Frontiers in rehabilitation sciences最新文献

{"title":"Spontaneous rupture of the plantar fascia: a case report.","authors":"Michele Venosa, Emilio Romanini, Lorenzo Vitale, Giandomenico Logroscino","doi":"10.3389/fresc.2024.1470002","DOIUrl":"https://doi.org/10.3389/fresc.2024.1470002","url":null,"abstract":"<p><strong>Introduction: </strong>The rupture of the plantar fascia is a rare but significant injury that predominantly affects athletes and individuals engaged in high-impact activities. Sudden increases in physical activity, direct trauma, corticosteroid injections, and chronic degeneration from plantar fasciitis can predispose individuals to rupture. It can involve a complete or partial tear of the plantar fascia fibers, leading to a loss of structural integrity and functional support. The tear may occur at the origin, mid-portion, or insertion of the fascia. Spontaneous ruptures of the plantar fascia (occurring without any predisposing factors) are rarely observed in clinical practice. No guidelines or other unequivocal recommendations are available for this pathological condition.</p><p><strong>Method: </strong>A healthy 35-year-old male who works in an office setting and is a recreational cyclist with a silent clinical anamnesis experienced a spontaneous rupture of the plantar fascia of the left foot with no history of trauma. He exhibited significant localized tenderness and swelling in the medial arch of the left foot with difficulty bearing weight on the affected foot. An MRI confirmed a partial rupture of the medial cord of the plantar fascia accompanied by surrounding inflammation. The patient underwent conservative treatment, which included rest, immobilization, physiotherapy (ultrasound therapy, high-power laser therapy, and transcutaneous electrical nerve stimulation), rehabilitation, and a gradual return to activity.</p><p><strong>Results: </strong>At the 12-week follow-up, the patient reported a significant reduction in pain and marked improvement in functional mobility (as confirmed by VAS and Foot Function Index scores). Physical examination showed no tenderness, and the patient could bear full weight on the foot without discomfort. A follow-up ultrasound demonstrated complete resolution of the plantar fascia rupture and no residual inflammation.</p><p><strong>Discussion: </strong>This case underscores the effectiveness of an integrated rehabilitative approach and provides a framework for managing similar cases in clinical practice.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1470002"},"PeriodicalIF":1.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11385299/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302541","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":"Dehumanizing air travel: a scoping review on accessibility and inclusion of people with disabilities in international airports.","authors":"David Gotti, Ernesto Morales, François Routhier, Jonathan Riendeau, Ahmed Hadj Hassen","doi":"10.3389/fresc.2024.1305191","DOIUrl":"10.3389/fresc.2024.1305191","url":null,"abstract":"<p><strong>Introduction: </strong>Worldwide, one in six individuals live with a disability. Many people continue to experience disabling situations, particularly when travelling. Travel can be an important part of the lives of many people, including people with disabilities. Barriers to accessing air travel can lead to a reluctance to travel for these potential passengers. As early as the flight planning stage, options to facilitate accessibility are limited. At airports, passengers must travel long distances in areas where navigation is complex, and accessibility limited. Furthermore, few aircraft are accessible. The travel experience can have adverse effects on the health of people with disabilities. Practices are sometimes not inclusive, not always available, and may not address the full spectrum of possible needs. The objective of this study is to provide a state of art on accessibility features available to people with disabilities in the busiest international airports.</p><p><strong>Methods: </strong>A scoping review of practices in airport accessibility was done. A search strategy was deployed in 4 databases (Avery index to architectural periodicals, Medline, CINAHL, and Web of science). The official websites of the 35 busiest airports were exhaustively consulted. All information regarding accessibility measures and inclusive services were extracted.</p><p><strong>Results: </strong>31 scientific articles, out of 3,640 screened, and all extracted data from airports' website were considered for synthesis. While efforts are made in major airports, there is a great inconsistency in accessibility features. Both facilitators and challenges are encountered by people with disabilities at every stage of air travel. These stages include journey planning; getting to and from the airport, obtain human assistance, navigate in the premises, check in, security screening, using facilities, boarding and disembarking, customs and immigration procedures, and luggage management.</p><p><strong>Discussion: </strong>Services need to be extensively planned, placing a significant burden on passengers. The disability-centric perspective disregard passengers' unique needs and capabilities, leading to a sense of dehumanization. The complexity of airport organizations, shared responsibilities, limited communication, training challenges can deter accessibility initiatives and create discomfort during travel. This study is the first step of a broader project supported by Canadian Accessibility Standards, focusing on enhancing inclusive accessibility in Canadian airports.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1305191"},"PeriodicalIF":1.3,"publicationDate":"2024-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11425591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142333796","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":"ICF-based hearing and functioning assessment: validation and research outcomes of utilizing the HEAR-COMMAND tool for patients with mild to moderately severe hearing loss and individuals with normal hearing.","authors":"Tahereh Afghah, Razan Alfakir, Markus Meis, Mahmoud Hammady, Mostafa Youssif, Mohamed Abd Al-Ghaffar, Sophia E Kramer, Kirsten C Wagener","doi":"10.3389/fresc.2024.1389653","DOIUrl":"https://doi.org/10.3389/fresc.2024.1389653","url":null,"abstract":"<p><strong>Objective: </strong>Current clinical assessments for Hearing Loss (HL) are often limited to controlled laboratory settings in which a narrow spectrum of hearing difficulties can be assessed. A majority of the daily life challenges caused by HL cannot be measured in clinical methodologies. To screen the individuals' needs and limitations, a questionnaire named the HEAR-COMMAND tool was developed and qualitatively validated through an international collaboration, aligning with the World Health Organization's International Classification of Functioning, Disability, and Health Framework (ICF) Core Sets for Hearing Loss. The tool empowers healthcare professionals (HCPs) to integrate the ICF framework into patient assessments and patient-reported outcomes (PRO) in clinical and non-clinical settings. The aim is to provide a general foundation and starting point for future applications in various areas including ENT and hearing acoustics. The outcome can be employed to define and support rehabilitation in an evidence-based manner. This article presents the validation and research outcomes of using the tool for individuals with mild to moderately severe HL in contrast to normal-hearing individuals.</p><p><strong>Design: </strong>Using a cross-sectional multicenter study, the tool was distributed among 215 participants in Germany, the USA, and Egypt, filled in German, English, or Arabic. Three outcome scores and the corresponding disability degree were defined: hearing-related, non-hearing-related, and speech-perception scores. The content and construct validation were conducted, and the tool's internal consistency was assessed.</p><p><strong>Results: </strong>The extracted constructs included \"Auditory processing functionality\", \"Sound quality compatibility\", \"Listening and communication functionality\", \"Interpersonal interaction functionality and infrastructure accessibility\", \"Social determinants and infrastructure compatibility\", \"Other sensory integration functionality\", and \"Cognitive functionality\". Regarding content validity, it was demonstrated that normal-hearing participants differed significantly from individuals with HL in the hearing-related and speech-perception scores. The reliability assessment showed a high internal consistency (Cronbach's alpha = 0.9).</p><p><strong>Conclusion: </strong>The outcome demonstrated the HEAR-COMMAND tool's high content and construct validity. The tool can effectively represent the patient's perspective of HL and hearing-related functioning and enhance the effectiveness of the treatment plans and rehabilitation. The broad range of targeted concepts provides a unique overview of daily life hearing difficulties and their impact on the patient's functioning and quality of life.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1389653"},"PeriodicalIF":1.3,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302538","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":"Chronic pain after traumatic brain injury: a collaborative care approach.","authors":"Mary C Curran, Sylvia Lucas, Jesse R Fann, Jennifer M Zumsteg, Jeanne M Hoffman","doi":"10.3389/fresc.2024.1398856","DOIUrl":"https://doi.org/10.3389/fresc.2024.1398856","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic pain is common after traumatic brain injury (TBI), frequently limits daily activities, and is associated with negative outcomes such as decreased community participation. Despite the negative impact of chronic pain, few people with TBI receive effective treatment. This paper describes a collaborative care (CC) intervention, TBI Care, adapted specifically to treat chronic pain in people living with TBI, emphasizing expert clinician input, cognitive behavioral therapy (CBT) techniques, and other non-pharmacological approaches for decreasing pain interference.</p><p><strong>Methods: </strong>79 participants engaged in the CC intervention from two academic medical rehabilitation clinics with weekly assessments of pain intensity, interference, and medication use. Participant feedback on the intervention was gathered by interview with the care manager (CM) at the last treatment session and/or booster session. Provider feedback was gathered by a confidential survey post intervention.</p><p><strong>Results: </strong>Ninety percent of participants received at least 11 of the target 12 sessions with a care manager (CM), the majority occurring over the phone. Participants endorsed an average of 7 pain locations. All participants received pain education, skills in self-monitoring, goal setting/behavioral activation and relaxation training. Pain interference scores (impact on activity and enjoyment), tracked weekly by the CM, significantly decreased across sessions. 89% of participants received recommendations for CBT skills, 65% received referrals for additional treatments targeting pain interference, and 43% received care coordination. 75% of participants reported 6 or more medications/supplements at both the first and last session, with changes recommended primarily for headache treatment. Feedback from participants and providers was positive.</p><p><strong>Discussion: </strong>TBI Care, a novel patient-centered CC approach, was flexibly delivered, tailored to the needs of those living with TBI and chronic pain, with a high level of participant engagement, and satisfaction among participants and providers. This approach, prioritizing pain self-management strategies and other non-pharmacological approaches, along with optimizing pharmacological treatment, led to significant reductions in self-reported pain interference and intensity during the intervention. Using a CC model in TBI is feasible and successfully improved access to evidence-based treatments for chronic pain as well as outcomes for pain interference and intensity.</p><p><strong>Clinical trial registration: </strong>ClinicalTrials.gov, identifier NCT03523923.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1398856"},"PeriodicalIF":1.3,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11381419/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302537","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":"SONOICE! a Sonar-Voice dynamic user interface for assisting individuals with blindness and visual impairment in pinpointing elements in 2D tactile readers.","authors":"Gaspar Ramôa, Vincent Schmidt, Thorsten Schwarz, Rainer Stiefelhagen, Peter König","doi":"10.3389/fresc.2024.1368983","DOIUrl":"10.3389/fresc.2024.1368983","url":null,"abstract":"<p><p>Pinpointing elements on large tactile surfaces is challenging for individuals with blindness and visual impairment (BVI) seeking to access two-dimensional (2D) information. This is particularly evident when using 2D tactile readers, devices designed to provide 2D information using static tactile representations with audio explanations. Traditional pinpointing methods, such as sighted assistance and trial-and-error, are limited and inefficient, while alternative pinpointing user interfaces (UI) are still emerging and need advancement. To address these limitations, we develop three distinct navigation UIs using a user-centred design approach: Sonar (proximity-radar sonification), Voice (direct clock-system speech instructions), and Sonoice, a new method that combines elements of both. The navigation UIs were incorporated into the Tactonom Reader device to conduct a trial study with ten BVI participants. Our UIs exhibited superior performance and higher user satisfaction than the conventional trial-and-error approach, showcasing scalability to varied assistive technology and their effectiveness regardless of graphic complexity. The innovative Sonoice approach achieved the highest efficiency in pinpointing elements, but user satisfaction was highest with the Sonar approach. Surprisingly, participant preferences varied and did not always align with their most effective strategy, underscoring the importance of accommodating individual user preferences and contextual factors when choosing between the three UIs. While more extensive training may reveal further differences between these UIs, our results emphasise the significance of offering diverse options to meet user needs. Altogether, the results provide valuable insights for improving the functionality of 2D tactile readers, thereby contributing to the future development of accessible technology.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1368983"},"PeriodicalIF":1.3,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11377411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156845","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":"Innovative approaches for managing patients with chronic vestibular disorders: follow-up indicators and predictive markers for studying the vestibular error signal.","authors":"Frédéric Xavier, Emmanuelle Chouin, Brahim Tighilet, Christian Chabbert, Stéphane Besnard","doi":"10.3389/fresc.2024.1414198","DOIUrl":"10.3389/fresc.2024.1414198","url":null,"abstract":"<p><strong>Introduction: </strong>Despite significant advancements in understanding the biochemical, anatomical, and functional impacts of vestibular lesions, developing standardized and effective rehabilitation strategies for patients unresponsive to conventional therapies remains a challenge. Chronic vestibular disorders, characterized by permanent or recurrent imbalances and blurred vision or oscillopsia, present significant complexity in non-pharmacological management. The complex interaction between peripheral vestibular damage and its impact on the central nervous system (CNS) raises questions about neuroplasticity and vestibular compensation capacity. Although fundamental research has examined the consequences of lesions on the vestibular system, the effect of a chronic peripheral vestibular error signal (VES) on the CNS remains underexplored. The VES refers to the discrepancy between sensory expectations and perceptions of the vestibular system has been clarified through recent engineering studies. This deeper understanding of VES is crucial not only for vestibular physiology and pathology but also for designing effective measures and methods of vestibular rehabilitation, shedding light on the importance of compensation mechanisms and sensory integration.</p><p><strong>Methods: </strong>This retrospective study, targeting patients with chronic unilateral peripheral vestibulopathy unresponsive to standard treatments, sought to exclude any interference from pre-existing conditions. Participants were evaluated before and after a integrative vestibular exploratory and rehabilitation program through questionnaires, posturographic tests, and videonystagmography.</p><p><strong>Results: </strong>The results indicate significant improvements in postural stability and quality of life, demonstrating positive modulation of the CNS and an improvement of vestibular compensation.</p><p><strong>Discussion: </strong>Successful vestibular rehabilitation likely requires a multifaceted approach that incorporates the latest insights into neuroplasticity and sensory integration, tailored to the specific needs and clinical progression of each patient. Focusing on compensating for the VES and enhancing sensory-perceptual-motor integration, this approach aims not just to tailor interventions but also to reinforce coherence among the vestibular, visual, and neurological systems, thereby improving the quality of life for individuals with chronic vestibular disorders.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1414198"},"PeriodicalIF":1.3,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11362045/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115663","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":"Recommendations for clinical decision-making when offering exoskeletons for community use in individuals with spinal cord injury.","authors":"Derrick Onate, Cassandra Hogan, Kathryn Fitzgerald, Kevin T White, Keith Tansey","doi":"10.3389/fresc.2024.1428708","DOIUrl":"https://doi.org/10.3389/fresc.2024.1428708","url":null,"abstract":"<p><p>Approved in 2014 by the Food and Drug Administration (FDA) for use with a trained companion, personal powered exoskeletons (PPE) for individuals with spinal cord injury (SCI) provide an opportunity for the appropriate candidate to ambulate in their home and community. As an adjunct to wheeled mobility, PPE use allows those individuals who desire to ambulate the opportunity to experience the potential physiological and psychosocial benefits of assisted walking outside of a rehabilitation setting. There exists, however, a knowledge gap for clinicians regarding appropriate candidate selection for use, as well as who might benefit from ambulating with a PPE. The purpose of this paper is to provide guidance for clinicians working with individuals living with SCI by outlining an expert consensus for a PPE decision-making algorithm, as well as a discussion of potential physiological and psychosocial benefits from PPE use based on early evidence in publication.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1428708"},"PeriodicalIF":1.3,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11349703/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142115664","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":"Editorial: Rehabilitation, communication disorders and person-family-centered care.","authors":"Faheema Mahomed-Asmail, Marien Alet Graham, Rachel Glade, Nannette Nicholson","doi":"10.3389/fresc.2024.1458662","DOIUrl":"10.3389/fresc.2024.1458662","url":null,"abstract":"","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1458662"},"PeriodicalIF":1.3,"publicationDate":"2024-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11345254/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142074673","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":"Person-centered aural rehabilitation program improved mood, cognition, and auditory processing in a professional musician who uses a hearing aid and cochlear implant: Case Report.","authors":"Christine Brennan, McKenna Spence-Olson, Kayla Cormier, Sherri Tennant, Anu Sharma","doi":"10.3389/fresc.2024.1399424","DOIUrl":"10.3389/fresc.2024.1399424","url":null,"abstract":"<p><strong>Introduction: </strong>Aural rehabilitation focused on music for individuals with cochlear implants (CIs) and/or hearing aids (HAs) typically emphasizes perceptual skills rather than enjoyment of music. Yet, those with CIs and/or HAs often struggle to enjoy music, complaining that it sounds distorted with the implant or HAs. Typically, aural rehabilitation programs require a significant time commitment, but this may not be feasible or preferable for many patients. This study aimed to evaluate the efficacy of two individualized intensive 3-week home practice programs focused on enjoyment of music, a personal goal for this subject.</p><p><strong>Methods: </strong>The subject was a professional musician who used a CI and HA. Cognitive measures of global cognitive function, executive function, processing speed, auditory working memory, visual-spatial abilities, verbal fluency, and auditory-verbal memory, as well as auditory electrophysiology (EEG) measures were conducted pre-post experiment 2. Two experiments were undertaken to evaluate responses to two practice programs that incorporated different variations in listening dosage and intervention activities.</p><p><strong>Results: </strong>Experiment 1 resulted in minimal measurable improvements related to music likability ratings, with the highest dosage condition showing a small increase in average likability rating from baseline to week 3. The results of experiment 2 revealed an improvement in likability ratings only when dosage steadily increased each week. The subject also reported improved mood and decreased frustration during weeks two and three of experiment 2. Finally, we found improvement pre-post experiment 2 on several cognitive and EEG measures.</p><p><strong>Discussion: </strong>The results of these experiments are encouraging and support the use of an individualized, person-centered, and semi-structured home practice program to increase music enjoyment and improve quality of life and auditory processing for individuals with hearing loss. Future studies should aim to increase sample size and explore pairing person-centered home practice programs with concurrent clinician-lead aural rehabilitation.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1399424"},"PeriodicalIF":1.3,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019729","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":"Changes in COPD-related anxiety symptoms during pulmonary rehabilitation: a prospective quantitative and qualitative study.","authors":"Ingeborg Farver-Vestergaard, Eva Holmegaard Buksted, Dorthe Sørensen, Sune Jonstrup, Henrik Hansen, Camilla Fischer Christiansen, Anders Løkke","doi":"10.3389/fresc.2024.1428893","DOIUrl":"10.3389/fresc.2024.1428893","url":null,"abstract":"<p><strong>Background: </strong>Fear-avoidance in COPD can have detrimental effects on pulmonary rehabilitation (PR) outcomes and is therefore important to address. This prospective study examined changes in and management of COPD-related anxiety symptoms over the course of a PR program.</p><p><strong>Methods: </strong>Patients with COPD referred to 9-weeks of PR in the municipality of Vejle, Denmark from January to December 2022 completed a six-minute walk test (6MWT) and the following questionnaires, both before and after PR: COPD Anxiety Questionnaire 20-item version (CAF-R), measuring COPD-related anxiety; COPD Assessment Test (CAT), measuring COPD-related disability; 12-Item Short-Form Health Survey (SF-12), measuring health-related quality of life (HR-QoL); sociodemographic and disease-related information. After PR, a subsample of the patients took part in semi-structured interviews exploring their understanding of how they managed COPD-related anxiety during PR. Pre- and post-assessment of COPD-related anxiety and other PR outcomes were analysed with <i>t</i>-tests and correlation analyses. Qualitative interviews were analysed using a thematic analysis approach.</p><p><strong>Results: </strong>A total of 72 patients with COPD (mean ± SD age 71 ± 8, 53% female) were included in the study, and 13 took part in qualitative interviews. A significant decrease in COPD-related anxiety was observed from before to after PR, corresponding to a small effect size (Cohen's <i>d </i>= 0.32; <i>p </i>= 0.018). Reductions in COPD-related anxiety were not associated with improvements in COPD-related disability, HR-QOL, or functional exercise capacity. The qualitative findings identified four anxiety management strategies, i.e., \"planning\", \"problem-solving\", \"accepting\", and \"confronting\", which were influenced by interactions with healthcare professionals and co-patients as well as patients' own perception.</p><p><strong>Conclusions: </strong>COPD-related anxiety symptoms was reduced after PR, potentially through the use of various management strategies. The strategies appeared to be influenced by interactional factors during the PR program.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"5 ","pages":"1428893"},"PeriodicalIF":1.3,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11335722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142019778","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}