Archives of rehabilitation research and clinical translation最新文献

{"title":"Applying a Motivational Instructional Design Model to Stroke Rehabilitation: A Feasibility Study on Occupational and Swallowing Therapies","authors":"","doi":"10.1016/j.arrct.2024.100344","DOIUrl":"10.1016/j.arrct.2024.100344","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the feasibility of poststroke interventions using a motivational instructional design model with occupational therapy (OT) and swallowing therapy (ST) and the model's potential physical and mental health effects.</p></div><div><h3>Design</h3><p>An open-label, single-arm, feasibility study on the Attention, Relevance, Confidence, and Satisfaction model.</p></div><div><h3>Setting</h3><p>Two convalescent rehabilitation wards.</p></div><div><h3>Participants</h3><p>Twenty-five patients with stroke (N=25) (19 men; mean age, 62.4±11.9y; 61.9±36.8d from the first stroke) were recruited.</p></div><div><h3>Interventions</h3><p>Twelve participants received a motivational approach based on the Attention, Relevance, Confidence, and Satisfaction model during OT (OT group), and 13 received it during ST (ST group). The intervention lasted 40-60 minutes daily, 5 days weekly, for 4 weeks.</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcomes included the dropout rate, an adverse event, and the participants’ acceptability of the intervention. Paretic arm function was assessed in the OT group; swallowing ability was assessed in the ST group; and activities of daily living, depressive symptoms, and apathy were assessed in both groups.</p></div><div><h3>Results</h3><p>No participants dropped out of the intervention or experienced an adverse event. Twenty-one participants (84%) were satisfied with the intervention, and 19 (76%) hoped to continue receiving it. The OT group showed statistically significant improvements in paretic arm function and activities of daily living (Cohen's <em>r</em>=0.68-0.77), whereas the ST group improved in swallowing ability, activities of daily living, and depressive symptoms (Cohen's <em>r</em>=0.62-0.85).</p></div><div><h3>Conclusions</h3><p>The interventions using the motivational instructional model with OT and ST were feasible and could improve poststroke paretic arm function, swallowing ability, and activities of daily living after stroke.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100344"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259010952400034X/pdfft?md5=f9644f729d605623ce86b7d6f3667b03&pid=1-s2.0-S259010952400034X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141036435","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":"Is There Room for Improvement? Stroke Rehabilitation Environments May Not Reflect Home Environments in Terms of Chair, Toilet, and Bed Heights","authors":"Katharine Scrivener PhD ,&nbsp;Louise Ada PhD ,&nbsp;Michael Pellegrini PhD ,&nbsp;Rebecca Nicks PhD ,&nbsp;Sharon Kramer PhD ,&nbsp;Lauren J. Christie ,&nbsp;Laura J. Jolliffe PhD ,&nbsp;Catherine Dean PhD ,&nbsp;Natasha A. Lannin PhD","doi":"10.1016/j.arrct.2024.100352","DOIUrl":"10.1016/j.arrct.2024.100352","url":null,"abstract":"<div><p>The present study aims to describe the chair, bed, and toilet heights in rehabilitation hospitals and home environments to challenge rehabilitation clinicians to better prepare stroke survivors for discharge home. This study uses analysis of secondary outcomes from a multicentre, phase II randomized controlled trial (HOME Rehab trial) and additional observation of hospital environment. Data were collected from six rehabilitation hospitals and the homes of two hundred first-time stroke survivors who were aged &gt;45 years. Chair, bed and toilet heights were measured; we measured 936 chairs and beds in hospital (17%) and home (83%) environments. Mean chair height at home was 47 cm (SD 6), which was 2 cm (95% CI, 0-4) lower than in the hospital ward and 5 cm (95% CI, 3-7) lower than in the hospital gym. Mean toilet height at home was 42 cm (SD 3), which was 3 cm (95% CI, 2-4) lower than in the hospital. Study findings suggest a disparity in heights between hospitals and home. Although clinicians may be aware of this disparity, they need to ensure that chair and bed heights within the hospital environment are progressively made lower to better prepare stroke survivors for discharge home.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100352"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000508/pdfft?md5=6a68ccc70ca44f8ee826f2a2242084bc&pid=1-s2.0-S2590109524000508-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241223","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 a Home-based Electroencephalogram Neurofeedback Intervention to Reduce Chronic Neuropathic Pain: A Cohort Clinical Trial","authors":"Mohamed Sakel MBBS ,&nbsp;Karen Saunders BSc (Hons) ,&nbsp;Christine Ozolins MSc ,&nbsp;Riya Biswas PhD","doi":"10.1016/j.arrct.2024.100361","DOIUrl":"10.1016/j.arrct.2024.100361","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the feasibility, safety, and potential health benefits of an 8-week home-based neurofeedback intervention.</p></div><div><h3>Design</h3><p>Single-group preliminary study.</p></div><div><h3>Setting</h3><p>Community-based.</p></div><div><h3>Participants</h3><p>Nine community dwelling adults with chronic neuropathic pain, 6 women and 3 men, with an average age of 51.9 years (range, 19-78 years) and with a 7-day average minimum pain score of 4 of 10 on the visual analog pain scale.</p></div><div><h3>Interventions</h3><p>A minimum of 5 neurofeedback sessions per week (40min/session) for 8 consecutive weeks was undertaken with a 12-week follow-up baseline electroencephalography recording period.</p></div><div><h3>Main Outcome Measures</h3><p>Primary feasibility outcomes: accessibility, tolerability, safety (adverse events and resolution), and human and information technology (IT) resources required. Secondary outcomes: pain, sensitization, catastrophization, anxiety, depression, sleep, health-related quality of life, electroencephalographic activity, and simple participant feedback.</p></div><div><h3>Results</h3><p>Of the 23 people screened, 11 were eligible for recruitment. One withdrew and another completed insufficient sessions for analysis, which resulted in 9 datasets analyzed. Three participants withdrew from the follow-up baselines, leaving 6 who completed the entire trial protocol. Thirteen adverse events were recorded and resolved: 1 was treatment-related, 4 were equipment-related, and 8 were administrative-related (eg, courier communication issues). The human and IT resources necessary for trial implementation were identified. There were also significant improvements in pain levels, depression, and anxiety. Six of 9 participants perceived minimal improvement or no change in symptoms after the trial, and 5 of 9 participants were satisfied with the treatment received.</p></div><div><h3>Conclusions</h3><p>It is feasible and safe to conduct a home-based trial of a neurofeedback intervention for people with chronic neuropathic pain, when the human and IT resources are provided and relevant governance processes are followed. Improvements in secondary outcomes merit investigation with a randomized controlled trial.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100361"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000594/pdfft?md5=44956e3d602a64f6bfd42e033f5f89b8&pid=1-s2.0-S2590109524000594-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142241225","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":"Canadian Physicians’ Use of Ultrasound in Spasticity Treatment: A National Cross-Sectional Survey","authors":"Fraser MacRae BSc ,&nbsp;Ève Boissonnault MD ,&nbsp;Alto Lo MD ,&nbsp;Heather Finlayson MD ,&nbsp;Paul Winston MD ,&nbsp;Omar Khan MD ,&nbsp;Heather Dow ,&nbsp;Farris Kassam BSc ,&nbsp;Rajiv Reebye MD","doi":"10.1016/j.arrct.2024.100353","DOIUrl":"10.1016/j.arrct.2024.100353","url":null,"abstract":"<div><h3>Objective</h3><p>To identify potential barriers and obstacles preventing clinicians from adopting ultrasound for spasticity management.</p></div><div><h3>Design</h3><p>A prospective, cross-sectional national survey.</p></div><div><h3>Setting</h3><p>Web-based platform.</p></div><div><h3>Participants</h3><p>Thirty-six physicians and surgeons from across Canada.</p></div><div><h3>Interventions</h3><p>Survey completion.</p></div><div><h3>Main Outcome Measures</h3><p>The use of ultrasound in clinical spasticity practice, perceived barriers, and risks associated with its implementation.</p></div><div><h3>Results</h3><p>In total, 36 Canadian physicians and surgeons responded. A total of 91% reported using the US in their practice. Nearly all of them used ultrasonography (US) to guide injections and reported using more than 1 guidance technique for their injections. Less than half of the survey respondents reported using the US for muscle architecture assessment or longitudinal evaluation of muscle echo intensity. A total of 47% of survey respondents reported that they believe there are disadvantages associated with US use in spasticity practice. Disadvantages included increased time requirements resulting in discomfort for the injector and patient, the risk of infection after the procedure, and the risk of needle-stick injury. The most important barrier identified was the increased time demands of US compared with other guidance techniques. Other barriers included a lack of feedback on identifying a spastic muscle compared with electrical guidance techniques, a lack of additional remuneration to complete injections under ultrasound guidance, and a lack of adequate training.</p></div><div><h3>Conclusions</h3><p>Future educational efforts should address clinicians’ lack of familiarity with US purposes outside of injection guidance. This survey has highlighted the need for a curriculum shift in spasticity education to improve physician's scanning and injection technique, to address concerns about increased time requirements for injecting under ultrasound guidance and to address perceived disadvantages from clinicians.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100353"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259010952400051X/pdfft?md5=92e6d530463b08b02a4447f8f5f09421&pid=1-s2.0-S259010952400051X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240708","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":"Social Determinants of Health and the Use of Community-Based Rehabilitation Following Stroke: Methodologic Considerations","authors":"Elizabeth R. Mormer MS, CCC-SLP ,&nbsp;Sara B. Jones Berkeley PhD, MPH ,&nbsp;Anna M. Johnson PhD, MSPH ,&nbsp;Kristin Ressel MS, ATC ,&nbsp;Shuqi Zhang MS ,&nbsp;Amy M. Pastva PT, PhD, MA ,&nbsp;Cheryl D. Bushnell MD, MHS ,&nbsp;Pamela Duncan PT, PhD ,&nbsp;Janet K. Freburger PT, PhD","doi":"10.1016/j.arrct.2024.100358","DOIUrl":"10.1016/j.arrct.2024.100358","url":null,"abstract":"<div><p>Social determinants are nonmedical factors frequently used to study disparities in health outcomes but have not been widely explored in regard to rehabilitation service utilization. In our National Institutes of Child Health and Human Development-funded study, Access to and Effectiveness of Community-Based Rehabilitation After Stroke, we reviewed several conceptual models and frameworks for the study of social determinants to inform our work. The overall objective of this special communication is to describe our approach to identifying, selecting, and using area-level measures of social determinants to explore the relationship between social determinants and rehabilitation use. We present our methods for developing a conceptual model and a methodologic framework for the selection of social determinant measures relevant to rehabilitation use, as well as an overview of publicly available data on social determinants. We then discuss the methodologic challenges encountered and future directions for this work.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100358"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000569/pdfft?md5=8c3e6aa55e5627f9a4cc1549b6c5ed16&pid=1-s2.0-S2590109524000569-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141846318","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":"Cryoneurolysis for the Treatment of Knee Arthritis to Facilitate Inpatient Rehabilitation: A Case Report","authors":"Fraser MacRae BSc ,&nbsp;Mahdis Hashemi MD ,&nbsp;Ève Boissonnault MD ,&nbsp;Romain David MD, MSc ,&nbsp;Paul Winston MD","doi":"10.1016/j.arrct.2024.100340","DOIUrl":"https://doi.org/10.1016/j.arrct.2024.100340","url":null,"abstract":"<div><p>A 65-year-old woman presenting with a sensory ganglionopathy complicated with COVID-19 is limited in her rehabilitation due to pain from lateral compartment knee osteoarthritis. To increase participation in rehabilitation, cryoneurolysis of the medial and lateral anterior femoral cutaneous nerve and infrapatellar branches of the saphenous nerve was provided to manage pain associated with knee osteoarthritis. The patient reported immediate relief from pain. Physiotherapy noted improvement immediately after the procedure. Follow-ups at 7- and 11-days post-treatment revealed ongoing increases in mobility and reduction in pain. The patient was discharged to live independently shortly after cryoneurolysis. Cryoneurolysis for knee osteoarthritis could be considered as a treatment option to increase participation in rehabilitation for hospital inpatients who are stalled in their rehabilitation due to pain and poor mobility from knee osteoarthritis.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 2","pages":"Article 100340"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000302/pdfft?md5=1cca255e222501b00caf39621a4df601&pid=1-s2.0-S2590109524000302-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141313669","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":"Individuals With Prior Chronic Pain and Long-Term Opioid Treatment May Experience Persistence of That Pain Even After Subsequent Complete Cervical Spinal Cord Injury: Suggestions From a Prospective Case-Controlled Study","authors":"Jeffrey S. Hecht MD ,&nbsp;Kyle L. Johnson Moore PhD ,&nbsp;Roy F. Roberts Jr MD","doi":"10.1016/j.arrct.2024.100338","DOIUrl":"https://doi.org/10.1016/j.arrct.2024.100338","url":null,"abstract":"<div><h3>Objective</h3><p>To determine whether chronic pain persists after complete spinal cord injury (SCI).</p></div><div><h3>Design</h3><p>Prospective observational study regarding the outcome of pre-existent chronic pain of inpatients admitted with new clinically diagnosed complete cervical SCI. For patients who acknowledged chronic pain of ≥3 years duration before the SCI, further questions explored whether they still experienced that pain, whether they were experiencing current posttraumatic pain, and whether they had any past exposure to opioids. The included patients were identified during the initial consultation in the trauma center for treatment of the SCI.</p></div><div><h3>Setting</h3><p>Level I trauma center.</p></div><div><h3>Participants</h3><p>From a total of 49 participants with acute cervical SCI with clinically diagnosed complete motor and sensory tetraplegia admitted between 2018 and 2020, 7 were selected on the basis of a history of chronic pain.</p></div><div><h3>Intervention</h3><p>Collected complete history and performed physical examination with serial follow-ups during the acute hospital stay until death or discharge.</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcome was a finding of chronic pain experienced before new clinical diagnosis of complete SCI, compared with whether or not that pain continued after the SCI injury. The secondary outcome was the relation of persistent pain with opioid use; it was formulated after data collection.</p></div><div><h3>Results</h3><p>Among 49 patients with clinically diagnosed complete cervical SCIs, 7 had experienced prior chronic pain. Four participants experienced a continuation of the prior pain after their complete tetraplegia (4/7), whereas 3 participants did not (3/7). All the participants with continued pain had been previously treated with opioids, whereas those whose pain ceased had not received chronic opioid therapy.</p></div><div><h3>Conclusions</h3><p>There may be a unique form of chronic pain that is based in the brain, irrespective of peripheral pain or spinal mechanisms. Otherwise healthy people with longstanding antecedent chronic pain whose pain persists after acute clinically complete SCI with tetraplegia may provide a new model for evaluation of brain-based pain. Opioids may be requisite for this type of pain.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 2","pages":"Article 100338"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000284/pdfft?md5=455d9948640cdef65ddd63a2243b89d4&pid=1-s2.0-S2590109524000284-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141313139","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":"An International and Multidisciplinary Consensus on the Labeling of Spatial Neglect Using a Modified Delphi Method","authors":"Timothy J. Rich PhD, OTR/L ,&nbsp;Lindy J. Williams BAppSc (OccTh) ,&nbsp;Audrey Bowen PhD ,&nbsp;Gail A. Eskes PhD, R. Psych ,&nbsp;Kimberly Hreha EdD, OTR/L ,&nbsp;Matthew Checketts PhD ,&nbsp;Mauro Mancuso MD ,&nbsp;Helena Fordell MD, PhD ,&nbsp;Peii Chen PhD","doi":"10.1016/j.arrct.2024.100343","DOIUrl":"10.1016/j.arrct.2024.100343","url":null,"abstract":"<div><p>Survivors of neurologic injury (most commonly stroke or traumatic brain injury) frequently experience a disorder in which contralesionally positioned objects or the contralesional features of individual objects are often left unattended or underappreciated. The disorder is known by &gt;200 unique labels in the literature, which potentially causes confusion for patients and their families, complicates literature searches for researchers and clinicians, and promotes a fractionated conceptualization of the disorder. The objective of this Delphi was to determine if consensus (≥75% agreement) could be reached by an international and multidisciplinary panel of researchers and clinicians with expertise on the topic.</p><p>To accomplish this aim, we used a modified Delphi method in which 66 researchers and/or clinicians with expertise on the topic completed at least 1 of 4 iterative rounds of surveys. Per the Delphi method, panelists were provided with results from each round prior to responding to the survey in the subsequent round with the explicit intention of achieving consensus. The panel ultimately reached consensus that the disorder should be consistently labeled <em>spatial neglect</em>. Based on the consensus reached by our expert panel, we recommend that researchers and clinicians use the label <em>spatial neglect</em> when describing the disorder in general and more specific labels pertaining to subtypes of the disorder when appropriate.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 2","pages":"Article 100343"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000338/pdfft?md5=d77bdee49591e9bd86e8635ac2c98072&pid=1-s2.0-S2590109524000338-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033834","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 Preliminary Efficacy of Virtual Rehabilitation for Middle and Older Aged Veterans With Mobility Limitations: A Pilot Study","authors":"Rebekah Harris PT, DPT, PhD ,&nbsp;Elisa F. Ogawa PhD ,&nbsp;Rachel E. Ward MPH, PhD ,&nbsp;Emma Fitzelle-Jones MPH ,&nbsp;Thomas Travison PhD ,&nbsp;Jennifer S. Brach PT, PhD, FAPTA ,&nbsp;Jonathan F. Bean MD, MPH","doi":"10.1016/j.arrct.2024.100325","DOIUrl":"10.1016/j.arrct.2024.100325","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the feasibility and preliminary efficacy of the transition of an outpatient center-based rehabilitation program for middle and older aged Veterans with mobility limitations to a tele-health platform.</p></div><div><h3>Design</h3><p>Non-randomized non-controlled pilot study including 10 treatment sessions over 8 weeks and assessments at baseline, 8, 16, and 24 weeks.</p></div><div><h3>Setting</h3><p>VA Boston Healthcare System ambulatory care between August 2020 and March 2021.</p></div><div><h3>Participants</h3><p>Veterans aged 50 years and older (n=178) were contacted via letter to participate, and 21 enrolled in the study.</p></div><div><h3>Intervention</h3><p>Participants had virtual intervention sessions with a physical therapist who addressed impairments linked to mobility decline and a coaching program promoting exercise adherence.</p></div><div><h3>Main Outcome Measures</h3><p>Ambulatory Measure for Post-Acute Care (AM-PAC), Phone-FITT, and Self-Efficacy for Exercise (SEE) scale.</p></div><div><h3>Results</h3><p>Completers (n=14, mean age 74.9 years, 86% men) averaged 9.8 out of 10 visits. Changes in the Ambulatory Measure for Post-Acute Care (AM-PAC) exceeded clinically meaningful change after 8 and 24 weeks of treatment, at 4.1 units and 4.3 units respectively. Statistically significant improvements from baseline in AM-PAC and Phone-FITT were observed after 8 weeks of treatment and at 24 weeks. No significant changes were observed in exercise self-efficacy.</p></div><div><h3>Conclusions</h3><p>In this group of veterans, telerehab was feasible and demonstrated preliminary efficacy in both mobility and physical activity, thus justifying further investigation in a larger scale clinical trial.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 2","pages":"Article 100325"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000089/pdfft?md5=c86967f9d37a69c58a15744206230534&pid=1-s2.0-S2590109524000089-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139890205","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":"Precision Rehabilitation After Neurostimulation Implantation for Multifidus Dysfunction in Nociceptive Mechanical Chronic Low Back Pain","authors":"Alexios Carayannopoulos DO, MPH ,&nbsp;David Johnson MD ,&nbsp;David Lee MD ,&nbsp;Anthony Giuffrida MD ,&nbsp;Kavita Poply MD, PhD ,&nbsp;Vivek Mehta MD ,&nbsp;Marco Amann MD ,&nbsp;Douglas Santillo PhD ,&nbsp;Yousef Ghandour DPT ,&nbsp;Amy Koch PT ,&nbsp;Meredith Langhorst MD ,&nbsp;Robert Heros MD","doi":"10.1016/j.arrct.2024.100333","DOIUrl":"https://doi.org/10.1016/j.arrct.2024.100333","url":null,"abstract":"<div><p>Chronic low back pain (CLBP) is a debilitating, painful, and costly condition. Implantable neuromuscular electrical stimulation targeting the multifidus musculature is growing as a non-pharmacologic option for patients with recalcitrant nociceptive mechanical CLBP who have failed conservative treatments (including medications and physical therapy) and for whom surgery is not indicated. Properly selecting patients who meet specific criteria (based on historical results from randomized controlled trials), who diligently adhere to implant usage and precisely implement neuromuscular rehabilitation, improve success of significant functional recovery, as well as pain medication reductions. Patients with nociceptive mechanical CLBP who underwent implanted multifidus neurostimulation have been treated by physicians and rehabilitation specialists who have honed their experience working with multifidus neurostimulation. They have collaborated on consensus and evidence-driven guidelines to improve quality outcomes and to assist providers when encountering patients with this device. Physicians and physical therapists together provide precision patient-centric medical management with quality neuromuscular rehabilitation to encourage patients to be experts of both their implants and quality spine motion to help override long-standing multifidus dysfunction related to their CLBP.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 2","pages":"Article 100333"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000235/pdfft?md5=8687d59f1db7bbd6e8312136a9766f95&pid=1-s2.0-S2590109524000235-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141313541","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}