Archives of physical medicine and rehabilitation最新文献

{"title":"Advancing Hospital Acquired Pressure Injury Prevention with a Data-Driven Transdisciplinary Model","authors":"Bridget Fowler King,&nbsp;Colleen Johnson,&nbsp;Matthew Grissom,&nbsp;Andrew Morris,&nbsp;Miriam Rafferty","doi":"10.1016/j.apmr.2025.03.025","DOIUrl":"10.1016/j.apmr.2025.03.025","url":null,"abstract":"<div><h3>Introduction</h3><div>Our project aims to reduce HAPI occurrences in spinal cord injury patients by translating risk identification research into effective quality improvement strategies.</div></div><div><h3>Objective</h3><div>To develop and implement a \"Pressure Injury Prevention Toolkit,\" enhanced by a HAPI reporting dashboard, to improve risk-based clinical decision-making and define clear roles for healthcare providers.</div></div><div><h3>Methods</h3><div>Using an 18-month Plan, Do, Study, Act (PDSA) cycle, we introduced new nursing workflows for identifying high-risk patients, real-time data visualization for HAPI metrics, and regular transdisciplinary meetings to refine patient care plans and interventions.</div></div><div><h3>Results</h3><div>The initial PDSA cycle highlighted areas for protocol refinement, such as increasing buy-in from floor managers and creating sustainable, adaptable work processes. Future cycles will focus on improving dashboard engagement, prevention compliance, and transdisciplinary discussion fidelity.</div></div><div><h3>Implications</h3><div>This approach integrates digital tools and transdisciplinary insights to revamp traditional HAPI prevention strategies, paving the way for broader implementation across the hospital.</div></div><div><h3>Conclusion</h3><div>Our project demonstrates the transformative potential of technology-enhanced, transdisciplinary strategies in improving patient care quality and reducing HAPI rates.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Page e7"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887657","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":"Implementation of Remote Therapeutic Monitoring into Physical Therapy at a Large Academic Healthcare System","authors":"Kevin McLaughlin","doi":"10.1016/j.apmr.2025.03.029","DOIUrl":"10.1016/j.apmr.2025.03.029","url":null,"abstract":"<div><div>Remote therapeutic monitoring (RTM) is an mHealth solution that allows physical therapists to communicate with patients who have musculoskeletal conditions and track their progress outside of clinic visits using a mobile application. By enhancing patients' engagement with their care, RTM stands to increase the effectiveness of physical therapy care for patients with musculoskeletal conditions. At the same time, RTM is very different than traditional physical therapy services as it is delivered through a mobile application outside of scheduled clinical visits. The procedural codes used to cover RTM services are also new, having been announced in 2022 by the Centers for Medicare and Medicaid Services. As such, best practice approaches for implementing RTM into clinical practice have not been established. Since early 2024, our team has been actively implementing a mobile application and RTM workflows across a large outpatient rehabilitation network. In this presentation, our team will describe our experiences implementing RTM services across our network. Guided by the RE-AIM framework, we will report on patient acceptance and utilization of these services, as well as provider uptake of RTM and utilization rates. We will also provide preliminary estimates regarding the influence of RTM on patient-reported outcomes, which are routinely collected at our institution. Lastly, we will discuss challenges we have experiences during implementation and recommendations for other institutions interested in implementing RTM services.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Page e8"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887782","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":"Building Context-Aware Digital Health Tools: A Framework for Evaluating Real-World Human Health and Behavior","authors":"Christopher DiCesare,&nbsp;Scott McLean","doi":"10.1016/j.apmr.2025.03.030","DOIUrl":"10.1016/j.apmr.2025.03.030","url":null,"abstract":"<div><div>Digital health tools that utilize innovative technologies (wearable / portable devices, human-centric artificial intelligence / machine learning [AI / ML], etc.) have enormous potential for targeted human performance monitoring, pain, disease, and/or disability management. Efforts in this space have, for the most part, yet to translate into clinically useful applications. For every potential opportunity that these tools present, challenges persist, including how to devise experimental protocols in unconstrained, real-world settings to ensure that meaningful data is captured, how to make sense of those data / reconcile with what we observe in the laboratory, and how best to integrate these insights within the clinical ecosystem. In this presentation, I discuss the generalized framework our team (EPIC Laboratory) has been developing that supports proactive planning for, anticipation of, and adaptation to real-world human behavior, with a specific emphasis on the principles of human movement and cognitive science, contextual design, and user experience evaluation as applied to engineering design and product development.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Page e8"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887783","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":"Walking Exercise Sustainability through Telehealth for Veterans with Lower-Limb Amputation","authors":"Rachael Akay ,&nbsp;Brecca Gaffney ,&nbsp;Ryan Stephenson ,&nbsp;Elizabeth Juarez-Colunga ,&nbsp;Paul Cook ,&nbsp;Cory Christiansen","doi":"10.1016/j.apmr.2025.03.020","DOIUrl":"10.1016/j.apmr.2025.03.020","url":null,"abstract":"<div><h3>Background</h3><div>The VA Durability of Rehabilitation Interventions for Veterans (DRIVE) funding mechanism supports novel, multimodal rehabilitation approaches, including clinician-directed interventions and Veteran self-managed components, to improve long-term durability of rehabilitation outcomes. This trial funded by the DRIVE mechanism focuses on sustained walking exercise after lower-limb amputation. While conventional lower-limb amputation rehabilitation effectively improves functional capacity, healthy levels of walking are not sustained post-rehabilitation.</div></div><div><h3>Objective</h3><div>The \"Walking Exercise Sustainability Training (WEST)\" trial examines a Veteran home-based self-maintenance intervention after lower-limb loss. The WEST trial, designed by a transdisciplinary team of patients, physical therapists, occupational therapists, physicians, psychologists, nurses, and bioengineers, is a psychologically informed approach based on behavioral frameworks and patient-centered communication. Wearable sensors and peer support are used in a telehealth environment to deliver the intervention with the aim of sustaining walking exercise.</div></div><div><h3>Methods</h3><div>WEST is a randomized controlled superiority trial that tests an 18-month telehealth walking exercise self-management program. Veteran participants will complete six one-on-one intervention sessions, and six peer-support group sessions. The experimental arm will receive a self-management program focused on sustaining walking exercise and the control group will receive attention-control health education. Daily walking step count (primary outcome; actigraphy) will be continuously monitored during study participation. Secondary outcomes assess potential translation of the WEST intervention into conventional VA amputation care. IMPACT The unique rehabilitation paradigm in this trial addresses the problem of persistent sedentary lifestyles following lower-limb amputation through a telehealth self-management model. The novel transdisciplinary strategy will inform implementation potential, including a signal for clinical effectiveness.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Pages e5-e6"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887913","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":"It's All About Communication! Teaching Researchers to Talk to Clinical Collaborators","authors":"Melissa Briody ,&nbsp;Bridget Fowler King ,&nbsp;James Silwa ,&nbsp;Richard Lieber","doi":"10.1016/j.apmr.2025.03.006","DOIUrl":"10.1016/j.apmr.2025.03.006","url":null,"abstract":"<div><div>Effective clinician-researcher partnerships rely on clear communication, yet these two groups often struggle to speak a common language. We have developed what we term, \"The IdeaLab,\" an initiative of Shirley Ryan AbilityLab and the Center for Smart Use of Technology to Assess Real World Outcomes (C-STAR), that provides a platform for investigators to present early-stage research ideas and receive expert guidance from clinicians. From 2021-2024, we held 20 IdeaLabs with an average of 35 employees per event (35.4±10.2). Participants included 45.6% Researchers/Engineers, 32.6% Allied Health, 11.4% Other staff, 9.0% Physicians, and 1.3% Registered Nurses (n=708). The success of these events hinges on presenters effectively communicating their research ideas to the interdisciplinary audience to produce valuable discussions of usability, feasibility, clinical applicability and potential impact. Drawing from our experience, we identified three key concepts and incorporated them into a template for successful IdeaLab presentations: (1) Start with the idea. Presenters must concisely articulate their idea and their understanding of its significance. (2) Simplify the content. Presenters must provide essential information with minimal technical jargon. Overly detailed methodology distracts from the clinical need and impact. (3) Focus on the nail. Presenters should aim to identify real clinical problems and tailor their solution (\"the hammer\") accordingly to increase the potential for impact. For some investigators, the IdeaLab may be their first meaningful interaction with clinical counterparts. By equipping researchers with effective interdisciplinary communication skills, we foster a culture of collaboration that empowers both researchers and clinicians to address real-world challenges for rehabilitation populations.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Pages e1-e2"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887918","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":"Archives Supplements","authors":"","doi":"10.1016/S0003-9993(25)00645-8","DOIUrl":"10.1016/S0003-9993(25)00645-8","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Pages 817-819"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887962","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":"Fueling Innovation: Catalyst Grants Spark Interdisciplinary Rehabilitation Research","authors":"Melissa Briody ,&nbsp;Bridget Fowler King ,&nbsp;James Silwa ,&nbsp;Richard Lieber","doi":"10.1016/j.apmr.2025.03.005","DOIUrl":"10.1016/j.apmr.2025.03.005","url":null,"abstract":"<div><div>Translational rehabilitation research and innovative thinking requires meaningful collaboration between researchers and clinicians, yet these opportunities are often not prioritized or incentivized. To address this gap, Shirley Ryan AbilityLab initiated the Catalyst Grant Program in November 2019. Our goal was to create interdisciplinary research teams throughout the organization that produce meaningful patient outcomes in the clinic and in the community. This presentation details the methods, outcomes, and lessons learned from administering this strategic initiative over the past five years. Organizational leaders designed the program to include four grant types (Project, Quality, Mentorship, and Foundational), to form a comprehensive program for all employees, including those with no research experience to career scientists. From 2019 to 2024, there were six rounds of Catalyst Grant funding. In total, 943 applicants contributed to 283 applications that resulted in 72 awards totaling $1.25M in funding. Applicants came from diverse professions, with 64% Non-researchers and 36% Researchers with further breakdown of 42% Allied Health, 36% Researchers/Engineers and 9% Physicians, 5% Nurses, and 8% Other staff (n=943). The interdisciplinary teams supported through the Catalyst Grant Program have demonstrated a high degree of scientific productivity. As of February 2024, the 55 awards in the first five cycles totaled a $980k investment that resulted in 14 publications, 12 external grant applications, and 8 external grant awards totaling $7.8M. These results demonstrate the program's effectiveness in building and sustaining productive clinical research partnerships, fostering innovation, and cultivating a research-driven culture within a rehabilitation hospital.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Page e1"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887963","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":"Building Innovative, Lasting, Interprofessional Teams: What I Have Learned from Others","authors":"Michael Boninger","doi":"10.1016/j.apmr.2025.03.021","DOIUrl":"10.1016/j.apmr.2025.03.021","url":null,"abstract":"<div><div>The talk will focus on the core elements of building innovative, lasting, interprofessional teams. It will not only reflect my own experiences, but draw on the invaluable lessons learned from my colleagues in rehabilitation research. In addition to insights on team building, the talk will showcase key findings of my colleagues; key findings that were make possible because of their ability to lead and work as a part of team.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Page e6"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887914","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":"Cross-disciplinary study of the neural basis of rehabilitation outcomes with virtual reality: a preliminary investigation","authors":"Neha Mehta,&nbsp;Rory O'Keeffe,&nbsp;Yair Shahar,&nbsp;Sarmad Mehrdad,&nbsp;Farokh Atashzar,&nbsp;Anat Lubetzky","doi":"10.1016/j.apmr.2025.03.022","DOIUrl":"10.1016/j.apmr.2025.03.022","url":null,"abstract":"<div><div>Virtual Reality (VR) is increasingly gaining traction as an innovative solution to enhance rehabilitation outcomes by providing a conducive environment for engaging and customizable physical activity. To harness the benefits of such technologies, it is imperative to understand their interaction at the neural level. Therefore, as a first step, we utilized Electroencephalography (EEG) to investigate the spatiotemporal dynamics of the brain in young adults with and without VR immersion. Five healthy young adults (4 males) performed boxing exercises guided by either a 3D VR-based game or an instructional video displayed on a 2D computer screen. A 64-channel EEG was recorded during 3 graded task intensity levels: (i) rest, (ii) moderate, and (iii) advanced. We calculated the mean power spectral density in the 20-100 Hz range as a proxy to the level of activation for each EEG channel. Median cortical activation in each pre-frontal, frontal, parietal, and occipital region increased in proportion to task intensity, both with and without VR. The overall cortical activation was higher with VR versus instructional video for advanced-intensity tasks (p&lt;0.001). Higher cortical activation indicates an underlying ion flow gradient for synaptic transmission, suggesting some neuroplastic changes during VR immersion. In this presentation, we will cover the implications of emerging results from the ongoing pilot randomized crossover study. We will discuss the rational for methodologies that combine VR headsets and EEG and our choice of outcome measures. This line of research holds significant potential to explain the effectiveness of VR and facilitate rehabilitation research and clinical translation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Page e6"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887915","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 'Test-Drive' Strategy for Prosthetic Foot Prescription Using a Robotic Prosthetic Foot Emulator","authors":"David Morgenroth ,&nbsp;Elizabeth Halsne ,&nbsp;Andrew Hansen ,&nbsp;Lee Childers ,&nbsp;Alexandria Lloyd ,&nbsp;Josh Caputo ,&nbsp;Brian Hafner","doi":"10.1016/j.apmr.2025.03.016","DOIUrl":"10.1016/j.apmr.2025.03.016","url":null,"abstract":"<div><div>Selecting an optimal prosthetic foot is vital to maximizing mobility and achieving functional goals in people with lower limb loss. However, patients do not generally have an opportunity to provide experiential input to the foot selection process. This study aimed to assess an innovative 'test-drive' strategy for foot selection. Sixty-eight individuals with transtibial amputation each trialed three commercial prosthetic feet and three corresponding emulated feet using a robotic foot emulator capable of switching between feet via a software interface during walking on level, inclined, and stair treadmills in the laboratory. Participants then wore each commercial foot for consecutive two-week community trials. All foot conditions were randomized and participant-blinded. Foot preference was measured on a 0-10 scale. Following each community trial, participants also completed self-reported and performance-based measures. Linear mixed-effects regression was used to assess associations between outcomes. Initial foot preference scores from trials with emulated feet correlated with preference scores after community trials with the corresponding commercial feet (p&lt;.001) and with Trinity Amputation and Prosthesis Experience Scales–Functional Satisfaction score (p=.036), but not with Two Minute Walk Test, Prosthetic Limb Users Survey of Mobility, or Activity-Balance Confidence scores. The most-preferred foot after the after the in-lab trial of the emulated foot matched the most-preferred foot after the community trial of the corresponding commercial foot for 48/68 participants. These results suggest that a patient-centered 'test-drive' strategy using a prosthetic foot emulator could potentially enhance prosthetic foot prescription and lead to improved patient satisfaction outcomes in people with lower limb amputation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 5","pages":"Page e4"},"PeriodicalIF":3.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143887964","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}