":"10.1016/j.arrct.2025.100457","DOIUrl":"10.1016/j.arrct.2025.100457","url":null,"abstract":"<div><h3>Objective</h3><div>To synthesize knowledge about physical activity engagement in community living stroke survivors.</div></div><div><h3>Data Sources</h3><div>Six electronic databases (Scopus, PubMed/MEDLINE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, PsycINFO/PsycARTICLES, and Web of Science) were searched between April 2023 and March 2024. Search parameters were set from database inception to 2024.</div></div><div><h3>Study Selection</h3><div>Studies were included if they were randomized controlled trials, (quasi)experimental, cross-sectional, or cohort/longitudinal; published in English; focused on measuring or promoting physical activity during rehabilitation or the postrehabilitation phase; and participants were at least 18 years old, living in the community, and had a clinical diagnosis of stroke.</div></div><div><h3>Data Extraction</h3><div>Data extracted included general study information; study design; participant characteristics; type of physical activity; program characteristics; type of support provided, type of physical activity engagement measure; and engagement outcomes and rates.</div></div><div><h3>Data Synthesis</h3><div>Twenty-one studies were included in this review; 6 promoted or measured physical activity as part of formal rehabilitation programs and 15 measured physical activity postrehabilitation. More than half of the studies reported low physical activity engagement. Eleven studies used objective measures of physical activity, whereas 8 used subjective measures and 2 used both. Only the 6 formal rehabilitation programs provided additional support for physical activity engagement, but the support was generally not underpinned by motivational theory or evidence. Walking and walk-related tasks were the most promoted type of physical activity poststroke.</div></div><div><h3>Conclusions</h3><div>We recommend that future interventions provide additional support for engagement that is underpinned by contemporary motivation theory. The type of support offered should differ depending on whether physical activity is part of a formal rehabilitation program or simply encouraged during postrehabilitation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100457"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Effectiveness of Early Rehabilitation in Patients With Stroke and Concomitant Kidney Disease: A Cohort Study With Claims Data","authors":"Takuaki Tani RPT, PhD ,&nbsp;Kiyohide Fushimi MD, PhD ,&nbsp;Shinobu Imai RPh, PhD","doi":"10.1016/j.arrct.2025.100434","DOIUrl":"10.1016/j.arrct.2025.100434","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the effectiveness and safety of early rehabilitation started within 24 to 48 hours in patients with stroke and chronic kidney disease (CKD).</div></div><div><h3>Design</h3><div>Database cohort study.</div></div><div><h3>Setting</h3><div>Acute hospital.</div></div><div><h3>Participants</h3><div>The study included patients with stroke (n=21,061) and concomitant CKD who were admitted to an acute hospital between April 1, 2018, and March 31, 2020, including those with CKD who underwent early rehabilitation (n=10,129) and usual care (n=2702), as well as those with end-stage kidney disease (ESKD) who underwent early rehabilitation (n=3086) and usual care (n=954). The mean (standard deviation) age of the population was 76.5 (11.1) years, and the sex distribution was 67.3% men and 32.7% women.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was hospitalization-related mortality, and the secondary outcomes included changes in activities of daily living, measured using the Barthel Index, and length of hospital stay.</div></div><div><h3>Results</h3><div>Early rehabilitation was no associated with increase in mortality risk (hazard ratio [HR], 0.82; 95% confidence interval (95% CI), 0.67-1.02; <em>P</em>=.070) in patients with CKD, whereas no significant association with mortality risk was observed in patients with ESKD (HR, 0.79; 95% CI, 0.55-1.14; <em>P</em>=.213). The activity of daily living improvement and length of stay did not differ between the early rehabilitation and usual care groups (<em>P</em>=.103 and <em>P</em>=.499, respectively). In the follow-up analysis, patients with CKD undergoing early rehabilitation exhibited a 29% reduction in mortality risk (HR, 0.76; 95% CI, 0.62-0.92; <em>P</em>=.006). In contrast, early rehabilitation did not affect the mortality risk in patients with ESKD (HR, 0.80; 95% CI, 0.56-1.14; <em>P</em>=.217).</div></div><div><h3>Conclusions</h3><div>This study supports the safety of implementing early rehabilitation in patients with stroke and CKD. Moreover, early rehabilitation may reduce mortality in patients requiring long-term hospitalization.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100434"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lived Experiences of Older Adults With Chronic Low Back Pain and Implications on Their Daily Life: A Metasynthesis of Qualitative Research","authors":"Chelsia K.C. Cheung MSc ,&nbsp;Esther T.C. Cheung BSc ,&nbsp;Veronika Schoeb PhD ,&nbsp;Emmanuelle Opsommer PhD ,&nbsp;Doris Y.K. Chong PhD ,&nbsp;Janet L.C. Lee PhD ,&nbsp;Christine Kumlien PhD ,&nbsp;Arnold Y.L. Wong PhD","doi":"10.1016/j.arrct.2025.100456","DOIUrl":"10.1016/j.arrct.2025.100456","url":null,"abstract":"<div><h3>Objective</h3><div>To synthesize and conceptualize the lived experiences of older adults with chronic low back pain (CLBP) by systematically reviewing qualitative studies.</div></div><div><h3>Data Sources</h3><div>CINAHL, PsycINFO, and PubMed were searched from their inception years (1961, 1967, and 1996, respectively) to September 2023 to identify qualitative studies on the lived experiences of older adults with CLBP.</div></div><div><h3>Study Selection</h3><div>Eligible qualitative studies included published journal article with qualitative design and analysis, and participants aged ≥65 years with chronic nonspecific low back pain (LBP) that lasted for over 3 months. Of 3669 citations screened, 17 studies met the inclusion criteria.</div></div><div><h3>Data Extraction</h3><div>Findings were analyzed using metasynthesis. Two reviewers independently conducted study selection and data extraction, and the methodological quality of each included study was assessed using the Consolidated Criteria for Reporting Qualitative Research framework.</div></div><div><h3>Data Synthesis</h3><div>Six themes emerged from the analysis: (1) perceived causes of CLBP; (2) interference with daily living; (3) family dynamics; (4) social life; (5) emotional responses to CLBP; and (6) coping strategies. Collectively, CLBP negatively affected older adults’ personal, family, and social life to varying extents. Suboptimal LBP management could lead to negative emotions (eg, depression) and avoidance behaviors. Accepting and adapting to the presence of CLBP, along with a clear diagnosis of LBP, might promote self-management. Conversely, comorbidities and rumination might hinder self-management efforts.</div></div><div><h3>Conclusions</h3><div>Given that the acceptance (acknowledging and adapting to the pain) of CLBP improves self-management of pain in older adults, clinicians should pay attention to the concerns of older adults with CLBP, understand the negative effects of CLBP on them, and provide personalized education and management strategies to enhance their self-management and engagement in value-driven actions.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100456"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Pulmonary Health and Quality of Life in Breast Cancer Survivors: A Randomized Controlled Trial Combining Incentive Spirometry and Aerobic Exercise","authors":"Dian Marta Sari MD, MSc, PhD ,&nbsp;Irma Ruslina Defi MD, PhD ,&nbsp;Andre Maharadja MD ,&nbsp;Nurvita Trianasari M.Stat, PhD ,&nbsp;Laurentia Cindy Gani Wijaya MD ,&nbsp;Patricia Helena Christiani Santoso MD ,&nbsp;Geraldi Christian Candra MD","doi":"10.1016/j.arrct.2025.100449","DOIUrl":"10.1016/j.arrct.2025.100449","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the combined effect of aerobic and breathing exercises using incentive spirometry on lung function and quality of life (QoL) in patients with breast cancer after radiation therapy (RT).</div></div><div><h3>Design</h3><div>A single-blind, randomized controlled trial.</div></div><div><h3>Setting</h3><div>Hasan Sadikin General Hospital Bandung.</div></div><div><h3>Participants</h3><div>Thirty-seven women aged 40-59 years post-RT breast cancer survivors divided into treatment (18 subjects) and control (19 subjects) groups.</div></div><div><h3>Intervention</h3><div>The treatment group engaged in thrice-weekly sessions of aerobic and breathing exercises using incentive spirometry, whereas the control group performed only aerobic exercises at the same frequency. Lung function was assessed using spirometry, and QoL was evaluated using the European Organization for Research and Treatment of Cancer QoL Questionnaires-Core30 (EORTC QLQ C30), both conducted before and after the exercise.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Lung function (assessed using spirometry) and QoL (measured using the EORTC QLQ C30).</div></div><div><h3>Results</h3><div>Between-group analyses revealed that the treatment group experienced significantly greater improvements than the control group in lung function (forced vital capacity increased by 7.72±3.51 vs. 3.45±1.22, <em>P</em>&lt;.05), physical function (difference of 8.06±5.76 vs. 0.68±2.06, <em>P</em>&lt;.05), dyspnea (difference of −22.22±22.92 vs. 0.00, <em>P</em>&lt;.05), and fatigue (difference of −22.78±20.39 vs. −1.74±5.52, <em>P</em>&lt;.05), with these improvements being clinically meaningful.</div></div><div><h3>Conclusions</h3><div>The addition of breathing exercises with incentive spirometry to aerobic exercise may improve lung function and QoL in patients with breast cancer who have completed RT.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100449"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Underrepresentation of Participants From Marginalized Racial and Ethnic Groups: A Secondary Analysis of the Cognitive Rehabilitation Literature","authors":"Jessica Kersey PhD, OTR/L ,&nbsp;Patricia Garcia PsyD, HSPP ,&nbsp;Emily Evans PT, PhD ,&nbsp;Zaccheus J. Ahonle PhD, CRC ,&nbsp;Pooja Jethani OT, OTD, MS, OTR ,&nbsp;Juan Carlos Arango-Lasprilla PhD ,&nbsp;Devina Kumar PhD, MSc, PT ,&nbsp;Anthony H. Lequerica PhD ,&nbsp;Gloria M. Morel Valdes PsyD ,&nbsp;Paige Salinas MS, MHA, LCSW, CBIST-AP ,&nbsp;Devan Parrott PhD","doi":"10.1016/j.arrct.2025.100431","DOIUrl":"10.1016/j.arrct.2025.100431","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the inclusion of people with brain injury from racially and ethnically marginalized groups in cognitive rehabilitation clinical trials.</div></div><div><h3>Data Sources</h3><div>We conducted a secondary analysis of the Cicerone et al (2019) cognitive rehabilitation review.</div></div><div><h3>Study Selection</h3><div>Of the originally included studies, we excluded those not conducted in the United States, along with case studies and case series studies.</div></div><div><h3>Data Extraction</h3><div>We extracted data on the racial and ethnic demographics of the study samples, along with eligibility criteria and recruitment and sampling strategies. We examined demographic data descriptively (frequencies and percentages) and examined other study methods thematically.</div></div><div><h3>Data Synthesis</h3><div>Sixty-five studies met criteria for inclusion in this secondary analysis. Of these, only 27 reported on the racial and ethnic demographics of the study samples. In all but 8, White non-Hispanic participants were overrepresented. We identified several frequently employed recruitment strategies and eligibility criteria that may disproportionately exclude participants from minoritized racial and ethnic groups, including English language, literacy, and baseline education requirements, exclusion based on comorbid conditions, and recruitment of participants from existing clinic patient pools.</div></div><div><h3>Conclusions</h3><div>We found notable underrepresentation of people with traumatic brain injury (TBI) from racially and ethnically marginalized groups in cognitive rehabilitation clinical trials, which have been used to guide practice and research. This underrepresentation likely exacerbates disparities in rehabilitation access and outcomes among marginalized groups. Further research should seek to comprehensively understand current recruitment and sampling strategies that contribute to this problem and identify opportunities to improve inclusivity in TBI rehabilitation research.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100431"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the Fiberoptic Endoscopy Evaluation of Swallowing in Aspiration Pneumonia: Utility of the Hyodo Dysphagia Score in Predicting the Development of Aspiration Pneumonia","authors":"Yoko Ibe MD, PhD ,&nbsp;Masayuki Tazawa MD, PhD ,&nbsp;Hironori Arii MD, PhD ,&nbsp;Yumiko Nakao MD, PhD ,&nbsp;Risa Toyama MD ,&nbsp;Naoki Wada MD, PhD","doi":"10.1016/j.arrct.2025.100435","DOIUrl":"10.1016/j.arrct.2025.100435","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze the characteristics of flexible endoscopic evaluation of swallowing (FEES) findings in patients with aspiration pneumonia using the Hyodo dysphagia score and to evaluate the risk of aspiration pneumonia.</div></div><div><h3>Design</h3><div>Retrospective study.</div></div><div><h3>Setting</h3><div>Observation in a single primary care institution.</div></div><div><h3>Participants</h3><div>Inpatients aged ≥20 years who underwent FEES in our hospital between April 2012 and March 2022. A total of 178 patients were eligible to calculate the Hyodo dysphagia score and were enrolled in this study. The mean ± SD age of the subjects was 73.4±13.3 years, and 116 of 178 patients (65.2%) were men.</div></div><div><h3>Intervention</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The development of aspiration pneumonia.</div></div><div><h3>Results</h3><div>Eighty-four of 178 patients (47.2%) developed aspiration pneumonia. Age, oral intake status, and serum albumin levels were not significantly different between the pneumonia and nonpneumonia groups. The total and each parameter of the Hyodo dysphagia score were significantly higher in the pneumonia group than in the nonpneumonia group. Logistic regression analysis showed that salivary retention (odds ratio [OR], 1.60; 95% confidence interval [CI], 1.09-1.33; <em>P</em>=.016) and poor cough reflex (OR, 1.88; 95% CI, 1.42-2.49; <em>P</em>&lt;.001) in the Hyodo dysphagia score were risk factors for aspiration pneumonia. The area under the curve of the receiver operating characteristic curve for the onset of pneumonia based on the total Hyodo dysphagia score was 0.75 (95% CI, 0.67-0.82). A cutoff value of 5 for the total Hyodo dysphagia score gave a sensitivity of 0.75 (95% CI, 0.67-0.83) and a specificity of 0.60 (95% CI, 0.49-0.71), with the Youden index having a maximum value of 0.35.</div></div><div><h3>Conclusions</h3><div>A cutoff value of 5 points for the total Hyodo dysphagia score was optimal in predicting the development of aspiration pneumonia. Salivary retention and poor cough reflex were risk factors for the development of pneumonia.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100435"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Systematic Review of the Effects of Therapeutic Exercise With Psychological Interventions on Disability and Personal Outcomes in Older Adults","authors":"Grace A. Rose ,&nbsp;Pietra T. Bruni PhD ,&nbsp;Mariana Wingood PT, DPT, PhD, MPH ,&nbsp;Selmi Kallmi PhD ,&nbsp;Elizabeth Finer MA ,&nbsp;Patricia M. Bamonti PhD","doi":"10.1016/j.arrct.2025.100447","DOIUrl":"10.1016/j.arrct.2025.100447","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effects of therapeutic exercise and psychological interventions on disability and personal outcomes in older adults.</div></div><div><h3>Data Sources</h3><div>Articles published from January 2013 to February 2025 are available in PubMed, Embase, ProQuest Health &amp; Medical and Psychology, PsycINFO, and PsycArticles.</div></div><div><h3>Study Selection</h3><div>Inclusion criteria were as follows: (1) intervention included therapeutic exercise combined or integrated with a psychological intervention; (2) randomized controlled trial; (3) sample mean age ≥60 years; (4) primary or secondary outcome(s) of disability. Two authors independently screened trials (n=7391) for inclusion; a third author verified results and resolved discrepancies.</div></div><div><h3>Data Extraction</h3><div>Data were extracted by a primary reviewer and verified by a second reviewer. The risk of bias assessment was performed using the risk of bias in randomized controlled trials.</div></div><div><h3>Data Synthesis</h3><div>Thirty-eight trials (n=18,550 participants) were included. Therapeutic exercise included: exercise programs (34%), physical activity counseling and monitoring (37%), rehabilitation (18%), or other (eg, Tai Chi; 13%). Psychological interventions were primarily motivational interviewing (53%) or cognitive-behavioral therapy/strategies (39%). Significant improvement in body functions and structures (n=14, 37%), activity (n=6, 16%), participation (n=20, 53%), and personal factors (n=11, 29%) was observed.</div></div><div><h3>Conclusions</h3><div>Therapeutic exercise with psychological interventions have a positive effect on disability and personal outcomes, especially in participation. Heterogeneity in the study design, intervention, and population challenged data synthesis. Nonetheless, the current review identified gaps within the literature and directions for future research. Testing the additive effect of these interventions compared to active comparators is a priority for future investigations.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100447"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Findings in the Lower Extremity Joints of Long-Term Users of Implanted Standing Neuroprostheses with Spinal Cord Injuries","authors":"H. Alex Hoyen BS ,&nbsp;Sean Li BS ,&nbsp;Michael Miller MS ,&nbsp;Sheeba Joseph MD ,&nbsp;Patrick Getty MD ,&nbsp;Lisa Lombardo MPT ,&nbsp;Gilles Pinault MD ,&nbsp;Ronald Triolo PhD","doi":"10.1016/j.arrct.2025.100448","DOIUrl":"10.1016/j.arrct.2025.100448","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether lower extremity degenerative joint changes developed in long-term users of implantable neuromuscular prostheses.</div></div><div><h3>Design</h3><div>Before-after radiographic assessment.</div></div><div><h3>Setting</h3><div>Tertiary care center.</div></div><div><h3>Participants</h3><div>Four individuals (4 men, average age 46.5y, injuries ranging from C7-T11) with spinal cord injury resulting in lower extremity paraplegia were included for analysis. All individuals previously received surgery for the placement of a neuroprosthesis implant system. Individuals were followed with specific spinal cord injury outcome measures and radiographs in a prospective manner. Individual implant usage was also recorded as part of the standard treatment. These individuals were selected because they were in the highest tier for daily use of the implant system.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Development of degenerative joint pathology, based on analysis of pre- and post-therapy radiographs and grading using the Kellgren and Lawrence and Van Dijk scales.</div></div><div><h3>Results</h3><div>None of the joints for the individuals that were graded 0-2 (no or mild arthritis) progressed to a grade 3 (moderate arthritis). Further, none of the joints developed an arthritic grade of &gt;3. Only 2 of the 24 total joints had statistically significant (<em>P</em>&lt;.05) degenerative changes: subject 1: right hip; <em>P</em>=.033 (average grade increased from 0.875-1.875); subject 2: right hip; <em>P</em>=.049 (average grade increased from 0.875-1.50).</div></div><div><h3>Conclusions</h3><div>At an average of 5 years after implantation, regular and independent weight bearing in 4 higher-than-average users of a neuromuscular prosthesis does not appear to promote lower extremity joint degeneration.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 2","pages":"Article 100448"},"PeriodicalIF":1.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}