Archives of physical medicine and rehabilitation最新文献

{"title":"Reconceptualizing Disorders of the Self as Disorders of Relationship.","authors":"Brick Johnstone, Daniel Cohen, Raeda Anderson, Andrew Cullen Dennison, Laura Bosque","doi":"10.1016/j.apmr.2024.12.019","DOIUrl":"10.1016/j.apmr.2024.12.019","url":null,"abstract":"<p><strong>Objective: </strong>To validate a universal neuropsychological model that suggests that disorders of the self are best conceptualized as disintegrated neuropsychological processes (ie, sensations, mental experiences) that lack a sense of relationship to the unified experience/sense of self.</p><p><strong>Design: </strong>Cross-sectional observational study.</p><p><strong>Setting: </strong>Rehabilitation hospital outpatient clinics.</p><p><strong>Participants: </strong>A total of 73 individuals including 33 with acquired brain injury and 40 with multiple sclerosis.</p><p><strong>Intervention: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>On the basis of the Cambridge Depersonalization Scale, a measure of general disintegration of sensations and mental experiences, a team of rehabilitation clinicians and researchers proposed 6 clinically derived indices of specific disintegrated neuropsychological inputs (ie, sensations), outputs (ie, mental experiences), and experiences of disintegration (ie, space, time, context).</p><p><strong>Results: </strong>As hypothesized (1) a confirmatory factor analysis supported the proposed factors including disintegrated bodily sensations (root mean square error of approximation [RMSEA]=0.193, P=.009; comparative fit index [CFI]=0.909; Tucker-Lewis index [TLI]=0.819), disintegrated context (RMSEA=0.143, P=.129; CFI=0.970; TLI=0.911), disintegrated emotions (RMSEA=0.090, P=.266; CFI=0.967; TLI=0.902), disintegrated cognition (RMSEA=0.091, P=.210; CFI=0.963; TLI=0.939), disintegrated smell/taste, and disintegrated spatial perception (measures of model fit for these last 2 factors could not be determined given they included only 2 items); and (2) Pearson correlations indicated that all 7 Cambridge Depersonalization Scale indices were negatively correlated with a measure associated with right hemisphere functioning, with 5 achieving/approaching statistical significance.</p><p><strong>Conclusion: </strong>The results suggest that (1) neuropsychological abilities should be conceptualized in terms of relatively singular neuropsychological domains (ie, affect, behavior, cognition, sensation) and the experience of relationship that is created when they are integrated, and (2) disorders of the self are best conceptualized as disorders of disintegration that are associated with decreased relationship between specific neuropsychological processes and the unified experience/sense of self.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Rehabilitation of Social Communication Skills in Patients With Acquired Brain Injury With Intensive and Standard Group Interactive Structured Treatment: A Randomized Controlled Trial","authors":"Parneet Kaur MPT,&nbsp;Anmol Bhatia MPT,&nbsp;Geetanjali Saggar MPT","doi":"10.1016/j.apmr.2024.06.025","DOIUrl":"10.1016/j.apmr.2024.06.025","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Page 150"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340077","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":"Editors' Selections From This Issue","authors":"","doi":"10.1016/S0003-9993(24)01377-7","DOIUrl":"10.1016/S0003-9993(24)01377-7","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Page A10"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129875","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":"Creative Arts Therapies in Rehabilitation","authors":"Charles E. Levy MD,&nbsp;Jay M. Uomoto PhD,&nbsp;Donna J. Betts PhD, ATR-BC,&nbsp;Helen Hoenig MD, MPH","doi":"10.1016/j.apmr.2024.07.008","DOIUrl":"10.1016/j.apmr.2024.07.008","url":null,"abstract":"<div><div>Appreciation for the utility of creative arts therapy in rehabilitation is on the rise. The limitations of conventional approaches to address posttraumatic stress disorder and co-occurring traumatic brain injury is spurring the development and increased use of creative arts therapies, especially in US military health care systems. However, emerging applications of creative arts therapies in rehabilitation extend well beyond posttraumatic stress disorder/traumatic brain injury and military populations to span the continuum of care, from the intensive care unit, postoperative recovery unit, acute inpatient medical and surgical wards, outpatient clinics, and home health, as well as in traditional long-term care and psychiatric settings. Critical steps to more fully integrating creative arts therapies in rehabilitation include the following: (1) incorporation of education about creative arts therapies into the curricula across rehabilitation disciplines; (2) alteration of national and state policies to promote greater inclusion of creative arts therapies as reimbursable treatments for a wide array of clinical diagnoses and conditions; and (3) significant expansion of creative arts therapies’ evidence base. This can be achieved by increasing funding levels to encourage rigorously designed and controlled studies to determine the efficacy, populations, diagnoses and conditions, cofactors, and the mechanisms of action of creative arts therapies. The time has come for a concentrated effort from the community of rehabilitation professional associations, advocacy organizations, and practitioners to promote the advancement and inclusion of creative arts therapies into appropriate clinical settings to optimize outcomes for patients.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 153-157"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141750937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Letter to the Editor: Rehabilitation of Social Communication Skills in Patients With Acquired Brain Injury With Intensive and Standard Group Interactive Structured Treatment: A Randomized Controlled Trial","authors":"Silje Merethe Hansen Ingebretsen PhD,&nbsp;Melanie Kirmess PhD,&nbsp;Jan Stubberud PhD","doi":"10.1016/j.apmr.2024.09.009","DOIUrl":"10.1016/j.apmr.2024.09.009","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 151-152"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142340078","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":"Should You Tell Others That You Live With Brain Injury? Things to Consider About Brain Injury and Disclosure","authors":"Lisa Engel PhD, MSc OS/OT,&nbsp;Wendy Waldman BSW, CBIST,&nbsp;Laurie Rippon MA Ed, HD,&nbsp;Elaheh Keshavarz MSc Rehab","doi":"10.1016/j.apmr.2024.09.018","DOIUrl":"10.1016/j.apmr.2024.09.018","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 159-162"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142563462","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":"Archives Supplements","authors":"","doi":"10.1016/S0003-9993(24)01392-3","DOIUrl":"10.1016/S0003-9993(24)01392-3","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 163-165"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143129949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Exercise Therapy in Axial Spondyloarthritis: A Systematic Review, Meta-analysis, and Meta-regression of Randomized Trials","authors":"Meng Zhang PhD ,&nbsp;Zhide Liang MD ,&nbsp;Liang Tian MD ,&nbsp;Yaqi Han MD ,&nbsp;Xu Jiang ,&nbsp;Yali Li ,&nbsp;Zhaoxi Su MD ,&nbsp;Tao Liu PhD","doi":"10.1016/j.apmr.2024.06.005","DOIUrl":"10.1016/j.apmr.2024.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to assess the effectiveness of exercise therapy for patients with axial spondyloarthritis (axSpA).</div></div><div><h3>Data Sources</h3><div>We searched MEDLINE (via PubMed), Cochrane Library, Embase, Web of Science, Scopus, and SPORTDiscus for all relevant publications from database inception to March 2024, without language restriction.</div></div><div><h3>Study Selection</h3><div>We included randomized controlled trials (RCTs) of patients with axSpA in which ≥1 group received exercise therapy.</div></div><div><h3>Data Extraction</h3><div>Two independent reviewers assessed the quality of the literature using the Cochrane Collaboration Risk of Bias Tool 2.0. The outcomes were ankylosing spondylitis (AS) disease activity score (ASDAS), Bath AS disease activity index (BASDAI), Bath AS functional index (BASFI), Bath AS metrology index (BASMI), 6-minute walk test (6MWT), chest expansion capacity, peak oxygen consumption (VO₂peak), pain, fatigue, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR).</div></div><div><h3>Data Synthesis</h3><div>A total of 20 RCTs, including 1670 patients, were included in this study. Compared with the control group, exercise therapy improved BASFI (weighted mean difference [WMD], −0.49; 95% confidence interval [CI], −0.65 to −0.32; <em>I</em>²=3.4%; <em>P</em>=.414), BASMI (WMD, −0.49; 95% CI, −0.87 to −0.11; <em>I</em>²=71.9%; <em>P</em>=.679), BASDAI (WMD, −0.78; 95% CI, −1.08 to −0.47; <em>I</em>²=55.9%; <em>P</em>=.021), ASDAS (WMD, −0.44; 95% CI, −0.64 to −0.24; <em>I</em>²=0.0%; <em>P</em>=.424), VO₂peak (WMD, 3.16; 95% CI, 1.37-4.94; <em>I</em>²=0.0%; <em>P</em>=.873), 6MWT (WMD, 27.64; 95% CI, 12.04-43.24; <em>I</em>²=0.0%, <em>P</em>=.922), pain (standardized mean difference [SMD], −0.47; 95% CI, −0.74 to −0.21; <em>I</em>²=66.0%, <em>P</em>=.046), and fatigue (SMD, −0.49; 95% CI, −0.71 to −0.27; <em>I</em>²=0.0%; <em>P</em>=.446). However, no significant benefit was found in chest expansion, CRP, and ESR outcomes.</div></div><div><h3>Conclusions</h3><div>Exercise therapy is an effective strategy for improving disease control and symptom relief in patients with axSpA.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 113-123"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Terminology Matter? Perspectives From People With Limb Difference, Clinicians, and Researchers","authors":"M.G. Finco PhD, CPO, MS ,&nbsp;Cody L. McDonald PhD, CPO, MPH ,&nbsp;Sarah C. Moudy PhD, MSc","doi":"10.1016/j.apmr.2024.07.019","DOIUrl":"10.1016/j.apmr.2024.07.019","url":null,"abstract":"<div><h3>Objective</h3><div>To elicit the preferred terminology among people with limb difference as well as health care and/or research professionals.</div></div><div><h3>Design</h3><div>Cross-sectional survey.</div></div><div><h3>Setting</h3><div>Online.</div></div><div><h3>Participants</h3><div>A convenience sample of N=122 individuals (people with limb difference, n=65; health care and/or research professionals, n=57) completed an online survey. People were included if they (1) were aged ≥18 years; (2) self-identified as having limb difference (regardless of etiology) or as a health care or research professional (with experience working with people with limb difference); and (3) lived in the United States for most of the time in their selected role.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Importance of terminology, preference toward person-first or identity-first terms, preferred terms, and individual perspectives on terminology preferences.</div></div><div><h3>Results</h3><div>Most participants identified as White (92.6%). Age significantly differed between groups (people with limb difference, 49.9±15.4y; professionals, 41.0±14.3y; <em>P</em>=.001). Approximately 50% of people with limb difference stated terminology was very or extremely important, compared to 70% of professionals (<em>χ²</em>=16.6, <em>P</em>=.002). While 73.7% of professionals reported a preference for person-first terminology, the sample of people with limb difference were more evenly split, as 42.9% reported a preference for identity-first terminology and 50.8% reported a preference for person-first terminology. The most frequently selected limb and population terms, respectively, were <em>residual limb</em> and <em>individual/person with limb difference</em>; however, many people with limb difference indicated they preferred “amputee” when speaking about a population.</div></div><div><h3>Conclusions</h3><div>Most of the participants indicated terminology was very or extremely important, and both groups tended to prefer the terms residual limb (limb term) and individual/person with limb difference (population term). However, this study was not intended to recommend terminology, but rather help inform terminology choices that are centered around people with limb difference. Individuality and context should be considered when deciding terminology. Future studies should include more participants from racially/ethnically minoritized groups and people with limb difference who have dysvascular and/or congenital etiologies.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 26-36"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141987324","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":"Model of Care for Chronic Brain Injury","authors":"John D. Corrigan PhD ,&nbsp;Flora M. Hammond MD ,&nbsp;Angelle M. Sander PhD ,&nbsp;Kurt Kroenke MD","doi":"10.1016/j.apmr.2024.08.001","DOIUrl":"10.1016/j.apmr.2024.08.001","url":null,"abstract":"<div><div>There is growing evidence that long-term outcomes after traumatic brain injury (TBI) are more dynamic than stable. People continue to change, both improving and declining, many years postinjury. Research, practice, and medical education have not yet fully embraced the implications of TBI as a chronic, dynamic condition. In 2020, the National Institute on Disability Independent Living and Rehabilitation Research funded the BeHEALTHY project to develop a model for long-term support of persons with chronic brain injury. Based on initial reviews of the available evidence and expert input from researchers, clinicians, and persons with lived experience, the BeHEALTHY model was proposed. Among existing chronic disease treatment models, Wagner's Chronic Care Model was selected as a starting point, with several critical refinements. The BeHEALTHY model endorses a person-centered approach, recognizing the individual with brain injury, and their social support system, as the primary source of goals in care planning. The model also acknowledges the critical importance of <em>self</em>-management and the need for health care programs to actively promote self-direction by the person using their social supports. The model also recognizes that outcomes are not determined solely by the person and the injury incurred but also by the environment in which a person lives and recovers. The importance of integrating health care with community resources is underscored by embracing environmental influences as a shared responsibility of the community and the health care system. This article recounts the impetus for developing the BeHEALTHY model and describes those it is intended to serve and its structural features and core components.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 1","pages":"Pages 145-149"},"PeriodicalIF":3.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999372","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}