Frontiers in rehabilitation sciences最新文献

{"title":"A systematic literature review to explore lived experiences with phantom limb phenomenon following a lower extremity amputation: a qualitative synthesis.","authors":"Abdullah Ali H Alabdullah, Saeed Saad Alyazidi, Ibrahim Ali Asiri, Hussain Saleh Ali, Sarah Abdullah Almutlaqah, Ahmed Saleh Alzahrani, Saeed Abdulrhman Alzahb, Sumaya Abdullah Alasmari, Dejan Nikolic, Natasa Radosavljevic","doi":"10.3389/fresc.2025.1667659","DOIUrl":"10.3389/fresc.2025.1667659","url":null,"abstract":"<p><strong>Objective: </strong>In this review we aimed to understand better frequent experiences accompanying phantom limb issues from patients' perspective and accordingly to generate recommendations for clinical practice.</p><p><strong>Methods: </strong>A systematic literature review approach was utilized and articles meeting the eligibility criteria were critically appraised using the Critical Appraisal Skills Program (CASP). Additionally, a meta-synthesis approach was adopted to combine and analyze the data.</p><p><strong>Results: </strong>Ten relevant studies were critiqued, key themes were: 1) early Information Provision about phantom Limb Pain (PLP) and Participants' Satisfaction; 2) the PLP's described characteristics; 3) different Emotions and Psychosocial Issues with PLP; 4) the Impact of the PLP on Performing Daily Activities<i>;</i> and 5) the experienced strategies to address the PLP.</p><p><strong>Conclusion: </strong>The experience of phantom limb varies among individuals with lower limb amputation (LLA); however, for many, PLP significantly affects both physical and psychological well-being, adding an additional burden to the overall experience of amputation. Addressing these challenges should begin with early education, followed by a rehabilitation process that considers individual differences in coping mechanisms. Moreover, patients' preferences should be prioritized when selecting prosthetic devices and determining the most appropriate treatment strategies for managing PLP.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1667659"},"PeriodicalIF":1.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12488712/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234489","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":"Persistent obstacles for return to work after COVID-19 infection - an explorative follow-up study in Sweden.","authors":"Hilda Öhlén, Iolanda Santos Tavares Silva, Marie Gustafsson, Sara Jarl, Ann Björkdahl","doi":"10.3389/fresc.2025.1628490","DOIUrl":"10.3389/fresc.2025.1628490","url":null,"abstract":"<p><strong>Design aim and method: </strong>To explore in patients with postcovid-19 condition the influence of various factors on return to work in the year following diagnosis. The study had an explorative quantitative and qualitative design based on interviews with 41 hospitalized (HC) and 63 primary care (PC) COVID-19 patients. RTW was described at 3 and 12 months, and differences between groups, changes over time and possible factors explaining RTW were analysed statistically. Qualitative analyses with content analysis of interviews were performed to describe obstacles to work.</p><p><strong>Result: </strong>The obstacles for RTW were persistent symptoms such as fatigue, cognitive dysfunction and breathlessness with the consequences for work as lack of energy, decreased physical capability, decreased mental stamina, reduced cognitive ability, increased sensitivity to stress and general reduced capacity. At 12 months, 50% and 70% of patients in the PC and HC groups, respectively, had returned to full-time work, while 20% of patients in both groups had not RTW at all. To function at work, many patients expressed that they required adaptations. RTW was not dependent on the initial severity of COVID-19 or type of work. The likelihood of RTW was higher in males with COVID-19 onset during the second wave.</p><p><strong>Conclusion: </strong>RTW may be limited after COVID-19 infection, regardless of its initial severity. Women with persistent covid had greater difficulty than men in returning to work. Limitations were due to a general reduced capacity mainly caused by physical and mental fatigue, and cognitive dysfunction. However, the support from employers and the environment also has an impact on the RTW. If necessary, appropriate rehabilitation measures should be offered and adaptations of work content and the organization of the work at the workplace are of great importance.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1628490"},"PeriodicalIF":1.9,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12490236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145234429","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 between post-COVID-19 symptoms and daily physical activity.","authors":"Antonio Sarmento, Sandra Webber, Shelley Sargent, Brenda Tittlemier, Diana C Sanchez-Ramirez","doi":"10.3389/fresc.2025.1646093","DOIUrl":"10.3389/fresc.2025.1646093","url":null,"abstract":"<p><strong>Background: </strong>Exertion-intolerant symptoms common in post-COVID-19 syndrome (PCS), often resembling myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), challenge conventional rehabilitation and highlight the need for research into the poorly understood relationship between PCS symptoms and physical activity.</p><p><strong>Objectives: </strong>We aimed to investigate the longitudinal associations between PCS symptoms and physical activity (same and following day), while accounting for the presence of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) symptoms. Additionally, to compare the characteristics and outcomes of PCS patients with and without ME/CFS symptoms.</p><p><strong>Methods: </strong>Adults with PCS participated in an in-person evaluation that included assessment of dyspnea (Borg scale), fatigue (Fatigue Severity Scale), ME/CFS symptoms screening (DePaul Symptom Questionnaire), and functional capacity. Participants were also instructed to complete a daily PCS symptoms survey and wear a smartwatch for a week to track daily physical activity (step count).</p><p><strong>Results: </strong>Eighteen individuals with PCS (78% females, 51 ± 11 years) participated in the study, averaging 4,067 steps per day (95%CI 3,638-4,497) over 117 days of valid data. Individuals with ME/CFS symptoms (<i>n</i> = 11) reported more severe PCS symptoms and had lower functional capacity than those without ME/CFS symptoms. After adjusting for ME/CFS symptoms, greater dizziness was associated with fewer steps on the same [OR 0.94 (95%CI 0.88-0.99), <i>p</i> = 0.026] and following day [OR 0.91 (95%CI 0.84-0.98), <i>p</i> = 0.016]. Lower levels of fatigue [OR 0.69 (95%CI 0.49-0.99), <i>p</i> = 0.043] and chest pain [OR 0.76 (95%CI 0.57-0.99), <i>p</i> = 0.048] were associated with walking ≥5,000 steps on the previous day.</p><p><strong>Conclusion: </strong>Regardless of the presence of ME/CFS symptoms, dizziness was negatively associated with physical activity on both the same and following day in PCS individuals. Additionally, lower levels of fatigue and chest pain were linked to walking 5,000 steps or more the previous day.</p><p><strong>Impact: </strong>These results provide insights into the relationships between symptoms and daily physical activity in PCS, which can help tailor interventions and improve the management of this condition. This research also highlights the value of using wearable devices and smartphone apps to collect data for monitoring individuals with PCS over time.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1646093"},"PeriodicalIF":1.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202235","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 assistive technology needs, unmet demands, barriers, and gaps in the Indian population: a protocol for large epidemiological survey.","authors":"Ashoo Grover, Hitesh K Sharma, Ravindra M Pandey, Ruchir Malik, Salaj Rana, Manisha Panda, Geeta Rani, Sunanda Deb, Shubhendu Singh, Akash, Daanish, Anjali Bajaj, Rupinder S Dhaliwal, Ravinder Singh","doi":"10.3389/fresc.2025.1650693","DOIUrl":"10.3389/fresc.2025.1650693","url":null,"abstract":"<p><strong>Background: </strong>Despite the critical role of assistive technologies (AT) in supporting individuals with functional impairments, there is limited information on AT needs and barriers across India's diverse regions. To fill this gap, we have designed a detailed survey protocol to gather nationally representative data on AT need, unmet need and satisfaction.</p><p><strong>Methods: </strong>A cross-sectional survey of 180,000 individuals (30,000 per region) across six regions i.e., North, South, East, West, Central, and North-East India will be conduct. Districts will be purposively selected to capture geographic diversity and institutional capacity; within each selected district, villages and urban wards will be chosen with probability proportional to size and households will then be selected by systematic random sampling. All members of each sampled household will be interviewed with the digital WHO Rapid Assistive Technology Assessment (rATA) tool, after staff complete standard training program; data quality will be ensured through real-time database checks, supervisory cross-checks, and monthly audits by the ICMR coordinating team.</p><p><strong>Analysis: </strong>We will estimate prevalence of AT need, unmet need, and satisfaction with 95 percent confidence intervals using univariate and multivariate logistic regression to identify associated factors. Sampling weights and sensitivity analyses will adjust and compare estimates.</p><p><strong>Discussion: </strong>This protocol describes the largest AT needs survey ever conducted in South-East Asia. The data generated will provide crucial evidence to guide India's national AT strategy. By sharing our detailed methodology, we aim to offer a practical framework that other low and middle-income countries can adapt to assess and enhance their own AT services.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1650693"},"PeriodicalIF":1.9,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12477122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145202209","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":"How recovery influences community reintegration: perspectives of persons with spinal cord injury and their support persons.","authors":"Anne M Bryden, Brian Gran, Susan Hinze, Mary Ann Richmond, Kim D Anderson","doi":"10.3389/fresc.2025.1617764","DOIUrl":"10.3389/fresc.2025.1617764","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate how perceived recovery influences perspectives on successful community reintegration, from the point of view of persons with spinal cord injury (PWS) and their support persons (SP).</p><p><strong>Methods: </strong>Our mixed methods approach included qualitative interviews conducted with civilians and Veterans with spinal cord injury (SCI) and their designated SP at three time points across the first year after SCI: during inpatient rehabilitation, 6 months, and 12 months. Participants with SCI completed measures of independence [Spinal Cord Injury Independence Measure III (SCIM-III)] and self-efficacy (Moorong Self-Efficacy Scale) during inpatient rehabilitation and at 12 months postinjury. Data analysis was informed by the Transformative Framework and International Classification of Functioning, Disability, and Health (ICF).</p><p><strong>Results: </strong>Regarding perceptions of how recovery influences community reintegration, PWS most often reported themes related to slow recovery whereas SPs expressed concerns about psychological impacts on PWS. While some participants were equally satisfied with rate of recovery and rate of community reintegration, several deviated from that expected trajectory. Associations between satisfaction with community reintegration and independence or self-efficacy were variable.</p><p><strong>Conclusions: </strong>Successful community reintegration cannot be predicted solely on clinical measures. Inclusion of perspectives of PWS and their support systems is critical to inform successful societal participation after SCI.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1617764"},"PeriodicalIF":1.9,"publicationDate":"2025-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12460264/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187676","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":"Do we need internal medicine specialists in physical therapy? Recognizing the need for updating the clinical practice paradigm.","authors":"Mansour M Alotaibi","doi":"10.3389/fresc.2025.1656054","DOIUrl":"10.3389/fresc.2025.1656054","url":null,"abstract":"<p><p>The growing demand for healthcare services and development of healthcare present an opportunity for expanding physical therapy roles into internal medicine. This perspective discusses the potential benefits and limitations of establishing a formal internal medicine specialization for physical therapists (PTs). While PTs already contribute significantly to chronic disease prevention and treatment, their current scope of practice lacks structured training in internal medicine domains such as metabolic, autoimmune, renal, and systemic inflammatory disorders. Integrating internal medicine into PT education and clinical practice could enhance early identification of red flags, embrace interdisciplinary collaboration, and improve non-pharmacological interventions for various internal medicine-related diseases. Nevertheless, this expansion must be approached with caution, ensuring clear scope definitions, adequate training, and collaborative implementation to mitigate risks such as role ambiguity or misdiagnosis. Drawing on global experiences from advanced practice models and emerging literature, this paper calls for a discussion on the feasibility, safety, and value of internal medicine specialization in physical therapy practice. The goal of this perspective is not to replace medical professionals but to augment chronic disease management through targeted evidence-based rehabilitation strategies and preventative approaches.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1656054"},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12454313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139703","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":"Preliminary study on the treatment of prepubescent adolescent idiopathic scoliosis with Schroth exercises combined with core exercises.","authors":"Han-Tao Jiang, Jia-Yan Chen, Feng-Ze Wu, Shu-Jun Chen, Wei-Qiang Wang, Min-Jiao Wu","doi":"10.3389/fresc.2025.1586538","DOIUrl":"10.3389/fresc.2025.1586538","url":null,"abstract":"<p><strong>Background: </strong>Adolescent Idiopathic Scoliosis (AIS) is a common spinal deformity affecting 1%-3% of adolescents aged 10-18, characterized by a lateral curvature with a Cobb angle ≥10°. Current treatments, including bracing and surgery, have limitations in patient compliance and invasiveness, highlighting the need for effective non-surgical alternatives.</p><p><strong>Methods: </strong>This retrospective cohort study included five prepubescent patients (age 10-14 years, Tanner Stage 1-2) with moderate AIS (Cobb angle 20°-40°). The intervention combined Schroth exercises with core exercises, performed 3-4 times daily over six months. Cobb angles were measured from standing full-spine radiographs at baseline and six months, while quality of life was assessed using the Scoliosis Research Society-22 (SRS-22) questionnaire.</p><p><strong>Results: </strong>The mean Cobb angle significantly reduced from 24.12° ± 4.80° at baseline to 12.68° ± 8.11° post-intervention (<i>p</i> = 0.012). Quality of life improved across all SRS-22 domains, with statistically significant gains in pain (<i>p</i> < 0.001), function (<i>p</i> = 0.011), mental health (<i>p</i> < 0.001), and self-image (<i>p</i> < 0.001). These findings suggest that the combined intervention effectively addresses spinal alignment and muscle strength, leading to improved clinical outcomes.</p><p><strong>Conclusion: </strong>This preliminary study demonstrates that combining Schroth exercises with core exercises is a promising non-surgical intervention for prepubescent AIS patients, significantly reducing Cobb angles and improving quality of life. Future research should include larger cohorts and longer follow-up periods to validate these findings and explore the long-term benefits of this combined approach.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1586538"},"PeriodicalIF":1.9,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12446239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114954","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":"Quality of life among lower limb prosthetic users in Jordan: a cross-sectional study using the Arabic SF-36.","authors":"Mahmoud Alfatafta, Huda Alfatafta, Amneh Alshawabka, Huthaifa Atallah, Anthony McGarry","doi":"10.3389/fresc.2025.1665006","DOIUrl":"10.3389/fresc.2025.1665006","url":null,"abstract":"<p><strong>Introduction: </strong>Lower limb amputation is a life-altering event that affects multiple dimensions of quality of life (QoL), including physical functioning, emotional well-being, and social participation. Despite the clinical importance of QoL assessment in prosthetic rehabilitation, few studies have examined the multidimensional impact of amputation and prosthesis use in the Jordanian context. This study aimed to evaluate the QoL of lower-limb prosthetic users in Jordan and examine potential differences based on gender, and amputation level.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 293 adults with lower limb amputations, using prostheses. Participants completed the Arabic version of the RAND 36-Item Health Survey (SF-36). Data were collected from public and private rehabilitation centers across Jordan. Eight QoL subscales were scored on a 0-100 scale. Descriptive statistics, group comparisons (gender and age group), and multiple linear regression were conducted to assess predictors of QoL.</p><p><strong>Results: </strong>The highest domain scores were observed in Emotional Well-being (median = 77.0, IQR 55.0-90.0) and Social Functioning (median = 100.0, IQR 62.5-100.0), while the lowest were in Role Physical (median = 50.0, IQR 0.0-100.0) and General Health (median = 41.7, IQR 33.3-58.3). Group comparisons revealed significant differences by amputation level in Role Physical, Role Emotional, and Composite QoL scores, with individuals with more proximal amputations reporting lower outcomes. Regression analyses showed that older age significantly predicted poorer Physical Functioning (<i>β</i> = -0.75, <i>p</i> < 0.001), and male participants scored higher than females in the same domain (<i>β</i> =  + 8.67, <i>p</i> = 0.0227). Amputation level was significantly associated with QoL in select domains in group comparisons, though it was not a significant predictor in multivariable regression. Education level was not a significant factor in either analysis. The models explained a modest proportion of variance, with <i>R</i>² values ranging from 0.03 to 0.19 across SF-36 domains.</p><p><strong>Conclusions: </strong>Lower limb prosthetic users in Jordan experience moderate impairments in physical QoL domains, particularly among older adults. Emotional and social domains were relatively preserved. Demographic factors, especially age and gender were associated with differences in specific QoL outcomes and should be considered in the development of personalized rehabilitation strategies.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1665006"},"PeriodicalIF":1.9,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12440895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088341","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":"Intramuscular hemorrhage during rehabilitation in a post-stroke patient with vascular Ehlers-Danlos syndrome: a case report and review of spasticity-related muscle injury.","authors":"Rina Izumi, Koji Hayashi, Mamiko Sato, Tomohisa Yamaguchi, Asuka Suzuki, Yuka Nakaya, Kazumi Ikeda, Masamichi Ikawa, Yasutaka Kobayashi","doi":"10.3389/fresc.2025.1638656","DOIUrl":"10.3389/fresc.2025.1638656","url":null,"abstract":"<p><p>We present the first documented case of vascular Ehlers-Danlos syndrome (vEDS) associated with muscle injury in a spastic muscle following a stroke, which occurred during physical therapy. The patient was a 46-year-old male with a family history of subarachnoid hemorrhage (SAH) and aortic dissection, who presented with sudden headache, dysarthria, and left hemiparesis, leading to transport to a nearby hospital. He was diagnosed with arterial dissection and subsequent SAH and cerebral infarction in the right hemisphere using brain computed tomography (CT) and magnetic resonance imaging (MRI). He received treatment with antihypertensive and antiplatelet medications. After five weeks, he was admitted for rehabilitation with moderate left-sided hemiparesis and spasticity. Twenty-six weeks post-onset, while participating in passive hamstring stretching, he experienced sudden pain and swelling in his left thigh. Imaging confirmed hematomas in the biceps femoris and semitendinosus muscles, indicating muscle injury. Clopidogrel was discontinued due to progressive anemia, and the hematoma resolved within five days. He quickly resumed ambulation with increasing independence. One month after the injury, he was discharged home, and subsequent genetic testing at another institution confirmed the diagnosis of vEDS with a pathogenic variant in <i>COL3A1</i>. Patients with vEDS are at an increased risk for injuries due to tissue fragility. A stroke can lead to limb spasticity, making spastic muscles more susceptible to injury during sudden stretching, such as passive stretching. This report highlights the need for clinicians to exercise caution when rehabilitating vEDS patients, especially in the absence of established guidelines. Further case reports and clinical evidence are essential to develop comprehensive rehabilitation standards for vEDS.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1638656"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12464579/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187689","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":"Mixed methods analysis of an interdisciplinary intervention to promote balance confidence in lower limb prosthesis users.","authors":"Noah J Rosenblatt, Kristin L Schneider, Steven A Miller, Kavork Hagopian, Sarah Hagg, Christopher Reddin, Rachel Churchill, Gregory M Dams, John E Calamari, Aaron Stachowiak, Matthew J Major","doi":"10.3389/fresc.2025.1626051","DOIUrl":"10.3389/fresc.2025.1626051","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Low balance confidence, i.e., low self-perception in ones' ability to maintain balance while performing activities, is prevalent among lower limb prostheses users (LLPUs) and can affect community participation and quality of life (QoL). Although low balance confidence can manifest from poor function, it also depends on one's beliefs in their abilities to engage in activities, which need not reflect actual abilities. Increasing low balance confidence and associated participation limitations requires approaches that address its' physical and psychological underpinnings.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A randomized controlled trial was conducted to evaluate the initial effectiveness of a multicomponent intervention to target balance confidence in LLPU. Nineteen adults with ≥6-months experience using a prosthesis for unilateral, transtibial amputation, and with low balance confidence (Activities-specific Balance Confidence (ABC) scale scores ≤ 80) completed up to eight intervention sessions following an established protocol, which integrated physical therapy exercises (primarily virtual reality active gaming) and cognitive behavioral therapy strategies, or eight weeks of at home-seated exercises. Outcome measures, collected before randomization, and 0- and 16- weeks after completing the intervention/at-home exercises, addressed four domains: (i) balance confidence-the ABC scale, modified Gait Self Efficacy scale and the Fear of Falling Avoidance Behavior Questionnaire; (ii) community participation-sections of the 36-Item Short Form Survey, sections of the Community Reintegration of Injured Servicemembers scale, the Frenchay Activity Index and step counts; (iii) QoL-the wellbeing scale of the Prosthetic Evaluation Questionnaire; and (iv) function-the Berge Balance Sale and the L-Test of walking. Statistical tests compared baseline and post-training assessment scores between groups, and individual responsiveness was evaluated by comparing change scores to minimum detectable change (MDC).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Overall, results support the initial efficacy of the intervention, with at least one outcome in 3-of-4 domains (balance confidence, community participation and functional mobility) showing strong, significant group-level effects, or individual-level effects (&gt;30% of participants having changes &gt; MDC). Moreover, semi-structured exit interviews suggest participants perceived benefit from the intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Discussion: &lt;/strong&gt;Integrating physical therapy exercises with cognitive behavioral therapy strategies to simultaneously address physical underpinnings and maladaptive cognitions around low balance confidence can meaningfully improve balance and walking confidence, as well as community participation. To the best of our knowledge the current study is the first to evaluate an intervention to specifically target balance confidence in LLPUs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Clinical trial registration: &lt;/strong&gt;","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"6 ","pages":"1626051"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12434030/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145076710","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}