Archives of physical medicine and rehabilitation最新文献

{"title":"Ed Board page","authors":"","doi":"10.1016/S0003-9993(25)00006-1","DOIUrl":"10.1016/S0003-9993(25)00006-1","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Page A4"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of mHealth Interventions to Improve Pain Intensity and Functional Disability in Individuals With Hip or Knee Osteoarthritis: A Systematic Review and Meta-analysis","authors":"Jean Mapinduzi PT, Msc. (OMT) ,&nbsp;Gérard Ndacayisaba PT, Msc. (OMT) ,&nbsp;Jonas Verbrugghe PT, PhD ,&nbsp;Annick Timmermans PT, PhD ,&nbsp;Oyéné Kossi PT, PhD ,&nbsp;Bruno Bonnechère DO, PhD","doi":"10.1016/j.apmr.2024.06.008","DOIUrl":"10.1016/j.apmr.2024.06.008","url":null,"abstract":"<div><h3>Objective</h3><div>This review aimed to investigate the effectiveness of mHealth-supported active exercise interventions to reduce pain intensity and disability level in persons with hip or knee osteoarthritis (OA).</div></div><div><h3>Data Sources</h3><div>Three databases (PubMed, Cochrane Library<span>, and Web of Science) were systematically searched for randomized controlled trials (RCTs) published between January 1, 2012 and July 31, 2023. PROSPERO registration number of this review was CRD42023394119.</span></div></div><div><h3>Study Selection</h3><div>We included only RCTs that were identified and screened by 2 independent reviewers (J.M. and G.N.). In addition, the reference lists of the identified studies were manually checked for further inclusion. Included studies had to provide mHealth-supported active exercises for persons with hip or knee OA, and evaluate pain intensity and disability using both questionnaires and performance tests.</div></div><div><h3>Data Extraction</h3><div>From the included studies, the 2 independent authors extracted data using a predetermined Excel form. Characteristics of the interventions were described and a meta-analysis was performed.</div></div><div><h3>Data Synthesis</h3><div><span>Twelve RCTs were included, representing 1541 patients with a mean age of 58.7±5 years, and a body mass index of 28.8±3.1 kg/m</span>²; women being more predominant than men with a total female to male ratio of 2.2. The methodological quality of the included studies was moderate in 75% of the studies. There was no statistically significant difference between mHealth-supported active exercises compared with the interventions without mHealth in terms of pain reduction (standard mean differences [SMD]=−0.42; 95% CI, −0.91 to 0.07; <em>P</em>=.08) and disability mitigation (SMD=−0.36; 95% CI, −0.81 to 0.09; <em>P</em>=.10). However, a statistically significant difference was found between patient education combined with mHealth-supported active exercises compared with patient education alone in terms of pain (SMD= −0.42; 95% CI, −0.61 to −0.22; <em>P</em>&lt;.01) and disability (SMD=−0.27; 95% CI, −0.46 to −0.08; <em>P</em>&lt;.01) reduction.</div></div><div><h3>Conclusions</h3><div>mHealth-supported exercises were found to be effective, especially when combined with patient education, in reducing pain and mitigating disability in patients with hip or knee OA.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 280-291"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141465854","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":"Prevalence of Spinal Segmental Sensitization Syndrome in Outpatients Attending Physical Medicine and Rehabilitation Centers for Chronic Musculoskeletal Pain: A Multicenter Study","authors":"Tomas Nakazato-Nakamine MD ,&nbsp;Franco Romani MD, MSc ,&nbsp;Cesar Gutierrez MD, MSc ,&nbsp;Pablo Quezada MD ,&nbsp;Ruth Vera MD ,&nbsp;Karina Artica MD","doi":"10.1016/j.apmr.2024.08.013","DOIUrl":"10.1016/j.apmr.2024.08.013","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the prevalence of spinal segmental sensitization (SSS) syndrome, a regional pain disorder, among patients visiting physical medicine and rehabilitation centers (PM&amp;RCs) for chronic musculoskeletal pain (CMSP).</div></div><div><h3>Design</h3><div>An observational, descriptive, cross-sectional study conducted from March to July 2023.</div></div><div><h3>Setting</h3><div>Seven PM&amp;RCs from 5 cities, representing 3 care systems: Social Security (SS), Ministry of Health (MH), and private practice (PP).</div></div><div><h3>Participants</h3><div>All patients, regardless of age, attending a physiatry consultation for CMSP for the first time and who provided informed consent to participate were included. Nonprobabilistic sampling was employed.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure</h3><div>We estimated the overall prevalence of SSS syndrome as a percentage among patients with CMSP, stratified by health care institution, sex, age, and occupation type. We also recorded the spinal segments involved and any concomitant painful disorders (CPDs). SSS syndrome was diagnosed using standardized criteria.</div></div><div><h3>Results</h3><div>Of the eligible participants, 319 with CMSP were enrolled; 73.4% were women, and the median age of participants was 56.9 (range, 13-89y) years. The overall prevalence of SSS syndrome was 53.3%. Of these, 69.1%, 42.2%, and 13.8% were in the SS, MH, and PP systems, respectively. The most affected were female participants (56.4%), those aged 50-64 years (60.4%), and those with active jobs (58.8%). Most commonly, the lumbosacral and lumbar segments were affected, followed by the lower and middle cervical levels. Spine pathologies were the most common CPDs.</div></div><div><h3>Conclusion</h3><div>The prevalence of SSS syndrome was high among patients who visited PM&amp;RCs for CMSP and varied according to the care system. Further research on SSS syndrome is warranted to relieve the burden it poses on patients with CMSP and ensure proper diagnosis in clinical practice.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 216-222"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142103832","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":"Skilled Nursing and Home Health Policy: A Primer for the Hospital Clinician","authors":"Rachel A. Prusynski DPT, PhD ,&nbsp;Cait Brown MA, CCC-SLP ,&nbsp;Joshua K. Johnson DPT, PhD ,&nbsp;Jessica Edelstein PhD, OTR/L","doi":"10.1016/j.apmr.2024.08.017","DOIUrl":"10.1016/j.apmr.2024.08.017","url":null,"abstract":"<div><div>This paper addresses the increasing challenges faced by hospital clinicians in coordinating and recommending postacute care for patients, focusing on issues related to access to the most common postacute services: skilled nursing facilities (SNFs) and home health agencies (HHAs). In coordinating discharges, hospital clinicians have minimal information on care delivery in these settings. This knowledge gap is exacerbated by the disrupted continuum of patient care between acute care hospitals, SNFs, and HHAs. To address these challenges, hospital clinicians must understand how recent federal policies have impacted SNF and HHA care provision. The paper provides an overview of recent Centers for Medicare and Medicaid Services (CMS) policies and programs affecting SNFs and HHAs, including: (1) fee-for-service reimbursement reform (ie, Patient Driven Payment Model [PDPM] and the Patient Driven Groupings Model [PDGM]); (2) bundled payment programs; (3) accountable care organizations; (4) Medicare Advantage plans. Overall, this paper aims to help hospital clinicians stay informed about the evolving landscape of postacute care delivery by providing relevant information on how recent policy changes have impacted patient care.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 311-320"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142131684","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":"Evaluating the Effectiveness of Transtibial Prosthetic Socket Shape Design Using Artificial Intelligence: A Clinical Comparison With Traditional Plaster Cast Socket Designs","authors":"Merel van der Stelt MSc ,&nbsp;Bo Berends MSc ,&nbsp;Marco Papenburg ,&nbsp;Tom Langenhuyzen ,&nbsp;Thomas Maal PhD ,&nbsp;Lars Brouwers PhD, MD ,&nbsp;Guido de Jong PhD ,&nbsp;Ruud Leijendekkers PhD","doi":"10.1016/j.apmr.2024.08.026","DOIUrl":"10.1016/j.apmr.2024.08.026","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate the feasibility of creating an artificial intelligence (AI) algorithm to enhance prosthetic socket shapes for transtibial prostheses, aiming for a less operator-dependent, standardized approach.</div></div><div><h3>Design</h3><div>The study comprised 2 phases: first, developing an AI algorithm in a cross-sectional study to predict prosthetic socket shapes. Second, testing the AI-predicted digitally measured and standardized designed (DMSD) prosthetic socket against a manually measured and designed (MMD) prosthetic socket in a 2-week within-subject cross-sectional study.</div></div><div><h3>Setting</h3><div>The study was done at the rehabilitation department of the Radboud University Medical Center in Nijmegen, the Netherlands.</div></div><div><h3>Participants</h3><div>The AI algorithm was developed using retrospective data from 116 patients from a Dutch orthopedic company, OIM Orthopedie, and tested on 10 randomly selected participants from Papenburg Orthopedie.</div></div><div><h3>Interventions</h3><div>Utilization of an AI algorithm to enhance the shape of a transtibial prosthetic socket.</div></div><div><h3>Main Outcome Measures</h3><div>The algorithm was optimized to minimize the error in the test set. Participants’ socket comfort score and fitting ratings from an independent physiotherapist and prosthetist were collected.</div></div><div><h3>Results</h3><div>Predicted prosthetic shapes deviated by 2.51 mm from the actual designs. In total, 8 of 10 DMSD and all 10 MMD-prosthetic sockets were satisfactory for home testing. Participants rated DMSD-prosthetic sockets at 7.1 ± 2.2 (n=8) and MMD-prosthetic sockets at 6.6 ± 1.2 (n=10) on average.</div></div><div><h3>Conclusions</h3><div>The study demonstrates promising results for using an AI algorithm in prosthetic socket design, but long-term effectiveness and refinement for improved comfort and fit in more deviant cases are necessary.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 239-246"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279798","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":"Reliability and Construct Validity of Three Self-report Questionnaires Assessing Dual-Task Difficulties in People With Multiple Sclerosis: An International Study","authors":"Zuhal Abasıyanık PhD ,&nbsp;Ludovico Pedullà PhD ,&nbsp;Turhan Kahraman PhD ,&nbsp;Mieke D'Hooge MSc ,&nbsp;Carme Santoyo-Medina MSc ,&nbsp;Bernardita Soler MD, PhD ,&nbsp;Andrea Tacchino PhD ,&nbsp;Renee Veldkamp PhD ,&nbsp;Edwin-Roger Meza-Murillo MD ,&nbsp;Areen Omar MSc ,&nbsp;Ethel Ciampi MD ,&nbsp;Serkan Özakbaş MD ,&nbsp;Daphne Kos PhD ,&nbsp;Alon Kalron PhD ,&nbsp;Peter Feys PhD","doi":"10.1016/j.apmr.2024.08.024","DOIUrl":"10.1016/j.apmr.2024.08.024","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Design</h3><div>Multicenter, cross-sectional study</div></div><div><h3>Setting</h3><div>Persons with multiple sclerosis (pwMS) were recruited from 7 multiple sclerosis centers across 6 countries (Belgium, Chile, Italy, Israel, Spain, and Turkey).</div></div><div><h3>Participants</h3><div>A total of 356 pwMS (mean age 47.5±11.5y, expanded disability status scale, 3.79±1.83) were enrolled.</div></div><div><h3>Interventions</h3><div>Not applicable</div></div><div><h3>Main Outcome Measures</h3><div>The reliability (internal consistency, test-retest, and measurement error) and construct validity (structural and convergent) were assessed.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 230-238"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","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":"Evaluation of Inadequate Response to Ultrasound-Guided Subacromial Corticosteroid Injection in Shoulder Impingement Syndrome: Treatment Failure or Central Sensitization?","authors":"Büşra Şirin Ahısha, Nurdan Paker, Nur Kesiktaş, Nazlı Derya Buğdayci, Yiğit Can Ahısha","doi":"10.1016/j.apmr.2025.01.469","DOIUrl":"10.1016/j.apmr.2025.01.469","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether central sensitization (CS), pain catastrophizing, and psychological factors are associated with inadequate response to ultrasound-guided subacromial corticosteroid injection in patients with chronic shoulder impingement syndrome.</p><p><strong>Design: </strong>This study was designed as a prospective observational study, combining analytical cross-sectional and prospective elements to evaluate associations and treatment responses.</p><p><strong>Setting: </strong>Secondary care outpatient clinic.</p><p><strong>Participants: </strong>A total of 72 patients aged 18-75 years with shoulder impingement syndrome and at least 6 months of shoulder pain, planned to undergo ultrasound-guided subacromial corticosteroid injection, were included in the study.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measure(s): </strong>Treatment response was defined as a ≥50% reduction in pain (visual analog scale [VAS]) at 4 weeks postinjection. The presence of CS was assessed using the Central Sensitization Inventory (CSI) and pressure pain threshold via algometry (ipsilateral deltoid, contralateral deltoid, and contralateral vastus lateralis). Negative thoughts related to pain were evaluated with the pain catastrophizing scale, and mood status was assessed using the Hospital Anxiety and Depression Scale (HADS).</p><p><strong>Results: </strong>Forty-eight patients (responders) experienced ≥50% VAS reduction, whereas 24 (nonresponders) did not. Nonresponders had significantly higher CSI (P=.000), HADS depression (P=.001), and HADS anxiety (P=.000) scores. The pressure pain threshold values were significantly lower in nonresponders at ipsilateral deltoid (P=.030), contralateral deltoid (P=.045), and contralateral vastus lateralis (P=.036). The CSI was significantly correlated with pressure pain threshold at ipsilateral deltoid (r=-0.400, P=.001), contralateral deltoid (r=-0.354, P=.002), and contralateral vastus lateralis (r=-0.442, P=.000); pain catastrophizing scale total score (r=0.449, P=.000); HADS depression score (r=0.572, P=.000); and HADS anxiety score (r=0.618, P=.000). CSI was the most predictive factor for nonresponse area under the curve (AUC=0.755, 95% confidence interval [CI]: 0.635-0.875). Multivariate analysis identified CSI as an independent predictor (P=.022), with a predictive accuracy of 72.2%.</p><p><strong>Conclusions: </strong>Inadequate response to subacromial corticosteroid injection in chronic shoulder impingement syndrome is strongly associated with CS, psychological distress, and altered pain perception. Integrating CS-targeted interventions into treatment strategies may improve outcomes.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122040","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 Efficacy of 5% Dextrose and Corticosteroid Injections in Carpal Tunnel Syndrome: A Systematic Review and Meta-analysis","authors":"Min Woo Oh MD ,&nbsp;Ji-in Park MD ,&nbsp;Ga Yang Shim MD, PhD ,&nbsp;Hyun-Ho Kong MD, PhD","doi":"10.1016/j.apmr.2024.07.005","DOIUrl":"10.1016/j.apmr.2024.07.005","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess the effectiveness of 5% dextrose (D5W) in comparison to corticosteroids for treating carpal tunnel syndrome (CTS).</div></div><div><h3>Data Sources</h3><div>A comprehensive systematic search was conducted across MEDLINE (PubMed), Embase, and the Cochrane Central Register of Controlled Trials on November 13, 2023. These were supplemented by manual searches using Google Scholar.</div></div><div><h3>Study Selection</h3><div>Two independent authors reviewed the literature, resolving any discrepancies through detailed discussions and consultation with a third author.</div></div><div><h3>Data Extraction</h3><div>Data on primary outcomes (pain assessment) and secondary outcomes (symptom severity and functional status using the Boston Carpal Tunnel Questionnaire, electrophysiologic measures, cross-sectional area, and adverse effects) were extracted independently by the 2 authors (M.W. and H.H.).</div></div><div><h3>Data Synthesis</h3><div>The analysis included 4 randomized controlled trials and 1 quasi-experimental study, encompassing a total of 212 patients (220 hands) with mild to moderate CTS.</div></div><div><h3>Results</h3><div>Within 3 months, the D5W injections showed a statistically significant improvement in functional status compared to the corticosteroids with a standard mean difference of −0.34 (95% CI, −0.62 to −0.05). D5W was associated with fewer adverse incidents than corticosteroids (risk ratio, 0.13; 95% CI: 0.03-0.51). No difference was observed between the 2 treatments in other areas.</div></div><div><h3>Conclusions</h3><div>For patients with mild to moderate CTS, D5W injections were more effective than corticosteroid injections in improving functional status and demonstrated fewer adverse effects. D5W injections also paralleled corticosteroids in pain reduction, symptom severity, electrodiagnostic measures, and cross-sectional area of nerve, recommending D5W as a preferred treatment for mild to moderate CTS.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 300-310"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733392","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":"Uphill Treadmill Running and Joint Mobilization Improve Dynamic Stability and Ankle Dorsiflexion Range of Motion in Young Adults With Chronic Ankle Instability: A Four-Arm Randomized Controlled Trial","authors":"Yongjie Lao BSc ,&nbsp;Zimei Zeng PT, BSc ,&nbsp;Zhenni Yu BSc ,&nbsp;Yu Gu BSc ,&nbsp;Yixiao Jia BSc ,&nbsp;Jianxiu Liu PhD ,&nbsp;Bing Ruan PT, MSc","doi":"10.1016/j.apmr.2024.08.025","DOIUrl":"10.1016/j.apmr.2024.08.025","url":null,"abstract":"<div><h3>Objective</h3><div>To observe the effect of uphill running and the combined effect of uphill running plus joint mobilizations on dynamic stability and ankle dorsiflexion in young adults with chronic ankle instability (CAI).</div></div><div><h3>Design</h3><div>Four-arm randomized controlled trial.</div></div><div><h3>Setting</h3><div>A college rehabilitation center.</div></div><div><h3>Participants</h3><div>Individuals with CAI (N=73).</div></div><div><h3>Interventions</h3><div>Participants were randomly assigned to 4 groups: combined uphill running and joint mobilization (URJM), uphill running alone (UR), joint mobilization alone (JM), and control group. The URJM and UR groups received 20-minute running sessions, and the URJM and JM groups received ankle joint mobilizations, all 3 times a week for 4 weeks.</div></div><div><h3>Main Outcome Measures</h3><div>Cumberland Ankle Instability Tool (CAIT) and Y-balance test (YBT) in anterior, posteromedial (PM), and posterolateral (PL) directions for dynamic stability; weight-bearing lunge test and non-weight-bearing ankle dorsiflexion degree using a goniometer (NWBG) for dorsiflexion.</div></div><div><h3>Results</h3><div>The UR group showed significant improvements in CAIT, YBT-PL, YBT-PM, and NWBG compared to the control group. The URJM group demonstrated large treatment effects in NWBG compared to both UR and JM groups. Responder analysis indicated that the UR, JM, and URJM groups had a higher likelihood of achieving clinically significant changes (exceeding minimal detectable change or minimal clinically important difference) in CAIT, YBT-PM, YBT-PL, and NWBG compared with the control group. Additionally, the combination of UR and JM was superior to either intervention alone for NWBG, with success rates 1.55 times greater than UR alone and 2.08 times greater than JM alone.</div></div><div><h3>Conclusions</h3><div>A 4-week UR program improves the subjective feeling of instability, dynamic postural control, and ankle dorsiflexion in young adults with CAI. Compared to UR or JM alone, their combined application can better improve the non-weight-bearing ankle dorsiflexion range of motion.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 177-186"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279802","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":"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 PhD ,&nbsp;Samantha J. McIntosh BHSc ,&nbsp;Chloe Boucher BSc ,&nbsp;Julie M. Joyce MSc ,&nbsp;Julia Batycky BHSc ,&nbsp;Jean-Michel Galarneau PhD ,&nbsp;Michael J. Esser MD, PhD ,&nbsp;Kathryn J. Schneider PT, PhD ,&nbsp;Sean P. Dukelow MD, PhD ,&nbsp;Ashley D. Harris PhD ,&nbsp;Chantel T. Debert MD, MSc","doi":"10.1016/j.apmr.2024.10.002","DOIUrl":"10.1016/j.apmr.2024.10.002","url":null,"abstract":"<div><h3>Objective</h3><div>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).</div></div><div><h3>Design</h3><div>The Aerobic exercise for treatment of Chronic symptoms following mild Traumatic Brain Injury (ACTBI) Trial was a randomized controlled trial with 2 groups.</div></div><div><h3>Setting</h3><div>Outpatient brain injury, pain, and physiotherapy clinics.</div></div><div><h3>Participants</h3><div>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.</div></div><div><h3>Interventions</h3><div>Participants were randomized to a 6-week AEP (n=27) or 6-week SP (n=25).</div></div><div><h3>Main Outcome and Measures</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>P</em>=.047) from baseline to 6 weeks. In the intention-to-treat analysis, between-group changes in primary and secondary outcomes were not significant.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 2","pages":"Pages 195-205"},"PeriodicalIF":3.6,"publicationDate":"2025-02-01","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}