American Journal of Physical Medicine & Rehabilitation最新文献

{"title":"Assessment of the robotic devices for overground gait training in post stroke patient: A Systematic review and Meta-analysis.","authors":"Α Ploumis, P Gkatziani, P Tsingeli, G Ntritsos, D Dimopoulos, A Athanasiou, A Kefalas, N D Varvarousis","doi":"10.1097/PHM.0000000000002793","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002793","url":null,"abstract":"<p><strong>Objective: </strong>Stroke is a major cause of disability, impacting mobility worldwide. Overground robotic-assisted gait training (o-RAGT) uses wearable exoskeletons to improve walking. This systematic review and meta-analysis assess its effectiveness versus conventional gait training in enhancing gait velocity and balance in post-stroke patients.</p><p><strong>Design: </strong>Our search was conducted in the Pubmed, Cochrane, ScienceDirect, Scopus and PEDro electronic databases for English journal articles about human randomized controlled trials (RCTs) of the last two decades, investigating o-RAGT effects on gait parameters of poststroke patients compared with conventional gait training.</p><p><strong>Results: </strong>A comprehensive literature search identified seven RCTs with a total of 288 participants. Meta-analysis results indicated that o-RAGT significantly improved post-intervention gait velocity (summary mean difference: 0.09 m/sec, 95% CI: 0.02-0.17), while other gait parameters, such as stride length and cadence, showed no statistically significant differences. The intervention was well-tolerated, with no major adverse events reported.</p><p><strong>Conclusion: </strong>Despite the positive impact on gait speed, challenges remain, including high device costs and the need for further research to optimize training parameters. These findings support the potential of o-RAGT as an effective tool for gait rehabilitation in stroke survivors, highlighting the need for larger studies with long-term follow-up to refine its clinical application.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551761","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}

{"title":"Natural History of an L5-S1 Disc Extrusion.","authors":"Austin Shokraeifard, Luis Valdez, Aditya Raghunandan","doi":"10.1097/PHM.0000000000002672","DOIUrl":"10.1097/PHM.0000000000002672","url":null,"abstract":"","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"e98"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977102","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}

{"title":"Mechanisms of Post-stroke Stiff-Knee Gait: A Narrative Review.","authors":"Kellen T Krajewski, J Sebastián Correa Bs, Ricardo Siu, David Cunningham, James S Sulzer","doi":"10.1097/PHM.0000000000002678","DOIUrl":"10.1097/PHM.0000000000002678","url":null,"abstract":"<p><strong>Abstract: </strong>Stiff-Knee gait is a dysfunction commonly observed post-stroke characterized by a decreased swing phase knee flexion angle. Importantly, Stiff-Knee gait can impair walking, ultimately reducing overall activity and participation. Interventions for Stiff-Knee gait have shown mixed results and, combined with more recent observational evidence, suggest that there are other potential causes requiring the need to re-examine its etiology. The aim of this review is to compile and appraise the current state of the science regarding the neurophysiological and biomechanical impairments of individuals post-stroke with Stiff-Knee gait. This narrative review will address the following topics to better understand Stiff-Knee gait: operationally define Stiff-Knee gait and further detail its presentation, describe its potential neurophysiological and biomechanical mechanisms, and synthesize findings. We explore evidence for quadriceps hyperreflexia, abnormal tone, motor incoordination, and impaired propulsion. We conclude that Stiff-Knee gait needs a commonly accepted definition, that more attention needs to be devoted to understanding its mechanisms, and that in prospective designs, larger sample sizes are needed to account for the heterogeneity of the condition.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"e101-e108"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12187528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142998796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring Rehabilitation Protocols for Primary Anterior Cruciate Ligament Repair: Insights From a Scoping Review.","authors":"Alan Chang, Cheng-Yen Chan, Meng-Ting Lin, Chueh-Hung Wu, Levent Özçakar","doi":"10.1097/PHM.0000000000002681","DOIUrl":"10.1097/PHM.0000000000002681","url":null,"abstract":"<p><strong>Objectives: </strong>The primary repair of the anterior cruciate ligament has re-emerged as a treatment for acute ruptures. While numerous studies have investigated rehabilitation after anterior cruciate ligament reconstruction, few have focused on primary repair. We aimed to describe the rehabilitation protocols for primary anterior cruciate ligament repair in order to identify knowledge gaps and differences between primary anterior cruciate ligament repair and reconstruction.</p><p><strong>Design: </strong>A scoping review design was selected because of the descriptive and exploratory nature, aiming to identify and map available research evidence from various databases relevant to the research question. Evaluation of study quality and risk of bias is not required in scoping reviews.</p><p><strong>Results: </strong>A comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science identified a total of 66 studies involving over 3100 participants. No randomized controlled trials directly comparing postoperative rehabilitation protocol were identified. Eight items of the rehabilitation protocols were analyzed, based on existing clinical practice guidelines for anterior cruciate ligament reconstruction. This review highlights the inadequacy and heterogeneity of the available data.</p><p><strong>Conclusions: </strong>This review revealed a lack of consistent evidence and called for the development of standardized, technique-specific rehabilitation guidelines after primary anterior cruciate ligament repair. Clinical trials and transparent reporting are needed to establish validated protocols.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"622-629"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920415","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}

{"title":"Extracorporeal Shock Wave Therapy for Limb Dysfunction After Stroke: A Systematic Review and Meta-analysis.","authors":"Wenfang Liu, Shuangmei Zhang","doi":"10.1097/PHM.0000000000002694","DOIUrl":"10.1097/PHM.0000000000002694","url":null,"abstract":"<p><strong>Objective: </strong>Recently, extracorporeal shock wave therapy has emerged as a novel and noninvasive approach for alleviating spasticity and pain, improving motor dysfunction after stroke. To determine the effectiveness of extracorporeal shock wave therapy and the effects of shock wave parameters in relieving spasticity, pain, and motor dysfunction after stroke.</p><p><strong>Design: </strong>We conducted a systematic search of PubMed, EBSCOhost, Embase, Cochrane Library, and Web of Science databases for randomized controlled trials on extracorporeal shock wave therapy for limb dysfunction after stroke from inception until February 1, 2023. Two researchers independently searched and screened articles identified from each database, used RevMan v.5.4 analyzing data.</p><p><strong>Results: </strong>This review included 9 articles and 327 patients. Extracorporeal shock wave therapy improved the spasticity, pain, and motor function after stroke. They also improved the passive range of motion in the lower limbs. The treatment effect was highest when the shock wave frequency was <8 Hz and pressure was <2 bar. However, the effect was not significantly affected by treatment duration. Compared to focused extracorporeal shock waves, released extracorporeal shock waves were associated with better outcomes.</p><p><strong>Conclusions: </strong>The treatment outcomes are optimal when a shock wave frequency <8 Hz, pressure <2 bar, and released extracorporeal shock waves are used.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"654-662"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920419","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}

{"title":"High-Intensity Interval Training Effects on People With Multiple Sclerosis: A Systematic Review and Meta-analyses for Exercise Capacity and Fatigue.","authors":"Javier Martín-Núñez, Sheila Gómez de Castro, Alejandro Heredia-Ciuró, Alba Navas-Otero, Irene Cabrera-Martos, Araceli Ortiz-Rubio, Marie Carmen Valenza","doi":"10.1097/PHM.0000000000002676","DOIUrl":"10.1097/PHM.0000000000002676","url":null,"abstract":"<p><strong>Objective: </strong>This study was to examine the effects of high-intensity interval training interventions on exercise capacity and fatigue in people with multiple sclerosis.</p><p><strong>Design: </strong>We performed a systematic review and meta-analysis. PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar databases were systematically searched from inception to January 2024. We reviewed randomized controlled trials that focused their intervention on high-intensity interval training for people with multiple sclerosis to improve exercise capacity or fatigue. Two researchers performed the search process independently in the different databases and assessed methodological quality and risk of bias.</p><p><strong>Results: </strong>Eleven studies were included in the systematic review and seven of them were meta-analyzed. The overall pooled effect favored high-intensity interval training interventions in improving exercise capacity (standardized mean difference = 0.29; 95% confidence interval = 0.05, 0.53; P = 0.02) and reducing fatigue (standardized mean difference = -0.26; 95% confidence interval = -0.50, -0.02; P = 0.03) in people with multiple sclerosis. We generally found a low risk of bias and a good methodological quality.</p><p><strong>Conclusions: </strong>The results of this review and meta-analysis provide evidence that high-intensity interval training interventions improved and reduced fatigue in people with multiple sclerosis. High-intensity interval training intervention may be a good option to improve exercise capacity and reduce fatigue of these people.</p><p><strong>To claim cme credits: </strong>Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME.</p><p><strong>Cme objectives: </strong>Upon completion of this article, the reader should be able to: (1) Determine the impact that whiplash-associated disorders have on a patient's life; (2) Identify and recognize the greater benefits of a supervised exercise therapy on recovery after a whiplash injury; and (3) Differentiate between the different exercise protocols conducted (types of exercises and duration) and incorporate therapy appropriately as part of an effective treatment plan.</p><p><strong>Level: </strong>Advanced.</p><p><strong>Accreditation: </strong>The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s) ™. Physicians should only claim credit commensurate with the extent of their participation in the activity.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"605-612"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789434","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}

{"title":"Observational Comparison of Fatigue and Sleep Disturbance After Traumatic Injury, in Those With and Without Concomitant Mild Traumatic Brain Injury.","authors":"Jacqueline F I Anderson, Jeong In Park","doi":"10.1097/PHM.0000000000002682","DOIUrl":"10.1097/PHM.0000000000002682","url":null,"abstract":"<p><strong>Objective: </strong>Fatigue and subjective sleep disturbance are elevated after mild traumatic brain injury, raising the question of whether mild traumatic brain injury specific factors contribute to the experience of fatigue and subjective sleep disturbance after mild traumatic brain injury.</p><p><strong>Design: </strong>One hundred ten premorbidly healthy individuals who had suffered a traumatic injury during an accident approximately 8 wks prior were examined and assessed with subjective measures of fatigue and sleep disturbance, psychological distress, and pain.</p><p><strong>Results: </strong>Individuals with a traumatic injury reported significant elevations in most fatigue and all subjective sleep disruption components compared to community-based control participants ( n = 45). After controlling for pain, psychological status, sex, and premorbid intellectual functioning, those individuals experiencing a mild traumatic brain injury at time of traumatic injury ( n = 64) had equivalent levels of fatigue and subjective sleep disruption as those who had experienced no head injury at time of traumatic injury ( n = 46). Trauma group membership did not significantly predict fatigue or subjective sleep disturbance. In contrast, psychological distress consistently predicted fatigue and subjective sleep disturbance, with pain also inconsistently predicting some fatigue and subjective sleep disturbance variables.</p><p><strong>Conclusions: </strong>This study suggests it is the experience of suffering traumatic injury, rather than mild traumatic brain injury specific factors, that is associated with elevations in fatigue and subjective sleep disturbance, approximately 8 wks after injury.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"630-637"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942834","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}

{"title":"Impact of Body-Height Increase on Gastrocnemius Muscle Stiffness in Children With Cerebral Palsy: A one-year Prospective Cohort Study.","authors":"Shinya Nakamura, Minoru Kimoto, Masahiko Wakasa, Akira Saito, Hitoshi Sakamoto, Akiko Misawa, Uki Kawanobe, Kyoji Okada","doi":"10.1097/PHM.0000000000002684","DOIUrl":"10.1097/PHM.0000000000002684","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to investigate whether the impacts of height increase on gastrocnemius muscle stiffness are greater in children with spastic cerebral palsy than in those with typical development.</p><p><strong>Design: </strong>This 1-yr cohort study enrolled children (cerebral palsy, 23; typical development, 23) who underwent two measurements conducted at entry and after 1 yr. Lateral and medial gastrocnemius muscle-strain ratios representing muscle stiffness were obtained using elastography.</p><p><strong>Results: </strong>All regression equations (dependent variable, rate of change of height; independent variable, rate of change of the gastrocnemius muscle-strain ratios) were significant and all R2 s in children with cerebral palsy (all P < 0.001; lateral gastrocnemius muscle's R2 = 0.81; medial gastrocnemius muscle's R2 = 0.74) were greater than those in children with typical development ( P < 0.001 and R2 = 0.49; medial gastrocnemius muscle's R2 = 0.49). The coefficients of equations in children with cerebral palsy were significantly larger than those in typical development ( P < 0.05).</p><p><strong>Conclusions: </strong>The greater R2 values in cerebral palsy than typical development could explain how the variation in height predicts the variations in gastrocnemius muscle stiffness more accurately in cerebral palsy than in typical development. Gastrocnemius muscle stiffness worsens more in children with cerebral palsy than that in typical development.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"638-645"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920428","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}

{"title":"Effects of Ultrasound-Guided Corticosteroid Injection Compared to Mesenchymal Stem Cell Injection in Patients With Grade II and III Knee Osteoarthritis: A Randomized Double-Blind Controlled Trial.","authors":"Masoumeh ZoghAli, Naser Amini, Arash Babaei-Ghazani, Bijan Forogh, Mohammad Taghi Joghataei, Mohammad Reza Babaei, Masih Rikhtehgar, Khatereh Abdolmaleki","doi":"10.1097/PHM.0000000000002691","DOIUrl":"10.1097/PHM.0000000000002691","url":null,"abstract":"<p><strong>Objective: </strong>This study investigated the effects of a single dose injection of mesenchymal stem cells under ultrasound guidance for knee osteoarthritis.</p><p><strong>Design: </strong>The study included 30 subjects in the intervention group, who received the mesenchymal stem cell injection and 27 in the control group who received triamcinolone. Various outcome measures, including pain levels, range of motion, and magnetic resonance imaging parameters, were evaluated before the intervention and at different time points after treatment.</p><p><strong>Result: </strong>The results showed that the mesenchymal stem cell group experienced more effective improvements in outcome measures compared to the control group. Pain improvement was significantly different in the mesenchymal stem cell group at 2 wks, 4 wks, and 24 wks after the treatment. Range of motion in extension improved significantly in the mesenchymal stem cell group after 4 wks. Physical function improved significantly in both groups at different time points. Furthermore, the mesenchymal stem cell group showed some positive changes in magnetic resonance imaging parameters, but it cannot be said definitively that they led to an increase in cartilage thickness.</p><p><strong>Conclusions: </strong>The study suggests that a single dose injection of mesenchymal stem cells is safe and holds promise for long-term treatment of knee osteoarthritis. No significant negative effects were reported in either group as a result of the study.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"646-653"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920433","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}

{"title":"Association Between Average Daily Activity Counts and Knee Osteoarthritis Progression.","authors":"Xiaozhen Tang, Dongze Li, Haishan Yao, Xuanchen Chen, Liangquan Fan, Zhenhai Hou","doi":"10.1097/PHM.0000000000002697","DOIUrl":"10.1097/PHM.0000000000002697","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to explore the relationship between daily activity counts and knee osteoarthritis progression.</p><p><strong>Design: </strong>A cohort study using Osteoarthritis Initiative data included 610 participants aged 45-79 yrs with knee osteoarthritis or at risk. Daily activity counts were measured using ActiGraph GT1M accelerometers. Osteoarthritis progression was assessed via Kellgren-Lawrence grade and joint space narrowing scores over 2 yrs. Cox proportional hazard and restricted cubic spline models identified the dose-response relationship and optimal activity threshold.</p><p><strong>Results: </strong>The average age of participants was 63.7 yrs, with 44.8% male. A U-shaped relationship was observed between daily activity counts and osteoarthritis progression. Moderate activity levels could be associated with a reduced risk of Kellgren-Lawrence-grade (adjusted hazard ratio: 0.33; 95% confidence interval: 0.24-0.44) and joint space narrowing-score progression (hazard ratio: 0.31; 95% confidence interval: 0.25-0.38) for activity below 3263.3 counts/min. However, higher activity levels may increase Kellgren-Lawrence-grade (hazard ratio: 1.57; 95% confidence interval: 1.40-2.75) and joint space narrowing-score progression risk (hazard ratio: 1.27; 95% confidence interval: 1.13-1.43).</p><p><strong>Conclusions: </strong>Moderate activity may protect against knee osteoarthritis progression, while low and high levels may increase risk. Tailored activity recommendations are needed for individuals with or at risk for osteoarthritis. Future research should investigate the mechanisms and refine activity thresholds for osteoarthritis management.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"663-670"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920396","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}