Archives of rehabilitation research and clinical translation最新文献

{"title":"Acceptability and Barriers of Exercise in Children With Osteogenesis Imperfecta","authors":"Misha Gilani MBChB ,&nbsp;Stacey Todd BSc ,&nbsp;Sze Choong Wong MD ,&nbsp;Helen McDevitt MD ,&nbsp;Andreas Kyriakou MD ,&nbsp;Avril Mason MBChB","doi":"10.1016/j.arrct.2025.100458","DOIUrl":"10.1016/j.arrct.2025.100458","url":null,"abstract":"<div><h3>Objective</h3><div>To define barriers to participation in exercise in pediatric osteogenesis imperfecta (OI) and to gauge the acceptance of an exercise intervention in pediatric OI.</div></div><div><h3>Design</h3><div>A quality improvement study involving the distribution of a custom-made questionnaire assessing exercise habits, perceived barriers to exercise, and acceptability of an exercise intervention as a potential treatment for improvement of muscle-bone outcomes.</div></div><div><h3>Setting</h3><div>Performed at a tertiary pediatric center in Scotland.</div></div><div><h3>Participants</h3><div>Seventeen children (N=17) with OI attending the pediatric bone service between June and September 2019 were included in the study. Because of the Coronavirus disease of 2019 (COVID-19) pandemic, this could not be continued further. No children were excluded. The median age of the population was 12.5 years (range, 3.6-17.7).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>To gauge the acceptability of an exercise intervention in children with OI by assessing exercise behaviors and attitudes.</div></div><div><h3>Results</h3><div>Out of the respondents, 11 of 17 were fully ambulant, 1 of 17 was ambulant with an aid, 3 of 17 were occasional wheelchair users, and 2 of 17 were full-time wheelchair users. Mostly, 16 of 17, were receiving bisphosphonate therapy, either orally or intravenously, while 5 of 17 used pain-relieving medication at least weekly. Additionally, 16 of 17 reported that having OI made exercise participation more challenging because of joint pain (69%), muscle weakness (50%), tiredness/fatigue (75%), and concern about fractures (75%). All children surveyed participated in sports outside of school, at least once a week, and 15 of 17 stated they would participate in at least 1 additional 30 minutes of exercise per week, with swimming being the most common (71%).</div></div><div><h3>Conclusions</h3><div>Despite barriers to participation in exercise in OI, most children surveyed would wish to participate in an exercise intervention to improve muscle-bone.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100458"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011275","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":"Transition Aged Individuals With Cerebral Palsy Have Larger Clinical Gains With Visual Performance Feedback During Power Training","authors":"Brad Corr PT, DPT, PhD ,&nbsp;Heidi Reelfs PT ,&nbsp;Michael Trevarrow PhD ,&nbsp;Sarah Baker MA ,&nbsp;Max J. Kurz PhD","doi":"10.1016/j.arrct.2025.100463","DOIUrl":"10.1016/j.arrct.2025.100463","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate if providing visual feedback (VFB) on the speed of the movement during a lower extremity power training treatment protocol results in greater clinical gains in transition aged individuals with cerebral palsy (CP).</div></div><div><h3>Design</h3><div>Nonrandomized controlled trial.</div></div><div><h3>Setting</h3><div>Academic medical center.</div></div><div><h3>Participants</h3><div>Twenty transition aged persons (N=20) with CP (age range, 11-24y; Gross Motor Function Classification Score [GMFCS], I-IV).</div></div><div><h3>Interventions</h3><div>Twenty-four (8wks; 3d/wk) lower extremity power training sessions while receiving either VFB of their performance or no feedback (NFB) on their performance.</div></div><div><h3>Main Outcome Measures</h3><div>Bilateral leg press 1-repetition maximum (1RM), bilateral leg peak power production and walking speed reserve.</div></div><div><h3>Results</h3><div>The VFB group had greater lower extremity strength gains than the NFB group (<em>P</em>=.026). Additionally, the 1RM clinical gains were dependent on the baseline 1RM (<em>P</em>&lt;.001). The VFB group also had greater lower extremity power production after power training (<em>P</em>=.009). The extent of the power production gains was partially dependent on the baseline power production (<em>P</em>&lt;.001). The VFB group also had a larger walking speed reserve after the treatment (<em>P</em>=.039). However, the extent of the walking speed reserve gains was linked with an individual’s GMFCS level (<em>P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>VFB during power training has the potential to results in larger clinical gains for transition aged individuals with CP. Individuals with higher GMFCS levels, lower muscular strength and muscular power at baseline might not demonstrate as large of gains after power training even when VFB is provided. Alternative treatment strategies should be considered for these cases. Nevertheless, our results convey that learning to perform fast lower extremity motor actions likely has clinically relevant benefits for transition aged individuals with CP.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100463"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011242","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":"Investigating Disparities in Physical Therapy Utilization: An Intersectionality Perspective","authors":"Lauren Rimmel PT, DPT ,&nbsp;Kathleen Taglieri-Noble PT, DPT ,&nbsp;Rebecca Pham PT, DPT ,&nbsp;Joseph Tolland PT, DPT ,&nbsp;Saloni Doshi PT, DPT ,&nbsp;Nicholas Capobianco PT, DPT ,&nbsp;Anshul Kumar PhD","doi":"10.1016/j.arrct.2025.100465","DOIUrl":"10.1016/j.arrct.2025.100465","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the role of race, ethnicity, language, insurance payor, and socioeconomic status, both individually and through an intersectional framework, on outpatient physical therapy (PT) utilization. A secondary aim was to examine the differences in scheduling and attendance based on the aforementioned factors.</div></div><div><h3>Design</h3><div>A retrospective cohort study examining outpatient PT referrals, scheduled appointments, and attendance. Data included the status of visit completion, race, ethnicity, language, insurance payor, and zip code. Multiple logistic regression models, with and without interaction terms, analyzed the association of demographic factors with outcomes of interest.</div></div><div><h3>Setting</h3><div>This retrospective cohort study collected data between July 2021 and July 2022 from electronic medical records within a large academic medical system in New England.</div></div><div><h3>Participants</h3><div>N=61,125.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>This study assessed 3 outcomes. Outcome 1 analyzed the rates of scheduling after referral. Outcome 2 analyzed the rates of attendance after scheduling. Outcome 3 analyzed the rates of attendance after referral.</div></div><div><h3>Results</h3><div>Race, language, and income were associated with differences in scheduling versus attending PT. Black or African American patients showed the highest appointment-making rates and lowest attendance rates after scheduling compared with White patients. Asian patients demonstrated the lowest appointment-making rates and highest attendance rates after scheduling compared with White patients. Non-English-speaking patients were less likely to schedule and attend PT compared with English-speaking patients. Higher socioeconomic status was associated with higher rates of scheduling and attendance. Further disparities were noted when examining the interaction of variables. Increasing income benefited most, but not all groups. Black or African American patients experienced a decrease in scheduling and attendance rates with rising income compared with White patients. Non-English-speaking patients experienced less of an increase in scheduling and attendance rates with rising income compared with English-speaking patients.</div></div><div><h3>Conclusions</h3><div>Findings highlighted disparities in PT utilization in scheduling and attendance with regard to race, language, and income. Disparities were amplified when examining interactions between race and income and language and income, underscoring the importance of an intersectional analysis.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100465"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011243","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":"Letter to the Editor on “Effectiveness of early cardiorespiratory rehabilitation combined with melatonin supplementation during the inpatient period following acute myocardial infarction.”","authors":"Amine Ghram PhD (Clinical Exercise Physiologist, AACVPR-CCRP),&nbsp;Helmi Ben Saad MD, PhD","doi":"10.1016/j.arrct.2025.100476","DOIUrl":"10.1016/j.arrct.2025.100476","url":null,"abstract":"","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100476"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011263","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":"Carnitine Deficiency in Rehabilitation Ward Individuals and its Association With Activities of Daily Living: A Pilot Retrospective Observational Study","authors":"Makoto Ueno MD ,&nbsp;Kentaro Kawamura MD, PhD ,&nbsp;Rintaro Ohama MD, PhD ,&nbsp;Keizo Shigenobu MD ,&nbsp;Tadashi Ogura MD ,&nbsp;Megumi Shimodozono MD, PhD","doi":"10.1016/j.arrct.2025.100493","DOIUrl":"10.1016/j.arrct.2025.100493","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the presence of carnitine deficiency in a rehabilitation ward and the differences in functional independence measure (FIM) motor scores between participants with and without carnitine deficiency.</div></div><div><h3>Design</h3><div>A pilot, single-center, cross-sectional, retrospective observational study.</div></div><div><h3>Setting</h3><div>A rehabilitation ward of a hospital where 34% of the local population is aged ≥65 years.</div></div><div><h3>Participants</h3><div>Hospitalized patients in a rehabilitation ward who underwent a blood test during the 3-month observation period; carnitine was measured in participants (N=141) (mean age, 80.3y; 46 men).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the proportion of participants with carnitine deficiency. The secondary outcome was the FIM motor score at admission. Other outcomes were exploratory.</div></div><div><h3>Results</h3><div>The prevalence of carnitine deficiency was 8.5% (12 of 141 participants); 9 of 116 participants (7.8%) were primarily hospitalized for musculoskeletal diseases, and 3 of 24 (12.5%) had cerebrovascular diseases. Participants with carnitine deficiency had significantly lower FIM motor scores (median, 25.0; interquartile range [IQR], 17.2-36.2) than those without (median, 45.0; IQR, 27.0-65.0]; <em>P</em>=.02). The median difference was estimated to be 18.0 (95% CI, 4.0-33.0).</div></div><div><h3>Conclusions</h3><div>This study revealed the presence of carnitine deficiency in a rehabilitation ward in patients who had suffered from stroke or musculoskeletal disease and suggests a possible association with greater difficulty in performing ADL. Further studies in this area are needed.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100493"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011277","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":"Characteristics and Outcomes of Limb Loss Support Groups","authors":"Jennifer Crumling MD,&nbsp;Nicole Crumling MD,&nbsp;Prateek Grover MD, PhD, MHA","doi":"10.1016/j.arrct.2025.100485","DOIUrl":"10.1016/j.arrct.2025.100485","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically understand the structure and outcomes of limb loss support groups.</div></div><div><h3>Data Sources</h3><div>Literature review performed during June and July 2024. Search strategy included terms related to amputation and support group. Databases included PubMed, Scopus, Web of Science, CINAHL, and Cochrane Library. Publication range was 2009-2024.</div></div><div><h3>Study Selection</h3><div>Preferred Reporting Items for Systematic Reviews and Metanalyses methodology was used to identify 7 appropriate articles of 199 initial articles. Study quality was assessed using the National Heart, Lung, and Blood Institute Scale.</div></div><div><h3>Data Extraction</h3><div>Logic model constructs were used to extract support group inputs, outputs, and outcomes, and Expert Recommendations for Implementing Change constructs were used to extract recommendations/strategies.</div></div><div><h3>Data Synthesis</h3><div>All 7 studies discussed inputs including participant age, sex, and race/ethnicity. Most support groups were predominantly White and younger and had more affluent attendees than the general limb loss population. Outputs were discussed in 5 studies, with location, group leadership, and other personnel being the most commonly discussed outputs. All studies discussed positive outcomes such as physical ability and mobility improvement on the Prosthetic Limb Users Survey of Mobility, emotional development with improved Posttraumatic Growth Index scores and depression symptoms, and learning and prosthesis advancement with improved self-efficacy and return to life. Six articles discussed implementation strategies including facilitation of support groups, promotion of adaptability, shadowing of other experts, and tailoring of strategies.</div></div><div><h3>Conclusions</h3><div>These data highlight structure, development strategies, and positive effects of support groups for mobility, emotional well-being, and learning in individuals with limb loss. Furthermore, this study emphasizes the need for continued investigation into support mechanisms and formal incorporation of support groups into limb loss rehabilitation programs.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100485"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011279","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":"The Use of Physiotherapy Navigators in Acute Cancer Care Settings: A Scoping Review","authors":"Holly Edward PT, MSc ,&nbsp;Nelani Paramanantharajah BSc ,&nbsp;Neeraja Nannapaneni BSc ,&nbsp;Jenette Wu BSc ,&nbsp;Sarah Wojkowski PT, PhD ,&nbsp;Luciana Macedo PT, PhD ,&nbsp;Som D. Mukherjee MD, MSc, FRCP(C) ,&nbsp;Jenna Smith-Turchyn PT, PhD","doi":"10.1016/j.arrct.2025.100489","DOIUrl":"10.1016/j.arrct.2025.100489","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this review was to explore and map the use of physiotherapist (PT) navigator roles, their settings, decision-making processes, interventions delivered, barriers, and facilitators in acute cancer care settings.</div></div><div><h3>Data Sources</h3><div>Five databases and gray literature sources were searched to July 4, 2024.</div></div><div><h3>Study Selection</h3><div>To be included in this review, studies must have included adults ≥18 years old living with cancer, used a navigation role or model of care led by a physiotherapist, and occurred in an acute cancer care setting (ie, a setting administering cancer treatments to individuals with a current diagnosis of cancer).</div></div><div><h3>Data Extraction</h3><div>Two independent reviewers completed all screening and data extraction.</div></div><div><h3>Data Synthesis</h3><div>Data were summarized narratively, and descriptive statistics were provided where applicable. Thirteen references were included; 6 perspective papers, 5 research articles, and 2 presentations. The characteristics of PT navigator roles varied but mainly included triaging through assessment (n=13; 100%), exercise planning and prescription (n=9; 69.2%), referral to appropriate services (n=7; 53.8%), barrier identification (n=5; 38.5%), providing education (n=4; 30.8%), and goal setting (n=2; 15.4%). Most PT navigators (n=10; 76.9%) interacted with patients within the first month of treatment and followed up at various timepoints (eg, weekly, monthly, as needed). A range of facilitators (eg, onsite services, support from the medical team, no patient cost to interact with the PT navigator) and barriers (eg, lack of health system funding, lack of medical team knowledge of rehabilitation, and additional patient costs) to the PT navigator role were identified.</div></div><div><h3>Conclusions</h3><div>This review summarized and mapped the current evidence regarding PT navigation in acute cancer care settings. Future research and clinical programs to enhance the design and implementation of such roles are recommended.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100489"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011258","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":"Associations of Sarcopenia With Medical Events and Inpatient Rehabilitation Outcomes in ACC/AHA Stage A, B, and C Heart Failure Individuals With Disabilities","authors":"Hideki Arai MD, PhD ,&nbsp;Masafumi Nozoe PT, PhD ,&nbsp;Kuniyasu Kamiya PT, PhD ,&nbsp;Tatsuyuki Fukuoka SLP, PhD ,&nbsp;Satoru Matsumoto MD","doi":"10.1016/j.arrct.2025.100483","DOIUrl":"10.1016/j.arrct.2025.100483","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the associations of sarcopenia with medical events and inpatient rehabilitation outcomes in American College of Cardiology (ACC)/American Heart Association (AHA) stage A, B, and C patients with heart failure (HF) and disabilities.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Inpatient rehabilitation ward.</div></div><div><h3>Participants</h3><div>ACC/AHA stage A, B, and C patients with HF (N=293) with or without sarcopenia who had disabilities because of neurologic disorders, musculoskeletal disorders, or hospital-associated deconditioning.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were medical events such as death and illness requiring interhospital transport for specialized medical care. The secondary outcomes were inpatient rehabilitation outcomes, including improvement efficiency of the FIM (gain in FIM score divided by length of stay) for motor function (FIM-M) and cognitive function (FIM-C).</div></div><div><h3>Results</h3><div>The adjusted hazard ratio indicating risk for medical events in the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group was 2.93 (95% CI, 1.12-7.67). The β coefficients of the ACC/AHA stage A, B, and C HF with sarcopenia group relative to those without sarcopenia group for the improvement efficiencies of FIM-M and FIM-C were 0.11 (lower confidence limit: −0.33, upper confidence limit: 0.56) and −0.28 (lower confidence limit: −1.51, upper confidence limit: 0.997), respectively.</div></div><div><h3>Conclusions</h3><div>This study showed that sarcopenia was significantly associated with medical events but not with inpatient rehabilitation outcomes in ACC/AHA stage A, B, and C HF patients with disabilities.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100483"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145009897","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":"Pilot Study to Assess the Ability of a 4-Week, Home-Based, Electrical Muscle Stimulation Program to Improve Lower Extremity Function and Reduce Sarcopenia in Older Individuals With Cancer","authors":"Hisashi Kosaka MD, PhD ,&nbsp;Tome Ikezoe MD, PhD ,&nbsp;Kimitaka Hase MD, PhD ,&nbsp;Yutaka Kimura MD, PhD ,&nbsp;Takumi Miyauchi ,&nbsp;Tung Thanh Lai MD ,&nbsp;Khanh Van Nguyen MD ,&nbsp;Kyoko Inoue ,&nbsp;Moriyasu Takada ,&nbsp;Hideyuki Matsushima MD, PhD ,&nbsp;Gozo Kiguchi MD, PhD ,&nbsp;Hidekazu Yamamoto MD, PhD ,&nbsp;Kosuke Matsui MD, PhD ,&nbsp;Megumi Taketani ,&nbsp;Tomoyuki Shirai ,&nbsp;Masaki Kaibori MD, PhD","doi":"10.1016/j.arrct.2025.100479","DOIUrl":"10.1016/j.arrct.2025.100479","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effectiveness of home-based self-rehabilitation using a portable electrical muscle stimulation (EMS) device for improving severe sarcopenia by improving lower extremity function.</div></div><div><h3>Design</h3><div>The effect of 4 weeks of EMS training on improving lower extremity function was compared between patients divided into 2 groups based on baseline lower extremity function. Self-rehabilitation was carried out with a portable EMS device, the SIXPAD Foot Fit, and each session lasted 15-23 minutes. Lower extremity function was assessed with the Short Physical Performance Battery (SPPB).</div></div><div><h3>Setting</h3><div>University hospital.</div></div><div><h3>Participants</h3><div>The study included 50 older outpatients (N=50) with a mean age of 75 years; 98% had hepatobiliary cancer, and 38% were men.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Patients were divided into 2 groups based on baseline SPPB value (SPPB ≤ 9 or SPPB &gt;9). Lower extremity function was observed prospectively during 4 weeks of home-based self-rehabilitation.</div></div><div><h3>Results</h3><div>EMS was used consistently, with a median duration of use of 28 days. In the baseline SPPB&gt;9 group, lower extremity function was not significantly improved (SPPB, 11.0-12.0; <em>P</em>=.290). In contrast, significant improvement was observed in the baseline SPPB ≤ 9 group, and the total score (SPPB score, 8.0-9.0; <em>P</em>=.001) and 2 of its 3 components, balance (balance score, 3.0-4.0; <em>P</em>=.009) and gait speed (gait speed score, 3.0-4.0; <em>P</em>=.002), improved significantly. Sit-to-stand ability did not improve (Sit-to-stand score, 1.0-2.0; <em>P</em>=.060). As a result, the proportion of patients with severe sarcopenia was initially 66.7% but decreased significantly to 36.4% (<em>P</em>=.002).</div></div><div><h3>Conclusions</h3><div>A home-based, self-rehabilitation program using a portable EMS device may improve lower extremity function and attenuate sarcopenic status in older patients with cancer with reduced lower extremity function.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100479"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011245","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":"Rates of Employment and Return to Work After Spinal Cord Lesion Onset in Israel","authors":"Dianne Michaeli MD ,&nbsp;Vadim Bluvshtein MD ,&nbsp;Haitham Gazawi MD ,&nbsp;Lilach Front MSc ,&nbsp;Amiram Catz MD, PhD ,&nbsp;Ilana Gelernter MSc ,&nbsp;Elena Aidinoff MD","doi":"10.1016/j.arrct.2025.100490","DOIUrl":"10.1016/j.arrct.2025.100490","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the employment rates, rates of return to work (RTW) in Israel, and factors affecting these rates after the onset of traumatic and nontraumatic spinal cord lesions (SCLs).</div></div><div><h3>Design</h3><div>Longitudinal retrospective cohort study, collecting demographic, clinical, and employment data from hospital records and by phone interviews.</div></div><div><h3>Setting</h3><div>A rehabilitation medical center.</div></div><div><h3>Participants</h3><div>Inpatients with SCLs (N=487) and no comorbidities, aged 43±14 years at SCL onset, 72% men, 45% traumatic, admitted to rehabilitation between 2010 and 2022.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Rates of employment and RTW, and factors affecting them.</div></div><div><h3>Results</h3><div>Patients’ American Spinal Injury Association Impairment Scale grades at discharge from rehabilitation were A, B, C, D, and E (normal according to the International Standards for Neurological Classification of Spinal Cord Injury(in 16.2%, 2.9%, 16.6%, 64.1%, and 0.2% of cases, respectively. The mean discharge Spinal Cord Independence Measure III score was 68±19). Before SCL onset, 79% of the patients had been employed. At any time after SCL onset, one-third (33.1%; 95% CI, 28.9%-37.2%) of the sample were employed; 29.7% and 35.8% for traumatic vs nontraumatic SCL. The RTW rate for those previously employed was 36.9% (95% CI, 32.0%-41.9%); 29% and 43.9% for traumatic vs nontraumatic SCL. Employment was independently related to former employment, education, and higher discharge Spinal Cord Independence Measure III scores (<em>P</em>&lt;.01). The level of injury, American Spinal Injury Association Impairment Scale grade, and SCL etiology had no independent association with employment or RTW. Factors perceived as assisting employment after SCL onset (catalysts) were motivation, rehabilitation process, and support of family, friends, or colleagues. Reported reasons for not working (obstacles) were disability, pain, older age, sleep disturbances, mental condition, studying, and inaccessibility.</div></div><div><h3>Conclusions</h3><div>Employment and RTW rates after SCL were low compared to those of people with other disabilities nationwide and to people with SCL in Western countries. The main catalysts were patient motivation and rehabilitation, and the main obstacles were disability and pain. To enhance employment after SCL, rehabilitation and an adequate national policy should be implemented. Rehabilitation should include vocational training and management of complications, pain, and patients’ motivation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"7 3","pages":"Article 100490"},"PeriodicalIF":2.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145011241","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}