Archives of rehabilitation research and clinical translation最新文献

{"title":"The Effect of Sensory Reweighting on Postural Control and Cortical Activity in Parkinson's Disease: A Pilot Study","authors":"Maryam Sadeghi MS ,&nbsp;Thomas Bristow BS ,&nbsp;Sodiq Fakorede BS ,&nbsp;Ke Liao PhD ,&nbsp;Jacqueline A. Palmer PhD ,&nbsp;Kelly E. Lyons PhD ,&nbsp;Rajesh Pahwa MD ,&nbsp;Chun-Kai Huang PhD ,&nbsp;Abiodun Akinwuntan PhD ,&nbsp;Hannes Devos PhD","doi":"10.1016/j.arrct.2024.100368","DOIUrl":"10.1016/j.arrct.2024.100368","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of sensory reweighting on postural control and cortical activity in individuals with Parkinson's disease (PD) compared to age-matched controls using a virtual reality sensory organization test (VR-SOT).</div></div><div><h3>Design</h3><div>Cross-sectional pilot study.</div></div><div><h3>Setting</h3><div>University research laboratory.</div></div><div><h3>Participants</h3><div>Ten participants with idiopathic Parkinson's disease and 11 age- and sex-matched control participants without neurologic disorders.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Changes in center of pressure (COP) and electroencephalography (EEG) activity (ie, power) in the alpha band and the theta/beta ratio recorded during the VR-SOT were the main outcome variables.</div></div><div><h3>Results</h3><div>PD participants exhibited greater COP displacement, particularly in the mediolateral direction across sensory conditions. They also showed increased alpha power when relying on visual inputs and increased theta/beta ratio power when depending on somatosensory inputs.</div></div><div><h3>Conclusion</h3><div>PD affects sensory reweighting mechanisms involved in postural control, as evidenced by greater COP displacement and altered cortical activity. These findings emphasize the potential of EEG and VR-SOT in understanding and monitoring postural control impairments in PD.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100368"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733815/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016336","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":"Enhancing Sensory Experiences for Infants Born Preterm: A Quality Improvement Project","authors":"Kate N. de Castro Mehrkens OTD, OTR/L, CLC, CIMI ,&nbsp;Elena V. Donoso Brown PhD, OTR/L","doi":"10.1016/j.arrct.2024.100377","DOIUrl":"10.1016/j.arrct.2024.100377","url":null,"abstract":"<div><h3>Objective</h3><div>To enhance neonatal sensory experiences in infants born preterm: a quality improvement project.</div></div><div><h3>Design</h3><div>This was a time-interruption quality improvement project. The time-interruption lasted 4 weeks with an 8-week data collection period before and after. Baseline data were collected on current program use for 8 weeks prior to the time interruption. The neonatal intensive care unit (NICU) occupational therapist provided staff education, training, and modeling of the Supporting and Enhancing NICU Sensory Experiences (SENSE) program during the time interruption. Data were collected for 8 weeks after the time interruption to track improvements.</div></div><div><h3>Participants</h3><div>Twenty infants and their families participated, as well as NICU nurses who provided positive sensory experiences and completed surveys.</div></div><div><h3>Main Outcome Measures</h3><div>Data related to delivery of, education on, and adherence to SENSE were collected before, during, and after the time interruption. Staff surveys were completed pre- and posteducation, training, and modeling to gather perspectives on program usage.</div></div><div><h3>Results</h3><div>On average, parents delivered 43.88 minutes of positive sensory input per day before and increased to 92.7 minutes per day after the time interruption. Positive tactile recommendations were met, on average, 19% of the time before and 47% of the time after the time interruption. After education, training and modeling, nursing staff unanimously supported the program according to surveys.</div></div><div><h3>Conclusions</h3><div>Although a higher percentage of infants received the recommended dosage of positive tactile input after intervention, opportunities still exist to improve and expand implementation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100377"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017282","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":"Exploratory Analysis of Unstable Surface Training: A Systematic Review and Meta-Analysis for Chronic Ankle Instability","authors":"Shuang Liu MS ,&nbsp;Bo Gou PhD ,&nbsp;Zhiguang Zhao PhD ,&nbsp;Qirong Wang PhD","doi":"10.1016/j.arrct.2024.100365","DOIUrl":"10.1016/j.arrct.2024.100365","url":null,"abstract":"<div><h3>Objective</h3><div>To conduct an exploratory systematic review and meta-analysis to evaluate the effect of unstable surface training on balance and hop function in individuals with chronic ankle instability (CAI).</div></div><div><h3>Data Sources</h3><div>Four major electronic databases were searched, including Cochrane Library, PubMed, Embase, and Web of Science, from January 1, 2000 to June 20, 2024.</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials that compare unstable surface training with either general intervention or no intervention in individuals with CAI were included.</div></div><div><h3>Data Extraction</h3><div>The physical therapy evidence database scale was used to assess the risk of bias and methodological quality of included studies. The mean differences (MDs) with 95% confidence intervals (CIs) were calculated using Review Manager 5.4 software.</div></div><div><h3>Data Synthesis</h3><div>The review ultimately included 9 studies involving 308 participants. Compared with the other exercises or no exercise, unstable surface training could improve the significant effects of the star excursion balance test (SEBT) in the direction of posterolateral (MD=5.80; 95% CI, 1.60-9.99; P=.007), posteromedial (MD=6.24; 95% CI, 2.32-10.16; P=.002), medial (MD=9.11; 95% CI, 6.42-11.80; P&lt;.00001), anteromedial (MD=7.25; 95% CI, 2.33-12.17; P=.004), the time-in-balance test (MD=8.45; 95% CI, 1.50-15.40; P=.02), the foot-lift test (MD=-1.39; 95% CI, -2.49 to -0.28; P=.01). However, there was no significant difference in the anterior direction of the SEBT (MD=3.22; 95% CI, -0.66 to 7.10; P=.10), the side-hop test (MD=-1.94; 95% CI, -4.82 to 0.95; P=.19), and the figure-of-8 hop test (MD=-0.97; 95% CI, -2.39 to 0.46; P=.18) between groups.</div></div><div><h3>Conclusions</h3><div>Compared with the other exercises or no exercise, unstable surface training has potential benefits in improving balance in people with CAI but has no significant effect on hop function. However, the exploratory nature of this study highlights the need for further research to confirm these findings.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100365"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734016/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017288","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":"Current Trends in Virtual Exercise Interventions Among People With Disabilities: A Scoping Review","authors":"Madison Mintz BS ,&nbsp;James Rimmer PhD ,&nbsp;Jereme Wilroy PhD ,&nbsp;Robert Oster PhD ,&nbsp;Leigh Bray PhD ,&nbsp;Robin Lanzi PhD ,&nbsp;Byron Lai PhD","doi":"10.1016/j.arrct.2024.100373","DOIUrl":"10.1016/j.arrct.2024.100373","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze existing literature on virtual exercise interventions delivered to people with disabilities to assess effectiveness, efficiency, usability, satisfaction, and feasibility, and describe current trends that aimed to improve health outcomes among people with disabilities.</div></div><div><h3>Data Sources</h3><div>CINAHL, MEDLINE, and PsycINFO were searched.</div></div><div><h3>Study Selection</h3><div>Articles were included if they were (1) incorporated a virtual exercise intervention including people with physical disabilities and mobility limitations aged 18 years and older and (2) published between the years of 2009-August 14, 2024 with free access to full-text, peer-reviewed papers; and (3) published in English. Exclusion criteria: (1) unrelated to disability; (2) non–peer-reviewed articles; (3) protocol or review papers; (4) study focused on virtual exercise through perspective other than that of the participant; (5) study's primary objectives were not related to physical functioning and/or rehabilitation; and (6) study used only qualitative methods.</div></div><div><h3>Data Extraction</h3><div>A single search was conducted from January 2023 and ceased on August 14, 2023. Duplicate records were pulled from the article search within each database; article abstracts were assessed; and finally, full-text articles were retained upon meeting inclusion criteria. The primary researcher conducted the initial search, while 2 independent reviewers, J.R. and J.W., assisted with and confirmed article extraction.</div></div><div><h3>Data Synthesis</h3><div>Thirty-seven articles were included. Trends were explained by recapitulating statistically significant results per study among each disability group and virtual exercise delivery mode, exercise type, and intervention synchronicity.</div></div><div><h3>Conclusions</h3><div>More facilitators, satisfaction, usability, and perceived benefits were reported when compared to reported barriers among people with physical disabilities and mobility limitations who participated in virtual exercise interventions.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100373"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017279","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":"Robotic Rigor: Validity of the Kinarm End-Point Robot Visually Guided Reaching Test in Multiple Sclerosis","authors":"Nick W. Bray PhD ,&nbsp;Syed Z. Raza MSc ,&nbsp;Joselyn Romero Avila BME(c) ,&nbsp;Caitlin J Newell BSc, BA ,&nbsp;Michelle Ploughman PhD","doi":"10.1016/j.arrct.2024.100382","DOIUrl":"10.1016/j.arrct.2024.100382","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether robotic metrics: (1) correlate with the Nine-Hole Peg Test (9HPT; good convergent validity); and (2) differentiate between those self-reporting “some hand problems” versus “no hand problems” (good criterion validity).</div></div><div><h3>Design</h3><div>Cross-sectional validation analyses.</div></div><div><h3>Setting</h3><div>Rehabilitation research laboratory located within a hospital.</div></div><div><h3>Participants</h3><div>People with multiple sclerosis self-reporting “some” (n=21; mean age, 52.52±10.69 y; females, n=16; disease duration, 18.81±10.38 y) versus “no” (n=21; age, 51.24±12.73 y; females, n=14; disease duration, 17.71±10.16 y) hand problems.</div></div><div><h3>Main Outcome Measures</h3><div>We assessed hand function using the criterion standard 9HPT and robotic testing. Robotic outcomes included an overall task score, as well as 2 movement planning (ie, reaction time and initial direction angle) and 2 movement correction (ie, movement time and path length ratio) spatiotemporal values. We identified participants reporting “some” versus “no” hand problems via the Multiple Sclerosis Impact Scale-29. We analyzed our nonparametric data using a Mann–Whitney <em>U</em> test and Spearman rank-order correlation.</div></div><div><h3>Results</h3><div>Those reporting “some hand problems” included more right-handed individuals (<em>P</em>=.038); otherwise, the 2 groups were characteristically similar. Visually guided reaching task score and movement planning but not movement correction spatiotemporal values demonstrated moderate correlations with 9HPT for both the dominant (reaction time: <em>r</em>=0.489, <em>P</em>=.001; initial direction angle: <em>r</em>=0.429, <em>P</em>=.005) and nondominant (reaction time: <em>r</em>=0.521, <em>P</em>&lt;.001; initial direction angle: <em>r</em>=0.321, <em>P</em>=.038) side. Further, reaction time, but not 9HPT or any other robotic outcome, differentiated between the 2 groups (<em>P</em>=.036); those reporting “no hand problems” moved faster (ie, dominant side: 0.2810 [0.2605-0.3215] vs 0.3400 [0.2735-0.3725] s).</div></div><div><h3>Conclusions</h3><div>Robotic test metrics demonstrated modest criterion and convergent validity in multiple sclerosis, with reaction time being the most compelling. When looking beyond the task score, spatiotemporal robotic measures may help discern subtle multiple sclerosis-related hand problems. Movement planning spatiotemporal values appear more meaningful than movement correction and could prove fruitful as the target for future intervention strategies.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100382"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143016334","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":"Nonresponse Bias on Inpatient Rehabilitation Hospitals’ Experience of Care Quality Measure Scores","authors":"Allen Walter Heinemann PhD ,&nbsp;Anne Deutsch RN, PhD, CRRN ,&nbsp;Dave Brewington PhD ,&nbsp;Linda Foster PT ,&nbsp;Karon Frances Cook PhD ,&nbsp;Ana Miskovic BA ,&nbsp;David Cella PhD","doi":"10.1016/j.arrct.2024.100363","DOIUrl":"10.1016/j.arrct.2024.100363","url":null,"abstract":"<div><h3>Objective</h3><div>To describe the magnitude of nonresponse bias on inpatient rehabilitation facility (IRF) experience of care survey data in patients with neurologic disorders.</div></div><div><h3>Design</h3><div>Cohort study of patients at 2 IRFs. Patients reported experience of care via an IRF-administered survey as part of routine operations approximately 2 weeks after discharge. A partially overlapping sample of research participants completed a similar survey approximately 2 weeks and 30 days after discharge.</div></div><div><h3>Setting</h3><div>Two inpatient rehabilitation facilities.</div></div><div><h3>Participants</h3><div>Patients aged ≥18 years with neurologic disorders who were discharged from 2 IRFs.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>Experience of care data collected via an IRF Survey (self-report or proxy responses) and a Research Survey (self-report only).</div></div><div><h3>Results</h3><div>Of the 1055 patients admitted during the study period who met the age and diagnosis criteria, 490 (46.4%) completed one or both of the surveys. Of the 325 IRF Survey respondents, 202 were self-report, 99 were proxy respondents, and 24 were unknown respondents. Only patients completed the Research Survey (N=285). One hundred twenty patients completed both surveys, of which 7 were proxy IRF Survey respondents. IRF Survey respondents had higher cognitive function than nonrespondents; patients with spinal cord injuries were more likely to complete the IRF Survey than other patients. There were no differences in the proportions of patients answering favorably on the IRF Survey (all respondents) compared with the Research Survey, except for physician communication and discharge information. Mutual information analysis revealed agreement between the scores produced by the 2 data sources.</div></div><div><h3>Conclusions</h3><div>There were subtle, potentially important differences in quality measure results across surveys, reflecting the extent to which patients are encouraged to complete experience of care surveys. There was higher agreement on questions about global hospital perceptions than specific aspects of patients’ experience.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100363"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017248","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":"Association of Rate of Functional Recovery With Therapy Time and Content Among Adults With Acquired Brain Injuries in Inpatient Rehabilitation","authors":"Alison M. Cogan PhD, OTR/L ,&nbsp;Pamela Roberts PhD, OTR/L, SCFES, FAOTA, CPHQ, FNAP, FACRM ,&nbsp;Trudy Mallinson PhD, OTR/L, FAOTA, FACRM","doi":"10.1016/j.arrct.2024.100370","DOIUrl":"10.1016/j.arrct.2024.100370","url":null,"abstract":"<div><h3>Objective</h3><div>To examine associations among the time and content of rehabilitation treatment with self-care and mobility functional gain rate for adults with acquired brain injury.</div></div><div><h3>Design</h3><div>Retrospective cohort study using electronic health record and administrative billing data.</div></div><div><h3>Setting</h3><div>Inpatient rehabilitation unit at a large, academic medical center.</div></div><div><h3>Participants</h3><div>Adults with primary diagnosis of stroke, traumatic brain injury, or nontraumatic brain injury admitted to the inpatient rehabilitation unit between 2012 and 2017 (N=799).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Gain rate in self-care and mobility function, using the Functional Independence Measure. Hierarchical regression models were used to identify the contributions of baseline characteristics, units, and content of occupational therapy, physical therapy, and speech-language pathology treatment to functional gain rates.</div></div><div><h3>Results</h3><div>Median length of rehabilitation stay was 10 days (interquartile range, 8-13d). Patients received an mean of 10.62 units of therapy (SD, 2.05) daily. For self-care care gain rate, the best-fitting model accounted for 32% of the variance. Occupational therapy activities of daily living units were positively associated with gain rate. For mobility gain rate, the best-fitting model accounted for 37% of the variance. Higher amounts of physical therapy bed mobility training were inversely associated with mobility gain rate.</div></div><div><h3>Conclusions</h3><div>More activities of daily living in occupational therapy is associated with faster improvement on self-care function for adults with acquired brain injury, whereas more bed mobility in physical therapy was associated with slower improvement. A potential challenge with value-based payments is the alignment between clinically appropriate therapy activities and the metrics by which patient improvement are evaluated. There is a risk that therapists and facilities will prioritize activities that drive improvement on metrics and deemphasize other patient-centered goals.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100370"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017270","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":"Cognitive Training Using Virtual Reality: An Assessment of Usability and Adverse Effects","authors":"Myeonghwan Bang MD ,&nbsp;Min A. Kim BS ,&nbsp;Sung Shin Kim BS ,&nbsp;Hyoung Seop Kim MD, PhD","doi":"10.1016/j.arrct.2024.100378","DOIUrl":"10.1016/j.arrct.2024.100378","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the usability and adverse effects associated with virtual reality (VR) cognitive training and identify factors influencing them.</div></div><div><h3>Design</h3><div>Survey-based observational study.</div></div><div><h3>Setting</h3><div>Department of Rehabilitation Medicine in the hospital.</div></div><div><h3>Participants</h3><div>Twenty rehabilitation professionals (mean [standard deviation] age; 30.0[4.8] years, men 8[40%], and women 12[60%]) and 10 patients with stroke (mean [SD] age; 64.1[13.6] years, men 2[20%] and women 8[80%]).</div></div><div><h3>Interventions</h3><div>The participants wore a head-mounted display (Meta Quest2) and consecutively underwent 5 custom-designed cognitive training.</div></div><div><h3>Main Outcome Measures</h3><div>After the training, participants completed 3 questionnaires: the systemic usability scale, user experience questionnaire (UEQ), and cybersickness in VR questionnaire.</div></div><div><h3>Results</h3><div>The mean systemic usability scale score was 55.1 and 52.3 for rehabilitation professionals and patients, respectively. For the UEQ, the mean score for each item, including attractiveness, perspicuity, efficiency, dependability, stimulation, and novelty, were 0.9/0.2, 0.6/0.2, 0.5/−0.5, 1.2/0.8, 0.9/0.4, and 0.6/0.8 for rehabilitation professionals/patients, respectively. Rehabilitation professionals had slightly higher scores in most UEQ items. The mean cybersickness in VR questionnaire scores were 18.6 and 19.0 for rehabilitation professionals and patients, respectively.</div></div><div><h3>Conclusions</h3><div>Participants reported moderate usability and a generally below-average user experience, with mild-to-moderate VR sickness during VR cognitive training. The rehabilitation professionals rated usability higher than the patient group, while patients experienced more severe VR sickness. These findings may serve as a significant insight for developing VR cognitive training for application to patients in the future.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100378"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734004/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017273","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":"Craniectomy and Cranioplasty Effects on Balance and Gait in Rehabilitation: A Retrospective Study","authors":"Leandra A. Stuckey PT, DPT ,&nbsp;Elizabeth E. Holland PT, DPT ,&nbsp;Miranda G. Gurra MS ,&nbsp;David Aaby MS ,&nbsp;Jennifer H. Kahn PT, DPT","doi":"10.1016/j.arrct.2024.100375","DOIUrl":"10.1016/j.arrct.2024.100375","url":null,"abstract":"<div><h3>Objective</h3><div>To analyze changes in balance and gait in patients undergoing rehabilitation postcraniectomy and postcranioplasty, including comparison of outcomes across time periods, rate of change, and among diagnoses.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Inpatient rehabilitation.</div></div><div><h3>Participants</h3><div>Fifty-three patients (mean age 52.3±16.9y; 62% male) with stroke, traumatic, or nontraumatic brain injury postcraniectomy or postcranioplasty.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Berg Balance Scale (BBS), Functional Gait Assessment (FGA), 6-minute walk test (6MWT), and 10-meter walk test (10MWT) were collected at baseline, first discharge, readmission, and final discharge.</div></div><div><h3>Results</h3><div>Across the full rehabilitation course, all 4 outcomes improved: BBS, 17.9 points (95% confidence interval [CI], 12.7-23.2); FGA, 7.8 points (95% CI, 0.6-15.0); 6MWT, 141.0 m (95% CI, 89.0-192.0); and 10MWT, 0.381 m/s (95% CI, 0.188-0.575). All outcomes improved at postcraniectomy admission: BBS, 13.0 points (95% CI, 8.4-17.5); FGA, 4.0 points (95% CI. −1.65 to 9.65); 6MWT, 100.0 m (95% CI, 58.2-142.0); and 10MWT, 0.160 m/s (95% CI, 0.004-0.316). During leave of absence from rehabilitation, BBS decreased 6.3 points (95% CI, −11.8 to −0.8); FGA decreased 6.6 points (95% CI, −13.8 to 0.6); 6MWT decreased 19.2 m (95% CI, −73.5 to 35.2); and 10MWT increased 0.089 m/s (95% CI, −0.097 to 0.276). All outcomes improved at postcranioplasty admission: BBS, 11.3 points (95% CI, 6.6-16.0); FGA, 10.4 points (95% CI, 4.8-16.1); 6MWT, 59.4 m (95% CI, 14.1-105.0); and 10MWT, 0.132 m/s (95% CI, −0.039 to 0.303). Diagnosis was not associated with changes in outcomes.</div></div><div><h3>Conclusions</h3><div>Gait and balance outcomes improved during postcraniectomy and postcranioplasty rehabilitation admissions but not immediately post cranioplasty.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100375"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017274","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":"Integrating Fitness Training in Oncologic Care: Lessons Learned from a Large Telemedicine Trial","authors":"Karen S. Schaepe PhD ,&nbsp;Jeffrey R. Basford MD, PhD ,&nbsp;Andrea L. Cheville MD, MSCE","doi":"10.1016/j.arrct.2024.100367","DOIUrl":"10.1016/j.arrct.2024.100367","url":null,"abstract":"<div><h3>Objective</h3><div>To provide insights from patients and clinicians regarding the benefits and barriers of the introduction of a telerehabilitation fitness program into the oncologic care of people with late-stage cancer.</div></div><div><h3>Design</h3><div>This study is a qualitative assessment of the COllaborative Care to Preserve PErformance in Cancer trial, which involved the insertion of a telerehabilitation fitness program into the oncologic care of patients with late-stage cancer.</div></div><div><h3>Setting</h3><div>A large midwestern medical center.</div></div><div><h3>Participants</h3><div>Thirty-one patients who matched the overall demographics of the study participants as well as 3 oncologists, 2 physical therapist fitness care managers (FCMs), nurse pain care manager, and 2 supervisory physicians involved in the study.</div></div><div><h3>Interventions</h3><div>Five hundred sixteen patients with late-stage (IIIC or IV) cancer were randomly assigned to 1 of 3 arms: a control group that received usual oncologic care and 2 intervention groups. The members of the latter continued with their usual care but also received either 6 months of a fitness program, with or without the addition of pain management assistance. All components were delivered via telemedicine with the fitness program consisting of progressive resistance and walking components.</div></div><div><h3>Main Outcome Measures</h3><div>Perceived benefits and shortcomings of the intervention were obtained via written narratives from the patients and as well as through interviews with the oncologists, FCMs, nurse pain care manager, and supervisory physicians involved in the study.</div></div><div><h3>Results</h3><div>Thematic analysis revealed 87% (27/31) of the participants found the program helpful. Regular contact with someone who understood their situation, helped improve their function, and encouraged active engagement in their care was perceived as particularly beneficial. The FCMs who worked remotely with participants to coordinate their exercise programs agreed that regular interactions with the patient facilitated engagement, education, and meaningful goal setting. The oncologists were supportive of the intervention but had concerns about patient suitability. The supervisory physicians noted a number of institutional barriers such as oncology workflows and the need for better sharing of information across disciplines.</div></div><div><h3>Conclusions</h3><div>A fitness program delivered via telemedicine was perceived as beneficial by the patients, the FCMs, and the supervising physicians. Success hinged on the quality of the interaction between patients and the FCMs. Institutional barriers to implementation seem similar to those encountered by many new programs that need to be inserted into the workflows of busy clinics and practices.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100367"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734039/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017290","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}