Archives of physical medicine and rehabilitation最新文献

{"title":"Effect of Aerobic Exercise on Symptom Burden and Quality of Life in Adults With Persisting Post-concussive Symptoms: The ACTBI Randomized Controlled Trial.","authors":"Leah J Mercier, Samantha J McIntosh, Chloe Boucher, Julie M Joyce, Julia Batycky, Jean-Michel Galarneau, Michael J Esser, Kathryn J Schneider, Sean P Dukelow, Ashley D Harris, Chantel T Debert","doi":"10.1016/j.apmr.2024.10.002","DOIUrl":"10.1016/j.apmr.2024.10.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate a 6-week sub-symptom threshold aerobic exercise protocol (AEP) versus a stretching protocol (SP) on symptom burden and quality of life (QoL) in adults with persisting post-concussive symptoms (PPCS).</p><p><strong>Design: </strong>The Aerobic exercise for treatment of Chronic symptoms following mild Traumatic Brain Injury (ACTBI) Trial was a randomized controlled trial with 2 groups.</p><p><strong>Setting: </strong>Outpatient brain injury, pain, and physiotherapy clinics.</p><p><strong>Participants: </strong>A total of 210 participants were screened. A consecutive sample of 52 adults with PPCS and exercise intolerance after mild traumatic brain injury were enrolled. No participants withdrew because of the adverse effects of the intervention.</p><p><strong>Interventions: </strong>Participants were randomized to a 6-week AEP (n=27) or 6-week SP (n=25).</p><p><strong>Main outcome and measures: </strong>The Rivermead Post Concussion Symptoms Questionnaire was the primary outcome. Secondary outcomes included QoL using the QoL After Brain Injury Questionnaire, in addition to measures of mood, anxiety, functional impact of headache, fatigue, dizziness, exercise tolerance, and sleep.</p><p><strong>Results: </strong>Participants were a mean (SD) of 43.0 (10.9) years old (75% female) and 24.7 (14.0) months post-injury. In per-protocol analysis, between-group difference (AEP vs SP) was not significant for the Rivermead Post Concussion Symptoms Questionnaire, but QoL After Brain Injury Questionnaire between-group difference was significant (mean change=5.024; 95% Cl, 0.057-9.992; P=.047) from baseline to 6 weeks. In the intention-to-treat analysis, between-group changes in primary and secondary outcomes were not significant.</p><p><strong>Conclusions: </strong>This trial provides preliminary data to support the prescription of aerobic exercise for adults with PPCS. Despite presenting with exercise intolerance, participants were able to engage in subsymptom threshold exercise with QoL benefits.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456800","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":"Individualized Versus General Exercise Therapy in People with Subacromial Pain Syndrome: A Randomized Controlled Trial.","authors":"Ghazaleh Momeni, Abbas Tabatabaei, Mehrnaz Kajbafvala, Morteza Nakhaei Amroodi, Lincoln Blandford","doi":"10.1016/j.apmr.2024.08.027","DOIUrl":"https://doi.org/10.1016/j.apmr.2024.08.027","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effect of individualized exercises based on movement fault (MF) control on pain intensity and disability in subjects with chronic subacromial pain syndrome (SAPS).</p><p><strong>Design: </strong>Randomized Controlled Trial (IRCT20221126056621N1) SETTING: Rehabilitation clinics PARTICIPANTS: Thirty-eight participants with chronic SAPS (aged 52.23(8.47), 60 %woman).</p><p><strong>Interventions: </strong>The participants were randomly allocated to one of the intervention groups (individualized exercises based on MFs control test designed to target specific movement faults) or the control group (commonly prescribed general scapular stabilization exercises). Both groups received exercise sessions twice a week for four weeks.</p><p><strong>Main outcome measures: </strong>The primary outcome measures were pain intensity at rest (PR) and during arm raising (PAR) using a visual analog scale. Disability was assessed as a key secondary outcome, including the disabilities of the arm, shoulder, and hand (DASH) questionnaire and the Shoulder Pain and Disability Index (SPADI).</p><p><strong>Results: </strong>Following completion of all exercise sessions, PAR was significantly lower in the intervention group compared to the control group (mean [CI]: 9.17 [0.31 to 18.03], p=0.04), with a large effect size [0.68]. The reduction of PAR remained significantly lower in the intervention group than in the control group after four months of follow-up (mean [CI]: 18.29 [9.09 to 27.48], p=0.00) with a large effect size [1.27]. Disability significantly decreased at two month (mean=14.58, p=0.002 on SPADI index; mean=10.26, p=0.006 on DASH index) and four month (mean=19.85, p=0.00 on SPADI index; mean=12.09, p=0.001 on DASH index) follow ups in the intervention group compared to the control group.</p><p><strong>Conclusion: </strong>Individualized exercises based on MFs control of the shoulder region was accompanied by decreased PAR and disability in subjects with SAPS.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reliability and Construct Validity of Three Self-report Questionnaires Assessing Dual-Task Difficulties in People With Multiple Sclerosis: An International Study.","authors":"Zuhal Abasıyanık, Ludovico Pedullà, Turhan Kahraman, Mieke D'Hooge, Carme Santoyo-Medina, Bernardita Soler, Andrea Tacchino, Renee Veldkamp, Edwin-Roger Meza-Murillo, Areen Omar, Ethel Ciampi, Serkan Özakbaş, Daphne Kos, Alon Kalron, Peter Feys","doi":"10.1016/j.apmr.2024.08.024","DOIUrl":"10.1016/j.apmr.2024.08.024","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the reliability and validity of the dual-tasking questionnaire (DTQ), dual-task screening list (DTSL), and dual-task impact on daily life activities questionnaire (DIDA-Q).</p><p><strong>Design: </strong>Multicenter, cross-sectional study SETTING: Persons with multiple sclerosis (pwMS) were recruited from 7 multiple sclerosis centers across 6 countries (Belgium, Chile, Italy, Israel, Spain, and Turkey).</p><p><strong>Participants: </strong>A total of 356 pwMS (mean age 47.5±11.5y, expanded disability status scale, 3.79±1.83) were enrolled.</p><p><strong>Interventions: </strong>Not applicable MAIN OUTCOME MEASURES: The reliability (internal consistency, test-retest, and measurement error) and construct validity (structural and convergent) were assessed.</p><p><strong>Results: </strong>The DTQ, DTSL, and DIDA-Q demonstrated excellent test-retest reliability (intraclass correlation coefficients [95% CI], 0.84 [0.80-0.87] to 0.90 [0.87-0.92]) and internal consistency (Cronbach α: 0.86-0.96). As hypothesized, the 3 questionnaires showed a strong correlation with each other, moderate-to-strong correlations with other self-report questionnaires (perceived walking difficulties, fatigue, and fear of falling), and low-to-moderate correlations with cognitive information processing speed, manual dexterity, and dual-task walking performance (walking with word list generation task), showing convergent validity. The DIDA-Q exhibited systematically superior properties. These results were also verified in subsets from 6 different countries. In the structural validity analysis, all questionnaires displayed 2 main factors, allocated as \"motor-driven\" and \"cognitive-driven\" subscales.</p><p><strong>Conclusions: </strong>The DTQ, DTSL, and DIDA-Q have good-to-excellent measurement properties, with the highest properties observed in DIDA-Q. The use of these self-reported questionnaires can be used in research and clinical practice to assess the effect of dual-task difficulties on the daily life of ambulatory pwMS.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456802","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":"Comparative Scoping Review: Robot-Assisted Upper Limb Stroke Rehabilitation in Low- and Middle-Income Countries Versus High-Income Nations.","authors":"Selvaraj Samuelkamaleshkumar, Suresh Annpatriciacatherine, Abrahamalex Jithu, Jones Jeromedanypraveenraj, Thangavelu Senthilvelkumar, Thomas Anand Augustine, Prashanth H Chalageri, Jacob George, Raji Thomas","doi":"10.1016/j.apmr.2024.09.014","DOIUrl":"10.1016/j.apmr.2024.09.014","url":null,"abstract":"<p><strong>Objective: </strong>To examine robotic interventions for upper limb rehabilitation poststroke, focusing on geographic distribution, stroke chronicity, outcome measures, outcomes of robotic interventions, and publication trends in low- and middle-income countries (LMICs) compared with high-income countries (HICs).</p><p><strong>Data sources: </strong>Using Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines, PubMed, CENTRAL, Embase, CINAHL, and PEDro databases were searched for studies on upper extremity rehabilitation with robotics poststroke.</p><p><strong>Study selection: </strong>This review focused on randomized controlled trials (RCTs) published between 2012 and 2024 that examined rehabilitation robots for upper limb impairments caused by stroke. The studies included adults aged ≥18 years in the acute, subacute, or chronic recovery phases. Eligible trials involved using robotic devices, independently or combined with other interventions. Only RCTs with 2 or more arms were considered, and all included studies were published in English.</p><p><strong>Data extraction: </strong>Reviewers independently extracted data on study characteristics, stroke chronicity, outcome measures, outcomes of robotic interventions, and temporal trends.</p><p><strong>Data synthesis: </strong>Of 129 articles meeting the criteria, 107 were from HICs, and 22 were from LMICs. Major contributors from HICs included Italy, Taiwan, and the USA, whereas China was a significant contributor among LMICs. Most studies focused on patients with chronic stroke, with varying assessment tools, the most common being the Fugl-Meyer Upper Extremity Evaluation. Positive outcomes were reported across studies, and recent research activity has increased in both settings.</p><p><strong>Conclusions: </strong>This review underscores the expanding research on robotic therapy for upper limb rehabilitation in patients with stroke, primarily from HICs with limited input from low- and middle-income nations. Although positive outcomes were frequently observed, disparities between high-income and low-and middle-income countries were clear. The growing research indicates rising interest and advancements in this domain.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142456799","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 Validation of a Novel Nomogram for Predicting Mechanical Ventilation After Cervical Spinal Cord Injury.","authors":"Guozhen Liu, Lei Liu, Ze Zhang, Rui Tan, Yuntao Wang","doi":"10.1016/j.apmr.2024.09.016","DOIUrl":"10.1016/j.apmr.2024.09.016","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the risk factors relating to the need for mechanical ventilation (MV) in isolated patients with cervical spinal cord injury (cSCI) and to construct a nomogram prediction model.</p><p><strong>Design: </strong>Retrospective analysis study.</p><p><strong>Setting: </strong>National Spinal Cord Injury Model System Database (NSCID) observation data were initially collected during rehabilitation hospitalization.</p><p><strong>Participants: </strong>A total of 5784 patients (N=5784) who had a cSCI were admitted to the NSCID between 2006 and 2021.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure(s): </strong>A univariate and multivariate logistic regression analysis was used to identify the independent factors affecting the use of MV in patients with cSCI, and these independent influencing factors were used to develop a nomogram prediction model. The area under the receiver operating characteristic curve (AUROC), calibration curve, and decision curve analysis (DCA) were used to evaluate the efficiency and the clinical application value of the model, respectively.</p><p><strong>Results: </strong>In a series of 5784 included patients, 926 cases (16.0%) were admitted to spinal cord model system inpatient rehabilitation with the need for MV. Logistic regression analysis demonstrated that associated injury, American Spinal Cord Injury Association Impairment Scale (AIS), the sum of unilateral optimal motor scores for each muscle segment of upper extremities (sUEM), and neurologic level of injury (NLI) were independent predictors for the use of MV (P<.05). The prediction nomogram of MV usage in patients with cSCI was established based on the above independent predictors. The AUROC of the training set, internal verification set, and external verification set were 0.871 (0.857-0.886), 0.867 (0.843-0.891), and 0.850 (0.824-0.875), respectively. The calibration curve and DCA results showed that the model had good calibration and clinical practicability.</p><p><strong>Conclusions: </strong>The nomograph prediction model based on sUEM, NLI, associated injury, and AIS can accurately and effectively predict the risk of MV in patients with cSCI, to help clinicians screen high-risk patients and formulate targeted intervention measures.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387469","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":"Outpatient Rehabilitation Utilization After Major Limb Loss in Adults Receiving Care in the Military Health System From 2001 to 2017.","authors":"Rebecca N Schulz, Kalyn C Jannace, Daniel B Cooper, Michelle L Luken, Alyssa R Michel, Tawnee L Sparling, Paul F Pasquina","doi":"10.1016/j.apmr.2024.09.017","DOIUrl":"10.1016/j.apmr.2024.09.017","url":null,"abstract":"<p><strong>Objective: </strong>To investigate exposures associated with outpatient rehabilitation encounters among Military Health System (MHS) beneficiaries with major limb loss.</p><p><strong>Design: </strong>Retrospective, cohort study.</p><p><strong>Setting: </strong>American military treatment facilities and civilian health care facilities that accept TRICARE benefits.</p><p><strong>Participants: </strong>Adult MHS beneficiaries with major limb amputation(s) acquired between January 2001 and September 2017 (N=5161).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>This exploratory analysis investigated associations between outpatient rehabilitation care and demographic and amputation characteristics in MHS beneficiaries with major limb loss.</p><p><strong>Results: </strong>Most beneficiaries were aged 55-64 (36%), male (73%) and retirees/dependents (60%) with enlisted sponsor rank (88%) and single limb loss (89%). The active/reserve beneficiaries were younger, majority male, and more likely to be diagnosed with incident behavioral health conditions. Unadjusted negative binomial regression models revealed increased rates of outpatient rehabilitation encounters in active-duty service members (ADSMs) than in retirees/dependents (rate ratio, 10.02; 95% confidence interval, 9.30-10.80). The rate ratios for sex, sponsor rank, limb(s) lost, incident behavioral health condition, incident traumatic brain injury, incident posttraumatic stress disorder, and outpatient care setting were attenuated after stratification by beneficiary category. Enlisted ADSMs had increased rates of outpatient rehabilitation encounter days compared with officers, whereas retirees/dependents with enlisted sponsors had decreased than those with officer sponsors. ADSMs who accessed outpatient care in direct and private care settings demonstrated high rates of outpatient rehabilitation encounters compared with those who only sought care from private care settings (rate ratio, 4.60; 95% confidence interval, 2.95-6.81).</p><p><strong>Conclusions: </strong>This study suggests that MHS beneficiaries with major limb loss use outpatient rehabilitation services differently, based on active/reserve duty or retiree/dependent status. This study is the first of its kind to quantify outpatient rehabilitation utilization for military beneficiaries with all-cause major limb loss and may inform MHS policymakers on the rehabilitation needs for combat- and noncombat-related amputee populations.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387472","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":"Association of Calf Circumference, Hand Grip Strength, and Physical Performance With Serious Adverse Events in Individuals With Subacute Stroke Hospitalized for Rehabilitation: An Observational Study.","authors":"Takuro Ohtsubo, Masafumi Nozoe, Masashi Kanai, Hiroki Kubo, Katsuhiro Ueno, Yosuke Morimoto","doi":"10.1016/j.apmr.2024.09.015","DOIUrl":"10.1016/j.apmr.2024.09.015","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether calf circumference, hand grip strength, and physical performance are linked to the incidence of serious adverse events (SAEs) in patients with subacute stroke.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Single rehabilitation hospital.</p><p><strong>Participants: </strong>Patients with stroke admitted for rehabilitation hospital.</p><p><strong>Intervention: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The incidence of SAEs, such as death, cardiovascular events including recurrent stroke, and conditions requiring transfer to another hospital for specialized care or immediate treatment for an acute illness during hospitalization.</p><p><strong>Results: </strong>A total of 341 patients (median age: 74y) participated in this study, with 232 patients (68%) exhibiting low-physical performance. In the adjusted model, low-physical performance was significantly associated with SAEs (hazard ratio [HR], 3.01; 95% confidence interval [CI], 1.04-8.68; P=.042). However, low calf circumference (HR, 1.60; 95% CI, 0.76-3.38; P=.219) and low hand grip strength (HR, 0.98; 95% CI, 0.39-2.42; P=.960) did not show an independent association.</p><p><strong>Conclusions: </strong>Low-physical performance was independently associated with the occurrence of SAEs during hospitalization for rehabilitation in patients with subacute stroke.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Home, but Homebound After Traumatic Brain Injury: Risk Factors and Associations With Nursing Home Entry and Death.","authors":"Raj G Kumar, Mary Louise Pomeroy, Katherine A Ornstein, Shannon B Juengst, Amy K Wagner, Jennifer M Reckrey, Kirk Lercher, Laura E Dreer, Emily Evans, Nicola L de Souza, Kristen Dams-O'Connor","doi":"10.1016/j.apmr.2024.09.012","DOIUrl":"10.1016/j.apmr.2024.09.012","url":null,"abstract":"<p><strong>Objective: </strong>To examine risk factors associated with homeboundness 1-year after traumatic brain injury (TBI) and to explore associations between homebound status and risk of future mortality and nursing home entry.</p><p><strong>Design: </strong>Secondary analysis of a longitudinal prospective cohort study.</p><p><strong>Setting: </strong>TBI Model Systems centers.</p><p><strong>Participants: </strong>Community-dwelling TBI Model Systems participants (n=6595) who sustained moderate-to-severe TBI between 2006 and 2016, and resided in a private residence 1-year postinjury.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Homebound status (leaving home ≤1-2d per week), 5-year mortality, and 2- or 5-year nursing home entry.</p><p><strong>Results: </strong>In our sample, 14.2% of individuals were homebound 1-year postinjury, including 2% who never left home. Older age, having less than a bachelor's degree, Medicaid insurance, living in the Northeast or Midwest, dependence on others or special services for transportation, unemployment or retirement, and needing assistance for locomotion, bladder management, and social interactions at 1-year postinjury were associated with being homebound. After adjustment for potential confounders and an inverse probability weight for nonrandom attrition bias, being homebound was associated with a 1.69-times (95% confidence interval, 1.35-2.11) greater risk of 5-year mortality, and a nonsignificant but trending association with nursing home entry by 5 years postinjury (RR=1.90; 95% confidence interval, 0.94-3.87). Associations between homeboundness and mortality were consistent by age subgroup (±65y).</p><p><strong>Conclusions: </strong>The negative long-term health outcomes among persons with TBI who rarely leave home warrants the need to re-evaluate home discharge as unequivocally positive. The identified risk factors for homebound status, and its associated negative long-term outcomes, should be considered when preparing patients and their families for discharge from acute and postacute rehabilitation care settings. Addressing modifiable risk factors for homeboundness, such as accessible public transportation options and home care to address mobility, could be targets for individual referrals and policy intervention.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387470","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":"Influence of Aerobic Exercise on Functional Capacity and Maximal Oxygen Uptake in Patients With Parkinson Disease: A Systematic Review and Meta-analysis.","authors":"Ricardo Augusto Barbieri, Fabio Augusto Barbieri, Nicolle Zelada-Astudillo, Vinicius Christianini Moreno, Carlos Augusto Kalva-Filho, Antonio Roberto Zamunér","doi":"10.1016/j.apmr.2024.09.013","DOIUrl":"10.1016/j.apmr.2024.09.013","url":null,"abstract":"<p><strong>Objective: </strong>To determine the effects of aerobic training in randomized controlled clinical trials on functional capacity, motor symptoms, and oxygen consumption in individuals with Parkinson disease (PD) through a systematic literature review and meta-analysis.</p><p><strong>Data sources: </strong>PUBMED, Web of Science, CINAHL, SciELO, and Medline databases were searched to identify published studies until September 2023.</p><p><strong>Study selection: </strong>Randomized controlled clinical trials that evaluated the long-term effect of aerobic exercise in individuals with PD were included.</p><p><strong>Data extraction: </strong>Two independent reviewers extracted the data and assessed the risk of bias and the Grading of Recommendation Assessment, Development, and Evaluation. In case of disagreement, a third reviewer was consulted.</p><p><strong>Data synthesis: </strong>Thirteen studies were included in the systematic review, and the number of participants was 588 with an average age of 66.2 years (57-73y). The study's exercise intervention lasted between 6 and 70 weeks, with most studies lasting 10-12 weeks, with 3 sessions per week and an average duration of 47 minutes per session. The meta-analysis revealed that aerobic exercise is effective in enhancing maximal oxygen uptake (standardized mean difference, SMD 0.42 [95% CI, 0.18, 0.66; P=.0007]) and functional capacity (SMD 0.48 [95% CI, 0.24-0.71; P<.0001]). In addition, aerobic exercise can reduce the motor-unified Parkinson disease rating scale (mean difference-2.48 [95% CI, -3.16 to -1.81; P<.00001]) score in individuals with PD.</p><p><strong>Conclusions: </strong>Aerobic exercise training conducted 2-3 times a week, with different intensities (low to high), can be an effective intervention for enhancing functional capacity, maximizing oxygen uptake, and reducing the UPDRS scores in individuals with PD.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142387471","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":"Quality Indicators for the Primary and Community Care of Musculoskeletal Conditions: A Systematic Review.","authors":"Alexander Braybrooke, Karl Baraks, Roanna Burgess, Anirban Banerjee, Jonathan Charles Hill","doi":"10.1016/j.apmr.2024.08.022","DOIUrl":"10.1016/j.apmr.2024.08.022","url":null,"abstract":"<p><strong>Objectives: </strong>To identify, appraise, and synthesize common themes from quality indicator (QI) sets designed for the assessment, management, and rehabilitation of musculoskeletal (MSK) conditions in primary and community care contexts.</p><p><strong>Data sources: </strong>A systematic search was performed on six databases (MEDLINE, EMBASE, AMED, Web of Sciences Core Collection, The Cochrane Library, and The Health Management Information Consortium), public repositories, and the websites of organizations involved in the reporting of MSK QIs.</p><p><strong>Study selection: </strong>Potential QI sources were screened for relevance using an a priori criteria. After the screening of 1493 titles, abstracts, 71 articles were reviewed independently by two authors, of which 25 met our criteria and were therefore included within the review.</p><p><strong>Data extraction: </strong>The development of the QI sets was appraised using the AIRE instrument. Key characteristics of QI sets were extracted and tabulated. Nine out of 25 QI sets had \"high\" developmental methodology quality. A total of 410 QIs were identified from 25 QI sets.</p><p><strong>Data synthesis: </strong>A narrative synthesis was undertaken to identify common themes among QIs. Themes were mapped against improvement drivers mentioned in recent British primary/community MSK care policy directives. Finally, \"Draft Indicators\" were synthesized from common themes identified. Eleven overarching themes were synthesized: policy and governance; optimizing access and provision of care; staffing and spending; optimizing assessment and diagnosis; optimizing patient education and self-management; pharmacology and injection guideline adherence; optimizing personalized care; optimizing imaging, investigations, and referral; public health management relevant to MSK conditions; optimizing patient experience; and optimizing patient outcomes.</p><p><strong>Conclusions: </strong>This review has identified common themes among QIs that focus on optimizing assessment, investigations, and treatment decisions for the primary/community care of MSK conditions. This work represents a valuable resource to commissioners, service managers, and clinicians internationally who resource, monitor, manage, assess, and rehabilitate individuals with MSK conditions.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142379978","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}