Archives of physical medicine and rehabilitation最新文献

{"title":"Burden of fall-related injury and its predictors among stroke survivors attending comprehensive specialized hospitals in the Amhara Regional State, Ethiopia, 2024: A multicenter prospective study.","authors":"Ermias Solomon Yalew, Kedir Sany, Melese Gobezie, Zeyneb Adem, Biruk Lelisa Eticha, Samuel Teferi Chanie, Matiyas Mamo Bekele, Getachew Azeze Eriku","doi":"10.1016/j.apmr.2026.09.022","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.09.022","url":null,"abstract":"<p><strong>Objectives: </strong>This study was conducted to identify the burden of fall-related injury and associated factors among stroke survivors attending comprehensive specialized hospitals in Amhara Regional State, Ethiopia, in 2024.</p><p><strong>Design: </strong>A multi-center cross-sectional study design was deployed among 269 stroke survivors from June 1 to August 1, 2024.</p><p><strong>Setting: </strong>This study was conducted in five comprehensive specialized hospitals in the Amhara region: the University of Gondar, Bahir Dar (Feleghiwot and Tebebe Ghion), Debreberhan, and Dessie.</p><p><strong>Participants: </strong>The study comprised stroke survivors who had experienced at least one fall, were able to walk independently with or without mobility aid, and were attending the outpatient physiotherapy departments in the five comprehensive specialized hospitals. A systematic random sampling techniques was employed with a sampling interval K =2 and participants were proportionally allocated for each comprehensive specialized hospital.</p><p><strong>Intervention: </strong>Not Applicable MAIN OUTCOME MEASURE(S): Fall-related injury: any injury caused by a fall, as reported by staff/patient/caregiver or documented in the medical record during the data collection period.</p><p><strong>Result: </strong>The prevalence of fall-related injury among stroke survivors in Amhara Regional State was 79.9% (95 CI: 75.1-84.4). Variables including age > 65 (AOR=2.670, 95% CI: 1.083-6.585), rural residence (AOR=2.352, 95% CI: 1.037-5.332), and injury occurring during walking and turning (AOR=2.960, 95% CI: 1.081-8.103) were significantly associated with fall-related injury.</p><p><strong>Conclusion: </strong>The burden of fall-related injury was relatively high among stroke survivors in Amhara Regional State, Ethiopia. Being older, living in a rural areas, and engaging in the activity of walking and turning were predictors associated with fall-related injury.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effects of blood flow restriction training on lower limb motor function and balance in stroke patients: a randomized clinical trial.","authors":"Fenghao Ma, Qian Qian, Taiyang Liu, Qi Qi, Jiayou Wang, Chaoyang Guo, Jiabao Kang, Shouxin Lu, Yan Xu, Duchun Zeng, Nan Wang, Lingjing Jin, Ronghua Hong","doi":"10.1016/j.apmr.2026.09.021","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.09.021","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effects of blood flow restriction (BFR) training, delivered as BFR‑walking or low‑load resistance training with BFR (LL‑BFR), on lower limb motor function and balance in stroke survivors.</p><p><strong>Design: </strong>A single-blind randomized clinical trial.</p><p><strong>Setting: </strong>Inpatient intensive rehabilitation unit.</p><p><strong>Participants: </strong>Ninety-six stroke patients had a mean (SD) age of 55.80 (13.17) years, and 27% were female.</p><p><strong>Intervention: </strong>Participants were allocated 1:1:1 to undergo a 3-week intervention (five sessions/week) consisting of either walking without BFR (Control), BFR-walking (120 mmHg cuff pressure), or LL-BFR (120 mmHg low-load resistance training at 20% 1RM). All received concurrent standard rehabilitation.</p><p><strong>Main outcome measures: </strong>The primary outcome was the Fugl-Meyer Assessment of Lower Extremity (FMA-LE), with secondary outcomes including the Berg Balance Scale (BBS), Timed Up and Go Test (TUG), 30-Second Sit-to-Stand Test (30sSTS), and Limits of Stability.</p><p><strong>Results: </strong>Significant Group × Time interactions were found for FMA‑LE (F [2, 93.054] =8.418, P<0.001, η²p=0.153), BBS (F [2, 93.000]=4.615, P=0.012, η²p=0.090), TUG (F [2, 93.000]=9.121, P<0.001, η²p=0.164), and 30sSTS (F [2, 93.000]=26.020, P<0.001, η²p=0.359). Both BFR‑Walking (adjusted mean difference vs. control: 1.66 points; 95% CI, 0.27 to 3.04; P=0.010) and LL‑BFR (2.25 points; 95% CI, 0.86 to 3.64; P<0.001) showed greater FMA‑LE improvements than control, with no difference between BFR modalities (P=0.165). Both BFR groups outperformed control on BBS, TUG, and 30sSTS (all P<0.05). Responder analysis showed 34.4% of LL‑BFR participants achieved FMA‑LE MCID (≥4 points) versus 15.6% in control (P=0.04). No serious adverse events occurred.</p><p><strong>Conclusion: </strong>A 3‑week BFR‑Walking or LL‑BFR regimen improved balance and mobility beyond conventional training. Although the average improvement is modest, a significantly greater number of patients may achieve clinically meaningful improvement, warranting larger, longer‑term trials before routine clinical use.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103351","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":"Interpreting Per-Protocol Efficacy Signals in a Pilot Trial of Inspiratory Muscle Training.","authors":"Yining Liu","doi":"10.1016/j.apmr.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.08.021","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149102876","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":"Adolescent Mental Health Risk post-mild Traumatic Brain Injury: Examination of Diagnostic codes in Electronic Health Records.","authors":"Surbhi Bhatnagar, Nanhua Zhang, Tess Guzman, Lynn Babcock, Shari L Wade, Brad G Kurowski","doi":"10.1016/j.apmr.2026.09.019","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.09.019","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to understand the frequency and association of post-mild traumatic brain injury (mTBI) mental health (MH) diagnoses, examining the prevalence and risk factors.</p><p><strong>Design: </strong>Retrospective matched cohort study using Electronic Health Record (EHR) data SETTING: Tertiary children's medical center PARTICIPANTS: Patients aged 11 to 17 from 2010 to 2024 were identified as mTBI cases, typically developing (TD), or orthopedic injury (OI) using diagnostic codes and Abbreviated Injury Scale (AIS) and Injury Severity Score (ISS). Cohort included 18755 cases of mTBI and 1:2 matched adolescents from OI and TD groups (n=93775, Mean age=14.9; SD=4, 44% F, 77% White).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure(s): </strong>MH diagnosis codes categorized using the Clinical Classifications Software Refined categorization.</p><p><strong>Results: </strong>mTBI had a mean age of injury of 14.4 years (SD=3.3). The mTBI group had an increased risk of any MH diagnosis at 3 (OR(CI)=1.151(1.067-1.241)), 6 (OR(CI)=1.525 (1.421-1.637)), 9 (OR(CI)=1.855 (1.733-1.986)), and 12 months (OR(CI)=2.165 (2.026-2.313)) compared to the TD group at 3 months. Females, higher socio-economic disadvantage, or a prior MH diagnosis were found to have a higher risk of a MH diagnosis in all three groups. Small-town/rural or micropolitan residents were found to have a higher risk of a MH diagnosis post-mTBI, but not in OI or TD. ADHD emerged as the most common condition; however, anxiety and trauma or stress-related disorders also continued to increase over time.</p><p><strong>Conclusions: </strong>MH diagnoses appear to be diagnosed at higher rates in adolescents after mTBI, increasing over the first 12 months. Factors such as sex, social disadvantage, history of MH disorders, and population density conferred higher risk. The results highlight the need for screening and early intervention with those at elevated risk.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103508","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":"Single Ultrasound-Guided Dextrose Prolotherapy Plus Therapeutic Exercise for Subacromial-Subdeltoid Bursitis: A Pilot Double-Blind Randomized Controlled Trial.","authors":"Ru-Lan Hsieh, Wen-Chung Lee, Wei-Min Chiu","doi":"10.1016/j.apmr.2026.09.018","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.09.018","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether a single ultrasound-guided dextrose prolotherapy (DPT) injection added to supervised therapeutic exercise improves outcomes versus saline injection plus the same program in adults with subacromial-subdeltoid (SASD) bursitis.</p><p><strong>Design: </strong>Pilot double-blind randomized controlled trial with 13-week follow-up.</p><p><strong>Setting: </strong>Tertiary referral hospital in XXXXX.</p><p><strong>Participants: </strong>Adults aged ≥20 years with ultrasound-confirmed SASD bursitis and shoulder pain ≤3 months were randomized (n=46; 23 per group); 42 completed 13-week follow-up.</p><p><strong>Interventions: </strong>Participants received one ultrasound-guided SASD bursal injection of 10 mL 20% dextrose or 10 mL normal saline, followed by a standardized 12-week therapeutic exercise program delivered 3 times weekly.</p><p><strong>Main outcome measures: </strong>The primary outcome was Shoulder Pain and Disability Index (SPADI) total score. Secondary outcomes included SPADI subscales, Disabilities of the Arm, Shoulder and Hand (DASH), visual analog scale (VAS) pain, shoulder range of motion (ROM), and World Health Organization Quality of Life-Brief (WHOQOL-BREF). Treatment effects were assessed by sex- and baseline-adjusted repeated-measures analysis of covariance using the group × time interaction.</p><p><strong>Results: </strong>SPADI total score showed a more favorable longitudinal trajectory with DPT+exercise than saline+exercise (group × time p=.004). At 13 weeks, the observed unadjusted between-group difference was -6.40 points (95% CI, -8.72 to -4.08), below the prespecified 8-point minimal clinically important difference. Significant group × time interactions also favored DPT+exercise for SPADI pain (p=.002) and disability (p=.017), active abduction (p<.001) and external rotation (p=.012), passive external rotation (p=.002) and internal rotation (p=.016), and VAS pain (p=.001). DASH and WHOQOL-BREF showed no differential longitudinal effects.Four DPT participants reported transient postinjection soreness; no serious adverse events occurred.</p><p><strong>Conclusions: </strong>Adding a single ultrasound-guided DPT injection to therapeutic exercise produced more favorable longitudinal changes in SPADI total score, selected ROM measures, and pain than saline injection plus exercise and was well tolerated. Larger trials with longer follow-up are warranted.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103413","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":"Companionship as a Mediator of the Relationship Between Marital Status and Psychosocial Outcomes: Findings in Individuals With Spinal Cord Injury","authors":"Devyn E. Smith PhD,&nbsp;Yue Cao PhD,&nbsp;Michael Harris MS, MAS,&nbsp;James S. Krause PhD","doi":"10.1016/j.apmr.2026.06.012","DOIUrl":"10.1016/j.apmr.2026.06.012","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To test a mediational model where companionship mediates the relationship between marital status and psychosocial outcomes among participants with spinal cord injuries (SCI), controlling for demographic, injury, and socioeconomic characteristics.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To test a mediational model where companionship mediates the relationship between marital status and psychosocial outcomes among participants with spinal cord injuries (SCI), controlling for demographic, injury, and socioeconomic characteristics.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Cross-sectional self-report study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Cross-sectional self-report study.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Medical University in the Southeastern United States.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Medical University in the Southeastern United States.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Participants (n=1810) were identified from one of 2 sources, including a specialty hospital and a state-based surveillance system in the Southeastern United States. Participants were at least 18 years old at enrollment with traumatic SCI. Participants were, on average, 55.9 years old at the time of the study and had an average of 22.2 years post-SCI onset.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Participants (n=1810) were identified from one of 2 sources, including a specialty hospital and a state-based surveillance system in the Southeastern United States. Participants were at least 18 years old at enrollment with traumatic SCI. Participants were, on average, 55.9 years old at the time of the study and had an average of 22.2 years post-SCI onset.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Not applicable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Not applicable.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Participants completed a self-report assessment that included the PROMIS Companionship scale, marital status (married, not married), Patient Health Questionnaire-9 to measure depressive symptom severity, Generalized Anxiety Disorder-7 to measure anxiety symptoms, and 3 life satisfaction outcomes: sex life satisfaction, home life satisfaction, and overall quality of life.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Participants completed a self-report assessment that included the PROMIS Companionship scale, marital status (married, not married), Patient Health Questionnaire-9 to measure depressive symptom severity, Generalized Anxiety Disorder-7 to measure anxiety symptoms, and 3 life satisfaction outcomes: sex life satisfaction, home life satisfaction, and overall quality of life.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Companionship partially mediated the relationship between marital status, depression, and anxiety, and completely mediated the relationships between marital status and life satisfaction outcomes. Higher levels of companionship were associated with reduced depression scores and anxiety levels and increased satisfaction with sex life, home life, and overall quality of life.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Companionship partially mediated the relationship between marital status, depression, and anxiety, and co","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2945-2950"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148293354","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":"Quantitative Ultrasonographic Assessment of Muscle Structure and Correlations With Motor Function Scales in Nusinersen-Treated Children With Spinal Muscular Atrophy","authors":"Eren Aygun MD,&nbsp;Burak Ugur Cetin MD,&nbsp;Tugce Ozekli Misirlioglu MD,&nbsp;Rana Terlemez MD,&nbsp;Kenan Akgun MD,&nbsp;Sema Saltik MD,&nbsp;Deniz Palamar MD","doi":"10.1016/j.apmr.2026.06.009","DOIUrl":"10.1016/j.apmr.2026.06.009","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate ultrasonographic muscle thickness (MT) and echointensity in children with spinal muscular atrophy (SMA) receiving nusinersen therapy by comparing these parameters with healthy controls and determining their relationship with motor function scale scores.</div></div><div><h3>Design</h3><div>Cross-sectional case-control study.</div></div><div><h3>Setting</h3><div>Tertiary university hospital.</div></div><div><h3>Participants</h3><div>Thirty-four children with SMA (types 1-3) receiving disease-modifying therapy with nusinersen and 34 age- and sex-matched healthy controls.</div></div><div><h3>Interventions</h3><div>N/A.</div></div><div><h3>Main Outcome Measure(s)</h3><div>MT of the biceps brachii/brachialis (BB/B), forearm flexors (FF), quadriceps femoris(QF), and tibialis anterior (TA) was measured using B-mode ultrasonography. Muscle echointensity was quantified using grayscale analysis in ImageJ software. Motor function was assessed using the Children’s Hospital of Philadelphia Infant Test of Neuromuscular Disorders (CHOP-INTEND), the Hammersmith Functional Motor Scale-Expanded (HFMSE), and the Revised Upper Limb Module (RULM).</div></div><div><h3>Results</h3><div>Children with SMA demonstrated significantly reduced MT and increased echointensity across all examined muscles compared with controls (<em>P</em>&lt;.05). TA echointensity showed strong negative correlations with CHOP-INTEND and HFMSE scores (<em>r</em>=−.781 and <em>r</em>=−.585, respectively; <em>P</em>&lt;.001). In addition, moderate positive correlations were observed between RULM scores and the thickness of the BB/B and FF muscles (<em>r</em>=.412 and <em>r</em>=.425, respectively; <em>P</em>&lt;.05).</div></div><div><h3>Conclusions</h3><div>Ultrasonography enables objective evaluation of muscle structure in children with SMA receiving disease-modifying therapy, with MT and echointensity demonstrating significant associations with motor function. TA echointensity may represent a promising biomarker for disease monitoring.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2937-2944"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148249086","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":"Assessing the Performance and Reliability of Deep Learning Autosegmentation in Videofluoroscopic Swallowing Studies: A Systematic Review and Meta-analysis","authors":"Wei-Kai Chuang MD,&nbsp;Bing-Fong Lin PhD,&nbsp;Yu-Hao Lee MD,&nbsp;Po-Hsun Su,&nbsp;Yung-Shuo Kao MD,&nbsp;Chia-Feng Lu PhD","doi":"10.1016/j.apmr.2026.03.016","DOIUrl":"10.1016/j.apmr.2026.03.016","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically evaluate the accuracy and reliability of deep learning–based autosegmentation methods in videofluoroscopic swallowing study (VFSS) through meta-analysis.</div></div><div><h3>Data Sources</h3><div>A comprehensive literature search was conducted across PubMed, IEEE Xplore, Embase, Web of Science, and Cochrane Library databases for studies published in English between 2013 and 2025.</div></div><div><h3>Study Selection</h3><div>Studies were included if they applied deep learning techniques to the autosegmentation of anatomical structures in VFSS, specifically the bolus, cervical spine, hyoid bone, or thyroid cartilage-vocal fold complex, and reported quantitative performance metrics such as the Dice similarity coefficient.</div></div><div><h3>Data Extraction</h3><div>Two independent reviewers extracted data on study characteristics, segmentation targets, deep learning model types, and performance metrics. Methodological quality was assessed using the Checklist for Artificial Intelligence in Medical Imaging and Quality Assessment of Diagnostic Accuracy Studies-2 tools.</div></div><div><h3>Data Synthesis</h3><div>Ten studies met the inclusion criteria. A random-effects meta-analysis yielded an overall pooled Dice score of 0.83 (95% CI, 0.76-0.88; <em>I</em>²=77%). Subgroup analyses showed similar performance for bolus segmentation (pooled Dice score=0.84; 95% CI, 0.70-0.92; <em>I</em>²=74%) and cervical spine segmentation (pooled Dice score=0.83; 95% CI, 0.69-0.91; <em>I</em>²=87%). Despite high accuracy, substantial heterogeneity was observed.</div></div><div><h3>Conclusions</h3><div>Deep learning–based autosegmentation in VFSS demonstrates promising accuracy across different anatomical targets. However, methodological variability among studies underscores the need for standardized protocols, multicenter datasets, and comparative evaluations of model architectures to enhance generalizability and clinical utility.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2963-2972"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147572012","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":"Impact of Sociodemographic Variables on Physical Therapists’ Documentation of Physical Activity Levels","authors":"Mariana Wingood PT, DPT, PhD,&nbsp;Clarissa A. McCall MSCR,&nbsp;Sania Bracey BS,&nbsp;Francois Modave PhD,&nbsp;Mitchell Paukner PhD","doi":"10.1016/j.apmr.2026.06.003","DOIUrl":"10.1016/j.apmr.2026.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>To examine how physical therapists document physical activity (PA) and how sociodemographic variables impact physical therapists’ PA documentation.</div></div><div><h3>Design</h3><div>Cross-sectional analysis of electronic health records.</div></div><div><h3>Setting</h3><div>An outpatient physical therapy clinic located within a large learning health system.</div></div><div><h3>Participants</h3><div>We randomly selected 10,000 initial evaluations (N=10,000) completed between 2018 and 2024 by the participating clinic’s 35 physical therapists.</div></div><div><h3>Interventions</h3><div>The documentation of patients’ PA.</div></div><div><h3>Main Outcome Measures</h3><div>Our main outcome was physical therapists’ documentation of patients’ PA levels. When PA was documented, we examined the presence or absence of the following documentation components: (1) strength, aerobic, or balance-based PA; and (2) frequency, intensity, time, and type/mode (FITT). Logistic regressions were conducted to examine how sociodemographic variables impacted PA documentation.</div></div><div><h3>Results</h3><div>Among the 4597 (45.97%) patients with documented PA, 2693 (58.59%) had 1 type of PA documented (ie, aerobic, strength, and balance). When we examined how PA documentation aligned with the FITT components, we identified that 9/4597 (&lt;1%) documentation included all the FITT components. The odds of having PA documented via FITT components decreased among individuals who identify as non-Hispanic Black or Hispanic, and those with increased social vulnerability.</div></div><div><h3>Conclusions</h3><div>Three major documentation gaps identified include the: (1) lack of PA documentation; (2) PA is not documented using the FITT components; and (3) sociodemographic variables impact if and how PA is documented.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2888-2894"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197193","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":"Assessing Disability Level and Fatigue in Multiple Sclerosis With Smart Sock Sensor Technology","authors":"Julie F. Stowell PT, DPT,&nbsp;Victory A. Ladipo,&nbsp;Russell Jeter PhD,&nbsp;Sujay S. Galen PhD,&nbsp;T. Bradley Willingham PhD","doi":"10.1016/j.apmr.2026.04.041","DOIUrl":"10.1016/j.apmr.2026.04.041","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether smart sock–derived gait metrics can distinguish disability levels and detect fatigue-related gait changes during prolonged walking in people with multiple sclerosis (MS).</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Outpatient rehabilitation program.</div></div><div><h3>Participants</h3><div>Thirty-two participants (N=32) with MS (Patient-Determined Disease Steps [PDDS] scores 0-6) completed 3 standardized walking tests while wearing smart socks. Gait metrics were derived via a validated analytic pipeline and included cadence, speed, step and stride length, gait cycle, stance, swing, and single- and double-support times. Disability groups were defined as mild-moderate (PDDS scores 0-4) and severe (PDDS 5-6).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Timed 25-foot walk test (T25FWT, 3 trials), 6-minute walk test (6MWT, 1 trial), and timed up and go (TUG, 3 trials) were used to assess gait metrics, and fatigue was assessed using pre/post Visual Analog Scale for Fatigue scores.</div></div><div><h3>Results</h3><div>Across tests, participants with severe disability exhibited significantly slower cadence (-24% to -35%) and speed (-45% to -50%) with prolonged temporal phases, including gait cycle (+34% to 45%), stance time (+40% to 51%), and double-support (+45% to 64%) compared with the mild-moderate group (<em>P</em>≤.05). Correlations between PDDS and spatiotemporal metrics were strongest for temporal variables during the 6MWT (ρ≈0.60 to 0.68). Discrimination of disability status was highest for timing metrics (area under the receiver operating characteristic curve [ROC-AUCs] 0.84-0.87) compared with spatial metrics (ROC-AUCs≤0.70). Least Absolute Shrinkage and Selection Operator regression retained cadence as a stable predictor for the timed up and go, with strong cross-validated discrimination (ROC-AUC≈0.84). The 6MWT also revealed fatigue-related declines, with gait cycle (7.5%±14.4%) and double-support time (49.1%±53.5%) increasing; perceived fatigue rose by 197%±236% (<em>P</em>≤.05).</div></div><div><h3>Conclusions</h3><div>Smart sock–derived spatiotemporal metrics differentiated disability levels and captured motor fatigability, with temporal coordination as the dominant impairment marker. These findings support the clinical utility of smart sock wearables as scalable tools for remote monitoring and precision rehabilitation in MS care.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2702-2712"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147940135","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}