Archives of physical medicine and rehabilitation最新文献

{"title":"Constant torque stretching in ankle contractures results in greater changes in range of motion than constant angle or dynamic stretching: A systematic review and meta-analysis.","authors":"Guido Geusebroek, Jacek Buczny, Han Houdijk, Kirsten A Ziesemer, Huub Maas, Jaap H van Dieën","doi":"10.1016/j.apmr.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.12.004","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the acute (directly post-stretching) and long-term (≥1 week of treatment) effects of stretching type, duration, and intensity on joint range of motion (ROM) and stiffness in ankle contractures.</p><p><strong>Data sources: </strong>PubMed, Embase.com, Clarivate Analytics/Web of Science Core Collection, EBSCO/SPORTDiscus, and EBSCO/CINAHL were searched for studies published in English from inception until September 12, 2023.</p><p><strong>Study selection: </strong>Fifty-five studies that met the inclusion criteria were included, covering observational, controlled and non-controlled studies.</p><p><strong>Data extraction: </strong>Pre and post-treatment ankle ROM and stiffness, and stretching duration, intensity and type were extracted from each eligible treatment group by one reviewer.</p><p><strong>Data synthesis: </strong>Most studies did not quantify stretching intensity and its effect was not tested. For the acute effects on ROM, fifteen effect sizes were obtained from eleven studies. ROM increased more after constant-torque (95% CI [1.35, 2.15]) than after constant-angle (95% CI [0.44, 1.40] or dynamic stretching (95% CI [0.50, 1.01]), F=11.99, p=.004, I²=0%, and increased with duration (95% CI [0.00, 0.05]), F=5.12, p=.011, I²=55%. Acute effects on joint stiffness could not be assessed. For the long-term effects, fifty-four and twelve effect sizes were estimated from forty-four and ten studies, for ROM and stiffness, respectively. No effect of stretching duration on either outcome was found (F=0.32, p=.57, I² =78% and F=0.74, p=.409, I²=5% respectively). No effect of stretching type on stiffness was found (F=0.02, p=.888, I²=0%). Not enough information was available to assess the long-term effects of stretch type.</p><p><strong>Conclusions: </strong>We conclude that constant-torque stretching acutely increases ROM more than constant-angle and dynamic stretching. To assess if these superior acute effects result in more substantial adaptations over time, future long-term studies should define stretching type more clearly. Also, torque and angle during stretching should be recorded as measures of intensity in future studies.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862925","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":"Physical and psychosocial consequences of falls in ambulatory individuals with cerebral palsy by age and gross motor function.","authors":"Marissa Thill Esterley, Linda E Krach, Kari Pederson, Nathan G Wandersee, Sandy Callen Tierney, Elizabeth R Boyer","doi":"10.1016/j.apmr.2024.12.010","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.12.010","url":null,"abstract":"<p><strong>Objective: </strong>To quantify physical and psychosocial impacts of falls by age and Gross Motor Classification System (GMFCS) level in ambulatory individuals with cerebral palsy (CP).</p><p><strong>Design: </strong>Cross-Sectional Survey.</p><p><strong>Setting: </strong>Tertiary specialty hospital and online CP communities.</p><p><strong>Participants: </strong>Ambulatory individuals with CP (N=201 adults; 18-76 years old) or the caregivers of minors (N=180; 5-17 years old).</p><p><strong>Main outcome measure(s): </strong>Participants completed online surveys to report fall frequency, fall characteristics, injuries, concern about falling (Short Falls Efficacy Scale-International), activity avoidance due to concern about falling (Short Falls Efficacy Scale-International Avoidance Behavior), and psychosocial constructs related to perceived consequences of falling (Consequences of Falling-Damage to Identity subscale).</p><p><strong>Results: </strong>Most participants fell in the past 12 months (86%). Fall frequency in the past 12 months differed by age (P<0.001) and GMFCS level (P=0.021). Individuals 5-12-years-old or GMFCS level II reported the most falls. The percentage of participants who experienced a past serious fall-related injury (e.g., head/face stitches, concussion, fractures) increased with age (P<0.001), affecting 80% of ≥50-year-olds. Falls often occurred in the forward direction, when wearing shoes, and during ambulation. Uneven surfaces and fatigue were notable causes. Concern about falling and associated activity avoidance scores differed by age and GMFCS level (all P<0.01), both which were highest for ≥50-year-olds and GMFCS level III. Although psychosocial consequences of falls (e.g., embarrassment, lost confidence) were elevated across all groups, they did not differ by age or GMFCS level (P=0.130, P=0.083). Nearly everyone (88%) wished they fell less.</p><p><strong>Conclusions: </strong>Falls are common for ambulatory children and adults with CP. Physical and psychosocial consequences of falls were frequent and impacted behavior. Differences observed by age and GMFCS level should be considered in care delivery. Clinically tracking and discussing falls and their repercussions across the lifespan will aid in addressing this under-researched and under-resourced concern of people with CP.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142862927","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":"Reliability of the repetition-to-fatigue method for estimating one-repetition maximum in unilateral strength exercises and its relationship with gait tests in people with multiple sclerosis.","authors":"David Barbado, Amaya Prat-Luri, Rafael Sabido, Ramón Gómez-Illán, Carmen Carpena, Gregori Valero-Conesa, Ángel P Sempere, Francisco J Vera-Garcia","doi":"10.1016/j.apmr.2024.12.005","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.12.005","url":null,"abstract":"<p><strong>Objective: </strong>to analyze the reliability of the estimated one-repetition maximum (e1RM) through the repetition to fatigue method in four unilateral resistance training exercises performed using weight machines (i.e., leg press, calf raises, leg extension, seated leg curl), and their relationship to gait-related tests.</p><p><strong>Design: </strong>cross-sectional study.</p><p><strong>Setting: </strong>university sports complex.</p><p><strong>Participants: </strong>twenty-four participants with multiple sclerosis completed three testing sessions. They performed three testing sessions that were integrated into a long-term multimodal exercise regime comprising strength, balance, and functional mobility exercises, conducted twice a week in 90-minute sessions.</p><p><strong>Main outcome measures: </strong>the first session consisted in the assessment of the gait-related tests [i.e., timed up and go (TUG), timed 25-foot walk (T25FW), 6-minute walk (6MW)]. Two testing sessions were dedicated to the assessment of the e1RM in the aforementioned exercises.</p><p><strong>Results: </strong>intraclass correlation coefficients (ICC_2.1) of absolute e1RM ranged from 0.92 to 0.97 and they were slightly higher than those relative to the body mass (0.85<ICC_2.1<0.96). Typical errors for the four exercises ranged between 2.2 and 4.7 kg (9.3 - 11.6%). The weaker leg e1RM for the calf raises and leg curl exercises were significantly associated with the 6MW (0.654≤r≤0.677), T25FW (-0.555≥r≥-0.557) and TUG (-0.480≥r≥-0.526). Between-leg e1RM asymmetries in these exercises were also correlated to the 6MW (0.420≤r≤0.467), T25FW (0.553≤r≤0.590) and TUG (0.626≤r≤0.627). Unilateral e1RMs during the leg press and leg extension showed no or few significant associations with gait-related tests.</p><p><strong>Conclusions: </strong>the results suggest that e1RM can be safely and reliably performed to quantify single-leg strength and to control the training load in these exercises. Knee flexors and ankle extensors strength, especially of the weaker leg, along with their asymmetry, seem to be the most relevant factors to consider in the strength assessment and training of this population.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852186","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":"Validating a universal measurement scale and standardized, reproducible unit for gross motor development.","authors":"Bryant A Seamon, Cynthia L Sears, Emily Anderson, Craig A Velozo","doi":"10.1016/j.apmr.2024.12.008","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.12.008","url":null,"abstract":"<p><strong>Objective: </strong>To validate a universal measurement scale and unit for gross motor development across multiple instruments.</p><p><strong>Design: </strong>Retrospective cohorts SETTING: Community and clinic PARTICIPANTS: Item difficulty calibrations were extracted from three published studies. 4,445 children from Brazil and Taiwan between the ages of 0 to 77 months with similar percentages of males and females were included. Majority were typically developing children with 655 having atypical development due to a variety of medical conditions.</p><p><strong>Intervention: </strong>None MAIN OUTCOME MEASURES: Gross Motor Units (GMU) and observed item difficulty calibrations for items on the Peabody Developmental Motor Scales-2 locomotor and stationary subscales and the Denver II gross motor subscale.</p><p><strong>Results: </strong>There was a strong linear association between observed item difficulty for a sample of children with typical development and a mixed sample of typical and atypical development for the PDMS-2 locomotor and stationary subscales, respectively (locomotor subscale, disattenuated r = 0.97; stationary subscale, disattenuated r = 0.98). GMUs had strong linear associations with observed difficulty for items on the PDMS-2 locomotor and stationary subscales (disattenuated r = 0.88-1.00) for each scale when correcting for measurement error. A similar linear association was found between GMUs and observed difficulty for items on the Denver II gross motor subscale (r = 0.90).</p><p><strong>Conclusions: </strong>The results of this study found that GMUs have a strong linear association with observed difficulty for gross motor development items from the PDMS-2 locomotor and stationary subscales and Denver II gross motor subscale. The strong association between observed item difficulties for children with typical and atypical development, across multiple scales suggests the GMU and construct specification equation can provide a means for consolidating all gross motor development items onto the same scale.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852263","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 Reha-Toolbox project: Linking item subsets of three established rehabilitation PROMs to nine domains of the Patient Reported Outcomes Measurement Information System (PROMIS).","authors":"Alexander Obbarius, Claudia Hartmann, Gregor Liegl, Felix Fischer, Matthias Rose","doi":"10.1016/j.apmr.2024.12.007","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.12.007","url":null,"abstract":"<p><strong>Objective: </strong>The overarching goal of the patient-reported outcomes measurement information system (PROMIS) is to standardize patient-reported outcomes (PROs) across settings and health conditions globally. Following this purpose, the Reha-Toolbox study aimed to link item subsets of the World Health Organization Disability Assessment Schedule (WHODAS 2.0), the Indicators of Rehabilitation Status (IRES-3), and the Hamburg Modules for the Assessment of Psychosocial Health (HEALTH-49) to the standardized metrics provided by PROMIS.</p><p><strong>Design: </strong>Cross-sectional, single-group linking study SETTING: Online survey PARTICIPANTS: Five experts mapped items from the three rehabilitation measures to PROMIS scales. Data were collected online from a sample of 1000 individuals from the general population. Items from the rehabilitation measures and their corresponding PROMIS short forms were administered to facilitate item linkage.</p><p><strong>Interventions: </strong>Not applicable MAIN OUTCOME MEASURES: WHODAS 2.0, IRES-3, HEALTH-49, PROMIS scales RESULTS: Overall, 96 of 171 outcome Items (56%) from the legacy measures and one additional IRES-3 item were mapped to nine PROMIS domains, including pain interference, physical function, dyspnea, fatigue, depression, anxiety, cognitive function, ability to participate in social roles and activities, and satisfaction with participation in social roles and activities. 95 items fulfilled the linking assumptions of construct similarity, unidimensionality, and measurement invariance. The legacy items were successfully calibrated on the corresponding PROMIS metrics using graded-response models. The range and precision of the measures varied, depending on the number of items in each domain. Domains that were assessed with four or more items achieved sufficient reliability for group-based analyses. Crosswalk tables were created for each measure and domain. We discussed the reasons for and implications of the fact that the rehabilitation measures were only partially linked to the PROMIS metrics.</p><p><strong>Conclusion: </strong>The study achieved robust linking between subsets of WHODAS 2.0, IRES-3, HEALTH-49 items, and nine PROMIS scales.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852191","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":"Effectiveness of exercise intervention on mobility, postural control, and falls for older adults with mild cognitive impairment: A systematic review and network meta-analysis.","authors":"Ziwei Zeng, Cheuk-Yin Ho, Cindy Hui-Ping Sit, Stephen Heung-Sang Wong, Jing Liao, Yijian Yang","doi":"10.1016/j.apmr.2024.12.002","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.12.002","url":null,"abstract":"<p><strong>Objective: </strong>To review and synthesize the effectiveness of exercise interventions on mobility, postural control, and falls in older adults with mild cognitive impairment (MCI).</p><p><strong>Data sources: </strong>This review was registered with PROSPERO (CRD42023453320) and adhered to the PRISMA guidelines. PubMed, Embase, APA PsycInfo, Cochrane Library, Web of Science, CINAHL, and SPORTDiscus were searched from inception until September 2024.</p><p><strong>Study selection: </strong>Randomized controlled trials (RCTs) examining the effectiveness of exercise interventions on mobility, postural control, and falls in older adults with MCI.</p><p><strong>Data extraction: </strong>Data extraction included author names, publication years, participant characteristics, intervention details, outcomes, key results, and attrition rates. Data accuracy was verified by two reviewers, with discrepancies resolved through consultation with a third reviewer.</p><p><strong>Data synthesis: </strong>Thirty-two RCTs met the criteria for qualitative systematic review, with 22 RCTs included in the pairwise meta-analysis and network meta-analysis. Aerobic exercise [SMD 1.07 (95% CI: 0.62-1.52)], multicomponent exercise [SMD 0.46 (95% CI: 0.18-0.74)], and simultaneous cognitive-motor training [SMD 0.56 (95% CI: 0.23-0.89)] significantly improved gait speed during single-task (p<0.05). Aerobic exercise was the most effective intervention for single-task walking performance (99.3%), while Exergaming was the most effective for Timed Up and Go performance (100.0%) according to the surface under the cumulative ranking. Paddling exercise [SMD 0.42 (95% CI: 0.16-0.68)] effectively increased handgrip strength (p<0.05). However, network meta-analyses revealed no intervention demonstrating significant effects on postural control performance (Berg Balance Scale and Functional Reach Test scores). The effect of exercise on falls remained inconclusive due to limited number of studies.</p><p><strong>Conclusions: </strong>Aerobic exercise, multicomponent exercise, and combined cognitive-motor training, significantly enhance gait speed and functional performance in older adults with MCI. However, the effect of exercise on fall risk remains unclear. These findings underscore the potential of tailored exercise interventions to improve physical function in this vulnerable population.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142823485","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":"Improving Life After Childhood Stroke: Helping Your Child Get the Most Out of Their Home Activity Program to Improve Upper Extremity Function.","authors":"Heather L Atkinson, Rachel M Vaughn, Ashley Binkowski, Charis Casey, Todd Levy","doi":"10.1016/j.apmr.2024.10.019","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.10.019","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799169","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":"Geographic Variation in Prosthesis Prescription Disparities Between White and Black Veterans After Major Lower Limb Amputation: A Retrospective Cohort Analysis: Geographic Variation in Lower Limb Prosthesis Prescription Disparities.","authors":"Anthony I Roberts, Linda J Resnik","doi":"10.1016/j.apmr.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.12.001","url":null,"abstract":"<p><strong>Objective: </strong>To examine racial disparities in lower limb prosthesis (LLP) prescription practices between White and Black Veterans across different geographic levels within the United States Veterans Health Administration (VHA) and explore how racial disparities in LLP prescription practices differ by amputation level.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>VHA facilities across the United States.</p><p><strong>Participants: </strong>A total of 12,143 White and 4,711 Black Veterans who underwent major lower limb amputation between 2010 and 2022 in a VHA facility, including 4,885 with transfemoral amputations (TFA) and 11,969 with transtibial amputations (TTA).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Age-standardized percentage point (pp) differences in LLP prescriptions between White and Black Veterans within 12 months post-amputation, analyzed at national, regional, and Veterans Integrated Service Network (VISN) levels. A positive pp difference indicates a racial disparity, meaning a higher proportion of White Veterans were prescribed LLPs compared to Black Veterans.</p><p><strong>Results: </strong>Nationally, 54.5% of Veterans received an LLP prescription within 12 months post-amputation, with the age-standardized pp difference in LLP prescriptions favoring White Veterans by 5.06 pp (95% CI: 2.51, 7.61). Regional analysis revealed variations, with the Continental region showing the largest disparity (9.10 pp; 95% CI: 4.48, 13.71) and the Pacific region the smallest (3.27 pp; 95% CI: -3.87, 10.42). The VISN-level analysis uncovered greater variations, ranging from -9.26 to 14.54 pp. Disparities were more pronounced for Veterans with TFA (5.25 pp; 95% CI: 1.91, 8.59) compared to TTA (4.52 pp; 95% CI: 1.54, 7.50).</p><p><strong>Conclusions: </strong>Significant geographic variations exist in racial disparities for LLP prescriptions across the VHA, with most areas favoring White Veterans. Disparities were more pronounced for Veterans with transfemoral amputations, highlighting the need for targeted interventions to improve equity in access to prosthetic care, especially for Veterans with more proximal amputations and in regions and VISNs with the largest disparities.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799167","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":"Which Sex- and Gender-Based Explanatory Variables are Associated with Memory Function Post-Stroke? A Cross Sectional Analysis of the National Health and Aging Trends Study.","authors":"Clare Thompson, Elise Wiley, Ada Tang","doi":"10.1016/j.apmr.2024.11.014","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.11.014","url":null,"abstract":"<p><strong>Objective: </strong>To identify sex- and gender-based variables associated with immediate and delayed recall in individuals with stroke.</p><p><strong>Design: </strong>This was a secondary analysis of data from the National Health and Aging Trends Study (NHATS) using general linear models with a standard stepwise approach.</p><p><strong>Setting: </strong>Community INTERVENTIONS: Not Applicable PARTICIPANTS: Participants were eligible for the current analysis if they had a self-reported history of stroke at NHATS Round 1 (2011), and data available on our variables of interest. The final analyses included 366 participants for the immediate recall model and 365 participants for the delayed recall model.</p><p><strong>Main outcome measures: </strong>Independent variables of interested included sex- (eight variables, for example biological sex, depression and anxiety, and comorbidities) and gender-related factors (fourteen variables, for example education, income, independence with banking). The dependent variables of interest were the 10-word immediate and delayed recall tests, respectively.</p><p><strong>Results: </strong>Higher immediate recall scores were associated with younger age, female biological sex, independence with banking, higher income, giving financial gifts, not requiring assistance with ADLs, and higher education (p<0.001-0.04). Higher delayed recall scores were associated with younger age, higher BMI, higher education, placing importance in socializing, and independence with banking (p<0.001-0.04).</p><p><strong>Conclusion: </strong>We conducted the largest analysis to date of sex- and gender-based factors associated with cognition in individuals with stroke. Stroke rehabilitation scientists and clinicians may consider both biological and sociodemographic factors associated with cognitive function, which may guide holistic post-stroke assessments and interventions.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794203","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":"Prevalence, Trajectory, and Predictors of Post-stroke Fatigue in Older Adults.","authors":"Hongmei Huang, Mengxia Lu, Jinghui Zhong, Yingjie Xu, Yiran Dong, Xinfeng Liu, Wen Sun","doi":"10.1016/j.apmr.2024.11.012","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.11.012","url":null,"abstract":"<p><strong>Objective: </strong>To explore the prevalence, trajectories, and predictors of Post-stroke fatigue (PSF) in older adults following a first ischemic stroke.</p><p><strong>Design: </strong>A longitudinal observational cohort study.</p><p><strong>Setting: </strong>Two hospitals.</p><p><strong>Participants: </strong>A total of 381 patients aged ≥ 65 years with their first ischemic stroke were included. The mean (SD) age was 71.1 (4.27) years, with 96 patients (25.2%) being women and 285 (74.8%) being men.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Patients were assessed using the Fatigue Severity Scale (FSS) at admission, 3 months, and 12 months. Growth mixture models (GMM) were used to identify distinct fatigue trajectories, and baseline variables were analyzed to determine their association with these trajectories.</p><p><strong>Results: </strong>The prevalence of clinical fatigue was 39.11%, 33.33%, and 22.31% at admission, 3 months, and 12 months, respectively. Five distinct fatigue trajectories were identified: persistently low fatigue (class 1, 49.1%), persistently high fatigue (class 2, 21.5%), initial high but early decreasing fatigue (class 3, 15.0%), initial high but late decreasing fatigue (class 4, 8.7%), and increasing-then-decreasing fatigue (class 5, 5.8%). Multinomial logistic regression analysis revealed that several factors were significantly associated with high and persistent fatigue (class 2), including older age, lower social support, decreased physical activity, higher depression and anxiety scores, cognitive impairment, and greater stroke severity.</p><p><strong>Conclusion: </strong>These findings indicate significant variability in the progression of fatigue among stroke survivors. Further research is necessary to determine the outcomes linked to these fatigue trajectory subgroups and to identify the most effective treatment strategies tailored to each specific subgroup.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778733","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}