Archives of physical medicine and rehabilitation最新文献

{"title":"Risk Factors for Dysphagia After Traumatic Cervical Spinal Cord Injury: A Retrospective Study","authors":"Iris Meißner BSc ,&nbsp;Stephanie Dietmann ,&nbsp;Gerrit Hüller MSc ,&nbsp;Orpheus Mach MSc ,&nbsp;Matthias Vogel MD ,&nbsp;Matthias Ehret ,&nbsp;Anke Scheel-Sailer MD ,&nbsp;Ludwig Aigner PhD ,&nbsp;Doris Maier MD ,&nbsp;Iris Leister PhD","doi":"10.1016/j.apmr.2024.12.014","DOIUrl":"10.1016/j.apmr.2024.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors for dysphagia in individuals who sustained traumatic cervical SCI. The pathophysiologic mechanisms of dysphagia in individuals with traumatic cervical spinal cord injury (SCI) are not well understood yet. Several risk factors for developing dysphagia after SCI were postulated including mechanical ventilation, tracheostomy, age, female sex, anterior surgical approach, SCI severity, and multilevel spinal fusion.</div></div><div><h3>Design</h3><div>Retrospective analysis: Candidate explanatory variables, including injury severity, age, neurological level of injury, surgical approach, number of fused spinal segments, and tracheostomy including its type, were analyzed using univariate and multivariable statistical analyses.</div></div><div><h3>Setting</h3><div>We included patients, who were treated at the BG Trauma Center Murnau between 2013 and 2022.</div></div><div><h3>Participants</h3><div>Datasets of a total of 407 patients with traumatic cervical SCI were included.</div></div><div><h3>Main Outcome Measures</h3><div>Dysphagia prevalence and identification of associated risk factors.</div></div><div><h3>Results</h3><div>Our analysis included 407 individuals, of whom 22.6% had dysphagia. Tracheostomy and age were identified as the main risk factors for dysphagia after traumatic cervical SCI. Contrary to previous literature, injury severity, an anterior surgical approach, the type of tracheostomy, a higher neurological level of SCI, and multilevel spinal fusion did not show an increased risk after accounting for other factors.</div></div><div><h3>Conclusions</h3><div>Our study identifies age and tracheostomy as primary risk factors for dysphagia after SCI, allowing to identify patients at risk and inform early-stage clinical management.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1189-1197"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Limb Strength Differentiates Between Fallers and Nonfallers With Multiple Sclerosis","authors":"Heather M. DelMastro MS ,&nbsp;Tracy Wall PT, PhD ,&nbsp;Deirdre J. McPartland PT, DPT ,&nbsp;Erik S. Plaia PT, DPT ,&nbsp;Naomi J. Trimble PT, DPT ,&nbsp;Jennifer A. Ruiz PT, DPT ,&nbsp;Katherine Harris PT, PhD ,&nbsp;Elizabeth S. Gromisch PhD","doi":"10.1016/j.apmr.2025.01.001","DOIUrl":"10.1016/j.apmr.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether hip flexion (HF), extension (HE), abduction (HA), knee flexion (KF) and extension (KE), and ankle plantarflexion (APF) and dorsiflexion maximum voluntary contraction (MVC) differentiates between nonfall and fall history in persons with multiple sclerosis (PwMS) after accounting for age, gender, fatigue, disability, and disease duration.</div></div><div><h3>Design</h3><div>Secondary analysis of a cross-sectional study.</div></div><div><h3>Setting</h3><div>Community-based comprehensive MS center.</div></div><div><h3>Participants</h3><div>A total of 172 PwMS who completed a 1-time visit.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Lower limb (LL) MVC was measured for each muscle group as isometric peak torque (Newton-meter: Nm) of both limbs (Strongest: S; Weakest: W) using a Biodex Dynamometer and normalized by body weight (Nm/kg). Falls in the past 6 months were retrospectively collected and participants were classified as nonfall history (0 falls [nonfallers]; n=78) or fall history (≥1 falls [fallers]; n=94). Fall history was further categorized as occasional (1-2 falls [occasional fallers]; n=51) and recurrent (≥3 falls [recurrent fallers]; n=43).</div></div><div><h3>Results</h3><div>Overall differences between participants with and without a fall history were noted on both limbs, with post-hoc analyses showing that those with a fall history had significantly lower strength (<em>P</em>&lt;.05) on all LL-W and HF-S, HE-S, HA-S, KF-S, and APF-S. When separated out by fall frequency, recurrent fallers had diminished strength on all LL-W and HF-S, HE-S, HA-S, and APF-S, whereas occasional fallers exhibited reductions on HA-W, KE-W, and KF-W compared with nonfallers. Recurrent and occasional fallers differed on HE-W.</div></div><div><h3>Conclusion</h3><div>All LL-W and aspects of LL-S differentiated between fallers and nonfallers, with further differences observed when fall history was separated by frequency. These findings provide the necessary information to clinicians to inform their plans of care to address falls in MS and provide education on the importance of maintaining LL strength.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1207-1216"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients","authors":"Karol Ramírez-Parada PT, MSc, MBA ,&nbsp;Cesar Sánchez MD ,&nbsp;Irene Cantarero-Villanueva PT, MSc, PhD ,&nbsp;Álvaro Reyes PT, MSc, PhD ,&nbsp;Mauricio P. Pinto PhD ,&nbsp;M. Loreto Bravo PhD ,&nbsp;Denise Montt-Blanchard MSc ,&nbsp;Francisco Acevedo MD ,&nbsp;Benjamín Walbaum MD ,&nbsp;Margarita Alfaro-Barra PT ,&nbsp;Margarita Barra-Navarro PT ,&nbsp;Scarlet Muñoz-Flores PT ,&nbsp;Constanza Pinto ,&nbsp;Sabrina Muñiz RN ,&nbsp;Felipe Contreras-Briceño PT, MSc, PhD ,&nbsp;Tomás Merino MD ,&nbsp;Gina Merino MSc","doi":"10.1016/j.apmr.2025.03.002","DOIUrl":"10.1016/j.apmr.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate if combining a prospective surveillance model (PSM) with a supervised multimodal exercise program prevents breast cancer-related lymphedema (BCRL) and its effect on the functional capacity and quality of life (QoL) of high-risk breast cancer (BC) patients undergoing treatment.</div></div><div><h3>Design</h3><div>Two-arm parallel superiority randomized controlled trial.</div></div><div><h3>Setting</h3><div>Outpatient physical therapy service in a public hospital.</div></div><div><h3>Participants</h3><div>116 adult women (N=116; age ≥18y) diagnosed with stage I-III BC were enrolled. Inclusion criteria included recent surgery and indication for adjuvant chemotherapy. Exclusion criteria were significant arm volume difference, previous cancer, exercise contraindications, and extreme body mass index values.</div></div><div><h3>Interventions</h3><div>Participants were randomized into experimental (n=61) or control groups (n=55) in a 1:1 ratio. The experimental group received PSM with a supervised multimodal exercise program for 12 weeks. The control group received PSM alone.</div></div><div><h3>Main Outcome Measures</h3><div>Arm volume, grip strength, 6-minute walk test, and QoL were blindly assessed at baseline, 3, 6, and 9 months.</div></div><div><h3>Results</h3><div>The combination of PSM with a supervised multimodal exercise program significantly reduced arm volume and body weight and improved grip strength, functional capacity, and the QoL of patients.</div></div><div><h3>Conclusions</h3><div>Combining PSM and physical exercise reduces arm volume, prevents BCRL, and improves physical performance and QoL in high-risk patients. The combination of PSM and STRONG-B was superior to PSM alone, validating the study's superiority design.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1163-1172"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Archives I/EP Guidelines","authors":"","doi":"10.1016/S0003-9993(25)00792-0","DOIUrl":"10.1016/S0003-9993(25)00792-0","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1300-1302"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-Task Resistance Training Improves Strength and Reduces Pain More Than Resistance Exercise Alone in Elbow Fracture Rehabilitation: A Randomized Controlled Trial","authors":"Carlos Cruz-Montecinos PhD, PT ,&nbsp;Laura López-Bueno PhD, PT ,&nbsp;Rodrigo Núñez-Cortés PhD, PT ,&nbsp;Rubén López-Bueno PhD ,&nbsp;Luis Suso-Martí PhD, PT ,&nbsp;Guillermo Mendez-Rebolledo PhD, PT ,&nbsp;Antoni Morral PhD ,&nbsp;Lars Louis Andersen PhD ,&nbsp;Joaquín Calatayud PhD","doi":"10.1016/j.apmr.2025.01.419","DOIUrl":"10.1016/j.apmr.2025.01.419","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the effects on strength, pain intensity, range of motion (ROM), and functionality of a 12-week dual-task resistance exercise program in patients undergoing rehabilitation from elbow fractures.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Rehabilitation hospital.</div></div><div><h3>Participants</h3><div>Individuals undergoing elbow fracture rehabilitation (N=32).</div></div><div><h3>Intervention</h3><div>Randomization was performed sequentially using numbered envelopes containing assignments to either an intervention group (dual-task resistance training using a mathematical task with self-regulation, N=18) or a control group (traditional resistance training, N=14) for 12 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were muscle strength for elbow flexors and extensors and pain assessed by the visual analog scale from 0 to 100 mm. The secondary outcomes were kinesiophobia assessed by the Tampa Scale-11 and disability using the Disabilities of the Arm, Shoulder, and Hand questionnaire and passive ROM.</div></div><div><h3>Results</h3><div>Dual-task resistance training improved strength and reduced pain more than resistance training alone (<em>P</em>&lt;.05), and only the dual-task group improved in kinesiophobia (<em>P</em>&lt;.05). The linear regression showed a significant negative association between kinesiophobia and increased elbow strength in the dual-task group (flexion, <em>r</em>=−0.53, <em>P</em>=.024; extension, <em>r</em>=−0.65, <em>P</em>=.004) but not in the control group (<em>P</em>&gt;.05). No significant differences were observed between the group for disability and passive ROM (<em>P</em>&gt;.05).</div></div><div><h3>Conclusions</h3><div>Dual-task resistance training and traditional resistance training both enhance strength, reduce pain, improve functionality, and increase ROM after 12 weeks of elbow fracture rehabilitation. However, dual-task resistance training is superior to resistance training alone in enhancing strength and reducing pain.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1155-1162"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cluster Analysis of Outpatient Prescription Medications After Combat-Related Amputations: A Retrospective Study","authors":"Ted Melcer PhD ,&nbsp;James Zouris MS ,&nbsp;Andrew MacGregor PhD ,&nbsp;LCDR Daniel Crouch PhD ,&nbsp;CAPT Robert Sheu MD ,&nbsp;Michael Galarneau MS","doi":"10.1016/j.apmr.2025.02.006","DOIUrl":"10.1016/j.apmr.2025.02.006","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives were (1) to conduct cluster analysis to explore patterns of outpatient prescription medications during the first year after combat-related amputations and (2) to analyze patient characteristics associated with prescription medication clusters.</div></div><div><h3>Design</h3><div>Retrospective study of Department of Defense casualty records and outpatient prescription medications during the first year postinjury. Hierarchical cluster analysis of American Hospital Formulary Service (AHFS) medication classes.</div></div><div><h3>Setting</h3><div>Military amputation rehabilitation program.</div></div><div><h3>Participants</h3><div>A total of 1651 US service members who sustained major limb amputations in Operations Iraqi and Enduring Freedom from 2001 to 2017 and had outpatient prescription medications.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Prescription medication clusters and patient characteristics.</div></div><div><h3>Results</h3><div>Cluster analysis identified 3 prescription medication profiles. Cluster 1: baseline (n=682) consisted of 6 AHFS classes: cathartics/laxatives, anticonvulsants, semisynthetic opioids, antidepressants, nonsteroidal anti-inflammatory drugs, and combination opioid analgesics. These 6 classes were part of all 3 profiles (ie, baseline medications). Cluster 2: baseline plus insomnia (B+I) (n=502): atypical antipsychotics, anxiolytics/sedatives, methadone, benzodiazepines, analgesics/antipyretics, and baseline medications. Cluster 3: baseline plus severe injury (B+SI) (n=467): anticoagulants, 5-HT3 receptor antagonists, multivitamins, anxiolytics/sedatives, analgesics/antipyretics, and baseline medications. The baseline cluster was characterized by early injury years (85%, 2001-2008), moderate/serious injuries (85%), single amputation, chronic pain, and posttraumatic stress disorder. Cluster B+I was characterized by early injury years (62%), minor injuries (16%), low rates of traumatic amputations, and postinjury complications. Cluster B+SI was characterized by later injury years (88%, 2009-2017), serious/severe injuries (62%), multiple amputations (42%), traumatic brain injury (43%), high rates of complications, and prescriptions.</div></div><div><h3>Conclusions</h3><div>Cluster analysis identified 3 outpatient prescription medication profiles during the first year postinjury. All profiles included analgesics and psychotherapeutics but differed in specific insomnia medications, multivitamins, and anticoagulants. Medication profiles had significant associations with injury years, injury severity, and postinjury complications. The results inform future research and prescription medication practices.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1238-1247"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(25)00781-6","DOIUrl":"10.1016/S0003-9993(25)00781-6","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Page A8"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peripheral Electrical Stimulation on Motor Function and Activities of Daily Living After Stroke: A Systematic Review and Network Meta-analysis","authors":"Yihao Zhou MD ,&nbsp;Siyu Yang MD ,&nbsp;Dongxia Li MM ,&nbsp;Wenqiang Li MM ,&nbsp;Chen Yang MM ,&nbsp;Hong Huo MD ,&nbsp;Shaojie Cai MD ,&nbsp;Xingyan Zhu MD ,&nbsp;Ruwen Zheng MD ,&nbsp;Xu Dong MD ,&nbsp;Dongyan Wang MD, PhD","doi":"10.1016/j.apmr.2025.01.466","DOIUrl":"10.1016/j.apmr.2025.01.466","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effects of different peripheral electrical stimulation protocols and current frequencies for poststroke motor function and activities of daily living.</div></div><div><h3>Data Sources</h3><div>Seven databases (PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database, Wan-Fang Database, and Chinese Biomedical Database) were searched from inception to August 2024.</div></div><div><h3>Study Selection</h3><div>Two reviewers independently performed the literature selection. The included studies were randomized controlled trials providing peripheral electrical stimulation for patients with stroke.</div></div><div><h3>Data Extraction</h3><div>Two reviewers independently extracted data following a predeveloped Excel data collection sheet, including trial characteristics, intervention and comparator details, and outcome data. The risk of bias was evaluated by RoB2 tool, and the PRISMA guidelines were followed for reporting.</div></div><div><h3>Data Synthesis</h3><div>A total of 106 trials with 7513 participants were included. Meta-analysis showed that neuromuscular electrical stimulation (NMES) could be the optimal electrical stimulation protocol for improving the Fugl-Meyer Assessment score (standardized mean difference=1.67; 95% confidence interval [1.14-2.21]) and the modified Barthel Index score (standardized mean difference=1.73; 95% confidence interval [1.10-2.37]). The results showed that different frequencies of electrical stimulation ranked the top 5 in descending order for improving: (1) the Fugl-Meyer Assessment scores as follows: 20-30 Hz_NMES (surface under the cumulative ranking curve [SUCRA]=87.5%)&gt;100 Hz_NMES (SUCRA=75.4%)&gt;100 Hz_functional electrical stimulation (SUCRA=70.9%)&gt;20/35 Hz_transcutaneous electrical acupoint stimulation (SUCRA=69.8%)&gt;1-4 Hz_electrical acupuncture (SUCRA=69.6%) and (2) the modified Barthel Index scores as follows: 100 Hz_transcutaneous electrical nerve stimulation (SUCRA=77.3%)&gt;5/15 Hz_NMES (SUCRA=68.3%)&gt;100 Hz_transcutaneous electrical acupoint stimulation (SUCRA=65.6%)&gt;35-50 Hz_functional electrical stimulation (SUCRA=64.8%)&gt;1-4 Hz_electrical acupuncture (SUCRA=60.0%).</div></div><div><h3>Conclusions</h3><div>Adding electrical stimulation based on routine rehabilitation training can improve the motor dysfunction and activities of daily living of patients with stroke. Specifically, NMES with 20-30 Hz improves motor function best, whereas 100 Hz_transcutaneous electrical nerve stimulation improves activities of daily living best.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1258-1266"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"End-of-Life Conversations With Adult Patients and Their Families: An Evidence-based Guide for Occupational and Physical Therapists","authors":"Olivia Crozier BHSc,&nbsp;Erica Lo BHSc,&nbsp;Neha Dewan PT, PhD,&nbsp;Atul Jaiswal MA, PhD,&nbsp;Ryan Carrick OTR/L, MHS, PhD,&nbsp;Timothy A. Reistetter OTR, PhD,&nbsp;Himani Puri MSc,&nbsp;Patricia Watford OTD, MS, OTR/L,&nbsp;Sodiq Fakorede BSc,&nbsp;Mandi L. Sonnenfeld PhD, MOT, OTR/L,&nbsp;Monika Gross BFA, M.AmSAT, M.ATI, M.STAT, MSME/T,&nbsp;Saurabh P. Mehta PT, PhD, GCS","doi":"10.1016/j.apmr.2025.03.045","DOIUrl":"10.1016/j.apmr.2025.03.045","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1295-1299"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing Hand Motor Recovery Poststroke: A Comparative Study of Robotic vs Conventional Mirror Therapy","authors":"Steven Kurniawan MD ,&nbsp;Husnul Mubarak MD, PhD ,&nbsp;Nuralam Sam MD, PhD ,&nbsp;Yose Waluyo MD, PhD ,&nbsp;Andi Alfian Zainuddin MD, PhD ,&nbsp;Andi Amijoyo Mochtar MD, PhD","doi":"10.1016/j.apmr.2024.11.008","DOIUrl":"10.1016/j.apmr.2024.11.008","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the therapeutic effect of using a robotic exoskeletal hand (RMT) combined with mirror therapy (MT) in hand rehabilitation for poststroke patients, compared to conventional MT.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Physical Medicine and Rehabilitation Outpatient Clinic.</div></div><div><h3>Participants</h3><div>Forty poststroke subjects.</div></div><div><h3>Interventions</h3><div>Participants were divided into 2 groups: one received robotic exoskeletal hand therapy combined with mirror therapy (RMT+MT), and the other received conventional MT. The intervention lasted for 6 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>Hand motor function abilities were assessed using the Fugl-Meyer Assessment for Upper Extremities (FMA-UE)—Hand Motor Domain, and finger dexterity was evaluated with the Nine-Hole Peg Test (NHPT).</div></div><div><h3>Results</h3><div>The RMT group showed significant improvement in hand motor function, with a median FMA-UE-Hand Motor Domain score increasing from 6 to 14 (<em>P</em>=.000). Finger dexterity also improved significantly in the RMT group (<em>P</em>=.000). The conventional MT group demonstrated significant improvements in both the FMA-UE-Hand Motor Domain (<em>P</em>=.001) and NHPT (<em>P</em>=.000). However, the RMT group achieved greater improvements, with significant differences between the 2 groups in both FMA-UE-Hand Motor Domain (<em>P</em>=.038) and NHPT (<em>P</em>=.026) scores.</div></div><div><h3>Conclusions</h3><div>RMT is significantly more effective in restoring hand motor skills and improving finger dexterity in patients with poststroke rehabilitation compared to conventional MT.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1183-1188"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}