Archives of physical medicine and rehabilitation最新文献

{"title":"MACHINE LEARNING ALGORITHMS FOR PREDICTION OF AMBULATION AND WHEELCHAIR TRANSFER ABILITY IN SPINA BIFIDA.","authors":"Gina McKernan, Matt Mesoros, Brad E Dicianno","doi":"10.1016/j.apmr.2024.11.013","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.11.013","url":null,"abstract":"<p><strong>Objective: </strong>To determine which statistical techniques enhance our ability to predict ambulation and transfer ability in people with spina bifida (SB).</p><p><strong>Design: </strong>Retrospective cohort study SETTING: 35 United States outpatient SB clinic sites PARTICIPANTS: individuals (n=4,589) with SB ages 5-73 (median age =13.59) INTERVENTION: not applicable MAIN OUTCOME MEASURE: ambulation ability, which consisted of the following categories: community ambulators, household ambulators, therapeutic ambulators, and non-ambulators SECONDARY OUTCOME: wheelchair transfer ability, as defined by the ability to transfer in and out of a wheelchair unassisted RESULTS: A Recurrent Neural Network (RNN) utilizing a multilayer perceptron discarded 76 cases during case processing, resulting in 4513 that were run through the RNN. The predictions in the resulting testing dataset were 83.22% accurate. Recall was 93.21% for community ambulators, 10.00% for household ambulators, 23.96% for therapeutic ambulators, and 76.70% for non-ambulators. Precision was 85.34% for community ambulators, 16.05% for household ambulators,16.67% for therapeutic ambulators, and 93.47% for non-ambulators. Total predictions included 68.39% for community ambulators, 2.25% for household ambulators, 3.83% for therapeutic ambulators, and 25.53% for non-ambulators. Correspondingly, the model accurately classified 70% of wheelchair transfers, while correctly identifying 97.3% of those able to transfer unassisted.</p><p><strong>Conclusions: </strong>RNN models hold promise for prediction of functional outcomes such as ambulation and transfer ability in people with SB, particularly for community and non-ambulators. Compared to previous work utilizing traditional logistic regression approaches which misclassified 16% of cases, the RNN resulted in greater prediction accuracy with fewer than 7% of cases misclassified.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142778724","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":"Associations Between Rehabilitation Utilization and Out-of-Pocket Costs Among Older Adults With Breast Cancer in the United States","authors":"Rachelle Brick PhD, MSPH, OTR/L ,&nbsp;Courtney P. Williams DrPH ,&nbsp;Luqin Deng PhD ,&nbsp;Michelle A. Mollica PhD, MPH, RN, OCN ,&nbsp;Nicole Stout DPT, CLT-LANA ,&nbsp;Jessica Gorzelitz PhD, MS","doi":"10.1016/j.apmr.2024.08.002","DOIUrl":"10.1016/j.apmr.2024.08.002","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the association between rehabilitation utilization within 12 months of breast cancer diagnosis and out-of-pocket costs in the second year (12-24mo after diagnosis).</div></div><div><h3>Design</h3><div>Secondary analysis of the 2009-2019 Surveillance, Epidemiology and End Results-Medicare linked database. Individuals who received rehabilitation services were propensity-score matched to individuals who did not receive services. Overall and health care service-specific models were examined using generalized linear models with a gamma distribution.</div></div><div><h3>Setting</h3><div>Inpatient and outpatient medical facilities.</div></div><div><h3>Participants</h3><div>A total of 35,212 individuals diagnosed with nonmetastatic breast cancer and were continuously enrolled in Medicare Fee-For Service (parts A, B, and D) in the 12 months before and 24 months postdiagnosis.</div></div><div><h3>Intervention</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Individual cost responsibility, a proxy for out-of-pocket costs, which was defined as deductibles, coinsurance, and copayments during the second year after diagnosis (12-24mo postdiagnosis).</div></div><div><h3>Results</h3><div>The mean individual cost responsibility was higher in individuals who used rehabilitation than those who did not ($4013 vs $3783), although it was not a clinically meaningful difference (<em>d</em>=0.06). Individuals who received rehabilitative services had significantly higher costs attributed to individual provider care ($1634 vs $1476), institutional outpatient costs ($886 vs $812), and prescription drugs ($959 vs $906), and significantly lower costs attributed to institutional inpatient costs ($455 vs $504), and durable medical equipment ($81 vs $86).</div></div><div><h3>Conclusions</h3><div>Older adults with breast cancer who received rehabilitation services had higher cost responsibility during the second year after diagnosis than those who did not. Future work is needed to examine the relationship between rehabilitation and out-of-pocket costs across longer periods of time and in conjunction with perceived benefit.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2301-2308"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035093","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":"Unraveling the Mechanisms Behind the Short-Term Effects of Dry Needling: New Insights From a Mediation Analysis With Repeatedly Measured Mediators and Outcomes","authors":"Carlos Murillo PhD ,&nbsp;Ester Cerezo-Téllez PhD ,&nbsp;María Torres-Lacomba PhD ,&nbsp;Thien Quy Pham BS ,&nbsp;Enrique Lluch PhD ,&nbsp;Deborah Falla PhD ,&nbsp;Tat-Thang Vo PhD","doi":"10.1016/j.apmr.2024.07.016","DOIUrl":"10.1016/j.apmr.2024.07.016","url":null,"abstract":"<div><h3>Objective</h3><div>To explore the causal pathways underlying the short-term effects of deep dry needling (DDN) in people with chronic neck pain.</div></div><div><h3>Design</h3><div>Explanatory longitudinal mediation analysis with repeatedly measured mediators and outcomes.</div></div><div><h3>Setting</h3><div>Primary care setting.</div></div><div><h3>Participants</h3><div>Patients (N=128) with chronic neck pain.</div></div><div><h3>Interventions</h3><div>Participants were randomized into 2 groups; DDN of the neck muscles combined with stretching (n=64) and stretching alone (n=64).</div></div><div><h3>Main Outcome Measures</h3><div>Two outcomes (pain intensity and neck pain–related disability) and 3 candidate mediators (local pressure pain thresholds [PPTs], cervical range of motion [ROM], and neck muscle strength) were included. Pain intensity was also included as a competing mediator in the mediation analysis for disability. Mediators and outcomes were measured at 3 time points: after intervention and at 2- and 4-week follow-up. Age, sex, and the baseline values of the outcome and mediators were included as pretreatment mediator-outcome confounders.</div></div><div><h3>Results</h3><div>Reductions in pain intensity strongly mediated the short-term effects of DDN on disability, from after intervention to 4-week follow-up. In addition, the attenuation of local hypersensitivity (via increasing PPTs) moderately mediated reductions in pain intensity at each time point. On the other hand, gains in cervical ROM contributed to reducing neck pain–related disability. Changes in muscle strength did not lead to better outcomes.</div></div><div><h3>Conclusions</h3><div>This novel study demonstrated that DDN effect on neck pain–related disability is strongly driven by the analgesic effects of this physical therapy modality. Increasing PPTs and cervical ROM seem to be also part of the mechanisms behind DDN's effect.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2269-2276"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987326","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":"Letter to the Editor: Establishing Normative Values for Performance-Based Tests in Older Thai Adults: A Nationwide Cross-Sectional Study","authors":"Prishita Kumar BPT, MPT (Sports),&nbsp;Anmol Bhatia BPT, MPT (Neurology),&nbsp;Thiagarajan Subramanian BPT, MPT (Advanced Cardiopulmonary Physiotherapy)","doi":"10.1016/j.apmr.2024.08.019","DOIUrl":"10.1016/j.apmr.2024.08.019","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Page 2392"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153042","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":"Letter to the Editor: Evaluating Equity in the Care of Patients in Acute Inpatient Rehabilitation Settings","authors":"Tobin T. Chakkala MD,&nbsp;Kimberly T. Sibille PhD, MA,&nbsp;Yevgeny Zadov MD","doi":"10.1016/j.apmr.2024.08.023","DOIUrl":"10.1016/j.apmr.2024.08.023","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Page 2390"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279799","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: Identifying Racial and Ethnic Disparities in Acute Inpatient Rehabilitation","authors":"Amanda A. Herrmann PhD,&nbsp;Bo B. Podgorski BA,&nbsp;Sarah J. Hatton BA,&nbsp;Ella A. Chrenka MS,&nbsp;Leah R. Hanson PhD,&nbsp;Steven D. Jackson MD, MBA","doi":"10.1016/j.apmr.2024.09.002","DOIUrl":"10.1016/j.apmr.2024.09.002","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Page 2391"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279800","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":"What Do I Need to Know About Long COVID-related Breathing Problems?","authors":"Monika Gross BFA, M.AmSAT, M.ATI, RSME,&nbsp;Noemi Lansang MPT,&nbsp;Urvashy Gopaul PhD, MSc,&nbsp;Karla Yoney PA-C,&nbsp;Elisa F. Ogawa PhD,&nbsp;Patricia C. Heyn PhD, FGSA, FCARM,&nbsp;Palavi Sood PT, PhD,&nbsp;Zaliha Omar MBBS, FRCP (Glasg), FAFRM, DMR (RCP, London),&nbsp;Preeti Pushpalata Zanwar PhD, MPH, MS,&nbsp;Julie Schwertfeger PhD, DPT, MBA, CBIST,&nbsp;Julie Faieta PhD, MOT, OTR/L","doi":"10.1016/j.apmr.2024.06.024","DOIUrl":"10.1016/j.apmr.2024.06.024","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2401-2405"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370839","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":"Dropout From Exercise Interventions in Adults With Knee or Hip Osteoarthritis: A Systematic Review and Meta-analysis","authors":"Davy Vancampfort PhD ,&nbsp;Tine Van Damme PhD ,&nbsp;Ryan L. McGrath PhD ,&nbsp;Laura Hemmings PhD ,&nbsp;Veerle Gillis MSc ,&nbsp;Koen Bernar MSc ,&nbsp;Eduarda Bitencourt MSc ,&nbsp;Felipe Schuch PhD","doi":"10.1016/j.apmr.2024.02.735","DOIUrl":"10.1016/j.apmr.2024.02.735","url":null,"abstract":"<div><h3>Objective</h3><div><span>To investigate the prevalence and moderators of dropout rates among adults with knee or hip osteoarthritis participating in exercise </span>randomized controlled trials (RCTs).</div></div><div><h3>Data Sources</h3><div>Two authors searched Embase<span>, CINAHL, PsycARTICLES, and PubMed up to 01/09/2023.</span></div></div><div><h3>Study Selection</h3><div>We included RCTs of exercise interventions in people with knee or hip osteoarthritis that reported dropout rates.</div></div><div><h3>Data Extraction</h3><div>Dropout rates from exercise and control conditions and exerciser/participant, provider, and design/implementation related moderators.</div></div><div><h3>Data Synthesis</h3><div><span>In total, 209 RCTs involving 277 exercise arms in 13,102 participants were included (mean age at study level=64 years; median prevalence of men participants=26.8%). The trim-and-fill-adjusted prevalence of dropout across all RCTs was 17.5% (95% CI=16.7%-18.2%), which is comparable with dropout observed in control conditions (trim-and-fill-adjusted odds ratio=0.89; 95% CI=0.71-1.12, </span><em>P</em>=.37). Higher prevalence of antidepressant use at study-level predicted higher dropout (R²=0.75, <em>P</em>=.002, N RCTs=6, n exercisers=412). Supervision by an exercise professional was associated with lower dropout rates, with a trim-and-fill-adjusted rate of 13.2% (95% CI=11.7%-14.9%) compared with 20.8% without supervision (95% CI=18.3%-23.5%) (<em>P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>Dropout rates for exercise in RCTs are comparable with control conditions, suggesting that exercise is a generally well-accepted intervention. However, interventions should be supervised by an exercise professional, such as a physiotherapist or exercise physiologist, to further minimize the risk of dropout. Health professionals should consider participants’ use of antidepressants as a risk factor for dropout from exercise.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2317-2326"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140128714","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":"Contralaterally Controlled Functional Electrical Stimulation for Improving Motor Function After Acquired Brain Injury: A Systematic Review and Meta-analysis","authors":"Shan Xie MS ,&nbsp;Yuqian Zhang MD ,&nbsp;Jing Li MS ,&nbsp;Zhefan Wu BS ,&nbsp;Yulong Bai MD","doi":"10.1016/j.apmr.2024.03.001","DOIUrl":"10.1016/j.apmr.2024.03.001","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically evaluate the effect of contralaterally controlled functional electrical stimulation<span> (CCFES) on motor function after acquired brain injury (ABI).</span></div></div><div><h3>Data Sources</h3><div>We searched the PubMed, Embase, Cochrane Central Register of Controlled Trials, Physiotherapy Evidence Database (PEDro), Web of Science, SinoMed, CNKI, VIP Database for Chinese Technical Periodicals and Wanfang Database, from inception to December 2023.</div></div><div><h3>Study Selection</h3><div>Studies were included if they were randomized controlled trials<span> assessing the effect of CCFES on motor function compared with routine rehabilitation or routine electrical stimulation after ABI. Two independent reviewers screened 894 articles for inclusion.</span></div></div><div><h3>Data Extraction</h3><div>The extracted data included study information, sample size, study population, interventions, measurement evaluated, and the test interval.</div></div><div><h3>Data Synthesis</h3><div>This study included 24 trials with 28 intervention-control pairs and 1148 participants with stroke. Meta-analysis showed that the CCFES group demonstrated more significant improvement than the control group in the Fugl-Meyer Assessment Scale (FMA) (standardized mean difference [SMD]=0.66, 95% confidence interval [CI]=0.44-0.88, <em>P</em>&lt;.001), active range of motion (AROM) (SMD=0.77, 95% CI=0.54-1.01, <em>P</em><span>&lt;.001), modified Barthel Index (MBI) (SMD=0.55, 95% CI=0.29-0.81, </span><em>P</em>&lt;.001), Motricity Index (MI) (SMD=0.60, 95% CI=0.26-0.94, <em>P</em><span>&lt;.001) surface electromyography (sEMG) (SMD=0.81, 95% CI=0.56-1.06, </span><em>P</em>&lt;.001), and Functional Ambulation Category (FAC) (SMD=0.53, 95% CI=0.24-0.83, <em>P</em>&lt;.001). The CCFES group showed no significant improvement over the control group in the Action Research Arm Test (ARAT) (SMD=0.24, 95% CI=-0.10-0.58, <em>P</em>=.17).</div></div><div><h3>Conclusions</h3><div>Our synthesized evidence suggests that CCFES could improve motor function in patients with stroke. More RCTs with other patients with brain injury are required to provide future evidence on the therapy effect of CCFES and make a contribution to the uniform standard of CCFES.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2327-2335"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140136411","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: Effect of a Mindfulness and Motivational Interviewing-Oriented Physical-Psychological Integrative Intervention for Community-Dwelling Spinal Cord Injury Survivors: A Mixed-Methods Randomized Controlled Trial","authors":"Yan Li PhD,&nbsp;Mengqi Li PhD,&nbsp;Daniel Bressington PhD,&nbsp;Kun Li PhD,&nbsp;Arnold Y.L. Wong PhD,&nbsp;Alex Molassiotis PhD,&nbsp;Christina Zong-Hao Ma PhD,&nbsp;Patrick Pui Kin Kor PhD,&nbsp;Wing Fai Yeung PhD","doi":"10.1016/j.apmr.2024.08.009","DOIUrl":"10.1016/j.apmr.2024.08.009","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"105 12","pages":"Pages 2394-2395"},"PeriodicalIF":3.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142071887","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}