{"title":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(24)01324-8","DOIUrl":"10.1016/S0003-9993(24)01324-8","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Page A4"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759189","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":"Response to Letter to the Editor: Establishing Normative Values for Performance-Based Tests in Older Thai Adults: A Nationwide Cross-Sectional Study","authors":"Nath Adulkasem MD, PhD, Aasis Unnanuntana MD","doi":"10.1016/j.apmr.2024.08.020","DOIUrl":"10.1016/j.apmr.2024.08.020","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2392-2393"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153043","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}
Sherin Hassan Mohammed Mehani PT, PhD , Zeinab Mohammed Helmy PT, PhD , Heba Mohammed Ali PT, PhD , Mahmoud Ibrahim Mohamed Mahmoud PT, PhD
{"title":"Effect of Adding Integrated Core and Graduated Upper Limb Exercises to Inpatient Cardiac Rehabilitation on Sternal Instability After Coronary Artery Bypass Grafting: A Randomized Controlled Trial","authors":"Sherin Hassan Mohammed Mehani PT, PhD , Zeinab Mohammed Helmy PT, PhD , Heba Mohammed Ali PT, PhD , Mahmoud Ibrahim Mohamed Mahmoud PT, PhD","doi":"10.1016/j.apmr.2024.08.012","DOIUrl":"10.1016/j.apmr.2024.08.012","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effect of adding integrated core and graduated resistance upper limb exercises to an inpatient cardiac rehabilitation program in patients with acute sternal instability after coronary artery bypass grafting (CABG)<strong>.</strong></div></div><div><h3>Design</h3><div>This was a single-center, randomized, controlled, parallel-group intervention study.</div></div><div><h3>Setting</h3><div>This study was conducted at the National Heart Institute.</div></div><div><h3>Participants</h3><div>Forty patients with post-CABG with sternal instability aged 50-60 years completed this study and were randomized into 2 groups: an intervention group (n=20) and an active control group (n=20).</div></div><div><h3>Intervention</h3><div>The intervention group (A) received a routine inpatient rehabilitation program from the first postoperative day plus integrated core and graduated resistance upper limb exercises, which started from the seventh postoperative day for approximately 4 weeks, whereas the control group (B) received only the routine inpatient rehabilitation program.</div></div><div><h3>Main Outcome Measures</h3><div>Sternal separation measured by ultrasonography, visual analog scale for measuring pain, and activities of daily living (ADL) index were main outcome measures.</div></div><div><h3>Results</h3><div>Patients in the intervention group (A) showed a significant reduction in sternal separation from the supine and long sitting positions, whereas those in the control group (B) showed a significant increase in sternal separation (<em>P</em>=.0001). Both groups showed a reduction in pain, and an increase in the ADL score was observed in group A. There was a significant interaction between the time and group effects (<em>P</em>=.0001).</div></div><div><h3>Conclusion</h3><div>Adding integrated core and graduated upper limb exercises to inpatient cardiac rehabilitation for patients with sternal instability after coronary artery bypass grafting significantly improved sternal healing, pain, and ADL.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2245-2252"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103831","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(24)01340-6","DOIUrl":"10.1016/S0003-9993(24)01340-6","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2406-2408"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142758754","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}
Meng-Jia You MSc , Ze-Yu Lu MD , Qing-Yin Xu MD , Peng-Bo Chen MD , Bo Li MD , Sheng-Dan Jiang MD , Lei-Sheng Jiang MD , Jun Xia PhD , Xin-Feng Zheng MD
{"title":"Effectiveness of Physiotherapeutic Scoliosis-Specific Exercises on 3-Dimensional Spinal Deformities in Patients With Adolescent Idiopathic Scoliosis: A Systematic Review and Meta-analysis","authors":"Meng-Jia You MSc , Ze-Yu Lu MD , Qing-Yin Xu MD , Peng-Bo Chen MD , Bo Li MD , Sheng-Dan Jiang MD , Lei-Sheng Jiang MD , Jun Xia PhD , Xin-Feng Zheng MD","doi":"10.1016/j.apmr.2024.04.011","DOIUrl":"10.1016/j.apmr.2024.04.011","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the effects of physiotherapeutic scoliosis-specific exercises (PSSE) on coronal, horizontal, and sagittal deformities of the spine in adolescent idiopathic scoliosis (AIS) as well as how curve severity, intervention duration, and intervention type could modify these effects.</div></div><div><h3>Data Sources</h3><div>Data sources included PubMed, Web of Science, Embase, Cochrane Library, and Scopus databases, which were searched from their inception to September 5, 2023.</div></div><div><h3>Study Selection</h3><div>Clinical controlled trials<span> reporting the effects of PSSE on the Cobb angle, angle of trunk rotation (ATR), thoracic kyphosis<span> (TK), or lumbar lordosis<span> in patients with AIS aged 10-18 years. The experimental groups received PSSE; the control groups received standard care (observation or bracing) or conventional exercise such as core stabilization exercise, Pilates, proprioceptive neuromuscular facilitation, and other nonspecific exercises.</span></span></span></div></div><div><h3>Data Extraction</h3><div><span>Two researchers independently extracted key information from eligible studies. The quality of the studies was assessed using the Cochrane Handbook version 5.1.0 risk of bias assessment and the JBI Center for Evidence-Based Health Care (2016) of quasi-experimental research authenticity assessment tool. The level and certainty of evidence were rated according to the Grading of Recommendations, Assessment, Development, and Evaluation framework. We followed the Preferred Reporting Items for </span>Systematic Reviews and Meta-Analyses statement. The protocol for this study was registered in PROSPERO (CRD42023404996).</div></div><div><h3>Data Synthesis</h3><div>Twelve randomized controlled trials<span> (RCTs) and 5 non-RCTs were meta-analyzed separately. The results indicated that compared with other nonsurgical management, PSSE significantly improved the Cobb angle, ATR, and TK, whereas the lumbar lordosis improvement was not statistically significant. Additionally, the efficacy of PSSE on Cobb angle was not significant in patients with curve severity ≥30° compared with controls. Nevertheless, the pooled effect of PSSE on Cobb angle was not significantly modified by intervention duration and intervention type and that on ATR was not significantly modified by intervention duration. The overall quality of evidence according to Grading of Recommendations, Assessment, Development, and Evaluation was moderate to low for RCT and very low for non-RCT.</span></div></div><div><h3>Conclusions</h3><div>PSSE exhibited positive benefits on the Cobb angle, ATR, and TK in patients with AIS compared with other nonsurgical therapies. In addition, the effectiveness of PSSE may be independent of intervention duration and intervention type but may be influenced by the initial Cobb angle. However, more RCTs are needed in the future to validate the efficacy of PSSE in moderate AIS with a mean Cobb a","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2375-2389"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140891146","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}
Nicole M. Coomer PhD , Jill Akiyama PhD, MA , Melissa Morley PhD , Melvin J. Ingber PhD , Benjamin Silver PhD , Anne Deutsch RN, PhD, CRRN
{"title":"Methods for Estimating Costs for Stays at Inpatient Rehabilitation Facilities and Long-Term Care Hospitals","authors":"Nicole M. Coomer PhD , Jill Akiyama PhD, MA , Melissa Morley PhD , Melvin J. Ingber PhD , Benjamin Silver PhD , Anne Deutsch RN, PhD, CRRN","doi":"10.1016/j.apmr.2024.07.018","DOIUrl":"10.1016/j.apmr.2024.07.018","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and compare 3 methods for estimating stay-level Medicare facility (Part A) costs using claims and cost report data for inpatient rehabilitation facilities (IRFs) and long-term care hospitals (LTCHs), the 2 hospital-based postacute care providers.</div></div><div><h3>Design</h3><div>We calculated stay-level facility costs using different methods. Method 1 used routine costs per day and ancillary cost-to-charge ratios. Method 2 used routine and ancillary cost-to-charge ratios (freestanding IRFs and LTCHs only). Method 3 used facility-specific operating cost-to-charge ratios from the Provider Specific File. For each method, we compared the costs with payments and charges at the claim and facility levels and examined facility margins.</div></div><div><h3>Setting</h3><div>Data are from 1619 providers, including 266 freestanding IRFs, 909 IRF units, and 444 LTCHs.</div></div><div><h3>Participants</h3><div>The analyses included 239,284 claims from 2014, of which 86,118 claims were from freestanding IRFs, 92,799 claims were from IRF units, and 60,367 claims were from LTCHs.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Costs and payments in 2014 United States Dollars.</div></div><div><h3>Results</h3><div>For freestanding IRFs, the mean facility stay-level costs were calculated to be $13,610 (method 1), $13,575 (method 2), and $13,783 (method 3). For IRF units, the mean facility stay-level costs were $17,385 (method 1) and $19,093 (method 3). For LTCHs, the mean facility stay-level costs were $36,362 (method 1), $36,407 (method 2), and $37,056 (method 3).</div></div><div><h3>Conclusions</h3><div>The 3 methods resulted in small differences in facility mean stay-level costs. Using the facility-level cost-to-charge ratio (method 3) is the least resource-intensive method. Although more resource-intensive, using routine cost per day and ancillary cost-to-charge ratios (method 1) for cost calculations allows for differentiation in costs across patients based on differences in the mix of services used. As policymakers consider postacute care payment reforms, cost, rather than charge or payment data, needs to be calculated and the results of the methods compared.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2294-2300"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987325","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}
Yu Tung Lo MBBS , Mervyn Jun Rui Lim MBBS, MPH , Chun Yen Kok , Shilin Wang MBBS , Sebastiaan Zhiyong Blok , Ting Yao Ang MBBS , Vincent Yew Poh Ng MBBS , Jai Prashanth Rao MBBS , Karen Sui Geok Chua MBBS
{"title":"Neural Interface-Based Motor Neuroprosthesis in Poststroke Upper Limb Neurorehabilitation: An Individual Patient Data Meta-analysis","authors":"Yu Tung Lo MBBS , Mervyn Jun Rui Lim MBBS, MPH , Chun Yen Kok , Shilin Wang MBBS , Sebastiaan Zhiyong Blok , Ting Yao Ang MBBS , Vincent Yew Poh Ng MBBS , Jai Prashanth Rao MBBS , Karen Sui Geok Chua MBBS","doi":"10.1016/j.apmr.2024.04.001","DOIUrl":"10.1016/j.apmr.2024.04.001","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the efficacy of neural interface–based neurorehabilitation, including brain-computer interface, through conventional and individual patient data (IPD) meta-analysis and to assess clinical parameters associated with positive response to neural interface–based neurorehabilitation.</div></div><div><h3>Data Sources</h3><div>PubMed, EMBASE, and Cochrane Library databases up to February 2022 were reviewed.</div></div><div><h3>Study Selection</h3><div>Studies using neural interface–controlled physical effectors (functional electrical stimulation and/or powered exoskeletons) and reported Fugl-Meyer Assessment–upper-extremity (FMA-UE) scores were identified. This meta-analysis was prospectively registered on PROSPERO (#CRD42022312428). PRISMA guidelines were followed.</div></div><div><h3>Data Extraction</h3><div>Changes in FMA-UE scores were pooled to estimate the mean effect size. Subgroup analyses were performed on clinical parameters and neural interface parameters with both study-level variables and IPD.</div></div><div><h3>Data Synthesis</h3><div>Forty-six studies containing 617 patients were included. Twenty-nine studies involving 214 patients reported IPD. FMA-UE scores increased by a mean of 5.23 (95% confidence interval [CI]: 3.85-6.61). Systems that used motor attempt resulted in greater FMA-UE gain than motor imagery, as did training lasting >4 vs ≤4 weeks. On IPD analysis, the mean time-to-improvement above minimal clinically important difference (MCID) was 12 weeks (95% CI: 7 to not reached). At 6 months, 58% improved above MCID (95% CI: 41%-70%). Patients with severe impairment (<em>P</em>=.042) and age >50 years (<em>P</em>=.0022) correlated with the failure to improve above the MCID on univariate log-rank tests. However, these factors were only borderline significant on multivariate Cox analysis (hazard ratio [HR] 0.15, <em>P</em>=.08 and HR 0.47, <em>P</em>=.06, respectively).</div></div><div><h3>Conclusion</h3><div>Neural interface–based motor rehabilitation resulted in significant, although modest, reductions in poststroke impairment and should be considered for wider applications in stroke neurorehabilitation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2336-2349"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140761344","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}
Naomi Bennett BS , Joyce S. Chung PhD, MPH , Marissa S. Lundstern MPH , Angela Bymaster MD
{"title":"Traumatic Brain Injury and Its Risk Factors in a Homeless Population","authors":"Naomi Bennett BS , Joyce S. Chung PhD, MPH , Marissa S. Lundstern MPH , Angela Bymaster MD","doi":"10.1016/j.apmr.2024.07.017","DOIUrl":"10.1016/j.apmr.2024.07.017","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the traumatic brain injury (TBI) profile and its associated risk factors in homeless individuals in Santa Clara County, CA.</div></div><div><h3>Design</h3><div>Observational cohort study.</div></div><div><h3>Setting</h3><div>Two homeless shelter health clinics in Santa Clara County, CA.</div></div><div><h3>Participants</h3><div>Currently or recently homeless individuals seeking health care at 2 homeless shelter health clinics between August 2013 and May 2014.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Demographics, TBI incidence and characteristics.</div></div><div><h3>Results</h3><div>The findings indicate that TBI history in the homeless population was higher (79.7%) than in the general population (12%). Almost half of the population (49.2%) reported that their TBI occurred before the age of 18. Of the participants, 68.2% reported sustaining a TBI with loss of consciousness. TBI caused by violence (60%) was lower in this cohort than other homeless cohorts but was the main cause of injury regardless of age. Alcoholism was a risk factor for having more TBIs. No differences in TBI profile were found between sexes.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the need for more research on the lifetime risk factors associated with TBI to prevent and reduce the number of brain injuries in homeless populations.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2286-2293"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141970481","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":"Center of Pressure- and Machine Learning-based Gait Score and Clinical Risk Factors for Predicting Functional Outcome in Acute Ischemic Stroke","authors":"Eun-Tae Jeon PhD , Sang-hun Lee MD, PhD , Mi-Yeon Eun MD, PhD , Jin-Man Jung MD, PhD","doi":"10.1016/j.apmr.2024.08.006","DOIUrl":"10.1016/j.apmr.2024.08.006","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate whether machine learning (ML)-based center of pressure (COP) analysis for gait assessment, when used in conjunction with clinical information, offers additive benefits in predicting functional outcomes in patients with acute ischemic stroke.</div></div><div><h3>Design</h3><div>A prospective, single-center cohort study.</div></div><div><h3>Setting</h3><div>A tertiary hospital setting.</div></div><div><h3>Participants</h3><div>A total of 185 patients with acute ischemic stroke, capable of walking 10 m with or without a gait aid by day 7 postadmission. From these patients, 10,804 pairs of consecutive footfalls were included for analysis.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The dependent variable was a 3-month poor functional outcome, defined as modified Rankin scale score ≥2. For independent variables, 65 clinical variables including demographics, anthropometrics, comorbidities, laboratory data, questionnaires, and drug history were included. Gait function was evaluated using a pressure-sensitive mat. Time-series COP data were parameterized into spatial and temporal variables and analyzed with logistic regression and 2 ML models (light gradient-boosting machine and multilayer perceptron [MLP]). We derived GAIT-AI output scores from the best-performing model analyzed COP data and constructed multivariable logistic regression models using clinical variables and the GAIT scores.</div></div><div><h3>Results</h3><div>Among the included patients, 70 (37.8%) experienced unfavorable outcomes. The MLP model demonstrated the highest predictive performance with an area under the receiver operating characteristic curve (AUROC) of 0.799. Multivariable logistic regression identified age, initial National Institutes of Health Stroke Scale, and initial Fall Efficacy Scale-International as associated factors with unfavorable outcomes. The combined multivariable logistic regression incorporating COP-derived output scores improved the AUROC to 0.812.</div></div><div><h3>Conclusions</h3><div>Gait function, assessed through COP analysis, serves as a significant predictor of functional outcome in patients with acute ischemic stroke. ML-based COP analysis, when combined with clinical data, enhances the prediction of poor functional outcomes.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2277-2285"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071883","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":"Editors' Selections From This Issue","authors":"","doi":"10.1016/S0003-9993(24)01326-1","DOIUrl":"10.1016/S0003-9993(24)01326-1","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Page A10"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142759191","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}