American Journal of Physical Medicine & Rehabilitation最新文献

{"title":"Model of Fear of Movement/(Re)injury Runs Clockwise From Catastrophizing: Evidence From a Sample of Outpatients With Chronic Nonspecific Low Back Pain.","authors":"Marco Monticone, Federico Arippa, Luca Frigau, Calogero Foti, Silvano Ferrari, Marco Guicciardi, Barbara Rocca","doi":"10.1097/PHM.0000000000002659","DOIUrl":"10.1097/PHM.0000000000002659","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to provide evidence that catastrophizing is the primer of the cognitive-behavioral model of fear of movement/(re)injury.</p><p><strong>Design: </strong>A cross-sectional analysis of 180 outpatients with chronic nonspecific low back pain who completed the Pain Catastrophizing Scale, the Tampa Scale of Kinesiophobia, the Roland-Morris Disability Questionnaire, the Hospital Anxiety and Depression Scale-Depression, and a pain intensity numerical rating scale. The intercorrelations of the outcome measures were estimated using Pearson's correlation coefficient (r), and regression analyses were used to examine their predictive values by following the left side of the fear of movement/(re)injury clockwise from the Pain Catastrophizing Scale ( P = 0.05). A postdictive analysis dichotomizing the sample into high- and low-level catastrophizers evaluated the effects of addressing catastrophizing on disability and pain.</p><p><strong>Results: </strong>The intercorrelations of the Pain Catastrophizing Scale with the Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire, Hospital Anxiety and Depression Scale-Depression and numerical rating scale were respectively r = 0.59, r = 0.54, r = 0.18, and r = 0.44. Pain Catastrophizing Scale was a significant predictor of Tampa Scale of Kinesiophobia; Pain Catastrophizing Scale and Tampa Scale of Kinesiophobia significantly predicted Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale-Depression; and Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Roland-Morris Disability Questionnaire and Hospital Anxiety and Depression Scale-Depression significantly predicted numerical rating scale. The postdictive analysis showed that addressing catastrophizing reduces disability and pain experience by 14% in high-level catastrophizers and 86% in low-level catastrophizers.</p><p><strong>Conclusions: </strong>Our findings provide evidence that catastrophizing is the primer of the fear of movement/(re)injury.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"506-510"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12105964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142977149","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":"Effects of Thermal and Pulsed Ultrasound on Pain and Function in Patients With Carpal Tunnel Syndrome: A Randomized Controlled Trial.","authors":"Mohamed M ElMeligie, Mahmoud M Ismail, Amr M Yehia, Hend R Sakr, Doaa I Amin","doi":"10.1097/PHM.0000000000002651","DOIUrl":"10.1097/PHM.0000000000002651","url":null,"abstract":"<p><strong>Objective: </strong>While ultrasound therapy is common for carpal tunnel syndrome, the relative merits of thermal versus pulsed ultrasound remain unclear. This study compares their therapeutic effects.</p><p><strong>Design: </strong>This is a randomized, double-blinded, placebo-controlled trial. Ninety-two adults aged 30-60 yrs with mild-moderate carpal tunnel syndrome (characteristic symptoms, positive clinical tests, abnormal electrophysiology) were randomized into four groups receiving 4-wk night splinting plus 12 ultrasound sessions: group A: 1 MHz, 1.0-W/cm 2 continuous ultrasound for 5 mins; group B: 1 MHz, 25% duty cycle, 1.0-W/cm 2 pulsed ultrasound for 15 mins; group C: 5 mins thermal plus 15 mins pulsed ultrasound; group D: sham ultrasound for 15 mins. Pain, function (Disability of Arm, Shoulder and Hand-Arabic), nerve conduction, and grip strength were measured at baseline, 4, and 8 wks.</p><p><strong>Results: </strong>Thermal and pulsed ultrasound groups improved in all outcomes versus placebo over 8 wks ( P < 0.05). Pulsed ultrasound decreased pain and distal motor latency more than placebo ( P < 0.05). Thermal ultrasound increased sensory nerve action potentials versus placebo ( P < 0.05).</p><p><strong>Conclusions: </strong>Thermal and pulsed ultrasound with splinting improved pain, disability, grip strength, and nerve conduction in carpal tunnel syndrome. Pulsed ultrasound was optimal for pain and motor function, while thermal ultrasound enhanced sensory nerve function.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"e83-e91"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942850","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":"Burnout in Canadian physiatrists: a national cross-sectional survey.","authors":"Robert Simpson, Eva Cohen, Alex Kiss, Marina Wasilewski, Sander Hitzig, Rosalie Steinberg, Carolyn Steele Gray, Sarah Munce, Anthony Feinstein, Larry Robinson, Mark Bayley, McKyla McIntyre","doi":"10.1097/PHM.0000000000002748","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002748","url":null,"abstract":"<p><strong>Objective: </strong>The prevalence of burnout in Canadian Physiatrists is unknown. This study describes the prevalence of burnout in Canadian Physiatrists and explores predictors.</p><p><strong>Design: </strong>This national cross-sectional web-based survey used convenience sampling, targeting Canadian physiatrists (staff, fellows, residents). The Checklist for Reporting Results of Internet E-Surveys was used to ensure reporting quality. Statistical analyses included descriptives, correlations, and logistic regressions. Survey items included personal and professional characteristics, and validated measures for burnout, relational compassion, emotion regulation, and moral injury.</p><p><strong>Results: </strong>118 responses were collected from a possible 501 Physiatrists across Canada. Majority were female (53%), White North American (55%), working in an urban setting (93%). 42% (n = 50) had burnout, 43% moral injury, and 40% difficulties regulating emotions. Burnout was more likely in females (p = 0.0064; OR 5.24, 95% CI 1.60-17.3), and White respondents (p = 0.0213; OR 0.24, 95% CI 0.07-0.81). Higher relational compassion conferred a lower risk of burnout (p = 0.0006; OR 0.80, 95% CI 0.71-0.91); greater difficulty regulating emotions predicted higher risk of burnout (p = 0.0406; OR 1.06, 95% CI 1.00-1.11), and moral injury (p < 0.0001; 95% OR 1.16, 95% CI 1.09-1.24).</p><p><strong>Conclusion: </strong>Burnout affects 4 in 10 Canadian Physiatrists. Physiatrists who are female, White, and report greater difficulties regulating emotions are at greater risk.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186272","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":"A Rare Cause of Shoulder Pain and the Importance of a Thorough History: A Clinical Vignette.","authors":"Alexa Ryder, Vishal Bansal, Ajai Sambasivan, Kemly Philip","doi":"10.1097/PHM.0000000000002783","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002783","url":null,"abstract":"","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155510","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":"Call for a Translational Orthobiologics Fellowship in the Era of Regenerative Medicine.","authors":"Shannon Strader, Andrew Villasenor, Saranya Wyles, Priya Chandan, Carmen Terzic, Allison C Bean, Zubin Master","doi":"10.1097/PHM.0000000000002782","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002782","url":null,"abstract":"<p><strong>Abstract: </strong>Regenerative medicine is a rapidly advancing field, particularly within the field of Physical Medicine and Rehabilitation. While orthobiologics are currently being used in clinical practice, there remains a need for high-quality clinical trials and translational research to standardize treatments and improve patient outcomes. Education is vital for streamlining development of evidence-based, practical, and effective treatments. In this article, we highlight the need for a one-year advanced fellowship in translational orthobiologics aiming to create a standardized core curriculum targeting physicians involved in treating musculoskeletal (MSK) diseases. The fellowship's objectives include advancing translational orthobiologics research, ethical considerations, and promoting effective communication regarding orthobiologic therapies. Such a program would serve as a foundation for physicians interested in conducting clinically oriented orthobiologics research for MSK disorders while improving the development of safe and effective therapeutics related to musculoskeletal disorders.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155512","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":"Modest Effects of Age on Inflammatory Markers and Histological Features in the Murine Intervertebral Disc Injury Model.","authors":"Huan Wang, Zuozhen Tian, Frances S Shofer, Ling Qin, Yejia Zhang","doi":"10.1097/PHM.0000000000002773","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002773","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effects of age on inflammatory markers and histological features in the injured mouse tail intervertebral disc (IVD).</p><p><strong>Design: </strong>Inflammatory marker gene (e.g., Cxcl1, Il6, Adam8, and Tipe2) expression and morphological changes (histological score and % red in Safranin O staining) in the injured IVDs are recorded in 3-, 10- and 18-month-old mice 1 week following injury.</p><p><strong>Results: </strong>The injured IVDs had higher histological scores (more degenerative) than intact discs at all ages post injury (p < 0.01). However, there was no significant difference among the histological scores of injured IVDs from mice of three ages (p > 0.05). Expression of inflammatory marker genes (e.g., Cxcl1 and Il6) was elevated in the injured compared with intact discs in mice of all ages (p < 0.01). The injury-induced increase in gene expression was greater in 10-month and 18-month-old mouse discs than in the 3-month-old mice (p < 0.01).</p><p><strong>Conclusions: </strong>The IVDs responded to injuries similarly, regardless of age. Due to the modest age-related differences in injury effects, using mice of the same age in experiments is essential, unless one aims to examine age-related differences. Given the costs of maintaining an aged mouse colony, the necessity of using old animals may need justification.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144155513","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":"Analysis of the impact of High Acuity Rehabilitation beds in reducing readmission rate to acute care.","authors":"Francesco Sammartino, Eunkyung Yu, Tracy Huffman, Angela Harris, Maureen Musto, Sarah Schultz, McKenzie Callicoat, Sheital Bavishi","doi":"10.1097/PHM.0000000000002780","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002780","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study is to describe the use of the high acuity rehabilitation program (HARP) at an academic rehabilitation institution to limit the readmission rate to acute care hospitals.</p><p><strong>Design: </strong>Retrospective data from inpatient admissions and discharges between January 2019 to June 2023 was used for this study. Modeling was performed using stepwise regression to select intrinsic and extrinsic patient factors associated with acute admission status. The model performance was assessed using confusion matrices and ROC curves.</p><p><strong>Results: </strong>Among the 199 patients who utilized the HARP unit from January 2019 to June 2023, 96 were discharged acutely to a hospital, while 103 were discharged to home, SNF, or LTAC. The most frequent impairment groups among HARP users were brain injury (22%), debility (21%), and spinal cord injury (18%). The improvement in GG scores for self-care and mobility was associated with successful discharges to non-acute care settings.</p><p><strong>Conclusions: </strong>Unplanned discharges from rehabilitation to acute care (RTAC) are a reason for prolonged hospital stays and increased financial burden on patients. The implementation of a High Acuity Rehabilitation Program (HARP) can help in the management of temporary medical conditions.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504664","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":"The Impact of Allopathic Medical School-PM&R Residency Program Affiliation on Match Patterns: A 5-Year Comparative Analysis.","authors":"Grace Olson, Hye Chang Rhim, Daniel Daneshvar","doi":"10.1097/PHM.0000000000002777","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002777","url":null,"abstract":"<p><strong>Abstract: </strong>Affiliated residency programs may provide key advantages to medical students, including early exposure, mentorship, and research opportunities. This study investigates the impact of having an affiliated home residency PM&R program on match patterns in allopathic medical students. Data was gathered from publicly available match lists from allopathic medical schools. The study included 153 allopathic medical schools with 89,191 medical students from 2020-2024. This study found that the presence of an affiliated PM&R residency program is associated with higher proportions of students matching into PM&R (1.54% vs. 1.05%; OR = 1.48; 95% CI:1.30-1.67; p < .001) and a higher likelihood of matching into the same geographic region as one's medical school (54.98% vs. 46.08%; OR = 1.43, 95% CI:1.11-1.84; p = .0074). In addition, 69.41% of the allopathic students matching into PM&R came from a medical school with an affiliate, and 31.57% of the students coming from a medical school with an affiliate matched into that home program. Thus, medical schools without a PM&R residency program may benefit from initiatives that enhance specialty engagement and support for students interested in PM&R.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109333","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":"Inpatient Rehabilitation Outcomes of Cancer Patients After Chimeric Antigen Receptor T-cell Therapy.","authors":"Eric W Villanueva, Christopher W Lewis, Kathryn Abplanalp, Samman Shahpar, Priya V Mhatre, Reem Karmali, Ishan Roy","doi":"10.1097/PHM.0000000000002774","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002774","url":null,"abstract":"<p><strong>Abstract: </strong>While patients receiving chimeric antigen receptor (CAR) T-cell therapy frequently experience functional decline that would benefit from inpatient rehabilitation facility (IRF), no currently published studies describe rehabilitation outcomes for this population. Thus, this study tested the hypothesis that CAR T-cell therapy patients have similar functional outcomes to other cancer patients in rehabilitation, when matched for disease and demographic variables. This retrospective cohort study identified 84 patients with hematologic malignancies who presented to IRF between January 2017 and December 2022. Nineteen CAR T-cell therapy patients were identified and matched by propensity scoring of disease and demographic variables to 19 patients without CAR T-cell therapy. Between the matched populations, changes in section GG/Functional Independence Measure ratios for self-care and transfers were not statistically different (p = 0.643 and 0.930, respectively). However, change in overall mobility ratio trended towards being significantly different between these two groups (p = 0.081), with CAR T-cell patients having a potentially higher gain (median = 0.333) compared to non-CAR T-cell patients (median = 0.133). Compared to hematologic malignancy patients matched for demographic and cancer variables, CAR T-cell patients had similar, and possibly superior, functional outcomes during inpatient rehabilitation. While further study of a larger sample size is needed, these data suggest the CAR T-cell population have the potential to achieve functional gains at a similar level to other hematologic cancer populations at IRF.</p>","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":"144109332","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":"Comparing Functional Response in Patients with and without COVID-19 Admitted to Inpatient Rehabilitation: A Retrospective Study.","authors":"Pamela Roberts, Debra Ouellette, Jeffrey Wertheimer, Mary Nasmyth, Gabrielle DeLauter","doi":"10.1097/PHM.0000000000002776","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002776","url":null,"abstract":"<p><strong>Objective s: </strong>To identify the self-care and mobility functional response in patients with and without COVID-19 who were admitted to inpatient rehabilitation.</p><p><strong>Design: </strong>Cross-sectional retrospective multi-site study using data collected from routine care data from the Rehabilitation Registry of COVID-19 patients within twelve Inpatient Rehabilitation Facilities across the United States from March 1 through December 31, 2020.</p><p><strong>Results: </strong>Data included 11,734 patients admitted to one of the participating hospitals. Of the patients admitted, 868 had active or had recently recovered from COVID-19 prior to their admission to the rehabilitation hospital. Patients with active or who had recently recovered from COVID-19 were younger with a mean age 65.74 years, over half being male (60.0%) and White (64.4%); with significance seen in the African American population. Fewer patients with COVID returned home, and the majority in both groups had neurological diagnoses, longer lengths of stay, fewer minutes of therapy, and a lower functional response in the self-care domain.</p><p><strong>Conclusions: </strong>This study demonstrates patients with active and recovered COVID-19 who received inpatient rehabilitation made significant gains in self-care and mobility. These findings suggest that a structured inpatient rehabilitation program may provide benefit in patients with active and recovered COVID-19.</p>","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":"144109330","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}