American Journal of Physical Medicine & Rehabilitation最新文献

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Feasibility and Outcomes of Gait Training with a Powered Exoskeleton in Individuals with Multiple Sclerosis. 用动力外骨骼对多发性硬化症患者进行步态训练的可行性和结果。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-03 DOI: 10.1097/PHM.0000000000002772
Samantha J Stallkamp Tidd, Nicolas R Thompson, Susan M Linder, Randy Karim, Francois Bethoux
{"title":"Feasibility and Outcomes of Gait Training with a Powered Exoskeleton in Individuals with Multiple Sclerosis.","authors":"Samantha J Stallkamp Tidd, Nicolas R Thompson, Susan M Linder, Randy Karim, Francois Bethoux","doi":"10.1097/PHM.0000000000002772","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002772","url":null,"abstract":"<p><strong>Objective: </strong>To report on real-world use of a powered exoskeleton (PES) for outpatient gait training in MS.</p><p><strong>Design: </strong>Retrospective chart review on 21 patients with MS who completed physical therapy gait training sessions using a PES. Training descriptors, PES parameters, adverse events (AE), and performance on mobility tests without PES were compared between first and last session.</p><p><strong>Results: </strong>The median number of gait training sessions was 11. There was a statistically significant increase in walk time (p = 0.008), number of steps (p = 0.011), and programmed step length (p < 0.001) while using PES. Three patients exhibited a greater than 20% increase in walking speed on the Timed 25 Foot Walk. The time to complete the Timed Up and Go (TUG) increased (p = 0.029), although patients who did not use a wheelchair outdoors showed a smaller mean increase in TUG time (0.59 s vs. 8.69 s, p = 0.050). Five patients had one mild AE without impact on training participation.</p><p><strong>Conclusion: </strong>Our findings suggest that gait training with a PES is safe and feasible in individuals with MS. Changes in mobility outcomes without PES were highly variable between patients. Further research is needed to establish the value of PES gait training and predictors of response to gait training.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224070","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 Performance in the Physical Medicine and Rehabilitation Part II Certification Oral Examination Based on Milestone Ratings. 基于里程碑评分的物理医学和康复第二部分认证口试成绩预测。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2024-12-03 DOI: 10.1097/PHM.0000000000002670
Gerard E Francisco, Mikaela M Raddatz, Kenji Yamazaki, Sunil Sabharwal, Keneshia Kirksey, Carolyn Kinney, Eric Holmboe
{"title":"Predicting Performance in the Physical Medicine and Rehabilitation Part II Certification Oral Examination Based on Milestone Ratings.","authors":"Gerard E Francisco, Mikaela M Raddatz, Kenji Yamazaki, Sunil Sabharwal, Keneshia Kirksey, Carolyn Kinney, Eric Holmboe","doi":"10.1097/PHM.0000000000002670","DOIUrl":"10.1097/PHM.0000000000002670","url":null,"abstract":"<p><strong>Abstract: </strong>The Accreditation Council for Graduate Medical Education introduced the Milestones to document learner development within a competency-based framework. On the other hand, board certifying examinations serve as a summative evaluation of a learner's readiness for independent medical practice. Scores in Part I of the American Board of Physical Medicine and Rehabilitation examination, which measures medical knowledge, has been shown to correlate only with Milestones ratings in medical knowledge. We hypothesized that combined ratings of various Milestone competencies can predict subsequent performance in related American Board of Physical Medicine and Rehabilitation Part II certifying examination domains. Milestones data and American Board of Physical Medicine and Rehabilitation Part II Examination scores of trainees in 3-yr PM&R residency programs in the United States from academic years 2014-2016 who sat for the American Board of Physical Medicine and Rehabilitation Parts I and II Examinations, immediately after completion of training, were reviewed. Regression analysis showed that Milestone subcompetencies, alone or in combination, did not correlate with Part II domain scaled scores. Medical Knowledge was the only Milestone subcompetency that was correlated with performance in the American Board of Physical Medicine and Rehabilitation Part I certifying examination. This current study found that no similar association exists between any of the Milestones Competencies and the American Board of Physical Medicine and Rehabilitation Part II certifying examination, suggesting that the two assessment tools measure different attributes.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"581-584"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789438","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
Effectiveness of Amnion Allograft Injections in Patients With Degenerative Musculoskeletal Diseases: A Systematic Review and Meta-analysis. 羊膜异体注射治疗退行性肌肉骨骼疾病的有效性:系统回顾和荟萃分析。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2025-01-03 DOI: 10.1097/PHM.0000000000002687
Wen-Hsuan Hou, Pi-Chu Lin, Kuang-Mou Tung, Su-Ru Chen
{"title":"Effectiveness of Amnion Allograft Injections in Patients With Degenerative Musculoskeletal Diseases: A Systematic Review and Meta-analysis.","authors":"Wen-Hsuan Hou, Pi-Chu Lin, Kuang-Mou Tung, Su-Ru Chen","doi":"10.1097/PHM.0000000000002687","DOIUrl":"10.1097/PHM.0000000000002687","url":null,"abstract":"<p><strong>Objective: </strong>Amnion allograft injections have emerged as potential regenerative therapy for degenerative musculoskeletal diseases. In this study, we conducted a systematic review and meta-analysis to evaluate the effectiveness of amnion allograft injections in patients with degenerative musculoskeletal diseases.</p><p><strong>Design: </strong>A search was conducted across the PubMed, Embase, Cochrane, and Web of Science databases to identify studies reporting on amnion allograft injections in patients with degenerative musculoskeletal diseases. The outcomes assessed were pain reduction at different time points, physical functional improvements, and quality of life.</p><p><strong>Results: </strong>In total, seven studies were included. The quality assessment indicated that only three studies had a low overall risk of bias. Pooled effect sizes indicated significant improvements in overall pain of -0.959 (95% confidence interval: -1.483 to -0.435, P < 0.001), pain at 2-4 wks of -2.609 (95% confidence interval: -3.334 to -1.884, P < 0.001), at 3-6 mos of 0.834 (95% confidence interval: -1.077 to -0.590, P < 0.001), and at 1-2 yrs of -0.518 (95% confidence interval: -1.025 to -0.011, P = 0.045), physical function of 0.679 (95% confidence interval: 0.202 to 1.156, P = 0.005), and quality of life of 1.407 (95% confidence interval: 0.273 to 2.541, P = 0.015). No significant covariant was identified by subgroup analyses.</p><p><strong>Conclusions: </strong>Results indicated that amnion allograft injections produced significant pain reduction, functional improvement, and quality of life enhancement in patients receiving injections compared to control groups, particularly in terms of pain reduction.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"567-575"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942852","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
Overview of Medical, Surgical, and Rehabilitation Outcome Measures Used in Randomized Controlled Trials of Moderate to Severe Traumatic Brain Injury. 中度至重度创伤性脑损伤随机对照试验中使用的医学、外科和康复结果指标综述
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2024-11-14 DOI: 10.1097/PHM.0000000000002656
Cecilia Flores-Sandoval, Emma A Bateman, Heather M MacKenzie, Keith Sequeira, Shannon Janzen, Robert Teasell
{"title":"Overview of Medical, Surgical, and Rehabilitation Outcome Measures Used in Randomized Controlled Trials of Moderate to Severe Traumatic Brain Injury.","authors":"Cecilia Flores-Sandoval, Emma A Bateman, Heather M MacKenzie, Keith Sequeira, Shannon Janzen, Robert Teasell","doi":"10.1097/PHM.0000000000002656","DOIUrl":"10.1097/PHM.0000000000002656","url":null,"abstract":"<p><strong>Abstract: </strong>Optimal reporting of outcomes is critical for the interpretation of research findings. This review aimed to examine the utilization of outcome measures in randomized controlled trials of moderate to severe traumatic brain injury. Systematic searches were conducted up to December 2022 in MEDLINE, PubMed, Scopus, CINAHL, Embase, and PsycINFO, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Randomized controlled trials were included if the population studied had ≥18 yrs and ≥50% had moderate to severe traumatic brain injury. A total of 662 met inclusion criteria. There was a total of 839 unique outcome measures across all included randomized controlled trials. Of these, only 195 (23.2%) were used in ≥4 randomized controlled trials. On average, randomized controlled trials included 1.26 outcome measures (range 1-23). A total of 495 (59%) of outcome measures were classified in the recovery and rehabilitation category, and 344 (41%) in the medical and surgical measures category. There was a more equal representation of outcome measures in high-income countries compared to low to middle income countries, with the latter using fewer recovery and rehabilitation outcome measures. Outcome measures used in randomized controlled trials of moderate to severe traumatic brain injury have significant heterogeneity and variable clinical relevance, which limits the impact and generalizability of research in moderate to severe traumatic brain injury, and the ability to compare across studies.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"585-592"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942827","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
Fellowship Training in Geriatric Rehabilitation: A Proposal. 老年康复研究培训:建议。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 DOI: 10.1097/PHM.0000000000002756
Walter R Frontera, Jonathan F Bean
{"title":"Fellowship Training in Geriatric Rehabilitation: A Proposal.","authors":"Walter R Frontera, Jonathan F Bean","doi":"10.1097/PHM.0000000000002756","DOIUrl":"10.1097/PHM.0000000000002756","url":null,"abstract":"","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":"104 6","pages":"499-500"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148919","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 Robot-Assisted Gait Training on Balance and Fear of Falling in Patients With Stroke: A Randomized Controlled Clinical Trial. 机器人辅助步态训练对脑卒中患者平衡和跌倒恐惧的影响:一项随机对照临床试验。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2024-12-03 DOI: 10.1097/PHM.0000000000002674
Merve Sevinc Gunduz, Rustem Mustafaoglu, Ibrahim Halil Ural
{"title":"Effects of Robot-Assisted Gait Training on Balance and Fear of Falling in Patients With Stroke: A Randomized Controlled Clinical Trial.","authors":"Merve Sevinc Gunduz, Rustem Mustafaoglu, Ibrahim Halil Ural","doi":"10.1097/PHM.0000000000002674","DOIUrl":"10.1097/PHM.0000000000002674","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this study was compare the effects of combined training, which included robot-assisted gait training in addition to traditional balance training, and traditional balance training alone on balance and fear of falling in patients with stroke based on objective assessment methods.</p><p><strong>Design: </strong>Patients were randomized into combined training group ( n = 21) and traditional balance training group ( n = 21) for duration of 5 wks. Balance were assessed with EncephaLog App recorded stand-up time, sit-down time, and directional sways during walking, Berg Balance Scale, and Timed Up and Go Test. International Fall Efficacy Scale measured fear of falling. Fugl-Meyer Assessment-Lower Extremity assessed limb impairment. Foot posture was assessed with Foot Posture Index.</p><p><strong>Results: </strong>After the treatments, EncephaLog sways (anterior, medial, lateral: P = 0.04, P = 0.01, P = 0.02), stand-up time ( P = 0.006), sit-down time ( P = 0.002), Berg Balance Scale ( P < 0.001), and International Fall Efficacy Scale ( P = 0.002) improved in combined training group. Timed Up and Go Test ( P = 0.01) and Fugl-Meyer Assessment-Lower Extremity ( P < 0.001) improved in traditional balance training group. Stand-up time ( P = 0.01) and sit-down time ( P = 0.04) showed statistically significant improvement in combined training group compared to traditional balance training group; Fugl-Meyer Assessment-Lower Extremity ( P = 0.002) demonstrated statistically significant improvement in traditional balance training group compared to combined training group.</p><p><strong>Conclusions: </strong>Objective assessment indicated that combined treatments in subacute and chronic stroke rehabilitation enhance balance and reduce fear of falling more effectively than isolated approaches.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"558-566"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789491","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
Physical Activity and Exercise Interventions in Abdominal Wall Hernia Patients: Impact on Quality of Life and Health Outcomes-A Systematic Review and Meta-analysis. 腹壁疝患者的身体活动和运动干预:对生活质量和健康结果的影响——系统回顾和荟萃分析
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2024-11-18 DOI: 10.1097/PHM.0000000000002657
José Luis Gil Delgado, Gonzalo Reverte Pagola, Francisco Javier Pecci Barea, Adrián Feria Madueño, Alejandro Sánchez Arteaga, Borja Sañudo Corrales
{"title":"Physical Activity and Exercise Interventions in Abdominal Wall Hernia Patients: Impact on Quality of Life and Health Outcomes-A Systematic Review and Meta-analysis.","authors":"José Luis Gil Delgado, Gonzalo Reverte Pagola, Francisco Javier Pecci Barea, Adrián Feria Madueño, Alejandro Sánchez Arteaga, Borja Sañudo Corrales","doi":"10.1097/PHM.0000000000002657","DOIUrl":"10.1097/PHM.0000000000002657","url":null,"abstract":"<p><strong>Objective: </strong>Abdominal wall hernias are a common pathology in the surgical field, often leading to symptoms such as pain and tightness that can significantly reduce quality of life. Some studies have suggested that exercise and physical activity may improve both quality of life and health outcomes. This study aimed to evaluate the impact of exercise on quality of life and health outcomes in abdominal wall hernia patients through a qualitative systematic review and a quantitative meta-analysis.</p><p><strong>Design: </strong>The systematic review identified six studies ( N = 2409) that met the inclusion criteria, all demonstrating that exercise and physical activity positively affected health outcomes in abdominal wall hernia patients. Because of the limited number of studies available, the meta-analysis focused specifically on the effects of exercise and physical activity on quality of life and pain.</p><p><strong>Results: </strong>The meta-analysis results indicated significant improvements in quality of life between presurgery and postsurgery after a physical exercise intervention. However, no significant differences were found in pain levels between presurgery and postsurgery after the exercise program.</p><p><strong>Conclusions: </strong>This systematic review and meta-analysis offer promising insights into the potential benefits of physical activity and exercise interventions on health outcomes for abdominal wall hernia patients.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"519-526"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142942835","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
Demographic and Clinical Factors Associated With Functional Changes in Long-Covid. 与长冠病毒功能改变相关的人口统计学和临床因素。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2025-01-03 DOI: 10.1097/PHM.0000000000002686
Barbara Mazer, Debbie Ehrmann Feldman
{"title":"Demographic and Clinical Factors Associated With Functional Changes in Long-Covid.","authors":"Barbara Mazer, Debbie Ehrmann Feldman","doi":"10.1097/PHM.0000000000002686","DOIUrl":"10.1097/PHM.0000000000002686","url":null,"abstract":"<p><strong>Abstract: </strong>Many people experience symptoms months or years after COVID-19 infection. The impact of these symptoms on daily functioning and factors associated with functional decline are not well understood. This study aimed to describe functional changes among persons with long-Covid and explore associated sociodemographic and clinical factors. A total of 2764 adults who tested positive for COVID-19 were recruited at ≥12 wks after diagnosis. Participants responded to an electronic survey ( Newcastle Post-COVID Syndrome Questionnaire (symptoms); COVID-19 Yorkshire Rehabilitation Screen (activities; perceived global health, mobility, personal care, daily activities). A total of 37.8% were classified as having long-Covid based on the positive response to \" Are you still troubled by symptoms?\" The majority reported a decline in global health, mobility, and participation in daily activities. Common changes in function included fatigue, breathlessness upon climbing stairs and when dressing, decline in participation in usual activities, anxiety, pain/discomfort, and reduced concentration. Having COVID-19 ≥ 1 yr prior was associated with change in perceived global health (odds ratio = 1.5). Being infected ≥12 mos prior (odds ratio = 1.5), hospitalized for COVID-19 (odds ratio = 2.2-2.4), ≥1 chronic comorbid conditions (odds ratio = 1.6), and obesity (odds ratio = 1.6) were associated with functional decline. Many of those infected with COVID-19 experience long-lasting symptoms impacting daily functioning. Multidisciplinary medical and rehabilitation services are needed to help improve recovery and maximize functioning.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"576-580"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920401","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
Bihemispheric Transcranial Direct Current Stimulation Over Primary Motor Cortex Potentiates Improvement of Neurological but not Upper Limb Motor Functions in Ischemic Stroke Patients Treated With Routine Physical Therapy: A Randomized, Double-Blind, Sham-Controlled Trial. 一项随机、双盲、假对照试验:对初级运动皮质的双脑经颅直流电刺激增强了接受常规物理治疗的缺血性卒中患者神经功能而非上肢运动功能的改善。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2024-11-28 DOI: 10.1097/PHM.0000000000002669
Niloufar Balikshahi, Sara Ramezani, Babak Bakhshayesh Eghbali, Mozaffar Hosseininezhad, Kamran Ezzati, Amirhomayoun Atefi, Mohammad Ali Yazdanipour, Sina Sedaghat Herfeh, Mohammad Shabani Chobe, Masoud Shabani Chobe
{"title":"Bihemispheric Transcranial Direct Current Stimulation Over Primary Motor Cortex Potentiates Improvement of Neurological but not Upper Limb Motor Functions in Ischemic Stroke Patients Treated With Routine Physical Therapy: A Randomized, Double-Blind, Sham-Controlled Trial.","authors":"Niloufar Balikshahi, Sara Ramezani, Babak Bakhshayesh Eghbali, Mozaffar Hosseininezhad, Kamran Ezzati, Amirhomayoun Atefi, Mohammad Ali Yazdanipour, Sina Sedaghat Herfeh, Mohammad Shabani Chobe, Masoud Shabani Chobe","doi":"10.1097/PHM.0000000000002669","DOIUrl":"10.1097/PHM.0000000000002669","url":null,"abstract":"<p><strong>Objectives: </strong>We investigated the therapeutic effect of transcranial direct current stimulation combined with routine physiotherapy on the neurological and upper limb motor function in ischemic stroke patients with hemiplegia.</p><p><strong>Methods: </strong>In a randomized double-blind controlled trial study, 52 eligible stroke patients were assigned to real transcranial direct current stimulation receiving bihemispheric electrical current with 1.5 mA for 30 mins over the primary motor cortex, and sham transcranial direct current stimulation with a current intensity of 0.5 mA for 30 secs. Both groups received routine physiotherapy, 5 sessions per week for 2 wks. The National Institute of Health Stroke Scale and the Medical Research Council Scale for Muscle Strength were used to assess the neurological and upper limb motor functions, respectively.</p><p><strong>Results: </strong>Both therapeutic approaches begot a significant improvement in upper limb motor function and neurological impairment at the last session of therapy and follow-up study. However, the treatment-induced neurological amelioration at the last session of therapy in real transcranial direct current stimulation was significantly more than sham, especially in those identified as female and under 60 yrs old.</p><p><strong>Conclusions: </strong>A gender and age-specific protocol of real transcranial direct current stimulation combined with routine physiotherapy might be beneficial to improve neurological impairment but not upper limb motor dysfunction after stroke.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"551-557"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789504","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 Unilateral Transfemoral Amputation on Lumbar Bone and Muscle Quality. 单侧经股截肢对腰椎骨骼肌质量的影响。
IF 2.2 4区 医学
American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-06-01 Epub Date: 2024-11-26 DOI: 10.1097/PHM.0000000000002667
Hannah A Levy, Marisa N Ulrich, Caden Messer, Andrew Pumford, Brian Kelley, Peter S Rose, Bradford Currier, Ahmad N Nassr, Brett A Freedman, Melvin Helgeson, Matthew Houdek, Fantley Smither, Brian A Karamian, Arjun S Sebastian
{"title":"Impact of Unilateral Transfemoral Amputation on Lumbar Bone and Muscle Quality.","authors":"Hannah A Levy, Marisa N Ulrich, Caden Messer, Andrew Pumford, Brian Kelley, Peter S Rose, Bradford Currier, Ahmad N Nassr, Brett A Freedman, Melvin Helgeson, Matthew Houdek, Fantley Smither, Brian A Karamian, Arjun S Sebastian","doi":"10.1097/PHM.0000000000002667","DOIUrl":"10.1097/PHM.0000000000002667","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study was to examine the long-term perioperative changes in lumbar bone density, muscle size and fatty atrophy, and facet degeneration after transfemoral amputation.</p><p><strong>Design: </strong>All patients who underwent transfemoral amputation at an academic center between 2002-2022 were retrospectively identified. Patients were required to have preoperative and postoperative computed tomography (>1 yr) and regularly utilize a prosthesis. Preoperative to postoperative changes in lumbar and muscular vertebral Hounsfield units, facet degeneration, and bilateral psoas, quadratus lumborum, multifidus, and erector spinae cross-sectional area were determined.</p><p><strong>Results: </strong>A total of 42 patients met the inclusion criteria. There were significant preoperative to postoperative decreases in Hounsfield units in the L1 and L3 vertebral bodies were -17.69 and -25.35, respectively. There were significant preoperative to postoperative increases in L4-5 and L5-S1 facet degeneration grade. There were significant preoperative to postoperative decreases in amputated side psoas Hounsfield unit and cross-sectional area. There were also significant preoperative to postoperative Hounsfield unit decreases in the bilateral multifidus and erector spinae muscles, where the changes were more pronounced on the contralateral side.</p><p><strong>Conclusions: </strong>Transfemoral amputation was associated with progression of lumbar facet degeneration, small scale decreases in lumbar bone quality, amputated side psoas atrophy, and bilateral fatty infiltration of the multifidus and erector spinae.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"544-550"},"PeriodicalIF":2.2,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789543","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
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