Archives of rehabilitation research and clinical translation最新文献

{"title":"Incorporating Physical Activity Assessments and Behavior Change Techniques Into Geriatrics","authors":"Mariana Wingood DPT, PhD, MPH ,&nbsp;Jonathan F. Bean MD, MPH ,&nbsp;Amy M. Linsky MD, MSc","doi":"10.1016/j.arrct.2023.100293","DOIUrl":"10.1016/j.arrct.2023.100293","url":null,"abstract":"<div><p>Ninety-one percent of adults 65 years and older do not perform the recommended levels of physical activity (PA), resulting in increased risk of disability, morbidity, and mortality. Despite knowing the benefits of PA and acknowledging the importance of assessing and addressing inadequate PA levels, 50%-75% of health care providers do not incorporate behavior change techniques into clinical practice. This clinical gap can be explained by a lack of knowledge or confidence in (1) assessing PA levels; (2) addressing inadequate PA levels; and (3) justifying the time needed to use these techniques in clinical practice. In this special communication, we address this gap by providing a 3-step theoretical-based clinical decision pathway that guides health care providers on how to identify older adults with inadequate PA levels, determine readiness to increase PA, and empower patents to develop an action plan that will increase their PA levels. We also provide a conceptual model that supports the use of techniques that assess and address inadequate PA by tying PA to the Age-Friendly Health System's 4Ms (ie, What <u>M</u>atters to the older adult, <u>M</u>entation, <u>M</u>obility, and <u>M</u>edications).</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100293"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000496/pdfft?md5=c20eaa27ff3f772344ac51774a375e20&pid=1-s2.0-S2590109523000496-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48646256","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":"The Functional Balance Ability Measure: A Measure of Balance Across the Spectrum of Functional Mobility in Persons Post-Stroke","authors":"Jasmine J. Cash MS ,&nbsp;Craig A. Velozo PhD, OTR/L ,&nbsp;Mark G. Bowden PT, PhD ,&nbsp;Bryant A. Seamon PT, DPT, PhD","doi":"10.1016/j.arrct.2023.100296","DOIUrl":"10.1016/j.arrct.2023.100296","url":null,"abstract":"<div><h3>Objective</h3><p>To determine whether the measurement properties of an instrument that combines items from the Berg Balance Scale (BBS) and the Functional Gait Assessment (FGA) called the <em>Functional Balance Ability Measure (FBAM)</em> supports measuring balance across the functional mobility spectrum<em>.</em></p></div><div><h3>Design</h3><p>Retrospective cohort.</p></div><div><h3>Setting</h3><p>Item-level data were from an archival research database.</p></div><div><h3>Participants</h3><p>Ambulatory individuals (N=93, BBS=50 [29-56], FGA=16 [0-30], Fugl-Meyer Assessment of Lower Extremities=27 [14-34], self-selected walking speed=0.4±0.2 m/s, mean age ± SD, 61.7±11.3y; 30.1% female) with chronic stroke (≥6 months).</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Unidimensionality was evaluated with a principal components analysis (PCA) of residuals. FBAM rating-scale characteristics, item hierarchy, item and person fit, and person separation were investigated using the Andrich Rating Scale Model.</p></div><div><h3>Results</h3><p>PCA findings indicate the FBAM is sufficiently unidimensional. Rating scale structure was appropriate without modifying the original BBS and FGA scoring systems. Item hierarchy aligned with clinical and theoretical predictions (hardest item: FGA-gait with narrow base of support, easiest item: BBS-sitting unsupported). One item (BBS-standing on 1 foot) misfit, however, removal marginally affected person measures and model statistics. The FBAM demonstrated high person reliability (0.9) and 6 people (∼6%) misfit the expected response pattern. The FBAM separated participants into 4 statistically distinct strata, without a floor or ceiling effect.</p></div><div><h3>Conclusions</h3><p>The FBAM is a unidimensional measure for balance ability across a continuum of functional tasks. Rating-scale characteristics, item hierarchy, item and person fit, and person separation support the FBAM's measurement properties in persons with chronic stroke. Future work should investigate measurement with fewer items and whether the FBAM addresses barriers to adoption of standardized balance measures in clinical practice.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100296"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000587/pdfft?md5=449e9ebb1ab368c0936ce40389fc7227&pid=1-s2.0-S2590109523000587-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135298122","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 Pilot Feasibility Trial of an Upper Extremity Assistive System","authors":"Emma Hammelef BSE ,&nbsp;Saami J. Zakaria MD ,&nbsp;Sarah H. Andersen MA ,&nbsp;Thomas J. Kelly IV MA ,&nbsp;Namrata Grampurohit PhD, OTR/L ,&nbsp;Mikael Avery MArch, MS, OTR/L ,&nbsp;Alessandro Napoli PhD ,&nbsp;Mary Jane Mulcahey PhD, OTR/L ,&nbsp;Mijail Demian Serruya MD, PhD","doi":"10.1016/j.arrct.2023.100308","DOIUrl":"10.1016/j.arrct.2023.100308","url":null,"abstract":"<div><h3>Objective</h3><p>To develop and clinically evaluate a customizable active upper extremity (UE) assistive system with integrated functional electrical stimulation (FES) that improves function and independence of individuals during activities of daily living (ADLs).</p></div><div><h3>Design</h3><p>Single-arm, prospective, open-label cohort feasibility trial.</p></div><div><h3>Setting</h3><p>An academic research institution.</p></div><div><h3>Participants</h3><p>Subjects were 5 adults with a medical history of stroke resulting in distal UE impairment (N=5). The subjects volunteered from recruitment materials that detailed information about the study.</p></div><div><h3>Interventions</h3><p>A novel, wearable, lightweight, low-profile, and patient-tailored UE assistive system. It comprises a splint component and FES unit that may each be controlled by electromyography (EMG) signals, inertial measurement units (IMUs), manual control source (joystick), and/or voice control.</p></div><div><h3>Main Outcome Measure(s)</h3><p>Several occupational therapy outcome measures were used, including the Canadian Occupational Performance Measure (COPM), Action Research Arm Test (ARAT), The Box and Blocks Test (BBT), the ABILHAND-Manual Ability Measure, and Patient Reported Outcomes Measurement Information System (PROMIS) UE Short Form.</p></div><div><h3>Results</h3><p>All participants learned to use our UE assistive system to perform ADLs and were able to use it independently at home. Most participants experienced a clinically meaningful improvement in both performance and satisfaction for the majority of their COPM goals while using the system. All participants experienced improvement in hand grip and release as shown by their baseline and post assessment scores for hand function (BBT, ARAT) and patient-reported outcomes (ABILHAND, PROMIS).</p></div><div><h3>Conclusions</h3><p>The clinical outcomes suggest that our UE assistive system improves functional performance in patients with UE impairment, allowing them to engage more actively in ADLs. Further innovation including elbow and shoulder components will allow users to have more degrees of freedom during tasks.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100308"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000708/pdfft?md5=e09b13d8eb4b860207a129b0874004b9&pid=1-s2.0-S2590109523000708-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136160770","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":"Concurrent Validity of Dual-Task Walking Speed With CERAD-NP Assessment Battery in Community-Dwelling Older Adults","authors":"Han suk Lee PT, PhD ,&nbsp;Mansoo Ko PT, PhD ,&nbsp;Hyung-Ji Kim MD","doi":"10.1016/j.arrct.2023.100291","DOIUrl":"10.1016/j.arrct.2023.100291","url":null,"abstract":"<div><h3>Objective</h3><p>To explore the concurrent validity of the dual-task walking speed assessments in older adults using the Consortium to Establish a Registry for Alzheimer's Disease Neuro-Psychological (CERAD-NP) Assessment Battery.</p></div><div><h3>Design</h3><p>Cross-sectional design.</p></div><div><h3>Setting</h3><p>Welfare care centers, Senior complex centers, and Dementia prevention care centers.</p></div><div><h3>Participants</h3><p>A total of 163 community-dwelling older adults (N=163) were recruited using consecutive sampling. Participants were composed of 65 older adults with cognitive decline and 98 without cognitive decline.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>This study assessed the concurrent validity between dual-task walking speed assessments and the Total II score of CERAD-NP using Spearman's rank order correlations. The effect of the dual-task walking speed assessments on the Total II score was further investigated through multiple linear regression analysis.</p></div><div><h3>Results</h3><p>There was a moderate and statically significant association between the Total II score and all 8 dual-task walking speed assessments (<em>P</em>&lt;.05). The Total II score was strongly associated with the dual tasks of walking on a straight path while counting backward and crossing over an obstacle (<em>r</em>=0.698, <em>r</em>=0.697, respectively; <em>P</em>&lt;.05). According to multiple linear regression, only the dual task of walking while counting backward was significantly associated with the Total II score (<em>P</em>&lt;.05).</p></div><div><h3>Conclusion</h3><p>The dual-task walking speed assessments, which involved walking and performing a secondary task such as counting backward or crossing an obstacle on a straight path, were highly indicative of cognitive decline. The combination of results from both tasks may provide a more comprehensive evaluation of cognitive decline compared with relying solely on a single-task assessment.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100291"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000472/pdfft?md5=c666332dd70d5f9f93dd613b98882e68&pid=1-s2.0-S2590109523000472-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49320145","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":"Mixed Martial Arts: Comparing the King-Devick and Sport Concussion Assessment Tool 5 in knockouts, technical knockouts and choke holds","authors":"Eric E. Twohey MD ,&nbsp;Ike B. Hasley MD ,&nbsp;Patrick J. Shaeffer MD ,&nbsp;George A. Ceremuga MD ,&nbsp;Stephen A. Firkins MD ,&nbsp;Gene C. Stringer MD ,&nbsp;Mario Roberto Vaz Carneiro Filho MD ,&nbsp;John H. Hollman P.T., PhD ,&nbsp;Rodolfo Savica MD, PhD ,&nbsp;Jonathan T. Finnoff DO","doi":"10.1016/j.arrct.2023.100301","DOIUrl":"10.1016/j.arrct.2023.100301","url":null,"abstract":"<div><h3>Objective</h3><p>To compare validity indices of the King-Devick (KD) test and Sport Concussion Assessment Tool 5 (SCAT5) for traumatic events in MMA, and to determine if perfusion events (alterations in consciousness as the result of choke holds) cause similar changes in KD/SCAT5 scores.</p></div><div><h3>Design</h3><p>A prospective cohort study in MMA fighters who completed KD and SCAT5 assessments before and after a match. Outcomes were categorized as non-event, traumatic event, or perfusion event. KD/SCAT5 changes were compared between all athletes.</p></div><div><h3>Participants</h3><p>One hundred forty MMA athletes (7 women, 133 men), mean age=27.1 ± 4.9 years.</p></div><div><h3>Intervention</h3><p>N/A</p></div><div><h3>Main outcome measures</h3><p>King-Devick (KD) test and Sport Concussion Assessment Tool 5 (SCAT5)</p></div><div><h3>Results</h3><p>Among the 140 athletes, 19 sustained traumatic and 15 perfusion events. Testing provided sensitivities/specificities of 21.05%/93.39% (KD) and 77.78%/52.99% (SCAT5) in detecting a traumatic event. KD and SCAT5 Symptom Severity scores differed between athletes with and without traumatic events (<em>P</em>=.041 and .014). KD and SCAT5 Symptoms Score changes were observed between athletes with and without traumatic events (<em>P</em>=.023 and .042). Neither KD nor SCAT5 differed significantly between athletes with and without perfusion events.</p></div><div><h3>Conclusions</h3><p>The KD test provides high specificity and the SCAT5 demonstrates reasonable sensitivity when detecting a traumatic event. Of the SCAT5, symptoms-related scores may most effectively identify a traumatic event. A traumatic event may cause KD/SCAT5 changes similar to a concussion, while perfusion events did not.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100301"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000630/pdfft?md5=97793eafd2e8c37f4e2772937ed0c855&pid=1-s2.0-S2590109523000630-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134935517","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":"Longitudinal Progression of White Matter Hyperintensity Severity in Chronic Stroke Aphasia","authors":"Natalie Busby PhD ,&nbsp;Roger Newman-Norlund PhD ,&nbsp;Janina Wilmskoetter PhD ,&nbsp;Lisa Johnson PhD ,&nbsp;Chris Rorden PhD ,&nbsp;Makayla Gibson BS ,&nbsp;Rebecca Roth BA ,&nbsp;Sarah Wilson MA ,&nbsp;Julius Fridriksson PhD ,&nbsp;Leonardo Bonilha MD, PhD","doi":"10.1016/j.arrct.2023.100302","DOIUrl":"10.1016/j.arrct.2023.100302","url":null,"abstract":"<div><h3>Objective</h3><p>To determine whether longitudinal progression of small vessel disease in chronic stroke survivors is associated with longitudinal worsening of chronic aphasia severity.</p></div><div><h3>Design</h3><p>A longitudinal retrospective study. Severity of white matter hyperintensities (WMHs) as a marker for small vessel disease was assessed on fluid-attenuated inversion recovery (FLAIR) scans using the Fazekas scale, with ratings for deep WMHs (DWMHs) and periventricular WMHs (PVHs).</p></div><div><h3>Setting</h3><p>University research laboratories.</p></div><div><h3>Participants</h3><p>This study includes data from 49 chronic stroke survivors with aphasia (N=49; 15 women, 34 men, age range=32-81 years, &gt;6 months post-stroke, stroke type: [46 ischemic, 3 hemorrhagic], community dwelling). All participants completed the Western Aphasia Battery-Revised (WAB) and had FLAIR scans at 2 timepoints (average years between timepoints: 1.87 years, <em>SD</em>=3.21 years).</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Change in white matter hyperintensity severity (calculated using the Fazekas scale) and change in aphasia severity (difference in Western Aphasia Battery scores) were calculated between timepoints. Separate stepwise regression models were used to identify predictors of WMH severity change, with lesion volume, age, time between timepoints, body mass index (BMI), and presence of diabetes as independent variables. Additional stepwise regression models investigated predictors of change in aphasia severity, with PVH change, DWMH change, lesion volume, time between timepoints, and age as independent predictors.</p></div><div><h3>Results</h3><p>22.5% of participants (11/49) had increased WMH severity. Increased BMI was associated with increases in PVH severity (<em>P</em>=.007), whereas the presence of diabetes was associated with increased DWMH severity (<em>P</em>=.002). Twenty-five percent of participants had increased aphasia severity which was significantly associated with increased severity of PVH (<em>P</em>&lt;.001, 16.8% variance explained).</p></div><div><h3>Conclusion</h3><p>Increased small vessel disease burden is associated with contributing to chronic changes in aphasia severity. These findings support the idea that good cardiovascular risk factor control may play an important role in the prevention of long-term worsening of aphasic symptoms.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100302"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000642/pdfft?md5=e84995db1d84243e449f07fc876cf13a&pid=1-s2.0-S2590109523000642-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134976536","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":"Feasibility and Safety of Sequential Transcranial Direct Current Stimulation and Physical Therapy in Older Adults at Risk of Falling: A Randomized Pilot Study","authors":"On-Yee Lo PhD ,&nbsp;Sarah Charest OTR/L ,&nbsp;Heather Margulis PT, MSPT ,&nbsp;Lewis Lipsitz MD ,&nbsp;Brad Manor PhD","doi":"10.1016/j.arrct.2023.100288","DOIUrl":"10.1016/j.arrct.2023.100288","url":null,"abstract":"<div><h3>Objective</h3><p>To establish the feasibility and safety of administering transcranial direct current stimulation (tDCS) immediately prior to physical therapy (PT) sessions in older adults at risk of falls.</p></div><div><h3>Design</h3><p>A pilot randomized controlled study.</p></div><div><h3>Setting</h3><p>Outpatient geriatric physical therapy clinic.</p></div><div><h3>Participants</h3><p>Ten older adults living within supportive housing facilities (86.8±7.9 y/o, 8F) were enrolled in the study.</p></div><div><h3>Interventions</h3><p>Participants received tDCS or sham stimulation targeting the left dorsal lateral prefrontal cortex for 20 minutes, immediately prior to up to 10 of their PT visits.</p></div><div><h3>Main Outcome Measures</h3><p>Feasibility, safety, and functional outcomes were reported to inform the design of a larger and more definitive trial.</p></div><div><h3>Results</h3><p>Six fallers (88.8±5.0 y/o, 5F) completed the study and received 82.3% of the possible stimulation sessions, suggesting adding a 20-minute session of stimulation immediately prior to PT training sessions, along with pre- and post-assessments is feasible. The blinding strategy was successful and all reported side effects were expected and transient. While feasible and safe, the trial was met with numerous challenges, including selection bias, time and energy commitment, and large variation in functional performance, that must be considered when designing and implementing larger more definitive trials.</p></div><div><h3>Conclusion</h3><p>This study provides preliminary evidence about the feasibility, safety, and challenges to combine PT and tDCS in very frail older adults.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100288"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000447/pdfft?md5=9f5d374c8112d31c0d7498a4bf6bcdd5&pid=1-s2.0-S2590109523000447-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47987911","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":"Traumatic Brain Injury Rehabilitation Outcome Prediction Using Machine Learning Methods","authors":"Nitin Nikamanth Appiah Balaji MS ,&nbsp;Cynthia L. Beaulieu PhD ,&nbsp;Jennifer Bogner PhD ,&nbsp;Xia Ning PhD","doi":"10.1016/j.arrct.2023.100295","DOIUrl":"10.1016/j.arrct.2023.100295","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the performance of machine learning (ML) methods for predicting outcomes from inpatient rehabilitation for subjects with TBI using a dataset with a large number of predictor variables. Our second objective was to identify top predictive features selected by the ML models for each outcome and to validate the interpretability of the models.</p></div><div><h3>Design</h3><p>Secondary analysis using computational modeling of relationships between patients, injury and treatment activities and 6 outcomes, applied to the large multi-site, prospective, longitudinal observational dataset collected during the traumatic brain injury inpatient rehabilitation study.</p></div><div><h3>Setting</h3><p>Acute inpatient rehabilitation.</p></div><div><h3>Participants</h3><p>1946 patients aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, and were admitted to 1 of 9 US inpatient rehabilitation sites between 2008 and 2011 (N=1946).</p></div><div><h3>Main Outcome Measures</h3><p>Rehabilitation length of stay, discharge to home, FIM cognitive and FIM motor at discharge and at 9-months post discharge.</p></div><div><h3>Results</h3><p>Advanced ML models, specifically gradient boosting tree model, performed consistently better than all other models, including classical linear regression models. Top ranked predictive features were identified for each of the 6 outcome variables. Level of effort, days to rehabilitation admission, age at rehabilitation admission, and advanced mobility activities were the most frequently top ranked predictive features. The highest-ranking predictive feature differed across the specific outcome variable.</p></div><div><h3>Conclusions</h3><p>Identifying patient, injury, and rehabilitation treatment variables that are predictive of better outcomes will contribute to cost-effective care delivery and guide evidence-based clinical practice. ML methods can contribute to these efforts.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100295"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000575/pdfft?md5=9ace6d4dfb6d2a43d2b3bbfa36a5e72f&pid=1-s2.0-S2590109523000575-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135458936","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":"Managing Fatigue: Experiences From a 6-week Course for Adults With Cerebral Palsy","authors":"Ellinor Nilsson MSc ,&nbsp;Séverine Hedberg Dubuc PhD ,&nbsp;Nazdar Ghafouri PhD ,&nbsp;Anne Söderlund Schaller PhD","doi":"10.1016/j.arrct.2023.100300","DOIUrl":"10.1016/j.arrct.2023.100300","url":null,"abstract":"<div><h3>Objective</h3><p>To explore experiences of a 6-week Fatigue Management course (FMC) in adults with cerebral palsy (CP).</p></div><div><h3>Design</h3><p>A qualitative study using semi-structured interviews. The study process followed the Consolidated Criteria for Reporting Qualitative Research (COREQ).</p></div><div><h3>Setting</h3><p>The study was conducted in southeastern Sweden in an out-patient setting.</p></div><div><h3>Participants</h3><p>Adults (N=8) with CP who had participated in FMC.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measure</h3><p>Qualitative content analysis of the transcribed interviews led to identification of a main category, categories, and subcategories, describing the participants’ experiences of FMC.</p></div><div><h3>Results</h3><p>The analysis identified 2 categories: Awareness regarding fatigue, with the 2 subcategories: A better understanding, and The feeling of not being alone; and Perceive opportunities for changes, with the 3 subcategories: Understanding the need for changes, Demanding process, and Taking steps toward change. These categories were summed up in the main category describing the participants’ experiences of FMC: A challenging and eye-opening course that gave deeper self-understanding and thoughts about making changes.</p></div><div><h3>Conclusions</h3><p>Overall, the participants described positive experiences of FMC, with increased awareness regarding fatigue and insight regarding the possibilities for change. Nevertheless, there were challenges in coping with the extensive information and with the home assignments. This study gives promising results regarding the applicability of FMC for adults with CP. However, there is a need for course modifications with more targeted and differentiated content that is manageable and does not overload the participants. The modifications should include extended time, the addition of individual support, and follow-up between sessions, to increase participants’ opportunities to implement new strategies and initiate behavioral change.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100300"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000629/pdfft?md5=cd2d33c561dbc4b11a6a0ce0a5acfa9f&pid=1-s2.0-S2590109523000629-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135458951","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":"Pain, Balance-Confidence, Functional Mobility, and Reach Are Associated With Risk of Recurrent Falls Among Adults With Lower-Limb Amputation","authors":"Mayank Seth PhD ,&nbsp;John Robert Horne CPO ,&nbsp;Ryan Todd Pohlig PhD ,&nbsp;Jaclyn Megan Sions PhD","doi":"10.1016/j.arrct.2023.100309","DOIUrl":"10.1016/j.arrct.2023.100309","url":null,"abstract":"<div><h3>Objective</h3><p>The study evaluated whether pain intensity and extent, balance-confidence, functional mobility, and balance (eg, functional reach) are potential risk factors for recurrent falls among adults with a lower-limb amputation.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Setting</h3><p>Research laboratory.</p></div><div><h3>Participants</h3><p>Eighty-three adults with unilateral lower-limb amputation that occurred &gt;1 year prior (26 transfemoral- and 57 transtibial-level amputation; 44.6% women; 51.8% traumatic cause of amputation; N=83).</p></div><div><h3>Intervention</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Participants reported on the number of falls in the past year, as well as pain intensity in the low back, residual, and sound limbs. Balance-confidence (per the Activities-Specific Balance-Confidence Scale [ABC]), functional mobility (per the Prosthetic Limb Users Survey of Mobility ([PLUS-M]), and balance (per the Functional Reach and modified Four Square Step Tests) were obtained.</p></div><div><h3>Results</h3><p>After considering non-modifiable covariates, greater extent of pain, less balance-confidence, worse self-reported mobility, and reduced prosthetic-side reach were factors associated with recurrent fall risk. Adults reporting pain in the low back and both lower-limbs had 6.5 times the odds of reporting recurrent falls as compared with peers without pain. A 1-point increase in ABC score or PLUS-M T score, or 1-cm increase in prosthetic-side reaching distance, was associated with a 7.3%, 9.4%, and 7.1% decrease in odds of reporting recurrent falls in the past year, respectively.</p></div><div><h3>Conclusions</h3><p>Of the 83 adults, 36% reported recurrent falls in the past year. Presence of pain in the low back and both lower-limbs, less balance-confidence, worse PLUS-M score, and less prosthetic-side reaching distance were identified as modifiable factors associated with an increased odd of recurrent falls.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100309"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259010952300071X/pdfft?md5=c4c0c4562ebf9a0f989a6fdb693e1062&pid=1-s2.0-S259010952300071X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135509543","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}