Frontiers in rehabilitation sciences最新文献

{"title":"Efficacy of reduced exertion high intensity interval training to modify cardiovascular disease-related risk factors-a narrative review.","authors":"Todd A Astorino, Riley Givens, Hayden Kunz, Matthew C DeSouza","doi":"10.3389/fresc.2026.1883275","DOIUrl":"https://doi.org/10.3389/fresc.2026.1883275","url":null,"abstract":"<p><p>Despite advances in medical imaging and treatment, cardiovascular disease (CVD) remains the primary cause of premature mortality in adults. Lifestyle modification including regular physical activity (PA) is a well recognized strategy to prevent onset of CVD, although the number of adults who attain recommended guidelines for PA is low, partially due to a perceived lack of time. Recent data show the efficacy of sprint interval training (SIT), brief, repeated \"all-out\" efforts performed at supramaximal intensities, to increase cardiorespiratory fitness (VO₂max) in diverse groups of adults. This adaptation is important due to the known association between VO₂max and all-cause mortality as well as mortality from CVD. A unique iteration of SIT is reduced exertion high intensity interval training (REHIT), which typically requires no more than 1 min of vigorous exercise consisting of two to three 20 s sprints within a 10 min exercise session. This review will define what REHIT is, explore its various health- and fitness-related benefits, and demonstrate its potential feasibility to modify cardiovascular disease-related risk factors in adults.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1883275"},"PeriodicalIF":2.5,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13479886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148802060","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":"Effects of a single bout of low-intensity isometric or moderate-intensity aerobic exercise on postexercise hypotension in adults of African and south-Asian descent: a randomized controlled crossover trial.","authors":"Marina Bersaoui, Se-Sergio Baldew, Karla Goessler, Kwame Van der Hilst, Gail Oldenstam, Pooja Chote, Shreya Basgiet, Jerry Toelsie, Veronique Cornelissen","doi":"10.3389/fresc.2026.1882762","DOIUrl":"10.3389/fresc.2026.1882762","url":null,"abstract":"<p><strong>Introduction: </strong>Current guidelines on physical activity and exercise to manage blood pressure (BP) in adults with hypertension are predominantly based on studies performed in Caucasian populations and little is known about the potency of exercise as a BP-lowering tool in non-Caucasians. Therefore, the \"Hypertension, Ethnicity and Exercise\" (HYPE²X) trial aimed to investigate whether a short bout of aerobic exercise or isometric strength exercise lowers BP in a non-Caucasian population.</p><p><strong>Methods: </strong>African and South-Asian descendants living in Suriname (18-65 years) with high-normal BP or grade I hypertension were invited to participate in a randomized controlled crossover trial. Participants completed: a 30-minute aerobic exercise (AEX) treadmill walking/running bout at 40%-60% of heart rate reserve, an isometric handgrip (IHG) session at 30% of maximal handgrip strength and a sitting control session. Office BP was measured 30 min after the experiment and ambulatory mean 8-hours, daytime and nighttime BP. Statistical analyses were performed using linear mixed models.</p><p><strong>Results: </strong>A total of 29 adults of African descent [mean age: 48.7 ± 9.9 years, 31% male, mean systolic BP (SBP) and diastolic BP (DBP) were 142.9 ± 11.2 and 88 ± 8.0 mmHg] and 28 adults of South-Asian descent (mean age: 51.5 ± 10.6 years, 46.4% male, mean SBP: 138.2 ± 6.9 and DBP 85.7 ± 4.5 mmHg) were included. In Africans, systolic BP was significantly reduced after AE at post 30 min [-9.0, 95%CI: (-13.4, -4.7) mmHg, <i>p</i> < 0.001], non-significantly reduced during daytime [-4.08, 95%CI (-0.26, -7.75) mmHg, <i>p</i> = 0.08]. Diastolic BP was non-significantly reduced after AEX at post 30 min [-3.46, 95%CI: (-6.56, -0.36) mmHg, <i>p</i> = 0.08] and non-significantly reduced during daytime hours [-3.07, 95%CI: (-0.27, -5.90) mmHg, <i>p</i> = 0.08]. In South-Asians systolic and diastolic BP were significantly reduced after AE at post 30 min [-7.40, 95%CI [-12.2, -2.6] mmHg, <i>p</i> < 0.01/-4.4, 95%CI [-7.5, -1.3] mmHg, <i>p</i> = 0.01].</p><p><strong>Conclusion: </strong>A single bout of AEX resulted in an immediate reduction in office BP at 30-minutes postexercise in both the African and South-Asian groups, while a more favorable reduction in daytime BP was observed in the African group only. A single bout of IHG did not elicit PEH in either ethnicity. Further exploration is needed to assess different intensity levels, volumes, or frequency levels of exercise in non-Caucasian populations.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1882762"},"PeriodicalIF":2.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13501518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148815218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A cross-sectional feasibility study of an English-language survey in Switzerland using the Patient-Reported Outcomes Measurement Information System-29.","authors":"Matthew Kerry, Thanh Elsener","doi":"10.3389/fresc.2026.1840636","DOIUrl":"https://doi.org/10.3389/fresc.2026.1840636","url":null,"abstract":"<p><strong>Study aims: </strong>English is the fourth most-used language in Switzerland at 6%, yet no health survey has specifically sampled English-speaking respondents, despite having compulsory health insurance. The purpose of this prospective survey is to explore the feasibility of collecting empirical evidence on the health status of English-speaking respondents living in Switzerland. In addition to reporting psychometrics, we further examine substantive correlates of subjective health, such as migration status, residency duration, and planned residency in Switzerland.</p><p><strong>Methods: </strong>A cross-sectional design with purposive sampling was used to collect <i>n</i> = 156 English-speaking respondents between December 2024 and January 2025. The Patient-Reported Outcomes Measurement Information System (PROMIS-29 v2.1) was administered. Several sociodemographic characteristics (age, sex, education, income, chronic condition, migration background, nationality, and employment) were also collected to inspect the convergent validity of the PROMIS-29 with external correlates. The measurement properties inspected included descriptives (normality and floor/ceiling effects), internal consistency reliability (<i>ω</i> ≥ 0.70), structural validity [root-mean-squared error of approximation (RMSEA) < 0.06], and convergent validity (correlation <i>r</i> = 0.30-0.50).</p><p><strong>Results: </strong><i>N</i> = 156 of 215 respondents completed the health survey (73% completion). A chronic condition was reported by 45% of the respondents. Regarding instrumentation, 5/7 scales exhibited normal distributions, and all scales exhibited high reliability (0.83-0.93). Structural validity evidence was mostly supported, but the smaller sample size compromised the overall comparative fit index (0.93). Finally, all scales exhibited moderate-strong convergence validity with self-rated health (<i>r</i> = 0.29-0.58).</p><p><strong>Conclusion: </strong>English-speaking respondent uptake seems to be feasible with a relatively high completion rate of 73%. Furthermore, a preliminary inspection of psychometrics indicated good quality evidence. Future research should expand on questions regarding health service utilization and remaining psychometric criteria, such as criterion validity, responsiveness, and cross-cultural validity with Switzerland's three primary spoken languages.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1840636"},"PeriodicalIF":2.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A central-peripheral approach to gait rehabilitation in chronic acquired brain injury: robotic training and motor imagery.","authors":"Alessandro Arnaudo, Eugenio Scaliti, Francesco Damosso, Federica Lovera, Roberto Rebaudengo, Katiuscia Sacco, Marina Zettin, Andrea Cavallo","doi":"10.3389/fresc.2026.1874725","DOIUrl":"https://doi.org/10.3389/fresc.2026.1874725","url":null,"abstract":"<p><strong>Background: </strong>Gait impairment is a major long-term consequence of acquired brain injury and remains difficult to treat in the chronic phase. Robot-assisted gait training can deliver high-intensity repetitive practice, but robotic assistance alone may not fully engage central motor processes; motor imagery may complement this limitation.</p><p><strong>Objective: </strong>The primary aim was to evaluate the feasibility of an integrated protocol combining robotic gait training with structured motor imagery in adults with chronic acquired brain injury; a secondary, exploratory, aim was to characterize preliminary clinical signals and kinematic parameters observed in associated with the protocol.</p><p><strong>Methods: </strong>Seven adults completed 12 sessions over 4 weeks (3 sessions/week, about 30 min of active robotic walking per session). Outcomes included gait kinematics at baseline, post-intervention, and 3-month follow-up, plus Berg Balance Scale and 6-Minute Walk Test at baseline and post-intervention. Gait variables were analysed during both single-task and dual-task walking.</p><p><strong>Results: </strong>Clinical outcomes improved from baseline to post-intervention (Berg Balance Scale and 6-Minute Walk Test). For gait outcomes, session effects indicated improvement over time in temporal efficiency and phase organization on the more-affected limb, and task type effects were observed in key spatiotemporal variables, with expected dual-task costs maintained.</p><p><strong>Conclusions: </strong>This preliminary study supports the feasibility of combining robotic gait training with motor imagery in chronic acquired brain injury and provides exploratory, hypothesis-generating signals of concurrent clinical and kinematic change, to be tested in future controlled studies.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1874725"},"PeriodicalIF":2.5,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473374/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762910","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":"Protective effects of early low-intensity exercise on the antigravity soleus muscle following focal cerebral infarction in rats.","authors":"Fumiyo Matsuda","doi":"10.3389/fresc.2026.1789922","DOIUrl":"10.3389/fresc.2026.1789922","url":null,"abstract":"<p><strong>Background: </strong>Skeletal muscle changes following stroke are a major factor influencing subsequent motor recovery.</p><p><strong>Objective: </strong>To examine the effects of early low-intensity exercise on motor function, neurological deficits, soleus muscle mass, fiber-type composition, and muscle fiber cross-sectional area following experimental stroke.</p><p><strong>Methods: </strong>Adult male Wistar rats were randomly assigned to ischemia-control (IC; <i>n</i> = 23) and ischemia-exercise (IE; <i>n</i> = 23) groups. Stroke was induced 90 min after occlusion of the left middle cerebral artery. The next day, the rats ran on a treadmill for 20 min once a day for up to 28 days. The beam-walking test and a neurological evaluation scale were used to assess post-ischemia functional recovery. The muscle fiber characteristics of the soleus of both sides were examined using histochemical and morphometric methods at 1, 3, 5, 7, 14, and 28 days post-stroke.</p><p><strong>Results: </strong>Compared to that in the IC group, the motor recovery and neurological function on day 28 were significantly greater in the IE group. The infarct volumes were initially comparable; however, the IE group exhibited a significant reduction beginning on day 5, and two-way ANOVA confirmed smaller infarct volumes in the IE group overall. The soleus muscle weight, fiber-type distribution, and cross-sectional area showed no significant temporal or between-group differences.</p><p><strong>Conclusions: </strong>Early exercise intervention promotes functional recovery and may attenuate lesion progression as assessed by TTC staining without detectable deterioration of soleus muscle morphology, highlighting the potential value of safe early mobilization after stroke.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1789922"},"PeriodicalIF":2.5,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13461910/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148725352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and usability of a wearable sensor-based telerehabilitation program for home-based exercise in patients with lower limb amputation: a pilot study.","authors":"Ravi Shankar, Pei Shan Tong, Emily Yee, Poo Lee Ong","doi":"10.3389/fresc.2026.1828171","DOIUrl":"10.3389/fresc.2026.1828171","url":null,"abstract":"<p><strong>Background: </strong>Lower limb amputation (LLA) presents significant rehabilitation challenges, with patients requiring comprehensive multidisciplinary care to achieve optimal functional outcomes. Telerehabilitation using wearable sensor technology offers a promising solution to improve therapy accessibility and exercise adherence among this population. This pilot study evaluated the feasibility, usability, and preliminary effects on hip strength, and user acceptability of a home-based telerehabilitation program using the Rebee wearable sensor system for patients with major lower extremity amputation.</p><p><strong>Methods: </strong>A prospective single-arm feasibility study was conducted at the Foot Care and Limb Design Centre, Tan Tock Seng Hospital, Singapore. Ten participants with unilateral major amputations (5 transtibial, 5 transfemoral) were enrolled. Participants performed daily home exercises using the Rebee inertial measurement unit (IMU) sensor system for 30 days, with remote monitoring and biweekly adjustments. Primary outcomes included hip extensor and abductor strength assessed using dynamometry at baseline (Week 0), Week 4, and Week 8. Secondary outcomes included quality of life (EQ-5D-5L), exercise compliance, patient satisfaction, and system usability (System Usability Scale).</p><p><strong>Results: </strong>All ten participants (80% male; median age 51.5 years, IQR 11) completed the intervention. Median hip extensor strength improved significantly from 8.43 kg at baseline to 9.87 kg at Week 4 (<i>p</i> < 0.05) and 10.88 kg at Week 8 (<i>p</i> < 0.05). Median hip abductor strength increased from 8.01 to 9.45 kg (Week 4) and 9.70 kg (Week 8), with statistically significant improvements (<i>p</i> < 0.05). Mean exercise compliance was 68%. The mean System Usability Scale score was 75.8, indicating favorable usability. Health-related quality of life showed mixed patterns: median self-rated health (EQ-VAS) increased from 80 at baseline to 87.5 by Week 8, whereas the proportion of participants reporting problems in several EQ-5D-5L dimensions did not improve and slightly increased. No adverse events were reported.</p><p><strong>Conclusions: </strong>Home-based telerehabilitation using the Rebee wearable sensor system is feasible, safe, and acceptable for patients with lower limb amputation, with preliminary improvements in hip strength. High user satisfaction and favorable usability support its potential. However, as a single-arm pilot without a control group, findings remain preliminary and not generalizable. Future RCTs are needed to confirm effectiveness and cost-effectiveness for clinical integration.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1828171"},"PeriodicalIF":2.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442527/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686783","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":"Neurocognitive and neurophysiological consequences of sleep-disordered breathing in bronchiectasis: the role of respiratory rehabilitation.","authors":"Elvia Giovanna Battaglia, Gloria Leonardi, Paolo Innocente Banfi, Eleonora Volpato","doi":"10.3389/fresc.2026.1846233","DOIUrl":"10.3389/fresc.2026.1846233","url":null,"abstract":"<p><p>Bronchiectasis (BE) is a chronic respiratory disease characterized by a vicious cycle of irreversible bronchial dilatation and persistent respiratory infections which results in progressive functional impairment and reduced quality of life. Increasing attention has been directed toward comorbidities that may aggravate disease burden, including sleep-disordered breathing (SDB), which remains underrecognized in this population. Emerging evidence suggests that SDB, particularly obstructive sleep apnea (OSA), is highly prevalent in BE and may contribute to adverse outcomes through mechanisms such as intermittent hypoxia, systemic inflammation, microbiome alterations, and ventilatory instability. This narrative review synthesizes current evidence on the relationship between BE and SDB, with a focus on the underlying pathophysiological mechanisms, the neurophysiological and cognitive consequences and the implications for rehabilitation. A comprehensive literature search was conducted using PubMed, Embase, and the Cochrane Library, supplemented by evidence from related chronic respiratory diseases. Available data indicate that sleep disturbances are common in BE and are associated with impaired daytime functioning, reduced quality of life as well as increased symptom burden, independent of disease severity. Rehabilitation interventions, in particular pulmonary rehabilitation, positive airway pressure (PAP), and non-invasive ventilation (NIV), may offer clinically meaningful benefits by enhancing gas exchange, improving sleep quality and patient-reported outcomes. However, high-quality evidence specific to BE populations remains limited. In conclusion, we consider that recognizing SDB as a potentially modifiable trait in bronchiectasis highlights the need for integrated, multidisciplinary management strategies. Future research should prioritize prospective studies to clarify the role of targeted rehabilitation interventions and to support evidence-based clinical practice.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1846233"},"PeriodicalIF":2.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438316/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681354","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":"Navigating airports: a scoping review of physical access challenges and experiences for persons with disabilities.","authors":"Ahmed Hadj Hassen, Ernesto Morales, David Gotti, Francois Routhier","doi":"10.3389/fresc.2026.1680067","DOIUrl":"10.3389/fresc.2026.1680067","url":null,"abstract":"<p><p>Airports present a uniquely complex environment for travelers with disabilities, where the promise of global mobility often collides with persistent physical, sensory, and procedural barriers. This scoping review synthesizes peer-reviewed and gray literature to examine the physical environment of airports and how it shapes access for persons with disabilities, including the interaction between spatial features and service-related components in real-world travel situations. Guided by Fougeyrollas's five-dimensional framework of access availability, accessibility, acceptability, affordability, and usability the review examines how each dimension shapes real-world travel experiences from curb to gate. The results suggest that, in the reviewed studies, accessibility often appears fragmented across the airport journey, with infrastructures that may be present but not always usable, available, or meaningfully integrated into the travel experience. Access often relies on assistance-based models, and important gaps remain in addressing diverse user needs, particularly for individuals with invisible disabilities. At the same time, the literature highlights promising practices and ongoing improvements, including digital wayfinding tools, dedicated assistance services, and growing attention to inclusive design principles. Overall, this review emphasizes that accessibility cannot be reduced to regulatory compliance or the mere presence of infrastructure. Rather, it must be understood as a dynamic and continuous process shaped by the interaction between environments and diverse human needs throughout the airport journey.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1680067"},"PeriodicalIF":2.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13438313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681322","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":"Functional capacity evaluations in medico-legal contexts: a scoping review of best practices, limitations, and areas for improvement.","authors":"Lisa Schwab, Dominique Van de Velde, Lutgart Braeckman, Stijn De Baets","doi":"10.3389/fresc.2026.1777330","DOIUrl":"10.3389/fresc.2026.1777330","url":null,"abstract":"<p><strong>Introduction: </strong>Functional Capacity Evaluations (FCEs) are commonly used to assess individuals' capacities in relation to work demands, with growing application in medico-legal contexts. Despite their broad use, various concerns persist regarding their administration, interpretation, and application within this setting.</p><p><strong>Objectives: </strong>This scoping review synthesized evidence on best practices, limitations, and areas for improvement and innovation in the medico-legal use of FCEs.</p><p><strong>Methods: </strong>The review followed standard methodological frameworks for scoping reviews and PRISMA-ScR guidelines, searching six major databases for peer-reviewed articles published between 1990 and 2026. Studies were included if they addressed the use of FCEs in return-to-work, insurance, disability assessment, or legal contexts. Data were extracted using a standardized form and synthesized thematically across three domains: best practices, key limitations, and improvement opportunities.</p><p><strong>Results: </strong>Fifty-one articles were included. Best practices emphasized standardization and psychometrics, effort monitoring, psychosocial integration, job-specific relevance, practical feasibility, and clear reporting. Limitations included inconsistent protocols, limited validation, insufficient psychosocial integration, and concerns regarding bias and legal defensibility. Recommendations emphasized the development of modular, job-specific, and resource-sensitive protocols; stronger psychometric validation; improved evaluator training; and the establishment of interdisciplinary reporting standards aligned with international frameworks.</p><p><strong>Conclusions: </strong>FCEs hold promise in medico-legal contexts, but variability and limited psychosocial integration undermine their defensibility. Progress requires both technical refinements, including standardized, validated protocols, and a shift toward biopsychosocial, person-centered approaches that reflect real work ability.</p><p><strong>Systematic review registration: </strong>https://doi.org/10.17605/OSF.IO/TYEKR.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1777330"},"PeriodicalIF":2.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681336","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 rehabilitation for critically ill adult patients: protocol for an umbrella review.","authors":"Kun Sun, Yongming Tian, Yuanyuan Song, Biantong Jiang, Huan Liu, Aiping Du","doi":"10.3389/fresc.2026.1885510","DOIUrl":"10.3389/fresc.2026.1885510","url":null,"abstract":"<p><strong>Background: </strong>Advances in critical care medicine have improved short-term survival for intensive care unit (ICU) patients, yet a large proportion of survivors experience lasting physical, cognitive, and psychological impairments collectively termed post-intensive care syndrome (PICS). Early rehabilitation (ER) is a core strategy to reduce PICS burden, but available systematic reviews (SRs) vary widely in intervention protocols, population scope, and methodological rigor. Evidence remains inconsistent regarding ER safety and efficacy in high-risk subgroups, and no high-level evidence synthesis has comprehensively appraised the current evidence base.</p><p><strong>Objective: </strong>This protocol outlines an umbrella review (overview of systematic reviews) designed to synthesise evidence on the effectiveness and safety of ER in critically ill adult patients, evaluate the methodological quality of existing SRs, and grade the certainty of evidence for key outcomes.</p><p><strong>Methods: </strong>Nine electronic databases (CINAHL, Cochrane Library, Embase, PubMed, Web of Science, CNKI, CBM, Wanfang, VIP) will be searched from inception to 30 April 2026, supplemented by manual reference screening and PROSPERO registry searches. Two independent reviewers will conduct title/abstract screening and full-text eligibility assessment, with disagreements resolved via consensus or third-party adjudication. Methodological quality of included SRs will be appraised using the AMSTAR 2 tool, and the certainty of evidence for primary outcomes will be graded using the GRADE framework. A narrative evidence synthesis will be performed to map findings across reviews; quantitative meta-analysis will only be conducted at the primary study level where methodologically appropriate, to avoid bias from overlapping study samples. Subgroup and sensitivity analyses will be undertaken to explore sources of heterogeneity.</p><p><strong>Anticipated contribution: </strong>This umbrella review will provide a rigorous, high-level synthesis of the current ER evidence base. If evidence certainty is sufficient, findings may inform evidence-based clinical decision-making, support standardised protocol development, and identify priority evidence gaps for future primary research.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD420250651183, Registration No. CRD420250651183.</p>","PeriodicalId":73102,"journal":{"name":"Frontiers in rehabilitation sciences","volume":"7 ","pages":"1885510"},"PeriodicalIF":2.5,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13437619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681410","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}