Archives of physical medicine and rehabilitation最新文献

{"title":"Patient functional outcomes in skilled nursing facilities: the mediating role of declining therapy.","authors":"Rachel A Prusynski, Andrew Humbert, Harsha Amaravadi, Addie Middleton, Natalie E Leland, Debra Saliba, Cait Brown, Janet Freburger, Tracy M Mroz","doi":"10.1016/j.apmr.2025.09.018","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.018","url":null,"abstract":"<p><strong>Objective: </strong>To estimate changes in functional outcomes in Medicare fee-for-service skilled nursing facility (SNF) patients after declines in therapy minutes that occurred after Patient-Driven Payment Model (PDPM) implementation and during the COVID-19 pandemic. We also tested the hypothesis that declines in therapy minutes mediated changes in patient functional outcomes.</p><p><strong>Design: </strong>Retrospective cohort study using mediation analysis. Exposures were PDPM implementation (October 2019) and COVID-19 pandemic onset (March 2020). The mediator was average minutes of therapy per day (MTD) including all physical, occupational, and speech therapy minutes during the SNF stay.</p><p><strong>Setting: </strong>All US SNFs.</p><p><strong>Participants: </strong>3,534,928 post-acute SNF stays from January 2018 through September 2021.</p><p><strong>Interventions: </strong>Not applicable MAIN OUTCOME MEASURE(S): : Functional outcomes based on changes in activities of daily living (ADL) scores between SNF admission and discharge, measured by a validated 28-point scale: (1) ADL decline and (2) high ADL improvement (≥4 points improvement). Mediation analysis quantified effects of declining MTD on functional outcomes, adjusting for patient, facility, and community-level confounders.</p><p><strong>Results: </strong>Average MTD declined from 122.2 pre-PDPM to 96.5 post-PDPM and further to 87.7 during COVID-19. After PDPM implementation, the adjusted probability of ADL decline increased by 1.7 percentage points (pp) (95% CI 1.6, 1.7); during COVID-19, ADL decline increased by 3.7pp (95% CI 3.6, 3.7). Declining MTD mediated 47.9% of the increase in ADL decline post-PDPM and 26.5% during COVID-19. The adjusted probability of high ADL improvement increased by 1.3pp (95% CI 1.1, 1.3) post-PDPM and 1.0pp (95% CI 0.8, 1.0) during COVID-19. Declining MTD negatively mediated this increase in high ADL improvement by -2.9pp post-PDPM (95% CI -2.9, -2.9) and by -3.5 pp during COVID-19 (95% CI -3.6, -3.5).</p><p><strong>Conclusions: </strong>Declines in SNF therapy after PDPM implementation and during COVID-19 mediated substantial worsening in patient functional outcomes. Ensuring adequate therapy provision may improve functional recovery in SNF patients.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211513","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":"Effects of physical exercise programs on fatigue and functional capacity in people with Guillain-Barré Syndrome and Chronic Inflammatory Demyelinating Polyneuropathy: A systematic review.","authors":"Alberto De León-Muñoz, Vicente Ávila-Gandía, Luis Andreu-Caravaca","doi":"10.1016/j.apmr.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.013","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of physical activity programs on fatigue and functional capacity, in addition to other variables related to patient's health in people suffering GBS and CIDP through a systematic review.</p><p><strong>Data sources: </strong>Four databases (PubMed, Web of Science, Scopus and EBSCO) were searched according to PRISMA guidelines. The search was conducted from the inception until 01 of March 2025.</p><p><strong>Data extraction: </strong>Data were extracted using Excel (v. 16051.17628.20144.0) and authors, country, year, study design, main variables, sample, intervention characteristics and primary outcomes of each article were used.</p><p><strong>Study selection: </strong>Inclusion criteria focused on studies involving GBS and CIDP patients undergoing exercise programs lasting a minimum of three weeks. A total of 13 articles were analyzed (including case studies, randomized and no-randomized clinical trials, a prospective study, case series and a replicated single-case design), comprising 173 participants. Of these, five studies specifically included patients with CIDP, accounting for a total of 37 participants.</p><p><strong>Data synthesis: </strong>The synthesis of the included studies indicates that multicomponent programs integrating resistance, aerobic, balance, and respiratory exercises are associated with improvements in fatigue and functional capacity, as well as other physical fitness variables. Furthermore, a pattern across the reviewed literature suggests that optimal results appear to be linked to supervised and individualized training sessions lasting 45-60 minutes, conducted 3-4 times per week for at least 12 weeks, although it must be noted that these findings were drawn from heterogeneous study designs.</p><p><strong>Conclusions: </strong>Multicomponent exercise programmes appear to improve fatigue, functional capacity and physical fitness in patients with GBS and CIDP. Optimal benefits are associated with supervised and individualized sessions (45-60 minutes, 3-4 times per week for >12 weeks). These findings support structured training as a valuable component of these conditions.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211507","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":"Inspiratory Muscle Training enhances Functional Sitting Balance more than Usual Care in Individuals with Spinal Cord Injury: A Randomized Controlled Trial.","authors":"Kanishka Gambhir, Shambhovi Mitra, Anne E Palermo","doi":"10.1016/j.apmr.2025.09.017","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.017","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of inspiratory muscle training (IMT) on functional sitting balance (FSB) in individuals with spinal cord injury (SCI).</p><p><strong>Design: </strong>Rater-masked, parallel, two-group randomized clinical trial.</p><p><strong>Setting: </strong>Tertiary care SCI rehabilitation hospital in Delhi, India.</p><p><strong>Participants: </strong>Forty-four participants (aged 18-60) with C4-T6 injuries (AIS A-C) (cervical-SCI=25, thoracic-SCI=19, AIS A=33, B=11, C=0) in their first SCI-specific inpatient rehabilitation were randomized into experimental and control groups.</p><p><strong>Interventions: </strong>Both groups received standard respiratory care and physiotherapy. The experimental group received additional flow-resistive IMT sessions over six weeks.</p><p><strong>Main outcome measures: </strong>FSB was measured using the Function in Sitting Test-SCI (FIST-SCI), and respiratory function was assessed via maximal inspiratory pressure (MIP), sustained maximal inspiratory pressure (SMIP), and Fatigue Index Test (FIT) score at baseline, four weeks and six weeks. Data was analyzed using repeated measures general linear model framework in IBM SPSS version 21.</p><p><strong>Results: </strong>Analysis showed significant improvements in FSB for both groups(p<0.001). SMIP, MIP, and FIT scores improved only for the experimental group(p<0.05). Post-hoc analyses of interaction effects showed significantly greater improvements in all variables in the experimental group.</p><p><strong>Conclusion: </strong>This study is the first to show that FSB improves more with addition of IMT to standard care in individuals with SCI.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211485","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":"Differences in narrative discourse ability in traumatic brain injury and a neurotypical comparison group: Influence of age, education, and sex.","authors":"Karen Lê, André Lindsey, Carl Coelho, Joanna Fiszdon, Richard Feinn","doi":"10.1016/j.apmr.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.015","url":null,"abstract":"<p><strong>Objective: </strong>To examine the influence of traumatic brain injury (TBI) on narrative discourse comprehension and production of individuals with TBI compared to a non-brain-injured (NBI) group. Further, this work investigated the potential influence of socio-demographic factors (i.e., age, education, sex) on narrative discourse performance.</p><p><strong>Design: </strong>Case-control design SETTING: General community PARTICIPANTS: A total of 44 adults were grouped into two age- and education-matched cohorts. The TBI group comprised 21 participants with mild-moderate cognitive impairment, and the NBI comprised 23 participants.</p><p><strong>Interventions: </strong>Not applicable MAIN OUTCOME MEASURES: Narrative discourse outcomes were measured by two comprehension measures (Discourse Comprehension Test, picture story comprehension task) and two production measures (story grammar, story completeness). Four univariate analyses of covariance (ANCOVA) were performed with age, education, and sex as covariates. The ANCOVAs were performed using parameter estimates with robust standard errors, and boxplots were constructed to understand differences between cohorts for each discourse measure.</p><p><strong>Results: </strong>No sociodemographic variables (i.e., the covariates) were significant for any of the four discourse measures. The NBI group outperformed the TBI group on the DCT (p = .003, 95% CI [1.46, 6.82], partial η² = .20), PSC (p = .005, 95% CI [.61, 3.26], partial η² = .18), and story completeness (p = .005, 95% CI [.43, 2.26], partial η² = .21). Effect sizes were large across these three discourse measures. No significant difference between groups was found for story grammar (p = .440, 95% CI [-.11, .25], partial η² = .02).</p><p><strong>Conclusions: </strong>TBI disrupts both narrative discourse comprehension and production ability. Findings underscore the need to evaluate both narrative comprehension and production performance following TBI. Age, education, and sex did not influence discourse outcomes.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211568","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 post-traumatic seizures, antiseizure medication, and duration of post-traumatic amnesia: a retrospective cohort analysis.","authors":"Sergiu Albu, Oyku Arslantas, Hatice Kumru","doi":"10.1016/j.apmr.2025.09.020","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.020","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the relationship between posttraumatic seizure (PTS) and anti-seizure medications (ASMs) use with post-traumatic amnesia (PTA) duration.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>Guttmann Institute, Neurorehabilitation Hospital (Badalona, Barcelona, Spain).</p><p><strong>Participants: </strong>Patients with PTA following traumatic brain injury (TBI) admitted for rehabilitation between February 2002 and May 2024.</p><p><strong>Interventions: </strong>none.</p><p><strong>Main outcome measures: </strong>Age, gender, Glasgow Coma Scale (GCS) score, Galveston Orientation and Amnesia Test (GOAT) scores at admission and discharge, presence of PTS and ASM use, and PTA duration (days from TBI to PTA emergence). Group comparisons were conducted between patients with or without PTS and ASM use to identify differences in clinically relevant variables related with PTA duration. Cox proportional-hazards models were conducted to estimate PTA duration.</p><p><strong>Results: </strong>A total of 352 patients (80.4% male; median age: 39.54 years) were distributed into four groups: Treatment-PTS (N=64, ASM for PTS), Prophylactic-ASM (N=46, ASM to prevent PTS), Behavior/Pain-ASM (N=160, ASM for behavioral impairment or neuropathic pain but no PTS), and noASM (N=82). Median PTA duration was shortest in noASM (59.1 days [IQR: 48.6-89.7]) compared to Treatment-PTS (74.7 [IQR: 55.5-111.5]), Prophylactic-ASM (84.5 [IQR: 59.0-102.2]) and Behavior/Pain-ASM (78.1 [56.6-102.5]) (p=0.02). Older age (HR: 0.98; 95% CI: 0.98 - 0.99), lower admission GOAT scores (HR: 1.02; 95% CI: 1.02 - 1.03), and being on Treatment for PTS as compared to noASM (HR:0.58; 95 % CI: 0.38-0.88) or Behavior/Pain-ASM (HR: 0.61; 95 % CI 0.42-0.89) had significant negative association with the PTA duration.</p><p><strong>Conclusions: </strong>ASM use, older age and lower GOAT score are associated with longer PTA duration. The high use rates of ASMs in TBI patients extending beyond those with PTS underscores the importance of careful evaluation of ASM use to optimize outcomes in TBI patients with PTA.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211553","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":"Microdialysis Evaluation of Blood Flow, Lactate, and Glucose in Active Trigger Points of Tension-Type Headache Patients and Latent Trigger Points in Healthy Muscle.","authors":"Albert F Moraska, Yue Wang, Robert C Hickner, Rachael Rzasa Lynn, Jonathan Hebert, Wendy M Kohrt","doi":"10.1016/j.apmr.2025.09.019","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.019","url":null,"abstract":"<p><strong>Objective: </strong>To assess nutritive blood flow, lactate, and glucose within active and latent TrPs compared to non-TrP muscle.</p><p><strong>Design: </strong>Case-controlled observational study.</p><p><strong>Setting: </strong>A University-based Clinical and Translational Research Center (CTRC).</p><p><strong>Participants: </strong>Active TrPs were identified through palpation of the upper trapezius muscle of individuals with episodic or chronic tension-type headache (TTH). Latent TrPs and muscle without TrPs were identified in age- and sex-matched subjects without a history of headache.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Nutritive blood flow, and interstitial lactate and glucose concentrations were determined at 12-20-minute intervals over 160 minutes through microdialysis sampling of interstitial fluid.</p><p><strong>Results: </strong>A total of 64 individuals participated in the study. Subjects were 33.8±10.8y, 64.1% female, and 73.4% white, with no statistical differences between active, latent, and no TrP groups on demographic or baseline variables (p>0.05). Subjects with TTH reported a median of 4 headaches/month and had experienced headaches for a median of 120 months. Active TrPs exhibit higher nutritive blood flow than anatomically matched no TrP muscle (p=0.026) but were not different from latent TrPs (p=0.554). There were no global differences between the three groups for lactate (p=0.329) or glucose (p=0.231).</p><p><strong>Conclusions: </strong>The present study provides in vivo evidence of higher nutritive blood flow in active TrPs from individuals with TTH but no difference in lactate and glucose compared to non-TrP muscle. Our data does not support the TrP as a tightly contracted, ischemic region within skeletal muscle. Interventions designed to relax muscle contraction or increase blood flow may have limited benefits in alleviating active trigger points.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205519","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":"Functional Outcomes of Individuals Undergoing the Ewing Amputation.","authors":"Lori Berger, Sarah Kelly Welch, Sarah Danforth, Stuart Lipsitz, Corey L Sullivan, Tawnee L Sparling, Matthew J Carty","doi":"10.1016/j.apmr.2025.09.016","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.016","url":null,"abstract":"<p><strong>Objective: </strong>To assess the postoperative performance of patients who have undergone the Ewing amputation (EA) on physical function tests and patient-reported outcome measures compared to their own preoperative state, as well as to normative data from non-EA transtibial amputees (TTAs) and able-bodied community adults (ABAs).</p><p><strong>Design: </strong>Intervention cohort study with follow up of approximately one year.</p><p><strong>Setting: </strong>Tertiary/quaternary care academic medical center.</p><p><strong>Participants: </strong>Patients aged 18-65 who were candidates for elective transtibial amputation following failed attempts at limb salvage.</p><p><strong>Intervention: </strong>The Ewing amputation - a novel approach to transtibial amputation incorporating the construction of agonist-antagonist myoneural interfaces (AMIs).</p><p><strong>Main outcome measures: </strong>Performance-based physical function tests and patient-reported outcomes measures.</p><p><strong>Results: </strong>A total of 22 patients with 26 EAs were studied. Over half of the studied EA patients were biological males (13, 59%) and the mean age of the intervention population was 40.6±12.9 years. All EA patients progressed to prosthetic fitting, with a mean time of 65±25 days. Functional testing was performed at a mean interval of 112±69 days prior to and 347±141 days following amputation. EA patients demonstrated statistically significant (p<0.01) improvements on all functional outcome measures and patient reported outcomes measures with the exception of Functional Reach (p=0.1222) when compared to themselves prior to amputation. EA patients demonstrated statistically significantly better performance on the 10-Meter Walk Test (10MWT), Timed Up and Go (TUG), 6-Minute Walk Test (6MWT) and Functional Reach Test than normative data from the TTA population (p<0.05), and equivalent performance to ABA patients on the 10MWT and TUG (p>0.5).</p><p><strong>Conclusions: </strong>Patient performance on functional outcome measures improved after undergoing the Ewing amputation and associated rehabilitation interventions. Additionally, EAs performed better on several physical function outcome measures postoperatively when compared to TTAs and equivalent to ABAs on several of the same measures.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145205432","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 the Letter to the Editor regarding \"Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients\" (Manuscript ID: ARCHIVES-PMR-D-24-01415).","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.2025.09.009","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.009","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181929","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":"Understanding multidimensional apathy in traumatic brain injury.","authors":"Meg Rankin, Jennie Ponsford, Amelia Hicks, Ruby Phyland, Trevor T-J Chong, Gershon Spitz","doi":"10.1016/j.apmr.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.011","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether individuals with moderate-to-severe chronic TBI exhibit higher levels of apathy-particularly in behavioural, cognitive, and emotional domains-compared to neurotypical controls, and examine the association between apathy severity and injury-related factors, productivity and quality of life.</p><p><strong>Design: </strong>Cross-sectional, cohort study.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>Participants were sampled from a larger longitudinal study of individuals recruited from consecutive inpatient TBI admissions to a rehabilitation hospital. We analysed data from 136 participants with moderate-to-severe TBI (53% male; M_Age = 51.8 years; M_{time post-injury} = 13.8 years, range 0.25-35.2) and 78 neurotypical controls (48.75% male; M_Age = 50.3 years).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Apathy Evaluation Scale, injury-related measures, Satisfaction with Life Scale, coded Productivity measure based on employment status.</p><p><strong>Results: </strong>Results indicated that individuals with TBI had significantly higher overall apathy (p = 0.031) and behavioural apathy (p = 0.037) compared to neurotypical controls, but did not differ in the cognitive or emotional subtypes. Individuals with TBI were 1.98 times more likely to exhibit clinically significant apathy (OR = 1.98, 95% CI [0.98, 4.22]). Glasgow Coma Scale score, post-traumatic amnesia duration, age at the time of injury, time post-injury, and abnormal computed tomography scan were not significantly related to any apathy subtype. Higher global apathy scores were significantly associated with lower productive activities (p = 0.021), while higher global and behavioural apathy were significantly associated with lower life satisfaction (p <.001, p = 0.021, respectively).</p><p><strong>Conclusions: </strong>These findings underscore the elevated prevalence of apathy following TBI, which may manifest primarily in the behavioural domain. The association between elevated apathy and lower functioning and reduced life satisfaction highlights that apathy is a key factor influencing long-term outcomes. Identifying and addressing apathy, especially its behavioural component, may therefore be critical for improving functional recovery and quality of life in this population.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136206","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: A Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients.","authors":"Chao-Chun Huang, Hsuei-Chen Lee","doi":"10.1016/j.apmr.2025.09.008","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.09.008","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129956","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}