Archives of physical medicine and rehabilitation最新文献

{"title":"Reining in Unbridled AI Enthusiasm: Protecting the Integrity of Rehabilitation Science and Clinical Care","authors":"Amanda Rabinowitz PhD,&nbsp;Mason Trauger PT, DPT,&nbsp;Michael Williams PhD","doi":"10.1016/j.apmr.2026.04.033","DOIUrl":"10.1016/j.apmr.2026.04.033","url":null,"abstract":"<div><div>Enthusiasm for artificial intelligence (AI) applications in rehabilitation medicine has accelerated rapidly, from 22 publications in 2015 to 1449 in 2025. This expansion reflects growing optimism that AI may enhance clinical efficiency, streamline research workflows, and support patient-centered care. Uncritical adoption carries significant risks for rehabilitation practice, research integrity, clinical workforce sustainability, health equity, and environmental impact. This commentary cautions against a hasty adoption of AI, and argues that responsible deployment in rehabilitation requires deliberate, ethical integration grounded in shared responsibility across clinicians, developers, health care systems, and researchers. For rehabilitation providers, ethical AI use demands grounding decisions in discipline-specific principles, understanding model capabilities and limitations, implementing transparent informed consent processes, ensuring data security, and reviewing AI outputs before clinical application. Clinicians must remain accountable for AI-generated recommendations while collaborating with developers to mitigate bias and inequities. Patient-facing applications require particular safeguards, including patient education and meaningful human oversight through regular auditing by trained clinicians. Developers should establish minimum standards for representative data curation, ongoing model updating, and quality assurance, while maintaining cultural responsiveness and transparency about uncertainty in recommendations. Health care systems must engage multistakeholder groups—including patients, clinicians, caregivers, and community representatives—to evaluate ethical, labor, societal, and environmental implications, prioritizing patient well-being over efficiency gains. Researchers must critically examine epistemological and ethical implications of AI methodologies while preserving theory-driven inquiry and community-based participatory approaches. These coordinated efforts are essential to ensure AI enhances rehabilitation while preserving core ethical principles, protecting patient rights, and promoting evidence-based equitable care.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 3024-3032"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147866458","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 of the First Ventilatory Threshold Assessment in People With Neuromuscular Diseases: Impact on Exercise Prescription and Evaluation","authors":"Tim Veneman MSc,&nbsp;Eric Lukas Voorn PhD,&nbsp;Jacco Engel MSc,&nbsp;Frans Nollet MD, PhD,&nbsp;Fieke Sophia Koopman MD, PhD","doi":"10.1016/j.apmr.2026.04.042","DOIUrl":"10.1016/j.apmr.2026.04.042","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the interrater and test-retest reliability of the first ventilatory threshold (VT1) assessment in people with neuromuscular diseases (NMD) and its impact on exercise prescription and evaluation.</div></div><div><h3>Design</h3><div>Reliability study.</div></div><div><h3>Setting</h3><div>Academic hospital.</div></div><div><h3>Participants</h3><div>Fifty-one ambulatory adults (mean ± SD age: 63.2±10.3) with Charcot-Marie-Tooth disease (n=20), chronic idiopathic axonal polyneuropathy (n=12), postpolio syndrome (n=11), muscular dystrophy (n=6), or other NMD (n=2).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Oxygen uptake, heart rate, and workload at VT1 were assessed independently by 2 raters from 2 submaximal incremental exercise tests on a cycle ergometer, 1 week apart. VT1 was determined using the V-slope and ventilatory equivalents methods. Reliability was determined using intraclass correlation coefficients (ICCs) and a paired <em>t</em> test for systematic differences. Measurement error was expressed as the standard error of the mean (SEM) or coefficient of variation (CV), and limits of agreement (LoA).</div></div><div><h3>Results</h3><div>ICCs were good to excellent for interrater reliability (95% confidence interval, 0.80-0.98), and moderate to excellent for test-retest reliability (95% confidence interval, 0.73-0.95). Interrater and test-retest SEM and CV ranged between 4.9% and 12.6%, with limits of agreement ranging from 14% to 31%.</div></div><div><h3>Conclusions</h3><div>ICCs indicated moderate to excellent reliability of VT1 assessments. Measurement errors were low at the group level, with small SEM values, but higher at the individual level, with wide LoA. Considering these results, VT1 can be used to detect changes in aerobic capacity in NMD at the group level, but not at the individual level. If VT1 is used to guide personalized exercise prescription, clinicians should anticipate that target intensity zones may be over- or underestimated in some cases, requiring close monitoring.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2730-2736"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147962132","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":"Reducing Recidivism After Traumatic Brain Injury: Results From the Re-entry Continuum for Brain Injury (RCBI) Trial","authors":"Devan Parrott PhD,&nbsp;Dawn Neumann PhD,&nbsp;Anthony Laffoon MS","doi":"10.1016/j.apmr.2026.05.025","DOIUrl":"10.1016/j.apmr.2026.05.025","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the effects of an intervention (Re-entry Continuum for Brain Injury [RCBI]) designed to support individuals with traumatic brain injury (TBI) pending release from prison. RCBI started about 6 months prior to release. The aims were to examine the impact of RCBI on (1) recidivism up to 3 years postrelease and (2) participants’ behavioral infractions, self-efficacy, aggression, negative attributions, and executive functioning while still incarcerated.</div></div><div><h3>Design</h3><div>Randomized controlled trial comparing RCBI with treatment as usual (TAU). Assessment times were: time 1 (∼6 months before prerelease); time 2 (near release); time 3 (2 weeks postrelease); and times 3-5 (1, 2, and 3 years postrelease, respectively).</div></div><div><h3>Setting</h3><div>Department of Corrections and community setting.</div></div><div><h3>Participants</h3><div>Men with TBI who were incarcerated and between 5 and 8 months of release (N=91; RCBI=45; TAU=46).</div></div><div><h3>Interventions</h3><div>RCBI intervention teaching brain injury coping skills and anger management while incarcerated, and 12 months of resource facilitation immediately after release.</div></div><div><h3>Main Outcome Measures</h3><div>(1) Recidivism (reincarceration, arrests, and criminal charges); (2) Brain Injury Coping Skills Questionnaire (BICS-Q; self-efficacy); (3) Aggression Questionnaire (AQ), Ambiguous Intentions Hostility Questionnaire (AIHQ), and Behavior Rating Inventory of Executive Function-Adult version (BRIEF-A).</div></div><div><h3>Results</h3><div>Compared with TAU, RCBI participants had significantly lower rates of returning to prison (46% vs 17%), arrests (86% vs 43%), and criminal charges resulting in prison or jail time (79% vs 42%) 3 years postrelease. Behavioral infractions while in prison decreased over time in both groups, but were significantly lower for RCBI participants after the intervention than for TAU participants. After controlling for baseline scores, RCBI participants had significantly better BICS-Q and BRIEF-A outcomes than TAU participants. No differences were observed in AQ or AIHQ outcomes.</div></div><div><h3>Conclusions</h3><div>Individuals with TBI are overrepresented in the justice system and susceptible to recidivism. RCBI improved successful community reintegration after incarceration in this TBI sample.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2879-2887"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148216067","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 and Performance Validation of an Automated Generative Pretrained Transformer–Based Evaluation Tool for the Physiotherapy Evidence Database Scale","authors":"Yu-Jeng Ju PhD,&nbsp;Yi-Ching Wang OT, PhD,&nbsp;Fan Chou MD,&nbsp;Wen-Hsuan Hou MD, MPH, PhD,&nbsp;Shu-Mei Chen PT, PhD,&nbsp;Ching-Lin Hsieh OTR, PhD","doi":"10.1016/j.apmr.2026.02.011","DOIUrl":"10.1016/j.apmr.2026.02.011","url":null,"abstract":"<div><h3>Objectives</h3><div>To develop an automated generative pretrained transformer (GPT)- physiotherapy evidence database (PEDro) evaluation tool (GPT-PEDro ET) and validate its performance (including intrarater reliability and concurrent validity) for evaluating the methodological quality of RCTs using the PEDro scale.</div></div><div><h3>Design</h3><div>A psychometric validation study with a repeated measurements design.</div></div><div><h3>Setting</h3><div>Research laboratory.</div></div><div><h3>Participants</h3><div>One hundred and twenty-five RCTs on neurofacilitation interventions in stroke rehabilitation were retrieved from the PEDro database.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcomes and Measures</h3><div>The primary outcome was RCT quality scores evaluated using the GPT-PEDro ET tool at both total score and individual item levels across 2 rounds of evaluation. Intrarater reliability was determined using the intraclass correlation coefficient (ICC) for total score and prevalence-adjusted and bias-adjusted κ (PABAK) for individual items. Concurrent validity was assessed with ICC (total score) and PABAK (individual item), Bland–Altman analysis with 95% limits of agreement, and heteroscedasticity testing.</div></div><div><h3>Results</h3><div>The GPT-PEDro ET tool achieved almost perfect intrarater reliability (total score ICC=1.00; individual item PABAK=0.94-1.00). The concurrent validity was moderate to high at both the total score level (ICCs=0.83, 0.83) and the individual item level for all the items (PABAKs=0.68-0.97).</div></div><div><h3>Conclusions</h3><div>The results suggest that the GPT-PEDro ET tool may be a useful automated tool for evaluating the methodological quality of RCTs. It shows potential for reducing manual evaluation workload and supporting clinical and research applications.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2647-2656"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147343371","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":"Accelerometry-Based 24-Hour Movement Behavior in Manual Wheelchair Users: A Cross-Sectional Study","authors":"Alena Vernerová,&nbsp;Jan Dygrýn PhD,&nbsp;František Chmelík PhD","doi":"10.1016/j.apmr.2026.03.003","DOIUrl":"10.1016/j.apmr.2026.03.003","url":null,"abstract":"<div><h3>Objective</h3><div>To describe 24-hour movement behavior in manual wheelchair users using accelerometry, with a focus on differences by sex, severity of disability, and timing of disability onset.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Free-living conditions.</div></div><div><h3>Participants</h3><div>Adult manual wheelchair users (N=72).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Adherence to 24-hour movement guidelines, defined as ≥150 min/wk of moderate-to-vigorous physical activity, 7-9 hours of sleep per night, and &lt;8 hours/day of sedentary behavior. Movement behaviors were assessed using a wrist-worn ActiGraph wGT3X-BT over 7 days and a sociodemographic questionnaire.</div></div><div><h3>Results</h3><div>No participants met all 3 guidelines because none met the sedentary behavior criterion. Overall, 90% met the physical activity guideline and 69% met the sleep guideline. Compared with participants with congenital disabilities, those with acquired disabilities accumulated more physical activity (Z=3.49, <em>P</em>&lt;.001) and less sedentary time (Z=3.85, <em>P</em>&lt;.001), and were more likely to meet the physical activity guideline (χ²=9.74, <em>P</em>=.0018), whereas participants with congenital disabilities more often met the sleep guideline (χ²=6.29, <em>P</em>=.012).</div></div><div><h3>Conclusion</h3><div>Sedentary behavior was the most challenging 24-hour guideline. These findings highlight the need for disability-specific movement guidelines that better reflect the unique circumstances and daily realities of manual wheelchair users.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2667-2672"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147430432","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":"Strengthening of Rotator Cuff and Scapular Muscles in Patients With Lateral Elbow Tendinopathy: A Randomized Controlled Study","authors":"Pelin Tiryaki PT, PhD,&nbsp;Derya Çelik PT, PhD","doi":"10.1016/j.apmr.2026.05.006","DOIUrl":"10.1016/j.apmr.2026.05.006","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the impact of scapular and rotator cuff muscle strengthening exercises in addition to an elbow-focused rehabilitation program for patients with lateral elbow tendinopathy (LET).</div></div><div><h3>Design</h3><div>Prospective, parallel group, randomized controlled trial.</div></div><div><h3>Setting</h3><div>Yalova Research and Training Hospital.</div></div><div><h3>Participants</h3><div>Individuals diagnosed with LET, between 18 and 65 years of age, unilateral pain for a minimum of 3 months, and pain in at least 2 of the 4 clinical tests (Cozen’s, Maudsley, Mill’s maneuver, and Thomsen’s tests).</div></div><div><h3>Interventions</h3><div>Participants were randomly assigned to 2 groups. Group 1 (n=29) received rotator cuff and scapular muscle strengthening exercises in addition to wrist extensor exercises, whereas Group 2 (n=29) performed only wrist extensor exercises. Participants in both groups received education on activity modifications. Supervised exercise programs for both groups conducted twice a week for 8 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcomes were the Patient-Rated Tennis Elbow Evaluation (PRTEE) and Numerical Pain Rating Scale (NPRS). Secondary outcomes included maximum and pain-free grip strength, pressure pain threshold (PPT), rotator cuff and scapular muscles strength, and Global Rating of Change score.</div></div><div><h3>Results</h3><div>A total of 58 participants (mean age 40.72±8.36y, 63% female, average symptom durations 35.2mo) completed primary and secondary outcomes at each follow-up time point. The mean difference (95% confidence interval) between Group 1 and Group 2 for PRTEE score was −13.06 [−16.73, 9.39] at 1-year follow-up. Group-by-time interaction for repeated measures analysis of covariance was significant for NPRS-activity and NPRS-rest, maximum and pain-free grip strength, PPT, and strength of rotator cuff and scapular muscles (<em>P</em>&lt;.05).</div></div><div><h3>Conclusions</h3><div>This study provides evidence of added benefit for the addition of rotator cuff and scapular muscle strengthening exercises to an elbow-focused rehabilitation program for patients with LET compared with an exercise program that targets the wrist extensors alone.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2755-2765"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148004273","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":"Smartphone Applications for Assisting Outdoor and Indoor Navigation for Persons with Blindness or Low Vision.","authors":"Taylor F Faust, Nazli Radfar, Giles Hamilton-Fletcher, Mahya Beheshti, John-Ross Rizzo","doi":"10.1016/j.apmr.2026.08.006","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.08.006","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103356","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":"Eating Well With Parkinson Disease: An Evidence-Based Guide to Nutrition, Digestion, and Swallowing","authors":"Olivia Crozier BHSc,&nbsp;Christopher Stavisky PhD, OTR/L,&nbsp;Jessica E. Huber PhD, CCC-SLP,&nbsp;Himani Puri RD,&nbsp;Urvashy Gopaul BSc, MSc, PhD","doi":"10.1016/j.apmr.2025.12.007","DOIUrl":"10.1016/j.apmr.2025.12.007","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 3047-3051"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146083949","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":"Beyond Clinical Predictors: Determining the Impact of Psychosocial Factors in Chronic Pain After Spinal Cord Injury","authors":"Andrew D. Delgado PhD,&nbsp;Rachel Fremont MD,&nbsp;Thomas N. Bryce MD,&nbsp;Lewis E. Tomalin PhD,&nbsp;Noam Y. Harel MD,&nbsp;John P. Handrakis PT, DPT, EdD,&nbsp;Ola A. Alsalman PhD,&nbsp;Lisa A. Spielman PhD","doi":"10.1016/j.apmr.2026.05.018","DOIUrl":"10.1016/j.apmr.2026.05.018","url":null,"abstract":"<div><div>Although chronic pain is common after traumatic spinal cord injury (SCI) and prognostic models have traditionally prioritized clinical injury characteristics, the relative contribution of sociodemographic and psychological factors remains undercharacterized.</div></div><div><h3>Methods</h3><div>Secondary analysis of a national longitudinal cohort from United States inpatient rehabilitation centers participating in the Spinal Cord Injury Model Systems. Adults with traumatic SCI (N=1303) completed Spinal Cord Injury Model Systems Form 1 and a 1-year follow-up Form 2 interview. Pain intensity at 1 year was assessed using the Numeric Rating Scale (0-10) for the prior 4 weeks (mean 4.3 [SD, 2.8]; 85.4% reported pain). Hierarchical linear and quantile regression models were used to evaluate the incremental predictive value of biopsychosocial (BPS) domains, alongside Elastic Net regression and Boruta feature selection to identify robust predictors.</div></div><div><h3>Results</h3><div>Sequential addition of BPS domains improved model fit across hierarchical regressions, regardless of entry order (full model <span><math><msubsup><mi>R</mi><mrow><mtext>Adjusted</mtext></mrow><mn>2</mn></msubsup></math></span>≈12%). Social/demographic variables accounted for the largest share of predictive signal and were consistently prioritized over clinical factors and psychological measures. Elastic Net regression selected 43 predictors across domains, whereas Boruta confirmed 27. Six predictors were consistently identified across all methods: median household income, race, education, tobacco use, primary payer, and depression severity.</div></div><div><h3>Conclusions</h3><div>Sociodemographic factors accounted for the most predictive value for chronic pain after SCI, often outperforming traditional clinical and psychological measures. Converging results across methods support the BPS model and highlight potential targets for screening and intervention. Prospective studies are needed to clarify causal pathways and inform pain prevention efforts.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2825-2832"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148142536","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":"Does Depressed Mood Affect Accuracy of Perceptions of Cognitive Function in Multiple Sclerosis? The Role of Momentary Depressive Symptoms in the Correspondence Between Subjective and Objective Cognition in Multiple Sclerosis","authors":"Erin G. Mistretta PhD,&nbsp;Dawn M. Ehde PhD,&nbsp;Aaron P. Turner PhD,&nbsp;Kevin N. Alschuler PhD,&nbsp;Nora E. Fritz PhD,&nbsp;Anna L. Kratz PhD","doi":"10.1016/j.apmr.2026.05.004","DOIUrl":"10.1016/j.apmr.2026.05.004","url":null,"abstract":"<div><h3>Objective</h3><div>To examine whether the momentary association between subjective cognitive dysfunction (SCD) and objective cognitive performance (OCP) varies as a function of within-person fluctuations in depressed mood among people with multiple sclerosis (PwMS).</div></div><div><h3>Design</h3><div>Secondary analysis of microlongitudinal data collected over 14 days from PwMS.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Ambulatory adults with MS (N=241).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Participants completed ecological momentary assessments 4x per day for 2 weeks, reporting SCD, depressed mood, and brief objective cognitive tasks assessing processing speed and working memory. Multilevel models tested within-person associations between OCP and SCD and moderation by depressed mood.</div></div><div><h3>Results</h3><div>Momentary objective processing speed corresponded to total SCD, such that slower processing speed was associated with higher perceived cognitive dysfunction (B=0.06, SE=0.01, <em>P</em>&lt;.001). In contrast, objective working memory did not correspond with total SCD. Depressed mood was independently associated with greater SCD (B=0.09, SE=0.01, <em>P</em>&lt;.001) but did not moderate the relationship between OCP and SCD.</div></div><div><h3>Conclusion</h3><div>PwMS appear accurate in their momentary perceptions of processing speed performance, but less so for working memory. Depressed mood states are associated with elevated perceptions of cognitive dysfunction regardless of objective performance.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2737-2745"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147970072","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}