Archives of physical medicine and rehabilitation最新文献

{"title":"Cognitive Strategy Use for Functional Compensation in Multiple Sclerosis: A Systematic Review","authors":"Rachel Nicholson PsyD,&nbsp;Aaron P. Turner PhD,&nbsp;Elizabeth S. Gromisch PhD","doi":"10.1016/j.apmr.2026.04.007","DOIUrl":"10.1016/j.apmr.2026.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the evidence supporting the use of specific compensatory cognitive strategies in people with multiple sclerosis (PwMS).</div></div><div><h3>Data Sources</h3><div>PubMed, MEDLINE, PsycINFO, and CINAHL were queried using an optimized string with Medical Subject Headings search terms to identify English language articles published through December 31, 2024.</div></div><div><h3>Study Selection</h3><div>Clinical trials and observations studies (eg, cohort and case-control studies) were eligible if they included adults with PwMS who underwent an intervention with one or more defined cognitive strategies. Included studies had at least one subjective or objective quantifiable cognitive outcome. Screening and eligibility checks were independently done by the first author and then reviewed by the senior author.</div></div><div><h3>Data Extraction</h3><div>Study demographics, cognitive strategy information, and cognitive outcome data were extracted by one author and then verified by a second author. Studies were summarized using established evidence grading criteria and effect size estimates were calculated for each cognitive domain where a strategy was assessed.</div></div><div><h3>Data Synthesis</h3><div>The most frequently used cognitive strategy in the 64 identified studies (n=3759) was visualization/imagery-based mnemonics (34.9%), followed by planning/organization strategies (28.6%), analog memory aids (19.0%), mental rehearsal strategies (15.9%), and mindfulness (15.9%). Small-to-medium improvements in objective and subjective learning and memory were observed with several attentional, internal memory, and external memory strategies that were used alone and in combination. Attentional and relaxation-based strategies were also associated with significant small effects on processing speed.</div></div><div><h3>Conclusions</h3><div>Several cognitive strategies have been examined in PwMS, with visualization/imagery-based mnemonics having the highest usage and subsequent supporting evidence. These findings can support clinicians when determining which approaches to include in a cognitive rehabilitation program for PwMS.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2973-2990"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147715799","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 Extreme Injustice Appraisal Phenotypes in Newly Acquired Spinal Cord Injury","authors":"Angela Hanks PhD,&nbsp;Susan J. Knight MA,&nbsp;Jessica M. Ketchum PhD,&nbsp;Subhan Amir,&nbsp;Mirza R. Baig,&nbsp;Sean Hushagen MA,&nbsp;Muhammad Tayyab Ihsan MBBS,&nbsp;Jenna Javorina BA,&nbsp;Quinn D. Kellerman PhD,&nbsp;Scott D. McDonald PhD,&nbsp;Ayyub Mohamed,&nbsp;Lillian D. Sidky BS,&nbsp;Abby Welch BS, BA,&nbsp;Kimberley R. Monden PhD","doi":"10.1016/j.apmr.2026.05.019","DOIUrl":"10.1016/j.apmr.2026.05.019","url":null,"abstract":"<div><h3>Objective</h3><div>To identify and characterize extreme phenotypes of injustice appraisals among individuals with recent spinal cord injury (SCI), with the goal of improving psychosocial interventions and future clinical research.</div></div><div><h3>Design</h3><div>Cross-sectional analysis using baseline data from a longitudinal cohort study.</div></div><div><h3>Setting</h3><div>Four inpatient rehabilitation centers in the United States.</div></div><div><h3>Participants</h3><div>A total of 101 adults (aged ≥18y) with recent traumatic or nontraumatic SCI who completed baseline assessments, including the Injustice Experience Questionnaire (IEQ).</div></div><div><h3>Main Outcome Measures</h3><div>Participants were classified into low (IEQ≤12) and high (IEQ≥26) injustice appraisal phenotypes using the 25th and 75th percentiles of IEQ. Measures included the Patient Health Questionnaire-8, Posttraumatic Stress Checklist (PCL-5), State-Trait Anger Expression Inventory-II, Appraisals of Disability: Primary and Secondary Scale, and the International Spinal Cord Injury Quality of Life Basic Data Set.</div></div><div><h3>Results</h3><div>Compared with individuals with low injustice appraisals, those with high injustice appraisals presented with significantly higher depressive symptoms (Patient Health Questionnaire-8: 10.3 vs 3.3; <em>P</em>&lt;.001), posttraumatic stress symptoms (PCL-5: 29.8 vs 6.6; <em>P</em>&lt;.001), anger (state anger: 14.2 vs 7.4; <em>P</em>&lt;.001), and maladaptive appraisals (Appraisals of Disability: Primary and Secondary Scale: 23.7 vs 13.4; <em>P</em>&lt;.001). They also reported lower satisfaction across all quality of life domains (all <em>P</em>&lt;.01). Effect sizes were large to very large (Hedges’ |<em>g</em>| range, 0.89-4.61) and displayed substantial psychological and emotional differentiation between phenotypes.</div></div><div><h3>Conclusions</h3><div>Extreme phenotyping of injustice appraisals revealed unique psychosocial profiles among individuals with recent SCI. High injustice appraisals were associated with elevated distress and reduced quality of life, emphasizing the need for targeted interventions addressing perceptions of unfairness and loss in early rehabilitation. Identifying these phenotypes offers a framework for future studies and intervention development to improve psychological outcomes after SCI.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2817-2824"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148148317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing Fall Risk in Older Adults: The Role of Reaction Time and Inhibitory Control Testing With ReacStick","authors":"Pawarut Palakawong Na Ayudhya MD,&nbsp;Chatkaew Pongmala PhD,&nbsp;James K. Richardson MD,&nbsp;Chernkhuan Stonsaovapak MD,&nbsp;Krisna Piravej MD","doi":"10.1016/j.apmr.2026.06.001","DOIUrl":"10.1016/j.apmr.2026.06.001","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine whether ReacStick parameters can differentiate recurrent fallers from nonfallers and to compare their diagnostic precision with that of functional tests.</div></div><div><h3>Design</h3><div>Cross-sectional study.</div></div><div><h3>Setting</h3><div>Outpatient Rehabilitation Clinic in a Tertiary Hospital.</div></div><div><h3>Participants</h3><div>Community-dwelling older adults were recruited using convenience sampling. Ninety participants were enrolled, with those having recurrent falls (&gt;1 time) in the prior year, age- and sex-matched with nonfallers.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Sensorimotor functions (visual acuity, vibratory sensation, and knee extensor strength), cognition, timed Up and Go, and Berg Balance Scale were evaluated. ReacStick parameters, which assessed simple reaction time (SRT) using the ruler-drop method and reaction accuracy by requiring participants to grasp or release the device within 390 ms based on a light cue, were collected. The percentage of correctly caught light on trials (ON Accuracy), correctly released light off trials (OFF Accuracy), and the combination (All Accuracy) was recorded. Group comparisons and receiver operating characteristic curves were used to assess the ability of the parameters to discriminate between fallers and nonfallers. Multivariate logistic regression identified independent variables for faller status.</div></div><div><h3>Results</h3><div>Recurrent fallers showed significantly worse SRT, OFF Accuracy, All Accuracy, and OFF Accuracy/SRT. The highest area under the curves was observed for All Accuracy (0.80), OFF Accuracy/SRT (0.79), and OFF Accuracy (0.76). OFF Accuracy/SRT best predicted faller status (adjusted odds ratio, 12.18; 95% confidence interval, 3.75-39.53). Timed Up and Go and Berg Balance Scale showed nonsignificant trends, while knee extensor strength was protective (adjusted odds ratio, 0.53; 95% confidence interval, 0.29-0.97).</div></div><div><h3>Conclusions</h3><div>Diminished short-latency inhibitory control was the most accurate means to identify faller status, whereas good knee extensor strength showed a protective effect. ReacStick may offer potential as a sensitive tool for assessing short-latency inhibitory control and processing speed related to faller status in older adults. When combined with strength assessment, incorporating ReacStick in clinical practice may improve the accuracy of fall-status classification.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2851-2859"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175131","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 Machine Learning–Driven Dual-Task Gait Test Model for Cognitive Impairment Screening","authors":"Mengshu Yang MSc,&nbsp;Qing Yang MSc,&nbsp;Gang Xiong MEng,&nbsp;Yangshiyu Zhou MEng,&nbsp;Huibin Liu MSc,&nbsp;Yikang Wu PhD,&nbsp;Xiangrong Wang MSc,&nbsp;Yan Song MEng,&nbsp;Weizhong Liu PhD,&nbsp;Chong Tian PhD","doi":"10.1016/j.apmr.2026.05.013","DOIUrl":"10.1016/j.apmr.2026.05.013","url":null,"abstract":"<div><h3>Objective</h3><div>To develop an artificial intelligence (AI)-aided dual-task gait test model for scalable, high-throughput cognitive impairment screening.</div></div><div><h3>Design</h3><div>A diagnostic case-control study between 2022 and 2023, community-dwelling adults aged ≥60 years capable of unaided walking were enrolled.</div></div><div><h3>Setting(s)</h3><div>Primary care.</div></div><div><h3>Participants</h3><div>A total of 201 participants were classified into 3 groups: dementia (n=26), mild cognitive impairment (n=124), and cognitively intact (n=51). All participants underwent 3 gait assessments: single-task, dual-task (serial subtraction by 7), and dual-task (animal-naming) gait test.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>A total of 45 gait parameter metrics were extracted using AI-assisted gait analysis. Cognition was adjudicated by an expert panel using cognitive tests, functional status, and clinical records. Logistic regression models were used to analyze the association between gait parameters and cognition, with area under the curve (AUC) used to evaluate diagnostic performance. Four machine learning models were employed for model optimization. Subgroup analyses were conducted to assess model fairness.</div></div><div><h3>Results</h3><div>Multiple gait parameters showed significant differences between groups, with gait speed and stride variability emerging as the strongest predictors. After adjustment for covariates, the logistic regression models demonstrated notable screening accuracy for dementia (AUC=0.883; 95% CI, 0.811-0.955) and for cognitive impairment (AUC=0.895; 95% CI, 0.850-0.941). Machine learning–based optimization further validated these findings, with the support vector machine model achieving an AUC of 0.786 (sensitivity: 83.54%, specificity: 78.18%) for dementia and an AUC of 0.808 (sensitivity: 85.54%, specificity: 76.46%) for cognitive impairment. Subgroup analyses were exploratory and constrained by small sample sizes, with results showing considerable variability.</div></div><div><h3>Conclusions</h3><div>The AI-aided dual-task gait paradigm is a scalable, cost-effective, and highly accurate tool for population-level cognitive impairment screening in older adults. Its transformative potential lies in enabling early detection in community settings, establishing a cornerstone for proactive dementia prevention through timely interventions.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2798-2806"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148136612","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":"Life Satisfaction After Spinal Cord Injury and Psychological Factors: A Prospective Longitudinal Cohort Study","authors":"Aline J. Hakbijl–van der Wind RN, MSc,&nbsp;Christel M.C. van Leeuwen PhD,&nbsp;Tijn van Diemen PhD,&nbsp;Janneke M. de Man-van Ginkel RN, PhD,&nbsp;Ilse J.W. van Nes MD, PhD,&nbsp;Ellen H. Roels MD, PhD,&nbsp;Janneke M. Stolwijk-Swüste MD, PhD,&nbsp;Marcel W.M. Post PhD","doi":"10.1016/j.apmr.2026.03.024","DOIUrl":"10.1016/j.apmr.2026.03.024","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine (1) the course of life satisfaction in individuals with spinal cord injury (SCI) from admission to inpatient rehabilitation to 4 years after discharge and (2) the associations between psychological factors and this course of life satisfaction.</div></div><div><h3>Design</h3><div>Prospective longitudinal cohort study.</div></div><div><h3>Setting</h3><div>Rehabilitation center and community.</div></div><div><h3>Participants</h3><div>This study includes 266 individuals with recent-onset SCI.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Life satisfaction was assessed using the 2-item Life Satisfaction Scale (range, 2-13) at 9 time points. Patient characteristics, psychological resources (general self-efficacy, disability management self-efficacy, resilience, neuroticism, and meaning in life), coping, and cognitive appraisals were assessed at admission. Multilevel regression analyses were performed.</div></div><div><h3>Results</h3><div>The mean age of the participants was 55.8 years (SD, 15.2); 47% had paraplegia, 50% had traumatic SCI, and 77% had incomplete SCI. Median duration of inpatient rehabilitation was 11 weeks. Life satisfaction gradually increased from 5.3 (SD, 2.3) at admission to 7.2 (SD, 2.1) 4 years after discharge, with significant increases in the first 4 weeks (Δ=0.8; SD=0.6), and between 1 and 4 years after discharge (Δ=.4; SD=.7). In the final regression model, younger age, Dutch nationality, higher education level, higher disability management self-efficacy, and lower threatening appraisals were independent predictors of a more positive course of life satisfaction.</div></div><div><h3>Conclusion</h3><div>Life satisfaction in individuals with SCI increased significantly over time. Results from this study suggest that long-term life satisfaction could be positively influenced by modifying low self-efficacy and high threatening appraisals during inpatient rehabilitation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2693-2701"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147986300","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":"Community-based Exercise for Chronic Pain in People With Spinal Cord Injury: A Pragmatic Randomized Controlled Trial","authors":"Kathleen A. Martin Ginis PhD,&nbsp;Cameron Gee PhD,&nbsp;Femke Hoekstra PhD,&nbsp;Sandra Blitz MSc,&nbsp;Julia K. Baumgart PhD,&nbsp;Jennifer C. Davis PhD,&nbsp;Mohammad Ehsanul Karim PhD,&nbsp;Jonathan Peter Little PhD,&nbsp;Joel Singer PhD,&nbsp;Kendra R. Todd PhD,&nbsp;Andrea Townson MD,&nbsp;Christopher R. West PhD,&nbsp;John L.K. Kramer PhD","doi":"10.1016/j.apmr.2026.06.010","DOIUrl":"10.1016/j.apmr.2026.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>To test the hypothesis that home- and community-based exercise, prescribed according to the spinal cord injury (SCI) exercise guidelines, reduces chronic pain.</div></div><div><h3>Design</h3><div>Single-blinded, pragmatic randomized controlled trial with 2 arms (exercise intervention, waitlist control) and assessments at baseline, 3 months, and 6 months.</div></div><div><h3>Setting</h3><div>Testing at 2 university-based laboratories located on separate campuses within the same institution. Exercise in participants’ preferred locations.</div></div><div><h3>Participants</h3><div>Forty-six adults with SCI (76% men/male; 59% paraplegic; <em>M</em>_age=50.6±14.1; <em>M</em>_{years since injury}=16.5±12.8) and chronic neuropathic or musculoskeletal pain, who did not routinely achieve the SCI exercise guidelines.</div></div><div><h3>Intervention</h3><div>Intervention participants (n=25) received an individualized exercise prescription for aerobic and strength training. Fitness trainers and exercise counselors supported implementation. Control participants (n=21) continued their usual activities.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was the SF-36 Pain score at 6 months. Secondary outcomes were International SCI Pain Basic Dataset version 2.0 (ISCIPBDS) pain-intensity and interference scores, and standardized measures of pain coping, well-being, conditioned pain modulation, and proinflammatory cytokines.</div></div><div><h3>Results</h3><div>In intent-to-treat analyses, the estimated treatment effect (95% CI) on SF-36 Pain was 7.9 (−1.9 to 17.7; <em>P</em>=.11) at 6 months. Tipping-point analyses suggested that these effects may have been significant if the target sample size had been achieved. Treatment effects for ISCIPBDS pain intensity were −1.8 (−3.4, −0.1; <em>P</em>=.04) at 6 months. Relative to controls, participants in the intervention condition reported significant reductions in pain interference at 3 months and reduced use of pain-coping strategies at 6 months (<em>P</em>s&lt;0.05). No other effects were significant.</div></div><div><h3>Conclusions</h3><div>Intervention effects on SF-36 Pain were inconclusive. Analyses of secondary outcomes (ISCIPBDS) suggest exercise prescribed according to the SCI exercise guidelines, and implemented in real-world settings, can reduce pain intensity. Meeting the aerobic-exercise guideline may be especially important. Further replication in pragmatic trials is required.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2924-2936"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148270116","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":"Comparison of the Efficacy of Hyaluronic Acid Versus Corticosteroids, Platelet-Rich Plasma, and Physical Therapy in Chronic Shoulder Pain: A Systematic Review and a Frequentist Network Meta-Analysis","authors":"Annachiara Marra PhD,&nbsp;Andrea Uriel de Siena MD,&nbsp;Carmine Iacovazzo MD,&nbsp;Angela Rita Bianco MD,&nbsp;Francesco Squillacioti MD,&nbsp;Maria Vargas PhD,&nbsp;Pasquale Buonanno PhD","doi":"10.1016/j.apmr.2026.04.026","DOIUrl":"10.1016/j.apmr.2026.04.026","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the effectiveness of injected low- and high-molecular-weight hyaluronic acid (HA-LMW, HA-HMW) versus corticosteroids (CCS), placebo—or physical therapy (PT), on pain at rest (Prest), at night (Pnight), and during activity (Pact), range of motion (ROM), functional status (FS), and quality of life in patients with chronic shoulder pain (Sp) at 3 and 6 months follow-up.</div></div><div><h3>Data Sources</h3><div>A systematic literature search was conducted through October 2024 across MEDLINE, Embase, and Cochrane CENTRAL.</div></div><div><h3>Study Selection</h3><div>Fourteen studies were included: 12 randomized controlled trials and 2 prospective cohort studies that compared at least 2 of the treatments of interest in adults with chronic Sp.</div></div><div><h3>Data Extraction</h3><div>Two reviewers independently extracted data related to the outcomes.</div></div><div><h3>Data Synthesis</h3><div>A frequentist network meta-analysis with mean differences (MDs) and standardized mean differences (SMD) was performed; <em>P</em>&lt;.05 was statistically significant. PT reduced Prest compared to HA-HMW (MD = −3.02, <em>P</em>&lt;.01 at 3 mo; MD = −2.08, <em>P</em>&lt;.01 at 6 mo) and HA-LMW (MD = −1.95, <em>P</em>&lt;.01 at 6 mo) in tendinopathy. PT showed greater reduction than both HA formulations in Pnight and Pact at 6 months in tendinopathy. No differences were observed between HA-HMW and HA-LMW for pain outcomes considering shoulder different diseases. HA improved adduction and internal rotation at 3 months considering shoulder different disease; PT was superior for flexion and external rotation at 6 months in tendinopathy. Stratified by pathology, HA-HMW showed moderate efficacy in adhesive capsulitis. HA-HMW improved FS compared to HA-LMW at 3 months. CCS improved abduction in shoulder disease due to different causes.</div></div><div><h3>Conclusions</h3><div>PT provides greater pain control for Sptendinopathy, particularly for Prest, Pnight, and Pact at both 3 and 6 months. HA may contribute to improved quality of life and specific ROM parameters. Further high-quality studies are required to consolidate these findings.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2991-3001"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147810061","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":"Multidimensional Analysis of the Clinical Spectrum and Symptom Burden of Unexplained Myofascial Pain","authors":"Siddhartha Sikdar PhD,&nbsp;Secili DeStefano DPT,&nbsp;María José Guzmán-Pavón DPT,&nbsp;Yu-Lin Hsu MS,&nbsp;Seiyon Lee PhD,&nbsp;John Srbely PhD,&nbsp;Jay Shah MD,&nbsp;William Rosenberger PhD,&nbsp;Samuel Acuña PhD,&nbsp;Yonathan Assefa BS,&nbsp;Matin Jahani Jirsaraei PhD,&nbsp;Antonio Stecco PhD,&nbsp;Lynn H. Gerber MD","doi":"10.1016/j.apmr.2026.05.014","DOIUrl":"10.1016/j.apmr.2026.05.014","url":null,"abstract":"<div><h3>Objective</h3><div>To assess potential contributors to the variability in the clinical spectrum of unexplained neck/shoulder pain and its associated myofascial component(s).</div></div><div><h3>Design</h3><div>Prospective cross-sectional study of adults reporting neck/shoulder pain and pain-free individuals.</div></div><div><h3>Setting</h3><div>Participants were recruited from the community and assessed in a research laboratory.</div></div><div><h3>Participants</h3><div>Of the N=96 adults recruited for the study, 84 had complete records (mean age±SD, 32.7±13.2 y; 58.3% women). On physical examination, they were classified into an <em>active</em> group (those with spontaneous MP without provocation, n=25), a <em>latent</em> group (those with MP upon provocation, n=38), or a <em>referent</em> group (those with no MP in the neck and shoulder, n=21).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Pain intensity and interference; symptom burden measured using patient-reported outcomes and objective measures: Pain Catastrophizing Scale (PCS); Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function; sleep disturbance; anxiety; depression; hypermobility (Beighton/Brighton); objective measures in the medial upper trapezius using pressure pain threshold and quantitative sensory testing.</div></div><div><h3>Results</h3><div>The symptom burden explained 75% of the variance in pain intensity and interference in the overall sample, 82% in the <em>active</em> group, and 92% in the <em>referent</em> group. PROMIS Physical Function and PCS were key predictors of pain intensity and interference. Network analysis identified unique symptom clusters in the <em>active</em> and <em>latent</em> groups.</div></div><div><h3>Conclusions</h3><div>Multidimensional symptom burden explains the variability in the clinical spectrum of pain intensity and interference in unexplained neck/shoulder MP. Network analysis can further improve clinical risk stratification. These findings represent a step toward the eventual goal of developing multidisciplinary clinical guidance for managing the whole patient, rather than the current emphasis on regional contributors to MP.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2807-2816"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175109","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":"Profiles of Quality of Life Outcomes Observed in Rehabilitation Patients Using Latent Profile Analysis","authors":"Callie E. Tyner PhD,&nbsp;Aaron J. Boulton PhD,&nbsp;Pamela A. Kisala MA,&nbsp;Nancy D. Chiaravalloti PhD,&nbsp;Heather B. Taylor PhD,&nbsp;Mark Sherer PhD,&nbsp;Jerry Slotkin PhD,&nbsp;David S. Tulsky PhD","doi":"10.1016/j.apmr.2026.06.005","DOIUrl":"10.1016/j.apmr.2026.06.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objective&lt;/h3&gt;&lt;div&gt;To explore patterns of quality of life (QOL) outcomes in a diverse group of patients commonly seen in rehabilitation settings, in an effort to understand shared profiles of experiences that cut across diagnostic groupings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;To explore patterns of quality of life (QOL) outcomes in a diverse group of patients commonly seen in rehabilitation settings, in an effort to understand shared profiles of experiences that cut across diagnostic groupings.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;Cross-sectional study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Cross-sectional study.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Academic research center.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Academic research center.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;English-speaking adults with a medically confirmed history of traumatic brain injury, spinal cord injury, stroke, or major limb injury and/or limb loss because of a sudden-onset cause, recruited from 3 clinical sites in the US.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;English-speaking adults with a medically confirmed history of traumatic brain injury, spinal cord injury, stroke, or major limb injury and/or limb loss because of a sudden-onset cause, recruited from 3 clinical sites in the US.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Not applicable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Not applicable.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome and Measures&lt;/h3&gt;&lt;div&gt;Standardized factor scores computed for 9 outcome cluster factor scores based on patient-reported outcome measures of economic QOL, fatigue/sleep, pain, independence, physical function, negative affect, positive affect, and social health, and cognitive measures from the brief test of adult cognition by telephone.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Standardized factor scores computed for 9 outcome cluster factor scores based on patient-reported outcome measures of economic QOL, fatigue/sleep, pain, independence, physical function, negative affect, positive affect, and social health, and cognitive measures from the brief test of adult cognition by telephone.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Optimal model fit for the latent profile analysis was achieved with a 4-profile model. These profiles were found to cut across clinical condition and were distinguished by a number of outcomes beyond symptom severity. Pain, independence, cognition, and social participation varied in important ways across the profiles.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;Optimal model fit for the latent profile analysis was achieved with a 4-profile model. These profiles were found to cut across clinical condition and were distinguished by a number of outcomes beyond symptom severity. Pain, independence, cognition, and social participation varied in important ways across the profiles.&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study supported the use of outcome cluster profiles as part of rehabilitation treatment, in addition to information about one’s clinical condition when conceptualizing patient needs. The findings reported here may be useful for developing distinct rehabilitation management approaches based on these outc","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2895-2905"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148238625","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":"Physical Recovery After Transfemoral Amputation Using the Press-Fit Percutaneous Osseointegrated Prosthesis","authors":"Jesse C. Christensen PT, DPT, PhD,&nbsp;Jacob Smith MS,&nbsp;Benjamin J. Darter PT, PhD,&nbsp;Bart Gillespie PT, DPT,&nbsp;Erik K. Kubiak MD,&nbsp;Jayant Agarwal MD,&nbsp;Sarina Sinclair PhD","doi":"10.1016/j.apmr.2026.02.494","DOIUrl":"10.1016/j.apmr.2026.02.494","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate physical recovery based on physiological measures of gait economy, gait speed, exertional heart rate, comprehensive high-level activity mobility predictor (CHAMP) and daily step counts over the first 12 months post-percutaneous osseointegrated prosthesis (post-POP).</div></div><div><h3>Design</h3><div>Prospective longitudinal cohort study.</div></div><div><h3>Setting</h3><div>Academic hospital.</div></div><div><h3>Participants</h3><div>Participants (N=10) underwent a unilateral POP implantation from a parent prospective study.</div></div><div><h3>Interventions</h3><div>Surgery.</div></div><div><h3>Main Outcome Measures</h3><div>Gait economy, gait speed, exertional heart rate, CHAMP, and daily step counts.</div></div><div><h3>Results</h3><div>Significant improvement in gait economy, relative to baseline, were observed at 3-month (<em>P</em>=.02), 6-month (<em>P</em>=.02) and 12-month (<em>P</em>&lt;.01) post-POP. Significant increase in CHAMP scores, relative to baseline, were observed at 6-months (<em>P</em>=.01) and 12-months (<em>P</em>&lt;.01) post-POP. Significant increase in exertional heart rate (<em>P</em>&lt;.01), gait speed (<em>P</em>=.03) and daily step count (<em>P</em>=.04), relative to baseline, was observed at 12-months post-POP. The gait economy and CHAMP scores showed earlier gains compared with exertional heart rate, gait speed, and daily step count scores, with the greatest gains observed in the first 3-6 months post-POP.</div></div><div><h3>Conclusions</h3><div>These data will help to inform expectations for outcomes for patients and clinicians considering POP implantation and could assist in detecting outliers from the normal recovery curve who may benefit from targeted interventions post-POP.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2657-2666"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147571998","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}