American Journal of Physical Medicine & Rehabilitation最新文献_第2页

Learner's Perspectives of Free, Online, International Continuing Medical Education in Rehabilitation: A Mixed-Methods Analysis. 免费、在线、国际CME在康复中的学习者视角：混合方法分析。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 Epub Date: 2025-02-25 DOI: 10.1097/PHM.0000000000002723

Britney Soll, Heather Dow, Eleanor Elisabeth Mohith-de Muinck Keizer, Paul Winston

{"title":"Learner's Perspectives of Free, Online, International Continuing Medical Education in Rehabilitation: A Mixed-Methods Analysis.","authors":"Britney Soll, Heather Dow, Eleanor Elisabeth Mohith-de Muinck Keizer, Paul Winston","doi":"10.1097/PHM.0000000000002723","DOIUrl":"10.1097/PHM.0000000000002723","url":null,"abstract":"Abstract: The COVID-19 pandemic spurred global engagement with continuing medical education. The Canadian Advances in Neuro-Orthopedics for Spasticity Consortium's free online platform offering interdisciplinary expert lectures on spasticity saw parallel growth. We analyzed 1733 responses from 41 post-session surveys to assess the learner's perspectives of online continuing medical education using a convergent mixed-methods design. The qualitative analysis produced four themes: [1] event value and satisfaction (subthemes: quality and impact of speakers , accessibility of the online format , discussions and interactions, and the benefits of visual learning ), [2] increased competence (subthemes: increased knowledge, intent to apply , and increased confidence), [3] inspiring collaboration (subthemes: need for multidisciplinary teams, international collaboration , and effective communication tools ), [4] considerations and recommendations (subthemes: relevance to developing countries , technical aspects , and academic level of content) . Quantitative analyses supported these findings, showing high levels of satisfaction and perceived gains in knowledge. Notably, 88% of participants indicated intent to apply their knowledge, and 84% stated that it would enhance their competence. The results underscore the importance of interaction in online education and highlight a need for communication skills training to facilitate multidisciplinary teamwork. The findings revealed disparities in perceptions of the academic difficulty of continuing medical education, which warrants investigation into participants' selection of continuing medical education webinars.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"762-769"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143555625","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

Comparing the Characteristics of Randomized Controlled Trials of Poststroke Upper Extremity Rehabilitation in Low-Middle-Income and High-Income Countries. 中低收入和高收入国家脑卒中后上肢康复随机对照试验的特点比较

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 Epub Date: 2025-03-06 DOI: 10.1097/PHM.0000000000002726

Robert Teasell, Mohamad R Safaei-Qomi, Jamie L Fleet, Sean P Dukelow, Manuel Murie-Fernandez, Amber Harnett, Sarvenaz Mehrabi

{"title":"Comparing the Characteristics of Randomized Controlled Trials of Poststroke Upper Extremity Rehabilitation in Low-Middle-Income and High-Income Countries.","authors":"Robert Teasell, Mohamad R Safaei-Qomi, Jamie L Fleet, Sean P Dukelow, Manuel Murie-Fernandez, Amber Harnett, Sarvenaz Mehrabi","doi":"10.1097/PHM.0000000000002726","DOIUrl":"10.1097/PHM.0000000000002726","url":null,"abstract":"Abstract: This review aimed to systematically identify and compare randomized controlled trials of poststroke upper extremity rehabilitation interventions conducted in low-middle-income countries and high-income countries over time and their differences in study characteristics and quality. Searches were conducted in CINAHL, Embase, PubMed, Scopus, and Web of Science up to April 1, 2021. Randomized controlled trials were included if ≥50% of the study population had stroke, if participants were adults (≥18 yrs), and if the randomized controlled trial examined an intervention to the hemiparetic upper extremity. A total of 1276 randomized controlled trials met inclusion criteria, and of these, 978 randomized controlled trials were conducted in high-income countries and 298 in low-middle-income countries. The number of randomized controlled trials increased at a comparable rate to high-income countries since 2011 although from a lower baseline. A higher percentage of randomized controlled trials in high-income countries were conducted in the chronic poststroke phase, and a higher percentage of randomized controlled trials in low-middle-income countries were conducted in the subacute phase. While the randomized controlled trials in low-middle-income countries were found to have comparable quality to randomized controlled trials of high-income countries, they were published in aggregate in journals with lower impact factors. It is important to better understand the potential barriers to publication in higher impact journals for randomized controlled trials conducted in low-middle-income countries.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"755-761"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143655934","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

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 : 2025-08-01 Epub 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":"10.1097/PHM.0000000000002724","url":null,"abstract":"Abstract: The rehabilitation field is advancing in the implementation of evidence-based practices into clinical care. Significant gaps remain, however, because of the complexity of patient populations and interventions, and resource intensive implementation strategies. Furthermore, implementation strategies are often designed for how clinicians ought to behave not how they actually behave. Translating evidence-based practices 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 previous work that may accelerate implementation of evidence-based practice 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 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":"750-754"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","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

Diagnostic Value of Median Nerve Cross-sectional Area Measured by Ultrasonography for the Severity of Carpal Tunnel Syndrome: A Machine Learning-Based Approach. 超声测量正中神经截面积对腕管综合征严重程度的诊断价值：一种基于机器学习的方法。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 Epub Date: 2025-02-03 DOI: 10.1097/PHM.0000000000002701

Fariborz Azizi, Babak Mohammadi, Mohammad Ahmadi-Dastgerdi, Neda Esfandiari

{"title":"Diagnostic Value of Median Nerve Cross-sectional Area Measured by Ultrasonography for the Severity of Carpal Tunnel Syndrome: A Machine Learning-Based Approach.","authors":"Fariborz Azizi, Babak Mohammadi, Mohammad Ahmadi-Dastgerdi, Neda Esfandiari","doi":"10.1097/PHM.0000000000002701","DOIUrl":"10.1097/PHM.0000000000002701","url":null,"abstract":"Objective: This study was conducted to evaluate the diagnostic performance and to establish cutoff values of median nerve cross-sectional area for classifying the severity of carpal tunnel syndrome.Design: The study dataset included 1069 wrists from 1034 patients with carpal tunnel syndrome (May 2017-December 2022). A machine learning algorithm was used to predict carpal tunnel syndrome severity based on median nerve cross-sectional area, adjusting for sex, age, body mass index, and disease duration.Results: The multivariable model showed a multiclass area under the receiver operating characteristic curve of 0.753 and s single-class area under the receiver operating characteristic curves of 0.733, 0.635, and 0.780 for mild, moderate, and severe syndrome, respectively. Optimal cross-sectional area cutoffs were identified as <14 mm 2 for mild and >16 mm 2 for severe syndrome, with area under the receiver operating characteristic curve values of 0.773 and 0.794, respectively. The model showed high sensitivity for mild and high specificity for severe syndrome but had a low performance for moderate carpal tunnel syndrome (area under the receiver operating characteristic curve = 0.568).Conclusions: Median nerve cross-sectional area is a valuable tool for diagnosing mild and severe carpal tunnel syndrome. While cross-sectional area provides limited accuracy for moderate carpal tunnel syndrome, it remains a useful adjunct to other diagnostic methods, potentially reducing the need for more invasive procedures.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"702-708"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405417","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

Unusual Cause of Posterolateral Elbow Pain: A Clinical Vignette. 一个不寻常的原因后外侧肘痛：临床小插曲。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 Epub Date: 2025-02-04 DOI: 10.1097/PHM.0000000000002710

Carly Berrios, Dane Daley, Matthew Sherrier

引用次数: 0

Spinal Cord Stimulation and Intrathecal Pump Infusion Management in Para-Athletes: A Retrospective Case Series. 脊髓刺激和鞘内泵输注管理在残疾人运动员：回顾性病例系列。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 Epub Date: 2025-04-16 DOI: 10.1097/PHM.0000000000002761

Rayan Fawaz, Camilla De Laurentis, Audrey Thomas, Muriel Curtet, Anne-Marie Giner, Manon Duraffourg

{"title":"Spinal Cord Stimulation and Intrathecal Pump Infusion Management in Para-Athletes: A Retrospective Case Series.","authors":"Rayan Fawaz, Camilla De Laurentis, Audrey Thomas, Muriel Curtet, Anne-Marie Giner, Manon Duraffourg","doi":"10.1097/PHM.0000000000002761","DOIUrl":"10.1097/PHM.0000000000002761","url":null,"abstract":"Objectives: To present our experience with 4 para-athletes implanted with intrathecal baclofen pump and spinal cord stimulation, detailing their management and the potential complications these patients may face.Design: For spinal cord stimulation, data collected included stimulation level, surgical complications, and pain scale assessment before the procedure and at 3-mo follow-up. For intrathecal baclofen, data collected included catheter level, surgical complications, baclofen concentration and dosage, and Modified Ashworth Scale.Results: The sports practiced by the patients include sitting volleyball, shooting, handcycling, and table tennis. Concerning patients implanted with spinal cord stimulation, the first patient showed benefits on her phantom limb pain allowing her to resume training while the second patient presented an electrode fracture. Patients receiving intrathecal baclofen improved their spasticity. One of the patients required only a continuous infusion, while the other needed a bolus infusion adapted to training hours.Conclusions: The use of spinal cord stimulation and intrathecal baclofen in para-sports is not contraindicated. Only the use of intrathecal morphine requires a therapeutic use exemption. Spinal cord stimulation and intrathecal baclofen require special monitoring, considering the needs of para-athletes and the particularities of the sport they practice. Further studies will be needed to assess the sporting performance of patients implanted with spinal cord stimulation or intrathecal infusion pumps.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"743-747"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960697","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

PLUS-M Mobility Values of Osseointegration Patients: How Do Osseointegration Limb Replacement Prosthesis Users Compare to Traditional Socket Amputee Prosthesis Users? 骨整合患者的PLUS-M活动价值：骨整合肢体置换假体使用者与传统的窝形截肢假体使用者相比如何？

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 Epub Date: 2024-09-09 DOI: 10.1097/PHM.0000000000002685

Brian Joseph Page, Gerard A Sheridan, Michael D Greenstein, Jason S Hoellwarth, Taylor J Reif, S Robert Rozbruch

{"title":"PLUS-M Mobility Values of Osseointegration Patients: How Do Osseointegration Limb Replacement Prosthesis Users Compare to Traditional Socket Amputee Prosthesis Users?","authors":"Brian Joseph Page, Gerard A Sheridan, Michael D Greenstein, Jason S Hoellwarth, Taylor J Reif, S Robert Rozbruch","doi":"10.1097/PHM.0000000000002685","DOIUrl":"10.1097/PHM.0000000000002685","url":null,"abstract":"Objective: The primary aim of this study was to compare osseointegration limb replacement prosthesis users to normative published Prosthetic Limb Users Survey of Mobility (PLUS-M) values for traditional socket prosthesis users. The secondary aim was to investigate whether patient factors were predictive of PLUS-M scores.Design: Retrospective review of all patients who underwent osseointegration maintained in a prospectively maintained registry. All patients ( N = 63) were invited to complete a PLUS-M survey. Thirty patients completed the survey (15 femoral osseointegration, 15 tibial osseointegration).Results: The osseointegration limb replacement prosthesis users cohort's composite median scores and interquartile ranges for the PLUS-M Raw Score, PLUS-M T-score, and PLUS-M percentile score were 57 (46-60), T-score 62.5 (51.275-71.4), and 89.5 (54.95-98.4). PLUS-M T-scores were higher in the osseointegration limb replacement prosthesis users compared with the age and etiology matched literature-reported outcomes in traditional socket prosthesis users for above-knee ( P = 0.027) and below-knee ( P = 0.029) amputees. Tibial osseointegration scores were slightly higher than femur osseointegration scores but did not reach statistical significance. PLUS-M raw ( P = 0.047) and PLUS-M percentile scores ( P = 0.041) were significantly improved for younger patients at the time index amputation. Regression analysis supported this finding.Conclusions: Osseointegration limb replacement prosthesis users demonstrate improved functional mobility outcome scores relative to traditional socket prosthesis users. PLUS-M functional scores were improved for younger patients at time of index amputation.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"687-692"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827130","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

Assessment of the robotic devices for overground gait training in post stroke patient: A Systematic review and Meta-analysis. 脑卒中后患者地面步态训练机器人设备的评估：系统回顾和荟萃分析。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-02 DOI: 10.1097/PHM.0000000000002793

Α Ploumis, P Gkatziani, P Tsingeli, G Ntritsos, D Dimopoulos, A Athanasiou, A Kefalas, N D Varvarousis

{"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":"Objective: 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.Design: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

Natural History of an L5-S1 Disc Extrusion. L5-S1圆盘挤压的自然历史。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-01 Epub Date: 2025-01-11 DOI: 10.1097/PHM.0000000000002672

Austin Shokraeifard, Luis Valdez, Aditya Raghunandan

引用次数: 0

Mechanisms of Post-stroke Stiff-Knee Gait: A Narrative Review. 脑卒中后膝关节僵硬步态的机制：叙述性回顾。

IF 2.2 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-01 Epub Date: 2025-01-16 DOI: 10.1097/PHM.0000000000002678

Kellen T Krajewski, J Sebastián Correa Bs, Ricardo Siu, David Cunningham, James S Sulzer

{"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":"Abstract: 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.","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}

引用次数: 0