Archives of rehabilitation research and clinical translation最新文献

{"title":"Trajectories and Predictors of Activity Participation Among People with Parkinson Disease: A 3-Year Longitudinal Study","authors":"Moon Young Kim PhD, MSOT ,&nbsp;Yejin Lee PhD, MSOT ,&nbsp;Carolyn M. Baum PhD ,&nbsp;Lisa T. Connor PhD, MSOT ,&nbsp;Chih-Hung Chang PhD ,&nbsp;Linda Tickle-Degnen PhD ,&nbsp;Erin R. Foster PhD, OTD","doi":"10.1016/j.arrct.2025.100567","DOIUrl":"10.1016/j.arrct.2025.100567","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate how participation changes over time among individuals with Parkinsondisease (PD) and identify factors influencing these changes, focusing on impairment level and social factors.</div></div><div><h3>Design</h3><div>Secondary analysis of a 3-year prospective cohort study of social self-management of PD. Data were collected during 4 in-person assessments conducted at baseline and then annually thereafter. Multilevel modeling was used to analyze data from the 4 time points.</div></div><div><h3>Setting</h3><div>Department of Occupational Therapy Research Laboratory and Department of Neurology Movement Disorder Clinic.</div></div><div><h3>Participants</h3><div>A total of 86 individuals (N = 86) with idiopathic PD (Hoehn &amp; Yahr stages I-IV; mean age ± SD, 65.0 ± 9.6y).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Participation was measured by the Activity Card Sort. Potential predictors contributing to changes in participation included motor impairment (Movement Disorder Society-Unified Parkinson Disease Rating Scale-III), depressive symptoms (Geriatric Depression Scale), cognitive function (Montreal Cognitive Assessment), social isolation (Nottingham Health Profile), and social support (Health Management Resources Survey).</div></div><div><h3>Results</h3><div>There were no significant changes in overall activity participation over the 3-year period among the participants with PD. More severe depressive symptoms were associated with reduced participation in instrumental (<em>β</em> = −0.42, <em>P</em> &lt; .01), high-demand leisure (<em>β</em> = −0.22, <em>P</em> = .04), and social activities (<em>β</em> = −0.41, <em>P</em> &lt; .01). Greater social support from family and friends (<em>β</em> = 0.77, <em>P</em> = .03) and organizations (<em>β</em> = 1.07, <em>P</em> &lt; .01) was associated with greater participation in social activities.</div></div><div><h3>Conclusions</h3><div>Depressive symptoms were a significant within-person driver of restricted participation in instrumental, high-demand leisure, and social activities, as well as in the global domain, whereas higher social support from organizations, family, and friends predicted greater participation, particularly in social and global activity participation. Early detection of depressive symptoms and strategies to enhance social support resources may help promote sustained activity participation in this population.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100567"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428877","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":"Efficacy of Aquatic Therapy in Improving Balance in Patients With Stroke: A Systematic Review and Meta-Analysis","authors":"Laura Gento-Andrés MSc,&nbsp;Ismael Sanz-Esteban PhD,&nbsp;Isabel Rodríguez-Costa PhD,&nbsp;María Dolores Sosa-Reina PhD,&nbsp;Marina Castel-Sánchez PhD","doi":"10.1016/j.arrct.2025.100548","DOIUrl":"10.1016/j.arrct.2025.100548","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of aquatic therapy in improving balance, gait speed, and fall risk in patients with stroke.</div></div><div><h3>Data Sources</h3><div>MEDLINE, Cumulative Index to Nursing and Allied Health Literature, PubMed, Scopus, Web of Science, and Physiotherapy Evidence Database were searched for studies published from 2013 to October 2024.</div></div><div><h3>Study Selection</h3><div>Experimental studies comparing aquatic therapy with conventional rehabilitation, land-based interventions, or no intervention. The primary outcome was balance, assessed using the Berg Balance Scale. Secondary outcomes included gait speed and fall risk.</div></div><div><h3>Data Extraction</h3><div>Study design characteristics, number of participants, interventions characteristics, and outcomes were extracted.</div></div><div><h3>Data Synthesis</h3><div>Twenty-seven interventional studies with 1134 participants (236 women and 225 men approximately) were included in the systematic review, among which 19 contributed to the meta-analysis. Ages ranged from 49.5 to 69.1 years. The time since injury varied from approximately 30 days to 5.4 years. Risk of bias of included studies was assessed using Cochrane Risk of Bias tool 2. Aquatic therapy significantly improved balance (Berg Balance Scale: MD, −5.10; 95% CI, −8.85 to −1.36; <em>P</em>=.008), gait speed (MD, −5.10; 95% CI, −8.85 to −1.36; <em>P</em>=.008), and reduced fall risk (MD, −4.38; 95% CI, −7.17 to −1.59; <em>P</em>=.002). Subgroup analyses based on session frequency (&gt;20 sessions vs 10-20 sessions) showed similar effects.</div></div><div><h3>Conclusions</h3><div>This meta-analysis suggests that aquatic therapy may be effective in enhancing balance and gait speed and in reducing fall risk among individuals with stroke; however, these findings should be interpreted with caution because of the high heterogeneity observed across studies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100548"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428611","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":"Stroke Recovery Program Incorporating Moderate-Intensity Aerobic Exercise Provides Sustained Improvement of Function: A 1-Year Follow-Up Study","authors":"Sara J. Cuccurullo MD ,&nbsp;Hayk Petrosyan PhD ,&nbsp;Lora J. Kasselman PhD, MPH ,&nbsp;Talya K. Fleming MD","doi":"10.1016/j.arrct.2025.100568","DOIUrl":"10.1016/j.arrct.2025.100568","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the 1-year long-term functional improvements and sustainability of a comprehensive stroke recovery program (SRP) administered early in the subacute phase of recovery compared with stroke survivors who received usual care.</div></div><div><h3>Design</h3><div>A prospective matched cohort study.</div></div><div><h3>Setting</h3><div>Academic medical center with inpatient and outpatient rehabilitation facilities.</div></div><div><h3>Participants</h3><div>A total of 236 patients (N=236) with stroke admitted to an inpatient rehabilitation facility were included in this study. Of these, 152 participated in the SRP, and 84 patients received usual care therapies.</div></div><div><h3>Interventions</h3><div>Outpatient rehabilitation program including 36 sessions of moderate-intensity aerobic exercise and risk factor education administered in addition to usual care therapies.</div></div><div><h3>Main Outcome Measures</h3><div>Activity Measure for Post-Acute Care (AM-PAC) scores for Basic Mobility (BM), Daily Activity (DA), and Applied Cognitive (AC) were collected at admission and discharge from the hospital, at 30, 60, 90, 120 days after stroke, and 6-month and 12-month long-term follow-ups.</div></div><div><h3>Results</h3><div>The mixed effects linear regression model revealed a significant interaction effect between the intervention and time across all 3 functional domains (<em>P</em>&lt;.001 each for BM, DA, AC). At the 1-year follow-up assessment, the mean score for AM-PAC BM was 61.5±10.7 for the SRP group compared with 55.1±15.5 in the control group (<em>P</em>&lt;.001), 58.0±17.4 vs 52.7±17.5 for AM-PAC DA (<em>P</em>=.032), and 49.4±11.5 vs 44.5±12.4 for AM-PAC AC scores (<em>P</em>=.225), respectively.</div></div><div><h3>Conclusions</h3><div>An early outpatient comprehensive stroke rehabilitation program, including aerobic exercise and stroke risk factor education within the first 6 months of stroke, not only demonstrated functional improvements after the program but was able to achieve sustained functional improvements in mobility, self-care, and cognitive ability at 1 year. Improving the long-term function of stroke survivors promotes functional independence.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100568"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428871","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":"Feasibility of Early Assessment of Cognitive Deficits in Patients With Ventilation Sepsis: A Cross-Sectional Study","authors":"Frederick V. Ahlhaus MD ,&nbsp;Marcus Vollmer PhD ,&nbsp;Michael Schröder ,&nbsp;Matthias Gründling PD ,&nbsp;Anke Steinmetz MD","doi":"10.1016/j.arrct.2025.100547","DOIUrl":"10.1016/j.arrct.2025.100547","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility of early computer-based assessment, quantify cognitive impairments and identify factors influencing cognition.</div></div><div><h3>Design</h3><div>Prospective, cross-sectional study.</div></div><div><h3>Setting</h3><div>Data were collected on a surgical intensive care unit. All patients underwent cognitive assessment once they reached a Richmond Agitation-Sedation Scale (RASS) score of −1 or higher.</div></div><div><h3>Participants</h3><div>During data collection, 60 patients (N=60) met the inclusion criteria: sepsis and 24 hours of ventilation. Patients with prior cognitive impairment, or neurologic or psychiatric diagnoses, were excluded. Therefore, a total of 28 patients were included in the study.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcome variables were tonic alertness, the general level of attention and phasic alertness, the temporarily increased attentiveness after a stimulus. They were normalized for age and sex. The hypothesis proposed was that testing would be feasible starting from a RASS score of −1.</div></div><div><h3>Results</h3><div>Testing was only possible when patients had a RASS of 0 and had regained orientation. On average, a successful test could be performed 6.6 (mean) days from RASS≥−1 or 4.7 (mean) days after the end of ventilation. On average, the results of tonic alertness were 3 standard deviations (95% CI, −3.8 to −2.2) worse. For phasic alertness, the mean score was −2.3 standard deviations (95% CI, −3.1 to −1.5).</div><div>There are significant typical markers for sepsis severity with moderate correlations between an increasing number of ventilation days [<em>r</em>=−0.38, 95% CI: −0.66 to −0.01], number of days required between the cessation of ventilation and testing [<em>r</em>=−0.40, 95% CI: −0.68 to −0.04], days with noradrenaline [<em>r</em>=−0.48, 95% CI: −0.73 to −0.13], and days from awakening to the day of testing [<em>r</em>=−0.5, 95% CI: −0.74 to −0.15] and worsened tonic cognition.</div></div><div><h3>Conclusions</h3><div>Early cognitive impairments are common in sepsis patients. Although early rehabilitation might be beneficial within this early stage, the utilization of computer-based assessments, appear to be limited. Detailed analysis of cognition should be considered later in recovery process. Further approaches could use demonstrated times at which assessment is likely to be successful.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100547"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428612","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":"Manual Dexterity in Patients with Disorder of Consciousness","authors":"Lingxiu Sun MS, PT ,&nbsp;Anqi Wang PhD, PT ,&nbsp;Ziqiang Yang PT ,&nbsp;Jie Huang MD ,&nbsp;Meiqi Li MS, RN ,&nbsp;Yan Chen PhD ,&nbsp;Nantu Hu PhD ,&nbsp;Lijuan Cheng PhD, RN ,&nbsp;Xiaochen Liu MS, MD ,&nbsp;Feng Chen PhD ,&nbsp;Yufei Xue ,&nbsp;Aurore Thibaut PhD ,&nbsp;Steven Laureys PhD ,&nbsp;Siyu Dai PhD ,&nbsp;Haibo Di PhD","doi":"10.1016/j.arrct.2025.100576","DOIUrl":"10.1016/j.arrct.2025.100576","url":null,"abstract":"<div><h3>Objective</h3><div>To examine hand motor features in individuals diagnosed with disorder of consciousness (DoC) after severe brain injury, and to investigate the relationship between manual dexterity and levels of consciousness.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Rehabilitation hospital.</div></div><div><h3>Participants</h3><div>Sixty patients with DoC (44 men and 16 women), with a mean age of 55.03±15.28 years and a mean postinjury duration of 10.68±7.98 months.</div></div><div><h3>Interventions</h3><div>Not applicable (no interventions were administered).</div></div><div><h3>Main Outcome Measures</h3><div>Manual dexterity (Brunnstrom Recovery Stage [BRS]), spasticity (Modified Ashworth Scale), pain (Nociception Coma Scale-Revised), and consciousness (Coma Recovery Scale-Revised) were assessed. Descriptive, nonparametric, and multivariate analyses were performed.</div></div><div><h3>Results</h3><div>Evaluation of the best-functioning hands in the 60 patients with DoC showed that 60% (n=36) had low dexterity (BRS&lt;4), and edema was revealed in 28.3% (17/60) of these hands. Compared with patients in minimally conscious state (MCS), those in unresponsive wakefulness syndrome (UWS) had significantly lower manual dexterity (96.2% vs 32.4%) and a higher prevalence of hand edema (42.3% vs 17.6%). BRS scores were significantly higher for hands than for arms (<em>P</em>&lt;.001). Manual dexterity was strongly associated with consciousness diagnosis (adjusted odds ratios=16.03, 95% confidence interval, 2.16-119.11; <em>P</em>=.007). No significant difference was found between right and left hands.</div></div><div><h3>Conclusions</h3><div>A considerable proportion of patients with DoC experience severe hand complications, which can negatively impact their clinical diagnosis and quality of life. The BRS is effective in detecting subtle hand motor responses that may reflect residual consciousness in DoC. The observed association between manual dexterity and consciousness suggests that hand motor control may engage neural circuits involved in consciousness processing.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100576"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428874","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":"Rehabilitation Dose Contributes to Improvement in Transfer and Mobility Activities Among Patients With Ischemic Stroke Who Required Assistance Before Hospitalization: A Nationwide Database Observational Study","authors":"Takuaki Tani PhD ,&nbsp;Kazuya Watanabe PhD ,&nbsp;Kiyohide Fushimi PhD","doi":"10.1016/j.arrct.2025.100577","DOIUrl":"10.1016/j.arrct.2025.100577","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between rehabilitation dose (≤40min, 40-60min, 60-80min, 80-120min, and ≥120 min) during the first 14 days and recovery of transfer and mobility activities among inpatients with ischemic stroke who required assistance before acute hospitalization.</div></div><div><h3>Design</h3><div>Nationwide Japanese retrospective observational database study.</div></div><div><h3>Setting</h3><div>Acute care and rehabilitation units.</div></div><div><h3>Participants</h3><div>Stroke patients admitted between April 1, 2016, and March 31, 2022, with modified Rankin scale scores of 4 and 5 before hospitalization. The study included 6531 patients (N=6531) (3869 men, 59.2%) with a mean age of 84.02 (±9.27) years.</div></div><div><h3>Interventions</h3><div>Not applicable (observational study without intervention).</div></div><div><h3>Main Outcome Measures</h3><div>The Barthel Index at 30 days was used to assess seated position, transfer ability (with or without assistance), and wheelchair self-propulsion, with each item dichotomized into achievement or nonachievement to facilitate clinical interpretation.</div></div><div><h3>Results</h3><div>Among 6531 patients, higher rehabilitation doses were associated with better outcomes in a dose–response manner. Compared with ≤40 min, ≥120 min/day was associated with improved seated position (relative risk [RR], 2.27; 95% CI, 2.06-2.51), transfer with assistance (RR, 2.18; 95% CI, 1.93-2.45), independent transfer (RR, 2.04; 95% CI, 1.58-2.65), and wheelchair self-propulsion (RR, 2.68; 95% CI, 1.90-3.87).</div></div><div><h3>Conclusions</h3><div>In patients with severe preischemic stroke disability, a higher daily rehabilitation dose was associated with improved transfer and mobility functions.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100577"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428876","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":"Vagus Nerve Stimulation Paired With Upper Extremity Rehabilitation for Chronic Stroke: Real-World Implementation and Outcomes","authors":"Amanda Saylor MS, OTR/L ,&nbsp;Laura Patrick PT, DPT ,&nbsp;Chandan G Reddy MD ,&nbsp;Ravi Gandhi MD","doi":"10.1016/j.arrct.2025.100580","DOIUrl":"10.1016/j.arrct.2025.100580","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;This initiative aimed to assess real-world implementation and outcomes of a paired vagus nerve stimulation (VNS) program at AdventHealth Sports Medicine and Rehabilitation, part of the AdventHealth Central Florida system.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Case series of stroke patients who were implanted with a US Food and Drug Administration-approved vagus nerve stimulator and subsequently underwent at least 6 weeks of paired VNS therapy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Ten outpatient therapy clinics in central Florida.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;In total, 35 participants (21 men, 14 women), at least 6 months post ischemic stroke with moderate to severe upper extremity deficits. The average age was 59.2 (± SD, 13.9) years, and participants were 3.7 (± SD, 3.5) years poststroke. The mean baseline Fugl-Meyer assessment upper extremity (FMA-UE) test score averaged 30.4 (± SD, 10.2) points.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;All patients were implanted with a vagus nerve stimulator and received VNS paired with outpatient occupational therapy focused on high-repetition task practice for a period of at least 6 weeks. Additionally, patients engaged in self-initiated use of VNS paired with daily tasks outside of the therapy clinic for periods of 30 minutes up to 8 times per day.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;FMA-UE test score, box and block test, and patient-specific functional scale were tested at baseline and after 6 weeks of paired VNS sessions. For program implementation, success was measured by the number of neuro-specialized occupational therapists fully trained and the number of therapy clinics in the AdventHealth Central Florida system trained and able to offer paired VNS sessions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;After the period of in-clinic therapy, the average FMA-UE test score improved by 10.8 (± SD, 5.4) points, with 28 of 35 (80%) participants classified as responders based on the FMA-UE test score’s minimal clinically important difference of ≥6 points. The average box and block test score change was 4.5 blocks/min (± SD, 2.9), with 10 of 23 meeting the minimal detectable change of 5.5 blocks. In just over 2 years of program implementation, 84% (21/25) of all neuro-specialized occupational therapists in AdventHealth Sports Medicine and Rehabilitation clinics are fully trained, and 10 out of 10 neuro-focused outpatient clinics are now prepared to refer and offer paired VNS sessions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;VNS paired with rehabilitation therapy in patients with chronic ischemic stroke resulted in meaningful functional improvements aligned with individual patient goals in a real-world practice setting. Our results support findings from the pivotal VNS-REHAB (Vagus nerve stimulation paired with rehabilitation for upper limb motor function after ischaemic stroke): a randomised, blinded, pivotal, device trial and provide evidence for the feasibi","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100580"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428607","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":"Clinical Determinants of Functional Independence at Discharge in Patients With Spinal Cord Dysfunction Due to Metastatic Spinal Tumors","authors":"Hiroyuki Ase PhD ,&nbsp;Kiyomi Miura BSc ,&nbsp;Tsukasa Yoshida BSc ,&nbsp;Eriko Kitahara PhD ,&nbsp;Tatsuya Takagi PhD ,&nbsp;Kaoru Honaga PhD ,&nbsp;Akira Tanuma PhD ,&nbsp;Mami Tani MD ,&nbsp;Yuhei Murakami PhD ,&nbsp;Aiko Ishikawa PhD ,&nbsp;Reina Isayama MS ,&nbsp;Toshiyuki Fujiwara PhD","doi":"10.1016/j.arrct.2025.100549","DOIUrl":"10.1016/j.arrct.2025.100549","url":null,"abstract":"<div><h3>Objectives</h3><div>To identify the clinical factors associated with independence in activities of daily living (ADL) at discharge in patients with spinal cord dysfunction resulting from metastatic spinal tumors.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>A single university hospital in Japan.</div></div><div><h3>Participants</h3><div>A total of 153 patients (N=153) (median age 69 [interquartile range: 58.5-75.5]; 67% men) with spinal cord dysfunction caused by metastatic spinal tumors received inpatient rehabilitation during hospitalization between 2012 and 2022. The inclusion criteria were age ≥18 years, a diagnosis of spinal cord dysfunction resulting from metastatic bone tumors, and participation in inpatient rehabilitation.</div></div><div><h3>Interventions</h3><div>Participants underwent standard inpatient rehabilitation care. No study-specific intervention was provided.</div></div><div><h3>Main Outcome Measures</h3><div>Independence in ADL was defined as a Barthel index score of ≥85 at discharge. Data on demographics, clinical characteristics, and potential risk factors were extracted from medical records. Logistic regression analysis, adjusted for age, was conducted to identify predictors of independence in ADL at discharge.</div></div><div><h3>Results</h3><div>Among the participants, 23 (15.0%) achieved independence in ADL at discharge. Logistic regression analysis identified the following 4 significant factors associated with reduced odds of independence in ADL: rapid-growing primary tumor type (odds ratio [OR]=5.93; 95% CI, 1.81-19.43), severe motor impairment at admission (OR=5.83; 95% CI, 1.89-18.00), elevated C-reactive protein/albumin ratio (OR=3.82; 95% CI, 1.53-17.80), and persistent movement-related pain (OR=1.34; 95% CI, 1.01-1.84).</div></div><div><h3>Conclusions</h3><div>Tumor aggressiveness, neurologic severity, systemic inflammation, and persistent pain significantly influenced independence in ADL at discharge. Early identification of these risk factors may guide individualized rehabilitation planning and optimize functional outcomes in this population.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100549"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428613","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":"Exoskeletal-Assisted Training in Veterans With Chronic Stroke: A Pilot Study","authors":"Michael Elliott BS ,&nbsp;Ingrid Lee MS ,&nbsp;Korishma Patram PT, DPT ,&nbsp;Shabana Sahai PT, DPT ,&nbsp;Luis Ortiz-Vasquez BS ,&nbsp;Stephen Kornfeld DO ,&nbsp;Pierre Asselin MS ,&nbsp;Steven Knezevic PhD ,&nbsp;Denis Doyle Green AS ,&nbsp;Ian Paez BA ,&nbsp;Ann M. Spungen EdD ,&nbsp;John P. Handrakis PT, DPT, EdD","doi":"10.1016/j.arrct.2025.100552","DOIUrl":"10.1016/j.arrct.2025.100552","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the safety and feasibility of using a robotically powered exoskeleton in outpatient stroke survivors (&gt;6mo). Treatment effect and functional outcome data were explored.</div></div><div><h3>Design</h3><div>Safety and feasibility pilot study.</div></div><div><h3>Setting</h3><div>Veterans Affairs Medical Center.</div></div><div><h3>Participants</h3><div>Convenience sample of 10 stroke survivors (N=10) who were independent ambulators but had mild-moderate limitations.</div></div><div><h3>Interventions</h3><div>Standard of care (SOC) rehabilitation and SOC plus a robotic exoskeleton (SOC+Exo). Both groups received 1 hour of outpatient gait, transfer, and mobility training, 3 times per week for 12 weeks. The SOC+Exo group performed all SOC training activities while wearing the Keeogo Dermoskeleton (KExo).</div></div><div><h3>Main Outcome Measures</h3><div>Safety was determined by adverse events (AEs), and feasibility by retention rate, adherence, participants’ subjective satisfaction across 8 KExo use aspects, and trainers’ subjective effort on 5 KExo donning/doffing tasks. Exploratory outcomes included the 5 Times Sit-to-Stand Test (5 × STS), distance and timed walking tests, stair climbing test, and step length during gait.</div></div><div><h3>Results</h3><div>Twenty-two participants were screened; 16 were eligible and enrolled in the protocol. Four were randomized to SOC rehabilitation and 12 to the SOC+Exo intervention. Early study termination occurred in 1 SOC (noncompliance) and 5 SOC+Exo participants (because of time commitment or noncompliance). Two study-related AEs occurred. Both AEs were resolved, and the participants continued in the protocol. Ten (3 SOC; 7 SOC+Exo) of the initial 16 participants completed the study, demonstrating a 63% retention rate. The 10 retained participants demonstrated a 100% adherence rate. Most participants were satisfied with KExo assistance. Trainers reported providing only supervision when using the device. Nonparametric analysis suggests improvement (pre-post) in the SOC+Exo group without the device for 5 × STS (mean ± SD, −20.3±14.2s; <em>P</em>=.018), gait speed (mean ± SD, 0.24±0.34m/s; <em>P</em>=.046), and paretic leg step length (mean ± SD, 8.4±15.5cm; <em>P</em>=.018).</div></div><div><h3>Conclusions</h3><div>Use of a robotically powered exoskeleton to augment SOC outpatient stroke rehabilitation was safe and feasible, and the protocol was well tolerated by participants and trainers. The effects of SOC+Exo training on the exploratory outcomes appear promising and warrant further investigation for efficacy in a more rigorous randomized controlled trial.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100552"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428870","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":"Motor Function Profiling and Its Impact on Health-Related Quality of Life in Childhood Stroke Survivors","authors":"Chai Yin Charlie Fan OT, MPhil ,&nbsp;Yuliang Wang MPhil ,&nbsp;Wan Yee Winnie Tso MBBS","doi":"10.1016/j.arrct.2025.100578","DOIUrl":"10.1016/j.arrct.2025.100578","url":null,"abstract":"<div><h3>Objective</h3><div>To profile motor function in childhood stroke survivors and examine the association between motor deficits and health-related quality of life (HRQoL) in this population.</div></div><div><h3>Design</h3><div>Cross-sectional.</div></div><div><h3>Setting</h3><div>Pediatric neurology and rehabilitation clinic.</div></div><div><h3>Participants</h3><div>Twenty-four childhood stroke survivors (N=24) (9 girls; mean age at assessment=13.3±3.5y).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The presence of motor deficits was defined as a below-average standard score (≤40) on a comprehensive measure of motor skills, the Bruininks-Oseretsky Test of Motor Proficiency, second edition. HRQoL was evaluated using the Pediatric Quality of Life (PedsQL) Generic Core Scales.</div></div><div><h3>Results</h3><div>Over 80% of childhood stroke survivors demonstrated below-average manual coordination, with over half of them showing deficits in both overall motor performance (62.5%) and fine manual control (54.2%). On the PedsQL, participants scored significantly lower on total (t=−2.9, <em>P</em>=.010, adjusted false discovery rate (FDR-adj.) <em>P</em>=.015) and psychosocial functioning (t=−3.4, <em>P</em>=.004, FDR-adj. <em>P</em>=.012). The motor domain significantly correlated with HRQoL: strength/agility showed the highest association with PedsQL total (<em>r</em>=.87, <em>P</em>&lt;.001) and physical scores (<em>r</em>=.84, <em>P</em>=.002), whereas manual coordination correlated most strongly with psychosocial functioning (<em>r</em>=.88, <em>P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>Motor impairments, especially in manual coordination and strength/agility, significantly affect quality of life after childhood stroke, warranting focused rehabilitation strategies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 1","pages":"Article 100578"},"PeriodicalIF":2.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147428608","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}