Alexa Ryder, Vishal Bansal, Ajai Sambasivan, Kemly Philip
{"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}
Shannon Strader, Andrew Villasenor, Saranya Wyles, Priya Chandan, Carmen Terzic, Allison C Bean, Zubin Master
{"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":"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}
Francesco Sammartino, Eunkyung Yu, Tracy Huffman, Angela Harris, Maureen Musto, Sarah Schultz, McKenzie Callicoat, Sheital Bavishi
{"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}
Eric W Villanueva, Christopher W Lewis, Kathryn Abplanalp, Samman Shahpar, Priya V Mhatre, Reem Karmali, Ishan Roy
{"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}
Pamela Roberts, Debra Ouellette, Jeffrey Wertheimer, Mary Nasmyth, Gabrielle DeLauter
{"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}
Dan Wu, Yanan Liu, Zhongshu Xue, Shiliang Han, Ming Zhou
{"title":"The Impact of Tai Chi on Physical and Mental Well-being in Individuals with Knee Osteoarthritis: A Systematic Review and Meta-analysis.","authors":"Dan Wu, Yanan Liu, Zhongshu Xue, Shiliang Han, Ming Zhou","doi":"10.1097/PHM.0000000000002762","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002762","url":null,"abstract":"<p><strong>Objective: </strong>The aim is to examine the potential impact of Tai Chi on the enhancement of both physical and mental well-being in individuals with knee osteoarthritis.</p><p><strong>Design: </strong>In this study, a search was conducted across the databases of PubMed, Cochrane library, and EMBASE. The keywords \"Tai Chi\" and \"knee osteoarthritis\" were employed.</p><p><strong>Results: </strong>Seventeen randomized controlled trials comprising 980 participants were included. The results indicated that Tai Chi was significantly associated with improvements in various measures, including the WOMAC pain score (WMD -1.87), WOMAC stiffness score (WMD -0.62), WOMAC physical function score (WMD -10.33), SF-36 PCS score (WMD 3.17) , and SF-36 MCS score (WMD 2.31). Furthermore, Tai Chi exercise demonstrated superior performance in the timed up and go test (TUG), while no significant difference was observed in the 6-minute walk test (WMD 10.43). No serious adverse events were reported.</p><p><strong>Conclusion: </strong>The results of this study suggest that Tai Chi may have a significant effect on reducing pain, joint stiffness, and improving physical function in individuals with knee osteoarthritis, as measured by the WOMAC scale. Furthermore, Tai Chi shows promise in enhancing both the physical and mental aspects of quality of life, as well as improving performance in the TUG test.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109334","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}
Merve Sekizkardeş, Ayşe Nur Bardak, Kadriye Öneş, Levent Özçakar
{"title":"Factors Associated with Shoulder Pain in Manual Wheelchair Users with Spinal Cord Injury.","authors":"Merve Sekizkardeş, Ayşe Nur Bardak, Kadriye Öneş, Levent Özçakar","doi":"10.1097/PHM.0000000000002759","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002759","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the relationship between shoulder pain and various factors, including patient demographics, physical examination findings, wheelchair setup, and imaging results in manual wheelchair (MW) users with spinal cord injury (SCI).</p><p><strong>Design: </strong>Thirty MW users with SCI participated in this cross-sectional clinical study. Hawkins - Kennedy, Neer and Speed tests were performed on both shoulders. Ultrasound shoulder pathology rating scale (USPRS) and critical shoulder angle (CSA) calculation on anteroposterior radiographs were used. Wheelchair measurements included the rear axle-to-acromion distance and the elbow angle while the patient held their hand at the top of pushrim.</p><p><strong>Results: </strong>Wheelchair users' shoulder pain index (WUSPI) correlated with duration of MW use, USPRS total score and several subcomponent scores. WUSPI was significantly higher in patients with a CSA of 35° or higher. Patients with the recommended elbow angle and rear axle-acromion distance had significantly lower WUSPI. Clinical tests were unable to detect pathologies identified by means of ultrasound examination in 41.7% to 79.3% of cases.</p><p><strong>Conclusion: </strong>Identifying risk factors for shoulder pain is crucial to preventing upper extremity dysfunction in SCI patients. This study supports that proper MW setup, including rear axle placement and elbow angle, reduces shoulder pain. USPRS and CSA can serve as valuable tools for early diagnosis and monitoring.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109331","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 Stroke Impairment and Phases in Daily Steps of Stroke Survivors Living in Community: A Systematic Review With Meta-analysis.","authors":"Amine Guediri, Stéphane Mandigout, Kokouvi Geovani Agbohessou, Jean-Christophe Daviet, Maxence Compagnat","doi":"10.1097/PHM.0000000000002649","DOIUrl":"10.1097/PHM.0000000000002649","url":null,"abstract":"<p><strong>Objective: </strong>The aim of the study is to provide detailed information about the number of steps taken by stroke survivors based on their level of impairment in order to guide recommendations for PA.</p><p><strong>Design: </strong>A meta-analysis was conducted, including studies that assessed daily steps and stroke impairment in community-dwelling stroke patients. Participants were categorized into three groups based on stroke impairment severity (minor, minor and moderate, moderate and severe) and into two groups based on stroke phase (subacute and chronic).</p><p><strong>Results: </strong>A total of 47 studies were included, encompassing 1749 participants. There were 494 in the minor stroke group, 1097 in the minor and moderate group, and 158 in the moderate and severe group. A significant difference in daily steps was observed across these groups ( P < 0.01), with the first group averaging 4645 steps/day, the second 3610 steps/day, and the third 1990 steps/day. No significant difference was found between the subacute and chronic groups in terms of daily steps (3839 vs 3783 steps/day).</p><p><strong>Conclusions: </strong>The study highlights the significant impact of stroke impairment on daily step count. We recommend implementing targeted interventions, particularly during the chronic phase, to increase PA levels in stroke survivors, tailored to the specific impairments of each patient.</p>","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":"e66-e74"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}