Archives of rehabilitation research and clinical translation最新文献

{"title":"Return to Community Living and Functional Ability Following Inpatient Rehabilitation for Hip Fracture in Patients Aged ≥65 Years: A Retrospective Descriptive Observational Study","authors":"Hitomi Oishi MD,&nbsp;Motoyuki Horii MD, PhD,&nbsp;Maki Asada MD, PhD,&nbsp;Norikazu Hishikawa RPT, PhD,&nbsp;Suzuyo Ohashi MD, PhD,&nbsp;Koshiro Sawada MD, PhD,&nbsp;Yasuo Mikami MD, PhD","doi":"10.1016/j.arrct.2026.100672","DOIUrl":"10.1016/j.arrct.2026.100672","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the proportion of older patients who returned to their original homes after inpatient rehabilitation for hip fracture, focusing on prefracture living arrangements (living with family or alone), and to assess their activities of daily living (ADL) ability at discharge.</div></div><div><h3>Design</h3><div>A retrospective descriptive observational study.</div></div><div><h3>Setting</h3><div>An inpatient rehabilitation ward in Japan.</div></div><div><h3>Participants</h3><div>A total of 650 patients (108 men, 542 women; mean age 83.6±7.19y) aged ≥65 years who were admitted for rehabilitation after hip fracture surgery between 2016 and 2022 and had lived at home before injury were included in the analysis, after excluding those who were transferred to acute care hospitals due to medical complications.</div></div><div><h3>Interventions</h3><div>Not applicable (standard inpatient rehabilitation).</div></div><div><h3>Main Outcome Measures</h3><div>Discharge destination (returning home with family, returning to living alone, or transfer to a residential facility or long-term care hospital) and Functional Independence Measure (FIM) scores, including motor and cognitive subscores.</div></div><div><h3>Results</h3><div>Among 364 patients who had lived with family before injury, 317 (87.1%) returned home, including 1 who began living alone after discharge. Among 179 patients who had lived alone, 136 (76.0%) returned home. The median total FIM scores (range) were 107 (24-126) for those living with family and 109 (66-125) for those living alone. Approximately 18% of patients who returned to living with family had total FIM scores &lt;80, whereas 26% of those who returned to living alone had scores below 100.</div></div><div><h3>Conclusions</h3><div>Although almost 90% of patients living with family and 3-quarters of those living alone returned home, a substantial proportion exhibited limited ADL ability, indicating a need for comprehensive care systems to support continued community living.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100672"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961822","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":"Investigating Disparities in Acute Rehabilitation Outcomes Among Individuals With TBI and SCI: A Retrospective Chart Review of UDS Data","authors":"Elizabeth C. Pasipanodya PhD,&nbsp;Benjamin Dirlikov MA,&nbsp;Tene A. Cage MD,&nbsp;James Crew MD","doi":"10.1016/j.arrct.2026.100661","DOIUrl":"10.1016/j.arrct.2026.100661","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the influence of multiple sociodemographic characteristics (sex, race/ethnicity, insurance type, and community socioeconomic status [SES]) on inpatient rehabilitation outcomes among individuals with traumatic brain injury (TBI) and spinal cord injury (SCI).</div></div><div><h3>Design</h3><div>Retrospective chart review.</div></div><div><h3>Setting</h3><div>Acute inpatient rehabilitation at a level 1 trauma hospital.</div></div><div><h3>Participants</h3><div>Participants meeting the inclusion criteria were individuals with (1) acute inpatient rehabilitation admission to our rehabilitation center between January 1, 2008, and December 31, 2020, (2) with traumatic SCI or TBI as their primary rehabilitation diagnosis, and (3) aged ≥18 years. A total of 1756 individuals (890 TBI and 866 SCI) were included in analyses.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Primary outcomes were FIM at discharge, total length of stay (LOS), and discharge disposition (“Acute,” “Other Rehabilitation/Long-term Facility,” and “Home”). Focal predictors were sex, race/ethnicity, insurance payor, and community SES.</div></div><div><h3>Results</h3><div>In uncontrolled analyses, individuals from communities with higher SES had higher discharge FIM scores, shorter LOS, and higher rates of discharge to other rehabilitation or long-term facilities. Those with workers’ compensation had significantly longer LOS than those with commercial insurance. Discharge FIM scores were highest among individuals with workers’ compensation, followed by those with commercial and then public insurance. In multivariate analyses that accounted for relevant covariates and other focal sociodemographic factors, only insurance type was significantly associated with discharge outcomes. Specifically, individuals with workers’ compensation had a longer LOS than those with commercial insurance and were more likely to be discharged to an acute care setting rather than home. Furthermore, individuals with public insurance had lower FIM scores than those with commercial insurance.</div></div><div><h3>Conclusions</h3><div>Beyond the relevant medical and sociodemographic factors, insurance type is a significant predictor of disparities in rehabilitation outcomes. Future work should examine outcomes at each cascade of the trauma care continuum and the moderators of these effects to understand social determinants of health.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100661"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961738","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":"Safety and Feasibility of Early Aquatic Physical Therapy for Military Survivors of Gunshot Wounds and Blast Injuries: A Case Series","authors":"Caroline Barmatz MHA,&nbsp;Melissa Crowe PhD,&nbsp;Erik Biros PhD,&nbsp;Diana Mendez PhD,&nbsp;Israel Dudkiewicz MD,&nbsp;Jacqueline Reznik PhD","doi":"10.1016/j.arrct.2026.100626","DOIUrl":"10.1016/j.arrct.2026.100626","url":null,"abstract":"<div><div>This study evaluated the safety and feasibility of early aquatic physical therapy (APT) for gunshot wounds (GSWs) and/or blast injuries (BIs). Early aquatic physical therapy (eAPT) is defined as “therapy conducted within the first month after injury, considering the injury type, setting, and environment.” APT facilitates the restoration of mobility and function after illness or injury. Although APT is helpful for patients with mobility issues, muscle weakness, and pain, its early use in high-functioning adults recovering from ballistic trauma remains underexplored. Usually, multidisciplinary rehabilitation occurs on land in sterile settings because of infection risks from GSWs and BIs. Water exercise offers a controlled, low-impact environment for recovery; however, precautions, particularly for infection prevention and control, are essential. Three case studies are described, all of whom received mobilization in water within their first month after injury. Two patients sustained only GSW, and a third experienced a combined GSW and BI. Participants also received conventional multidisciplinary treatment and were followed up for almost 7 months. Adverse events, feasibility, and functional improvements were assessed. Range of motion assessment, the manual muscle test, and the FIM instrument were used to evaluate progress. The eAPT program was feasible for all 3 patients who completed it. Noninfected open wounds were covered with waterproof dressings before eAPT, and assistance was provided and at the poolside, on steps, and during pool entry and exit using hoists. Exercises were performed at a safe water depth. No adverse events occurred, and patients showed clear functional improvements in and out of the water. eAPT appears to be a safe, feasible adjunct to early rehabilitation after complex ballistic or blast trauma, supporting further investigation into its broader clinical application.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100626"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961823","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":"Recovery After Nontraumatic Lower Limb Amputation: A Scoping Review of Longitudinal Research Studies","authors":"Szu-Ping Lee PT, PhD,&nbsp;Fateme Eskandarighargheh CPO, MS,&nbsp;Faiza Magsi DPT,&nbsp;Chloe Akiona-Bannan DPT,&nbsp;Jocelyn Contreras DPT,&nbsp;Kayla Cheyenne Francisco DPT,&nbsp;Kentaro Lee DPT,&nbsp;Xan Goodman MLIS,&nbsp;Jenny Kent PhD,&nbsp;Sheila Clemens PT, PhD","doi":"10.1016/j.arrct.2026.100671","DOIUrl":"10.1016/j.arrct.2026.100671","url":null,"abstract":"<div><h3>Objective</h3><div>Longitudinal research studies are essential for understanding the time course of functional recovery after lower limb amputation (LLA). The purpose of this scoping review was to evaluate the existing evidence base regarding midterm to long-term outcomes following nontraumatic LLA.</div></div><div><h3>Data Sources</h3><div>A scoping review was conducted per the Joanna Briggs Institute and Open Science Framework guidelines. Based on purpose, 7 databases (PubMed, CINAHL, Embase, Scopus, Web of Science, SportDiscus, and Google Scholar) were searched for studies published between 2000 and 2024, in English, Mandarin Chinese, Tagalog, Persian, or Spanish.</div></div><div><h3>Study Selection</h3><div>Eligible studies must include ≥50% of participants with nontraumatic major LLA within 3 years after their amputation and report outcomes at ≥2 time points spanning ≥3 months.</div></div><div><h3>Data Extraction</h3><div>We extracted data including study design, phase of rehabilitation, duration of follow-up, participant characteristics, outcome measures used, and intervention purpose and types.</div></div><div><h3>Data Synthesis</h3><div>Of 5936 records screened, 85 were included in this review. Most studies were conducted in Europe (42.4%), with much less representation from Asia, Oceania/Australia/New Zealand, Africa, and Latin America. The studies encompass data from a total of 424,422 participants (mean age: 58.3y; 55% men). Specific to time since amputation, 57 studies (67%) started immediately after amputation, and only 21% of studies followed patients beyond 1 year postamputation. The most commonly reported outcome domains are performance-based (19.5%), psychological (18.3%), and other medical outcomes (17.2%). Of the 174 unique outcome measures identified, 55.7% are patient-reported, and 44.2% are performance-based measures.</div></div><div><h3>Conclusions</h3><div>This review highlights a growing body of evidence regarding longitudinal recovery after nontraumatic LLA. The current evidence base focuses primarily on the perioperative phase. Identified gaps in research include disparity in geographical and population representation, lack of long-term follow-up, and lack of participation outcomes such as social reintegration and returning to work.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100671"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961687","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":"Systematic Review and Meta-analysis Assessing the Effects of Focal and Radial Extracorporeal Shockwave Therapy on Pain and Function in Patellar Tendinopathy","authors":"Adam Friedman DO, MBS,&nbsp;Seth Spicer DO,&nbsp;Jared Garfinkle BS,&nbsp;Hassan Tahir DO","doi":"10.1016/j.arrct.2026.100657","DOIUrl":"10.1016/j.arrct.2026.100657","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of focal or radial extracorporeal shockwave therapy (ESWT) in improving pain and function in individuals with patellar tendinopathy (PT) through a systematic review and meta-analysis.</div></div><div><h3>Data Sources</h3><div>A comprehensive literature search was conducted in PubMed, Embase, and Web of Science up to May 27, 2025. Search terms were related to ESWT and PT. Additional gray literature was assessed using Google Scholar.</div></div><div><h3>Study Selection</h3><div>Studies were included if they used focused or radial ESWT to treat PT and reported pre- and posttreatment outcomes using the visual analog scale (VAS) and/or the Victorian Institute of Sport Assessment (VISA). Randomized controlled trials, prospective cohort studies, and retrospective chart reviews were eligible. Thirteen studies (n=530 for VAS; n=369 for VISA) met the inclusion criteria.</div></div><div><h3>Data Extraction</h3><div>Two authors independently extracted VAS, VISA, SDs, and sample sizes. Data from 12- to 16-week follow-up were prioritized when multiple follow-up points were reported.</div></div><div><h3>Data Synthesis</h3><div>A random-effects meta-analysis was performed across 13 studies totaling 899 participants (530 for VAS, 369 for VISA). ESWT demonstrated a significant VAS reduction of 2.53 (from 5.24 to 2.71) and VISA increase of 20.22 (from 54.65 to 74.86), both exceeding minimal clinically important difference thresholds (VAS: 1.2; VISA: 7.3). Effect sizes were large (VAS <em>d</em>=−1.54; VISA <em>d</em>=1.76). Randomized trials generally had a low risk of bias; nonrandomized studies had higher bias but minimal influence on pooled effects. Certainty of evidence was rated using Grading of Recommendations Assessment, Development, and Evaluation: 4 high, 6 moderate, and 3 low-quality studies. Heterogeneity was high, but most ESWT arms showed consistent clinical benefit.</div></div><div><h3>Conclusions</h3><div>ESWT significantly reduces pain and improves function in patients with PT, with effect sizes exceeding clinically meaningful thresholds. It represents a viable noninvasive treatment option for individuals not responding to conservative care. Future research should focus on standardizing ESWT protocols and follow-up intervals to enhance reproducibility and clinical translation.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100657"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961828","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":"Ultrasound-Guided Alcohol Neurolysis for Poststroke Upper Limb Spasticity to Facilitate Arteriovenous Fistula Creation in Hemodialysis: A Case Report","authors":"Ruoxi Cao MBBS, MMed, MRCP,&nbsp;Jia Yi Sandra Lau MBBS, MMed, MRCP,&nbsp;Deepali Bang PhD, MD,&nbsp;Geoffrey Sithamparapillai Samuel MBBS, MMed, MRCP","doi":"10.1016/j.arrct.2026.100625","DOIUrl":"10.1016/j.arrct.2026.100625","url":null,"abstract":"<div><div>Spasticity affects up to 80% of stroke survivors and is associated with significant pain, impaired function, and reduced quality of life. In patients with end-stage renal disease, severe upper limb spasticity presents additional challenges by restricting positioning for arteriovenous fistula (AVF) creation. Oral antispasmodic agents are often poorly tolerated because of impaired renal clearance and systemic side effects. Although alcohol neurolysis is an established intervention for focal spasticity, its use to facilitate AVF creation has not been previously described. We report the case of a 53-year-old woman with newly diagnosed end-stage renal disease who developed multi-territorial strokes resulting in severe generalized spasticity (Modified Ashworth Scale 3-4) with associated pain and abnormal limb posturing. Spasticity presented a major barrier to AVF creation. Oral agents, including baclofen and tizanidine, were avoided or discontinued because of safety concerns in the setting of ESRD with recurrent intradialytic hypotension. Botulinum toxin injections improved pain but failed to restore sufficient range of motion. At 7 months after her strokes, she underwent ultrasound-guided alcohol neurolysis of the right musculocutaneous and median nerves. This produced significant spasticity reduction (elbow flexors: Modified Ashworth Scale 3→1+; forearm pronators: 3→1; wrist flexors: 4→2 by 28d), pain resolution, and improved joint mobility, enabling successful right radiocephalic AVF creation under local anesthesia 13 days later without complications. To our knowledge, this is the first reported case of alcohol neurolysis facilitating AVF creation in a dialysis-dependent stroke patient with refractory spasticity. This case highlights alcohol neurolysis as a safe and effective intervention when systemic agents and botulinum toxin are unsuitable or inadequate, and underscores the importance of an individualized, multimodal, and multidisciplinary approach to spasticity management in complex patients.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100625"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961325","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":"Application of Ultrasound Shear Wave Elastography as an Objective Outcome Measure in Nonspecific Low Back Pain Associated with Myofascial Trigger Points","authors":"Wiraphong Sucharit PT, PhD,&nbsp;Piangdaw Adchaithor PT, PhD,&nbsp;Pham Thi Thuy Linh PT, MSPT,&nbsp;Wichai Eungpinichpong PT, PhD,&nbsp;Punthip Thammaroj MD","doi":"10.1016/j.arrct.2026.100659","DOIUrl":"10.1016/j.arrct.2026.100659","url":null,"abstract":"<div><h3>Objectives</h3><div>To assess the reliability, clinical association, and discrimination of an ultrasound shear wave elastography (SWE) protocol in individuals with nonspecific low back pain (NSLBP) associated with myofascial trigger points.</div></div><div><h3>Design</h3><div>Cross-sectional observational study.</div></div><div><h3>Setting</h3><div>A university laboratory.</div></div><div><h3>Participants</h3><div>Fifteen individuals (N=15) with NSLBP had a mean age of 37.60±6.50 years, with a sex distribution of 4 men and 11 women and a symptom duration of &gt;3 months. An additional 15 asymptomatic controls (ACs) (mean age 36.73±6.65y) were individually matched to the NSLBP group based on age (±5y), sex, physical activity level, and side of image acquisition.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was muscle stiffness, assessed using SWE and quantified by shear wave speed. Secondary outcomes included pain intensity and disability, assessed using the Visual Analog Scale and the Oswestry Disability Index, respectively.</div></div><div><h3>Results</h3><div>Both physiotherapist and radiologist demonstrated good-to-excellent reliability for SWE and shear wave speed measurements. Quadratus lumborum (QL) stiffness was strongly and negatively correlated with pain intensity (<em>r</em>=−0.64, <em>P</em>=.03) and age (<em>r</em>=−0.64, <em>P</em>=.02). Psoas major (PM) stiffness was also negatively correlated with age (<em>r</em>=−0.58, <em>P</em>&lt;.05). The protocol discriminated QL stiffness between individuals with NSLBP and AC, with a median between-group difference of 5.98 kPa (95% CI, 0.42-7.30 kPa; <em>P</em>=.02).</div></div><div><h3>Conclusions</h3><div>A well-trained physiotherapist appears to be able to quantify deep lumbar muscle stiffness. QL and PM stiffness values were preliminarily associated with clinical characteristics and showed potential to discriminate between individuals with NSLBP and ACs. Further validation with larger samples and multiple raters is required to support its potential as an objective outcome measure for clinical assessment and treatment monitoring in NSLBP.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100659"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961715","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 of Behavioral Intervention and Guided Stepping Training Early Post-Stroke (BIG STEPS): A Pilot Randomized Trial","authors":"Victor E. Ezeugwu PT, PhD,&nbsp;Mona Iyizoba PT, BScPT,&nbsp;Asya Shiloff-Rogers PT, MScPT,&nbsp;Joy C. Ezeugwa PT, MSc,&nbsp;Sophia E. Pawelko BSc,&nbsp;Andrew Chan MD, PhD,&nbsp;Jake Hayward MD,&nbsp;Carmen Tuchak MD,&nbsp;Jaime C. Yu MD","doi":"10.1016/j.arrct.2026.100665","DOIUrl":"10.1016/j.arrct.2026.100665","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the feasibility and preliminary effects of a behavioral intervention with guided stepping training early poststroke (BIG STEPS).</div></div><div><h3>Design</h3><div>Pilot waitlist-controlled randomized trial.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Twenty-eight individuals with ischemic or hemorrhagic stroke (13 women [46%]; mean age: 67.8±13.3y).</div></div><div><h3>Interventions</h3><div>A 12-week BIG STEPS intervention to reduce sedentary time and increase daily steps was delivered to the early BIG STEPS group (n=14) and, after a 12-week waitlist period, to the delayed BIG STEPS group (n=14). Both groups received usual care.</div></div><div><h3>Main Measures</h3><div>Feasibility, adherence, and safety. Exploratory outcomes included accelerometer-derived movement behaviors, timed walking tests, and patient-reported outcomes.</div></div><div><h3>Results</h3><div>Recruitment averaged 2.3 participants per month. Retention exceeded a priori threshold of 80% at weeks 12 and 24 (86%-93%). No intervention-related serious adverse events occurred. At week 12, the early BIG STEPS group accumulated a mean of 6534±2773 steps/day compared with 4031±2072 steps/day in the delayed BIG STEPS group. Sedentary time decreased by ∼1.4 h/d in the early group and 0.7 h/d in the delayed group. Between-group effects favored the early group for daily steps (Hedges’ <em>g</em>=1.4) and reduced sedentary time (Hedges’ <em>g</em>=−1.1). At week 24, outcomes converged after the delayed BIG STEPS group received the intervention. Between-group differences for timed walking tests and patient-reported outcomes were small.</div></div><div><h3>Conclusion</h3><div>A behavioral intervention combined with guided stepping training early after stroke was feasible and safe, with promising preliminary effects.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100665"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961743","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":"Using Patient-Reported Outcome Measures to Identify Mobility Limitation in Incurable Cancer","authors":"Carmine Petrasso PhD,&nbsp;Joanne Bayly PhD,&nbsp;Stephen Ashford PhD,&nbsp;Subashini Rajagopalan MSc,&nbsp;Julie Whitney PhD,&nbsp;Matthew Maddocks PhD,&nbsp;INSPIRE consortium","doi":"10.1016/j.arrct.2026.100633","DOIUrl":"10.1016/j.arrct.2026.100633","url":null,"abstract":"<div><h3>Objectives</h3><div>To (1) examine the relationship between a single-item and multicomponent patient-reported outcome measure (PROM) for mobility; (2) identify mobility profiles (PROM-defined patterns of mobility difficulty) using these measures; and (3) explore associations between demographic or clinical characteristics and mobility profiles.</div></div><div><h3>Design</h3><div>Analysis of baseline data from an ongoing multinational trial of a rehabilitation intervention for people with incurable cancer.</div></div><div><h3>Setting</h3><div>Oncology and palliative care outpatient services participating in an international rehabilitation trial.</div></div><div><h3>Participants</h3><div>A consecutive sample of 211 adults with incurable solid tumors, Eastern Cooperative Oncology Group Performance Status 2-3, and a clinician estimated prognosis of ≥3 months. Of these, 206 had complete mobility data and formed the analytic sample.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Mobility was assessed using the Integrated Palliative Care Outcome Scale (IPOS) mobility item and the World Health Organization Disability Assessment Schedule (WHODAS 2.0) mobility subdomain; higher scores reflect greater mobility limitation or difficulty. Secondary outcomes included WHODAS 2.0 self-care and participation scores and quality of life measured using the Functional Assessment of Cancer Therapy-General.</div></div><div><h3>Results</h3><div>IPOS and WHODAS 2.0 mobility scores were positively correlated (ρ=0.650; 95% CI, 0.55-0.74; <em>P</em>&lt;.001). Five mobility profiles were identified (Silhouette≈0.6), each defined by a single IPOS score (0-4) and WHODAS 2.0 mean scores ranging from 8.3 (SD, 3.7) to 19.3 (SD, 3.9). These groups primarily reflected a graded spectrum of mobility difficulty rather than distinct patterns. WHODAS 2.0 self-care, participation, and Functional Assessment of Cancer Therapy-General scores did not significantly differ by mobility profile. However, younger patients and those using mobility devices were represented more in mobility profiles with greater perceived mobility difficulty.</div></div><div><h3>Conclusions</h3><div>A single-item PROM identified broad functional limitations and may help identify mobility profiles among people with incurable cancer. These findings support the utility of the IPOS mobility item as a tool that may help clinicians screen for difficulties with mobility and determine when detailed assessment or rehabilitation input is warranted. The PROM-defined mobility profiles should be interpreted as exploratory stratification and not as independently validated clinical subtypes. Further studies should validate the mobility profiles’ stability and clinical usefulness in longitudinal cohorts.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100633"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961748","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 Between Traumatic Brain Injury (TBI)–Related Clinical Burden and Posttraumatic Stress Disorder Symptom Severity Among Special Operations Forces (SOF): Cross-sectional and Longitudinal Inferences","authors":"Jolie N. Haun PhD, Eds,&nbsp;Justin McDaniel PhD,&nbsp;Risa Nakase-Richardson PhD, FACRM,&nbsp;Tali Schneider PhD,&nbsp;Julie McMahon-Grenz MS, OTR/L,&nbsp;Sharon Barton MS, CRC, CVE, CBIS, CPD,&nbsp;Roberto Sandoval PT, PhD,&nbsp;Karen M. Skop PT, DPT, MS,&nbsp;Clara Dismuke-Greer PhD,&nbsp;Jerome Sabangan PT, DPT,&nbsp;Kimberly Samson PT, DPT, MS,&nbsp;Daniel W. Klyce PhD, ABPP,&nbsp;Yvonne Friedman MA, OTR/L,&nbsp;Leah R. Gause PsyD,&nbsp;Shannon R. Miles PhD,&nbsp;Kevin Wells MPH,&nbsp;Mary Jo Pugh PhD","doi":"10.1016/j.arrct.2026.100638","DOIUrl":"10.1016/j.arrct.2026.100638","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine how traumatic brain injury (TBI)–related clinical burden (eg, neurobehavioral symptoms, TBI-related lifestyle/participation deficits) is associated with posttraumatic stress disorder (PTSD) symptom trajectories during inpatient rehabilitation.</div></div><div><h3>Design</h3><div>Cross-sectional and longitudinal cohort study.</div></div><div><h3>Setting</h3><div>Veterans Health Administration Intensive Evaluation and Treatment Program for TBI distributed across 5 sites in the United States.</div></div><div><h3>Participants</h3><div>Participants were male Special Operations Forces with an average age of 42 years (SD, 5.4) and a history of mild to moderate TBI (n=105).</div></div><div><h3>Interventions</h3><div>A longitudinal cohort evaluation was conducted to analyze baseline, discharge, and 6-month follow-up data from Special Operations Forces enrolled in the Veterans Health Administration’s Intensive Evaluation and Treatment Program for TBI, which is a variable-length program with interdisciplinary rehabilitation opportunities.</div></div><div><h3>Main Outcome Measures</h3><div>TBI-related clinical burden was operationalized using neurobehavioral symptom burden and functional participation impairment, and PTSD symptom severity was assessed using the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition. Multivariable linear regression and linear mixed-effects models were used to analyze the data.</div></div><div><h3>Results</h3><div>Greater neurobehavioral symptom burden (b=1.00; <em>P</em>&lt;.001) and participation-related impairment (b=2.60; <em>P</em>&lt;.001) were independently associated with higher PTSD symptom severity at baseline. Longitudinal analyses indicated that functional participation (b=–0.35; <em>P</em>=.01), but not neurobehavioral symptoms (b=–0.06; <em>P</em>=.14), moderated PTSD symptom trajectories, with greater participation scores predicting steeper reductions in PTSD symptoms over time.</div></div><div><h3>Conclusions</h3><div>These findings suggest that functional participation may represent an important measure of TBI-related clinical burden that is associated with PTSD symptom trajectories in a TBI rehabilitation program.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"8 3","pages":"Article 100638"},"PeriodicalIF":2.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148961751","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}