Archives of physical medicine and rehabilitation最新文献

{"title":"Contextualizing Employment Outcomes After Spinal Cord Injury With Novel Area-Level Economic Measures: A Cross-Sectional Analysis of the National Spinal Cord Injury Model Systems Database","authors":"Lauren F. Murphy PhD,&nbsp;Susan Charlifue PhD,&nbsp;Anthony Lequerica PhD,&nbsp;Amanda L. Botticello PhD, MPH","doi":"10.1016/j.apmr.2026.04.028","DOIUrl":"10.1016/j.apmr.2026.04.028","url":null,"abstract":"<div><div><strong>Objective:</strong> To investigate the association of area-level economic characteristics with employment outcomes in a sample of participants in the national Spinal Cord Injury Model Systems (SCIMS) database.</div><div><strong>Design:</strong> Secondary analysis of cross-sectional survey data collected for the SCIMS database linked to administrative data from the 2019 American Community Survey (ACS) 5-year estimates.</div><div><strong>Setting:</strong> Community.</div><div><strong>Intervention:</strong> Not applicable.</div><div><strong>Participants:</strong> People with traumatic spinal cord injury (SCI) who completed a follow-up interview during the 2016-2021 SCIMS database cycle and who had census tract-level geographic identifiers to link to the 2019 ACS data (N=4660).</div><div><strong>Main Outcome Measure:</strong> Employment status was a binary measure indicating participants’ status as employed (=1) or not employed (=0) at the time of follow-up interview.</div><div><strong>Results:</strong> A total of 40% of participants reported being employed at the time of interview. Compared with those living in low socioeconomic status (SES) neighborhoods, those living in moderate-SES neighborhoods had 50% greater odds of being employed and those living in high-SES neighborhoods had more than double the odds of employment. The probability of employment also varied by urbanicity. Among all people living in low-SES neighborhoods, the probability of employment was lower for people in rural (27%) versus urban (38%) areas, whereas people living in high-SES rural and urban areas had a similar probability of being employed.</div><div><strong>Conclusion:</strong> Area-level economic characteristics have a significant effect on the odds of employment after SCI over and above individual-level characteristics. People living in low-SES neighborhoods had poorer odds of employment, especially those in low-SES rural areas. These findings inform rehabilitation professionals’ consideration of community characteristics in employment initiatives for people living with SCI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2499-2507"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810148","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":"Feasibility and Validity of a Remotely Administered 30-Second Sit-to-Stand in People with Multiple Sclerosis","authors":"Parisa Najafi PhD,&nbsp;Louise Declerck PT, PhD,&nbsp;Trinh L.T. Huynh PhD,&nbsp;Brenda Jeng PhD,&nbsp;Robert W. Motl PhD","doi":"10.1016/j.apmr.2026.04.018","DOIUrl":"10.1016/j.apmr.2026.04.018","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the feasibility and validity of the remotely administered 30-second Sit-to-Stand (30s STS) test as a measure of lower-extremity function in a convenience sample of people with multiple sclerosis (MS).</div></div><div><h3>Design</h3><div>Cross-sectional observational study.</div></div><div><h3>Setting</h3><div>Remote, videoconference-based assessments conducted via Zoom.</div></div><div><h3>Participants</h3><div>Convenience sample of adults with MS (n=541) and healthy controls (n=74).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Number of 30s STS repetitions, completion rate, and correlations of 30s STS performance with cognitive and patient-reported outcome measures.</div></div><div><h3>Results</h3><div>The remote 30s STS test was completed by 498 participants with MS (92%) and all 74 healthy controls (100%) with no adverse events. The 30s STS performance was significantly lower in the MS than in healthy controls (10.4 vs 14.0 repetitions; <em>P</em>&lt;.001; <em>d</em>=−0.75), and this group difference remained significant after adjusting for group differences in age, sex, and marital status. The 30s STS repetitions were strongly associated with mobility disability (patient-determined disease step: <em>r</em>=−0.56) and walking limitations (12-Item Multiple Sclerosis Walking Scale: <em>r</em>=−0.57); moderately associated with physical health (12-Item Short Form Health Survey Physical Component Summary: <em>r</em>=0.41) and processing speed (Symbol Digit Modalities Test: <em>r</em>=0.34); and weakly associated with symptoms, mental status, verbal learning and memory (California Verbal Learning Test–Second Edition), and physical activity in MS.</div></div><div><h3>Conclusions</h3><div>The remotely administered 30s STS appears to be a feasible and valid measure of lower-extremity physical function in stable, relapse-free individuals with MS and may be a useful outcome for telerehabilitation research in this population.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2381-2387"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760471","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 Between Trajectories of Activity-Level Recovery and Fall Risk: A Retrospective Cohort Study of Older Patients With Stroke in a Subacute Rehabilitation Setting","authors":"Hideaki Matsuzaki PT, PhD,&nbsp;Teppei Fukuda PT,&nbsp;Daisuke Furukawa OT,&nbsp;Masahiro Matsuo PT,&nbsp;Takehiro Shirota PT,&nbsp;Momoka Tsushima PT,&nbsp;Shiori Yoshida OT,&nbsp;Atsuhiro Takayama PT,&nbsp;Yuria Oishi PT","doi":"10.1016/j.apmr.2026.04.010","DOIUrl":"10.1016/j.apmr.2026.04.010","url":null,"abstract":"<div><h3>Objective</h3><div>To identify distinct latent classes of activity-level recovery trajectories during subacute stroke rehabilitation using growth mixture modeling and examine their association with fall risk.</div></div><div><h3>Design</h3><div>Observational retrospective cohort study.</div></div><div><h3>Setting</h3><div>Single subacute rehabilitation hospital.</div></div><div><h3>Participants</h3><div>N=233 patients with stroke aged ≥65 years admitted between April 1, 2023, and March 31, 2025.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Incidence of a first fall after admission.</div></div><div><h3>Results</h3><div>Four distinct activity-level recovery trajectories were identified: low baseline-rapid improvement (14.2%), very low baseline-slow improvement (36.1%), moderate baseline-steady improvement (32.6%), and high baseline-early plateau (17.2%). The baseline motor and cognitive functions differed significantly across the trajectory groups. Compared with the high baseline-early plateau trajectory, older patients in the low baseline-rapid improvement trajectory exhibited a significantly higher risk of falls (hazard ratio=3.57, 95% confidence interval, 1.09-11.73).</div></div><div><h3>Conclusions</h3><div>Distinct activity-level recovery trajectories during subacute stroke rehabilitation exhibit different associations with fall risk. Rapid activity-level recovery correlates with a higher fall risk, suggesting that risk may increase during transitional phases of improvement in activity-level motor functioning. Together, these findings underscore the clinical relevance of recovery dynamics in understanding fall risk in the setting of subacute rehabilitation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2356-2362"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147687338","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(26)00866-X","DOIUrl":"10.1016/S0003-9993(26)00866-X","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Page A2"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148861597","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":"Long-Term Outcomes of Patients Seeking Specialized Health Care for Persisting Postconcussion Symptoms After a Mild Head Injury","authors":"Linda Fordal PhD,&nbsp;Jonas Stenberg PhD,&nbsp;Turid Follestad PhD,&nbsp;Simen B. Saksvik PhD,&nbsp;Helge Skirbekk PhD,&nbsp;Alexander Olsen PhD,&nbsp;Toril Skandsen PhD","doi":"10.1016/j.apmr.2026.03.018","DOIUrl":"10.1016/j.apmr.2026.03.018","url":null,"abstract":"<div><h3>Objective</h3><div>To examine long-term outcomes of persisting postconcussion symptoms (PPCS) after mild head injury in patients seeking specialist care.</div></div><div><h3>Design</h3><div>Longitudinal cohort study. Baseline interview at outpatient admission and follow-up interviews at 3, 6, 12, 18, 24, 30, 36, 48, and 60 months postinjury, and 5 years after outpatient admission.</div></div><div><h3>Setting</h3><div>Rehabilitation clinic.</div></div><div><h3>Participants</h3><div>Patients (N=191) with PPCS after mild head injury over the past 5 years.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Symptoms assessed by Rivermead Postconcussion Symptoms Questionnaire, functioning via Glasgow Outcome Scale-Extended and return to full-time work. Linear and logistic mixed models with and without interaction terms evaluated outcomes over time, while within-subject change was assessed from participants’ first to last assessments.</div></div><div><h3>Results</h3><div>The sample comprised 800 assessments (mean 4.2 [SD, 1.7] per participant). Patients were divided into groups by time from injury to outpatient admission (group 1: 0-3mo [n=44]; group 2: 3-6mo [n=54]; group 3: 6-12mo [n=47]; group 4: 12-24mo [n=26]; group 5: 24-60mo [n=20]). Although the groups had similar clinical characteristics at outpatient admission, their outcomes over time differed. Substantial symptom reduction and functional improvement were observed over time in groups 1-4, but not in group 5. Most symptom relief across groups occurred in the months after outpatient admission.</div></div><div><h3>Conclusions</h3><div>In patients seeking care for PPCS, most exhibited improvement over time and worsening was rare. However, many still experienced symptoms years after outpatient admission, and outpatient admission ≥2 years postinjury was associated with significantly poorer outcomes.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2255-2265"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147621791","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":"Dysphagia Management in Individuals With Parkinson Disease and Cognitive Dysfunction: A Scoping Review","authors":"Rabab Rangwala PhD, CCC-SLP,&nbsp;Godfrey Lee MEd,&nbsp;Jared F. Benge PhD, ABPP,&nbsp;Corinne A. Jones PhD, CCC-SLP","doi":"10.1016/j.apmr.2026.03.012","DOIUrl":"10.1016/j.apmr.2026.03.012","url":null,"abstract":"<div><h3>Objective</h3><div>To examine dysphagia management options for individuals with Parkinson’s disease (PD), with attention to the inclusion of individuals with co-occurring cognitive dysfunction across all levels of severity.</div></div><div><h3>Data Sources</h3><div>This scoping review was completed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses – Scoping Review guidelines. A comprehensive search across 7 databases (PubMed, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, ClinicalTrials.gov, Scopus, and Embase) was conducted using predefined search terms.</div></div><div><h3>Study Selection</h3><div>The inclusion criteria focused on studies addressing dysphagia management in PD, including behavioral interventions, medical and surgical treatments, and stimulation interventions. Observational studies that did not include individuals with PD or dysphagia interventions were excluded.</div></div><div><h3>Data Extraction</h3><div>The data extraction template compiled study details, sample characteristics, dysphagia interventions, and cognitive-based exclusion criteria.</div></div><div><h3>Data Synthesis</h3><div>Of 13,614 identified studies, 48 were included in the final analysis, addressing interventions for dysphagia management in PD. Among these 4 studies did not exclude individuals with cognitive dysfunction, of which 3 were case studies with a single participant. Of 25 behavioral intervention studies included, 17 explicitly excluded individuals based on their cognitive abilities, whereas 5 did not report cognitive criteria. Among 9 surgical and medical intervention studies, 6 excluded participants because of cognitive functioning, and 3 did not provide information regarding cognitive status. Similarly, of 14 stimulation-based intervention studies, 5 excluded individuals with cognitive impairment, and 8 did not report cognitive-related criteria.</div></div><div><h3>Conclusions</h3><div>There is limited information available guiding clinicians in the management of dysphagia in patients with both PD and cognitive dysfunction. This review aims to guide future research by highlighting the need for development of evidence-based dysphagia rehabilitation protocols for individuals with PD and with cognitive impairments.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2590-2601"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147509054","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":"Association of Polytrauma Care and Primary Care With Utilization of Health Services for Veterans With Traumatic Brain Injury","authors":"Amol M. Karmarkar PhD,&nbsp;Aryan Esmaeili MD, PhD,&nbsp;Clara E. Dismuke-Greer PhD,&nbsp;Vidhur Raveendran MS,&nbsp;Bani Malhotra PhD, LPC, ATR-BC,&nbsp;Daniel W. Klyce PhD, ABPP,&nbsp;Kurt Kroenke MD,&nbsp;John D. Corrigan PhD,&nbsp;Flora M. Hammond MD,&nbsp;David X. Cifu MD","doi":"10.1016/j.apmr.2026.04.025","DOIUrl":"10.1016/j.apmr.2026.04.025","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between primary care (PC) and/or polytrauma care (PTr) with health services utilization in veterans with traumatic brain injury (TBI).</div></div><div><h3>Design</h3><div>Retrospective analysis of data from the Long-term Impact of Military-Relevant Brain Injury Consortium–Chronic Effects of Neurotrauma Consortium Phenotype study cohort.</div></div><div><h3>Setting</h3><div>Veterans Health Administration.</div></div><div><h3>Participants</h3><div>Veterans after the TBI-related first encounter in the Veterans Health Administration (VA) system for 4 groups: control; received only PC, but no PTr; received only PTr, but no PC; and received both PC+PTr.</div></div><div><h3>Interventions</h3><div>None.</div></div><div><h3>Main Outcome Measures</h3><div>Three-year utilization of subsequent emergency department, inpatient, and outpatient services.</div></div><div><h3>Results</h3><div>The cohort of veterans with TBI who received both PC and PTr had the most decline in their VA-provided health services utilization (emergency, inpatient, and outpatient). For the non-VA health services utilization, the trends were mixed and inconclusive.</div></div><div><h3>Conclusions</h3><div>Veterans who had frontloading of both PC and PTr had the most significant decline in subsequent VA-provided health services utilization, whereas trends for non-VA health services utilization were mixed and inconclusive. To enhance care coordination and outcomes, the Veterans Health Administration could implement integrated care models that promote collaboration between PC providers and polytrauma teams. This approach may optimize resource use and improve long-term recovery and health stability for veterans with TBI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2434-2443"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760544","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":"Musculo-Tendinous Changes in Spastic Plantar-Flexor Muscles After Spinal Cord Injury","authors":"Katsutoshi Yaeshima PhD,&nbsp;Daisuke Negishi MEng,&nbsp;Shin-Ichiroh Yamamoto PhD,&nbsp;Toru Ogata PhD,&nbsp;Kimitaka Nakazawa PhD,&nbsp;Noritaka Kawashima PhD","doi":"10.1016/j.apmr.2026.04.014","DOIUrl":"10.1016/j.apmr.2026.04.014","url":null,"abstract":"<div><h3>Objective</h3><div>To identify the underlying mechanisms of time-course stiffness reduction in plantar-flexor muscles after chronic spinal cord injury (SCI) with spasticity.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Research laboratory.</div></div><div><h3>Participants</h3><div>Volunteer sample of 24 participants (N=24), including 14 participants with SCI and 10 participants without SCI.</div></div><div><h3>Interventions</h3><div>The participants’ ankles were rotated from 10° plantar flexion (PF) to 20° dorsiflexion by a dynamometer at 5°/s with the hip and the knee fixed at right angles. PF torque, ankle angle, and ultrasound images of the gastrocnemius (gas) muscle belly and muscle tendon junction (MTJ) were recorded. Changes in muscle fascicle length (MFL), pennation angle, and excursions of the MTJ were obtained.</div></div><div><h3>Main Outcome Measures</h3><div>Stiffness indices (SI) were calculated for the whole plantar-flexor muscles (SI whole PF), outer tendon (SI tendon), proximal portion of MTJ (SI MTJ), and muscle fascicle (SI MFL). In addition, calf circumference and medial gastrocnemius (MG) muscle thickness were evaluated.</div></div><div><h3>Results</h3><div>SI whole PF, SI MTJ, and SI MFL were negatively correlated with injury duration, and time constants of the changes were 92.5, 36.4, and 85.4 months (∼8, 3, and 7y, respectively). In terms of the partial correlation coefficients controlled, the morphologic variables (calf circumference and MG), age, and injury localization, only 2 parameters (SI whole PF and SI MTJ) retained significance.</div></div><div><h3>Conclusions</h3><div>These results indicated that a reduction in the elasticity of plantar-flexor muscles in spastic SCI is partly explained by alterations of tissues in the proximal portion of the gas MTJ (aponeurosis and/or connective tissues), especially in the first several years of the chronic stage.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2408-2417"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760510","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":"Quality Measurement: Technical Specifications and Key Development Considerations","authors":"Anne Deutsch RN, PhD, CRRN, FACRM,&nbsp;Laura Smith PhD","doi":"10.1016/j.apmr.2026.02.508","DOIUrl":"10.1016/j.apmr.2026.02.508","url":null,"abstract":"<div><div>In the United States, payers of health care and home and community-based services, such as the Centers for Medicare &amp; Medicaid Services, have implemented various quality programs as a lever for improving the quality of services. A key component of any quality program is the set of quality measures adopted for use in the program. Quality measure results are calculated at regular intervals for each accountable entity (eg, organization) and can be shared with the respective organization in confidential feedback reports, displayed on websites (public reporting), and used in pay-for-performance programs to encourage providers to improve the quality of services. In this special communication, we focus on quality outcome measures, describing quality measure design options using the 5 core elements of a fully specified outcome, which have been defined in reporting guidelines for clinical trial protocols (Standard Protocol Items: Recommendations for Interventional Trials [SPIRIT]-Outcomes 2022 Extension), and clinical trial reports (CONsolidated Standards Of Reporting Trials [CONSORT]-Outcomes 2022 Extension). Element 1 of a measure is the domain or subdomain (the concept to be measured), element 2 is the specific measurement items or instrument, element 3 is the specific metric used to characterize participants’ results (eg, end value, change from baseline, or time to event), element 4 is the method of aggregation (eg, mean for continuous data, proportion for categorical data, or risk-adjustment approach), and element 5 is the time point of the follow-up measurements. We explain risk adjustment for quality measures, which is used to adjust for case-mix differences across providers. We describe considerations for selecting quality measure risk factors, which can be used as covariates in a regression model, stratification variables, or exclusion criteria. Finally, we describe quality measure endorsement standards and future directions for quality measurement.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2619-2625"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147760503","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":"Test-Retest Reliability and Convergent and Discriminant Validity of the Proprioception Measures in Poststroke Patients","authors":"Aisuke Takahashi MPT,&nbsp;Daiki Haruyama Adv Dip,&nbsp;Daisuke Kobayashi PhD,&nbsp;Katsuhiro Furukawa PhD","doi":"10.1016/j.apmr.2026.04.008","DOIUrl":"10.1016/j.apmr.2026.04.008","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the test-retest reliability and validity of the threshold to detect passive motion (TDPM) and joint position sense (JPS) tests using an image-capture technique compared with the Fugl-Meyer Assessment (FMA) and the Erasmus MC modifications to the Nottingham Sensory Assessment (EmNSA) for evaluating proprioceptive impairment in poststroke patients.</div></div><div><h3>Design</h3><div>Repeated-measures design.</div></div><div><h3>Setting</h3><div>A rehabilitation department in a hospital.</div></div><div><h3>Participants</h3><div>Fifty patients with acute or subacute stroke, with stroke severity ranging from mild to moderate, assessed based on the National Institutes of Health Stroke Scale.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>TDPM, JPS, FMA, and EmNSA assessments were performed twice at a 24-h interval. Reliability was assessed using the intraclass correlation coefficient (ICC) and Bland-Altman analysis, and the minimal detectable change (MDC) was calculated. Convergent and discriminant validity of the proprioceptive measures were evaluated using Spearman’s rank correlation coefficients (<em>r_s</em>).</div></div><div><h3>Results</h3><div>TDPM demonstrated moderate-to-good reliability (ICC=0.63-0.84; MDC=4.26°-8.34°) without systematic bias. Furthermore, TDPM demonstrated discriminant validity (<em>r_s</em>=−0.40 to 0.11) with JPS, FMA, and EmNSA. Multijoint TDPM demonstrated excellent reliability (ICC=0.91-0.93; MDC=14.57°-15.57°), and convergent validity (<em>r_s</em>=0.80-0.92) was confirmed between TDPM measures corresponding to different movement patterns. FMA and EmNSA demonstrated good-to-excellent reliability (ICC=0.85-0.93; MDC=0.71 score) and convergent validity (<em>r_s</em>=0.72). However, a ceiling effect was observed in 74% of the participants. Conversely, JPS exhibited low reliability (ICC&lt;0.44) and poor validity.</div></div><div><h3>Conclusions</h3><div>TDPM and multijoint TDPM using the image-capture technique are reliable and useful measures for evaluating proprioception in poststroke patients. Both measures evaluate dimensions distinct from those captured by FMA and EmNSA, indicating the variability of proprioceptive function in poststroke patients.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 9","pages":"Pages 2347-2355"},"PeriodicalIF":4.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147697142","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}