Archives of physical medicine and rehabilitation最新文献

{"title":"Increased Stiffness Is Evidenced in the Deep But Not Superficial Lumbar Multifidus Muscle in Professional Athletes With Chronic Low Back Pain","authors":"Emma Feng Ming Zhou MPT ,&nbsp;Arnold Yu Lok Wong PhD ,&nbsp;Guohui Lin MSc ,&nbsp;Jianhui Fang MM ,&nbsp;Tao Wen MM ,&nbsp;Juhua Peng CP ,&nbsp;Siu Ngor Fu PhD","doi":"10.1016/j.apmr.2024.11.004","DOIUrl":"10.1016/j.apmr.2024.11.004","url":null,"abstract":"<div><h3>Objectives</h3><div>Elevated lumbar multifidus stiffness has been observed in populations with chronic low back pain (LBP). However, the modulation of deep (DLM) and superficial (SLM) lumbar multifidus stiffness, considering their distinct structural characteristics and functions, remains unaddressed, especially in athletes. This study aimed to compare differences in DLM and SLM stiffness in professional athletes from different sports with and without chronic LBP.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>This study was conducted at a provincial sports training center.</div></div><div><h3>Participants</h3><div>Ninety-nine professional athletes (age: 18-27 years) from weightlifting, badminton, and track and field teams were recruited. Thirty-eight had chronic bilateral LBP.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Ultrasound shear wave elastography measured Young's modulus (stiffness indicator) of DLM and SLM at the L4/5 facet joint level. Two-way analysis of variance examined the effects of chronic LBP and sport type on DLM and SLM stiffness while considering proper confounders. Significance was set at <em>P&lt;.</em>05.</div></div><div><h3>Results</h3><div>Athletes with chronic LBP demonstrated significantly higher DLM stiffness on the dominant (by 17.73%, mean difference [MD]=2.52 kPa, <em>P=.</em>001) and nondominant sides (by 13.54%, MD=1.83 kPa, <em>P=.</em>046) compared with pain-free counterparts. SLM stiffness varied significantly among the 3 athlete groups. Post-hoc analyses revealed greater SLM stiffness on the nondominant side in weightlifters than in badminton players (by 51.76%, MD=8.97 kPa, <em>P=.</em>010) or track and field athletes (by 72.01%, MD=11.01 kPa, <em>P=.</em>008).</div></div><div><h3>Conclusions</h3><div>Chronic LBP and sport type significantly impact multifidus muscle stiffness, suggesting the need for targeted clinical assessments and reconditioning strategies focusing on DLM for chronic LBP and SLM for athletes in trunk extension-intensive sports.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 902-909"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142695239","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 Interview and Online Self-Report Versions of Motor and Sensory Components of a Neurological Exam for Classifying Spinal Cord Injury (One-SCI).","authors":"Thomas N Bryce, Laiba Afzal, Stephen P Burns, Marcel P Dijkers, Steven Kirshblum, Ralph J Marino, Jayme O'Connor, Arianny Ramirez, Brittany Snider, Lisa Spielman, Chung-Ying Tsai","doi":"10.1016/j.apmr.2024.10.021","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.10.021","url":null,"abstract":"<p><strong>Objective: </strong>To develop a patient-reported outcome (PRO) survey measure of the motor, sensory, and anorectal components needed for classifying spinal cord injury (SCI) according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) DESIGN: Questionnaire development through an iterative process of review, feedback provision, and consensus revision incorporating two rounds of cognitive interviewing (CI) SETTING: Community PARTICIPANTS: 34 individuals with SCI who were English-speaking and aged 18 and older were recruited nationally through social media and advertisements to complete CI. Purposive sampling was used to ensure participants with complete and incomplete injuries in six cohorts based upon neurological level of injury (C1-4, C5-6, C7-T1, T2-T6, T7-T12, and L1-S5) were enrolled.</p><p><strong>Interventions: </strong>Not applicable MAIN OUTCOME MEASURE: Online Neurological Exam for Spinal Cord Injury (One-SCI) RESULTS: A group of SCI clinicians, a graphic artist, ISNCSCI experts, researchers with expertise in questionnaire development, cognitive interviewing, and statistics; and a person with SCI who has lived experience with SCI developed the initial One-SCI questionnaire. A CI script with pre-determined verbal probing questions was developed, designed to assess language appropriateness, vocabulary, concept simplicity, grammar, question structure, visual aids, emotional and mental burden both in the instructions and in the questions and available responses. Participants completed an online or interview version of the survey during two rounds of CI. After each round, changes were made to the instructions, questions, responses, and graphics. The final survey has a minimum of 154 and a maximum of 210 items, depending on branching logic driven by previous answers.</p><p><strong>Conclusions: </strong>One-SCI allows online or interviewer-administered self-report documentation of the motor and sensory components of a neurological examination for classifying SCI. Developed using an in-depth CI process, it may allow remote assessments of the elements required by an individual trained to interpret ISNCSCI examination findings to determine neurological status and classify SCI when an in-person ISNCSCI examination is not obtainable.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214774","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":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(25)00686-0","DOIUrl":"10.1016/S0003-9993(25)00686-0","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Page A4"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190278","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":"Effectiveness of Microelectrolysis Associated With Exercises Versus Exercises Alone on Pain Intensity and Disability in Individuals With Chronic Rotator Cuff Tendinopathy: A Randomized Controlled Trial","authors":"Geraldo Carvalho Magalhães PT, MSc ,&nbsp;Danilo Harudy Kamonseki PT, PhD ,&nbsp;Ana Catarine Tavares da Silva PT, BSc ,&nbsp;Janaynna Araújo Nunes PT, BSc ,&nbsp;Antonio Ismayle Araújo Firmino de Sousa PT, BSc ,&nbsp;Daniel Cury Ribeiro PT, PhD ,&nbsp;Valéria Mayaly Alves de Oliveira PT, PhD","doi":"10.1016/j.apmr.2024.10.016","DOIUrl":"10.1016/j.apmr.2024.10.016","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effectiveness of intratissue percutaneous microelectrolysis (IPM) in addition to shoulder exercise program on pain intensity and disability in individuals with rotator cuff tendinopathy.</div></div><div><h3>Study Design</h3><div>Two parallel arms, single-blind superiority randomized controlled trial.</div></div><div><h3>Site</h3><div>Outpatient clinic (Alcides Carneiro University Hospital).</div></div><div><h3>Participants</h3><div>Forty-two individuals with rotator cuff tendinopathy were randomly allocated (1:1) into 2 groups: IPM associated with exercises (IPM+Ex) and exercises only (Ex).</div></div><div><h3>Interventions</h3><div>Both groups underwent a therapeutic exercise program (6 in-person sessions) conducted by a physiotherapist, but only the IPM+Ex group received additional treatment with IPM (6 sessions). Linear mixed models were used to compare groups.</div></div><div><h3>Main Outcome Measures</h3><div>Pain intensity was measured with the Numerical Pain Rating Scale and shoulder disability with the Shoulder Pain and Disability Index. The outcomes were evaluated (blinded assessor) at baseline and 8 weeks after the intervention protocol. The secondary outcomes included adverse effects, frequency of the weekly home exercises, and overall perceived effect.</div></div><div><h3>Results</h3><div>Forty individuals completed the 8-week follow-up. There were statistically significant within-group changes in both IPM+Ex and Ex for pain (IPM+Ex: mean difference −3.19; 95% CI: −4.45 to −1.94; Ex: mean difference: −3.99; 95% CI: −5.27 to −2.72) and disability (IPM+Ex: mean difference −35.76; 95% CI: −47.77 to −23.76; Ex: mean difference: −38.26; 95% CI: −50.45 to −26.07). We found no between-group significant differences in either pain (mean difference: −1.23; 95% CI: −2.54, 0.07) or disability (mean difference 7.17; 95% CI: −7.02, 21.35). We found no differences between the groups (<em>P</em>&lt;.05) regarding adverse effects, frequency of the weekly home exercises, and overall perceived effect.</div></div><div><h3>Conclusion</h3><div>Applying IPM along with therapeutic exercises does not have additional effects on pain intensity and disability in individuals with rotator cuff tendinopathy.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 837-844"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685823","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":"Causal Mediation Analysis of Factors Influencing Physical Activity and Community Access Among People With Mild-to-Moderate Parkinson Disease","authors":"Serene S. Paul PhD ,&nbsp;Franchino Porciuncula PhD ,&nbsp;James T. Cavanaugh PhD ,&nbsp;Kerri S. Rawson PhD ,&nbsp;Timothy J. Nordahl DPT ,&nbsp;Teresa C. Baker DPT ,&nbsp;Ryan P. Duncan DPT ,&nbsp;Gammon M. Earhart PhD ,&nbsp;Theresa D. Ellis PhD","doi":"10.1016/j.apmr.2024.10.012","DOIUrl":"10.1016/j.apmr.2024.10.012","url":null,"abstract":"<div><h3>Objective</h3><div>To examine how known causal factors (exercise self-efficacy, balance, walking capacity) affect outcomes (moderate-intensity physical activity, community access) in people with Parkinson disease (PD): through a direct pathway, indirectly through potential mediators (nonmotor impairments), or through combined direct and mediated paths.</div></div><div><h3>Design</h3><div>Causal mediation analyses using baseline and three-month data from pooled treatment groups in a randomized controlled trial.</div></div><div><h3>Setting</h3><div>Data were collected at 2 university clinical research centers.</div></div><div><h3>Participants</h3><div>One hundred thirty-eight people with PD.</div></div><div><h3>Interventions</h3><div>Home and community-based walking and strength exercise program.</div></div><div><h3>Main Outcome Measure(s)</h3><div>Exposures were exercise self-efficacy, walking capacity, and balance. Potential mediators included pain, fatigue, mood (anxiety, depression, affect, apathy), stigma, and cognition (executive function and cognitive flexibility). The outcomes were physical activity and community access behavior at follow-up 3 months later. Separate models were developed for each causal factor-mediator-outcome combination. To minimize bias, all models were adjusted for known confounders (comorbidities, freezing of gait, severity of motor impairment, and/or age) and baseline values of the outcomes.</div></div><div><h3>Results</h3><div>Self-efficacy of walking duration had a causal relationship with moderate-intensity physical activity through direct and combined paths (<em>P</em>&lt;.001). Walking capacity had a causal relationship with community access through direct (<em>P</em>=.03-.04) and combined (<em>P</em>=.02-.03) paths. Balance did not affect community access (<em>P</em>&gt;.05). There were no significant mediation effects through indirect pathways for either outcome.</div></div><div><h3>Conclusions</h3><div>The effect of known causal factors on physical activity and community access was not mediated by nonmotor impairments. Walking self-efficacy and walking capacity remain the primary intervention targets for improving physical activity and community access, respectively, in people with PD.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 871-879"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142589703","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":"Test–Retest Reliability and Responsiveness of the Machine Learning-Based Short-Form of the Berg Balance Scale in Persons With Stroke","authors":"Po-Ting Chen MS ,&nbsp;I-Ping Hsueh MS ,&nbsp;Shih-Chie Lee PhD ,&nbsp;Meng-Lin Lee MD, PhD ,&nbsp;Chih-Wen Twu MD, PhD ,&nbsp;Ching-Lin Hsieh PhD","doi":"10.1016/j.apmr.2024.10.013","DOIUrl":"10.1016/j.apmr.2024.10.013","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the test–retest reliability, responsiveness, and clinical utility of the machine learning-based short form of the Berg Balance Scale (BBS-ML) in persons with stroke.</div></div><div><h3>Design</h3><div>Repeated-measures design.</div></div><div><h3>Setting</h3><div>A department of rehabilitation in a medical center.</div></div><div><h3>Participants</h3><div>This study recruited 2 groups: 50 persons who were more than 6 months post-stroke to examine the test–retest reliability, and 52 persons who were within 3 months post-stroke to examine the responsiveness. Test–retest reliability was investigated by administering assessments twice at a 2-week interval. Responsiveness was investigated by gathering data at admission and discharge from the hospital.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure</h3><div>BBS-ML.</div></div><div><h3>Results</h3><div>The BBS-ML exhibited excellent test–retest reliability (intraclass correlation coefficient=0.99), acceptable minimal random measurement error (minimal detectable change %=13.6%), and good responsiveness (Kazis’ effect size and standardized response mean values≥1.34). On average, the participants completed the BBS-ML in around 6 minutes per administration.</div></div><div><h3>Conclusions</h3><div>Our findings indicate that the BBS-ML appears an efficient measure with excellent test–retest reliability and responsiveness. Moreover, the BBS-ML may be used as a substitute for the original BBS to monitor the progress of balance function in persons with stroke.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 880-886"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142613900","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":"A Patient Education Guide to Manage the Effects of Cataracts While Waiting for Surgery","authors":"Kimberly Hreha EdD, OTR/L,&nbsp;Virginia Quellmalz-Zallocco OTD-S, COTA, CLT,&nbsp;Omar Mohiuddin OTR/L, MS, MPH, CLVT,&nbsp;Fay Tripp MS, OTR/L, CLVT, CDRS,&nbsp;Cassidy Warner OTD-S","doi":"10.1016/j.apmr.2025.02.010","DOIUrl":"10.1016/j.apmr.2025.02.010","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 975-977"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490527","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":"Virtual Assessment Protocols for Timed-Up-and-Go, 5-Repetition Chair Rise, and 1-Minute Sit-to-Stand Tests in Community-Dwelling Older Adults: Investigating Feasibility, Reliability, and Validity","authors":"Stephanie Saunders MA,&nbsp;Julie Reid PT, PhD,&nbsp;Ava Mehdipour MSc,&nbsp;Cassandra D'Amore BSc,&nbsp;Ayse Kuspinar PT, PhD,&nbsp;Julie Richardson PT, PhD,&nbsp;Marla Beauchamp PT, PhD","doi":"10.1016/j.apmr.2024.11.011","DOIUrl":"10.1016/j.apmr.2024.11.011","url":null,"abstract":"<div><h3>Objective</h3><div>To develop and evaluate virtual assessment protocols for the Timed-Up-and-Go usual and fast pace, Chair Rise-5 repetition, and the 1-minute Sit-to-Stand tests and examine their feasibility, reliability, and validity.</div></div><div><h3>Design</h3><div>This was a prospective cohort study, where participants engaged in up to 2 virtual assessments and data were collected prospectively for 1 year.</div></div><div><h3>Setting</h3><div>Assessments took place in participants’ homes in the community. Toolkits were delivered that included the required equipment and internet-enabled tablet.</div></div><div><h3>Participants</h3><div>Participants included a random sample of adults ≥65 years old who could walk 10 m without assistance from another person and communicate in English.</div></div><div><h3>Main Outcome Measures</h3><div>Falls and health care utilization data were collected for 1 year after initial assessments. Descriptive data were used to examine feasibility; intraclass correlation (ICC), and Pearson's/Spearman's correlation and areas under the curve (AUCs) were used to evaluate reliability and validity, respectively.</div></div><div><h3>Results</h3><div>Sixty participants (mean age 76.6±5.6; 55% female) completed visit 1 and 52 completed visit 2. Technology issues were relatively common, yet no safety incidents occurred. All the virtual mobility tests demonstrated excellent test-retest (ICCs=0.86-0.95) and inter-rater (ICC=0.98-0.99) reliability. The tests had weak-to-moderate correlations with measures of physical function (r=–0.14 to –0.43) and physical activity (r=–0.19 to 0.32). Fifty-seven total falls were recorded by 28 participants (46%) over 1 year. The virtual mobility tests did not have adequate accuracy for predicting falls (AUCs=0.53-0.59), specialist (AUCs=0.48-0.60), family doctor (AUCs=0.48-0.59), or rehabilitation professional visits (AUCs=0.65-0.67), or hospitalizations (AUCs=0.56-0.63).</div></div><div><h3>Conclusion</h3><div>Results support the feasibility and reliability of virtual administration of the Timed-Up-and-Go usual and fast pace, Chair Rise-5 repitition, and 1-minute Sit-to-Stand tests. Clinicians and researchers can use the included manuals to conduct these tests virtually. Future research should examine the clinical utility of these tests for remote monitoring and mobility assessment.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 926-933"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765784","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":"A Novel Approach of Enhanced, Multidisciplinary Rehabilitation Services in the Hospital to Facilitate Home Discharge: The Rehab2Home Program","authors":"Nicole Langton-Frost CCC-SLP, BCS-S ,&nbsp;Annette Lavezza OTR/L ,&nbsp;Shannon Wilkins PT, DPT ,&nbsp;Marybeth Moscirella OTD, OTR/L, BCPR ,&nbsp;Noor Zaghlula CCC-SLP ,&nbsp;Lisa Reider PhD ,&nbsp;Alison Turnbull DVM, MPH, PhD ,&nbsp;Daniel L. Young PT, DPT, PhD ,&nbsp;Michael Friedman PT, DPT, MBA ,&nbsp;Erik H. Hoyer MD","doi":"10.1016/j.apmr.2024.10.020","DOIUrl":"10.1016/j.apmr.2024.10.020","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the effectiveness of an early, targeted, individualized, intensive rehabilitation program called Rehab2Home, designed to transition surgical patients directly from acute care to home.</div></div><div><h3>Design</h3><div>The Rehab2Home program was implemented using a quality improvement (QI) approach between March 2023 and June 2023. The outcomes of the program were compared with a historical cohort of similar patients.</div></div><div><h3>Setting</h3><div>Academic medical center.</div></div><div><h3>Participants</h3><div>Postsurgical patients (n=74) included were aged 18 years or older, recommended for subacute rehabilitation by physical therapy or occupational therapy, had some level of support at home, mild to no cognitive impairments, and moderate mobility impairments.</div></div><div><h3>Interventions</h3><div>Patients received an enhanced rehabilitation therapy program from physical therapy, occupational therapy, speech–language pathology, and consultations with a physiatrist emphasizing readiness for discharge home. The team also conducted weekday interdisciplinary huddles.</div></div><div><h3>Main Outcome Measure(s)</h3><div>The primary outcome for the evaluation of the program was discharge location from the hospital. Secondary outcomes included the length of hospital stay and emergency department visits and potentially avoidable utilization (PAU) within 30 days of hospital discharge.</div></div><div><h3>Results</h3><div>Seventy-four patients were included in the Rehab2Home program, with 66% discharging home compared to 47% in the historical controls. The program resulted in a 1.4 (95% CI, 1.1-1.6) times greater likelihood of discharging home and decreased the proportion of patients with potentially avoidable health care utilization by 63% (Risk Ratio: 0.37, 95% CI, 0.1-0.7), without a significant increase in length of stay (-0.6 days, 95% CI, -2.2 to 1.9).</div></div><div><h3>Conclusions</h3><div>The Rehab2Home program for postsurgical patients successfully facilitated home discharges and reduced postdischarge utilization. This model of rehabilitation shows promise for improving transitions of care from the hospital in this population.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 910-916"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142749811","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":"Psychometric Validation of the In-Hand Manipulation Assessment","authors":"Karen P.Y. Liu PhD ,&nbsp;Angela Chapman BHSc(Hons)/MOT ,&nbsp;Tess L.Y. Tsoi ,&nbsp;Peter Thach BM ,&nbsp;Nandana Welage PhD ,&nbsp;Nikki Tulliani PhD","doi":"10.1016/j.apmr.2024.11.009","DOIUrl":"10.1016/j.apmr.2024.11.009","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the inter-rater reliability, and criterion and discriminant validity of the In-Hand Manipulation Assessment (IHMA) with patients after stroke.</div></div><div><h3>Design</h3><div>Participants were videotaped, completing the IHMA and scored by 2 blinded assessors to determine the inter-rater reliability. Stroke participants also completed the Jebsen-Taylor Hand Function Test, and healthy participants completed the Nine-Hole Peg Test to determine the validity of the IHMA.</div></div><div><h3>Setting</h3><div>Community and hospital settings.</div></div><div><h3>Participants</h3><div>A total of 46 participants with 22 healthy young adults, 14 healthy older adults and 10 people with stroke.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Not applicable.</div></div><div><h3>Results</h3><div>The inter-rater reliability of the IHMA was good (for all participants: intraclass correlation coefficient = 0.78-0.98, <em>P</em>≤.001; for stroke participants: Kappa statistics = 0.70-1.00, <em>P</em>≤.001). The IHMA demonstrated good discriminant validity between the healthy young adults and healthy older adults for time and completion scores (<em>P</em>s=.012 and ≤.001). The criterion validity of the IHMA was moderate to good when compared with the Nine-Hole Peg Test (<em>r</em> = −0.45 to 0.84), but no significant correlation was found with the Jebsen-Taylor Hand Function Test. Modifications to the IHMA tasks and instructions were made based on the performance of participants to improve its clinical utility with people after stroke.</div></div><div><h3>Conclusions</h3><div>The IHMA demonstrated good inter-rater reliability, good discriminant validity, and moderate-to-good criterion validity with the Nine-Hole Peg Test. The proposed modifications to the IHMA will enhance its administration.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 6","pages":"Pages 917-925"},"PeriodicalIF":3.6,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142754500","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}