Journal of rehabilitation medicine. Clinical communications最新文献

{"title":"Bone health post-stroke: a survey of stroke care physiatrists in Canada.","authors":"Jamie L Fleet, Nicole Billias, Alexandria Roa Agudelo, Ujjoyinee Barua, Sydney Knight, Robert Teasell, Kristin K Clemens","doi":"10.2340/jrm-cc.v8.43707","DOIUrl":"10.2340/jrm-cc.v8.43707","url":null,"abstract":"<p><strong>Objective: </strong>People who have experienced stroke are at a high risk for falls, fractures, and osteoporosis. Bone health post-stroke is often overlooked. The goal of this study was to understand current practice perspectives and barriers to bone health care post-stroke among physiatrists.</p><p><strong>Methods: </strong>We conducted an online survey of English-speaking stroke physiatrists practicing in Canada from October 2023 to April 2024. We recruited participants through the Canadian Association of Physical Medicine and Rehabilitation newsletter and direct contact via hospital or university email. The survey included demographic and multiple-choice questions as well as open-ended queries. Data were summarized using frequencies and percentages, and open-ended questions were assessed qualitatively for themes.</p><p><strong>Results: </strong>Twenty-two physiatrists completed the survey. Female physiatrists made up 45.5% of respondents, and 36.4% were in their first 5 years of practice. Most worked in an academic hospital (81.8%). The majority (81.9%) of respondents felt there is a need for post-stroke bone health guidelines. Important themes that emerged from open-ended questions included a lack of awareness, research, and resources.</p><p><strong>Conclusions: </strong>In this study of Canadian physiatrists, most respondents feel post-stroke bone health guidelines would be beneficial. More research and resources focused upon bone health in this population is needed.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"43707"},"PeriodicalIF":0.0,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031242","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":"RETURN-TO-WORK AFTER ACETABULAR FRACTURES: THE IMPACT OF INJURY SEVERITY ON THE POST-REHABILITATION WORKING CAPACITY AND WORKLOAD.","authors":"Anna L Schiltenwolf, Tina Histing, Maximilian M Menger, Christof K Audretsch, Florian Laux, Markus A Kueper, Steven C Herath","doi":"10.2340/jrm-cc.v8.44156","DOIUrl":"10.2340/jrm-cc.v8.44156","url":null,"abstract":"<p><strong>Objective: </strong>Acetabular fractures are among the most severe injuries in trauma surgery. In younger patients, they typically result from high-energy trauma and are often associated with polytrauma. Treatment complexity and rehabilitation outcomes are influenced by overall injury severity. This study aimed to evaluate return to work (RTW) after acetabular fracture in relation to the overall injury severity score (ISS).</p><p><strong>Design/subjects/patients: </strong>A retrospective study included 22 patients treated for acetabular fractures at a Level I Trauma Centre spanning a period from January 2009 - December 2020.</p><p><strong>Methods: </strong>Patients completed a questionnaire assessing work-related factors and workload before (PRE) and after (POST) trauma (median [MD] = 126.4 ± 46.4 months POST). Based on ISS, patients were categorized as < 16 = \"no polytrauma\" (<i>n</i> = 8) and ≥ 16 = \"polytrauma\" (<i>n</i> = 14).</p><p><strong>Results: </strong>The RTW rate was 75% in both groups. However, descriptively the median workload reduction was greater in the \"polytrauma\" group (-50%) compared to the \"no polytrauma\" group (-33.3%). A shift toward sedentary work was seen in both groups, more prominently in the \"polytrauma\" subgroup (+40%) compared to the \"no polytrauma\" group (+11.4%).</p><p><strong>Conclusion: </strong>Possible workload was reduced after acetabular fracture. Despite similar RTW rates, polytrauma patients descriptively returned to less physically demanding work. Thus, ISS significantly predicts the outcome of the rehabilitations process after acetabular fractures.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"44156"},"PeriodicalIF":0.0,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12416338/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145031287","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":"THE SWEDISH NEEDS ASSESSMENT PROJECT TO ENHANCE LIFE FOR PEOPLE LIVING WITH SPINAL CORD INJURY: SYNTHESIZED EVIDENCE OF NEEDS TO BE MET, RESEARCHER PRIORITIES, AND KNOWLEDGE GAPS.","authors":"Jeanette Melin, Emelie Axwalter, Gunilla Åhrén, Katharina Stibrant Sunnerhagen, Åsa Lundgren Nilsson, Johanna Wangdell","doi":"10.2340/jrm-cc.v8.43069","DOIUrl":"10.2340/jrm-cc.v8.43069","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this report is to describe the aggregated insights and key findings from a Swedish need assessment project. The project comprised 3 parallel studies identifying [a] needs to be met, [b] research questions, and [c] knowledge translation gaps related to enhancing the lives of people with spinal cord injury (SCI).</p><p><strong>Methods: </strong>The project included people living with SCI, their relatives, health professionals, and personal care assistants. Analyses were conducted with the aim of identifying commonalities and connections between the results of the 3 individual studies.</p><p><strong>Results: </strong>The aggregated insights and key findings from this project can be summarized into 3 themes. First, a well-functioning healthcare, rehabilitation, and supporting system must have a holistic perspective on what it means to live with SCI. Second, aging is about living with the SCI and getting old with the SCI. Third, when family members receive their own support, they can provide good support to the person living with SCI.</p><p><strong>Conclusion: </strong>New evidence from the Swedish needs assessment project reveals the needs that currently have the greatest impact on improving the lives of people with SCI, which can guide researchers, healthcare providers, and knowledge translators.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"43069"},"PeriodicalIF":0.0,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12340991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839265","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":"AN INTELLIGIBLE AI-DRIVEN DECISION SUPPORT SYSTEM FOR POSTSTROKE MOBILITY ASSESSMENT.","authors":"Jin Cheng Liaw, Dominik Raab, Malte Weber, Mario Siebler, Harald Hefter, Dörte Zietz, Marcus Jäger, Andrés Kecskeméthy, Francisco Geu Flores","doi":"10.2340/jrm-cc.v8.42379","DOIUrl":"10.2340/jrm-cc.v8.42379","url":null,"abstract":"<p><strong>Objective: </strong>Long-term mobility impairment is a sequel of stroke victims which requires intensive medical and physiotherapeutic care. Detailed assessment of therapeutic success is relevant to achieving efficacy, but requires expert knowledge, since mobility disorders are complex. Increasing shortage of qualified staff and larger numbers of patients are thus major problems in this field. To meet these challenges, we show that machine learning algorithms can reproduce expert mobility assessment from gait data with acceptable accuracy, supporting poststroke evaluation while giving intelligible feedback into how the assessments were generated.</p><p><strong>Methods: </strong>A total of 100 hemiparetic stroke patients received clinical examinations followed by instrumented gait analysis and were assigned a Stroke Mobility Score by an interdisciplinary expert board. From each measured stride pair, 680 features were extracted. After removing non-discriminating features, two regression models were trained: a decision tree and a multilayer perceptron artificial neural network.</p><p><strong>Results: </strong>The models yielded good to very good (Cohen) coefficients of determination. The interpretable decision-trees and the explanations obtained from the neural network unveiled key features supporting the mobility assessments.</p><p><strong>Conclusion: </strong>The automated assessments agree well with those of the experts. Synergistic interactions between system, and experts via the computed key features may improve quality in diagnosis and objectify therapeutic targets.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"42379"},"PeriodicalIF":0.0,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12305971/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746339","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":"PILOT STUDY OF COMBINED TRANSVERTEBRAL MAGNETIC AND TRANSCUTANEOUS STIMULATION FOR THE REHABILITATION OF COMBAT ACUTE SPINAL CORD INJURIES.","authors":"Oleksandr Kulyk, Ivan Mazurchuk, Valeriia Polousova, Anna Pshenychna, Oksana Yarmolenko","doi":"10.2340/jrm-cc.v8.42686","DOIUrl":"10.2340/jrm-cc.v8.42686","url":null,"abstract":"<p><strong>Aim of the study: </strong>To improve the effectiveness of neurorehabilitation in patients with severe combat spinal cord injury by combining spinal cord repetitive transvertebral magnetic stimulation (rTvMS) and non-invasive transcutaneous electrical stimulation (TcES) of peripheral nerves.</p><p><strong>Clinical rationale for study: </strong>For the best recovery from severe combat spinal cord injury, neurorehabilitation must start in the acute phase. Only technologies targeting sensorimotor conduction and functional improvement can confirm the potential of the time factor. Non-invasive neuromodulation has been shown to work for combat spinal cord injury of varying severity.</p><p><strong>Material and methods: </strong>We have analysed 154 cases of severe combat spinal cord injury, followed continuously for at least 12 months from the start of neurorehabilitation. A unified «end-to-end» protocol combined rTvMS of the spinal cord with simultaneous TcES of peripheral nerves in different modes was developed for non-invasive spinal cord neuromodulation.</p><p><strong>Results: </strong>The combination of these parameters produced the most positive results in post-traumatic sensory-motor disorders: (<i>i</i>). rTvMS, level ThX-LI: 2000 pulses per set, 100 pulse packages, 5-10 Hz, intensity \"+ 30--40%\" of the threshold of the evoked motor potential; TcES n. tibialis or n. peroneus: 5-10 Hz, pulse intensity corresponded to the threshold of the motor response, functional electrical stimulation (FES) mode. (<i>ii</i>). rTvMS, level C_II-Th_II: 2000 pulses per set, 50 pulse packages, 5-7 Hz, intensity + 20-30% of the threshold of the evoked motor potential; TcES n. medianus or n. ulnaris; n. tibialis or n. peroneus: 5-10 Hz, pulse intensity corresponded to the threshold of the motor response, FES mode. Approximately 28% of patients in group A (FRANKEL/ASIA) moved to a higher level of function after 3 courses of neurorehabilitation intervention (90 working days).</p><p><strong>Conclusions and clinical implications: </strong>Electro-magnetic stimulation of the spinal cord excitatory cell conduction system according to the principle of \"end-to-end: as in Hebb's theory,\" combined with physical movement, led to an increase in spinal cord conduction in the acute phase of combat spinal cord injury. This was manifested by neurological and functional improvement.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"42686"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144683672","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":"SWEDISH TRANSLATION, CULTURAL ADAPTATION AND TESTING OF THE PROSTHETIC UPPER EXTREMITY FUNCTIONAL INDEX-2.","authors":"Cathrine Widehammar, Lis Sjöberg","doi":"10.2340/jrm-cc.v8.42151","DOIUrl":"10.2340/jrm-cc.v8.42151","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to translate, culturally adapt and test the Prosthetic Upper Extremity Functional Index-2 for a Swedish context.</p><p><strong>Subjects: </strong>Ten children with congenital upper limb deficiency with an upper limb prosthesis and their parents.</p><p><strong>Methods: </strong>The translation and cultural adaptation of the Prosthetic Upper Extremity Functional Index-2 was conducted according to the International Society for Pharmacoeconomics and Outcomes Research Principles of Good Practice for cross-cultural adaptation of patient-reported outcome measures; this comprises 10 steps, including Preparation, Forward Translation, Reconciliation, Back Translation, Back Translation Review, Harmonization, Cognitive Debriefing, Review of Cognitive Debriefing Results and Finalization, Proofreading and Final Report.</p><p><strong>Result: </strong>The new translated version, tested on 10 children, 4 boys and 6 girls, 3-14 years showed good relevance for the Swedish context, the questions were easy to understand, and response options were easy to interpret. It was also easily accessible on computers and mobile devices.</p><p><strong>Conclusion: </strong>The Swedish version of the Prosthetic Upper Extremity Functional Index-2 is user-friendly and provide information of the child's self-reported prosthesis use in a Swedish context. Children's right to express their opinions, is crucial, and using the questionnaire prior to their clinic visits gives children the opportunity to participate in goal setting and treatment planning.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"42151"},"PeriodicalIF":0.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12171865/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144318879","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":"ORTHOPAEDIC MANUAL PHYSICAL THERAPY FOR POST-STROKE SHOULDER PAIN: TWO CASE REPORTS INCLUDING CLINICAL ASSESSMENTS AND PARTICIPANTS' EXPERIENCES.","authors":"Ingrid Lindgren, Arne G Lindgren, Håkan Carlsson, Tobias Lundgren, Christina Brogårdh","doi":"10.2340/jrm-cc.v8.43201","DOIUrl":"10.2340/jrm-cc.v8.43201","url":null,"abstract":"<p><strong>Objective: </strong>To descriptively evaluate Orthopaedic Manual Physical Therapy - a novel intervention for post-stroke shoulder pain - by use of clinical assessments and the participants' experiences.</p><p><strong>Design: </strong>Two case reports.</p><p><strong>Methods: </strong>Two individuals with mild to moderate upper extremity impairments and persistent post-stroke shoulder pain, underwent Orthopaedic Manual Physical Therapy for 12 weeks. The intervention comprised a thorough clinical examination, joint mobilization, stretching, and exercises targeting the affected structures and incorrect movement patterns. Participants were clinically assessed pre- and post-intervention and followed up 4-5 months later. They also answered interviews about their experiences of the intervention and perceived effects.</p><p><strong>Results: </strong>After Orthopaedic Manual Physical Therapy, both participants showed decreased pain intensity during movements and increased range of motion. One of the participants also experienced decreased resistance to passive movements, improved motor function, grip strength, and upper extremity daily activities after the intervention and at follow-up. Interviews revealed that the participants tolerated the therapy well and were satisfied with the intervention and long-lasting results.</p><p><strong>Conclusion: </strong>Orthopaedic Manual Physical Therapy may be a useful method to reduce post-stroke shoulder pain in persons with mild to moderate upper extremity paresis after stroke. To confirm the results, further studies are warranted.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"43201"},"PeriodicalIF":0.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287473","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 EFFICACY OF SPASTICITY-CORRECTIVE SURGERY AND BOTULINUM TOXIN INJECTIONS FOR UPPER LIMB SPASTICITY TREATMENT.","authors":"Therese Ramström, Johanna Wangdell, Carina Reinholdt, Trandur Ulfarsson, Lina Bunketorp Käll","doi":"10.2340/jrm-cc.v8.42928","DOIUrl":"10.2340/jrm-cc.v8.42928","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the long-term efficacy of spasticity-corrective surgery and botulinum toxin treatment in patients with upper limb spasticity.</p><p><strong>Design: </strong>Pretest-posttest quasi-experimental study.</p><p><strong>Patients: </strong>Thirty-four patients with disabling spasticity.</p><p><strong>Methods: </strong>Patients were divided into 2 groups based on their treatment preference: the surgery group, which underwent tendon lengthening/release (<i>n</i> = 17), and the botulinum toxin injection group (<i>n</i> = 17). The primary outcome measure was the Modified Ashworth Scale. Secondary outcomes included range of motion, grip strength, and activity performance. Assessments were conducted at baseline for both groups, at 3 months following botulinum toxin injection, and at 6 months following surgery, with an additional peak-effect evaluation for botulinum toxin at week 5.</p><p><strong>Results: </strong>The surgery group demonstrated significantly greater reductions in composite Modified Ashworth Scale scores, with a mean change of 2.7 (SD 0.8), compared to the botulinum toxin group (1.1, SD 0.6 at peak; 0.3, SD 0.5 at long-term; <i>p</i> < 0.001). Surgery also led to significantly larger improvements in range of motion, grip strength, task performance, and patient satisfaction. While botulinum toxin effects were transient, surgery provided sustained benefits.</p><p><strong>Conclusion: </strong>Spasticity-corrective surgery achieves superior and longer-lasting benefits compared to botulinum toxin treatment in patients with disabling upper limb spasticity.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"42928"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12081954/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144096374","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":"IMPROVING THE PREDICTION OF FUNCTIONAL RECOVERY IN OLDER ADULTS WITH STROKE IN GERIATRIC REHABILITATION USING AN INERTIAL MEASUREMENT UNIT COMBINED WITH THE UTRECHT SCALE FOR EVALUATION OF REHABILITATION.","authors":"Jules J M Kraaijkamp, Margot W M DE Waal, Niels H Chavannes, Wilco P Achterberg, Eléonore F VAN Dam VAN Isselt, Michiel Punt","doi":"10.2340/jrm-cc.v8.43129","DOIUrl":"https://doi.org/10.2340/jrm-cc.v8.43129","url":null,"abstract":"<p><strong>Background: </strong>Prediction of functional recovery in older adults recovering from stroke is typically based on observational scales, such as the Utrecht Scale for Evaluation of Rehabilitation (USER). Objectively measuring postural sway using inertial measurement devices (IMU) may complement or improve conventional approaches. The aim of this study was to evaluate whether integrating an IMU with USER data enhances the accuracy of predicting functional recovery at discharge.</p><p><strong>Methods: </strong>This prospective cohort study included older adults (≥ 65 years) recovering from stroke. Postural sway was assessed using an IMU during 2 different balance conditions and analysed using principal component analysis (PCA). Using 3 different regression models, percentage explained variance was compared to assess predictive performance on functional recovery of USER vs an IMU.</p><p><strong>Results: </strong>The 71 patients included had a mean age of 78 (SD 7.6) and a median time since stroke of 16 days (IQR 19-60). Of the 71 patients, 12 (16.9%) were unable to perform balance condition 2 due to insufficient balance. Of 35 postural sway features displaying reliability for both balance conditions, 12 were selected for PCA. Incorporation of principal components for both balance conditions in the final model increased the explained variance compared to a model in which only USER-mobility at admission was used to predict delta-USER at discharge (<i>R</i> ² = 0.61 vs 0.30).</p><p><strong>Conclusions: </strong>Sitting and standing balance as measured by an IMU improves the prediction of functional recovery at discharge compared to USER alone.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"43129"},"PeriodicalIF":0.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12079043/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082561","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":"STEPWISE CARDIAC REHABILITATION ADJUSTMENT AFTER EXERCISE-INDUCED IMPLANTABLE CARDIOVERTER DEFIBRILLATOR SHOCK: A CASE REPORT.","authors":"Hidetoshi Yanagi, Harumi Konishi, Saori Yamada, Kazuya Yamamoto, Fumiyuki Otsuka","doi":"10.2340/jrm-cc.v8.42483","DOIUrl":"https://doi.org/10.2340/jrm-cc.v8.42483","url":null,"abstract":"<p><strong>Objective: </strong>To report an in-hospital cardiac rehabilitation strategy after exercise-induced implantable cardioverter defibrillator shock.</p><p><strong>Case report: </strong>A 72-year-old man with heart failure, peripheral artery disease, a history of percutaneous coronary intervention and coronary artery bypass surgery, exercise-induced ventricular fibrillation, and an implantable cardioverter defibrillator was hospitalised after experiencing recurrent ventricular fibrillation while walking, which triggered implantable cardioverter defibrillator shock. While hospitalised, his medication regimen was adjusted. After passing the 200-m walking test, he started in-hospital cardiac rehabilitation. During cardiopulmonary exercise testing, he experienced non-sustained ventricular tachycardia. Percutaneous coronary intervention was performed to relieve ischaemia; however, ventricular tachycardia recurred during walking, causing another implantable cardioverter defibrillator shock. After further medication adjustments and setting heart rate limits, he gradually resumed cycling and low-intensity resistance exercises, followed by walking, and was subsequently discharged without ventricular tachycardia recurrence.</p><p><strong>Discussion: </strong>Peripheral artery disease-associated pain and increased heart rate may have contributed to ventricular tachycardia. A stepwise exercise programme involving heart rate monitoring and medication therapy adjustments enabled safe exercise resumption after implantable cardioverter defibrillator shock in a patient with multiple comorbidities.</p><p><strong>Conclusion: </strong>This case emphasises the importance of personalised exercise strategies that consider both arrhythmic risk and comorbidities for patients at high risk of exercise-induced arrhythmias.</p>","PeriodicalId":73929,"journal":{"name":"Journal of rehabilitation medicine. Clinical communications","volume":"8 ","pages":"42483"},"PeriodicalIF":0.0,"publicationDate":"2025-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12016661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043293","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}