Archives of physical medicine and rehabilitation最新文献

{"title":"Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients","authors":"Karol Ramírez-Parada PT, MSc, MBA ,&nbsp;Cesar Sánchez MD ,&nbsp;Irene Cantarero-Villanueva PT, MSc, PhD ,&nbsp;Álvaro Reyes PT, MSc, PhD ,&nbsp;Mauricio P. Pinto PhD ,&nbsp;M. Loreto Bravo PhD ,&nbsp;Denise Montt-Blanchard MSc ,&nbsp;Francisco Acevedo MD ,&nbsp;Benjamín Walbaum MD ,&nbsp;Margarita Alfaro-Barra PT ,&nbsp;Margarita Barra-Navarro PT ,&nbsp;Scarlet Muñoz-Flores PT ,&nbsp;Constanza Pinto ,&nbsp;Sabrina Muñiz RN ,&nbsp;Felipe Contreras-Briceño PT, MSc, PhD ,&nbsp;Tomás Merino MD ,&nbsp;Gina Merino MSc","doi":"10.1016/j.apmr.2025.03.002","DOIUrl":"10.1016/j.apmr.2025.03.002","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate if combining a prospective surveillance model (PSM) with a supervised multimodal exercise program prevents breast cancer-related lymphedema (BCRL) and its effect on the functional capacity and quality of life (QoL) of high-risk breast cancer (BC) patients undergoing treatment.</div></div><div><h3>Design</h3><div>Two-arm parallel superiority randomized controlled trial.</div></div><div><h3>Setting</h3><div>Outpatient physical therapy service in a public hospital.</div></div><div><h3>Participants</h3><div>116 adult women (N=116; age ≥18y) diagnosed with stage I-III BC were enrolled. Inclusion criteria included recent surgery and indication for adjuvant chemotherapy. Exclusion criteria were significant arm volume difference, previous cancer, exercise contraindications, and extreme body mass index values.</div></div><div><h3>Interventions</h3><div>Participants were randomized into experimental (n=61) or control groups (n=55) in a 1:1 ratio. The experimental group received PSM with a supervised multimodal exercise program for 12 weeks. The control group received PSM alone.</div></div><div><h3>Main Outcome Measures</h3><div>Arm volume, grip strength, 6-minute walk test, and QoL were blindly assessed at baseline, 3, 6, and 9 months.</div></div><div><h3>Results</h3><div>The combination of PSM with a supervised multimodal exercise program significantly reduced arm volume and body weight and improved grip strength, functional capacity, and the QoL of patients.</div></div><div><h3>Conclusions</h3><div>Combining PSM and physical exercise reduces arm volume, prevents BCRL, and improves physical performance and QoL in high-risk patients. The combination of PSM and STRONG-B was superior to PSM alone, validating the study's superiority design.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1163-1172"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Archives I/EP Guidelines","authors":"","doi":"10.1016/S0003-9993(25)00792-0","DOIUrl":"10.1016/S0003-9993(25)00792-0","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1300-1302"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738447","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":"Dual-Task Resistance Training Improves Strength and Reduces Pain More Than Resistance Exercise Alone in Elbow Fracture Rehabilitation: A Randomized Controlled Trial","authors":"Carlos Cruz-Montecinos PhD, PT ,&nbsp;Laura López-Bueno PhD, PT ,&nbsp;Rodrigo Núñez-Cortés PhD, PT ,&nbsp;Rubén López-Bueno PhD ,&nbsp;Luis Suso-Martí PhD, PT ,&nbsp;Guillermo Mendez-Rebolledo PhD, PT ,&nbsp;Antoni Morral PhD ,&nbsp;Lars Louis Andersen PhD ,&nbsp;Joaquín Calatayud PhD","doi":"10.1016/j.apmr.2025.01.419","DOIUrl":"10.1016/j.apmr.2025.01.419","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the effects on strength, pain intensity, range of motion (ROM), and functionality of a 12-week dual-task resistance exercise program in patients undergoing rehabilitation from elbow fractures.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Rehabilitation hospital.</div></div><div><h3>Participants</h3><div>Individuals undergoing elbow fracture rehabilitation (N=32).</div></div><div><h3>Intervention</h3><div>Randomization was performed sequentially using numbered envelopes containing assignments to either an intervention group (dual-task resistance training using a mathematical task with self-regulation, N=18) or a control group (traditional resistance training, N=14) for 12 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were muscle strength for elbow flexors and extensors and pain assessed by the visual analog scale from 0 to 100 mm. The secondary outcomes were kinesiophobia assessed by the Tampa Scale-11 and disability using the Disabilities of the Arm, Shoulder, and Hand questionnaire and passive ROM.</div></div><div><h3>Results</h3><div>Dual-task resistance training improved strength and reduced pain more than resistance training alone (<em>P</em>&lt;.05), and only the dual-task group improved in kinesiophobia (<em>P</em>&lt;.05). The linear regression showed a significant negative association between kinesiophobia and increased elbow strength in the dual-task group (flexion, <em>r</em>=−0.53, <em>P</em>=.024; extension, <em>r</em>=−0.65, <em>P</em>=.004) but not in the control group (<em>P</em>&gt;.05). No significant differences were observed between the group for disability and passive ROM (<em>P</em>&gt;.05).</div></div><div><h3>Conclusions</h3><div>Dual-task resistance training and traditional resistance training both enhance strength, reduce pain, improve functionality, and increase ROM after 12 weeks of elbow fracture rehabilitation. However, dual-task resistance training is superior to resistance training alone in enhancing strength and reducing pain.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1155-1162"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(25)00781-6","DOIUrl":"10.1016/S0003-9993(25)00781-6","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Page A8"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144738535","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":"Cluster Analysis of Outpatient Prescription Medications After Combat-Related Amputations: A Retrospective Study","authors":"Ted Melcer PhD ,&nbsp;James Zouris MS ,&nbsp;Andrew MacGregor PhD ,&nbsp;LCDR Daniel Crouch PhD ,&nbsp;CAPT Robert Sheu MD ,&nbsp;Michael Galarneau MS","doi":"10.1016/j.apmr.2025.02.006","DOIUrl":"10.1016/j.apmr.2025.02.006","url":null,"abstract":"<div><h3>Objectives</h3><div>The objectives were (1) to conduct cluster analysis to explore patterns of outpatient prescription medications during the first year after combat-related amputations and (2) to analyze patient characteristics associated with prescription medication clusters.</div></div><div><h3>Design</h3><div>Retrospective study of Department of Defense casualty records and outpatient prescription medications during the first year postinjury. Hierarchical cluster analysis of American Hospital Formulary Service (AHFS) medication classes.</div></div><div><h3>Setting</h3><div>Military amputation rehabilitation program.</div></div><div><h3>Participants</h3><div>A total of 1651 US service members who sustained major limb amputations in Operations Iraqi and Enduring Freedom from 2001 to 2017 and had outpatient prescription medications.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Prescription medication clusters and patient characteristics.</div></div><div><h3>Results</h3><div>Cluster analysis identified 3 prescription medication profiles. Cluster 1: baseline (n=682) consisted of 6 AHFS classes: cathartics/laxatives, anticonvulsants, semisynthetic opioids, antidepressants, nonsteroidal anti-inflammatory drugs, and combination opioid analgesics. These 6 classes were part of all 3 profiles (ie, baseline medications). Cluster 2: baseline plus insomnia (B+I) (n=502): atypical antipsychotics, anxiolytics/sedatives, methadone, benzodiazepines, analgesics/antipyretics, and baseline medications. Cluster 3: baseline plus severe injury (B+SI) (n=467): anticoagulants, 5-HT3 receptor antagonists, multivitamins, anxiolytics/sedatives, analgesics/antipyretics, and baseline medications. The baseline cluster was characterized by early injury years (85%, 2001-2008), moderate/serious injuries (85%), single amputation, chronic pain, and posttraumatic stress disorder. Cluster B+I was characterized by early injury years (62%), minor injuries (16%), low rates of traumatic amputations, and postinjury complications. Cluster B+SI was characterized by later injury years (88%, 2009-2017), serious/severe injuries (62%), multiple amputations (42%), traumatic brain injury (43%), high rates of complications, and prescriptions.</div></div><div><h3>Conclusions</h3><div>Cluster analysis identified 3 outpatient prescription medication profiles during the first year postinjury. All profiles included analgesics and psychotherapeutics but differed in specific insomnia medications, multivitamins, and anticoagulants. Medication profiles had significant associations with injury years, injury severity, and postinjury complications. The results inform future research and prescription medication practices.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1238-1247"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143466658","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":"Peripheral Electrical Stimulation on Motor Function and Activities of Daily Living After Stroke: A Systematic Review and Network Meta-analysis","authors":"Yihao Zhou MD ,&nbsp;Siyu Yang MD ,&nbsp;Dongxia Li MM ,&nbsp;Wenqiang Li MM ,&nbsp;Chen Yang MM ,&nbsp;Hong Huo MD ,&nbsp;Shaojie Cai MD ,&nbsp;Xingyan Zhu MD ,&nbsp;Ruwen Zheng MD ,&nbsp;Xu Dong MD ,&nbsp;Dongyan Wang MD, PhD","doi":"10.1016/j.apmr.2025.01.466","DOIUrl":"10.1016/j.apmr.2025.01.466","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effects of different peripheral electrical stimulation protocols and current frequencies for poststroke motor function and activities of daily living.</div></div><div><h3>Data Sources</h3><div>Seven databases (PubMed, Embase, Cochrane Library, Chinese National Knowledge Infrastructure, VIP Database, Wan-Fang Database, and Chinese Biomedical Database) were searched from inception to August 2024.</div></div><div><h3>Study Selection</h3><div>Two reviewers independently performed the literature selection. The included studies were randomized controlled trials providing peripheral electrical stimulation for patients with stroke.</div></div><div><h3>Data Extraction</h3><div>Two reviewers independently extracted data following a predeveloped Excel data collection sheet, including trial characteristics, intervention and comparator details, and outcome data. The risk of bias was evaluated by RoB2 tool, and the PRISMA guidelines were followed for reporting.</div></div><div><h3>Data Synthesis</h3><div>A total of 106 trials with 7513 participants were included. Meta-analysis showed that neuromuscular electrical stimulation (NMES) could be the optimal electrical stimulation protocol for improving the Fugl-Meyer Assessment score (standardized mean difference=1.67; 95% confidence interval [1.14-2.21]) and the modified Barthel Index score (standardized mean difference=1.73; 95% confidence interval [1.10-2.37]). The results showed that different frequencies of electrical stimulation ranked the top 5 in descending order for improving: (1) the Fugl-Meyer Assessment scores as follows: 20-30 Hz_NMES (surface under the cumulative ranking curve [SUCRA]=87.5%)&gt;100 Hz_NMES (SUCRA=75.4%)&gt;100 Hz_functional electrical stimulation (SUCRA=70.9%)&gt;20/35 Hz_transcutaneous electrical acupoint stimulation (SUCRA=69.8%)&gt;1-4 Hz_electrical acupuncture (SUCRA=69.6%) and (2) the modified Barthel Index scores as follows: 100 Hz_transcutaneous electrical nerve stimulation (SUCRA=77.3%)&gt;5/15 Hz_NMES (SUCRA=68.3%)&gt;100 Hz_transcutaneous electrical acupoint stimulation (SUCRA=65.6%)&gt;35-50 Hz_functional electrical stimulation (SUCRA=64.8%)&gt;1-4 Hz_electrical acupuncture (SUCRA=60.0%).</div></div><div><h3>Conclusions</h3><div>Adding electrical stimulation based on routine rehabilitation training can improve the motor dysfunction and activities of daily living of patients with stroke. Specifically, NMES with 20-30 Hz improves motor function best, whereas 100 Hz_transcutaneous electrical nerve stimulation improves activities of daily living best.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1258-1266"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143073763","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":"End-of-Life Conversations With Adult Patients and Their Families: An Evidence-based Guide for Occupational and Physical Therapists","authors":"Olivia Crozier BHSc,&nbsp;Erica Lo BHSc,&nbsp;Neha Dewan PT, PhD,&nbsp;Atul Jaiswal MA, PhD,&nbsp;Ryan Carrick OTR/L, MHS, PhD,&nbsp;Timothy A. Reistetter OTR, PhD,&nbsp;Himani Puri MSc,&nbsp;Patricia Watford OTD, MS, OTR/L,&nbsp;Sodiq Fakorede BSc,&nbsp;Mandi L. Sonnenfeld PhD, MOT, OTR/L,&nbsp;Monika Gross BFA, M.AmSAT, M.ATI, M.STAT, MSME/T,&nbsp;Saurabh P. Mehta PT, PhD, GCS","doi":"10.1016/j.apmr.2025.03.045","DOIUrl":"10.1016/j.apmr.2025.03.045","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1295-1299"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960278","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":"Enhancing Hand Motor Recovery Poststroke: A Comparative Study of Robotic vs Conventional Mirror Therapy","authors":"Steven Kurniawan MD ,&nbsp;Husnul Mubarak MD, PhD ,&nbsp;Nuralam Sam MD, PhD ,&nbsp;Yose Waluyo MD, PhD ,&nbsp;Andi Alfian Zainuddin MD, PhD ,&nbsp;Andi Amijoyo Mochtar MD, PhD","doi":"10.1016/j.apmr.2024.11.008","DOIUrl":"10.1016/j.apmr.2024.11.008","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the therapeutic effect of using a robotic exoskeletal hand (RMT) combined with mirror therapy (MT) in hand rehabilitation for poststroke patients, compared to conventional MT.</div></div><div><h3>Design</h3><div>Randomized controlled trial.</div></div><div><h3>Setting</h3><div>Physical Medicine and Rehabilitation Outpatient Clinic.</div></div><div><h3>Participants</h3><div>Forty poststroke subjects.</div></div><div><h3>Interventions</h3><div>Participants were divided into 2 groups: one received robotic exoskeletal hand therapy combined with mirror therapy (RMT+MT), and the other received conventional MT. The intervention lasted for 6 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>Hand motor function abilities were assessed using the Fugl-Meyer Assessment for Upper Extremities (FMA-UE)—Hand Motor Domain, and finger dexterity was evaluated with the Nine-Hole Peg Test (NHPT).</div></div><div><h3>Results</h3><div>The RMT group showed significant improvement in hand motor function, with a median FMA-UE-Hand Motor Domain score increasing from 6 to 14 (<em>P</em>=.000). Finger dexterity also improved significantly in the RMT group (<em>P</em>=.000). The conventional MT group demonstrated significant improvements in both the FMA-UE-Hand Motor Domain (<em>P</em>=.001) and NHPT (<em>P</em>=.000). However, the RMT group achieved greater improvements, with significant differences between the 2 groups in both FMA-UE-Hand Motor Domain (<em>P</em>=.038) and NHPT (<em>P</em>=.026) scores.</div></div><div><h3>Conclusions</h3><div>RMT is significantly more effective in restoring hand motor skills and improving finger dexterity in patients with poststroke rehabilitation compared to conventional MT.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1183-1188"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765780","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":"Evaluation of Inadequate Response to Ultrasound-Guided Subacromial Corticosteroid Injection in Shoulder Impingement Syndrome: Treatment Failure or Central Sensitization?","authors":"Büşra Şirin Ahısha MD ,&nbsp;Nurdan Paker MD ,&nbsp;Nur Kesiktaş MD, PhD ,&nbsp;Nazlı Derya Buğdayci MD ,&nbsp;Yiğit Can Ahısha MD","doi":"10.1016/j.apmr.2025.01.469","DOIUrl":"10.1016/j.apmr.2025.01.469","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate whether central sensitization (CS), pain catastrophizing, and psychological factors are associated with inadequate response to ultrasound-guided subacromial corticosteroid injection in patients with chronic shoulder impingement syndrome.</div></div><div><h3>Design</h3><div>This study was designed as a prospective observational study, combining analytical cross-sectional and prospective elements to evaluate associations and treatment responses.</div></div><div><h3>Setting</h3><div>Secondary care outpatient clinic.</div></div><div><h3>Participants</h3><div>A total of 72 patients aged 18-75 years with shoulder impingement syndrome and at least 6 months of shoulder pain, planned to undergo ultrasound-guided subacromial corticosteroid injection, were included in the study.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Treatment response was defined as a ≥50% reduction in pain (visual analog scale [VAS]) at 4 weeks postinjection. The presence of CS was assessed using the Central Sensitization Inventory (CSI) and pressure pain threshold via algometry (ipsilateral deltoid, contralateral deltoid, and contralateral vastus lateralis). Negative thoughts related to pain were evaluated with the pain catastrophizing scale, and mood status was assessed using the Hospital Anxiety and Depression Scale (HADS).</div></div><div><h3>Results</h3><div>Forty-eight patients (responders) experienced ≥50% VAS reduction, whereas 24 (nonresponders) did not. Nonresponders had significantly higher CSI (<em>P</em>=.000), HADS depression (<em>P</em>=.001), and HADS anxiety (<em>P</em>=.000) scores. The pressure pain threshold values were significantly lower in nonresponders at ipsilateral deltoid (<em>P</em>=.030), contralateral deltoid (<em>P</em>=.045), and contralateral vastus lateralis (<em>P</em>=.036). The CSI was significantly correlated with pressure pain threshold at ipsilateral deltoid (r=-0.400, <em>P</em>=.001), contralateral deltoid (r=-0.354, <em>P</em>=.002), and contralateral vastus lateralis (r=-0.442, <em>P</em>=.000); pain catastrophizing scale total score (r=0.449, <em>P</em>=.000); HADS depression score (r=0.572, <em>P</em>=.000); and HADS anxiety score (r=0.618, <em>P</em>=.000). CSI was the most predictive factor for nonresponse area under the curve (AUC=0.755, 95% confidence interval [CI]: 0.635-0.875). Multivariate analysis identified CSI as an independent predictor (<em>P</em>=.022), with a predictive accuracy of 72.2%.</div></div><div><h3>Conclusions</h3><div>Inadequate response to subacromial corticosteroid injection in chronic shoulder impingement syndrome is strongly associated with CS, psychological distress, and altered pain perception. Integrating CS-targeted interventions into treatment strategies may improve outcomes.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1227-1237"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122040","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 Clinical Efficacy of Extracorporeal Shock Wave Therapy Combined With Platelet-Rich Plasma and Exercise for Lateral Epicondylitis: Prospective Randomized Sham-Controlled Ultrasonographic Study","authors":"Ali İzzet Akçin MD ,&nbsp;Nuran Eyvaz MD ,&nbsp;Ümit Dündar MD ,&nbsp;Hasan Toktaş MD ,&nbsp;Hilal Yeşil MD ,&nbsp;Selma Eroğlu MD ,&nbsp;Sevda Adar MD","doi":"10.1016/j.apmr.2025.01.420","DOIUrl":"10.1016/j.apmr.2025.01.420","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the combined effect of 2 different regenerative therapies, extracorporeal shock wave therapy (ESWT) and platelet-rich plasma (PRP), along with therapeutic exercise, in patients with lateral epicondylitis (LE).</div></div><div><h3>Design</h3><div>Prospective, randomized, sham-controlled trial.</div></div><div><h3>Settings</h3><div>Outpatient clinic.</div></div><div><h3>Participants</h3><div>Ninety-one patients (N=91) with LE for &gt;3 months were randomly allocated into 3 groups.</div></div><div><h3>Interventions</h3><div>Participants were assigned to PRP+ESWT, Sham PRP+ESWT, or ESWT only treatment group. All groups received exercise therapy.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the visual analog scale (VAS) pain score. Secondary outcomes included handgrip strength, Patient-rated Tennis Elbow Evaluation (PRTEE), Quick Disabilities of the Arm, Shoulder, and Hand (Quick DASH), Short Form 36, ultrasonographic assessments (common extensor tendon [CET] measurement and total ultrasonography scale score [TUSS]), and isokinetic evaluation. Participants were evaluated 3 times: pre-treatment (T0), after 4 weeks (T1), and after 12 weeks (T2).</div></div><div><h3>Results</h3><div>The PRP group showed superiority over other groups in terms of VAS (activity and night) scores at follow-ups. With regard to the secondary outcomes, in the short term, the PRP group demonstrated a statistically significant difference in the PRTEE-function. In the 12th week, PRP outperformed only against ESWT in all PRTEE parameters, and also showed superior Quick DASH scores to the other groups. In handgrip strength, the PRP group demonstrated superiority over the Sham PRP group at T1 and over both groups at T2. In the isokinetic evaluation, PRP group showed superiority over the Sham PRP group in both wrist flexion/extension peak torque scores during follow-ups. No significant differences were found in any of the ultrasonographic parameters, including CET thickness and TUSS scores, between the groups at the 4th and 12th week.</div></div><div><h3>Conclusions</h3><div>The combined application of ESWT and PRP in the management of LE has demonstrated superior efficacy, as evidenced by significant improvements in clinical parameters.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1173-1182"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143021997","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}