Archives of physical medicine and rehabilitation最新文献

{"title":"Beyond functional limitations: unique contribution of the environment in predicting participation of transition-aged youth with and without disabilities across settings.","authors":"Yu-Hsin Hsieh, Saeideh Shahin Varnousfaderany, Michal Waisman, Yonat Ivzori, Dana Anaby","doi":"10.1016/j.apmr.2026.04.034","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.04.034","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the extent to which environmental supports predict participation indicators of youth with and without disabilities in the presence of functional limitations and age across four settings: home, educational setting, community, and workplace.</p><p><strong>Design: </strong>Cross-sectional study SETTING: Youth completed the self-reported measures.</p><p><strong>Participants: </strong>Youth with disabilities without cognitive impairments (n = 112) and youth without disabilities (n = 57), aged 12-31 years (x̄ = 21.8, IQR = 18-25 years).</p><p><strong>Interventions: </strong>Not applicable MAIN OUTCOME MEASURE(S): The Youth, young-adult Participation and Environment Measure assessed three participation indicators (e.g., frequency, involvement, and desire for change) and environmental supports within each setting. Youth's functional limitations were evaluated using a self-reported 11-item checklist.</p><p><strong>Results: </strong>Hierarchical multiple regression modeling revealed that environmental supports exhibited a unique contribution (R² change up to 9%) and consistently predicted participation scores on at least two of three participation indicators across all four settings. Greater environmental support was significantly associated with fewer activities wherein youth desired change in participation across all settings (standardized b = -0.306 to -0.186, 95% CI: -0.117 to -0.010). Environmental support demonstrated the most consistent contribution to home participation in terms of frequency (standardized b = 0.255 [95% CI: 0.008 to 0.029]), involvement (standardized b = 0.172 [95% CI: 0.001 to 0.019]), and desire for change (standardized b = -0.272 [95% CI: -0.116 to -0.034]).</p><p><strong>Conclusions: </strong>Findings underscore the unique contribution of environmental supports in predicting variation in subjective and objective participation across settings beyond the variance predicted by youth-related factors (age and number of functional limitations). These findings support environment-based interventions to enhance participation during this challenging transitioning phase, particular focusing on those activities where youth desire change. Moreover, our findings can inform service providers and policymakers in promoting environmental supports that enhance multiple dimensions of participation for youth with disabilities.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863449","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":"Comparing the effects of cognitive and physical training on cognitive function and brain activation in people with mild cognitive impairment and mild dementia: a randomized controlled trial.","authors":"Wei-Han Weng, Yea-Ru Yang, Yin-Hsiang Wang, Nai-Chen Yeh, Ray-Yau Wang","doi":"10.1016/j.apmr.2026.04.036","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.04.036","url":null,"abstract":"<p><strong>Objective: </strong>Cognitive and physical training are frequently used interventions in individuals with early cognitive impairment. This study compared the effects of different training strategies in individuals with mild cognitive impairment (MCI) and mild dementia (MD).</p><p><strong>Design: </strong>Randomized controlled trial.</p><p><strong>Setting: </strong>University laboratory.</p><p><strong>Participants: </strong>Older adults aged over 65 years with a diagnosis of MCI or MD were eligible.</p><p><strong>Interventions: </strong>Sixty participants were randomly assigned to cognitive training group (CTG), physical training group (PTG), and control group (CG), with 20 participants in each group. CTG and PTG received interventions for 30 minutes/session, 3 sessions/week, for 8 weeks. CG received health education.</p><p><strong>Main outcomes measures: </strong>Primary outcomes were cognition and prefrontal cortex (PFC) activation during a cognitive task. Global cognition was measured by the Alzheimer's disease assessment scale-cognitive subscale (ADAS-cog), executive function by the frontal assessment battery (FAB) and trail making test-B (TMT-B), attention by the trail making test-A (TMT-A), and memory by the category fluency test (CFT). PFC activation was documented with functional near-infrared spectroscopy. Secondary outcomes included the timed up and go (TUG) test and the modified falls efficacy scale (MFES). Data were analyzed using generalized estimating equations (GEE).</p><p><strong>Results: </strong>CTG significantly improved ADAS-cog (p=0.022), FAB (p<0.001), TMT-A (p=0.014), TMT-B (p=0.008), and CFT (p=0.004) than CG. PTG significantly improved ADAS-cog (p=0.008), TMT-B (p=0.033), and CFT (p=0.005) compared with CG. CTG exhibited significantly decreased PFC activation compared to CG and PTG (p=0.002 vs. physical training, p=0.015 vs. control). PTG significantly improved TUG performance compared to CG and CTG (p=0.046 vs. cognitive training, p=0.003 vs. control).</p><p><strong>Conclusions: </strong>Both training strategies showed potential cognitive benefits, with only PTG exceeding the minimal clinically important difference on the ADAS-Cog. Reduced PFC activation in the CTG may reflect improved neural efficiency; however, this interpretation requires further verification.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833027","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":"Normative Values and Measurement Properties of the Bed Bridge Test.","authors":"Larissa Guimarães Paiva, Nara Batista de Souza, Eduarda Aparecida Silva Coimbra, Sabrina Campos Furtado, Levy Soares da Silva Junior, Túlio Medina Dutra de Oliveira, Cristino Carneiro Oliveira, Anderson José, Carla Malaguti","doi":"10.1016/j.apmr.2026.04.029","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.04.029","url":null,"abstract":"<p><strong>Objective: </strong>To establish normative values and develop reference equations for four variants of the Bed Bridge Test (BBT) in healthy adults, and to evaluate their measurement properties, including reliability and validity.</p><p><strong>Design: </strong>Methodological cross-sectional study.</p><p><strong>Setting: </strong>University-based research setting.</p><p><strong>Participants: </strong>A total of 120 healthy adults (18-79 years), equally distributed by sex, were included. Participants were independent in daily activities and free from significant clinical conditions.</p><p><strong>Interventions: </strong>Participants performed four randomized variants of the BBT: 5 repetitions (5XBBT), 10 repetitions (10XBBT), 30 seconds (30sBBT), and 60 seconds (60sBBT), following standardized procedures.</p><p><strong>Main outcome measures: </strong>Normative values, reference equations, test-retest reliability (intraclass correlation coefficient [ICC]), measurement error, floor and ceiling effects, and criterion and construct validity.</p><p><strong>Results: </strong>Normative values were established according to age and sex. Performance declined with age and was higher in men across all variants. Reference equations explained 29% to 46% of performance variability, with age and sex as significant predictors. The equations were: 5XBBT= 3.49-1.96×(sex)+0.07×age; 10XBBT= 6.93-4.51×(sex)+0.14×age; 30sBBT= 44.21+9.36×(sex)-0.36×age; and 60sBBT= 80.28+20.38×(sex)-0.62×age. All BBT variants demonstrated good to excellent reliability (ICC = 0.87-0.95), with acceptable floor and ceiling effects. Criterion validity was supported by moderate to strong correlations with sit-to-stand tests.</p><p><strong>Conclusion: </strong>The BBT variants demonstrated adequate reliability and validity for assessing functional capacity in healthy adults. The normative values and reference equations provide preliminary support for clinical interpretation and may assist in identifying functional limitations and guiding rehabilitation strategies, particularly in individuals with reduced mobility.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147833002","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":"Rehabilitation in Conflict—A Conceptual Framework for the Rehabilitation Sector in Fragile Settings","authors":"Cornelia Anne Barth PT, PhD ,&nbsp;Andreas Wladis MD, PhD ,&nbsp;Maggie Donovan-Hall PhD ,&nbsp;Fekadu Elias Sadamo MPH ,&nbsp;Cliona O’Sullivan PT, PhD","doi":"10.1016/j.apmr.2025.09.006","DOIUrl":"10.1016/j.apmr.2025.09.006","url":null,"abstract":"<div><div>Rehabilitation is an essential component of health systems. Yet in fragile, conflict-affected settings it remains neglected despite growing needs. Fragmented governance, disrupted health systems, and political instability hamper sector development. Existing frameworks, including the World Health Organization health system building blocks, the International Classification of Functioning, Disability and Health, and operational tools such as Systematic Assessment of Rehabilitation Situation or Emergency Rehabilitation Standards, provide valuable global guidance. However, they are less suited to capture the systemic, cross-sectoral, and contextual complexity of rehabilitation in conflict. This <em>Special Communication</em> introduces the “Rehabilitation in Conflict” (RiC) framework—a conceptual model explicitly designed to support analysis and strengthening of rehabilitation in conflict-affected settings. Developed through a 6-step process combining literature review, field-based research, and stakeholder engagement, the framework consists of 4 interdependent components: Context, Systems, Population, and Services. The RiC framework’s novelty lies in its sector-wide perspective: it bridges health, social, political, and humanitarian systems, highlights their dynamic and multidirectional interactions, and positions rehabilitation within the broader realities of conflict. In doing so, the RiC framework fills a critical gap and responds to an urgent need for conceptual clarity to inform rehabilitation planning, assessment, and coordination and strengthening. It is particularly relevant for clinicians, researchers, and policymakers working in global rehabilitation, humanitarian response, and postconflict recovery. By offering a structured yet flexible approach, the framework invites debate, further adaptation, and application across diverse fragile settings.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 5","pages":"Pages 1138-1147"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102599","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":"Fear-Avoidant Adults Have Worse Clinical Outcomes and Recovery Time After Concussion","authors":"Alicia M. Trbovich PhD ,&nbsp;Aaron J. Zynda PhD ,&nbsp;Anne Mucha DPT ,&nbsp;Nacona Bunker PsyD ,&nbsp;Courtney Perry MS ,&nbsp;Michael W. Collins PhD ,&nbsp;Anthony P. Kontos PhD","doi":"10.1016/j.apmr.2025.09.024","DOIUrl":"10.1016/j.apmr.2025.09.024","url":null,"abstract":"<div><h3>Objective</h3><div>To compare initial multidomain clinical outcomes and recovery time between fear-avoidant (FA) and nonfear-avoidant (NFA) adults after concussion.</div></div><div><h3>Design</h3><div>Prospective cohort study.</div></div><div><h3>Setting</h3><div>Specialty concussion clinic.</div></div><div><h3>Participants</h3><div>Adults aged 18 to 50 years within 30 days of a diagnosed concussion. Based on clinical cutoffs for the Fear Avoidance Components Scale at the initial clinic visit, participants were categorized into FA (41-100; moderate to severe) and NFA (0-40; none to mild) groups. A total of 74 participants (N=74) (<em>M=</em>28.7±8.4y, 68.9% women) were included, 37 (50.0%) in the FA and 37 (50.0%) in the NFA group.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>(1) Clinical intake and interview, (2) Fear Avoidance Components Scale, (3) Concussion Clinical Profiles Screening Tool (CP Screen), (4) Postconcussion Symptom Scale, (5) Immediate Postconcussion Assessment and Cognitive Testing, (6) Vestibular/Ocular Motor Screening (VOMS), (7) Generalized Anxiety Disorder 7-Item Assessment, (8) Patient Health Questionnaire-9, (9) Patient Health Questionnaire-15, and (10) Recovery Time (days to medical clearance).</div></div><div><h3>Results</h3><div>There were no differences in demographics, medical history, or injury characteristics between groups. The FA group had worse CP Screen anxiety/mood (<em>P</em>=.04), cognitive (<em>P</em>=.04), and total symptoms (<em>P</em>=.04); Immediate Postconcussion Assessment and Cognitive Testing reaction time (<em>P</em>=.01); VOMS visual motion sensitivity (<em>P</em>=.03) and total VOMS (<em>P</em>=.04); Generalized Anxiety Disorder 7-Item Assessment (<em>P</em>&lt;.01); and Patient Health Questionnaire-9 (<em>P</em>&lt;.01) scores than the NFA group. Results from a Cox proportional hazards model demonstrated that the FA group had a 62% lower instantaneous recovery likelihood on any given day than the NFA group (hazard ratio=0.38; 95% confidence interval, 0.15-0.96; <em>P</em>=.04) while controlling for CP Screen total.</div></div><div><h3>Conclusions</h3><div>FA adults demonstrated worse concussion symptoms, reaction time, and vestibular impairments compared with NFA adults after concussion. Moreover, after controlling for initial symptom severity, FA adults took significantly longer to recover than NFA adults. Future research should explore potential mechanisms underlying the relationship between fear avoidance and poor outcomes, including reduced adherence to treatment recommendations.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 5","pages":"Pages 936-944"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145237815","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":"The Effects of Clean Intermittent Catheterization Training With a Mobile Application on Quality of Life and Compliance in Spinal Cord Injury Patients: a Single Blind Randomized Controlled Study","authors":"Nilgun Aras RN, PhD ,&nbsp;Nurcan Çalışkan RN, PhD ,&nbsp;Bilge Yılmaz MD","doi":"10.1016/j.apmr.2025.10.011","DOIUrl":"10.1016/j.apmr.2025.10.011","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the effects of Clean Intermittent Catheterization (CIC) training provided via a mobile application on the quality of life and compliance with catheterization in individuals living with spinal cord injury.</div></div><div><h3>Design</h3><div>Single-blinded parallel-group, randomized, controlled trial.</div></div><div><h3>Setting</h3><div>A rehabilitation hospital located in a metropolitan area.</div></div><div><h3>Participants</h3><div>The study included patients aged 18-65 years, who were receiving CIC training for the first time during inpatient rehabilitation after spinal cord injury, and who could then perform CIC on their own. A total of 42 participants (N=42) were randomly assigned to control (n=21) and intervention (n=21) groups.</div></div><div><h3>Interventions</h3><div>The control group received routine CIC training from the hospital, and patients in the intervention group received CIC training via a mobile application after discharge in addition to routine training. The mobile application included 10 training videos, a CIC alarm module, a urine volume recording section, and an “ask the expert” section.</div></div><div><h3>Main Outcome Measures</h3><div>Data were collected using the World Health Organization Quality of Life Scale, Intermittent Self Catheterization Questionnaire, Intermittent Catheterization Adherence Scale, Mobile Application Usability Scale and Mobile Application Satisfaction Scale before the intervention and at 12 weeks after discharge.</div></div><div><h3>Results</h3><div>At 12 weeks after discharge, data were collected from 19 (90.4%) patients in the intervention group and 20 (95.2%) in the control group. The CIC training provided via the mobile application was determined to have increased catheter-related quality of life and compliance. No significant difference was found between the groups in terms of health-related quality of life.</div></div><div><h3>Conclusions</h3><div>Using the mobile application after CIC training will increase individuals’ compliance and catheter-related quality of life.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 5","pages":"Pages 809-819"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145443734","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":"NIDILRR ARRT: Quantitative Assessment of Knee Pain and Proprioception in Tibial Rotation in Individuals with Knee Osteoarthritis 1053","authors":"Zongpan Li,&nbsp;Raziyeh Baghi,&nbsp;Giovanni Oppizzi,&nbsp;Peter Bowman,&nbsp;Frank Henn,&nbsp;Li-Qun Zhang","doi":"10.1016/j.apmr.2026.02.017","DOIUrl":"10.1016/j.apmr.2026.02.017","url":null,"abstract":"<div><h3>Research Objectives</h3><div>To test a newly developed robot-assisted device for the measurement of knee pain and proprioception during tibial rotation in individuals with knee osteoarthritis (OA).</div></div><div><h3>Design</h3><div>A case-control study.</div></div><div><h3>Setting</h3><div>University laboratory.</div></div><div><h3>Participants</h3><div>Twelve patients with symptomatic medial knee OA (64.6 ± 9.5 years) and 12 age-matched controls (62.7 ± 11.5 years).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>For patients with knee OA, knee pain was quantified using the pain threshold angle (PTA), the angle at which pain was first perceived during robot-controlled tibial internal rotation (IR) and external rotation (ER) at 0.5°/sec [1-3]. Knee Injury and Osteoarthritis Outcome Score (KOOS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were also collected. For knee OA and control groups, knee proprioception was measured as the threshold of passive movement detection (TPMD), the angle at which participants first perceived tibial rotation. Pearson’s correlation coefficients were calculated to assess the relationship between KOOS/WOMAC scores and PTA. An independent t-test compared TPMD between knee OA and control groups, while paired t-tests compared PTA and TPMD between tibial IR and ER.</div></div><div><h3>Results</h3><div>In patients with symptomatic medial knee OA, PTA in IR was significantly correlated with KOOS/WOMAC scores (r = 0.59–0.70; P &lt; 0.05), and PTA in tibial IR was lower than in tibial ER (P = 0.009). Patients with medial knee OA exhibited a larger TPMD in tibial ER than controls (P = 0.019).</div></div><div><h3>Conclusions</h3><div>Lower PTA in IR, indicative of increased pain sensitivity, is associated with worse KOOS/WOMAC scores. Greater pain sensitivity in IR than ER may be related to medial knee OA [4]. Knee OA patients exhibit reduced tibial rotation, possibly as a compensatory adaptation to mitigate mechanical stimuli on surrounding tissues that could otherwise provoke knee pain [5]. Thus, the PTA at which knee pain is sensed may reflect that surrounding tissues have received mechanical stimuli sufficient to exceed the nociceptive threshold. Modifying foot progression angles (corresponding to tibial rotation) has been used as a gait retraining technique for knee OA [6]. Hence, the PTA could help pinpoint the optimal angles to be modified for better pain reduction. Additionally, patients with medial knee OA exhibit poorer proprioception in ER. This may provide a scientific basis for developing individualized neuromuscular training to improve knee control and pain reduction [1, 2]. Therefore, this study introduces a robot-assisted method for measuring knee pain and proprioception, potentially facilitating the precise rehabilitation of knee OA.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 5","pages":"Page e2"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807185","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":"A 3D Anatomical Foundation for the Development of Radiofrequency Ablation Procedures to Treat Posterior Elbow Joint Pain 1859","authors":"Denise Arnold,&nbsp;Emily Ho,&nbsp;Sharon Switzer-McIntyre,&nbsp;Catherine Amara,&nbsp;Anne Agur","doi":"10.1016/j.apmr.2026.02.047","DOIUrl":"10.1016/j.apmr.2026.02.047","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Research Objectives&lt;/h3&gt;&lt;div&gt;To determine the innervation of the posterior elbow joint in three-dimensional (3D) space, compare innervation patterns, and identify landmarks that could be used to target articular nerves with ultrasound (US) guided radiofrequency ablation (RFA) procedures.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Observational 3D anatomical study of the innervation of the posterior elbow joint.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Division of Anatomy, Department of Surgery, Temerty Faculty of Medicine, University of Toronto&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Twelve cadaveric upper extremity specimens were used in this study. Specimens with visible signs of injury, pathology, or previous surgery of the elbow region were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Twelve upper extremity specimens were dissected to expose the articular branches from the ulnar nerve, radial nerve, and medial and posterior antebrachial cutaneous nerves from the brachial plexus to their termination. Origin and course of the articular branches were digitized using a MicroscribeTM digitizer, and the skeletonized humerus, ulna, radius and posterior elbow joint capsule were laser scanned (FaroArm®). The digitized cartesian coordinate data and laser scanned point cloud data were reconstructed into 3D models using Maya® with plug-ins developed in our laboratory. The 3D models of each specimen were combined into a 3D frequency map.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;1. Map of the origin and course of articular branches innervating the posterior elbow joint. 2. Comparison of innervation patterns between specimens. 3. Frequency and capsular distribution of the articular branches to the posterior elbow joint. 4. Identification of anatomical landmarks that could be used for ultrasound guidance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The medial portion of the posterior elbow joint was innervated by articular branches originating from the ulnar nerve directly (92%) and from branches to forearm flexors (100%). The radial nerve innervated the superior and lateral portions of the elbow joint via the ulnar collateral nerve (92%), lateral branch to triceps (100%), nerve to anconeus (100%) and, when present, branch to extensor carpi ulnaris (58%). The medial (100%) and posterior (83%) antebrachial cutaneous nerves supplied the medial and lateral epicondylar areas respectively. Landmarks that could be used for US guidance included the epicondyles, olecranon, olecranon fossa, and margins of triceps.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The posterior elbow joint is consistently innervated by articular branches from the ulnar nerve (medial capsule), radial nerve (superior and lateral capsule) and medial and posterior antebrachial cutaneous nerves (epicondylar areas). This study enables identification of target sites for US guided RFA to capture the articular branches, 3D simulation of needle placements, and US correlation of anatomical lan","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 5","pages":"Page e16"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807324","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":"The Associations of Executive Functioning Skills and Depressive Symptoms with Social Skills in Transition Age Adults with Disabilities","authors":"Emily Kernan,&nbsp;Christine Petranovich","doi":"10.1016/j.apmr.2026.02.032","DOIUrl":"10.1016/j.apmr.2026.02.032","url":null,"abstract":"<div><h3>Research Objectives</h3><div>Amongst transition age adults with pediatric onset disabilities, including acquired brain injury (ABI), spina bifida (SB), and neuromuscular disease (NMD), socialization is a common problem. Social skills may be associated with modifiable factors, though few existing studies speak to this. In view of this gap in the current literature, the goal of this study is to examine the relationships of executive functioning, specifically meta-cognitive and behavioral regulation skills, and depressive symptoms with social skills in a sample of young adults with pediatric-onset disabilities.</div></div><div><h3>Design</h3><div>Using cross-sectional data, generalized linear regression was used to examine the associations of informant-rated executive functioning skills (the Metacognitive and Behavioral Regulation indices of Behavior Rating Inventory of Executive Functions – Adult Version [BRIEF-A]) and patient-reported depressive symptoms (Center for Epidemiologic Studies- Depression Scale), controlling for patient medical complexity.</div></div><div><h3>Setting</h3><div>Outpatient specialty rehabilitation clinics at a regional academic children’s hospital in the Western United States.</div></div><div><h3>Participants</h3><div>This pilot study included 47 young adults between the ages of 18-28 and their informants (e.g., parents, partners, siblings). Participants were followed by pediatric rehabilitation clinics for acquired brain injury (ABI=16), neuromuscular disorders (NMD=22), or spina bifida (SB=9).</div></div><div><h3>Interventions</h3><div>Not applicable</div></div><div><h3>Main Outcome Measures</h3><div>Informants rated the participant’s current social skills using the Adaptive Behavior Assessment System- 3rd Edition (ABAS-3).</div></div><div><h3>Results</h3><div>Controlling for patient medical complexity, informant-rated behavioral regulation was significantly associated with informant-rated social skills with a large effect size (β = -0.57, p &lt;.001). Contrary to study hypotheses, metacognitive skills (β =-.004, p = 0.79) and depressive symptoms (β = -0.10, p =0.94) were non-significantly associated with social skills.</div></div><div><h3>Conclusions</h3><div>In young adults with a history of pediatric-onset disabilities, therapeutic supports that target behavioral regulation may be particularly helpful for those with social skills deficits. Contrary to expectations, depressive symptoms were not associated with informant-rated social skills. Depression might be associated with social participation, but not necessarily to the skills that are required for effective socializing. Without appropriate psychosocial support during these crucial years when transitioning to adulthood, participants may be at increased risk for behavioral dysregulation and social skills challenges. These factors may contribute to social isolation, a prevalent issue amongst this population.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 5","pages":"Page e9"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807326","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":"Understanding Chronic Pain and Opioid Use After Traumatic Brain Injury: Leveraging Integrated Data to Identify High-risk Use Patterns","authors":"Amy Starosta,&nbsp;Andrew Humbert,&nbsp;Jeanne Hoffman","doi":"10.1016/j.apmr.2026.02.074","DOIUrl":"10.1016/j.apmr.2026.02.074","url":null,"abstract":"<div><h3>Research Objectives</h3><div>Characterize high-risk opioid use following traumatic brain injury (TBI) in a civilian population using an integrated dataset of medical records, trauma registry data, and prescription monitoring data.</div></div><div><h3>Design</h3><div>Observational cohort study using retrospective data from multiple sources spanning acute hospitalization through post-acute care.</div></div><div><h3>Setting</h3><div>Regional Level I trauma center (Harborview Medical Center, Seattle, WA), linked with Washington State Department of Health Prescription Monitoring Program (PMP) data.</div></div><div><h3>Participants</h3><div>Adults with TBI treated at Harborview Medical Center between 2012–2020.</div></div><div><h3>Interventions</h3><div>Not applicable</div></div><div><h3>Main Outcome Measures</h3><div>Opioid prescriptions dispensed post-hospitalization, as recorded in the WA State DOH PMP. Opioid prescription metrics were calculated by quarter for the first year after discharge using the Bree Collaborative Opioid Prescribing Metrics (e.g., overlapping prescriptions, high daily morphine milligram equivalents, concurrent sedative medication).</div></div><div><h3>Results</h3><div>Analyses from over 11,000 patients with TBI indicate that approximately 12% filled an opioid prescription within the each full quarter after hospitalization, with a drop to 5% by the 4th quarter. Of those who received opioid, an average of 26% per quarter had at least a 60-day supply of opioids, 13% received opioid prescriptions greater than the recommended ceiling of 50 MED, and &lt; 1% received concurrent prescriptions for at least 60-days of sedative medications. PMP data reveal persistent opioid use in a subset of individuals up to one-year post-injury. Preliminary descriptive trends suggest a decrease in opioid prescribing in the quarter hospitalization after the implementation of 2017 opioid policy reforms may be present, with a subsequent plateauing of the trend during the early COVID-19 pandemic. Final analyses will characterize trajectories of high-risk opioid use and their associations with demographic and medical care factors, including gender, age, race, and admission to inpatient rehabilitation.</div></div><div><h3>Conclusions</h3><div>Opioid exposure remains highly prevalent following TBI, with early opioid use potentially contributing to prolonged and high-risk prescribing patterns. Integrating prescription monitoring data with trauma registry and longitudinal research data provides a powerful approach to identify individuals at greatest risk and to inform clinical and policy interventions.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 5","pages":"Page e28"},"PeriodicalIF":3.7,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147807547","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}