Archives of rehabilitation research and clinical translation最新文献

{"title":"Shoulder Pain in Persons With Tetraplegia and the Association With Force Application During Manual Wheelchair Propulsion","authors":"Ursina Arnet PhD ,&nbsp;Fransiska M. Bossuyt PhD ,&nbsp;Benjamin J.H. Beirens MSc ,&nbsp;Wiebe H.K. de Vries PhD","doi":"10.1016/j.arrct.2023.100310","DOIUrl":"https://doi.org/10.1016/j.arrct.2023.100310","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the association between propulsion biomechanics, including force application and spatio-temporal characteristics, and shoulder pain in persons with tetraplegia.</p></div><div><h3>Design</h3><p>Cross-sectional, observational study.</p></div><div><h3>Setting</h3><p>Non-university research institution.</p></div><div><h3>Participants</h3><p>16 community dwelling, wheelchair dependent persons with a chronic tetraplegia between C4 and C7, with and without shoulder pain (age, 49.1±11.7 years; 94% men, 23.4±9.5 years past injury).</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Force application and spatio-temporal characteristics of wheelchair propulsion on a treadmill (0.56 m/s, 10W and 0.83 m/s, 15W). Participants were stratified in groups with low, moderate, and high pain based on their Wheelchair User Shoulder Pain Index (WUSPI) score on the day of measurement.</p></div><div><h3>Results</h3><p>The mixed-effect multilevel analysis showed that wheelchair users with high levels of shoulder pain applied propulsion force more effectively (and with a lower medial component) and over a longer push angle, thus shortening the recovery time as compared with persons with low or moderate levels of shoulder pain.</p></div><div><h3>Conclusions</h3><p>In contrast with previous results from persons with a paraplegia, persons with tetraplegia and high levels of shoulder pain propel their wheelchair more optimal with regard to risk factors for shoulder pain. Our results therefore affirm that there is a different interaction of shoulder pain and propulsion biomechanics in persons with a tetraplegia which should be considered when further analyzing risk factors for shoulder pain in wheelchair users or applying literature results to different patient populations.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100310"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000721/pdfft?md5=ee61899426717f3a2bea20ec810a3087&pid=1-s2.0-S2590109523000721-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139999098","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":"Predicting Delayed In-Hospital Recovery of Physical Function After Total Knee Arthroplasty","authors":"Louisa T.M.A. Mulder MSc ,&nbsp;Danielle D.P. Berghmans PhD ,&nbsp;Peter Z. Feczko MD, PhD ,&nbsp;Sander M.J. van Kuijk PhD ,&nbsp;Rob A. de Bie PhD ,&nbsp;Antoine F. Lenssen PhD","doi":"10.1016/j.arrct.2024.100321","DOIUrl":"10.1016/j.arrct.2024.100321","url":null,"abstract":"<div><h3>Objective</h3><p>To identify patients at high risk of delayed in-hospital functional recovery after knee replacement surgery by developing and validating a prediction model, including a combination of preoperative physical fitness parameters and patient characteristics.</p></div><div><h3>Design</h3><p>Retrospective cohort study using binary logistic regression.</p></div><div><h3>Setting</h3><p>University hospital, orthopedic department.</p></div><div><h3>Participants</h3><p>260 adults (N=260) (≥18y) with knee osteoarthritis awaiting primary unilateral total knee arthroplasty and assessed during usual care between 2016 and 2020.</p></div><div><h3>Intervention</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>Time to reach in-hospital functional independence (in days), measured by the modified Iowa Level of Assistance Scale. A score of 0 means completely independent. Potential predictor variables are a combination of preoperative physical fitness parameters and patient characteristics.</p></div><div><h3>Results</h3><p>Binary logistic regression modeling was applied to develop the initial model. A low de Morton Mobility Index (DEMMI), walking aid use indoors, and a low handgrip strength (HGS) were the most important predictors of delayed in-hospital recovery. This model was internally validated and had an optimism-corrected <em>R</em>² of 0.07 and an area under curve of 61.2%. The probability of a high risk of delayed in-hospital recovery is expressed by the following equation:</p><p><span><math><mrow><msub><mi>P</mi><mrow><mi>h</mi><mi>i</mi><mi>g</mi><mi>h</mi><mi>r</mi><mi>i</mi><mi>s</mi><mi>k</mi></mrow></msub><mo>=</mo><mrow><mi>(</mi><mn>1</mn><mo>/</mo><mrow><mo>(</mo><mn>1</mn><mo>+</mo><msup><mrow><mi>e</mi></mrow><mrow><mo>(</mo><mo>−</mo><mo>(</mo><mn>2.638</mn><mo>−</mo><mn>0.193</mn><mo>×</mo><mi>D</mi><mi>E</mi><mi>M</mi><mi>M</mi><mi>I</mi><mo>+</mo><mn>0.879</mn><mo>×</mo><mi>i</mi><mi>n</mi><mi>d</mi><mi>o</mi><mi>o</mi><mi>r</mi><mi>w</mi><mi>a</mi><mi>l</mi><mi>k</mi><mi>i</mi><mi>n</mi><mi>g</mi><mi>a</mi><mi>i</mi><mi>d</mi><mo>−</mo><mn>0.007</mn><mo>×</mo><mi>H</mi><mi>G</mi><mi>S</mi><mo>)</mo><mo>)</mo></mrow></msup><mo>)</mo></mrow><mi>)</mi></mrow><mo>×</mo><mn>100</mn><mo>%</mo></mrow></math></span>.</p></div><div><h3>Conclusions</h3><p>The model has a low predictive value and a poor discriminative ability. However, there is a positive association between preoperative physical fitness and postoperative recovery of physical function. The validity of our model to distinguish between high and low risk, based on preoperative fitness values and patient characteristics, is limited.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100321"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109524000041/pdfft?md5=5852e7f52b28f2fec37ae4256c993373&pid=1-s2.0-S2590109524000041-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139538806","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 Prospective Intervention Study With 6 Months Follow-up of the Effect of Reablement in Home Dwelling Elderly: Patient-reported and Observed Outcomes","authors":"Jeanette Kjernsholen MD ,&nbsp;Inger Schou-Bredal PhD, RN, OUS ,&nbsp;Rolf Kaaresen MD, PhD, OUS ,&nbsp;Helene Lundgaard Soberg PhD ,&nbsp;Aase Sagen PhD","doi":"10.1016/j.arrct.2023.100311","DOIUrl":"10.1016/j.arrct.2023.100311","url":null,"abstract":"<div><h3>Objectives</h3><p>To investigate the effect of a reablement intervention (a person-centered, interdisciplinary rehabilitation approach) compared with usual care services in home-dwelling elderly experiencing functional declines in activities of daily living.</p></div><div><h3>Design</h3><p>A non-randomized controlled trial comparing a reablement intervention with usual care; outcomes were measured at baseline, after intervention, and at a 6-month from baseline in both groups.</p></div><div><h3>Setting</h3><p>Municipal public health service.</p></div><div><h3>Participants</h3><p>Sixty-five home-dwelling elderly with functional decline were assigned by the participants home care service zone to a reablement group (n=35), or a usual care group (n=30). The mean participant age was 80±11 years in the reablement group and 78±12 in the usual care group.</p></div><div><h3>Intervention</h3><p>The reablement group received a person-centered and tailored reablement program provided by an interdisciplinary team, consisting of a physiotherapist, an occupational therapist, and a nurse. The usual care group received standard home care services.</p></div><div><h3>Main Outcome Measures</h3><p>The dimension “Your health today” from the European Quality of Life-Visual Analog Scale (HRQOL), the patient-specific functional scale for goals in ADL (PSFS), the short physical performance battery (SPPB), and home care services in hours per week.</p></div><div><h3>Results</h3><p>There were significant differences over time in favor of the reablement group with between-group effect sizes of Cohen h²=0.36 (<em>P</em>=.001) for HRQOL, h²=0.60 (<em>P</em>=.001) for PSFS, h²=0.30 (<em>P</em>=.001) for SPPB, and h²=0.10 (<em>P=</em>.013) for hours of home care services per week. The within-group effect size for PSFS was h²=0.15 (<em>P=</em>.010) in favor of the reablement group. The mean number of hours of home care services per week was mean 0.38±1.07 (<em>P</em>=.001) in the reablement group and mean 30.38±64.13 (<em>P</em>=.023) in the usual care group.</p></div><div><h3>Conclusions</h3><p>The participants in the reablement group achieved and maintained better physical function, a higher HRQOL and needed considerably less home care services than the usual care group participants. Thus, reablement appears to be a more beneficial and sustainable approach than the usual care services for the home-dwelling elderly with functional decline.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100311"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000733/pdfft?md5=f307fb070aae2676db1f261e9d5ca0e2&pid=1-s2.0-S2590109523000733-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139305205","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 a Self-directed Upper Extremity Training Program to Promote Actual Arm Use for Individuals Living in the Community With Chronic Stroke","authors":"Grace J. Kim PhD ,&nbsp;Amanda Gahlot MS ,&nbsp;Camile Magsombol OTD ,&nbsp;Margaret Waskiewicz OTD ,&nbsp;Nettie Capasso MS ,&nbsp;Stephen Van Lew PhD ,&nbsp;Hayejin Kim MS ,&nbsp;Avinash Parnandi PhD ,&nbsp;Victoria Vaughan Dickson PhD ,&nbsp;Yael Goverover PhD","doi":"10.1016/j.arrct.2023.100316","DOIUrl":"10.1016/j.arrct.2023.100316","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the feasibility of a self-directed training protocol to promote actual arm use in everyday life. The secondary aim was to explore the initial efficacy on upper extremity (UE) outcome measures.</p></div><div><h3>Design</h3><p>Feasibility study using multiple methods.</p></div><div><h3>Setting</h3><p>Home and outpatient research lab.</p></div><div><h3>Participants</h3><p>Fifteen adults (6 women, 9 men, mean age=53.08 years) with chronic stroke living in the community. There was wide range of UE functional levels, ranging from dependent stabilizer (limited function) to functional assist (high function).</p></div><div><h3>Intervention</h3><p>Use My Arm-Remote protocol. Phase 1 consisted of clinician training on motivational interviewing (MI). Phase 2 consisted of MI sessions with participants to determine participant generated goals, training activities, and training schedules. Phase 3 consisted of UE task-oriented training (60 minutes/day, 5 days/week, for 4 weeks). Participants received daily surveys through an app to monitor arm training behavior and weekly virtual check-ins with clinicians to problem-solve challenges and adjust treatment plans.</p></div><div><h3>Outcome Measures</h3><p>Primary outcome measures were feasibility domains after intervention, measured by quantitative study data and qualitative semi-structured interviews. Secondary outcomes included the Canadian Occupational Performance Measure (COPM), Motor Activity Log (MAL), Fugl-Meyer Assessment (FMA), and accelerometry-based duration of use metric measured at baseline, discharge, and 4-week follow-up.</p></div><div><h3>Results</h3><p>The UMA-R was feasible in the following domains: recruitment rate, retention rate, intervention acceptance, intervention delivery, adherence frequency, and safety. Adherence to duration of daily practice did not meet our criteria. Improvements in UE outcomes were achieved at discharge and maintained at follow-up as measured by COPM-Performance subscale (F[1.42, 19.83]=17.72, <em>P</em>&lt;.001) and COPM-Satisfaction subscale (F[2, 28]=14.73, <em>P</em>&lt;.001), MAL (F[1.31, 18.30]=12.05, <em>P</em>&lt;.01) and the FMA (F[2, 28]=16.62, <em>P</em>&lt;.001).</p></div><div><h3>Conclusion</h3><p>The UMA-R was feasible and safe to implement for individuals living in the community with chronic stroke. Adherence duration was identified as area of refinement. Participants demonstrated improvements in standardized UE outcomes to support initial efficacy of the UMA-R. Shared decision-making and behavior change frameworks can support the implementation of UE self-directed rehabilitation. Our results warrant the refinement and further testing of the UMA-R.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100316"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000836/pdfft?md5=0820b37c0308f78548d0cb7acdc91cdc&pid=1-s2.0-S2590109523000836-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139632272","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":"Exercise and Musculoskeletal Health in Men With Low Bone Mineral Density: A Systematic Review","authors":"Katherine Hu MD ,&nbsp;Maree Cassimatis BAppSc(ExPhys) ,&nbsp;Christian Girgis MD","doi":"10.1016/j.arrct.2023.100313","DOIUrl":"10.1016/j.arrct.2023.100313","url":null,"abstract":"<div><h3>Objective</h3><p>This systematic review aims to determine the effects of exercise on bone and muscle health in men with low bone density.</p></div><div><h3>Data Sources</h3><p>An electronic search in the following databases was performed: Medline, AMED, Embase, Scopus, and SPORTDiscus between January 1940 and September 2021.</p></div><div><h3>Study Selection</h3><p>Randomized or non-randomized trials involving any form of exercise in adult men with a densitometric diagnosis of osteoporosis or osteopenia and reported outcomes relating to bone or muscle health. Two independent reviewers screened 12,018 records, resulting in 13 eligible articles.</p></div><div><h3>Data Extraction</h3><p>One reviewer extracted data into a pre-formed table, including characteristics of the exercise intervention, population examined, and primary and secondary outcomes. Study quality was assessed by 2 independent reviewers using the Tool for assEssment of Study qualiTy and reporting in Exercise (TESTEX).</p></div><div><h3>Data Synthesis</h3><p>Thirteen publications, originating from 6 unique trials, were eligible for inclusion, which assessed the effect of resistance training, impact training, whole body vibration, and traditional Chinese exercises. Resistance training was the most effective: it stimulates the replacement of adipose tissue with muscle, and in some cases, improved bone density.</p></div><div><h3>Conclusions</h3><p>Exercise, especially resistance training, slowed down the natural progression of osteoporosis and sarcopenia in men. These benefits are reflected in enhancements to function, such as improved mobility and balance. Other exercise modalities, such as whole body vibration and traditional Chinese exercises, generated minimal improvements to bone health, strength, and balance.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"6 1","pages":"Article 100313"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000800/pdfft?md5=544a4523bcf6f0747f34a33589d79934&pid=1-s2.0-S2590109523000800-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138627045","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":"Incidents and Sudden Patient Deteriorations Occurring During Their Rehabilitation Sessions in an Acute Care Hospital: A Retrospective Cohort Study","authors":"Koji Mizutani PT, MSc ,&nbsp;Yohei Otaka MD, PhD ,&nbsp;Masaki Kato PT ,&nbsp;Miwako Hayakawa PT, MSc ,&nbsp;Yoshitaka Wada MD, PhD ,&nbsp;Takamichi Tohyama MD, PhD ,&nbsp;Megumi Ozeki MD, PhD ,&nbsp;Hirofumi Maeda MD, PhD ,&nbsp;Satoshi Hirano MD, PhD ,&nbsp;Seiko Shibata MD, PhD","doi":"10.1016/j.arrct.2023.100307","DOIUrl":"10.1016/j.arrct.2023.100307","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the occurrence of incidents and sudden deteriorations during rehabilitation in an acute care setting by disease category based on the International Classification of Diseases and Related Health Problems, 10th Revision.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting</h3><p>University hospital in Japan with 1376 beds.</p></div><div><h3>Participants</h3><p>A total of 49,927 patients who were admitted to the acute care wards and underwent rehabilitation over 8 years, from April 1, 2013, to March 31, 2021.</p></div><div><h3>Interventions</h3><p>Rehabilitation in an acute care setting.</p></div><div><h3>Main Outcome Measures</h3><p>Incidents and sudden deteriorations reported in medical charts.</p></div><div><h3>Results</h3><p>Among 49,927 admissions, 455 incidents and 683 sudden deteriorations occurred during rehabilitation. The incidents and sudden deteriorations occurred at rates of 0.009/person (0.50 case/1000 h) and 0.012/person (0.75 case/1000 h), respectively. The 3 most frequent incidents were “route-related incidents” (178 cases, 39.1%), followed by “bleeding/abrasions” (131 cases, 28.8%) and “falls” (125 cases, 27.5%). Among 12 disease categories with over 500 admissions and 10,000 rehabilitation hours, the highest incident rate occurred in “certain infectious and parasitic diseases” (0.81 case/1000 h), followed by “diseases of the musculoskeletal system and connective tissue” (0.67 case/1000 h) and “diseases of the genitourinary system” (0.66 case/1000 h). The commonest sudden deterioration was “vomiting” (460 cases, 67.3%), followed by “decreased level of consciousness (with reduced blood pressure)” (42 cases, 6.1%) and “seizure” (39 cases, 5.7%). Furthermore, the highest sudden deterioration rate was in the “endocrine, nutritional, and metabolic diseases” (1.19 case/1000 h) category, followed by “neoplasms” (1.04 case/1000 h) and “certain infectious and parasitic diseases” (0.99 case/1000 h).</p></div><div><h3>Conclusions</h3><p>An incident and sudden deterioration occurred every 2000 and 1333 h, respectively, during rehabilitation. Therefore, understanding the actual occurrence of incidents and sudden deteriorations during rehabilitation may provide valuable insights into preventing incidents and emergencies.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100307"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000691/pdfft?md5=4bca478d4eab7cc14bafefa686ccd9fc&pid=1-s2.0-S2590109523000691-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136160954","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":"Effect of Post-stroke Depression on Functional Outcomes of Patients With Stroke in the Rehabilitation Ward: A Retrospective Cohort Study","authors":"Yoshitaka Wada MD, PhD ,&nbsp;Yohei Otaka MD, PhD ,&nbsp;Taiki Yoshida OTR, PhD ,&nbsp;Kanako Takekoshi RN ,&nbsp;Raku Takenaka MD ,&nbsp;Yuki Senju MD, PhD ,&nbsp;Hirofumi Maeda MD, PhD ,&nbsp;Seiko Shibata MD, PhD ,&nbsp;Taro Kishi MD, PhD ,&nbsp;Satoshi Hirano MD, PhD","doi":"10.1016/j.arrct.2023.100287","DOIUrl":"10.1016/j.arrct.2023.100287","url":null,"abstract":"<div><h3>Objective</h3><p>To investigate the prevalence of post-stroke depression in a rehabilitation ward and elucidate its effect on functional improvement and outcomes.</p></div><div><h3>Design</h3><p>Retrospective cohort study.</p></div><div><h3>Setting</h3><p>A convalescent rehabilitation ward at a University Hospital.</p></div><div><h3>Participants</h3><p>A total of 114 patients with stroke (mean [SD] age, 67.2 [13.5] years; men, 76) assessed at 2 weeks after admission using the Mini-International Neuropsychiatric Interview were enrolled.</p></div><div><h3>Main Outcome Measure</h3><p>Functional independence measure (FIM) efficiency during hospitalization in the ward.</p></div><div><h3>Results</h3><p>Eleven patients (9.6%) had depression based on the Mini-International Neuropsychiatric Interview. Total FIM efficiency and FIM efficiency in the subtotal of motor items were significantly higher in the non-depression group than in the depression group (median [interquartile range]: 0.69 [0.39-0.95] vs 0.41 [0.24-0.63], <em>P</em>=.027; and 0.56 [0.38-0.80] vs 0.42 [0.18-0.49], <em>P</em>=.023, respectively). Patients in the non-depression group had higher FIM scores at discharge (median [interquartile range]: 116.0 [104.5-123.0] vs 104.0 [82.5-112.0], <em>P</em>=.013, respectively), and were more likely to be discharged home (80.6% vs 36.4%, <em>P</em>=.003). Furthermore, patients in the depression group also stayed significantly longer in the ward (71.0 [36.1] vs 106.1 [43.3], <em>P</em>=.010).</p></div><div><h3>Conclusions</h3><p>Patients with post-stroke depression showed poorer efficiency of functional recovery than those without depression. A future multicenter study with a larger sample size is needed to verify these findings.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100287"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000435/pdfft?md5=ccc69e29e3536f322048fe7bcd204db7&pid=1-s2.0-S2590109523000435-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43914197","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":"Relationship of Age And Mobility Levels During Physical Rehabilitation With Clinical Outcomes in Critical Illness","authors":"Kirby P. Mayer PT, PhD ,&nbsp;Susan Silva PhD ,&nbsp;Amanda Beaty PT ,&nbsp;Anne Davenport PT ,&nbsp;Melissa Minniti PT ,&nbsp;Sara Uribe Dorn PT ,&nbsp;Lane S. White PT ,&nbsp;Valerie K. Sabol PhD, MBA ,&nbsp;Amy M. Pastva PT, MA, PhD","doi":"10.1016/j.arrct.2023.100305","DOIUrl":"10.1016/j.arrct.2023.100305","url":null,"abstract":"<div><h3>Objective</h3><p>To determine whether age, mobility level, and change in mobility level across the first 3 physical rehabilitation sessions associate with clinical outcomes of patients who are critically ill.</p></div><div><h3>Design</h3><p>Retrospective, observational cohort study.</p></div><div><h3>Setting</h3><p>Medical Intensive Care Unit (MICU).</p></div><div><h3>Participants</h3><p>Hospitalized adults (n = 132) who received 3 or more, consecutive rehabilitation sessions in the MICU.</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Measurements and Main Results</h3><p>Sample included 132 patients with 60 (45%) classified as younger (18-59 years) and 72 (55%) as older (60+ years). The most common diagnosis was sepsis/septicemia (32.6%). Older relative to younger patients had a significantly slower rate of improvement in ICU Mobility Scale (IMS) scores across rehabilitation sessions (mean slope coefficient 0.3 vs 0.6 points, <em>P</em>&lt;.001), were less likely to be discharged to home (30.6% vs 55.0%, <em>P</em>=.005), and were more likely to die within 12 months (41.7% vs 25.0%, <em>P</em>=.046). Covariate-adjusted models indicated greater early improvement in IMS scores were associated with discharge home (<em>P</em>=.005). Longer time to first rehabilitation session, lower initial IMS scores, and slower improvement in IMS scores were associated with increased ICU days (all <em>P</em>&lt;.03).</p></div><div><h3>Conclusion</h3><p>Older age and not achieving the mobility milestone of sitting at edge of bed or limited progression of mobility across sessions is associated with poor patient outcomes. Our findings suggest that age and mobility level contribute to outcome prognostication, and can aide in clinical phenotyping and rehabilitative service allocation.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100305"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000678/pdfft?md5=4ee695cd17194771a3475e0fae5bb07e&pid=1-s2.0-S2590109523000678-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135654321","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":"Oxygen Therapy During Activities of Daily Living Rehabilitation and Outcome in Patients With Severe-to-critical COVID-19","authors":"Shuen-Loong Tham MRCP ,&nbsp;Koh Kuan Cheryl Tan Dip PT ,&nbsp;Na-Ling Lin BSc OT, MSc OT ,&nbsp;Alfred Wai Ping Seng MRCP","doi":"10.1016/j.arrct.2023.100304","DOIUrl":"10.1016/j.arrct.2023.100304","url":null,"abstract":"<div><h3>Objective</h3><p>To primarily study the duration of supplemental oxygen use while performing ADLs (activities of daily living) and associations leading to a more prolonged oxygen therapy during these tasks. Secondary objectives include (1) studying the presence of COVID-19 related complications during inpatient rehabilitation and after discharge and (2) describing functional outcomes of participants after supplemental oxygen liberation and hospital discharge.</p></div><div><h3>Design</h3><p>Explorative prospective observational cohort study.</p></div><div><h3>Setting</h3><p>Rehabilitation center within a tertiary hospital, caring for post-COVID patients.</p></div><div><h3>Participants</h3><p>Twenty-three (N=23) community-dwelling persons with severe-to-critical COVID-19 disease and ongoing oxygen therapy needs. There was a preponderance of men (69.6%), with mean age of 69.5 (range 46-85) years.</p></div><div><h3>Interventions</h3><p>Inpatient pulmonary rehabilitation.</p></div><div><h3>Main Outcome Measures</h3><p>The primary outcome was the duration of supplemental oxygen use (from initiation till wean) for ambulation, toileting, dressing, and showering. Secondary outcomes included the presence of COVID-19 related complications (during rehabilitation and after discharge) and post-discharge functional status.</p></div><div><h3>Results</h3><p>After rehabilitation center transfer, all subjects only required oxygen therapy during task(s) performance, and not at rest. ADLs that took the shortest and longest time for supplemental oxygen weaning were dressing (mean 38.4±SD 17.1 days) and showering (mean 47.7±SD 18.1 days), respectively. The mean duration of oxygen therapy application was 48.6±SD 18.3 days. On multivariable analysis, mechanical ventilation and exertional desaturation were significantly associated with prolonged duration for oxygen therapy in all ADLs.</p></div><div><h3>Conclusion</h3><p>The duration of needful oxygen therapy was dissimilar for different ADLs. Showering, which required the longest duration of supplemental oxygen wean, might prove to be the rate-limiting ADL for discharge home.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100304"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000666/pdfft?md5=1677796492be299030823ecae0e9aa2a&pid=1-s2.0-S2590109523000666-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135705747","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":"Characteristics of Gait Event and Muscle Activation Parameters of the Lower Limb on the Affected Side in Patients With Hemiplegia After Stroke: A Pilot Study","authors":"Jeong-Woo Seo PhD ,&nbsp;Geon‐hui Kang MS ,&nbsp;Cheol-hyun Kim PhD ,&nbsp;Jeeyoun Jung PhD ,&nbsp;Junggil Kim BS ,&nbsp;Hyeon Kang MS ,&nbsp;Sangkwan Lee KMD, PhD","doi":"10.1016/j.arrct.2023.100274","DOIUrl":"10.1016/j.arrct.2023.100274","url":null,"abstract":"<div><h3>Objectives</h3><p>To confirm the characteristics of gait events and muscle activity in the lower limbs of the affected and unaffected sides in patients with hemiplegia.</p></div><div><h3>Design</h3><p>Cross-sectional study.</p></div><div><h3>Setting</h3><p>Motion analysis laboratory of the Wonkwang University Gwangju Hospital.</p></div><div><h3>Participants</h3><p>Outpatients, diagnosed with ischemic stroke more than 3 months and less than 9 months before participating in the study (N=29; 11 men, 18 women).</p></div><div><h3>Interventions</h3><p>Not applicable.</p></div><div><h3>Main Outcome Measures</h3><p>The gait event parameters and time- and frequency-domain electromyogram (EMG) parameters of the lower limbs of the affected and unaffected sides was determined using BTS motion capture with the Delsys Trigno Avanti EMG wireless system.</p></div><div><h3>Results</h3><p>The swing time, stance phase, swing phase, single support phase, and median power frequency of the gastrocnemius muscle showed a significant difference between the affected and unaffected sides. Using a logistic regression model, the swing phase, single support phase, and median frequency of the gastrocnemius muscle were selected to classify the affected side.</p></div><div><h3>Conclusion</h3><p>The single support phase of the affected side is shortened to reduce load bearing, which causes a reduction in the stance phase ratio. Unlike gait-event parameters, EMG data of hemiplegic stroke patients are difficult to generalize. Among them, the logistic regression model with some affected side parameters expected to be set as the severity and improvement baseline of the affected side. Additional data collection and generalization of muscle activity is required to improve the classification model.</p></div>","PeriodicalId":72291,"journal":{"name":"Archives of rehabilitation research and clinical translation","volume":"5 4","pages":"Article 100274"},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2590109523000307/pdfft?md5=a22b8245be2e279559acc1aba3cdf042&pid=1-s2.0-S2590109523000307-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47906502","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}