Archives of rehabilitation research and clinical translation最新文献

{"title":"Neurovisual Training With Acoustic Feedback: An Innovative Approach for Nystagmus Rehabilitation","authors":"Damiano Antognetti MD ,&nbsp;Luca Maggiani DPT ,&nbsp;Elena Gabbrielli DPT ,&nbsp;Luca Allegrini MD ,&nbsp;Stefania Dalise MD ,&nbsp;Carmelo Chisari MD","doi":"10.1016/j.arrct.2024.100371","DOIUrl":"10.1016/j.arrct.2024.100371","url":null,"abstract":"<div><div>Nystagmus has various clinical manifestations, including downbeat, upbeat, and torsional types, each associated with distinct neurologic features. Current rehabilitative interventions focusing on fixation training and optical correction often fail to achieve complete resolution. When nystagmus coexists with fragile X-associated tremor/ataxia syndrome (FXTAS), functional impairments worsen, particularly affecting balance. Recognizing these limitations, the authors propose an innovative approach using audiovisual stimulation to complement visual pursuit training and optical compensation, potentially improving rehabilitation outcomes. This study describes the case of a 60-year-old woman with worsening nystagmus and cerebellar ataxia suggestive of FXTAS who underwent a customized rehabilitation program. The program included 30 sessions involving audiovisual training and physical exercises. Visual performance assessments were conducted using AV-Desk and Nidek MP-1 microperimeters, with functional assessments including the Barthel Modified Index, 10-meter walking test, timed Up and Go, and Berg Balance Scale. After treatment, visual performance improved with reduced response times and higher success rates, especially without drugs. Fixation stability improved consistently using the bivariate contour ellipse area method. Functional assessments showed enhanced mobility and balance, with benefits sustained at the 6-month follow-up. The combined approach of audiovisual training, proprioceptive training, and targeted muscle strengthening has proven effective. Notable improvements in overall physical performance, especially in balance and gait, and a reduction in nystagmus severity were observed. Integrating audiovisual stimulation into rehabilitation protocols shows promising results in managing nystagmus and ataxia, significantly enhancing patients' quality of life. Further studies are needed to validate these findings and expand upon this approach.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100371"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733972/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017297","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":"Psychometrics of Wearable Devices Measuring Physical Activity in Ambulant Children With Gait Abnormalities: A Systematic Review and Meta-analysis","authors":"Huib van Moorsel MSc ,&nbsp;Barbara Engels MSc ,&nbsp;Jacek Buczny PhD ,&nbsp;Jan Willem Gorter MD ,&nbsp;Kelly Arbour-Nicitopoulos PhD ,&nbsp;Tim Takken PhD ,&nbsp;Raoul H.H. Engelbert PhD ,&nbsp;Manon A.T. Bloemen PhD","doi":"10.1016/j.arrct.2024.100384","DOIUrl":"10.1016/j.arrct.2024.100384","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate psychometrics of wearable devices measuring physical activity (PA) in ambulant children with gait abnormalities due to neuromuscular conditions.</div></div><div><h3>Data Sources</h3><div>We searched PubMed, Embase, PsycINFO, CINAHL, and SPORTDiscus in March 2023.</div></div><div><h3>Study Selection</h3><div>We included studies if (1) participants were ambulatory children (2-19y) with gait abnormalities, (2) reliability and validity were analyzed, and (3) peer-reviewed studies in the English language and full-text were available. We excluded studies of children with primarily visual conditions, behavioral diagnoses, or primarily cognitive disability. We performed independent screening and inclusion, data extraction, assessment of the data, and grading of results with 2 researchers.</div></div><div><h3>Data Extraction</h3><div>Our report follows Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We assessed methodological quality with Consensus-based Standards for the selection of health measurement instruments. We extracted data on reported reliability, measurement error, and validity. We performed meta-analyses for reliability and validity coefficient values.</div></div><div><h3>Data Synthesis</h3><div>Of 6911 studies, we included 26 with 1064 participants for meta-analysis. Results showed that wearables measuring PA in children with abnormal gait have high to very high reliability (intraclass correlation coefficient [ICC]_{+, test-retest reliability}=0.81; 95% confidence interval [CI], 0.74-0.89; <em>I</em>²=88.57%; ICC_{+, interdevice reliability}=0.99; 95% CI, 0.98-0.99; <em>I</em>²=71.01%) and moderate to high validity in a standardized setting (<em>r</em>_{+, construct validity}=0.63; 95% CI, 0.36-0.89; <em>I</em>²=99.97%; <em>r</em>_{+, criterion validity}=0.68; 95% CI, 0.57-0.79; <em>I</em>²=98.70%; <em>r</em>_{+, criterion validity cutoff} _{point based}=0.69; 95% CI, 0.58-0.80; <em>I</em>²=87.02%). The methodological quality of all studies included in the meta-analysis was moderate.</div></div><div><h3>Conclusions</h3><div>There was high to very high reliability and moderate to high validity for wearables measuring PA in children with abnormal gait, primarily due to neurological conditions. Clinicians should be aware that several moderating factors can influence an assessment.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100384"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015746","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":"Adaptive Approaches to Exercise Rehabilitation for Postural Tachycardia Syndrome and Related Autonomic Disorders","authors":"Lauren Ziaks PT, DPT, ATC ,&nbsp;Kathryn Johnson PT, DPT ,&nbsp;Kelsi Schiltz PT, DPT ,&nbsp;Ryan Pelo PT, DPT, PhD ,&nbsp;Guillaume Lamotte MD, MSc ,&nbsp;Claudia Dal Molin DO, RMSK ,&nbsp;Tae Chung MD ,&nbsp;Melissa M. Cortez DO","doi":"10.1016/j.arrct.2024.100366","DOIUrl":"10.1016/j.arrct.2024.100366","url":null,"abstract":"<div><div>Exercise is a well-documented, nonpharmacologic treatment for individuals with autonomic dysfunction and associated orthostatic intolerance, such as postural tachycardia syndrome and related disorders. Exercise has been shown to increase blood volume, reverse cardiovascular deconditioning, and improve quality of life. Current first-line standard of care treatment for autonomic dysfunction combines graded approaches to exercise with medications and lifestyle modifications. However, current exercise rehabilitation protocols for postural orthostatic tachycardia syndrome contain rigid timelines and progression paradigms that often threaten tolerability and adherence. In addition, they fail to account for clinical variables potentially critical to care and lack guidance for individualization, limiting accessibility to patients with co-morbidities that affect exercise appropriateness and safety. Therefore, we introduce an adaptive approach to exercise prescription for orthostatic intolerance that allows patient-specific modifications to meet functional goals for a wider spectrum of patients, thus improving adherence. The proposed approach integrates iterative physiological and symptomatic assessments to provide flexible, yet structured, exposure to aerobic exercise and strength training to improve functional capacity and tolerance of daily activities for patients with postural tachycardia syndrome and related autonomic disorders.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100366"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734034/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017225","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 Step Count with Cardiorespiratory Fitness: Results from the Virtual 2-Minute Step Test","authors":"Krisann K. Oursler MD ,&nbsp;Brandon C. Briggs PhD ,&nbsp;Alicia J. Lozano MS ,&nbsp;Nadine M. Harris MD ,&nbsp;Vincent C. Marconi MD ,&nbsp;Alice S. Ryan PhD ,&nbsp;FIT VET Project Team","doi":"10.1016/j.arrct.2024.100369","DOIUrl":"10.1016/j.arrct.2024.100369","url":null,"abstract":"<div><h3>Objective</h3><div>To test the hypothesis that step count based on a virtual 2-minute step test (2MST) predicts cardiorespiratory fitness (CRF).</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Veteran Affairs Medical Centers participating in a randomized trial of functional exercise training delivered by videoconferencing.</div></div><div><h3>Participants</h3><div>People with human immunodeficiency virus (HIV) (PWH) who were aged ≥50 years and clinically stable on antiretroviral therapy were eligible for the trial. Consecutive male participants who were enrolled prior to November 9, 2023 and completed a baseline 2MST and cardiopulmonary exercise test (CPET) were included in the cross-sectional study (N=74).</div></div><div><h3>Intervention</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>Step count was measured by a 2MST performed by live videoconferencing using the Rikli and Jones protocol. CRF was measured by peak oxygen utilization (VO₂peak) during a modified Bruce cardiopulmonary exercise testing.</div></div><div><h3>Results</h3><div>Most participants (62.2%) were ≥60 years of age. The mean (SD) VO₂peak was 23.6 (5.7) mL/kg/min, which represented 72.4% (SD, 14.1) of expected VO₂peak. Step count correlated with VO₂peak (<em>r</em>=0.47, <em>P</em>&lt;.001). Multivariable linear regression showed that step count was significantly associated with VO₂peak independently of age and body mass index. Based on this model, the prediction of VO₂peak based on step count explained 60% of the variance in VO₂peak. A Bland-Altman plot showed good agreement between predicated and measured VO₂peak without heteroscedasticity.</div></div><div><h3>Conclusions</h3><div>The virtual 2MST predicted VO₂peak independently of age and body mass index in men with well-controlled HIV. In ambulatory populations with known impaired cardiorespiratory fitness, the virtual 2MST may be a feasible and valid estimate of VO₂peak that can be used in the telerehabilitation setting. Future work is required in more demographically diverse individuals with various chronic conditions.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100369"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734009/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017271","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":"Perceived Barriers to Leisure-Time Physical Activity Among Physically Active Individuals With Spinal Cord Injury","authors":"Paul K. Watson BAppSci ,&nbsp;Laura Stendell MPhysio ,&nbsp;Camila Quel De Oliveira PhD ,&nbsp;James W. Middleton MBBS, PhD ,&nbsp;Mohit Arora PhD ,&nbsp;Glen M. Davis PhD","doi":"10.1016/j.arrct.2024.100380","DOIUrl":"10.1016/j.arrct.2024.100380","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate barriers to leisure-time physical activity (LTPA) for physically active people with spinal cord injury (SCI).</div></div><div><h3>Design</h3><div>Prospective cross-sectional.</div></div><div><h3>Setting</h3><div>General community.</div></div><div><h3>Participants</h3><div>One hundred and five physically active individuals with SCI.</div></div><div><h3>Interventions</h3><div>Semi-structured interviews and surveys.</div></div><div><h3>Main Outcome Measure</h3><div>Participants were surveyed and interviewed to determine barriers and determinants of LTPA participation. SCI-specific physical activity (PA) guideline adherence was documented. Barriers were categorized using the capability, opportunity, motivation, and behavior model, and regression statistics were used to determine relationships between LTPA volume and barriers.</div></div><div><h3>Results</h3><div>Health problems, costs of equipment and programs, pain, and a lack of energy were the most common capability barriers, and a lack of accessible facilities, confidence in the knowledge and skill of a health professional, and a lack of time were common opportunity barriers. Motivation barriers pertained to self-consciousness in a fitness center and a lack of interest. Believing LTPA to be too difficult, uninteresting, and unable to improve health emerged as significant barriers to SCI-specific PA guideline adherence.</div></div><div><h3>Conclusion</h3><div>SCI-specific PA guideline adherence was below 50% in physically active individuals. There are still numerous capability and opportunity barriers that physically active people with SCI must overcome when engaging in LTPA. Motivational barriers such as feeling self-conscious in a fitness center significantly influence PA guideline compliance in this population. Service providers should emphasize the benefit of LTPA to people with SCI while providing LTPA options that facilitate enjoyment, interest, and inclusivity, particularly for those who do not meet PA guideline recommendations.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100380"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734005/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015743","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":"Assessing the Effect of Fatigue on Swallowing Function in Adults with Acute Stroke. A Pilot Study","authors":"Hope E. Baylow DA","doi":"10.1016/j.arrct.2024.100381","DOIUrl":"10.1016/j.arrct.2024.100381","url":null,"abstract":"<div><h3>Objective</h3><div>To determine if fatigue systematically effects the timing of swallowing events and to discuss underlying causes of fatigue other than peripheral neuromuscular fatigue.</div></div><div><h3>Design</h3><div>Pre-post within-subject repeated-measures design.</div></div><div><h3>Setting</h3><div>General acute care hospital and designated stroke center.</div></div><div><h3>Participants</h3><div>Thirteen patients (10 males and 3 females) aged 52-80 years (mean 64.84±9.58 y) with acute stroke and clinically suspected dysphagia.</div></div><div><h3>Interventions</h3><div>Under videofluoroscopy, each participant swallowed a pre- and post-study 1-mL liquid barium bolus and, in an attempt to fatigue the system, 30-45 additional bolus trials of varying amounts (ie, 5 mL, 10 mL, and bite-sized) and consistencies (ie, International Dysphagia Diet Standardisation Initiative Level 0-7).</div></div><div><h3>Main Outcome Measures</h3><div>Six temporal sequences (ie, oral, pharyngeal, and pharyngeal delay transit times and durations of laryngeal vestibule closure, cricopharyngeal opening, and laryngeal elevation) for 1-mL liquid boluses were measured pre- and postvideofluoroscopic swallowing study and compared.</div></div><div><h3>Results</h3><div>Findings indicated that only 2 of the 6 temporal factors yielded significant differences pre- to post fatigue. The postvideofluoroscopic 1-mL liquid swallow took longer than the pre-videofluoroscopic 1-mL liquid swallow in terms of pharyngeal transit (_1,11=5.362, <em>P</em>=.046) and pharyngeal delay time (<em>F</em>_1,11=5.228, <em>P</em>=.048).</div></div><div><h3>Conclusions</h3><div>These findings indicate that peripheral neuromuscular fatigue is unlikely to be the primary cause of the observed changes, as only 2 of the 6 temporal measures—pharyngeal transit time and pharyngeal delay time—were affected. In cases of peripheral neuromuscular fatigue, one would expect increases across all 6 timing measures due to the integrated nature of the swallowing process. Instead, the results suggest that the inconsistencies may stem from a delayed excitatory response of neurons or a delay in synaptic transmission within the nucleus tractus solitarius, potentially associated with stroke. This delay likely contributes to the prolongation of both pharyngeal transit and pharyngeal delay times. Thus, a model focused solely on peripheral neuromuscular fatigue does not fully account for the findings, highlighting the importance of considering central neural mechanisms in the clinical evaluation of swallowing disorders.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100381"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017230","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 Impact of Executive Function on Retention and Compliance in Physical Therapy in Veterans","authors":"Elisa F. Ogawa PhD ,&nbsp;Rebekah Harris PT, DPT, PhD ,&nbsp;Rachel E. Ward PhD ,&nbsp;Mary-Kate Palleschi BA ,&nbsp;William Milberg PhD ,&nbsp;David R. Gagnon MD, PhD ,&nbsp;Ildiko Halasz MD ,&nbsp;Jonathan F. Bean MD, MPH","doi":"10.1016/j.arrct.2024.100383","DOIUrl":"10.1016/j.arrct.2024.100383","url":null,"abstract":"<div><h3>Objective</h3><div>To examine retention and compliance to a novel physical therapy (PT) treatment among Veterans with and without executive function deficits (EFD+/EFD−).</div></div><div><h3>Design</h3><div>This study was a preplanned secondary analysis of an ongoing randomized controlled trial.</div></div><div><h3>Setting</h3><div>Outpatient PT at VA Boston Healthcare System.</div></div><div><h3>Participants</h3><div>Seventy-two community-dwelling middle-aged and older Veterans (mean age, 72 years [range 51-91]; 87% male) with gait speed between 0.5 and 1.0 m/second were recruited from primary care practices.</div></div><div><h3>Interventions</h3><div>Eight-week moderate-to-vigorous intensity PT program.</div></div><div><h3>Main outcome measure</h3><div>Veterans’ baseline mobility, retention (dropouts), and treatment compliance and posttreatment exercise compliance to 8-week PT treatment were evaluated based on their baseline EFD status.</div></div><div><h3>Results</h3><div>Of the 72 participants, 22% (n=16) were EFD+. Veterans with EFD+ at baseline had worse mobility performance (Short Physical Performance Battery [SPPB], 7.7 vs 9.5, <em>P</em>&lt;.001) and patient-reported mobility (Activity Measure for Post-Acute Care [AM-PAC], 57.6 vs 62.2, <em>P</em>&lt;.01) after adjusting for age, gender, number of comorbidities, depressive symptoms, and pain interference. Dropout rates for EFD+ and EFD− were 44% and 25%, respectively (<em>P</em>&gt;.05). In multivariable logistic regression modeling, pain interference, depressive symptoms, mobility, and living alone but not EFD status were associated with dropping out. Among study completers, there was no evidence of significant differences in treatment compliance or posttreatment exercise compliance, measured by the number of attended sessions and the number of posttreatment exercise days by EFD status.</div></div><div><h3>Conclusion</h3><div>EFD+ was associated with poor baseline mobility. Although the dropout rate was higher among Veterans with EFD+, we were unable to conclude whether EFD status impacts retention or compliance due to the small sample size. Further investigation is needed to determine whether EFD status may identify individuals who need additional support during and/or after rehabilitation treatment.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100383"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11733977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017192","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":"Overview of Effects of Motor Learning Strategies in Neurologic and Geriatric Populations: A Systematic Mapping Review","authors":"Li-Juan Jie PhD ,&nbsp;Melanie Kleynen PhD ,&nbsp;Guus Rothuizen MSc ,&nbsp;Elmar Kal PhD ,&nbsp;Andreas Rothgangel PhD ,&nbsp;Susy Braun PhD","doi":"10.1016/j.arrct.2024.100379","DOIUrl":"10.1016/j.arrct.2024.100379","url":null,"abstract":"<div><h3>Objective</h3><div>To provide a broad overview of the current state of research regarding the effects of 7 commonly used motor learning strategies to improve functional tasks within older neurologic and geriatric populations.</div></div><div><h3>Data Sources</h3><div>PubMed, CINAHL, and Embase were searched.</div></div><div><h3>Study Selection</h3><div>A systematic mapping review of randomized controlled trials was conducted regarding the effectiveness of 7 motor learning strategies—errorless learning, analogy learning, observational learning, trial-and-error learning, dual-task learning, discovery learning, and movement imagery—within the geriatric and neurologic population.</div></div><div><h3>Data Extraction</h3><div>Two thousand and ninety-nine articles were identified. After screening, 87 articles were included for further analysis. Two reviewers extracted descriptive data regarding the population, type of motor learning strategy/intervention, frequency and total duration intervention, task trained, movement performance measures, assessment time points, and between-group effects of the included studies. The risk of bias 2 tool was used to assess bias; additionally, papers underwent screening for sample size justification.</div></div><div><h3>Data Synthesis</h3><div>Identified articles regarding the effects of the targeted motor learning strategies started around the year 2000 and mainly emerged in 2010. Eight populations were included, for example, Parkinson's and stroke. Included studies were not equally balanced: analogy learning (n=2), errorless learning and trial-and-error learning (n=5), mental practice (n=19), observational learning (n=11), discovery learning (n=0), and dual-tasking (n=50). Overall studies showed a moderate-to-high risk of bias. Four studies were deemed sufficiently reliable to interpret effects. Positive trends regarding the effects were observed for dual-tasking, observational learning, and movement imagery.</div></div><div><h3>Conclusions</h3><div>Findings show a skewed distribution of studies across motor learning interventions, especially toward dual-tasking. Methodological shortcomings make it difficult to draw firm conclusions regarding the effectiveness of motor learning strategies to improve functional studies. Future researchers are strongly advised to follow guidelines that aid in maintaining methodological quality. Moreover, alternative designs fitting the complex practice situation should be considered.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100379"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734024/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryoneurolysis and Quadriplegia: A Case Report on Pain and Severe Spasticity Management","authors":"Laura Schatz BSc ,&nbsp;Samuel Herzog ,&nbsp;Mahdis Hashemi MD ,&nbsp;Paul Winston MD","doi":"10.1016/j.arrct.2024.100374","DOIUrl":"10.1016/j.arrct.2024.100374","url":null,"abstract":"<div><div>Spasticity, a common symptom after spinal cord injury, often leads to pain, muscle contracture, and compromised daily activities. Cryoneurolysis, a minimally invasive, drug-free procedure for the treatment of pain, is now gaining recognition for treating spasticity. It involves using an ultrasound-guided probe to freeze and destroy overactive target nerves. The objective of this case study was to assess the effect of cryoneurolysis on joint range of motion (ROM) by reducing spasticity and pain in a person with quadriparesis spinal cord injury. A 52-year-old male with C4 incomplete quadriplegia presented with severe right hip osteoarthritis, causing a severe hip flexion deformity with hip flexor spasms, as well as spasticity in the upper limbs. Previous attempts with exceeding maximum-dose botulinum toxin injections for the lower limb proved insufficient to improve ROM. Percutaneous cryoneurolysis was performed on multiple nerves, contributing to spasticity in the upper and lower limbs. Immediately after each procedure, the patient experienced an increased ROM in the upper and lower limb targeted regions. During the patient's follow-up, he also reported improvements in performing daily activities, such as independent showering, no falls, and a significant decrease in muscle tone. Results were primarily maintained up to 9 months postprocedure when cryoneurolysis was repeated for the lower limbs only. On repeat cryoneurolysis, results were re-established. Cryoneurolysis is a nonsurgical, percutaneous procedure that could be considered for pain and spasticity management in patients with quadriplegia. It can provide an option for improved quality of life and independence for patients.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100374"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734012/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017276","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":"Entry-to-Practice Rehabilitation Competencies and the Rehabilitation Competency Framework: A Gap Analysis","authors":"Nicole F. Beamish PhD, MScPT ,&nbsp;Shala Cunningham PhD ,&nbsp;Cheryl Footer PhD ,&nbsp;Rachael Lowe BSc (Hons)","doi":"10.1016/j.arrct.2024.100364","DOIUrl":"10.1016/j.arrct.2024.100364","url":null,"abstract":"<div><h3>Objectives</h3><div>To systematically map the entry-level competencies of rehabilitation professions to the World Health Organization's Rehabilitation Competency Framework (RCF) to identify overlapping commonalities and gaps across available rehabilitation frameworks.</div></div><div><h3>Design</h3><div>The competence frameworks of audiology, occupational therapy, physical and rehabilitation medicine, psychology, physiotherapy, prosthetics and orthotics, rehabilitation nursing, and speech and language therapy were researched online. In cases where international standards or competencies were unavailable online, expert colleagues in the related field were consulted to confirm the absence of an international document. A nationally recognized and freely available document was selected to represent the profession if no international document was found. The frameworks were then mapped to the RCF domains.</div></div><div><h3>Setting</h3><div>Desk-based research.</div></div><div><h3>Participants</h3><div>Not applicable.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Not applicable.</div></div><div><h3>Results</h3><div>The professional documents demonstrated a stronger alignment with the competencies outlined in the RCF activities. The practice and professionalism domains showed the greatest congruence with profession-specific competencies, whereas the learning and development, management and leadership, and research domains had varying levels of alignment. This consistency in mapping may be attributed to the profession-specific competencies’ focus on the fundamental entry-level knowledge, skills, values, and abilities essential for delivering safe and effective patient care.</div></div><div><h3>Conclusions</h3><div>The mapping exercise revealed that competencies in the profession-specific frameworks primarily focused on individual-level skills for effective patient care rather than societal-level impact, such as acting as rehabilitation advocates. The study provides valuable insights into the alignment between profession-specific competencies among the rehabilitation professions. Identifying commonalities and gaps can facilitate the development of shared educational resources for foundational support across diverse rehabilitation disciplines. This effort can contribute to building a robust and unified rehabilitation workforce capable of meeting the emerging health needs of diverse populations worldwide.</div></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 4","pages":"Article 100364"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11734040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143017284","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}