Archives of physical medicine and rehabilitation最新文献

{"title":"Psychometric Properties and Clinical Utility of the Boston Cognitive Assessment (BOCA) on an Acute Rehabilitation Unit","authors":"Jeffrey Wertheimer, Ann Gottuso PhD, ABPP-CN, Mia Wertheimer, Dov Gold","doi":"10.1016/j.apmr.2025.01.082","DOIUrl":"10.1016/j.apmr.2025.01.082","url":null,"abstract":"<div><h3>Objectives</h3><div>To elucidate the psychometric properties of the Boston Cognitive Assessment (BOCA) in a sample of inpatients in an Acute Rehabilitation Unit (ARU). To introduce the clinical utility of the BOCA, a digital cognitive screen on an ARU.</div></div><div><h3>Design</h3><div>Retrospective cross-sectional design.</div></div><div><h3>Setting</h3><div>Acute Rehabilitation Unit at a free-standing, 138-bed inpatient medical rehabilitation hospital.</div></div><div><h3>Participants</h3><div>Hospital records from 32 patients were identified wherein individuals completed the BOCA and Montreal Cognitive Assessment (MoCA). Admission diagnoses included neurological and nonneurological injuries.</div></div><div><h3>Interventions</h3><div>The BOCA and MoCA test administration were 10 and 15 minutes, respectively. BOCA Total Score and individual subtest scores were examined, along with demographic and clinical variables. Exploratory factor analysis, internal consistency, concurrent validity, and known-group validity were examined.</div></div><div><h3>Main Outcome Measures</h3><div>The BOCA is a computerized, self-administered measure of global cognition (Gold et al., 2021; Vyshedskiy et al., 2022) and evaluates immediate recall, delayed recall, language reasoning, visuospatial reasoning, executive functioning, attention, mental math, and orientation. The MoCA is a paper-and-pencil screening instrument for cognition (Nasreddine, 2005) and evaluates wordlist recall, visuospatial and executive functions, language, attention, and orientation. For both measures, the maximum score is 30; lower scores reflect greater cognitive difficulties.</div></div><div><h3>Results</h3><div>Average age was 59.13 years (SD, 16.49y; range, 25-85y). Average years of education was 14.9 years (SD, 3.46y). Average BOCA total score was 25.13 (SD, 4.46) and average MoCA total score was 23.44 (SD, 4.59). Similar to studies of outpatients, the BOCA demonstrated a unitary factor structure accounting for a plurality of the variance, adequate internal consistency (<em>a</em>=0.73), and strong concurrent validity with the MoCA (<em>r</em>=0.57; <em>P</em>=.003). This study explored differences in BOCA performance among those admitted with primary brain injuries compared with those admitted for nonneurologic conditions. Those admitted to the ARU with brain injuries scored significantly lower than those admitted for nonneurological etiologies (<em>U</em>=67.50, <em>P</em>=.025).</div></div><div><h3>Conclusions</h3><div>There is increasing need to access novel and efficient cognitive screening tools within an inpatient rehabilitation setting. This study provides initial evidence that the BOCA maintains similar factor structure, reliability, and validity in inpatient samples compared with what has been observed in outpatient samples. These findings provide preliminary support for deploying the BOCA in inpatient settings. The BOCA is a useful screening instrument for assessing ","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e32"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"NIDILRR ARRT: Intersecting Marginalized Identities Among People with Disabilities: Impact on Access to Employment Support Resources and Employment Outcomes","authors":"Suyoung Kwon,&nbsp;Ivan R. Molton","doi":"10.1016/j.apmr.2025.01.006","DOIUrl":"10.1016/j.apmr.2025.01.006","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine if demographic factors impact the disparity of resources supporting employment (RSE) and employment among people with disabilities (PWD).</div></div><div><h3>Design</h3><div>Prospective cohort study with a 2-year follow-up.</div></div><div><h3>Setting</h3><div>A nationwide disability research registry at the University of Washington used convenience sampling to recruit community-dwelling individuals with multiple sclerosis, muscular dystrophy, spinal cord injury, or postpolio syndrome, resulting in a sample size of over 2000 individuals from 2009 to 2017.</div></div><div><h3>Participants</h3><div>This study comprised 920 working-age individuals from 2014 to 2017, with more non-Hispanic White participants (86%) than Black, Indigenous, and People of Color.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>RSE (unawareness and level of availability, score range, 0-15) was assessed using 3 questions from the environmental item bank, covering disability accommodation, job placement and training, as well as information on work and volunteer opportunities. Additionally, participants’ employment status (employed and working hours for pay) was determined by their reported weekly hours worked for pay.</div></div><div><h3>Results</h3><div>PWD who belong to marginalized groups based on race, sex, age, education, and household income reported lower access to RSE and worse employment outcomes. One point higher in RSE was associated with lower unemployment (odds ratio, 0.61; 95% confidence interval, 0.46-0.81) after adjusting for confounding variables and demographics. Significant interactions on employment were found between RSE and education, as well as between RSE and household income. The impact of RSE on employment status was more substantial for PWD with a bachelor's degree or high household income compared with their counterparts with a high-school education or lower and those with low household income.</div></div><div><h3>Conclusions</h3><div>Results suggest that marginalized PWD have less access to RSE, and this inequality directly affects subsequent employment rates, particularly PWD with lower education and household income. Ensuring equitable job opportunities requires increased allocation of RSE for marginalized PWD.</div></div><div><h3>Disclosures</h3><div>none. The contents of this report were developed under a grant from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant number H133B130018). National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this report do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e2"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761089","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":"Living Longer and Stronger with SCI: Using Participatory Research to Develop an Online Group Health Promotion Program for People Aging with SCI 1144","authors":"Susan Robinson-Whelen,&nbsp;Rosemary Hughes,&nbsp;Diana Gonzalez,&nbsp;Linda Norah-Davis,&nbsp;Garett Parrish,&nbsp;Heather Taylor","doi":"10.1016/j.apmr.2025.01.036","DOIUrl":"10.1016/j.apmr.2025.01.036","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To develop and beta-test an online group health promotion program for people aging with spinal cord injury (SCI) in preparation for a national randomized controlled trial.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;People with SCI participated in a beta-test of the intervention to provide feedback on acceptability and ways to improve the program.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;The group program was implemented online via Zoom.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Meeting the same criteria to be used in the full trial, the 6 beta-testers were community-residing adults with SCI who were either 45+ years of age or had been living with their SCI for 15+ years. Beta-testers were diverse in terms of gender, race/ethnicity, level of injury, and geographic location.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;The investigators partnered closely with community advisors with SCI and a multidisciplinary medical advisory board to develop the Living Longer and Stronger with SCI program. The 8-session program, cofacilitated by a person with SCI and a coinvestigator, addresses physical and psychosocial health of people aging with SCI. Community advisors and the multidisciplinary team codeveloped and reviewed each session to assure relevance, usability, and sensitivity for people with SCI. Sessions included educational content, group discussion, action planning, and relaxation exercises. The team developed intervention materials including PowerPoints, a Participant Handbook, and a detailed Facilitator Manual.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Beta-testers completed brief evaluation surveys after each session. At the end of the program, they were asked to rate, on a 5-point scale, the program overall and the extent to which each aspect of the program (content, discussion, action planning, relaxation exercises, participant handbook) was helpful. They also responded to open-ended questions asking for suggestions for improving the program overall, the program materials, and the Zoom platform. They were also invited to share additional comments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The Living Longer and Stronger with SCI program was well received. All 6 beta-testers (100%) rated the program overall as excellent. The majority rated all aspects of the program as helpful: content (100% “very” helpful), discussion (100% “very” helpful), action planning (83% “very,” 17% “somewhat” helpful), relaxation (33% “very,” 50% “somewhat,” 17% “undecided”), and participant handbook (66% “very,” 17% “somewhat,” 17% “undecided”). Although open-ended responses were positive, a few beta-testers suggested more time for group interaction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Participatory research methods were successful in the development and review of the Living Longer and Stronger with SCI program. Beta-test results were positive and provided additional suggestions that will be used to improve the program prior to the randomized con","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e14"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761187","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":"Abnormal Prefrontal Functional Network in Adult Obstructive Sleep Apnea – A Resting-state fNIRS Study","authors":"Hao (Howe) Liu,&nbsp;Yasser Salem,&nbsp;Rachel Wellons,&nbsp;Mingming Zhao","doi":"10.1016/j.apmr.2025.01.063","DOIUrl":"10.1016/j.apmr.2025.01.063","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate prefrontal brain network abnormality in adult with obstructive sleep apnea (OSA) based on resting-state functional near-infrared spectroscopy (rs-fNIRS).</div></div><div><h3>Design</h3><div>This was a cross-sectional study.</div></div><div><h3>Setting</h3><div>In a general hospital setting.</div></div><div><h3>Participants</h3><div>Fifty-two subjects, including 27 with OSA and 25 healthy controls (HC) were recruited PSG monitored apnea-hypopnea index (AHI) ≥5 times/h, accompanied by daytime sleepiness and other symptoms. All participants in both groups were right-handed, had no history of nervous system or mental illnesses (including brain trauma), and had not taken psychotropic drugs or consumed substances such as sleeping pills, alcohol, or coffee within 24 hours before the examination.</div></div><div><h3>Interventions</h3><div>Assessment of a 3-minute resting-state prefrontal cortex (PFC) activity with the fNIRS technique. Only the oxygenated hemoglobin (HbO₂) signal was used to calculate resting-state functional connectivity (RSFC) and construct a brain connection network.</div></div><div><h3>Main Outcome Measures</h3><div>The differences between the patients with OSA and HC group were compared in connection edge number and graph-based indicators. The correlation between these network indicators and also the cognitive performance were also calculated.</div></div><div><h3>Results</h3><div>Compared with the HC group, patients with OSA showed widely decreased connection edge number, especially in the connection between the right medial frontal cortex (MFG-R) and other right-hemisphere regions. Graph-based analysis revealed that patients with OSA had lower global efficiency, local efficiency, and clustering coefficient than the HC group. Further, both of connection edge number and graph-based indicators were significantly positive correlation with the Montreal Cognitive Assessment score in patients with OSA.</div></div><div><h3>Conclusions</h3><div>This study suggests that the prefrontal brain network may be impaired in patients with OSA and that this impairment is associated with cognitive performance, as measured by rs-fNIRS. These findings provide initial evidence that prefrontal rs-fNIRS could be a useful and powerful tool for objectively and quantitatively assessing cognitive function impairment in patients with OSA.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e25"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761216","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":"“HIST at HOME”: Care Partner–Assisted High-Intensity Stepping Training at Home After Stroke","authors":"Julia Karsten,&nbsp;Toni Ann Polsinelli","doi":"10.1016/j.apmr.2025.01.062","DOIUrl":"10.1016/j.apmr.2025.01.062","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the feasibility of patients participating in a care partner–assisted high-intensity stepping (HIST) program in the home after discharge from inpatient rehabilitation (IR) and describe factors that may influence successful adherence.</div></div><div><h3>Design</h3><div>Participants with stroke who successfully performed HIST at 60%-85% of their heart rate reserve (HRR) or rate of perceived exertion (RPE) of 15-17 for at least 24 minutes, 5 days per week in IR were included. The participants had a care partner who was able to monitor their heart rate or RPE at home and demonstrated the ability to safely assist in HIST in IR. The patient and care partner underwent hands-on training sessions for implementing the program while in IR. Patients and their care partner were given written instructions and a tracking calendar. The participants were asked to track exercise intensity and number of minutes exercised per day at home. Follow-up emails were sent to participants to retrieve the calendar 1-month post DC.</div></div><div><h3>Setting</h3><div>Supervised physical therapy in IR and care partner assisted exercise at home.</div></div><div><h3>Participants</h3><div>Preliminary results include N=3 persons after acute stroke in IR, discharging to home with care partner support.</div></div><div><h3>Interventions</h3><div>Care partners and participants underwent hands-on training for administration of the home-based program before DC home. “HIST at HOME” consists of participants engaging in walking training at 60%-85% of HRR or RPE of 15-17, for at least 24 minutes, 5 days per week with supervision of trained care partner.</div></div><div><h3>Main Outcome Measures</h3><div>Number of minutes participants walked at the recommended target intensity, number of days exercised, and reports of adverse reactions to the program were tracked.</div></div><div><h3>Results</h3><div>All patients reported adherence to the recommended program for 1 month after DC. All patients reached the target intensity during walking training at least 5 days per week with supervision of a care partner. No adverse responses were noted.</div></div><div><h3>Conclusions</h3><div>All patients demonstrated adherence to “HIST at home” with the assistance of a care partner without adverse reactions. Factors including having care partner support, a therapist providing training, and having a 1-month follow-up may have a positive influence on adherence.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e24"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761291","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":"Promotion of Poststroke Upper Extremity Usage: A Comparison of Commercial Fitness Trackers and a Research-grade Accelerometer","authors":"Yi-An Chen,&nbsp;Alaina Nickerl,&nbsp;Ella Atkinson,&nbsp;Annie Solomon","doi":"10.1016/j.apmr.2025.01.081","DOIUrl":"10.1016/j.apmr.2025.01.081","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To compare commercial fitness trackers and the “gold standard” research-grade accelerometer in regards to accurately quantifying upper extremity movements. To assess the feasibility of commercial fitness trackers in both clinical settings and natural, uncontrolled environments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;In this observational study, participants were recruited to engage in a 2-hour initial visit, followed by a 3-day home monitoring period, and brief follow-up visit with an exit interview. Participants were asked to wear 3 sensors (ActiGraph, Fitbit, and Apple Watch) in a sleeve on both forearms. During the initial visit, participants performed activities of daily living (eg, dressing, typing, walking) in a laboratory environment.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Both laboratory and home environments were study settings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Thirty healthy participants and 10 stroke participants were recruited for this study. Stroke participants were required to be right-side affected, right-hand dominant, and community-dwelling in order to be included in the study. Healthy participants were required to be ≥50 years and also community-dwelling.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;The intervention in this study was use of commercial fitness trackers and a research-grade accelerometer to measure upper extremity movements. For the home monitoring period, sensors are worn in sleeves for 3 days, with the exception of sleeping and showering.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;The main outcome measures used for Apple and Fitbit were step counts and active minutes. Step count assesses the changes in acceleration direction, or up and down movements of the UE. Active minutes is a combined measurement of the duration and intensity of an activity. The outcome measures for ActiGraph are time (duration in activity counts) and magnitude (intensity). Data from ActiGraph is preprocessed through ActiLife and further analyzed via a custom-written MATLAB program based on validated methods.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Preliminary analysis showed that the sensitivity of the commercial sensors varies across activities. During the fine motor activities (eg, using iPad), although ActiGraph indicated consistent small movements, Fitbit and Apple Watch showed limited changes. In other gross activities (eg, folding towels), Fitbit and Apple Watch estimated 60%-70% of the hand-use movements captured in ActiGraph.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Further analysis using correlations and regressions will be conducted to demonstrate the relationship between commercial and research-grade sensors in stroke. We expect to establish algorithms to transform commercial data to directly indicate daily hand use. The results may suggest an alternative for clinical use to allow clinicians and patients to utilize low-cost, widely used commercial sensors to understand and promote hand use in ","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Pages e31-e32"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761311","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":"Toward a Sex-positive View of Sexuality After Spinal Cord Injury: A Qualitative Metasynthesis 0416","authors":"Roxanna Pebdani,&nbsp;Marita Heck,&nbsp;Blaze Ireland,&nbsp;Asmita Mudholkar,&nbsp;Michele Verdonck","doi":"10.1016/j.apmr.2025.01.010","DOIUrl":"10.1016/j.apmr.2025.01.010","url":null,"abstract":"<div><h3>Objective(s)</h3><div>To explore facilitators of sexuality for people with spinal cord injury (SCI) using a strengths-based and sex-positive approach, we conducted a systematic review and qualitative metasynthesis of qualitative studies.</div></div><div><h3>Data Sources</h3><div>A systematic search of 6 online databases (Web of Science, Scopus, PubMed, PsycINFO, MEDLINE, Embase) was conducted by 5 authors. Search terms were organized using the PICo Framework and were developed with the support of an academic librarian. Search terms included: Population: “spinal cord injur*” OR “spinal injur*” OR “spinal cord” OR “spinal cord trauma” OR “spinal cord lesion” OR quadriplegi* OR paraplegi* OR tetraplegi*; Interest: sex* OR sexual* OR sensual* OR intimate OR intimacy; Context: qualitative OR “focus group” OR “grounded theory” OR interview* OR ethnography OR phenomenology OR phenomenological OR experience. Papers were included if they: focused on sexuality/intimacy, included participants with SCI, were qualitative (including interviews and focus groups), were in English, were peer-reviewed, and their qualitative findings were clearly articulated. They were excluded if they were quantitative or mixed methods, if the researchers were unable to parse out the voice of the participants with SCI, full text was not available, or were thesis or gray literature.</div></div><div><h3>Study Selection</h3><div>Studies were imported into Covidence Systematic Review Software for screening and each paper was screened at every point by at least 2 authors. A systematic search of 6 databases found 3655 articles about sexuality and SCI. Title and abstract screening narrowed these down to 144 for full-text screening, further narrowed to 33 articles to be analyzed using thematic synthesis.</div></div><div><h3>Data Extraction</h3><div>Data were extracted into NVIVO for coding and thematic synthesis. All papers were comparatively coded by at least 2 authors. Paper quality was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research.</div></div><div><h3>Data Synthesis</h3><div>Codes were then grouped into descriptive themes by 4 authors. Themes were iteratively discussed and reassessed by the entire research team, to develop analytical themes.</div></div><div><h3>Conclusions</h3><div>The 6 analytical themes addressing facilitators for sexuality post-SCI included: an evolving understanding of sexuality, new and other ways of sexual expression, being sexually active, access to appropriate resources, having the right partner, and establishing a sexual self. These will be discussed in-depth in our presentation and published in an upcoming journal article. The results of this study use a novel lens of sex-positivity to analyze the results of 33 qualitative papers on sexuality and SCI. Results can be used to inform clinical practice and future sex-positive research.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Pages e3-e4"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143760976","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":"Lessons Learned: Counseling and Peer Support for Individuals with Spinal Cord Injury 4362","authors":"Sue Ann Sisto","doi":"10.1016/j.apmr.2025.01.035","DOIUrl":"10.1016/j.apmr.2025.01.035","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To understand the background of counseling and peer support. To describe how a program of counseling and peer support was and can be established. To learn barriers and facilitators in implementation of a counseling and peer support program. To summarize lessons learned on implementing a counseling and peer support program.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Longitudinal descriptive qualitative study of reports of the participants who were enrolled in the study over the course of 6 weeks.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Fitness and Wellness Facility for Spinal Cord Injury Rehabilitation and Recovery.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Nine participants with spinal cord injury (SCI) volunteered for the study. All participants alternated between individual and group counseling sessions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;First a focus group was established of 9 people with SCI in the community who guided the dosage and direction of the topic list needed to lead the counseling sessions. The counselors were social workers who had SCIs and were active in the planning and implement and the planning of the study. Participants were followed for 6 weeks, alternating between individual and group gatherings. The topic list provided ranged from transportation, sex, relationships and more. There were guiding questions began the discussion, which were modified based on the participants’ responses. A qualitative analysis was performed on the notes assembled for all participants (n=9). Program feedback was provided by social workers.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Qualitative summaries over the 6 weeks for all participants and program evaluation review.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Participants found the in-person meetings useful and wished the program would continue indefinitely. All participants found the group sessions most helpful and reported beneficial engagement with other participants. Several participants who had transportation or health challenges, who were offered a virtual option to continue their participation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;A counseling support program could be generated in most clinical settings with the appropriate expertise such as Social Work or Psychology and is most beneficial in a community setting. This allows individuals with SCI to describe barriers or challenges that could enable a rich discussion and a sharing of possible solutions. It is important that the content of these discussions remain private and only deidentified key issues were available for this analysis. The word “counseling” had a negative connotation so other less imposing terms should be considered. Challenges included the time needed to on-board the counselors into the HR system to be paid, and recruitment/retention, however the virtual option was desirable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Disclosures&lt;/h3&gt;&lt;div&gt;I am the PI on the Perry Grant that funded this study and a Board Membe","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Pages e13-e14"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761186","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":"Integrative, Mindfulness, Compassion, and Somatic Approach to Treatment of Chronic Pain and Posttraumatic Stress Disorder Among Military Populations with Brain Injury: A Case Series","authors":"Esther Estey,&nbsp;Carey Pawlowski,&nbsp;Esther Estey","doi":"10.1016/j.apmr.2025.01.074","DOIUrl":"10.1016/j.apmr.2025.01.074","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;Military service populations with traumatic brain injury (TBI) report high levels of chronic pain (CP) and posttraumatic stress disorder (PTSD). These comorbid conditions severely impact physical and social functioning, identity, cognition, mood, and performance. Evidence supports the inclusion of mindfulness and compassion in cognitive treatment of co-occurring CP and PTSD, and has also shown positive outcomes from somatosensory approaches targeting this relationship (eg, greater nervous system regulation and embodiment, decreased symptomology). Mental skills training and sport enhancement may enhance these models by promoting enhanced resilience, performance, and strategies for managing the challenges inherent to these conditions. To date, there are no body-centered treatment frameworks that integrate these modalities to target comorbidity among rehabilitation populations. This is the first investigation to examine an integrated clinical model for military service members with TBI and co-occurring CP and PTSD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A case series featuring mixed methods with pre-post intervention measures and qualitative responses.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;An intensive postacute brain injury inpatient rehabilitation program within a veterans affairs hospital that provides service to active-duty military members.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Male special operations forces service members (N=3) with TBI, CP, PTSD, other comorbid psychiatric disorders, and neurobehavioral symptoms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Treatment consisted of 3 weeks of 1-hour, 2 × a week acceptance and commitment as well as cognitive behavioral psychotherapy sessions, mindfulness and meditation, self-compassion practices, sport psychology psychoeducation, performance coaching, somatic exercises, mindful movement, experiential practices, and homework.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Participants completed the GAD-7, PHQ-9, PCL-5, Headache Management and Self-Efficacy Scale, Migraine Disability Assessment, and Neurobehavioral Symptom Inventory. Acceptability and usability were also assessed via open-ended questions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Participants reported significant decreases in anxiety, depression, PTSD, and neurobehavioral symptoms. They also reported increased, significant ability to manage pain and greater self-efficacy. Results on migraine disability were mixed. Positive changes such as relating more adaptively to self and symptoms, increased self-mastery, and sense of competency in the face of stress were reported.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;To our awareness, this is the first evidence to support initial efficacy and acceptability of an individualized, integrative treatment framework for co-occurring PTSD and CP among active-duty service members with TBI. Results are an innovative contribution to the literature, highlighting the possible","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e29"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761193","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":"AssistKey: Efficient Operation & Mode Selection of a Wheelchair-mounted Assistive Robot","authors":"Asif Al Zubayer Swapnil,&nbsp;Md Ishrak Islam Zarif,&nbsp;Md Samiul Haque Sunny,&nbsp;Md Mahafuzur Rahaman Khan,&nbsp;Nayan Banik,&nbsp;Sheikh Iqbal Ahamed,&nbsp;Inga Wang,&nbsp;Mohammad Rahman","doi":"10.1016/j.apmr.2025.01.064","DOIUrl":"10.1016/j.apmr.2025.01.064","url":null,"abstract":"<div><h3>Objectives</h3><div>We have developed AssistKey, which incorporates mode control and operation functions in a compact 8-key input device in which the key operations can be switched between different motion commands of a 6 degrees of freedom assistive robotic arm and a gripper and an efficient method of switching between the function mode of each key. AssistKey aims to enable complex operations of an assistive robot within the limited activity range of a single finger, improving the user's ease and capability of performing activities of daily living (ADLs) with the help of a wheelchair-mounted assistive robot.</div></div><div><h3>Design</h3><div>Experimental study.</div></div><div><h3>Setting</h3><div>In the BioRobotics Laboratory.</div></div><div><h3>Participants</h3><div>We conducted experiments with 6 healthy individuals (age, 25-45y; weights, 140-180lb; height, 1.5-1.85m) to manipulate a wheelchair-mounted assistive robot with the AssistKey to perform ADL tasks.</div></div><div><h3>Interventions</h3><div>Participants are seated in a powered wheelchair. The multifunctional robotic assistive arm (mR2A) was mounted on the wheelchair. Participants used the AssistKey to control mR2A performing ADLs, such as picking/placing and manipulating objects in identified workspaces.</div></div><div><h3>Main Outcome Measures</h3><div>The study focused on assessing improvements in user's ease and capability of controlling the assistive robot using AssistKey in contrast of using the wheelchair joystick for robot operations. User's ease of switching between different directions of motion, and rate of error of user input for desired motion is used as the performance metric.</div></div><div><h3>Results</h3><div>Preliminary findings suggest that the intuitive design of the 8-key input device allowed users to efficiently switch between different modes and control the multifunctional robotic assistive arm (mR2A) with ease. However, the proximity of the keys on AssistKey may pose difficulties in accurately pressing individual buttons, and combined button presses, intended for more complex operations, were particularly challenging for individuals with limited fine motor skills.</div></div><div><h3>Conclusions</h3><div>The AssistKey's seamless functions enhance ADL performance, but its design needs refining for users with diverse motor skills. Future versions should focus on ergonomic improvements and adaptive technologies to ease button use and manage complex operations. By resolving these issues, AssistKey could better serve a broader disability spectrum, enhancing user independence and quality of life.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e25"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761217","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}