Archives of physical medicine and rehabilitation最新文献

{"title":"Does Terminology Matter? Perspectives From People With Limb Difference, Clinicians, and Researchers","authors":"M.G. Finco PhD, CPO, MS ,&nbsp;Cody L. McDonald PhD, CPO, MPH ,&nbsp;Sarah C. Moudy PhD, MSc","doi":"10.1016/j.apmr.2024.07.019","DOIUrl":"10.1016/j.apmr.2024.07.019","url":null,"abstract":"<div><h3>Objective</h3><div>To elicit the preferred terminology among people with limb difference as well as health care and/or research professionals.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Setting</h3><div>Online.</div></div><div><h3>Participants</h3><div>A convenience sample of N=122 individuals (people with limb difference, n=65; health care and/or research professionals, n=57) completed an online survey. People were included if they (1) were aged ≥18 years; (2) self-identified as having limb difference (regardless of etiology) or as a health care or research professional (with experience working with people with limb difference); and (3) lived in the United States for most of the time in their selected role.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Importance of terminology, preference toward person-first or identity-first terms, preferred terms, and individual perspectives on terminology preferences.</div></div><div><h3>Results</h3><div>Most participants identified as White (92.6%). Age significantly differed between groups (people with limb difference, 49.9±15.4y; professionals, 41.0±14.3y; <em>P</em>=.001). Approximately 50% of people with limb difference stated terminology was very or extremely important, compared to 70% of professionals (<em>χ²</em>=16.6, <em>P</em>=.002). While 73.7% of professionals reported a preference for person-first terminology, the sample of people with limb difference were more evenly split, as 42.9% reported a preference for identity-first terminology and 50.8% reported a preference for person-first terminology. The most frequently selected limb and population terms, respectively, were <em>residual limb</em> and <em>individual/person with limb difference</em>; however, many people with limb difference indicated they preferred “amputee” when speaking about a population.</div></div><div><h3>Conclusions</h3><div>Most of the participants indicated terminology was very or extremely important, and both groups tended to prefer the terms residual limb (limb term) and individual/person with limb difference (population term). However, this study was not intended to recommend terminology, but rather help inform terminology choices that are centered around people with limb difference. Individuality and context should be considered when deciding terminology. Future studies should include more participants from racially/ethnically minoritized groups and people with limb difference who have dysvascular and/or congenital etiologies.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 26-36"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987324","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":"Model of Care for Chronic Brain Injury","authors":"John D. Corrigan PhD ,&nbsp;Flora M. Hammond MD ,&nbsp;Angelle M. Sander PhD ,&nbsp;Kurt Kroenke MD","doi":"10.1016/j.apmr.2024.08.001","DOIUrl":"10.1016/j.apmr.2024.08.001","url":null,"abstract":"<div><div>There is growing evidence that long-term outcomes after traumatic brain injury (TBI) are more dynamic than stable. People continue to change, both improving and declining, many years postinjury. Research, practice, and medical education have not yet fully embraced the implications of TBI as a chronic, dynamic condition. In 2020, the National Institute on Disability Independent Living and Rehabilitation Research funded the BeHEALTHY project to develop a model for long-term support of persons with chronic brain injury. Based on initial reviews of the available evidence and expert input from researchers, clinicians, and persons with lived experience, the BeHEALTHY model was proposed. Among existing chronic disease treatment models, Wagner's Chronic Care Model was selected as a starting point, with several critical refinements. The BeHEALTHY model endorses a person-centered approach, recognizing the individual with brain injury, and their social support system, as the primary source of goals in care planning. The model also acknowledges the critical importance of <em>self</em>-management and the need for health care programs to actively promote self-direction by the person using their social supports. The model also recognizes that outcomes are not determined solely by the person and the injury incurred but also by the environment in which a person lives and recovers. The importance of integrating health care with community resources is underscored by embracing environmental influences as a shared responsibility of the community and the health care system. This article recounts the impetus for developing the BeHEALTHY model and describes those it is intended to serve and its structural features and core components.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 145-149"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999372","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":"A Directed Content Analysis for Greatest Problems Among People With and Without Traumatic Brain Injury","authors":"Emily Dudek BS ,&nbsp;Michael W. Williams PhD ,&nbsp;Chung Lin (Novelle) Kew PhD ,&nbsp;Annalyn DeMello PhD, MPH, RN ,&nbsp;Brittany Wright PhD ,&nbsp;Alexandra B. Holland LMSW ,&nbsp;Alyssa Day-Gorman MA ,&nbsp;Alexa S. Gonzalez MS ,&nbsp;Luis Leon Novelo PhD ,&nbsp;Xiangyi Liu MS ,&nbsp;Shannon B. Juengst PhD, CRC","doi":"10.1016/j.apmr.2024.08.008","DOIUrl":"10.1016/j.apmr.2024.08.008","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the greatest problem or need among individuals with a history of traumatic brain injury (TBI), as compared with individuals with a history of other neurologic conditions, mental health conditions, and no history of neurologic or mental health conditions.</div></div><div><h3>Design</h3><div>A directed content analysis of open-text responses to a single online survey question using a framework guided by the Mayo-Portland Adaptability Inventory-4.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>A total of 2861 community-dwelling adults (n=274 with TBI; n=289 with other neurologic conditions besides TBI; n=454 with mental health conditions but no neurologic conditions; and n=1844 controls).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Open-text responses to the survey prompt: “<em>What was your greatest problem or need over the past 2 weeks?</em>”</div></div><div><h3>Results</h3><div>The Participation index comprised the greatest proportion of responses across all 4 participant groups. A quarter (25.4%) of controls reported None (no problem/need), whereas only 7.9%-10.7% of participants in all other groups reported None. Among all groups, individuals with TBI reported the greatest proportion of problems in the Adjustment and Ability indices. Among people with TBI, Money Management (19.7%), None (10.6%), and Anxiety (7.7%) were the 3 most frequently reported problems. Compared with individuals with mild TBI (mTBI), individuals with moderate-to-severe TBI (msTBI) reported a higher proportion of problems in the Ability and Adjustment indices. Among individuals with msTBI, the Adjustment index accounted for the greatest proportion of problems.</div></div><div><h3>Conclusions</h3><div>This study employed a person-centered approach to understanding the greatest needs among individuals with TBI. Qualitative differences were observed between individuals with and without TBI, between people with mTBI and msTBI, and across genders among people with TBI. These findings can help guide research and policy toward addressing challenges perceived as highly important by people living in the community with TBI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 42-50"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071882","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":"Mixed-Method Evaluation to Understand Clinician Perspectives of a Program to Implement High-Intensity Resistance Rehabilitation Into Skilled Nursing Facilities","authors":"Lauren A. Hinrichs-Kinney PT, DPT, PhD, OCS ,&nbsp;Janell Pisegna PhD, OTR/L, CSRS ,&nbsp;Mattie E. Pontiff PT, DPT, PhD, OCS ,&nbsp;Emma H. Beisheim-Ryan PT, DPT, PhD ,&nbsp;Rebecca Altic PT, DPT ,&nbsp;Heather Coats PhD, APRN-BC ,&nbsp;Jennifer E. Stevens-Lapsley PT, PhD, FAPTA","doi":"10.1016/j.apmr.2024.09.006","DOIUrl":"10.1016/j.apmr.2024.09.006","url":null,"abstract":"<div><h3>Objective</h3><div>To assess rehabilitation clinicians’ viewpoints regarding a multicomponent implementation program aimed at promoting high-intensity resistance rehabilitation (HIR), as well as practical implications for its use in skilled nursing facility (SNF) rehabilitation.</div></div><div><h3>Design</h3><div>Prospective convergent mixed-method design.</div></div><div><h3>Setting</h3><div>Eight rural SNFs within the Department of Veterans Affairs.</div></div><div><h3>Participants</h3><div>Physical rehabilitation clinicians (physical and occupational therapists, physical and occupational therapy assistants, recreational therapists, and kinesiotherapists) who engaged with the implementation program (n=38).</div></div><div><h3>Interventions</h3><div>Clinicians engaged with the multicomponent implementation program to promote the use of HIR in clinical practice. The program components included clinician training (i.e., virtual didactic modules with synchronous case discussions), provision of resources (e.g., equipment, job aids), and facilitated implementation (e.g., external implementation facilitator support, distributed tips and tricks).</div></div><div><h3>Main Outcome Measures</h3><div>Acceptability of Intervention Measure, Training Acceptability Rating Scale, study-specific questionnaires, and qualitative focus groups exploring perceived acceptability, feasibility, and effect on work experience.</div></div><div><h3>Results</h3><div>Questionnaires revealed high levels of implementation program acceptability and perceived effect, alongside moderate levels of feasibility. Focus group themes supported these findings, explaining high acceptability and effect through differentiation from other trainings and prolonged engagement. Feasibility results were explained qualitatively by facilitatory factors (i.e., team participation, reduced caseloads, training characteristics) and inhibitory factors (i.e., training timing, self-paced scheduling logistics, lack of protected time and space). There was no reported negative effect on clinician work experience.</div></div><div><h3>Conclusions</h3><div>According to SNF clinician perspectives, a positive HIR implementation experience may be enhanced through implementation programs that provide prolonged engagement and a self-paced structure with built-in accountability. Leadership and organizational support appear important to protect time and space for clinicians who experience competing priorities to successfully facilitate evidence uptake. Future work can evaluate the applicability across various contexts beyond rural VA SNFs.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 61-73"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340036","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":"Influence of Aerobic Exercise on Functional Capacity and Maximal Oxygen Uptake in Patients With Parkinson Disease: A Systematic Review and Meta-analysis","authors":"Ricardo Augusto Barbieri PhD ,&nbsp;Fabio Augusto Barbieri PhD ,&nbsp;Nicolle Zelada-Astudillo MSc ,&nbsp;Vinicius Christianini Moreno MSc ,&nbsp;Carlos Augusto Kalva-Filho PhD ,&nbsp;Antonio Roberto Zamunér PhD","doi":"10.1016/j.apmr.2024.09.013","DOIUrl":"10.1016/j.apmr.2024.09.013","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the effects of aerobic training in randomized controlled clinical trials on functional capacity, motor symptoms, and oxygen consumption in individuals with Parkinson disease (PD) through a systematic literature review and meta-analysis.</div></div><div><h3>Data Sources</h3><div>PUBMED, Web of Science, CINAHL, SciELO, and Medline databases were searched to identify published studies until September 2023.</div></div><div><h3>Study Selection</h3><div>Randomized controlled clinical trials that evaluated the long-term effect of aerobic exercise in individuals with PD were included.</div></div><div><h3>Data Extraction</h3><div>Two independent reviewers extracted the data and assessed the risk of bias and the Grading of Recommendation Assessment, Development, and Evaluation. In case of disagreement, a third reviewer was consulted.</div></div><div><h3>Data Synthesis</h3><div>Thirteen studies were included in the systematic review, and the number of participants was 588 with an average age of 66.2 years (57-73y). The study's exercise intervention lasted between 6 and 70 weeks, with most studies lasting 10-12 weeks, with 3 sessions per week and an average duration of 47 minutes per session. The meta-analysis revealed that aerobic exercise is effective in enhancing maximal oxygen uptake (standardized mean difference, SMD 0.42 [95% CI, 0.18, 0.66; <em>P</em>=.0007]) and functional capacity (SMD 0.48 [95% CI, 0.24−0.71; <em>P&lt;</em>.0001]). In addition, aerobic exercise can reduce the motor-unified Parkinson disease rating scale (mean difference−2.48 [95% CI, −3.16 to −1.81; <em>P&lt;</em>.00001]) score in individuals with PD.</div></div><div><h3>Conclusions</h3><div>Aerobic exercise training conducted 2-3 times a week, with different intensities (low to high), can be an effective intervention for enhancing functional capacity, maximizing oxygen uptake, and reducing the UPDRS scores in individuals with PD.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 134-144"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387471","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":"Individualized Versus General Exercise Therapy in People With Subacromial Pain Syndrome: A Randomized Controlled Trial","authors":"Ghazaleh Momeni MSc ,&nbsp;Abbas Tabatabaei PhD ,&nbsp;Mehrnaz Kajbafvala PhD ,&nbsp;Morteza Nakhaei Amroodi ,&nbsp;Lincoln Blandford MRes","doi":"10.1016/j.apmr.2024.08.027","DOIUrl":"10.1016/j.apmr.2024.08.027","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity, and disability in subjects with chronic subacromial pain syndrome (SAPS).</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Rehabilitation clinics.</div></div><div><h3>Participants</h3><div>Thirty-eight participants with chronic SAPS (mean [SD] age, 52.23 (8.47); 60 % women).</div></div><div><h3>Interventions</h3><div>The participants were randomly allocated to 1 of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for 4 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).</div></div><div><h3>Results</h3><div>Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean, 9.17; 95% confidence interval; 0.31-18.03; <em>P</em>=.04), with a large effect size (0.68). The reduction of PAR remained significantly lower in the intervention group than in the control group after 4 months of follow-up (mean, 18.29; 95% confidence intervals [CI], 9.09-27.48; <em>P</em>&lt;.00) with a large effect size (1.27). Disability significantly decreased at 2-month (mean, 14.58, <em>P</em>=.002 on SPADI index; mean, 10.26, <em>P</em>=.006 on DASH index) and 4-month (mean, 19.85, <em>P&lt;</em>.001 on SPADI index; mean, 12.09, <em>P</em>=.001 on DASH index) follow-ups in the intervention group compared to the control group.</div></div><div><h3>Conclusion</h3><div>Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 1-13"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456801","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":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(24)01375-3","DOIUrl":"10.1016/S0003-9993(24)01375-3","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Page A4"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129759","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":"A Role for Health Literacy in Protecting People With Limited English Proficiency Against Falling: A Retrospective, Cohort Study","authors":"Natalie F. Douglas PhD, CCC-SLP ,&nbsp;Sarah E. Wallace PhD, CCC-SLP, ASHA Fellow ,&nbsp;Chin-I Cheng PhD ,&nbsp;Nancy Christensen Mayer MBA/HSA, CCC-SLP ,&nbsp;Ellen Hickey PhD, SLP-Reg. (NS), CCC-SLP ,&nbsp;Kate Minick PT, DPT, PhD","doi":"10.1016/j.apmr.2024.08.011","DOIUrl":"10.1016/j.apmr.2024.08.011","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors related to falls within the scope of speech-language pathology (SLP) using assessments from the Inpatient Rehabilitation Facility-Patient Assessment Instrument over a 4-month period in 4 inpatient rehabilitation facilities (IRFs).</div></div><div><h3>Design</h3><div>Observational retrospective cohort study.</div></div><div><h3>Setting</h3><div>Four IRFs as part of a larger learning health system.</div></div><div><h3>Participants</h3><div>Adults aged ≥18 years admitted to the IRFs from October 1, 2022 to February 28, 2023 were included.</div></div><div><h3>Intervention</h3><div>N/A.</div></div><div><h3>Main Outcome Measures</h3><div>Occurrence of falls.</div></div><div><h3>Results</h3><div>Analyses of 631 patient records revealed that the odds of falling were almost 3 times greater in people with limited English proficiency than in English speakers (odds ratio [OR], 2.92; 95% confidence interval [CI], 1.09-6.85). People with limited English proficiency who reported poorer health literacy had 4 times higher odds of falling (OR, 3.90; 95% CI, 1.13-13.44) than English speakers who reported adequate health literacy. People with limited English proficiency who reported adequate health literacy had the same risk of falling as English speakers (OR, 0.98; 95% CI, 0.16-6.12), suggesting the protective role of health literacy for people with limited English proficiency.</div></div><div><h3>Conclusions</h3><div>Language barriers have a significant effect on falls among patients in IRFs. SLPs improving health literacy and providing language support may play a crucial role in mitigating fall risk, thereby enhancing patient safety and outcomes.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 37-41"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11695147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103828","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":"Effect of Early Multiprofessional Mobilization on Quality Indicators of Intensive Care in a Less Economically Developed Country: An Action on “Rehabilitation 2030” in Brazil","authors":"Thaís Marina Pires de Campos Biazon PhD ,&nbsp;Henrique Pott Jr. PhD ,&nbsp;Flávia Cristina Rossi Caruso PhD ,&nbsp;José Carlos Bonjorno Jr. PhD ,&nbsp;Viviane Castello-Simões PhD ,&nbsp;Maria Thereza Bugalho Lazzarini MD ,&nbsp;Mariana Taconelli SD ,&nbsp;Audrey Borghi-Silva PhD ,&nbsp;Renata Gonçalves Mendes PhD","doi":"10.1016/j.apmr.2024.08.010","DOIUrl":"10.1016/j.apmr.2024.08.010","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of implementing early multiprofessional mobilization on quality indicators of intensive care in Brazil.</div></div><div><h3>Design</h3><div>This is a retrospective cohort study.</div></div><div><h3>Setting</h3><div>A Brazilian educational and research-intensive care unit (ICU).</div></div><div><h3>Participants</h3><div>A total of 1047 patients were hospitalized from May 2016 to April 2018.</div></div><div><h3>Interventions</h3><div>Implementation of early multiprofessional mobilization using the MobilizAÇÃO Program (MAP).</div></div><div><h3>Main Outcome Measures</h3><div>Clinical, ventilation and safety quality indicators, and physical function before (preprogram period) and after (postprogram period) the MAP.</div></div><div><h3>Results</h3><div>There was a reduction in sedation time (4 vs 1d), hospital stay (21 vs 14d) and ICU stay (14 vs 7d), mechanical ventilation (8 vs 4d), hospital death rate (46% vs 26%) (<em>P&lt;</em>.001), and ICU readmission (21% vs 16%; <em>P=</em>.030) from pre to post MAP. Successful weaning (42% vs 55%) and discharge rate (50% vs 71%) (<em>P</em>&lt;.001) increased after MAP. No differences were found to safety quality indicators between periods. After MAP, complex physical functions assessed using the Manchester Mobility Score (MMS) were more frequent. The in-bed intervention was a predictor for readmission (<em>P=</em>.009; <em>R²</em>=0.689) and death (<em>P=</em>.035; <em>R²</em>=0.217), while walking was a predictor for successful weaning (<em>P=</em>.030; <em>R²</em>=0.907) and discharge (<em>P=</em>.033; <em>R²</em>=0.373). The postprogram period was associated with the MMS at ICU discharge (<em>P&lt;</em>.001; <em>R²</em>=0.40).</div></div><div><h3>Conclusions</h3><div>Early mobilization implementation through changes in low mobility culture and multiprofessional actions improved quality indicators, including clinical, ventilation, and physical functional quality, without compromising patient safety in the ICU.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 51-60"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142118874","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 Effects of Near-Infrared Phototherapy Preirradiation on Lower-Limb Muscle Strength and Injury After Exercise: A Systematic Review and Meta-analysis","authors":"PeiQiang Peng MM ,&nbsp;XuFei Zheng MM ,&nbsp;YueTing Wang MM ,&nbsp;ShuNing Jiang MM ,&nbsp;JiaJu Chen MM ,&nbsp;Xin Sui MM ,&nbsp;LiJing Zhao MD ,&nbsp;Haiyan Xu MD ,&nbsp;Yuming Lu MD ,&nbsp;Shuang Zhang MD","doi":"10.1016/j.apmr.2024.04.013","DOIUrl":"10.1016/j.apmr.2024.04.013","url":null,"abstract":"<div><h3>Objective</h3><div>To assess near-infrared preirradiation effects on postexercise lower-limb muscle damage and function and determine optimal dosage.</div></div><div><h3>Data Sources</h3><div>PubMed, Embase, Cochrane Library, EBSCO, Web of Science, China National Knowledge Infrastructure, and Wanfang Data were systematically searched (2009-2023).</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials of near-infrared preirradiation on lower-limb muscles after fatigue exercise were incorporated into the meta-analysis. Out of 4550 articles screened, 21 met inclusion criteria.</div></div><div><h3>Data Extraction</h3><div>The included studies’ characteristics were independently extracted by 2 authors, with discrepancies resolved through discussion or by a third author. Quality assessment was performed using the Cochrane risk of bias tool and the Grading of Recommendations, Assessment, Development, and Evaluation System.</div></div><div><h3>Data Synthesis</h3><div>In 21 studies, near-infrared preirradiation on lower-limb muscles inhibited the decline in peak torque (standardized mean difference [SMD], 1.33; 95% confidence interval [CI], 1.08-1.59; <em>p</em><span>&lt;.001; increasing 27.97±4.87N·m), reduced blood lactate (SMD, −0.2; 95% CI, −0.37 to −0.03; </span><em>p</em><span>=.272; decreasing 0.54±0.42mmol/L), decreased creatine kinase (SMD, −2.11; 95% CI, −2.57 to −1.65; </span><em>p</em>&lt;.001; decreasing 160.07±27.96U/L), and reduced delayed-onset muscle soreness (SMD, −0.53; 95% CI, −0.81 to 0.24; <em>p</em>&lt;.001). Using a 24-hour cutoff revealed 2 trends: treatment effectiveness depended on power and energy density, with optimal effects at 24.16 J/cm² and 275 J/cm² for energy, and 36.81 mW/cm² and 5495 mW/cm² for power. Noting that out of 21 studies, 19 are from Brazil, 1 from the United States, and 1 from Australia, and the results exhibit high heterogeneity.</div></div><div><h3>Conclusions</h3><div>Although we would have preferred a more geographic dispersion of laboratories, our findings indicate that near-infrared preirradiation mitigates peak torque decline in lower-limb muscles. Influenced by energy and power density with a 24-hour threshold, optimal energy and power densities are observed at 24.16 J/cm², 275 J/cm², 36.81 mW/cm², and 5495 mW/cm²<span>, respectively. Laser preirradiation also reduces blood lactate, creatine kinase, and delayed-onset muscle soreness.</span></div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 74-90"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140847696","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}