Archives of rehabilitation research and clinical translation最新文献

{"title":"Submaximal, Low-Dose Eccentric vs Traditional Cycling Exercise: Reduced Oxygen Uptake and Pulmonary Artery Pressure Assessed by Echocardiography in Healthy Middle-aged Adults. A Randomized Controlled, Crossover Trial","authors":"Julian Müller MSc ,&nbsp;Meret Bauer MD ,&nbsp;Simon R. Schneider PhD ,&nbsp;Laura Mayer MD ,&nbsp;Anna Titz MD ,&nbsp;Nico Sturzenegger ,&nbsp;Esther I. Schwarz MD ,&nbsp;Christoph Bauer PhD ,&nbsp;Ekkehard Grünig MD ,&nbsp;Malcolm Kohler MD ,&nbsp;Mona Lichtblau MD ,&nbsp;Silvia Ulrich MD","doi":"10.1016/j.arrct.2024.100331","DOIUrl":"10.1016/j.arrct.2024.100331","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the ventilatory and circulatory differences between eccentric (ECC) and concentric (CON) cycling exercise at submaximal, low-dose intensity from onset to end-exercise in healthy middle-aged participants.</p></div><div><h3>Design</h3><p>Randomized controlled crossover trial.</p></div><div><h3>Setting</h3><p>The participants underwent 1 ECC and 1 CON test according to stepwise incremental exercise protocols at identical, submaximal intensities. Breath-by-breath analyses of ventilatory gas exchange and echocardiography were used to assess cardiopulmonary function during exercise.</p></div><div><h3>Participants</h3><p>24 healthy middle-aged, untrained participants (14 women, 10 men, 50±14 years) were included.</p></div><div><h3>Interventions</h3><p>1 ECC and 1 CON test at submaximal intensities.</p></div><div><h3>Main Outcome Measure</h3><p>The main outcome was oxygen uptake (V'O₂).</p></div><div><h3>Results</h3><p>The V'O₂ increase was reduced by -422 mL/min (-52%, 95% confidence interval: -513 to -292, <em>P</em>&lt;.001) during ECC, as well as the ventilatory drive. Echocardiographic parameters, heart rate (-14%), cardiac output (-21%), stroke volume (-15%), and pulmonary artery pressure by tricuspid regurgitation pressure gradient (TRPG) (-26%) were also significantly reduced during ECC compared with CON at identical intensities. Participants reported significantly less dyspnea and unchanged perceived leg fatigue in ECC.</p></div><div><h3>Conclusion</h3><p>ECC was well tolerated, and significant reductions were observed in V'O₂, ventilation, and right ventricular load compared with CON, even at low intensity levels. This study, conducted on healthy middle-aged participants, did not raise concerns that would hinder further investigation of the effects of ECC in patients with severely limited cardiopulmonary disease, and it calls for further research on this topic.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 2","pages":"Article 100331"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000211/pdfft?md5=4a78afc8c2f7a78562f1645d9e79c901&pid=1-s2.0-S2590109524000211-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140281661","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":"New Dizziness Impact Measures of Positional, Functional, and Emotional Status Were Supported for Reliability, Validity, and Efficiency","authors":"Daniel Deutscher PT, MScPT, PhD ,&nbsp;Deanna Hayes PT, DPT, MS ,&nbsp;Michael A. Kallen PhD, MPH","doi":"10.1016/j.arrct.2024.100320","DOIUrl":"10.1016/j.arrct.2024.100320","url":null,"abstract":"<div><h3>Objective</h3><p>To calibrate the 25 items from the Dizziness Handicap Inventory (DHI) patient-reported outcome measure (PROM), using item response theory (IRT), into 1 or more item banks, and assess reliability, validity, and administration efficiency of scores derived from computerized adaptive test (CAT) or short form (SF) administration modes.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting</h3><p>Outpatient rehabilitation clinics.</p></div><div><h3>Participants</h3><p>Patients (N=28,815; women=69%; mean age [SD]=60 [18]) included in a large national dataset and assessed for dizziness-related conditions who responded to all DHI items at intake.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>IRT model assumptions of unidimensionality, local item independence, item fit, and presence of differential item functioning (DIF) were evaluated. Generated scores were assessed for reliability, validity, and administration efficiency.</p></div><div><h3>Results</h3><p>Patients were treated in 976 clinics from 49 US states for either vestibular-, brain injury-, or neck-related impairments. Three unidimensional item banks were calibrated, creating 3 distinct PROMs for Dizziness Functional Status (DFS, 13 items), Dizziness Positional Status (DPS, 4 items), and Dizziness Emotional Status (DES, 6 items). Two items did not fit into any domain. A DFS-CAT and a DFS 7-item SF were developed. Except for 2 items by age groups and 1 item by main impairment, no items were flagged for DIF; DIF impact was negligible. Median reliability estimates were 0.91, 0.72, and 0.79 for the DFS, DPS, and DES, respectively. Scores discriminated between patient groups in clinically logical ways and had a large effect size (&gt;0.8), with acceptable floor and ceiling effects (&lt;15%), except for a floor effect for DPS (20.4%). DFS-CAT scores were generated using a median of 8 items; they correlated highly with full-bank scores (<em>r</em>=0.99).</p></div><div><h3>Conclusion</h3><p>The 3 dizziness impact PROMs demonstrated moderate to high reliability, were valid, and highly responsive to change; thus, they are suitable for research and routine clinical administration.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100320"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S259010952400003X/pdfft?md5=80841769b40d76d04c4d9a5ff5094b93&pid=1-s2.0-S259010952400003X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139395082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Initial Assessment of the Correlation Between Virtual Reality and Paper and Pencil Line Bisection Test Results","authors":"Takuma Miyaguchi PT ,&nbsp;Masayuki Tazawa MD, PhD ,&nbsp;Takafumi Kanaya MD ,&nbsp;Yoko Ibe MD, PhD ,&nbsp;Hironori Arii MD ,&nbsp;Kenji Yajima MD ,&nbsp;Yumiko Nakao MD, PhD ,&nbsp;Naoki Wada MD, PhD","doi":"10.1016/j.arrct.2024.100322","DOIUrl":"10.1016/j.arrct.2024.100322","url":null,"abstract":"<div><h3>Objective</h3><p>To make an initial assessment of the correlation between immersive virtual reality–based (ILBT) line bisection testing and paper-and-pencil–based line bisection (PLBT) testing in healthy subjects.</p></div><div><h3>Design</h3><p>Diagnostic study.</p></div><div><h3>Setting</h3><p>Research laboratory.</p></div><div><h3>Participants</h3><p>Twenty healthy adults (51.5 [11.0] years old, 55% women; N=20).</p></div><div><h3>Interventions</h3><p>Participants underwent an ILBT and a conventional PLBT in near space (NS) and more distant space (MDS). Correlations between the ILBT and PLBT, deviation rates in the NS and MDS, horizontal gaze distribution, and presence of virtual reality sickness (VRS) were evaluated.</p></div><div><h3>Main Outcome Measures</h3><p>Correlation between the deviation rates of the PLBT and ILBT.</p></div><div><h3>Results</h3><p>There was no significant correlation between the ILBT and PLBT for evaluating the deviation rate of the line bisection test (LBT). There was no significant difference in the deviation rate of the LBTs between the NS and MDS, but there was a significant difference in the horizontal line-of-sight distribution. VRS was not observed as an adverse event.</p></div><div><h3>Conclusions</h3><p>In healthy adult subjects, our results suggested that there was no significant correlation between the deviation rates of the ILBT and PLBT. We also found that the ILBT is a useful and safe method for evaluating the horizontal line-of-sight distribution and percentage deviation of line segments from the center in the NS and MDS without inducing VRS.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100322"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000053/pdfft?md5=ae786c648011b139ab7271e20f8fd0d4&pid=1-s2.0-S2590109524000053-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139539089","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":"Five Functional Classes Identified Among Patients Hospitalized for Pneumonia Characterized by Activity Limitations With Mobility and Self-Care Tasks","authors":"Jessica Edelstein PhD, OTR ,&nbsp;Adam R. Kinney PhD, OTR/L ,&nbsp;Amanda Hoffman MS, OTR/L, BCPR ,&nbsp;James E. Graham PhD ,&nbsp;Matthew P. Malcolm PhD, OTR","doi":"10.1016/j.arrct.2024.100323","DOIUrl":"10.1016/j.arrct.2024.100323","url":null,"abstract":"<div><h3>Objective</h3><p>Latent class analysis was used to identify functional classes among patients hospitalized for pneumonia. Then, we determined predictors of class membership and examined variation in distal outcomes among the functional classes.</p></div><div><h3>Design</h3><p>An observational, cross-sectional study design was used with retrospectively collected data between 2014 and 2018.</p></div><div><h3>Setting</h3><p>The study setting was a single health system including 5 acute care hospitals.</p></div><div><h3>Participants</h3><p>A total of 969 individuals hospitalized with the primary diagnosis of pneumonia and receipt of an occupational and/or physical therapy evaluation were included in the study.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcomes</h3><p>The following 5 distal outcomes were examined: (1) occupational therapy treatment use, (2) physical therapy treatment use, (3) discharge to home with no services, (4) discharge to home with home health, and (5) institutional discharge.</p></div><div><h3>Results</h3><p>Five functional classes were identified and labeled as follows: <em>Globally impaired, Independent with low-level self-care, Independent low-level mobility, Independent self-care,</em> and <em>Independent</em>. Probability of occupational therapy treatment use (χ²[4]=50.26, <em>P</em>&lt;.001) and physical therapy treatment use (χ²[4]=50.86, <em>P</em>&lt;.001) varied significantly across classes. The <em>Independent with low-level self-care</em> class had the greatest probability of occupational therapy treatment use and physical therapy treatment use. Probability of discharging to home without services (yes/no; χ²[4]=88.861, <em>P</em>&lt;.001), home with home health (yes/no; χ²[4]=15.895, <em>P</em>=.003), and an institution (yes/no; χ²[4]=102.013, <em>P</em>&lt;.001) varied significantly across the 5 classes. The <em>Independent</em> class had the greatest probability of discharging to home without services.</p></div><div><h3>Conclusions</h3><p>Five functional classes were identified among individuals hospitalized for pneumonia. Functional classes could be used by the multidisciplinary team in the hospital as a framework to organize the heterogeneity of functional deficits after pneumonia, improve efficiency of care processes, and help deliver targeted rehabilitation treatment.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100323"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000065/pdfft?md5=dd741263fb560adce5b18e623a6ab111&pid=1-s2.0-S2590109524000065-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632026","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":"Financial Capability and Financial Well-Being Challenges and Vulnerabilities of Adults Living With Acquired Brain Injury: A Pilot Survey","authors":"Lisa Engel PhD ,&nbsp;Roheema Ewesesan MPH ,&nbsp;Ibiyemi Arowolo PhD ,&nbsp;Celine Latulipe PhD ,&nbsp;Jane Karpa PhD ,&nbsp;Mohammad N. Khan PhD","doi":"10.1016/j.arrct.2024.100324","DOIUrl":"10.1016/j.arrct.2024.100324","url":null,"abstract":"<div><h3>Objective</h3><p>To describe the financial capability (FC) and financial well-being (FWB) of adults living with acquired brain injury (ABI) from a lived experience perspective.</p></div><div><h3>Design</h3><p>People living with ABI completed a 32-item and close others a 22-item anonymous survey using either online or print/mail-in options.</p></div><div><h3>Setting</h3><p>Responses were collected from adults in the province of Manitoba (Canada) during August-October 2021.</p></div><div><h3>Participants</h3><p>Respondents were adults (18+) living with ABI (n=38) or close others of ABI survivors (n=19). Adults living with ABI experienced traumatic brain injury (n=22; 58%), stroke (n=8; 21%), or other ABI mechanisms (n=8; 21%). Nineteen (50%) respondents with ABI were men, 17 (45%) were women, and 1 (2.5%) was nonbinary; 95% were more than 1-year post-ABI. Close others were spouses/partners, parents, other family, and paid caregivers. Three of the 19 close others self-reported as men and 16 as women.</p></div><div><h3>Interventions</h3><p>n/a.</p></div><div><h3>Main Outcome Measure(s)</h3><p>n/a.</p></div><div><h3>Results</h3><p>For key FC indicators, 13 (34%) people living with ABI felt their current knowledge and skills were insufficient, and 26 (70%) felt that ABI had affected their ability to make financial decisions or complete financial activities. Fourteen of the 19 close others have worried about the finance-related choices, skills, or behaviors of the person living with ABI, and 17 felt that ABI symptoms had affected the FC of the person living with ABI. For key FWB indicators, 22 (58%) adults living with ABI felt stressed or anxious about finances at least some of the time. Seventeen (45%) of the adults living with ABI reported having trouble making ends meet at least some of the time.</p></div><div><h3>Conclusions</h3><p>Respondents reported FC limitations and FWB challenges for people living with ABI, which can be indicative of financial vulnerabilities and unmet needs. Future research should explore optimal ways to address these financial-related challenges after ABI.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100324"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000077/pdfft?md5=4cfafdb532b697a8e2367dfa3a865cda&pid=1-s2.0-S2590109524000077-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139891636","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":"External Validation of a Dynamic Prediction Model for Upper Limb Function After Stroke","authors":"Iris C. Brunner PhD ,&nbsp;Eleni-Rosalina Andrinopoulou PhD ,&nbsp;Ruud Selles PhD ,&nbsp;Camilla Biering Lundquist PhD ,&nbsp;Asger Roer Pedersen PhD","doi":"10.1016/j.arrct.2023.100315","DOIUrl":"10.1016/j.arrct.2023.100315","url":null,"abstract":"<div><h3>Objective</h3><p>To externally validate the dynamic prediction model for prediction of upper limb (UL) function 6 months after stroke. The dynamic prediction model has been developed and cross-validated on data from 4 Dutch studies.</p></div><div><h3>Design</h3><p>Data from a prospective Danish cohort study were used to assess prediction accuracy.</p></div><div><h3>Setting</h3><p>A Danish neurorehabilitation hospital.</p></div><div><h3>Participants</h3><p>In this external validation study, follow-up data for 80 patients in the subacute phase after stroke (N=80), mean age 64 (SD11), 43% women, could be obtained. They were assessed at 2 weeks, 3 months, and 6 months after stroke with the Action Research Arm Test (ARAT), Fugl-Meyer Motor Assessment upper limb (FMA), and Shoulder Abduction (SA) Finger Extension (FE), (SAFE) test.</p></div><div><h3>Intervention</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Prediction accuracy at 6 months was examined for 3 categories of ARAT (0-57 points): mild (48-57), moderate (23-47), and severe (0-22). Two individual predictions of ARAT scores at ±6 months post-stroke were computed based on, respectively, baseline (2 weeks) and 3 months ARAT, FE, SA values. The absolute individual differences between observed and predicted ARAT scores were summarized.</p></div><div><h3>Results</h3><p>The prediction model performed best for patients with relatively good UL motor function, with an absolute error median (IQR) of 3 (2-9), and worst for patients with severe UL impairment, with a median (IQR) of 30 (3-39) at baseline. In general, prediction accuracy substantially improved when data obtained 3 months after stroke was included compared with baseline at 2 weeks after stroke.</p></div><div><h3>Conclusion</h3><p>We found limited clinical usability due to the lack of prediction accuracy 2 weeks after stroke and for patients with severe UL impairments. The dynamic prediction model could probably be refined with data from biomarkers.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100315"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000824/pdfft?md5=a74868c5cfa728d6c18c02302d8b188d&pid=1-s2.0-S2590109523000824-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138985882","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":"A Preliminary Comparison of the Katrak Hand Movement Scale With the Upper Extremity Fugl Meyer Assessment Shows a Strong Correlation After Stroke","authors":"Ann Winkler MBBS (FAFRM) ,&nbsp;Paul Sunderland PhD ,&nbsp;Brendan Major PhD ,&nbsp;Natasha A. Lannin PhD","doi":"10.1016/j.arrct.2023.100317","DOIUrl":"10.1016/j.arrct.2023.100317","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the concurrent validity of the KHMS with the FMA-UE.</p></div><div><h3>Design</h3><p>The FMA-UE and the KHMS were administered to 50 adults with stroke to evaluate their concurrent validity.</p></div><div><h3>Setting</h3><p>Three tertiary rehabilitation hospitals.</p></div><div><h3>Participants</h3><p>Participants were aged ≥18 years, receiving stroke or rehabilitation services from a participating hospital, and had a confirmed diagnosis of stroke (ischemic or hemorrhagic) with upper limb involvement. Fifty patients were recruited to the study (20 women, 30 men, N=50) with a mean age of 71 (SD 13.4, range 35-90) years. Time since stroke varied from 2 days to 187 months, with a median of 0.8 months.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Concurrent validity of the KHMS with the FMA-UE.</p></div><div><h3>Results</h3><p>A correlation of <em>r</em>=0.948 was found between the 2 scales (<em>P</em>=.0001). Moderate floor effects were noted in our sample (16%); however, significant ceiling effects were recorded (44%).</p></div><div><h3>Conclusion</h3><p>The KHMS demonstrated a statistically strong correlation with the FMA-UE and holds promise for use, particularly in the clinical setting, to evaluate upper limb motor impairment after stroke.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100317"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000848/pdfft?md5=9a588aa8fe67eeba872c5e5e5959d02d&pid=1-s2.0-S2590109523000848-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139195424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individuals With Multiple Sclerosis Exhibit More Regular Center of Mass Accelerations After Physical Therapy","authors":"Brenda L. Davies PhD ,&nbsp;Rashelle M. Hoffman PhD ,&nbsp;Heidi Reelfs MPT ,&nbsp;Kathleen G. Volkman PT ,&nbsp;Max J. Kurz PhD","doi":"10.1016/j.arrct.2024.100318","DOIUrl":"10.1016/j.arrct.2024.100318","url":null,"abstract":"<div><h3>Objective</h3><p>The purpose of this investigation was to explore if a physical therapy program involving strength, flexibility, balance, and walking can improve the uncharacteristic gait variability and overall mobility of persons living with multiple sclerosis (pwMS).</p></div><div><h3>Design</h3><p>Pre-post design to evaluate the mobility improvements after undergoing 6 weeks of a gait and balance physical therapy intervention.</p></div><div><h3>Setting</h3><p>The initial 2 weeks were conducted at a medical center under close supervision of a physical therapist. The remaining 4 weeks were performed by the patient at their home and monitored via teleconferences.</p></div><div><h3>Participants</h3><p>Fifteen pwMS with relapsing-remitting (N=11) or secondary progressive multiple sclerosis (N=4) were enrolled in this study (7 women; mean age: 54.8±9 years; Kurtzke Expanded Disability Status Score range: 3.0-6.5). A group of healthy age-matched controls (N=15) were used for comparisons.</p></div><div><h3>Interventions</h3><p>The 6-week physical therapy intervention included exercises that targeted strength, flexibility, balance, and walking. The initial 2 weeks of the intervention were performed on-site with the remaining 4 weeks home-based. The therapy was performed twice-a-day for 5 consecutive days each week. Each session was 45 minutes in length.</p></div><div><h3>Main Outcome Measures</h3><p>Preferred walking speed, spatiotemporal gait kinematics, and a 6-minute walk test were completed before and after therapy. The standard deviation (SD) and sample entropy were used to evaluate the amount of variability and the regularity of the time-dependent variations in the center of mass (COM) accelerations during the 6-minute walk test.</p></div><div><h3>Results</h3><p>Before the intervention, the SD of the COM was reduced, and the time-dependent variations were less regular in the pwMS than the control group. After therapy, the SD was 12% larger, and the time-dependent variations were more 7% regular in the pwMS. The effect size for these changes were large (0.91 and 0.94, respectively), suggesting these changes were meaningful. The changes in the regularity of the COM were related to the mobility improvements in the preferred walking velocity and 6-minute walk test.</p></div><div><h3>Conclusions</h3><p>The results suggest that pwMS have altered COM variability during gait, which can be improved with a similar physical therapy program. These changes appear to be linked with the extent of the mobility improvements.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100318"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000016/pdfft?md5=eeacd0498be8cfb6ee53daaa6be626bf&pid=1-s2.0-S2590109524000016-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394473","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 of the Femoral Nerve for Focal Spasticity in an Ambulatory Patient","authors":"Ève Boissonnault MD ,&nbsp;Fraser MacRae BSc ,&nbsp;Mahdis Hashemi MD ,&nbsp;Andrei Bursuc MD ,&nbsp;Paul Winston MD","doi":"10.1016/j.arrct.2024.100319","DOIUrl":"10.1016/j.arrct.2024.100319","url":null,"abstract":"<div><h3>Introduction</h3><p>Spasticity of the knee extensors is a common presentation among patients with multiple sclerosis. The resulting stiff leg gait can result in increased risk of falls, heightened energy expenditure during gait, lowered gait speed, and compensatory gait mechanisms that increase wear on the hips. Cryoneurolysis is a novel percutaneous, minimally invasive treatment for focal spasticity.</p></div><div><h3>Methods</h3><p>A single patient with multiple sclerosis was treated with cryoneurolysis of the femoral nerve branch to rectus femoris. The patient was followed for 15 months. Spasticity severity, gait speed, and patient reported outcomes were collected at each follow-up.</p></div><div><h3>Results</h3><p>Spasticity severity as per the Modified Ashworth Scale was reduced at 1 month, with change persisting up to 15 months post-procedure. Range of motion as per the Modified Tardieu Scale showed gradual improvement over the 15-month period. Gait speed increased after the procedure from 21.15 seconds to 12.49 seconds for the 10 m walk test 1 month post-procedure, then slowed to baseline after 15 months. The patient's confidence in their gait improved and their independence was maintained throughout the follow-up period. Because of the regression in the 10 m walk test, the patient elected to have the procedure repeated after 15 months. Immediately after the procedure, the 10 m test time improved to 16.20 seconds.</p></div><div><h3>Conclusion</h3><p>Cryoneurolysis of the femoral nerve may be an effective, long-lasting treatment for spasticity causing stiff knee gait in patients with multiple sclerosis.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100319"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000028/pdfft?md5=34e837f42bd23ed3aafd803d2fdfa350&pid=1-s2.0-S2590109524000028-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139394382","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 Baseline Skeletal Muscle Mass Index With Adverse Events and Rehabilitation Outcomes in Patients Admitted for Rehabilitation","authors":"Hideki Arai MD ,&nbsp;Syuya Okada PT ,&nbsp;Tatsuyuki Fukuoka SLP, PhD ,&nbsp;Masafumi Nozoe PT, PhD ,&nbsp;Kuniyasu Kamiya PT, PhD ,&nbsp;Satoru Matsumoto MD ,&nbsp;Takeshi Morimoto MD, PhD MPH","doi":"10.1016/j.arrct.2023.100314","DOIUrl":"10.1016/j.arrct.2023.100314","url":null,"abstract":"<div><h3>Objective</h3><p>To assess the associations of baseline skeletal muscle mass index (SMI) with adverse events and rehabilitation outcomes in patients admitted for rehabilitation.</p></div><div><h3>Design</h3><p>A retrospective cohort study.</p></div><div><h3>Participants</h3><p>The subjects were 409 patients (mean age, 79 years; men, 167 [41%]) undergoing rehabilitation because of neurologic disease, musculoskeletal disorders, or hospital-associated deconditioning. Patients were divided into 2 groups according to the definition of sarcopenia by the Asian Working Group for Sarcopenia: those with low SMI (&lt;7.0 kg/m² in men and &lt;5.7 kg/m² in women) and those with high SMI (≥7.0 kg/m² in men and ≥5.7 kg/m² in women).</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcomes were adverse events including death and acute illness requiring transfer to other hospitals for specialized treatments. The secondary outcomes were rehabilitation outcomes including the efficiency scores (changes in functional independence measure [FIM] score divided by length of stay) of FIM for motor function (FIM-M) and FIM for cognitive function (FIM-C).</p></div><div><h3>Results</h3><p>Of the 409 patients, 299 (73%) had a low SMI. The adjusted hazard ratio (95% confidence interval) of the low SMI group relative to the high SMI group for adverse events was 2.79 (1.06-7.34). There were no significant differences between the 2 groups in FIM-M efficiency scores [mean ± SD, low SMI group: 0.4 (0.58) vs high SMI group: 0.47 (0.54), <em>P</em>=.3] and FIM-C efficiency scores [mean ± SD, 0.05 (0.14) vs 0.06 (0.2), <em>P</em>=.4]. Multiple linear regression models did not show significant associations between the low SMI group and FIM-M efficiency or FIM-C efficiency scores (β=0.064, <em>P</em>=.3; β=−0.05, <em>P</em>=.4, respectively).</p></div><div><h3>Conclusion</h3><p>Low baseline SMI was significantly associated with adverse events but not with rehabilitation outcomes in patients undergoing rehabilitation.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100314"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000812/pdfft?md5=988096583e1173b04c964aaa4aa11244&pid=1-s2.0-S2590109523000812-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138611363","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}