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, Cesar Sánchez, Irene Cantarero-Villanueva, Álvaro Reyes, Mauricio P Pinto, M Loreto Bravo, Denise Montt-Blanchard, Francisco Acevedo, Benjamín Walbaum, Margarita Alfaro-Barra, Margarita Barra-Navarro, Scarlet Muñoz-Flores, Constanza Pinto, Sabrina Muñiz, Felipe Contreras-Briceño, Tomás Merino, Gina Merino","doi":"10.1016/j.apmr.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.002","url":null,"abstract":"<p><strong>Objective: </strong>to evaluate if combining prospective surveillance model (PSM) with a supervised multimodal exercise program prevents breast cancer-related lymphedema (BCRL) and its impact on the functional capacity and quality of life (QoL) of high-risk breast cancer (BC) patients undergoing treatment.</p><p><strong>Design: </strong>two-arm parallel superiority randomized controlled trial.</p><p><strong>Setting: </strong>outpatient physical therapy service in a public hospital.</p><p><strong>Participants: </strong>116 adult women (≥18-year-old) 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 BMI values.</p><p><strong>Interventions: </strong>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.</p><p><strong>Main outcome measures: </strong>arm volume, grip strength, 6-minute walk test, and QoL were blindly assessed at baseline, 3, 6, and 9 months.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","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":"Reliability and Validity of Instrumented Timed Up and Go Test in Typical Adults and Elderly: A Systematic Review.","authors":"Jinyu Zhou, Qihang Yao, Ruihua Han, Patrick De Bock, Gabrielle Vassard-Yu, Ann Hallemans, Lien Van Laer","doi":"10.1016/j.apmr.2025.03.001","DOIUrl":"10.1016/j.apmr.2025.03.001","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the available literature investigating the reliability and validity of the instrumented Timed Up and Go (iTUG) in typical adults and elderly.</p><p><strong>Data sources: </strong>Data were collected from PubMed, Web of Science, and hand searching up until July 15, 2024.</p><p><strong>Study selection: </strong>English-language studies investigating the reliability and validity of the 3-meter version of the iTUG in typical adults and elderly were included. Eligibility was blindly reviewed by 2 reviewers.</p><p><strong>Data extraction: </strong>Data on demographics, settings, reliability, and validity of the iTUG were independently extracted by 2 reviewers. The methodological quality was blindly assessed by 2 reviewers using the Consensus-Based Standards for the Selection of Health Status Measurement Instruments tools, and the certainty of evidence was evaluated by the modified Grading of Recommendations Assessment, Developement and Evaluation (GRADE) approach.</p><p><strong>Data synthesis: </strong>Nineteen studies were included investigating 1729 participants, of which 334 were typical adults and 1395 typical elderly. For intrarater reliability (n=1 study), intraclass correlation coefficient ranged from 0.39 (95% CI, 0.30-0.50) to 0.97 (95% CI, 0.95-0.98), test-retest reliability (n=2 studies) from 0.27 (95% CI, -0.47 to 0.63) to 0.89 (95% CI, 0.78-0.95), and interrater reliability (n=1 study) generally sufficient from 0.929 to 0.99 (CI not reported). One study on criterion validity showed sufficient agreement (intraclass correlation coefficient >0.7) with the criterion standard for most outcome measures, except for 3 outcome measures measuring time of turn. Moreover, 12 studies used iTUG to predict cognitive decline (area under the curve [AUC] = 0.80), maximal mobility performance (R²=0.278), physical function (AUC ≤0.75), or falls [(AUC ≤0.853 (95% CI, 0.759-0.948)].</p><p><strong>Conclusions: </strong>iTUG can be a reliable and valid tool for assessing mobility in adults and elderly. However, the complexity and nonstandardization of outcome measures reduce the reliability and validity of iTUG, which needs to be addressed in future research.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584495","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":"Pneumonia Prolongs Rehabilitation Length of Stay and Induces Excess Costs in Adults With Acute Spinal Cord Injury: A Causal Inference Study Using Prospective Multicenter Data.","authors":"Sven Mostberger, Martin W G Brinkhof, Boris Polanco, David J Berlowitz, David Gobets, Margret Hund-Georgiadis, Xavier Jordan, Karin Postma, Anja M Raab, Martin Schubert, Gabi Mueller","doi":"10.1016/j.apmr.2025.02.014","DOIUrl":"10.1016/j.apmr.2025.02.014","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the causal effect of pneumonia on the length of stay (LOS) and associated costs during inpatient rehabilitation following an acute spinal cord injury (SCI).</p><p><strong>Design: </strong>Prospective multicenter cohort study using a causal inference framework.</p><p><strong>Setting: </strong>Ten centers specialized in SCI rehabilitation in high-income countries.</p><p><strong>Participants: </strong>Newly injured SCI patients with complete or incomplete lesions at cervical or thoracic levels (C1-T12) admitted for inpatient rehabilitation. The study included adults (N=486), predominantly men (76.1%), with a median age of 55 years, who were roughly evenly divided between paraplegia (46.5%) and tetraplegia (53.5%).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Additional rehabilitation LOS and associated excess costs because of pneumonia.</p><p><strong>Results: </strong>Experiencing at least 1 episode of pneumonia was associated with an 11% increase in rehabilitation LOS on average. The resulting excess LOS was 21.3 days (95% confidence interval (CI), 18.9-23.7). The additional LOS because of pneumonia costs, on average, $41,812.57 (standard deviation 20,909.73) per patient. Patients with motor complete tetraplegia had the longest rehabilitation LOS, both with and without pneumonia (256.0d; 95% CI, 226.7-285.2 vs 228.9d; 95% CI, 201.6-256.2) and subsequential higher costs.</p><p><strong>Conclusions: </strong>Our findings indicate that pneumonia increases the average rehabilitation length of stay by 21 days and incurs additional costs exceeding $41,000 per patient in individuals with acute SCI. Early screening and prevention are essential to manage these impacts, especially in patients with motor complete tetraplegia.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571927","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":"Technology-Based Physical Rehabilitation for Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-analysis.","authors":"Cristina Lirio-Romero, Sara Reina-Gutiérrez, Purificación López-Muñoz, Elisabeth Bravo-Esteban, Ana Torres-Costoso, María José Guzmán-Pavón","doi":"10.1016/j.apmr.2025.02.011","DOIUrl":"10.1016/j.apmr.2025.02.011","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize the current evidence on technology-based physical rehabilitation for balance in people with multiple sclerosis and to compare its effectiveness with that of conventional physical therapy.</p><p><strong>Data sources: </strong>A comprehensive search of databases including CENTRAL Scopus, CINAHL, PsycINFO, PubMed, and PEDro was conducted up to March 2024.</p><p><strong>Study selection: </strong>Studies were selected based on predefined inclusion criteria.</p><p><strong>Data extraction: </strong>Data extraction and quality assessment were performed independently by 2 reviewers. Statistical analyses were conducted using a random effects model.</p><p><strong>Data synthesis: </strong>A total of 24 studies involving 985 participants were included. The meta-analysis revealed that compared with conventional physical therapy, technology-based physical rehabilitation significantly improved balance outcomes by 0.16 (95% CI, 0.04- 0.29; P=.027) with moderate heterogeneity (I²=39.1%). Subgroup analyses were performed by intervention modality (robotic assistive gait training, exergaming, and telerehabilitation), and only exergaming interventions had a medium effect on balance in this population of 0.29 (95% CI, 0.08-0.251; P=.03).</p><p><strong>Conclusions: </strong>Among technology-based physical rehabilitation approaches, exergaming interventions have shown promising effectiveness in improving balance in people with multiple sclerosis. Despite the moderate heterogeneity, the findings support the use of exergaming as a viable option. Further high-quality randomized controlled trials are needed to confirm these results.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571928","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":"Development of a Multidimensional, Multigroup Measure of Cognitive-Communication for Inpatient Rehabilitation.","authors":"Julia Carpenter, Caitlin Deom, Andrew Bodine, Allen W Heinemann, Richard L Lieber, James Sliwa","doi":"10.1016/j.apmr.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.02.007","url":null,"abstract":"<p><strong>Objective: </strong>To develop a comprehensive, repeatable measure of cognitive-linguistic function for use in inpatient rehabilitation facility (IRF) settings using contemporary methods and to compare the sensitivity of this measure to the FIM cognitive items.</p><p><strong>Design: </strong>Retrospective analysis of clinician-reported assessment data collected as part of routine clinical operations.</p><p><strong>Setting: </strong>Free-standing inpatient rehabilitation facility in the Midwestern United States.</p><p><strong>Participants: </strong>A convenience sample of 12,245 inpatients with motor speech, voice, aphasia and/or cognitive-communicative diagnoses, 18 years of age and older who were admitted to an IRF.</p><p><strong>Interventions: </strong>Standard of care rehabilitation services.</p><p><strong>Main outcome measure: </strong>Cognitive-Communication Ability Quotient (AQ) composed of 10 standard measures used by speech-language pathologists.</p><p><strong>Results: </strong>Confirmatory factor analysis resulted in good-fitting models (root-mean-square errors of approximation ≤0.08, comparative fit indices, and non-normed fit indices ≥0.95) for 5 groups defined by primary communication impairment (Aphasia, Cognitive-Communication Disorder, Brain Injury, Right Hemisphere Dysfunction, Motor Speech/Voice). Re-estimation as a multigroup, MIRT model yielded scores more sensitive to change compared to the FIM cognitive score. True score equating analysis demonstrated a higher ceiling and lower floor for the Cognitive-Communication AQ compared to the FIM.</p><p><strong>Conclusions: </strong>We constructed 5 forms of a novel cognitive-communication measure, the Cognitive-Communication AQ, that demonstrates superior measurement characteristics compared to the FIM cognition score with a lower floor and higher ceiling. The AQ can detect changes in cognitive-communicative function that typically occur during an IRF stay. Repeated measurement during the IRF stay allows clinicians to monitor patients' progress and modify rehabilitation plans accordingly.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565867","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":"Balance Interventions to Improve Upright Balance Control and Balance Confidence in People With Motor-Incomplete Spinal Cord Injury or Disease: A Systematic Review and Meta-analysis","authors":"Natasha L. Benn MPT ,&nbsp;Hope Jervis-Rademeyer PhD ,&nbsp;Wagner H. Souza PhD ,&nbsp;Maureen Pakosh MISt ,&nbsp;Elizabeth L. Inness PhD ,&nbsp;Kristin E. Musselman PhD","doi":"10.1016/j.apmr.2024.07.013","DOIUrl":"10.1016/j.apmr.2024.07.013","url":null,"abstract":"<div><h3>Objectives</h3><div>To assist with clinical decision making, evidence syntheses are needed to demonstrate the efficacy of available interventions and examine the intervention components and dosage parameters. This systematic review and meta-analysis described the efficacy, components and dosage of interventions targeting upright balance control, balance confidence, and/or falls in adults with motor-incomplete spinal cord injury/disease (SCI/D).</div></div><div><h3>Data Sources</h3><div>A search strategy following the population, intervention, control, outcome framework was developed. Six databases were searched: APA PsychInfo, Cumulative Index to Nursing and Allied Health Literature, Embase, Emcare Nursing, Web of Science CC, and Medline.</div></div><div><h3>Study Selection</h3><div>Title, abstract, and full-text screening were conducted by 2 researchers independently. Inclusion criteria included the following: (1) adults with chronic, motor-incomplete SCI/D; (2) physical intervention targeting upright postural control; and (3) clinical and/or biomechanical measures of upright balance control and/or balance confidence and/or documentation of falls.</div></div><div><h3>Data Extraction</h3><div>Participant characteristics, balance intervention details, adverse events, and study results were extracted. The Downs and Black Checklist was used to assess methodological quality. Meta-analyses on pre-post intervention outcomes and a meta-regression of dosage were completed. Grading of Recommendations, Assessment, Development, and Evaluations approach was used to evaluate the quality of the evidence.</div></div><div><h3>Data Synthesis</h3><div>The search returned 1664 unique studies; 26 were included. Methodological quality was moderate to good. Participants were 500 individuals with SCI/D, aged 18-74 years (males: females = 2.4:1). Minor adverse events were reported in 8 studies (eg, muscle soreness and fatigue). Walking interventions and upright balance training with visual feedback had clinically meaningful and significant pooled effects on improving standing balance control. Only walking interventions had a significant pooled effect on improving balance confidence. There were no significant findings on dosage response. Few studies evaluated the effects of balance interventions on the occurrence of falls.</div></div><div><h3>Conclusions</h3><div>Walking interventions and upright balance training with visual feedback had greater effects on upright balance control than conventional physiotherapy; however, the quality of the evidence was very low.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 444-458"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141900802","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":"Four-Year Trajectories of Symptoms and Quality of Life in Individuals Hospitalized After Mild Traumatic Brain Injury","authors":"Kathleen Cairns BSc ,&nbsp;Simon Beaulieu-Bonneau PhD ,&nbsp;Valérie Jomphe MSc ,&nbsp;Marie-Ève Lamontagne PhD ,&nbsp;Élaine de Guise PhD ,&nbsp;Lynne Moore PhD ,&nbsp;Josée Savard PhD ,&nbsp;Marie-Josée Sirois PhD ,&nbsp;Bonnie Swaine PhD ,&nbsp;Marie-Christine Ouellet PhD","doi":"10.1016/j.apmr.2024.09.005","DOIUrl":"10.1016/j.apmr.2024.09.005","url":null,"abstract":"<div><h3>Objectives</h3><div>To (1) detect distinct trajectories of symptoms and quality of life (QoL) over the first 4 years after mild traumatic brain injury (mTBI); (2) assess the relationship between symptom trajectory membership and QoL trajectory membership; and (3) identify participant characteristics associated with QoL trajectory membership.</div></div><div><h3>Design</h3><div>Prospective longitudinal cohort study. Assessments occurred at 4, 8, 12, 24, 36, and 48 months after mTBI.</div></div><div><h3>Setting</h3><div>Recruitment occurred in Level 1 Trauma Centers; follow-up was completed in the community.</div></div><div><h3>Participants</h3><div>Participants were 143 adults (aged 18-65y) who sustained an mTBI and were hospitalized (≥24h) at a Level 1 Trauma Center.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Fatigue Severity Scale, Hospital Anxiety and Depression Scale, Insomnia Severity Index, Medical Outcomes Study Cognitive Functioning Scale, Quality of Life after Brain Injury questionnaire, presence/absence of headaches or dizziness.</div></div><div><h3>Results</h3><div>Group-based trajectory modeling revealed relatively stable symptom and QoL trajectories over time. Considerable percentages of participants were classified in trajectories of clinically significant symptoms throughout the full follow-up period: 62% for subjective cognitive issues, 54% for fatigue, 44% for anxiety, 43% for insomnia, 27% for depression, 23% for headaches, and 17% for dizziness. Sixty-six percent of participants belonged to trajectories of persistently poor QoL. For all symptoms, trajectories of greater severity were associated with trajectories of poorer QoL. None of the sociodemographic or injury-related variables examined were associated with QoL trajectory membership.</div></div><div><h3>Conclusions</h3><div>A substantial proportion of individuals hospitalized after mTBI experiences clinically significant persistent symptoms ≤4 years after injury, and those with more severe symptoms have poorer QoL. Further research is required to better understand the factors leading to symptom persistence and poor QoL.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 358-365"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340049","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":"Association of Calf Circumference, Hand Grip Strength, and Physical Performance With Serious Adverse Events in Individuals With Subacute Stroke Hospitalized for Rehabilitation: An Observational Study","authors":"Takuro Ohtsubo PT ,&nbsp;Masafumi Nozoe PT, PhD ,&nbsp;Masashi Kanai PT, PhD ,&nbsp;Hiroki Kubo PT, PhD ,&nbsp;Katsuhiro Ueno PT, MSc ,&nbsp;Yosuke Morimoto PT, PhD","doi":"10.1016/j.apmr.2024.09.015","DOIUrl":"10.1016/j.apmr.2024.09.015","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether calf circumference, hand grip strength, and physical performance are linked to the incidence of serious adverse events (SAEs) in patients with subacute stroke.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Single rehabilitation hospital.</div></div><div><h3>Participants</h3><div>Patients with stroke admitted for rehabilitation hospital.</div></div><div><h3>Intervention</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>The incidence of SAEs, such as death, cardiovascular events including recurrent stroke, and conditions requiring transfer to another hospital for specialized care or immediate treatment for an acute illness during hospitalization.</div></div><div><h3>Results</h3><div>A total of 341 patients (median age: 74y) participated in this study, with 232 patients (68%) exhibiting low-physical performance. In the adjusted model, low-physical performance was significantly associated with SAEs (hazard ratio [HR], 3.01; 95% confidence interval [CI], 1.04-8.68; <em>P</em>=.042). However, low calf circumference (HR, 1.60; 95% CI, 0.76-3.38; <em>P</em>=.219) and low hand grip strength (HR, 0.98; 95% CI, 0.39-2.42; <em>P</em>=.960) did not show an independent association.</div></div><div><h3>Conclusions</h3><div>Low-physical performance was independently associated with the occurrence of SAEs during hospitalization for rehabilitation in patients with subacute stroke.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 397-403"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387459","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":"Association Between Depressive Symptoms in Spousal Caregivers and Falls in Care Recipients With Disability: A Nationwide Population-Based Cohort Study.","authors":"Rixiang Xu, Dandan Chen, LiJiangshan Hua, Tingyu Mu, Guiyue Ma","doi":"10.1016/j.apmr.2025.02.015","DOIUrl":"10.1016/j.apmr.2025.02.015","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between depressive symptoms in spousal caregivers and both fall risk and the frequency of falls requiring medical treatment in care recipients with disabilities.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>Data from the China Health and Retirement Longitudinal Study.</p><p><strong>Participants: </strong>1357 patient-caregiver dyads.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The incidence of falls and the frequency of falls requiring medical treatment among care recipients.</p><p><strong>Results: </strong>The mean (standard deviation) age of care recipients was 61.6 (9.1) years, and 62.1% of them were women. After adjusting for covariates, it was found that caregiver depressive symptoms were associated with a 32% higher risk of falls (relative risk [RR], 1.32; 95% confidence interval [CI], 1.08-1.61). Moreover, caregivers who exhibited depressive symptoms only at follow-up had a RR of falls requiring medical treatment of 2.74 (95% CI, 1.28-5.88), whereas those who had depressive symptoms at both the baseline and follow-up had a RR of 2.13 (95% CI, 1.19-3.80). The likelihood ratio test showed that grouping depressive symptoms significantly improved the model fit for both fall risk (likelihood ratio [LR] χ²(3)=8.89, P=.031) and falls requiring medical treatment (LR χ²(3)=14.50, P=.002).</p><p><strong>Conclusion: </strong>Caregiver depressive symptoms are significantly associated with an increased risk of falls and a higher frequency of falls requiring medical treatment among care recipients with disabilities. Addressing the mental health of caregivers may help reduce fall-related risks in this population.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143539848","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":"Comparison of the Efficacy of 2 Different Botulinum Toxin Injection Techniques in Gastrocnemius Muscle Spasticity in Hemiplegic Patients: A Randomized Double-Blind Controlled Study","authors":"Savaş Karpuz MD,&nbsp;Ramazan Yılmaz MD,&nbsp;Halim Yılmaz MD","doi":"10.1016/j.apmr.2024.09.011","DOIUrl":"10.1016/j.apmr.2024.09.011","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the efficacy of the innervation zone–targeted injection technique (EUROMUSCULUS/USPRM (Ultrasound Study Group of the International Society of Physical and Rehabilitation Medicine) spasticity approach) and the injection technique along the muscle length.</div></div><div><h3>Design</h3><div>A double-blind randomized controlled trial.</div></div><div><h3>Setting</h3><div>Department of rehabilitation medicine of a medical center.</div></div><div><h3>Participants</h3><div>One hundred patients with stroke experiencing ankle plantar flexor spasticity.</div></div><div><h3>Interventions</h3><div>In addition to conventional rehabilitation, eligible patients were randomly assigned to 2 groups. The experimental group was injected with botulinum toxin along the length of the muscle, whereas the control group was injected with the same dose and volume of botulinum toxin 25%-35% proximal to the medial head and 20%-30% proximal to the lateral aspect of the head of the gastrocnemius muscle.</div></div><div><h3>Main Outcome Measures</h3><div>Modified Ashworth scale, modified Tardieu scale, ankle range of motion measurement, and 10-meter walk test were used before and 1 month after injection.</div></div><div><h3>Results</h3><div>The study was completed by 60 participants with a mean age of 59.96±12.15 years. Both injection methods were found to be effective on range of motion, spasticity level, ambulation, and walking speed. There was no statistically significant difference between injection methods.</div></div><div><h3>Conclusions</h3><div>Both injection methods of botulinum toxin A produce similar clinical effects.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 3","pages":"Pages 327-332"},"PeriodicalIF":3.6,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340037","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}