American Journal of Physical Medicine & Rehabilitation最新文献_第9页

Harnessing Behavioral Economics to Accelerate Implementation in Rehabilitation. 运用行为经济学加快康复实施。

IF 2.4 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":2.4,"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 2.4 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":2.4,"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 2.4 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 2.4 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":2.4,"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

Health surveillance for South African Para athletes: an 88-week prospective study in a resource-limited setting. 南非残疾人运动员的健康监测：一项资源有限的为期88周的前瞻性研究

IF 2.4 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-08-01 DOI: 10.1097/PHM.0000000000002810

Eirik Halvorsen Wik, Phoebe Runciman, Maaike Eken, Lovemore Kunorozva, Jan Lexell, Wayne Derman, Kristina Fagher

{"title":"Health surveillance for South African Para athletes: an 88-week prospective study in a resource-limited setting.","authors":"Eirik Halvorsen Wik, Phoebe Runciman, Maaike Eken, Lovemore Kunorozva, Jan Lexell, Wayne Derman, Kristina Fagher","doi":"10.1097/PHM.0000000000002810","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002810","url":null,"abstract":"Objectives: Longitudinal health monitoring studies including Para athletes are lacking in low- and middle-income countries (LMICs). This study aimed to introduce a surveillance programme developed for Swedish Para athletes to high-level South African Para athletes and describe their self-reported health outcomes.Design: Using a prospective cohort design, we distributed weekly electronic surveys to Para athletes for 88 weeks. These included questions relating to training (e.g., volume, intensity), health (e.g., pain, injury, illness, symptoms of anxiety or depression) and lifestyle (e.g., diet, sleep).Results: Of 28 recruited athletes, 21 responded to ≥1 survey (13 males and 8 females; 42.6% response rate). During an average week, 48% of athletes experienced mild-to-severe pain, 25% reported a new or ongoing injury or illness, 67% slept less than eight hours per night, and 20% reported symptoms of anxiety or depression. The overall injury incidence was 3.1 per 1000 hours.Conclusion: Longitudinal health monitoring is challenging in LMICs and each setting's unique barriers and facilitators must be explored and acknowledged if such programmes are to be sustained. Our data suggest that pain, injuries, illnesses and symptoms of anxiety or depression are common among high-level South African Para athletes and efforts should be made to manage these.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939442","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 2.4 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":2.4,"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

The metabolic syndrome in ambulatory people with post-polio syndrome, Charcot-Marie-Tooth disease and other neuromuscular diseases. 脊髓灰质炎后综合征、腓骨肌萎缩症和其他神经肌肉疾病患者的代谢综合征。

IF 2.4 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-29 DOI: 10.1097/PHM.0000000000002800

Eric Lukas Voorn, Sander Oorschot, Nicolette Janine Wierdsma, Maarten René Soeters, Fieke Sophia Koopman, Annerieke Ceciel van Groenestijn

{"title":"The metabolic syndrome in ambulatory people with post-polio syndrome, Charcot-Marie-Tooth disease and other neuromuscular diseases.","authors":"Eric Lukas Voorn, Sander Oorschot, Nicolette Janine Wierdsma, Maarten René Soeters, Fieke Sophia Koopman, Annerieke Ceciel van Groenestijn","doi":"10.1097/PHM.0000000000002800","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002800","url":null,"abstract":"Objective: The metabolic syndrome (MetS) is a growing health issue. This study evaluated the prevalence of MetS, and individual MetS risk factors, in people with different neuromuscular diseases (NMD).Design: We used baseline data of a randomized controlled trial on the efficacy of a physical activity program in NMD. MetS was defined as the presence of at least 3 out of 5 risk factors of the revised National Cholesterol Education Program Adult Treatment Panel III.Results: The 84 participants (50 female, median age = 63 years, IQR = 48, 68 years) were diagnosed with post-polio syndrome (PPS, n = 22), Charcot-Marie-Tooth disease (CMT, n = 37) or other NMD (n = 25). MetS was present in 18 participants (21%). The most common risk factors were hypertension (56%), central obesity (49%) and increased fasting blood glucose (33%). Logistic regression results showed that, adjusted for age and muscle strength as confounders, participants with CMT (Exp(B) = 0.107, 95%CI: 0.019-0.609) and other NMD (Exp(B) = 0.039, 95%CI: 0.004-0.390) had significantly lower odds of MetS compared with PPS.Conclusion: The MetS prevalence that we found is comparable to the general Dutch population. However, a focus on the prevention of MetS in neuromuscular rehabilitation is warranted, as certain NMD subgroups may be at increased risk of developing MetS.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741004","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

Atypical Femur Fracture with Chronic Denosumab Use: A Case Report. 非典型股骨骨折伴慢性地诺单抗1例报告。

IF 2.4 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-29 DOI: 10.1097/PHM.0000000000002832

Alexander Goggins, Theodora Swenson, Tanner Kimball

引用次数: 0

Serial ultrasound imaging leading up to an Achilles tendon rupture after identification of a thickened paratenon: a case report. 连续超声成像导致跟腱断裂后增厚的副腱：一个病例报告。

IF 2.4 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-28 DOI: 10.1097/PHM.0000000000002826

Kory Ford, Nick Monson, Sica Glauser, Daniel M Cushman

引用次数: 0

Ultrasound-guided needle electromyography of the extensor carpi radialis longus and brevis muscles for preoperative tendon transfer planning in cervical spinal cord injuries: technique description and case report. 超声引导下桡侧腕长伸肌和短肌的针肌电图在颈脊髓损伤术前肌腱转移计划中的应用：技术描述和病例报告。

IF 2.4 4区医学

American Journal of Physical Medicine & Rehabilitation Pub Date : 2025-07-28 DOI: 10.1097/PHM.0000000000002813

James B Meiling, Andrea J Boon, Marianne T Luetmer, Peter C Rhee, Kitty Y Wu

{"title":"Ultrasound-guided needle electromyography of the extensor carpi radialis longus and brevis muscles for preoperative tendon transfer planning in cervical spinal cord injuries: technique description and case report.","authors":"James B Meiling, Andrea J Boon, Marianne T Luetmer, Peter C Rhee, Kitty Y Wu","doi":"10.1097/PHM.0000000000002813","DOIUrl":"https://doi.org/10.1097/PHM.0000000000002813","url":null,"abstract":"Abstract: Reconstructive surgery, including tendon transfers, can potentially offer marked improvement in function in those with cervical spinal cord injuries. Given the anatomic redundancy of both the extensor carpi radialis longus (ECRL) and brevis (ECRB) in producing active wrist extension, one muscle can be utilized as a donor for a tendon transfer without sacrificing wrist extension. Needle electromyography (EMG) does not routinely evaluate the ECRL and ECRB, and the functional status of each muscle is difficult to discern based on clinical exam alone. Here is presented a case of a 20-year-old male with C6 complete tetraplegia and preserved active wrist extension who underwent a novel ultrasound (US) -guided EMG technique to accurately and reproducibly assess the ECRB and ECRL muscles. This technique was employed to aid his surgeon in determining candidacy for tendon transfer procedures utilizing the wrist extensors as donors. US-guided EMG showed intact volitional activation in both the ECRL and ECRB. Subsequent ECRL to flexor digitorum profundus tendon transfer was pursued, and he had preserved postoperative anti-gravity wrist extension strength through ECRB alone. Accurate assessment of the ECRL and ECRB allows for more complete preoperative planning and provides critical information on whether active pinch and grasp reconstruction as possible.","PeriodicalId":7850,"journal":{"name":"American Journal of Physical Medicine & Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144741005","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