Frontiers in rehabilitation sciences最新文献

{"title":"Assistive devices identified as most useful for people with Parkinson's disease - a patient-centered survey.","authors":"Hollie Adams, Charles Babbush, Camilla Kilbane","doi":"10.3389/fresc.2026.1898569","DOIUrl":"https://doi.org/10.3389/fresc.2026.1898569","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify everyday assistive devices perceived as most useful by people with Parkinson's disease (PwP) and their caregivers.</p><p><strong>Methods: </strong>A 45-item web-based survey was distributed through the Parkinson & Movement Disorder Alliance website and an online educational event. The survey included four respondent-characteristic items, ratings of 40 assistive devices using a 5-point Likert scale ranging from \"not useful\" to \"very useful,\" and one free-response item.</p><p><strong>Results: </strong>A total of 293 online surveys were completed. The five devices with the highest percentages of \"very useful\" ratings were grab bars for shower (80%), grab bars (71%), electric toothbrushes (63%), jar openers (54%), and grabber tools (43%).</p><p><strong>Conclusions: </strong>Numerous assistive devices are available to make activities of daily living easier for PwP. Identifying which devices PwP and caregivers perceive as most useful may help clinicians prioritize practical recommendations and support greater independence in daily activities.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1898569"},"PeriodicalIF":2.5,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169019","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":"Patient-reported experiences and patient-reported experience measures in primary care, home care, and community settings. A scoping review.","authors":"Ilaria Marcomini, Nicoletta Troiano, Mattia Bozzetti, Debora Rosa, Giulia Villa, Andrea Poliani, Duilio Fiorenzo Manara","doi":"10.3389/fresc.2026.1966101","DOIUrl":"10.3389/fresc.2026.1966101","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-reported experience measures (PREMs) are increasingly used to evaluate person-centred and value-based healthcare. However, evidence regarding their application in primary, home, and community care remains fragmented.</p><p><strong>Objective: </strong>To map how patient-reported experiences (PREs) and patient-reported experience measures (PREMs) have been conceptualized, measured, and used across primary, home, and community care settings.</p><p><strong>Methods: </strong>The review followed Joanna Briggs Institute methodology and PRISMA-ScR reporting guidelines. MEDLINE, CINAHL, PsycINFO, Scopus, and Web of Science were searched from inception to July 2025. Peer-reviewed studies investigating PREs or PREMs in primary, home, or community care were included. Data were synthesized using descriptive statistics, thematic content analysis, and narrative synthesis.</p><p><strong>Results: </strong>Overall, 168 studies were included, predominantly quantitative and conducted in high-income countries. Among them, 105 exclusively used validated PREMs, 45 used <i>ad hoc</i> instruments, and 14 combined both approaches. The most frequently assessed domains were communication and information, access to services, patient-professional relationships, quality of care, continuity, care coordination, and patient involvement. Equity-related domains were less consistently represented, while pediatric populations, older adults, and low- and middle-income countries were underrepresented.</p><p><strong>Discussion: </strong>PREM use in primary, home, and community care is increasing but remains heterogeneous in terms of conceptualization, measurement approaches, and domains assessed. Greater standardization of PREMs and broader inclusion of equity-sensitive domains are needed to strengthen the relevance and comparability of patient experience assessment across care settings.</p><p><strong>Conclusion: </strong>PREMs offer substantial potential to support person-centred quality improvement beyond hospital settings, but their current use does not yet fully capture the diversity of patient experiences. Future research should prioritize standardized and context-sensitive measurement approaches, greater attention to equity, and stronger representation of underserved populations and low- and middle-income settings.</p><p><strong>Systematic review registration: </strong>https://doi.org/10.17605/OSF.IO/R5SQF, Identifier: 10.17605/OSF.IO/R5SQF.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1966101"},"PeriodicalIF":2.5,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13646105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139479","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":"Robot-assisted gait training yields superior functional gains in non-ambulatory subacute stroke patients.","authors":"Alice Najsrova, Iva Fiedorova, István Szegedi, Sarka Banikova, Tomas Adamec, Adela Konde, Pavla Hanzlikova, Aravind Ganesh, Michal Bar, Ondrej Volny","doi":"10.3389/fresc.2026.1897418","DOIUrl":"10.3389/fresc.2026.1897418","url":null,"abstract":"<p><strong>Introduction: </strong>A randomized controlled trial (NCT04910217) demonstrated that the addition of robot-assisted gait training (RAGT) using the Lokomat Pro FreeD to protocol-defined conventional rehabilitation in the early subacute phase of first-ever ischemic stroke produced significant gains in functional ambulation category (FAC), Timed Up and Go (TUG), and Berg Balance Scale (BBS). Whether these benefits differ across clinically relevant subgroups remains unclear. We investigated potential effect modification by baseline characteristics.</p><p><strong>Methods: </strong>We performed a secondary analysis of a randomized controlled trial (<i>n</i> = 42 randomized; 36 completed follow-up: 17 RAGT, 19 conventional). Outcomes included ≥2-point FAC improvement and changes in BBS and TUG at 3 months. Subgroups were defined by stroke localization, baseline FAC (0-1 vs. 2-3), age, and recanalization treatment. Interaction effects were assessed using logistic regression for FAC; continuous outcomes were compared within subgroups using Mann-Whitney tests. No correction happened for multiple comparisons.</p><p><strong>Results: </strong>The largest differential effect of RAGT was observed in patients with low baseline ambulatory capacity (FAC 0-1): 90.0% of RAGT patients versus 45.5% in the conventional group achieved ≥2-point FAC improvement at 3 months (<i>p</i> = 0.039, <i>n</i> = 15). BBS gains were higher in this subgroup (median 27 vs. 12 points; <i>p</i> = 0.031), although this may partly reflect lower baseline values and greater recovery potential. Greater TUG improvement was observed in patients with anterior circulation stroke (<i>p</i> = 0.041). No subgroup showed a reversal of treatment effect.</p><p><strong>Conclusion: </strong>RAGT may confer greater benefit in patients with severe initial gait impairment. These exploratory findings support targeted evaluation in larger trials.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1897418"},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642629/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139548","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":"Long-term use of an assistive exercise product in young people with cerebral palsy who are non-ambulant is a balancing act-a phenomenographic study.","authors":"Jenny Gårdling, Katarina Lauruschkus, Åsa B Tornberg","doi":"10.3389/fresc.2026.1927259","DOIUrl":"10.3389/fresc.2026.1927259","url":null,"abstract":"<p><strong>Introduction: </strong>According to the World Health Organisation (WHO), children should be physically active, including exercise, for 60 min a day, and limit sedentary behaviour across the week regardless of physical disabilities. Children with cerebral palsy who are non-ambulant (CP-NA), with Gross Motor Function Classification System Expanded & Revised IV to V, are known to be sedentary up to 92% of the time they spend awake and are dependent on assistive technology and assistive exercise products (AEP), such as the Innowalk. The aim of this study is therefore to explore the family and professional caregivers' perceptions of the long-term use of the AEP after three to five years of use.</p><p><strong>Method: </strong>An inductive phenomenographic design was used, with the aim of describing and understanding variations in how individuals perceive a phenomenon; i.e., what something is and how something is perceived. 11 family caregivers and one professional caregiver to 11 young people (11-24 years) with CP-NA were interviewed individually using a semi-structured interview guide, after having used the AEP for three to five years. The analysis of the interviews followed the iterative steps of phenomenographic design.</p><p><strong>Results: </strong>Long-term use of the AEP was described by caregivers as a life-long project involving balancing between maintaining control and aspects that were beyond their control in everyday life to provide physical activity and exercise in the AEP. When the caregiver managed to reach such a balance, and were able to provide physical activity and exercise in the AEP, it was experienced as rewarding, creating a feeling of meaningfulness.</p><p><strong>Conclusion: </strong>Long-term use of the AEP requires substantial caregiver coordination and support from surrounding services. When such support is available, the AEP may contribute to meaningfulness and improved quality of life for both the young person and their caregivers.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1927259"},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129493","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":"Long-term electromyography-based virtual reality training for chronic upper-limb motor paralysis after stroke: an exploratory single-case experimental design.","authors":"Yohei Nagaoka, Shinya Suzuki, Tsuyoshi Nakajima, Hiroyuki Ohtsuka, Akimasa Hayashi, Max Ortiz-Catalan, Yukari Ohki","doi":"10.3389/fresc.2026.1946303","DOIUrl":"10.3389/fresc.2026.1946303","url":null,"abstract":"<p><strong>Introduction: </strong>Stroke commonly causes various symptoms, such as motor paralysis. Limited motor recovery during the chronic stage of stroke is a challenge in rehabilitation. Motor training using myoelectric pattern recognition (MPR) and virtual reality (VR) may improve maladaptive sensorimotor integration, thereby promoting motor recovery after stroke (MVR training). We evaluated the feasibility of adding upper-limb MVR training to conventional rehabilitation therapy for >3 months in individuals with chronic motor paralysis after stroke.</p><p><strong>Methods: </strong>Two individuals with chronic stroke participated in this preliminary, single-case study. An open-label, repeated-measures design was used for Participant A, and an ABA-type single-case experimental design was used for Participant B. During the intervention period (Participant A: 40 sessions over 8 months; Participant B: 20 sessions over 3 months), participants underwent MVR training in addition to conventional rehabilitation care. During MVR training, the participants performed the posture-matching test (30 min, twice a week), requiring them to voluntarily move their paretic hand with real-time visual feedback of the virtual hand that was controlled by the MPR of the paretic upper-limb muscles.</p><p><strong>Results: </strong>Both participants completed the planned training sessions without serious adverse events. The Fugl-Meyer assessment score of the upper extremities was used to assess upper-limb motor function. Following VR training, the improvement from baseline exceeded the estimated minimal clinically important difference in Participant A (+7 points) but not in Participant B (+5 points).</p><p><strong>Discussion: </strong>In conclusion, these findings suggest that long-term MVR training is feasible and can be implemented without serious adverse events in individuals with chronic motor paralysis after stroke. Although improvement in upper-limb motor function was observed in one participant, further studies with larger samples and controlled designs are warranted to assess the efficacy of MVR training.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1946303"},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139517","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":"Education as a factor in social participation for people affected by disabilities in communities endemic to neglected tropical diseases in Benin and Côte d'Ivoire, West Africa.","authors":"Fifamin Noël Christelle Gbaguidi, Florentine Adjouavi Houedenou, Ginette Victoire Senami Gandigbe, Sonagnon Ines Elvire Agbo, Yévèdo Borel Tossou, Sètondji Diane Edwige Zanvo, Karine Lucrèce Marie Codjo-Seignon, Sèdjro Gimatal Esaï Anagonou, Dagbédji Damien Toffa, Franck Zinsou Mignanwande, Paule Héléna Biaka, Mamadou Kaloga, Anna Gine-March, Manuel Pozzati, Roch Christian Johnson","doi":"10.3389/fresc.2026.1810112","DOIUrl":"10.3389/fresc.2026.1810112","url":null,"abstract":"<p><strong>Introduction: </strong>Disability significantly affects access to fundamental rights, including education. This study aimed to analyse the factors associated with non-schooling among people with disabilities due to Neglected Tropical Diseases and other causes in Benin and Côte d'Ivoire.</p><p><strong>Methods: </strong>This was a descriptive cross-sectional study with an analytical focus using a sequential mixed-methods formative approach. Quantitative data were collected from 841 people with disabilities using structured questionnaires and analyzed with SPSS version 25 to identify factors associated with non-schooling. Qualitative interviews were thematically analyzed to explore participants' experiences and needs, which informed the co-development of three context-adapted intervention modules. The modules were subsequently piloted and qualitatively evaluated among a small group of participants.</p><p><strong>Results: </strong>Factors associated with non-schooling included multiple disabilities [ORa = 3.91; 95% CI (2.01-7.2); <i>p</i> < 0.001], sensory disability [ORa = 1.47; 95% CI (1.00-2.16); <i>p</i> = 0.048], restrictions on social participation [ORa = 1.63; 95% CI (1.19-2.23); <i>p</i> = 0.002] and country of origin [ORa = 3.10; 95% CI (2.28-4.23); <i>p</i> < 0.001]. The pilot qualitative evaluation suggested perceived improvements in self-esteem, social participation, and engagement in income-generating activities among intervention participants.</p><p><strong>Conclusion: </strong>These findings highlight the importance of addressing educational barriers faced by people with disabilities. They also suggest that context-adapted educational and psychosocial interventions may support social participation, although further studies are required to evaluate their effectiveness.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1810112"},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139453","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":"Accessory-vagal crosstalk at the jugular foramen: a hypothesis for reflex dry cough during posterior cervical extracorporeal shockwave therapy.","authors":"Xuewen Jia","doi":"10.3389/fresc.2026.1915218","DOIUrl":"10.3389/fresc.2026.1915218","url":null,"abstract":"<p><strong>Background: </strong>Extracorporeal shockwave therapy (ESWT) is a core modality for treating myofascial pain and degenerative cervical spine conditions in the nuchal and back regions. However, a subset of patients clinically experiences sudden, transient, and irritative dry coughs when receiving treatment near the seventh cervical vertebra (C7, the Dazhui acupoint region). Traditional perspectives vaguely attribute this to \"physical acoustic waves penetrating and vibrating the lung parenchyma,\" which has caused excessive panic regarding iatrogenic pneumothorax and limited the rational titration of treatment intensity.</p><p><strong>Objective: </strong>This perspective aims to refute the traditional \"lung vibration theory\" through quantitative acoustic physics deductions and, for the first time, constructs a novel cross-system \"Accessory-Vagal Crosstalk at the Jugular Foramen\" hypothesis by integrating recent advancements in microanatomy.</p><p><strong>Mechanism: </strong>Recent anatomical studies confirm that the main trunk and dense branches of the accessory nerve (CN XI), which innervate the upper trapezius, are highly concentrated near C7. High-frequency and high-pressure mechanical shear forces released by ESWT strongly irritate the accessory nerve, detonating retrograde conduction of action potentials in the periphery. When this explosive electrical signal ascends to the narrow jugular foramen at the skull base, it breaches the myelin insulation barrier between nerve fibers and erroneously activates the closely aligned sensory fibers of the vagus nerve (CN X) and glossopharyngeal nerve (CN IX) through ephaptic transmission. This leaked electrical signal ascends into the nucleus tractus solitarius (NTS) in the medulla, which the central nervous system instinctively misinterprets as a high-level airway foreign body intrusion, thereby forcibly initiating a reflex dry cough.</p><p><strong>Clinical significance: </strong>This reflex exhibits a distinct \"Instantaneous On-Off Effect\". In clinical practice, adjusting the applicator angle to a 15° to 30° tilt toward the vertebral body (to avoid the main accessory nerve plexus) and implementing a low-energy gradient \"stepwise titration\" can completely block this cross-system abnormal reflex while ensuring safety.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1915218"},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149139489","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":"Beyond fixed beats: adaptive musical entrainment for precision neurorehabilitation in neurodegenerative disorders.","authors":"Benoît G Bardy","doi":"10.3389/fresc.2026.1909811","DOIUrl":"10.3389/fresc.2026.1909811","url":null,"abstract":"<p><p>Music-based interventions have become a promising avenue for neurorehabilitation in neurodegenerative disorders, particularly through rhythmic auditory stimulation to improve gait and movement timing. However, many current interventions still rely on pre-specified or externally imposed rhythmic structures, treating music primarily as a cue to be followed. In this Opinion article, I argue that the next generation of music-based neurorehabilitation should move beyond fixed beats or individualized cueing protocols toward real-time adaptive musical entrainment. Two biologically grounded principles are central to this shift. First, healthy movement is not metronomic: gait exhibits structured variability, including long-range correlations and 1/f-like temporal organization, which can be disrupted in neurodegenerative disease. Because music can contain 'pink,' multiscale temporal structure in specific acoustic or rhythmic time series, it offers a promising medium for adaptive cue design and for testing whether structured auditory variability can support more functional movement organization. Second, adaptive music should be understood not merely as tempo matching, but as adaptive auditory-motor timing control in which phase synchronization is one important dimension, among others. Closed-loop musical technologies can continuously sense movement, adapt musical parameters, and support stable yet flexible coupling between body and sound. Because the empirical foundation for music-based gait rehabilitation is currently strongest in Parkinson's disease, this article uses PD gait as the primary model while treating extension to atypical parkinsonian syndromes and other neurodegenerative disorders as a translational hypothesis requiring disease-specific validation. I propose that precision neurorehabilitation may integrate individual movement signatures, structured temporal variability, and phase-based adaptive cueing to guide the development of interventions that are more personalized, engaging, and ecologically grounded. Music, in this framework, does not simply tell the patient when to move; it listens back and adapts to support more functional movement dynamics.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1909811"},"PeriodicalIF":2.5,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13642663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149129468","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":"Effectiveness of tailored individual follow-up vs. standard one-day group course on health-related quality of life in patients with post COVID-19 condition: a randomized controlled trial.","authors":"Marte Wilson, Henriette Michalsen, Audny Anke, Synne G Pedersen, Marina Espinasse, Nina Langeland, Rebecca J Cox, Pål Aukrust, Tuva B Dahl, Axel Sandvig, Maja Wilhelmsen","doi":"10.3389/fresc.2026.1927300","DOIUrl":"10.3389/fresc.2026.1927300","url":null,"abstract":"<p><strong>Background: </strong>Post COVID-19 condition (PCC), is characterized by a wide range of symptoms, including fatigue and cognitive problems. Symptoms may lead to disability in everyday life and reduced health-related quality of life (HRQoL). Evidence for effective rehabilitation strategies for this patient group remains limited.</p><p><strong>Objective: </strong>To examine the effectiveness of tailored individual follow-up compared with a standard one-day group course, both based on cognitive behavioral approach, in patients with PCC 6 months after the intervention.</p><p><strong>Methods: </strong>A single-center, parallel-group, superiority randomized controlled trial (1:1) was conducted among outpatients aged 18-65 years with PCC. Patients were randomized to either a rehabilitation program with individual follow-up over 6-8 weeks or a standard one-day multidisciplinary self-management group course. Both groups were introduced to graded activity based on principles from cognitive behavioral therapy (CBT) and were offered the app \"My COVID rehabilitation\". The primary outcome was the between-group difference in patient reported HRQoL (EQ-5D-5L-index score) at 6 months. Secondary self-reported outcomes included fatigue measured with the Chalder Fatigue Scale, EQ-VAS, and symptom registration. Neuropsychological function was assessed with objective neuropsychological tests.</p><p><strong>Results: </strong>60 participants were randomized, the mean age was 46 years (22-66 years), and 43 (72%) were female. Outcome assessments were completed for the primary outcome for 29 participants in each arm. No significant between-group difference was found in the primary outcome (score difference EQ-5D-5L-index =0.07; 95% CI [-0.18,.04]; <i>p</i> = .11). The adjusted linear model confirmed the absence of significant difference between groups. No persistent significant group differences were observed for any secondary outcomes. Both groups showed statistically and clinically significant sustained improvements in fatigue and EQ-VAS, as well as significant reductions in the number of symptoms. Within neuropsychological test, both groups demonstrated significant improvement in episodic memory (RAVLT), and the standard course group additionally showed significant improvement in attention (CPT).</p><p><strong>Conclusion: </strong>Tailored individual follow-up was not more effective than a standard one-day group course in improving HRQoL in PCC, both based on principles of CBT. However, significant improvements in both groups were observed in several secondary outcomes, including some objective neuropsychological tests. Larger studies are needed to confirm these results.<b>Clinical Trial Registration</b>: https://clinicaltrials.gov/study/NCT06085911, identifier NCT06085911.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1927300"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638556/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119534","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":"Early occupational therapy use of a 3D printer introduced with minimal formal support: a single-site pre-post observational study.","authors":"Yusuke Harada, Yuki Sawada, Hiroshi Momma, Rie Takeshima, Jun Suzurikawa","doi":"10.3389/fresc.2026.1859684","DOIUrl":"10.3389/fresc.2026.1859684","url":null,"abstract":"<p><strong>Introduction: </strong>Three-dimensional (3D) printers can produce customized assistive devices in occupational therapy; however, occupational therapists' perceptions and early usage following clinical introduction remain poorly understood. This study examined perceptions, perceived barriers and enabling conditions, and early usage patterns among occupational therapists following 3D printer introduction in a rehabilitation hospital with minimal formal implementation support.</p><p><strong>Methods: </strong>A 3D printer was installed in the occupational therapy department, allowing trial printing of existing design data after brief basic instruction was provided to one representative therapist; no structured staff training, CAD instruction, formal usage recommendations, workflow integration, or dedicated institutional support was provided. A self-administered study-specific, non-validated questionnaire assessed perceptions and selected implementation-related conditions before and six months after installation. Paired data from 43 participants (follow-up rate: 79.6%) were analyzed using the Wilcoxon signed-rank and McNemar tests.</p><p><strong>Results: </strong>After installation, selection of the barrier \"there is no 3D printer in the workplace\" significantly decreased (adjusted <i>p</i> < 0.001), whereas selection of institutional and operational constraints, including insufficient time (adjusted <i>p</i> < 0.001) and lack of medical reimbursement (adjusted <i>p</i> = 0.044), increased. Participants showed less agreement that using a 3D printer was difficult (adjusted <i>p</i> = 0.047), while agreement that 3D printing was useful in occupational therapy practice also decreased (adjusted <i>p</i> = 0.044). Although statistically significant, these changes were small in magnitude. No statistically significant change was observed in future intention to use 3D printing (adjusted <i>p</i> = 0.063). Available printer records did not permit quantitative assessment of individual use; use remained limited to exploratory printing of existing designs.</p><p><strong>Discussion: </strong>The introduction of a printer with minimal formal support was not accompanied by clear progression toward routine clinical use during the six-month observation period. These exploratory findings support further evaluation of structured education, technical assistance, workflow integration, and institutional arrangements, but do not establish their effectiveness or the causal effect of printer availability.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1859684"},"PeriodicalIF":2.5,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13638619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149119437","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}