Archives of physical medicine and rehabilitation最新文献

{"title":"Balance Interventions to Improve Upright Balance Control and Balance Confidence in People With Motor-Incomplete Spinal Cord Injury or Disease: A Systematic Review and Meta-analysis","authors":"Natasha L. Benn MPT ,&nbsp;Hope Jervis-Rademeyer PhD ,&nbsp;Wagner H. Souza PhD ,&nbsp;Maureen Pakosh MISt ,&nbsp;Elizabeth L. Inness PhD ,&nbsp;Kristin E. Musselman PhD","doi":"10.1016/j.apmr.2024.07.013","DOIUrl":"10.1016/j.apmr.2024.07.013","url":null,"abstract":"<div><h3>Objectives</h3><div>To assist with clinical decision making, evidence syntheses are needed to demonstrate the efficacy of available interventions and examine the intervention components and dosage parameters. This systematic review and meta-analysis described the efficacy, components and dosage of interventions targeting upright balance control, balance confidence, and/or falls in adults with motor-incomplete spinal cord injury/disease (SCI/D).</div></div><div><h3>Data Sources</h3><div>A search strategy following the population, intervention, control, outcome framework was developed. Six databases were searched: APA PsychInfo, Cumulative Index to Nursing and Allied Health Literature, Embase, Emcare Nursing, Web of Science CC, and Medline.</div></div><div><h3>Study Selection</h3><div>Title, abstract, and full-text screening were conducted by 2 researchers independently. Inclusion criteria included the following: (1) adults with chronic, motor-incomplete SCI/D; (2) physical intervention targeting upright postural control; and (3) clinical and/or biomechanical measures of upright balance control and/or balance confidence and/or documentation of falls.</div></div><div><h3>Data Extraction</h3><div>Participant characteristics, balance intervention details, adverse events, and study results were extracted. The Downs and Black Checklist was used to assess methodological quality. Meta-analyses on pre-post intervention outcomes and a meta-regression of dosage were completed. Grading of Recommendations, Assessment, Development, and Evaluations approach was used to evaluate the quality of the evidence.</div></div><div><h3>Data Synthesis</h3><div>The search returned 1664 unique studies; 26 were included. Methodological quality was moderate to good. Participants were 500 individuals with SCI/D, aged 18-74 years (males: females = 2.4:1). Minor adverse events were reported in 8 studies (eg, muscle soreness and fatigue). Walking interventions and upright balance training with visual feedback had clinically meaningful and significant pooled effects on improving standing balance control. Only walking interventions had a significant pooled effect on improving balance confidence. There were no significant findings on dosage response. Few studies evaluated the effects of balance interventions on the occurrence of falls.</div></div><div><h3>Conclusions</h3><div>Walking interventions and upright balance training with visual feedback had greater effects on upright balance control than conventional physiotherapy; however, the quality of the evidence was very low.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 444-458"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Four-Year Trajectories of Symptoms and Quality of Life in Individuals Hospitalized After Mild Traumatic Brain Injury","authors":"Kathleen Cairns BSc ,&nbsp;Simon Beaulieu-Bonneau PhD ,&nbsp;Valérie Jomphe MSc ,&nbsp;Marie-Ève Lamontagne PhD ,&nbsp;Élaine de Guise PhD ,&nbsp;Lynne Moore PhD ,&nbsp;Josée Savard PhD ,&nbsp;Marie-Josée Sirois PhD ,&nbsp;Bonnie Swaine PhD ,&nbsp;Marie-Christine Ouellet PhD","doi":"10.1016/j.apmr.2024.09.005","DOIUrl":"10.1016/j.apmr.2024.09.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To (1) detect distinct trajectories of symptoms and quality of life (QoL) over the first 4 years after mild traumatic brain injury (mTBI); (2) assess the relationship between symptom trajectory membership and QoL trajectory membership; and (3) identify participant characteristics associated with QoL trajectory membership.</div></div><div><h3>Design</h3><div>Prospective longitudinal cohort study. Assessments occurred at 4, 8, 12, 24, 36, and 48 months after mTBI.</div></div><div><h3>Setting</h3><div>Recruitment occurred in Level 1 Trauma Centers; follow-up was completed in the community.</div></div><div><h3>Participants</h3><div>Participants were 143 adults (aged 18-65y) who sustained an mTBI and were hospitalized (≥24h) at a Level 1 Trauma Center.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Fatigue Severity Scale, Hospital Anxiety and Depression Scale, Insomnia Severity Index, Medical Outcomes Study Cognitive Functioning Scale, Quality of Life after Brain Injury questionnaire, presence/absence of headaches or dizziness.</div></div><div><h3>Results</h3><div>Group-based trajectory modeling revealed relatively stable symptom and QoL trajectories over time. Considerable percentages of participants were classified in trajectories of clinically significant symptoms throughout the full follow-up period: 62% for subjective cognitive issues, 54% for fatigue, 44% for anxiety, 43% for insomnia, 27% for depression, 23% for headaches, and 17% for dizziness. Sixty-six percent of participants belonged to trajectories of persistently poor QoL. For all symptoms, trajectories of greater severity were associated with trajectories of poorer QoL. None of the sociodemographic or injury-related variables examined were associated with QoL trajectory membership.</div></div><div><h3>Conclusions</h3><div>A substantial proportion of individuals hospitalized after mTBI experiences clinically significant persistent symptoms ≤4 years after injury, and those with more severe symptoms have poorer QoL. Further research is required to better understand the factors leading to symptom persistence and poor QoL.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 358-365"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Calf Circumference, Hand Grip Strength, and Physical Performance With Serious Adverse Events in Individuals With Subacute Stroke Hospitalized for Rehabilitation: An Observational Study","authors":"Takuro Ohtsubo PT ,&nbsp;Masafumi Nozoe PT, PhD ,&nbsp;Masashi Kanai PT, PhD ,&nbsp;Hiroki Kubo PT, PhD ,&nbsp;Katsuhiro Ueno PT, MSc ,&nbsp;Yosuke Morimoto PT, PhD","doi":"10.1016/j.apmr.2024.09.015","DOIUrl":"10.1016/j.apmr.2024.09.015","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether calf circumference, hand grip strength, and physical performance are linked to the incidence of serious adverse events (SAEs) in patients with subacute stroke.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Single rehabilitation hospital.</div></div><div><h3>Participants</h3><div>Patients with stroke admitted for rehabilitation hospital.</div></div><div><h3>Intervention</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The incidence of SAEs, such as death, cardiovascular events including recurrent stroke, and conditions requiring transfer to another hospital for specialized care or immediate treatment for an acute illness during hospitalization.</div></div><div><h3>Results</h3><div>A total of 341 patients (median age: 74y) participated in this study, with 232 patients (68%) exhibiting low-physical performance. In the adjusted model, low-physical performance was significantly associated with SAEs (hazard ratio [HR], 3.01; 95% confidence interval [CI], 1.04-8.68; <em>P</em>=.042). However, low calf circumference (HR, 1.60; 95% CI, 0.76-3.38; <em>P</em>=.219) and low hand grip strength (HR, 0.98; 95% CI, 0.39-2.42; <em>P</em>=.960) did not show an independent association.</div></div><div><h3>Conclusions</h3><div>Low-physical performance was independently associated with the occurrence of SAEs during hospitalization for rehabilitation in patients with subacute stroke.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 397-403"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of the Efficacy of 2 Different Botulinum Toxin Injection Techniques in Gastrocnemius Muscle Spasticity in Hemiplegic Patients: A Randomized Double-Blind Controlled Study","authors":"Savaş Karpuz MD,&nbsp;Ramazan Yılmaz MD,&nbsp;Halim Yılmaz MD","doi":"10.1016/j.apmr.2024.09.011","DOIUrl":"10.1016/j.apmr.2024.09.011","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the efficacy of the innervation zone–targeted injection technique (EUROMUSCULUS/USPRM (Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine) spasticity approach) and the injection technique along the muscle length.</div></div><div><h3>Design</h3><div>A double-blind randomized controlled trial.</div></div><div><h3>Setting</h3><div>Department of rehabilitation medicine of a medical center.</div></div><div><h3>Participants</h3><div>One hundred patients with stroke experiencing ankle plantar flexor spasticity.</div></div><div><h3>Interventions</h3><div>In addition to conventional rehabilitation, eligible patients were randomly assigned to 2 groups. The experimental group was injected with botulinum toxin along the length of the muscle, whereas the control group was injected with the same dose and volume of botulinum toxin 25%-35% proximal to the medial head and 20%-30% proximal to the lateral aspect of the head of the gastrocnemius muscle.</div></div><div><h3>Main Outcome Measures</h3><div>Modified Ashworth scale, modified Tardieu scale, ankle range of motion measurement, and 10-meter walk test were used before and 1 month after injection.</div></div><div><h3>Results</h3><div>The study was completed by 60 participants with a mean age of 59.96±12.15 years. Both injection methods were found to be effective on range of motion, spasticity level, ambulation, and walking speed. There was no statistically significant difference between injection methods.</div></div><div><h3>Conclusions</h3><div>Both injection methods of botulinum toxin A produce similar clinical effects.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 327-332"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340037","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":"Outpatient Rehabilitation Utilization After Major Limb Loss in Adults Receiving Care in the Military Health System From 2001 to 2017","authors":"Rebecca N. Schulz MPH ,&nbsp;Kalyn C. Jannace PhD ,&nbsp;Daniel B. Cooper MPH ,&nbsp;Michelle L. Luken DSc ,&nbsp;Alyssa R. Michel BS ,&nbsp;Tawnee L. Sparling MD ,&nbsp;Paul F. Pasquina MD","doi":"10.1016/j.apmr.2024.09.017","DOIUrl":"10.1016/j.apmr.2024.09.017","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate exposures associated with outpatient rehabilitation encounters among Military Health System (MHS) beneficiaries with major limb loss.</div></div><div><h3>Design</h3><div>Retrospective, cohort study.</div></div><div><h3>Setting</h3><div>American military treatment facilities and civilian health care facilities that accept TRICARE benefits.</div></div><div><h3>Participants</h3><div>Adult MHS beneficiaries with major limb amputation(s) acquired between January 2001 and September 2017 (N=5161).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>This exploratory analysis investigated associations between outpatient rehabilitation care and demographic and amputation characteristics in MHS beneficiaries with major limb loss.</div></div><div><h3>Results</h3><div>Most beneficiaries were aged 55-64 (36%), male (73%) and retirees/dependents (60%) with enlisted sponsor rank (88%) and single limb loss (89%). The active/reserve beneficiaries were younger, majority male, and more likely to be diagnosed with incident behavioral health conditions. Unadjusted negative binomial regression models revealed increased rates of outpatient rehabilitation encounters in active-duty service members (ADSMs) than in retirees/dependents (rate ratio, 10.02; 95% confidence interval, 9.30-10.80). The rate ratios for sex, sponsor rank, limb(s) lost, incident behavioral health condition, incident traumatic brain injury, incident posttraumatic stress disorder, and outpatient care setting were attenuated after stratification by beneficiary category. Enlisted ADSMs had increased rates of outpatient rehabilitation encounter days compared with officers, whereas retirees/dependents with enlisted sponsors had decreased than those with officer sponsors. ADSMs who accessed outpatient care in direct and private care settings demonstrated high rates of outpatient rehabilitation encounters compared with those who only sought care from private care settings (rate ratio, 4.60; 95% confidence interval, 2.95-6.81).</div></div><div><h3>Conclusions</h3><div>This study suggests that MHS beneficiaries with major limb loss use outpatient rehabilitation services differently, based on active/reserve duty or retiree/dependent status. This study is the first of its kind to quantify outpatient rehabilitation utilization for military beneficiaries with all-cause major limb loss and may inform MHS policymakers on the rehabilitation needs for combat- and noncombat-related amputee populations.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 366-378"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387472","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 Supplements","authors":"","doi":"10.1016/S0003-9993(25)00516-7","DOIUrl":"10.1016/S0003-9993(25)00516-7","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 477-479"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511167","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":"Analysis of the Recovery Process and Activities of Daily Living Independence in Pusher Behavior and Unilateral Spatial Neglect","authors":"Yuichi Kato MS, PT ,&nbsp;Yu Sato BS, PT ,&nbsp;Takumi Orimoto BS, PT ,&nbsp;Yuto Sudo BS, OT ,&nbsp;Masafumi Suzuki PT ,&nbsp;Shigeyasu Ishida BS, PT ,&nbsp;Tokihide Jyashiki PT ,&nbsp;Masanari Kikura PT ,&nbsp;Yumi Ikeda PhD, PT ,&nbsp;Kazu Amimoto PhD, PT","doi":"10.1016/j.apmr.2024.09.019","DOIUrl":"10.1016/j.apmr.2024.09.019","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the recovery processes of pusher behavior (PB) and unilateral spatial neglect (USN) based on the severity of PB and USN, and to determine the relationship between activities of daily living (ADL) independence levels.</div></div><div><h3>Design</h3><div>This retrospective study aimed to examine the temporal changes and their association with ADL independence levels based on the severity of PB and USN.</div></div><div><h3>Setting</h3><div>Recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022.</div></div><div><h3>Participants</h3><div>We included all patients with cerebrovascular disease admitted to the recovery ward of Moriyama Neurological Center Hospital between March 2017 and October 2022. A total of 174 patients with PB and USN were classified into 4 groups as follows: severe PB and severe USN (Group A), severe PB and mild USN (Group B), mild PB and severe USN (Group C), and mild PB and mild USN (Group D).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Kaplan-Meier survival analysis was used to determine whether the time to recovery from PB or USN (SCP: ≤1.75 points; Catherine Bergego Scale: 0 points) differed between groups. In addition, group differences in functional independence measure (FIM) scores and efficiencies were examined.</div></div><div><h3>Results</h3><div>There were significant differences among Groups A and B, and Groups A and C, as determined by the log-rank test (<em>P</em>&lt;.05), and recovery was prolonged when both PB and USN were severely impaired. Similarly, FIM scores and efficiencies were lower in Group A (<em>P</em>&lt;.05). When PB and USN were severely impaired, ADL was adversely affected, and the recovery process was prolonged. In addition, when 1 of the 2 symptoms was severe and the other was mild, each recovery course tended to show improvement, suggesting that they exerted a mutual influence on each other.</div></div><div><h3>Conclusions</h3><div>These findings indicate that severity classification may help to determine functional prognosis in patients with PB and USN.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 387-396"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567084","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)00506-4","DOIUrl":"10.1016/S0003-9993(25)00506-4","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Page A5"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143511266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Attention Training After Moderate-to-Severe Traumatic Brain Injury in Adults: A Systematic Review","authors":"Alexa C. Soule MA,&nbsp;Taryn J. Fish MA,&nbsp;Kevin G.F. Thomas PhD,&nbsp;Leigh Schrieff-Brown PhD","doi":"10.1016/j.apmr.2024.07.010","DOIUrl":"10.1016/j.apmr.2024.07.010","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the extent and efficacy of attentional training as a form of neuropsychological rehabilitation to ameliorate attention deficits in adults with moderate-to-severe traumatic brain injury.</div></div><div><h3>Data Sources</h3><div>Articles published in Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PubMed, PsycINFO, Scopus, and Web of Science were searched between January 17, and February 27, 2021.</div></div><div><h3>Study Selection</h3><div>Two reviewers blindly assessed studies for eligibility according to the following criteria: any article evaluating the efficacy of any type of behavioral intervention that targeted attention (by means of cognitive rehabilitative, psychoeducational, or neuropsychological strategies, at either an individual or group level) in adults who had sustained a formally documented moderate-to-severe traumatic brain injury.</div></div><div><h3>Data Extraction</h3><div>Methodological quality of each article was blindly assessed by 2 reviewers. Data were extracted from each study, including study type, sample size, sample characteristics, summary of intervention, measures used to assess attention, statistical outcomes and results, effect size, conclusion, and limitations.</div></div><div><h3>Data Synthesis</h3><div>7314 articles were retrieved from databases, 4325 articles remained after duplicate removal, and finally 21 articles met eligibility criteria and were included in this review. Articles represented varied methodological quality in group or single subject design. Irrespective of the heterogeneity regarding intervention types and attentional outcome measures used across the studies, overall findings suggest that attentional gains can be made in this sample, irrespective of time since injury, age, and injury severity. Further, a growing interest in technology-based interventions is frequently used and holds promise to bettering rehabilitation efforts. However, there is still limited evidence supporting the ecological validity of attentional training interventions (eg, the transfer of treatment effects to daily activities).</div></div><div><h3>Conclusions</h3><div>This article plays a crucial role in informing ongoing rehabilitation practices, guiding clinicians with evidence-based strategies and shaping future research directions for more effective attentional training guidelines.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 433-443"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wheelchair Repairs: Delays, Causes, and Associated Outcomes","authors":"Lynn A. Worobey PhD, DPT, ATP ,&nbsp;Daniel Canter BS ,&nbsp;Denise Fyffe PhD ,&nbsp;Chloe Slocum MD ,&nbsp;Thomas N. Bryce MD ,&nbsp;Chad Swank PT, PhD ,&nbsp;Kimberly Monden PhD ,&nbsp;Candace Tefertiller PT, DPT, PhD, NCS ,&nbsp;Allen Heineman PhD ,&nbsp;Rachel Cowan PhD ,&nbsp;Theresa Berner OTR/L, ATP ,&nbsp;Michael L. Boninger MD","doi":"10.1016/j.apmr.2024.10.001","DOIUrl":"10.1016/j.apmr.2024.10.001","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the length of time to complete wheelchair repairs and the relationship between negative outcomes and the factors that prevented or determined who performed the repairs.</div></div><div><h3>Design</h3><div>Survey, cross-sectional.</div></div><div><h3>Setting</h3><div>Nine spinal cord injury (SCI) Model Systems Centers.</div></div><div><h3>Participants</h3><div>Wheelchair users with SCI reporting at least 1 repair (N=301).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Prevalence of adverse consequences associated with wheelchair repairs, repairs completed of those needed, and time elapsed before wheelchair repair.</div></div><div><h3>Results</h3><div>Of the participants, 76% reported all necessary repairs were completed, 7% indicated that some repairs were addressed, and 14% reported none of the repairs were completed. The most common reason for incomplete repairs (30%) was the vendor's failure to complete the repair after being contacted. Among the repairs that were successfully completed, 56% were performed by vendors. The median time elapsed before repair was 14 days, with no significant difference observed in the time taken for repairs across different components. The most common consequences were being forced to use a backup wheelchair or being confined at home. A greater percentage of participants experienced each type of consequence, except injury, for repairs completed by vendors.</div></div><div><h3>Conclusions</h3><div>The high percentage of uncompleted wheelchair repairs poses a significant risk to users, and this risk is compounded by prolonged time taken by vendors to address breakdowns. Unsatisfactory vendor service was common, with a significantly larger proportion of participants experiencing consequences for repairs that required a vendor. This seems to indicate structural inadequacies within the repair process and the need for interventions to address these issues.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 379-386"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}