American Journal of Physical Medicine & Rehabilitation最新文献

Harnessing Behavioral Economics to Accelerate Implementation in Rehabilitation. 运用行为经济学加快康复实施。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-09 DOI: 10.1097/PHM.0000000000002724

Kimberly J Waddell, Miriam R Rafferty, Jessica Edelstein, Rinad S Beidas

{"title":"Harnessing Behavioral Economics to Accelerate Implementation in Rehabilitation.","authors":"Kimberly J Waddell, Miriam R Rafferty, Jessica Edelstein, Rinad S Beidas","doi":"10.1097/PHM.0000000000002724","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002724","url":null,"abstract":"Abstract: The rehabilitation field is advancing in the implementation of evidence-based practices (EBPs) into clinical care. Significant gaps remain, however, due to the complexity of patient populations and interventions, and resource intensive implementation strategies. Further, implementation strategies are often designed for how clinicians ought to behave not how they actually behave. Translating EBPs into practice requires behavior change among clinicians within organizational constraints. Behavioral economics is a field that combines insights from economics and psychology to explain human decision making and its impact on behavior. Nudges are strategies that are rooted in behavioral economic principles and guide decision-making without restricting choice. Nudges seek to make the optimal choice the easiest choice, without increasing clinician burden. This paper explores five applications from prior work that may accelerate implementation of EBP in the rehabilitation field: (1) embedding nudges within the electronic health record, (2) developing clinical decision support tools, (3) framing of performance feedback, (4) aligning nudges with existing workflows, and (5) applying the Easy-Attractive-Social-Timely (EAST) Framework to ensure nudges are appropriately designed for the clinician and setting. Lastly, we discuss the special considerations of designing a nudge to avoid unintended consequences such as increased clinician burnout or alert fatigue.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962742","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Quality Indicators Prospectively Associated With Falls in Inpatient Rehabilitation Facilities. 与住院康复设施中跌倒相关的质量指标展望。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-09-16 DOI: 10.1097/PHM.0000000000002625

Jonathan Robert Wright, Jamie D'Ausilio, Thomas Cappaert, Jeffery D Lau

{"title":"Quality Indicators Prospectively Associated With Falls in Inpatient Rehabilitation Facilities.","authors":"Jonathan Robert Wright, Jamie D'Ausilio, Thomas Cappaert, Jeffery D Lau","doi":"10.1097/PHM.0000000000002625","DOIUrl":"10.1097/PHM.0000000000002625","url":null,"abstract":"Objective: Retrospective studies suggest quality indicators are associated with falls in inpatient rehabilitation facilities, but this claim has not yet been validated prospectively. The aim of this study was to analyze the associations between quality indicator codes and falls in a prospective sample.Design: For this prospective observational cohort study, we followed 658 patients from four inpatient rehabilitation facilities who were consecutively admitted and discharged over a 6-mo period. On admission, we collected patients' quality indicator codes, and then, tracked whether they fell during their inpatient rehabilitation facility stay.Results: Univariable logistic regressions revealed that most individual quality indicator items for communication, self-care, and mobility were significantly associated with falls. In a multivariable model with six different quality indicator items, only patients' performance going up and down one step was significantly associated with falls. To explain this finding, we investigated the relationships between these quality indicator items and found three of them to be highly correlated.Conclusions: Most individual quality indicator items seem prospectively associated with falls. Patients with lower quality indicator codes are more likely to fall. Combining quality indicator items (such as expression and toileting) may improve fall-risk assessment, but some quality indicator items may be too interrelated to use together.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"430-435"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of Stroke Impairment and Phases in Daily Steps of Stroke Survivors Living in Community: A Systematic Review With Meta-analysis. 生活在社区的中风幸存者的中风损伤和日常步骤的影响：一项系统回顾与荟萃分析。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-11-20 DOI: 10.1097/PHM.0000000000002649

Amine Guediri, Stéphane Mandigout, Kokouvi Geovani Agbohessou, Jean-Christophe Daviet, Maxence Compagnat

{"title":"Impact of Stroke Impairment and Phases in Daily Steps of Stroke Survivors Living in Community: A Systematic Review With Meta-analysis.","authors":"Amine Guediri, Stéphane Mandigout, Kokouvi Geovani Agbohessou, Jean-Christophe Daviet, Maxence Compagnat","doi":"10.1097/PHM.0000000000002649","DOIUrl":"10.1097/PHM.0000000000002649","url":null,"abstract":"Objective: The aim of the study is to provide detailed information about the number of steps taken by stroke survivors based on their level of impairment in order to guide recommendations for PA.Design: A meta-analysis was conducted, including studies that assessed daily steps and stroke impairment in community-dwelling stroke patients. Participants were categorized into three groups based on stroke impairment severity (minor, minor and moderate, moderate and severe) and into two groups based on stroke phase (subacute and chronic).Results: A total of 47 studies were included, encompassing 1749 participants. There were 494 in the minor stroke group, 1097 in the minor and moderate group, and 158 in the moderate and severe group. A significant difference in daily steps was observed across these groups ( P < 0.01), with the first group averaging 4645 steps/day, the second 3610 steps/day, and the third 1990 steps/day. No significant difference was found between the subacute and chronic groups in terms of daily steps (3839 vs 3783 steps/day).Conclusions: The study highlights the significant impact of stroke impairment on daily step count. We recommend implementing targeted interventions, particularly during the chronic phase, to increase PA levels in stroke survivors, tailored to the specific impairments of each patient.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"e66-e74"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Should We Add McKenzie Exercises to Current Guidelines for the Treatment of (Sub)Acute Nonspecific Low Back Pain? A Cochrane Review Summary With Commentary. 我们是否应该将麦肯齐运动添加到目前治疗（亚）急性非特异性腰痛的指南中？Cochrane Review综述，附评论。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-12-26 DOI: 10.1097/PHM.0000000000002695

Carlotte Kiekens, Stefano Negrini

引用次数: 0

Factors Involved in Higher Knee Extension Torque Induced by Repetitive Peripheral Magnetic Stimulation: Erratum. 重复性外周磁刺激引起的高膝伸转矩相关因素：勘误。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2025-04-03 DOI: 10.1097/PHM.0000000000002610

Masanori Kamiue, Tomotaka Ito, Akio Tsubahara, Tomoya Kishimoto

引用次数: 0

Dr Augusta Strongman Alba 1924-2024, Homage to a PM&R Legend. 奥古斯塔·强人阿尔巴博士1924年至2024年，向PM&R传奇致敬。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-12-26 DOI: 10.1097/PHM.0000000000002696

John R Bach

引用次数: 0

Role of Virtual Reality to Promote Mobilization in the Critical Care Setting: A Narrative Review. 虚拟现实在重症监护环境中促进动员的作用：叙述回顾。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-11-20 DOI: 10.1097/PHM.0000000000002648

Maxwell Li, Meaghan Race, Fanny Huang, Miguel X Escalon

{"title":"Role of Virtual Reality to Promote Mobilization in the Critical Care Setting: A Narrative Review.","authors":"Maxwell Li, Meaghan Race, Fanny Huang, Miguel X Escalon","doi":"10.1097/PHM.0000000000002648","DOIUrl":"10.1097/PHM.0000000000002648","url":null,"abstract":"Abstract: Virtual reality is an emerging technology that can be used as an early complementary intervention to promote early mobilization for critically ill patients. This narrative review examines early mobilization outcomes of virtual reality intervention for patients in the intensive care unit and pediatric critical care unit. Comprehensive medical databases were searched for publications detailing the application of virtual reality interventions in association with critical care. In total, seven studies were screened and selected for the review. Various virtual reality programs help promote early mobilization by using movement-based programs and virtual environments to encourage increased activity and heightened diversity of movements. Furthermore, virtual reality can enhance engagement and enjoyment for therapies and rehabilitation. The emergence of virtual reality modalities shows increased mobility, motivation, and treatment satisfaction among critically ill patients. However, the limited data available, vulnerability of the patient population, safety concerns, and need for more controlled studies emphasize the importance of continued research and cautious implementation of virtual reality interventions in critical care settings.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"487-494"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Predicting Discharge Destination From Inpatient Rehabilitation Using Machine Learning. 利用机器学习预测住院患者康复的出院目的地。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-12-31 DOI: 10.1097/PHM.0000000000002680

Hans E Anderson, Alexandra O Polovneff, Matthew J Durand

{"title":"Predicting Discharge Destination From Inpatient Rehabilitation Using Machine Learning.","authors":"Hans E Anderson, Alexandra O Polovneff, Matthew J Durand","doi":"10.1097/PHM.0000000000002680","DOIUrl":"10.1097/PHM.0000000000002680","url":null,"abstract":"Abstract: Predicting discharge destination for patients at inpatient rehabilitation facilities is important as it facilitates transitions of care and can improve healthcare resource utilization. This study aims to build on previous studies investigating discharges from inpatient rehabilitation by employing machine learning models to predict discharge disposition to home versus nonhome and explore related factors. Fifteen machine learning models were tested. A total of 4922 patient encounters from 4401 patients undergoing inpatient rehabilitation at a Midwestern academic center's inpatient rehabilitation facilities were included. Input variables included demographic and hospital encounter-specific data. The total dataset contained 3687 discharges to home, and 1235 discharges to nonhome destinations. A bagging classifier utilizing a decision tree base classifier utilizing random undersampling and without feature selection performed the best in terms of area under the receiver operating characteristic curve with a score of 0.722. Shapley value analysis suggested that length of stay, intravenous medication administration, urinary dysfunction, age, abnormalities white blood cell count or plasma sodium, and fatigue were the factors with the greatest impact on model output. Machine learning can help predict inpatient rehabilitation discharge disposition and identify factors associated with home or nonhome discharges.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"473-477"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effects of Inspiratory Muscle Training in Patients With Chronic Obstructive Pulmonary Disease Exacerbations: A Randomized Controlled Trial. 吸气肌训练对COPD加重患者的影响：一项随机对照试验。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-11-11 DOI: 10.1097/PHM.0000000000002654

Wei-Yu Huang, Chien-Tzu Lee, Jung-Yien Chien, Miaoju Hsu, Li-Ying Wang

{"title":"Effects of Inspiratory Muscle Training in Patients With Chronic Obstructive Pulmonary Disease Exacerbations: A Randomized Controlled Trial.","authors":"Wei-Yu Huang, Chien-Tzu Lee, Jung-Yien Chien, Miaoju Hsu, Li-Ying Wang","doi":"10.1097/PHM.0000000000002654","DOIUrl":"10.1097/PHM.0000000000002654","url":null,"abstract":"Objective: Pulmonary rehabilitation (PR) is considered for patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, the impact of adding inspiratory muscle training (IMT) to PR on inspiratory muscle function is underexplored. This study aimed to evaluate the effects of IMT in addition to PR on inspiratory muscle function, functional exercise capacity (FEC), and quality of life (QoL) in patients with AECOPD.Design: Sixteen patients with AECOPD and a maximal inspiratory pressure < 80 cmH 2 O were randomized into the experimental (PR + IMT) or the control (PR + sham IMT) group for an 8-wk intervention. Inspiratory muscle activation was measured using surface electromyography, FEC was examined by 6-min walk distance (6MWD), and QoL was assessed with COPD Assessment Test.Results: The experimental group showed sustained and significant improvements in inspiratory muscle function, 6MWD, and QoL after intervention (all P < 0.05). The experimental group had higher maximal inspiratory pressure with less diaphragm activation (both P < 0.001) and more improvements in 6MWD and QoL after intervention (both P < 0.05).Conclusions: Adding IMT to PR resulted in more improvements in inspiratory muscle function, FEC, and QoL for patients with AECOPD, suggesting IMT as a beneficial addition to PR.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"458-464"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Multisite Pain Is Longitudinally Associated With an Increased Risk of Fall Among Older Adults With or at Risk of Knee Osteoarthritis: Data From the Osteoarthritis Initiative. 来自骨关节炎倡议的数据显示，在患有或有患膝骨关节炎风险的老年人中，多部位疼痛与跌倒风险增加有纵向相关性。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-05-01 Epub Date: 2024-11-20 DOI: 10.1097/PHM.0000000000002650

Aqeel M Alenazi

{"title":"Multisite Pain Is Longitudinally Associated With an Increased Risk of Fall Among Older Adults With or at Risk of Knee Osteoarthritis: Data From the Osteoarthritis Initiative.","authors":"Aqeel M Alenazi","doi":"10.1097/PHM.0000000000002650","DOIUrl":"10.1097/PHM.0000000000002650","url":null,"abstract":"Objective: The aim of the study is to examine the association between baseline multisite pain (two and three or more sites) and longitudinal risk of fall and recurrent falls among older adults with or at risk of knee osteoarthritis.Design: This prospective longitudinal cohort study included older adults with or at risk of knee osteoarthritis. Fall, including the history of falls, number of falls, and recurrent falls, were assessed at baseline and during six follow-up visits at 12, 24, 36, 48, 72, and 96 mos. Multisite pain was categorized into the following four categories: no pain, one site, two sites, ≥three sites.Results: This study included 2585 older adults. Baseline two sites (odds ratio = 1.50, P = 0.018) and ≥three sites (odds ratio = 1.89, P < 0.001) were significantly associated with increased risk of fall over time compared to no pain sites. Baseline two sites (incidence rate ratio = 1.44, P = 0.024) and ≥three sites (incidence rate ratio = 1.73, P < 0.001) were significantly associated with an increased number of falls over time. Only ≥three sites were associated with the recurrent falls (odds ratio = 2.16, P = 0.003).Conclusions: Baseline multisite pain (≥3 sites) was longitudinally associated with increased fall incidence, number of falls, and recurrent falls over 7 yrs of follow-up.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"452-457"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0