Archives of rehabilitation research and clinical translation最新文献

{"title":"Randomized Trial to Evaluate Effects of Peer- and Clinician-Led Interventions for Caregivers of Individuals With Acquired Brain Injury","authors":"","doi":"10.1016/j.arrct.2024.100351","DOIUrl":"10.1016/j.arrct.2024.100351","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate the effectiveness of 2 interventions for caregivers of patients with acquired brain injury (ABI) transitioning home after inpatient rehabilitation, to prepare them for the role of caregiving and reduce stress and depression.</p></div><div><h3>Design</h3><p>Controlled trial with participants randomly assigned to (1) usual care (UC), (2) clinician-delivered Problem-Solving Training (PST), or (3) peer-led Building Better Caregivers (BBC) training; both experimental interventions initiated during the inpatient rehabilitation stay, delivered virtually, of similar intensity (six 60-minute sessions), and focused on managing stress and building skills related to caregiving.</p></div><div><h3>Setting</h3><p>Nonprofit rehabilitation hospital specializing in care of persons with acquired brain and spinal cord injuries.</p></div><div><h3>Participants</h3><p>Caregivers (n=169) of patients with ABI (54 stroke; 115 other ABI) admitted for rehabilitation whose discharge location was home with care provided by family members (caregivers: 83% women, 62% White, age [mean ± SD]: 51±11.5 y). Participants were recruited from February 2021 to November 2022, when COVID-19 restrictions were in place.</p></div><div><h3>Interventions</h3><p>Noted above.</p></div><div><h3>Main Outcome Measures</h3><p>Caregiver-reported stress, depressive symptoms, and caregiving self-efficacy; patient unplanned hospital readmissions and emergency department visits 30 days post discharge.</p></div><div><h3>Results</h3><p>Only 61% of participants in the 2 intervention groups completed 3 or more of 6 intervention sessions and only 53% completed all data collection surveys. Statistically significant improvements between UC and PST groups were noted for caregiver stress (<em>p</em>=.039). Positive differences in caregiver self-efficacy found between UC and the BBC intervention groups approached significance at 30 days after discharge (<em>p</em>=.054). Patient unplanned hospital readmissions and days hospitalized were also higher, albeit not statistically significant, for UC participants than both intervention groups.</p></div><div><h3>Conclusions</h3><p>Although positive findings were noted, results were negatively affected by study limitations including low enrollment and limited engagement (intervention completion and follow-up outcomes assessment). These limitations resulted, in part, from restrictions put into place during the COVID-19 pandemic, which limited contact with study participants and required alterations to the BBC intervention likely influencing its effectiveness. Despite limitations noted, the encouraging findings suggest the need for further research.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100351"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000491/pdfft?md5=0f36b77514f9315c393427f79f61f0d7&pid=1-s2.0-S2590109524000491-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141412556","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":"Virtual Assessment of Functional Mobility in Lower Extremity Prosthesis Clients: An Exploratory Study","authors":"Oluwagbemiga DadeMatthews MD, PhD ,&nbsp;Jaimie A. Roper PhD ,&nbsp;Adan Vazquez MS ,&nbsp;David Shannon PhD ,&nbsp;JoEllen M. Sefton MS, PhD","doi":"10.1016/j.arrct.2024.100355","DOIUrl":"10.1016/j.arrct.2024.100355","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the relationship between patient perception of lower extremity function and a home-based virtual clinician assessment of mobility in lower limb prosthesis clients.</p></div><div><h3>Design</h3><p>Descriptive observational study using a clinician-administered functional mobility survey and timed Up and Go test to assess lower extremity function under supervision.</p></div><div><h3>Setting</h3><p>Health Insurance Portability and Accountability Act-compliant online virtual platform.</p></div><div><h3>Participants</h3><p>Twelve lower limb loss clients currently using prostheses, aged ≥19 years, not pregnant, and with no stroke, seizure disorder, or cancer.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Main outcomes were mobility survey scores and mean timed Up and Go duration.</p></div><div><h3>Results</h3><p>Most participants reported significant ease of completing basic indoor ambulation and toileting tasks (66%-75%) and significant difficulty in running or prolonged ambulation activities (83%) requiring use of lower limb prosthesis. Timed Up and Go test was faster (11.0±2.9 s) than the reference range for transtibial prosthesis users and negatively associated with self-reported lower extremity functional status (<em>r</em>=−.70, <em>P</em>=.02).</p></div><div><h3>Conclusions</h3><p>Self-reported movement with lower limb prostheses at home and evaluation of mobility via a virtual platform is a feasible assessment modality that may reduce the frequency of therapy visits, defray some rehabilitation costs, and minimize the travel burden to distant prosthetic clinics.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100355"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000533/pdfft?md5=8999de8e7f0138c6685f4a4a0acbc4cf&pid=1-s2.0-S2590109524000533-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240569","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":"Effects of Virtual Reality on Biomechanical Parameters of Gait in Older Adults: A Systematic Review","authors":"Rafael Reimann Baptista PhD ,&nbsp;Alejandra A. Huaco Aranguri MD ,&nbsp;Gustavo A. Sanchez Zevallos MD ,&nbsp;Cynthia B. Juarez Huanca MD ,&nbsp;Massiel Huanca Machon MD","doi":"10.1016/j.arrct.2024.100354","DOIUrl":"10.1016/j.arrct.2024.100354","url":null,"abstract":"<div><h3>Objectives</h3><p>To conduct a systematic review of the literature on the effect of virtual reality (VR) on biomechanical gait parameters (BGPs) in older adults. Specifically, the spatial-temporal parameters of gait, gait velocity, kinematics, and ground reaction forces, and examine how they are affected by VR interventions. To evaluate the effectiveness and validity of VR gait training and subsequently its potential integration into rehabilitation therapies. This review is a valuable contribution to the current literature as it does not limit its focus to a particular disease. By examining a wide range of studies, we sought to provide a comprehensive analysis of the effects of VR on the BGP in older adults. Our findings can inform future research on VR gait training and its potential role in rehabilitation for older adults.</p></div><div><h3>Data Sources</h3><p>Two authors independently conducted an electronic search from August 18, 2021, to December 17, 2021, using the PubMed, Scopus, and Web of Science databases, including articles published between January 1997 and July 2021.</p></div><div><h3>Study Selection</h3><p>The search yielded 1226 articles, and after exclusion, 16 articles were included in the analysis.</p></div><div><h3>Data Extraction</h3><p>The Joanna Briggs Institute appraisal tool for randomized controlled trials and experimental studies, and the Cochrane risk of bias tool, version 2, were used to assess the level of evidence and bias in the studies.</p></div><div><h3>Data Synthesis</h3><p>In our synthesis, we included data from 9 studies with a total of 217 subjects. The range of follow-up periods across these studies was 2-10 weeks, and 40% of the studies conducted the study in community-dwelling individuals. Of the randomized controlled trials, 9 had a low-risk level, whereas 1 study had moderate risk. All studies with control groups and low bias levels demonstrated a positive effect of VR intervention on the BGP in older adults.</p></div><div><h3>Conclusions</h3><p>Consistent evidence suggests that VR intervention has positive effects on gait performance in older adults.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100354"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000521/pdfft?md5=d8b61131da397bcbbfdd69b41e478be9&pid=1-s2.0-S2590109524000521-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240592","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 Effectiveness of Conservative Interventions on Pain, Function, and Quality of Life in Adults with Hypermobile Ehlers-Danlos Syndrome/Hypermobility Spectrum Disorders and Shoulder Symptoms: A Systematic Review","authors":"Anna Higo BSc ,&nbsp;Shea Palmer PhD ,&nbsp;Behnam Liaghat PhD ,&nbsp;Jason Tallis PhD ,&nbsp;Lucy Silvester MSc ,&nbsp;Gemma Pearce PhD","doi":"10.1016/j.arrct.2024.100360","DOIUrl":"10.1016/j.arrct.2024.100360","url":null,"abstract":"<div><h3>Objective</h3><p>To synthesize the evidence on conservative interventions for shoulder symptoms in hypermobile Ehlers-Danlos Syndrome (hEDS) and hypermobility spectrum disorder (HSD).</p></div><div><h3>Data Sources</h3><p>A literature search was conducted using data sources Medline, PEDro, CINAHL, AMED, Elsevier Scopus, and the Cochrane Library from January 1998 to June 2023.</p></div><div><h3>Study Selection</h3><p>The review included primary empirical research on adults diagnosed with hEDS or HSD who experienced pain and/or mechanical shoulder symptoms and underwent conservative interventions. Initially, 17,565 studies were identified, which decreased to 9668 after duplicate removal. After title and abstract screening by 2 independent authors, 9630 studies were excluded. The full texts of the remaining 38 were assessed and 34 were excluded, leaving 4 articles for examination.</p></div><div><h3>Data Extraction</h3><p>Two authors independently extracted data using a predefined extraction table. Quality assessment used the Joanna Briggs Institute checklists and the Template for Intervention Description and Replication.</p></div><div><h3>Data Synthesis</h3><p>The review covered 4 studies with a total of 7 conservative interventions, including exercise programs, kinesiology taping, and elasticized compression orthoses. Standardized mean differences were calculated to determine intervention effects over time. The duration of interventions ranged from 48 hours to 24 weeks, showing positive effect sizes over time in the Western Ontario Shoulder Instability Index, pain levels, improved function in activities of daily living, and isometric and isokinetic strength. Small to negligible effect sizes were found for kinesiophobia during completion of exercise programs.</p></div><div><h3>Conclusions</h3><p>Shoulder symptoms in hEDS/HSD are common, yet significant gaps in knowledge remain regarding conservative interventions, preventing optimal evidence-based application for clinicians. Further research is necessary to explore the most effective intervention types, frequencies, dosages, and delivery methods tailored to the specific requirements of this patient population.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100360"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000582/pdfft?md5=91b3a14b38d416b7bb2340113abda858&pid=1-s2.0-S2590109524000582-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240593","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":"Creation of a Limb Loss and Preservation Registry for Improving the Quality of Patient Care in the United States","authors":"Kenton R. Kaufman PhD, PE ,&nbsp;Kathie Bernhardt MBA ,&nbsp;Shawn Murphy BS, PMP ,&nbsp;Marah Archer MBA, CAPM ,&nbsp;Jeffrey M. Brandt CPO ,&nbsp;Leon Bowman XX ,&nbsp;Bart Phillips MS ,&nbsp;Registry External Advisory Board","doi":"10.1016/j.arrct.2024.100356","DOIUrl":"10.1016/j.arrct.2024.100356","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the development of a national Limb Loss and Preservation Registry (LLPR) designed to collect, standardize, and report patient outcomes data on limb loss and limb difference in the United States.</p></div><div><h3>Design</h3><p>Clinical Data Registry</p></div><div><h3>Setting</h3><p>The LLPR was developed through consensus of key stakeholders from academia, industry, patient advocacy, and payers as well as the available scientific evidence. Data are collected from multiple sources, including hospitals, providers, and patients.</p></div><div><h3>Participants</h3><p>Data are collected from all 50 states.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>More than 1100 trigger codes are used to identify patients who have limb difference or have received a limb preservation or amputation procedure. Once a patient is identified, all subsequent episodes of care are collected for the life of the patient. An integrated model is used for collecting, validating, cleaning, transforming, aggregating, and storing the data received from all sources. The information contained is then provided in a thorough and easily comprehensible manner.</p></div><div><h3>Results</h3><p>To date, the LLPR has captured data from &gt;435,000 patients and &gt;11.5 million episodes of care.</p></div><div><h3>Conclusions</h3><p>The LLPR creates opportunities to apply large-data analytical methodologies to provides caregivers, researchers, manufacturers, payers, and policy makers the tools needed to improve the quality of clinical care, quantify patient-centric outcomes, develop clinical practice guidelines, assess patient quality of life, identify appropriate technology, and guide creation of national policies to allocate scarce sources appropriately.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100356"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000545/pdfft?md5=95e8bf3c917c0dcfcd1248194a59a50b&pid=1-s2.0-S2590109524000545-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696504","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":"Comparison of Diagnosis-Related Group Rehabilitation Reimbursement Payments With Those of a Novel Patient Classification-Based Payment System","authors":"Ruixue Ye PhD ,&nbsp;Xiaolong Zhu MD ,&nbsp;Mingchao Zhou PhD ,&nbsp;Jianjun Long MD ,&nbsp;Yan Gao PhD ,&nbsp;Jianglin Zhou MD ,&nbsp;Yongjun Jiang MD ,&nbsp;Zejun Wang MD ,&nbsp;Yulong Wang MD","doi":"10.1016/j.arrct.2024.100357","DOIUrl":"10.1016/j.arrct.2024.100357","url":null,"abstract":"<div><h3>Objective</h3><p>To compare the difference of reimbursement payments between diagnosis-related group (DRG) and a novel patient classification-based payment system, diagnosis-intervention packet (DIP), among rehabilitation inpatients in tertiary hospitals.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting</h3><p>TTertiary hospitals in Shenzhen, China.</p></div><div><h3>Participants</h3><p>We assessed the records of 268,362 individuals who visited tertiary hospitals providing rehabilitation services.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>The outcome variable was the patients’ rehabilitation hospitalization cost of in our study. A quantile regression analysis was conducted to estimate the effects of DIP payment on the rehabilitation hospitalization cost.</p></div><div><h3>Results</h3><p>The results showed that the predicted marginal hospitalization cost with DRG payment were 9%, 7%, 14%, and 10% higher than that with DIP payments in 2019, 2020, 2021, and 2022. The total difference in predicted marginal hospitalization cost between DRG and DIP was −1269 RMB (−193 USD). This difference in 2019, 2020, 2021, and 2022 was −1419 RMB (−228 USD), −1088 RMB (−158 USD), −1585 RMB (−246 USD), and −1034 RMB (−154 USD), respectively. All differences in predicted marginal hospitalization cost between DRG and DIP was significant (<em>P</em>&lt;.001), after controlling for patients’ age, sex, public or private hospital, the type of disease, and the length of stay of hospitalization.</p></div><div><h3>Conclusions</h3><p>The findings of DIP payment reduced the rehabilitation hospitalization cost would be helpful in developing more effectively and efficiently tailored interventions for rehabilitation health care in China. Furthermore, the results of this study could provide advice on building more effective strategies and intervention options for other countries that struggle with controlling rehabilitation hospitalization costs.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100357"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000557/pdfft?md5=d9b23f1bae5a57f88cebd57410905012&pid=1-s2.0-S2590109524000557-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141710512","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":"Classification Into Different Patient Groups—A Step Toward Tailoring Care After Major Oncological Surgery?","authors":"Petra Bor PhD ,&nbsp;Karin Valkenet PhD ,&nbsp;Sjaak Bloem PhD ,&nbsp;Richard van Hillegersberg PhD ,&nbsp;Cindy Veenhof PhD","doi":"10.1016/j.arrct.2024.100350","DOIUrl":"10.1016/j.arrct.2024.100350","url":null,"abstract":"<div><h3>Objective</h3><p>To evaluate how the distribution of patients in groups (based on subjective health experience) changes over time and to investigate differences in physical functioning and mental health between these patient groups.</p></div><div><h3>Design</h3><p>An observational cohort study.</p></div><div><h3>Setting</h3><p>University medical center.</p></div><div><h3>Participants</h3><p>Patients who underwent gastrointestinal or bladder oncological surgery (N=98).</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>The classification of patients into different groups based on the subjective health experience model (acceptance and perceived control), preoperatively and 1 and 3 months after discharge.</p></div><div><h3>Results</h3><p>In total, 98 patients were included. Preoperatively, 31% of the patients were classified as having low acceptance and perceived control (group 4), and this proportion increased to 47% and 45% 1 and 3 months after discharge, respectively. These patients had significantly lower levels of physical functioning (preoperatively, 55 vs 61; <em>P</em>=.030; 1 month, 47 vs 57; <em>P</em>=.002; 3 months, 52 vs 62; <em>P</em>=.006) and higher levels of anxiety and depression (preoperatively, 14 vs 9; <em>P</em>&lt;.001; 1 month, 11 vs 3; <em>P</em>=.001; 3 months, 10 vs 3; <em>P</em>=.009) than patients with high acceptance and perceived control (group 1).</p></div><div><h3>Conclusions</h3><p>The classification of patients to different groups provides insight in different levels of physical and mental health. However, frequent evaluation is important because of changes in patient groups over time.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 3","pages":"Article 100350"},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000466/pdfft?md5=07f9dd765a97bc867f7e85999d3bad64&pid=1-s2.0-S2590109524000466-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142240693","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":"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}