Archives of physical medicine and rehabilitation最新文献

{"title":"Peri-Neuromal Botulinum Toxin Injection for War-Related Postamputation Pain: A Pragmatic, Multicenter, Comparative-Effectiveness Study.","authors":"Nadiya Segin, Roman Smolynets, Joana Barroso, Natalia Molinets, Paul F Pasquina, Steven P Cohen","doi":"10.1016/j.apmr.2025.09.026","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.026","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the comparative-effectiveness of botulinum toxin (BT) injections vs. comprehensive medical and surgical treatment (CMST) for war-related postamputation pain.</p><p><strong>Design: </strong>Prospective, comparative-effectiveness study evaluating outcomes in patients treated with BT or CMST in 2 Ukrainian hospitals.</p><p><strong>Participants: </strong>Patients with at least 2 out of 10 residual (RLP) or phantom (PLP) limb pain were included.</p><p><strong>Interventions: </strong>In the BT group, patients received BT injections around neuromas in the residual limb (peri-neuromal), subcutaneously over sensitized tissue, or as trigger point injections, plus physical and pharmacotherapy as indicated. The CMST group received injections, surgical therapies, physical and pharmacotherapies, and integrative treatments.</p><p><strong>Main outcome measures: </strong>Mean reduction in RLP and PLP at 3-month follow-up. Secondary outcome measures were RLP and PLP and success defined as ≥30% decrease in PAP.</p><p><strong>Results: </strong>At 3 months, the reduction in PLP scores was greater in the CMST than the BT group (2.0±2.0 vs. 3.5±3.5, p=0.002). For RLP, the reduction did not differ significantly between groups (BT 2.0±2.5 vs. CMST 3.0±2.8, p=0.50). Conversely, the reduction in PLP at 1-month favored BT (4.0±3.5 vs. 1.0±2.5, p>0.001), with no significant difference in RLP reduction. Responder rates favored BT for PLP at 1-month (68.6% vs. 43.1%, P=0.01), and CMST for RLP (97.1% vs. 63.2%, p<0.001) but not PLP at 3-months.</p><p><strong>Conclusions: </strong>On some measures, BT outperforms or is non-inferior to CMST at 1-month but not 3-months, suggesting multimodal treatment is superior in the long-term.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145353553","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":"Effects of a Hybrid Telerehabilitation Model on Mobility and Functional Capacity in patients with Multiple Sclerosis: A Single Blind Randomized Controlled Study.","authors":"Güzin Kaya Aytutuldu, Duygu Yalcınkaya, Buket Akıncı, Hikmet Uçgun, Rabia Gökçen Gözübatık Çelik, Mesude Tütüncü","doi":"10.1016/j.apmr.2025.09.034","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.034","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of hybrid telerehabilitation (Hybrid TR), telerehabilitation (TR-only), and clinic-based rehabilitation on gait speed (primary outcome: Timed 25-Foot Walk Test), as well as on fatigue, functional capacity, mobility, quality of life, and muscle activation in MS patients.</p><p><strong>Design: </strong>A single blind randomized controlled trial with assessments conducted at baseline, mid-treatment (week 4), and post-treatment (week 8).</p><p><strong>Setting: </strong>Rehabilitation settings included hybrid (combination of telerehabilitation and clinic-based interventions), only telerehabilitation, and clinic-based environments.</p><p><strong>Participants: </strong>A total of 44 participants diagnosed with MS (Expanded Disability Status Scale scores ranging from 0 to 4) were randomized into three groups: Hybrid TR(Group A), TR-only(Group B), and clinic-based rehabilitation(Group C). Participants underwent an 8-week intervention program. Selection was based on specific eligibility criteria, and random allocation methods were applied.</p><p><strong>Interventions: </strong>Participants engaged in an 8-week program consisting of breathing exercises, aerobic training, and strengthening exercises delivered through Hybrid TR, TR-only, or clinic-based rehabilitation.</p><p><strong>Main outcome measures: </strong>Primary outcome was mobility assessed by the Timed 25-Foot Walk(T25FW).Secondary outcomes included functional capacity assessed by 2-Minute Walk Test(2MWT), and mobility assessed by Timed Up and Go(TUG); fatigue assessed by the Modified Fatigue Impact Scale(MFIS); quality of life assessed by the Multiple Sclerosis International Quality of Life questionnaire(MusiQoL); and muscle activation measured by surface electromyography(EMG) of the rectus femoris muscle.</p><p><strong>Results: </strong>Significant within-group improvements in mobility, fatigue, functional capacity, quality of life, and EMG parameters were observed by week 8 across all groups. However, statistically significant between-group differences were not observed, and effect sizes were small to moderate(η²ₚ = 0.01-0.07).</p><p><strong>Conclusions: </strong>Hybrid telerehabilitation appears to be a feasible and potentially beneficial approach for individuals with multiple sclerosis, with clinical outcomes that may be comparable to those of clinic-based rehabilitation in terms of mobility, fatigue, functional capacity, quality of life, and muscle activation.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312322","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":"Intimate Partner Violence and Traumatic Brain Injury: A Commentary.","authors":"Angela Colantonio, Flora Nikolaou, Denise Gobert, Brooke Holt","doi":"10.1016/j.apmr.2025.09.029","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.029","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312309","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 RCS-E is Predictive of Outcomes and Resource Allocation in a Large Neuromotor Rehabilitation Setting.","authors":"Davide Antonio Di Pietro, Adriana Olivares, Laura Comini, Alessia Saverino, Stefania De Trane, Rachele Piras, Giuliana Vezzadini, Sharon Cammisuli, Stefano Corna, Giorgio Ferriero, Francesco Negrini, Laura Marcuccio, Chiara Ferretti, Antonio Nardone, Valeria Pingue, Christian Lunetta","doi":"10.1016/j.apmr.2025.10.001","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.10.001","url":null,"abstract":"<p><strong>Objective: </strong>To assess the reliability of the Rehabilitation Complexity Scale - Extended (RCS-E) as a measure of rehabilitation complexity. Secondary outcomes include identifying which baseline data, including the RCS-E, are most predictive of rehabilitation stay effectiveness and exploring its role as a predictor of reimbursement for hospital admissions.</p><p><strong>Design: </strong>A retrospective observational study. Demographic and clinical variables were collected, including Length of Stay (LoS), modified Rankin Scale, modified Barthel Index (mBI), RCS-E, and reimbursement of stay.</p><p><strong>Setting: </strong>Study on inpatients admitted to the neuromotor Rehabilitation Units of the 16 Istituti Clinici Scientifici Maugeri IRCCS (November 2023 and June 2024).</p><p><strong>Participants: </strong>Of 5870 hospitalizations, 4091 (mean age 71.8 ±13 years; 42.2% male) met the inclusion criteria. The pre-post analysis was performed on 3792 patients (mean age 71.8 ±12.8 years; 41.6% male).</p><p><strong>Interventions: </strong>Rehabilitation program for neurological or orthopedic condition [median (1^st - 3^rd quartile) duration: 27 days (20-41)] MAIN OUTCOMES AND MEASURES: RCS-E scores on admission were categorised as follows: <8 (low complexity); 8-10 (medium complexity); >10 (high complexity). For each patient, we calculated the mBI derived parameters: mBI Gain, rehabilitation efficiency, and rehabilitation effectiveness.</p><p><strong>Results: </strong>A significant moderate Spearman correlation was found between RCS-E score and mBI (rho=-0.53, p<0.0001), LoS (rho=0.41, p<0.0001) and premorbid mRS (rho=0.23, p<0.0001). Rehabilitation efficiency and effectiveness were significantly lower in the high complexity group. Both RCS-E and mBI at admission significantly correlated with total reimbursement (both p<0.0001, rho=0.48 and rho=-0.43, respectively). Regression models indicated a predictive effect of RCS-E at admission on mBI at discharge.</p><p><strong>Conclusions: </strong>This study demonstrates the reliability and utility of RCS-E in assessing neurological and orthopedic rehabilitation complexity, predicting outcomes, and informing funding models.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145312337","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":"Implementation context of outpatient physical therapy clinics preparing to launch a new evidence-based clinical program for knee osteoarthritis: Findings from a national multisite implementation trial.","authors":"Connor Drake, Sara Webb, Livia Anderson, Graham Cummin, Matthew Tucker, Amy Webster, Nina Sperber, Cynthia J Coffman, Natalie K FullenKamp, Leah L Zullig, Jaime M Hughes, Susan N Hastings, Courtney H Van Houtven, Lauren M Abbate, Helen Hoenig, Lindsay A Ballengee, Kelli D Allen","doi":"10.1016/j.apmr.2025.09.032","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.032","url":null,"abstract":"<p><strong>Objective: </strong>We evaluated implementation context to identify barriers and facilitators to delivering a new evidence-based clinical program, Group physical therapy (Group PT) for knee osteoarthritis, overall and by rurality and facility complexity.</p><p><strong>Design: </strong>Baseline surveys from an implementation trial of Group PT.</p><p><strong>Setting: </strong>Outpatient PT clinics (n=19) in the Veterans Health Administration.</p><p><strong>Participants: </strong>Staff at Group PT sites (n=59).</p><p><strong>Main outcome measures: </strong>Validated measures of implementation context included: organizational readiness to implement change (ORIC; score range 1-5), organizational resilience via the benchmark resilience tool (BRT; score range 8-32) and implementation climate scale (ICS; score range 0-4); surveys also included questions regarding anticipated challenging and helpful factors for implementing Group PT.</p><p><strong>Results: </strong>Mean scores on the ORIC (4.6, SD=0.4) and BRT (26.2, SD=2.9) did not vary substantially by rurality or facility complexity. For the ICS, mean scores were lower for low complexity vs high complexity sites (2.0, SD=0.4 vs 2.6, SD=0.6) and lower for high rurality vs low rurality sites (1.9, SD=0.4 vs 2.5, SD=0.6). The most endorsed challenging factors were lack of experience implementing new programs (49%), staffing (47%) and patient awareness (45%). The most endorsed helpful factors were guidance on starting the program (96%), program effectiveness (96%) and staff resources (93%).</p><p><strong>Conclusions: </strong>Based on ORIC and BRT scores, staff perceived high levels of preparedness to implement Group PT, but they also identified specific factors that could make implementation challenging. Rural and low complexity sites reported lower levels of organizational prioritization for implementing evidence-based practices and may benefit from additional support.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145290859","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":"Discriminatory characteristics of responders and non-responders septic patients to neuromuscular electrical stimulation - A subanalysis of a randomized controlled double-blinded trial.","authors":"Leandro Teixeira Saraiva, Wesla Neves da Silva Costa, Samantha Torres Grams, Isabel Chateaubriand Diniz Salles, Mariane Tami Amano, Wellington Pereira Yamaguti","doi":"10.1016/j.apmr.2025.09.027","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.027","url":null,"abstract":"<p><strong>Objective: </strong>To define the discriminatory characteristics of patients with sepsis or septic shock, as well as responders and non-responders to the NMES protocol.</p><p><strong>Design: </strong>This was a sub-analysis of a randomized, controlled, double-blind clinical trial.</p><p><strong>Setting: </strong>An intensive care unit (ICU) at a private hospital.</p><p><strong>Participants: </strong>Fifteen adult patients diagnosed with sepsis or septic shock underwent NMES sessions, among whom eight were classified as the responder group (RG) and seven were classified as the non-responder group (NRG) Interventions: The NMES protocol was initiated at 24 hours after admission with daily sessions. Assessments were performed through ultrasound measurements of the quadriceps femoris muscle and physical function scales.</p><p><strong>Results: </strong>The rectus femoris thickness was maintained for RG from day 1 to day 4 and reduced by more than 10% for NRG. The Surgical ICU Optimal Mobilization Score (SOMS) statistically differed (p = 0.04) between the RG (2 points; IQI 0.25-3.5) and NRG (score 0) in the initial assessment. De Morton Mobility Index (DEMMI) in the RG increased from 19 ± 20 points to 33 ± 30 points at the final evaluation (p = 0.04), suggesting higher levels of mobility. There was a strong correlation between the initial SOMS (r = 0.72, p = 0.04), DEMMI (r = 0.77, p = 0.02), and muscle thickness in the RG. The NRG exhibited a strong negative correlation between the Sepsis-related Organ Failure Assessment (SOFA) score and rectus femoris thickness at baseline (r = -0.82, p = 0.04).</p><p><strong>Conclusion: </strong>The SOMS and DEMMI could characterize responders to the NMES protocol, whereas the SOFA score did not correlate with responders.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285241","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":"Using Machine Learning with Wearable Devices to Advance Research and Patient Care Using Spinal Cord Injury as a Model.","authors":"Andrew D Delgado, Shane J T Balthazaar, Alexandra E Soltesz, Tom E Nightingale, Gino S Panza","doi":"10.1016/j.apmr.2025.09.025","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.025","url":null,"abstract":"<p><p>Wearable devices (WDs) and machine learning (ML) are increasingly used to monitor physiological signals outside of traditional clinical environments, creating new opportunities for real-time, personalized insights. Yet the practical and ethical integration of these technologies into clinical research remains underdeveloped, especially for populations with complex, unstable physiology such as persons with spinal cord injury (SCI). In this perspective, we argue that the promise of WDs and ML can only be realized through deliberate alignment between device capabilities, physiological relevance, analytic rigor, and clinical context. Using SCI as a case example, we highlight the limitations of current measurement tools for capturing autonomic and sleep dysfunction, the challenges of interpreting high-frequency wearable data, and the need for customized ML approaches that account for individual variability and contextual noise. We present a conceptual framework to guide the responsible design, interpretation, and deployment of WD-ML systems in rehabilitation research and practice. This includes strategies for addressing missing data, signal artifacts, confounding, and bias, as well as for ensuring interpretability, data privacy, and clinical relevance. Ultimately, this paper calls for interdisciplinary collaboration, linguistic transparency, and critical engagement with emerging technologies to ensure that innovation in wearable analytics leads to equitable, actionable, and patient-centered care.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145278756","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":"Validity of Scores from the 12-Item Multiple Sclerosis Walking Scale Among Young, Middle-Aged, and Older Adults with Multiple Sclerosis.","authors":"Robert W Motl, Petra Šilić, Trinh L T Huynh, Brenda Jeng","doi":"10.1016/j.apmr.2025.09.023","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.023","url":null,"abstract":"<p><strong>Objective: </strong>To examine the construct validity of inferences from MSWS-12 scores as a PROM of walking dysfunction among young, middle-aged, and older adults with MS.</p><p><strong>Design: </strong>Cross-sectional, comparative research design.</p><p><strong>Setting: </strong>University research laboratory.</p><p><strong>Participants: </strong>The sample included 187 participants with MS who were categorized into young (20-39 years, n=50), middle-aged (40-59 years, n=83), and older (60-79 years, n=54) adult age-groups.</p><p><strong>Intervention: </strong>N/A MAIN OUTCOME MEASURES: The participants completed the MSWS-12; the Timed 25-Foot Walk (T25FW), Six-Minute Walk (6MW), and Timed-Up-and-Go (TUG); and Brief International Cognitive Assessment for MS (BICAMS). The data analyses were performed using IBM SPSS Version 29.0.2.0 for the iOS platform.</p><p><strong>Results: </strong>There were similar patterns of linear worsening of scores for the MSWS-12 (F_1,187=12.7, p<.001, η²=.07), T25FW (F_1,187=11.5, p<.001, η²=.06), 6MW (F_1,187=13.1, p<.001, η²=.08), and TUG (F_1,184=10.8, p<.001, η²=.06) across the three age-groups. MSWS-12 scores had strong partial correlations with T25FW, 6MW, and TUG in the overall sample (partial r's of .59, .66, .55, respectively) and across the three age-groups, when controlling for BICAMS outcomes.</p><p><strong>Conclusions: </strong>We provide new evidence for the construct validity of MSWS-12 scores as a PROM of walking dysfunction across the adult lifespan in MS. Our results, in particular, support the application of the MSWS-12 in clinical research and practice involving older adults with MS who experience the combined effects of advanced age and MS disease progression.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145257185","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 Following Concussion.","authors":"Alicia M Trbovich, Aaron J Zynda, Anne Mucha, Nacona Bunker, Courtney Perry, Michael W Collins, Anthony P Kontos","doi":"10.1016/j.apmr.2025.09.024","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.024","url":null,"abstract":"<p><strong>Objective: </strong>To compare initial multidomain clinical outcomes and recovery time between fear-avoidant (FA) and non-fear-avoidant (NFA) adults following concussion.</p><p><strong>Setting: </strong>Specialty concussion clinic.</p><p><strong>Participants: </strong>Adults aged 18-50 years within 30 days of a diagnosed concussion. Based on clinical cutoffs for the Fear Avoidance Components Scale (FACS) at the initial clinic visit, participants were categorized into FA (41-100; moderate to severe) and NFA (0-40; none to mild) groups.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Main measures: </strong>1) Clinical intake and interview, 2) FACS, 3) Concussion Clinical Profiles Screening Tool (CP-Screen), 4) Post-Concussion Symptom Scale (PCSS), 5) Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), 6) Vestibular/Ocular Motor Screening (VOMS), 7) Generalized Anxiety Disorder 7-Item Assessment (GAD-7), 8) Patient Health Questionnaire (PHQ-9), 9) Patient Health Questionnaire (PHQ-15), 10) Recovery Time (days to medical clearance).</p><p><strong>Results: </strong>74 participants (M=28.7 ± 8.4 years, 68.9% female) were included, 37 (50.0%) in the FA and 37 (50.0%) in the NFA group. There were no differences in demographics, medical history, or injury characteristics between groups. The FA group had worse CP Screen anxiety/mood (p=0.04), cognitive (p=0.04), and total (p=0.04); ImPACT reaction time (p=0.01); VOMS visual motion sensitivity (p=0.03) and total (p=0.04); GAD-7 (p<0.01); and PHQ-9 (p<0.01) 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 (HR=0.38, 95% CI: 0.15-0.96, p=0.04) while controlling for CP Screen total.</p><p><strong>Conclusions: </strong>Fear-avoidant adults demonstrated worse concussion symptoms, reaction time, and vestibular impairments compared to non-fear-avoidant adults following concussion. Moreover, after controlling for initial symptom severity, fear-avoidant adults took significantly longer to recover than non-fear-avoidant adults. Future research should explore potential mechanisms underlying the relationship between fear avoidance and poor outcomes, including reduced adherence to treatment recommendations.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-04","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":"Measurement properties of patient-reported outcome measures for measuring fatigue in people with spinal cord injury: a systematic review.","authors":"Silvia Lahuerta-Martín, Daniel García-García, Ricardo Medrano-de-la-Fuente, María Teresa Mingo-Gómez, Sandra Jiménez-Del-Barrio, Luis Ceballos-Laita, Ignacio Hernando-Garijo, Lidwine B Mokkink","doi":"10.1016/j.apmr.2025.09.021","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.021","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review the measurement properties of patient-reported outcome measures (PROMs) for measuring fatigue in people with spinal cord injury (SCI) to recommend the most suitable PROM for use in research/clinical practice.</p><p><strong>Data sources: </strong>This systematic review was conducted following the COSMIN guideline for systematic reviews of PROMs version 2.0. PubMed, EMBASE, Web of Science and SCOPUS were systematically searched up to September 2024.</p><p><strong>Study selection: </strong>Two independent reviewers evaluated articles that examined any (subscale of) PROM that measure fatigue in people with SCI, and reported information about the development of the PROM or the evaluation of at least one measurement property.</p><p><strong>Data extraction: </strong>Data were extracted following the COSMIN guideline. The methodological quality of the included studies was evaluated with the Risk of Bias checklist and the results for each study were rated with the Criteria for good measurement properties. The evaluation of each PROM was conducted by summarizing the results of all the studies per measurement property. The quality of evidence was analyzed per measurement property per PROM using the GRADE approach.</p><p><strong>Data synthesis: </strong>Seventeen articles describing 18 (subscales of) PROMs for measuring fatigue were included. There were only 3 high-quality studies on measurement properties of PROMs measuring fatigue in people with SCI. The PROMIS Fatigue SF7a and 8a were rated as sufficient with moderate quality of evidence for content validity. Sufficient ratings with high-quality evidence were obtained for structural validity and internal consistency for the PROMIS Fatigue SF8a. For measurement invariance sufficient ratings with low or very low-quality evidence were obtained for PROMIS Fatigue SF7a and 8a, respectively. The other PROMs showed limited quality of evidence in the measurement properties studied.</p><p><strong>Conclusions: </strong>The PROMIS Fatigue SF7a and 8a are the most suitable options to assess fatigue in adults with SCI in research and clinical practice.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145231435","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}