Archives of physical medicine and rehabilitation最新文献

{"title":"Virtual Reality in Training of Sustained Attention, Processing Speed, and Working Memory After Traumatic Brain Injury: A Randomized Controlled Trial.","authors":"Truls Johansen, Martin Matre, Marianne Løvstad, Alexander Olsen, Anne Lund, Anne-Catrine Trægde Martinsen, Frank Becker, Cathrine Brunborg, Albert Rizzo, Jacoba M Spikman, Dawn Neumann, Jennie Ponsford, Sveinung Tornås","doi":"10.1016/j.apmr.2025.07.005","DOIUrl":"10.1016/j.apmr.2025.07.005","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to evaluate the effect of playing a commercially available virtual reality (VR)-game on sustained attention as primary outcome, and processing speed and working memory as secondary outcomes, after traumatic brain injury (TBI).</p><p><strong>Design, setting, and participants: </strong>The study was a parallel-group randomized controlled trial with 1:1 allocation to VR training or an active control condition. One hundred participants aged 18-65 years with complicated mild-to-severe TBI and consequently impaired sustained attention, processing speed, and/or working memory were enrolled. Participants were assessed at baseline, after intervention, and 16 weeks postbaseline.</p><p><strong>Intervention: </strong>The intervention arm played Beat Saber, a VR game requiring sustained attention and processing speed, 30 minutes per day, 5 days per week for 5 weeks. The control arm received information about everyday activities that might impact cognition.</p><p><strong>Outcome measures: </strong>Primary outcome was sustained attention measured by Connors Continuous Performance Test-third edition (CPT-3). Secondary outcomes included processing speed (CPT-3 hit reaction time), working memory (digit span backward and sequencing from Wechsler Adult Intelligence Scale-fourth edition), and self-report measures: Behavior Rating Inventory of Executive Function-Adult Version, Patient Competency Rating Scale, Fatigue Severity Scale, and Quality of Life after BRain Injury.</p><p><strong>Results: </strong>No statistically significant between-group effect was found for the primary outcome measure, sustained attention (P=.473). However, the VR group demonstrated a significant increase in processing speed (P=.035), which was accompanied by a reduction in the number of errors (P<.001). No differences were observed for working memory. Self-reported executive functioning (P=.017) and quality of life (P=.039) were significantly improved in the VR group.</p><p><strong>Conclusion: </strong>VR training did not improve sustained attention. However, a combination of prolonged reaction times and a decrease in errors in the VR group may indicate improved attentional control. In addition, the findings suggest that VR training might positively affect executive functioning. VR training may be used for cognitive training after TBI.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717274","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":"Impacts of ACC/AHA Stage A, B, and C Heart Failure on Improvement Efficiency in Activities of Daily Living in Individuals With Disabilities Who Underwent Inpatient Rehabilitation.","authors":"Hideki Arai, Masafumi Nozoe, Kuniyasu Kamiya, Tatsuyuki Fukuoka, Satoru Matsumoto","doi":"10.1016/j.apmr.2025.07.010","DOIUrl":"10.1016/j.apmr.2025.07.010","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impacts of American College of Cardiology (ACC)/American Heart Association (AHA) stage A, B, and C heart failure (HF) on improvement efficiency in activities of daily living in patients with disabilities who underwent inpatient rehabilitation.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Setting: </strong>An inpatient rehabilitation ward.</p><p><strong>Participants: </strong>The ACC/AHA stage 0, A, B, and C HF patients (N=368) with disabilities because of neurologic disorders, musculoskeletal disorders, or hospital-associated deconditioning were included.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The outcomes included improvement efficiency of functional independence measure (FIM) (gain in FIM score divided by duration of stay) for motor function and FIM for cognitive function.</p><p><strong>Results: </strong>The beta coefficients of the ACC/AHA stage A HF group, stage B HF group, and stage C HF group relative to the stage 0 HF group for the improvement efficiency of FIM for motor function were -0.36 (lower confidence limit: -0.77; upper confidence limit: 0.08), -0.78 (lower confidence limit: -1.35; upper confidence limit: -0.22), and -0.58 (lower confidence limit: -1.17; upper confidence limit: -0.02), respectively. Improvement efficiency values of FIM for cognitive function were -0.82 (lower confidence limit: -1.96; upper confidence limit: 0.45), -1.35 (lower confidence limit: -3.09; upper confidence limit: 0.22), and -1.12 (lower confidence limit: -2.86; upper confidence limit: 0.43), respectively.</p><p><strong>Conclusions: </strong>This study showed that ACC/AHA stage B and C HF had negative impacts on the improvement efficiency of physical function in patients with disabilities who underwent inpatient rehabilitation.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717354","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":"Mental and Physical Well-Being of Informal Stroke Caregivers Compared With Noncaregiver Family and Friends.","authors":"Lynda D Lisabeth, Linda C Gallo, Janet Prvu Bettger, Madeline Kwicklis, Elizabeth M Almendarez, Erin Case, Melinda A Smith, Lewis B Morgenstern","doi":"10.1016/j.apmr.2025.06.020","DOIUrl":"10.1016/j.apmr.2025.06.020","url":null,"abstract":"<p><strong>Objective: </strong>To compare physical/mental health in caregivers and noncaregiver family/friends of stroke survivors within a population-based study.</p><p><strong>Design: </strong>Study is a cohort study design with data from medical records and interviews.</p><p><strong>Setting: </strong>Population-based stroke study in south Texas.</p><p><strong>Participants: </strong>Stroke survivors and their informal caregivers and noncaregiver family and friends.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Physical/mental health measures included Patient Health Questionnaire-8 (PHQ-8; range, 0-24; higher→worse); Patient-Reported Outcomes Measurement Information System-10 physical (range, 16.2-67.7) and mental health (range, 21.2-67.6) summary scores (higher→better) at 90 days poststroke.</p><p><strong>Results: </strong>Compared with noncaregivers (n=360), caregivers (n=320) had lower socioeconomic status, were more likely women, Mexican American, offspring rather than spouse of care recipient, and to reside with a stroke survivor. Median PHQ-8 scores were worse in caregivers (median=4; IQR, 1-8, mild) than noncaregivers (median=2; IQR, 0-5; no depression). Physical (median=47.7; IQR, 39.8-54.1; median=50.8; IQR, 44.9-57.7) and mental health (median=45.8; IQR, 41.1-50.8; median=50.8; IQR, 45.8-56.0) scores were good to very good in caregivers and noncaregivers, respectively. Caregivers had greater depression symptoms (β=1.5; 95% confidence interval [CI], 0.5-2.5) and worse physical (β=-2.2; 95% CI, -4.0 to -0.4) and mental health (β=-3.2; 95% CI, -5.1 to -1.4) than noncaregivers.</p><p><strong>Conclusions: </strong>Physical/mental health in caregivers has rarely been compared with those not in the caregiving role. In this study, which controlled for the effect of having a family member or friend with stroke, caregivers had worse physical/mental health than noncaregivers, suggesting that caregiver interventions may improve well-being.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144673854","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 and Characteristics of Prehabilitation Utilization Among Older Medicare Beneficiaries Undergoing Elective Inpatient Lower Extremity Joint Replacement.","authors":"Jenni S Reiff, Jennifer L Wolff, John McGready, Jennifer Schrack, Tracy Mroz, Lisa Reider","doi":"10.1016/j.apmr.2025.07.002","DOIUrl":"10.1016/j.apmr.2025.07.002","url":null,"abstract":"<p><strong>Objectives: </strong>To characterize trends and characteristics in individual receipt and facility delivery of preoperative rehabilitation (\"prehabilitation\") for lower extremity joint replacement (LEJR), and to characterize prehabilitation services delivered in terms of timing, frequency, duration, examining differences by preoperative frailty status and operative joint.</p><p><strong>Design: </strong>Retrospective cohort study using administrative claims data.</p><p><strong>Setting: </strong>Inpatient facilities conducting elective LEJR surgery for Medicare beneficiaries in the United States.</p><p><strong>Participants: </strong>Medicare fee-for-service beneficiaries ages ≥65 years undergoing an incident elective inpatient hip or knee replacement between January 1, 2016, and December 31, 2019, identified in claims from a 20% random sample of Medicare beneficiaries.</p><p><strong>Interventions: </strong>Physical or occupational therapy initiated within 30 days preceding LEJR surgery.</p><p><strong>Main outcome measures: </strong>(1) Prevalence and characteristics of individual receipt of prehabilitation; (2) prevalence and characteristics of inpatient facility delivery of prehabilitation; and (3) prehabilitation attributes (timing, volume, setting).</p><p><strong>Results: </strong>In this sample of 196,690 older adult Medicare beneficiaries undergoing inpatient LEJR (mean age, 73y; 45.4% nonfrail; 37.5% hip), prehabilitation prevalence increased from 8.03% in 2016 to 11.14% in 2019. Stratifying by operative joint and frailty status, greatest increase was noted among nonfrail knee replacement patients (+3.64%). Most prehabilitation patients (77%) received a single visit, primarily in the outpatient physical therapy setting. Odds of receiving prehabilitation varied by patient race, sex, and financial and health characteristics. More than half (55.7%) of inpatient facilities delivered prehabilitation to at least one LEJR patient during the study period; odds of delivering prehabilitation varied by facility location, size, and financial characteristics.</p><p><strong>Conclusions: </strong>Findings demonstrate growth in LEJR prehabilitation utilization over time, supporting further investigation of why and how providers are implementing prehabilitation, what factors may affect patient access, and what strategies may maximize the utility of this spreading service delivery innovation.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12424444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144666953","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":"Understanding Brain Injury in Intimate Partner Violence: A Guide for Frontline Professionals Working with IPV in Shelters.","authors":"Flora Nikolaou, Brooke Holt, Iro Michael, Fofi Constantinidou, Eve Valera, Denise Gobert, Angela Colantonio","doi":"10.1016/j.apmr.2025.06.007","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.06.007","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144641619","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":"Developing Cognitive Control Training for Aphasia: Insights From Treatment Theory and Enablement Theory.","authors":"Anna Krason, Erica L Middleton, John Whyte, Malathi Thothathiri","doi":"10.1016/j.apmr.2025.07.001","DOIUrl":"10.1016/j.apmr.2025.07.001","url":null,"abstract":"<p><p>It remains challenging to optimize treatment for individuals with aphasia. One of the reasons is that the language processing deficits associated with aphasia have various underlying linguistic and nonlinguistic causes. The utility of cognitive training focusing on attention and working memory has been investigated in aphasia treatment. However, a related cognitive function, namely, cognitive control, remains underexplored. This article leverages treatment and enablement theories to evaluate current cognitive treatments and guide the development of new treatments focused on cognitive control in aphasia. We provide the theoretical and empirical rationale for exploring the clinical significance of cognitive control in aphasia rehabilitation and discuss how treatment and enablement theories may be used to develop a systematic cognitive training approach. We conclude with future directions for cognitive control research that can advance more personalized aphasia rehabilitation.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12373312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144635982","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":"Investigating the Effectiveness of Pelvic Floor Muscle Training, Including Sensor-Based Diaphragm Exercises in Women With Stress Urinary Incontinence: A Randomized Controlled Study.","authors":"Seda Yakıt Yeşilyurt, Gonca Şahiner Pıçak, Merve Başol Göksülük, Meriç Balıkoğlu, Nuriye Özengin","doi":"10.1016/j.apmr.2025.06.019","DOIUrl":"10.1016/j.apmr.2025.06.019","url":null,"abstract":"<p><strong>Objective: </strong>To compare the effects of pelvic floor muscle exercises (PFME) combined with standard diaphragm exercises and 360° expanded diaphragm exercises on urinary symptoms, pelvic floor muscle (PFM) function, and respiratory function in women with stress urinary incontinence (SUI).</p><p><strong>Design: </strong>Randomized controlled study.</p><p><strong>Setting: </strong>The study conducted between November 2023 and 2024.</p><p><strong>Participants: </strong>Women with SUI (n=74).</p><p><strong>Interventions: </strong>Participants were randomly allocated into 2 groups: (1) PFME + standard diaphragm (n=37) and (2) PFME + 360° expanded diaphragm exercises (n=37). The 360° exercises were taught using 2 sensor-based biofeedback devices. Both groups completed an 8-week program with weekly sessions.</p><p><strong>Main outcome measures: </strong>The primary outcome was precontraction of the PFM. Secondary outcomes included the Incontinence Severity Index, The International Consultation on Incontinence Questionnaire-Short Form, PFM, and respiratory functions [maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP)].</p><p><strong>Results: </strong>The sociodemographic and clinical characteristics of the PFME + standard diaphragm (49.29±6.73y) and the PFME + 360° expanded diaphragm exercises groups (50.97±7.70y) were similar (P>.05). Before and after the 8-week exercise program, both groups showed significant improvement in PFM functions as well as in incontinence severity index, incontinence questionnaire-short form, and MIP and MEP values (P<.05). Additionally, the initiation time for PFM contraction during the Valsalva maneuver (precontraction of PFM) was reduced in the PFME + 360° expanded diaphragm exercises group after treatment (P=.010).</p><p><strong>Conclusions: </strong>This study demonstrated that PFME combined with various diaphragm exercises improved urinary symptoms and PFM function in women with SUI. Specifically, PFME with 360° expansion diaphragm exercises reduced the initiation time of PFM contraction during Valsalva. This approach may enhance PFME effectiveness in women with impaired precontraction ability. As this study focused only on women, future research should explore the efficacy of similar interventions in sex-diverse populations.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Preliminary Examination of a Fidelity Assessment for the Spinal Cord Injury Movement Index.","authors":"Nicole M Gerhardt, Rachel Y Kim, Maclain Capron, M J Mulcahey","doi":"10.1016/j.apmr.2025.06.010","DOIUrl":"10.1016/j.apmr.2025.06.010","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to describe the development and refinement of a fidelity assessment for a novel performance-based item pool, the Spinal Cord Injury Movement Index (SCI-MovIn), and report on its interrater agreement.</p><p><strong>Design: </strong>Guidance for the development of intervention fidelity assessments was adapted to create a framework for the development of an assessment fidelity checklist. An initial draft of the SCI-MovIn fidelity checklist was drafted. The set-up and administration fidelity criteria were exposed to iterative modified Delphi surveys with individuals knowledgeable about the SCI-MovIn. Interrater agreement was then assessed through field-testing of the fidelity assessment by fidelity raters who viewed the same video-recorded SCI-MovIn testing sessions.</p><p><strong>Setting: </strong>Academic institution in an urban area.</p><p><strong>Participants: </strong>Three individuals participated in the modified Delphi survey (purposeful sample). Three individuals served as fidelity raters for interrater agreement testing.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The modified Delphi technique was completed iteratively until 100% agreement among respondents was reached that every criterion on the fidelity assessment was relevant, clear, specific, and in alignment with the response scale. Descriptive statistics were used to examine exact percent interrater agreement for the ratings on the SCI-MovIn fidelity assessment across 3 raters.</p><p><strong>Results: </strong>Four survey rounds were iteratively completed until 100% agreement among respondents was reached that fidelity criteria were relevant, clear, specific, and aligned with the fidelity response scale. Across 21 sessions (394 items), raters' total absolute exact percent agreement on scores of fidelity was 79.33%. Nine of 13 criteria had >75% agreement.</p><p><strong>Conclusions: </strong>The SCI-MovIn fidelity assessment was developed using a framework modified from guidance for intervention fidelity assessments. It was refined over 4 rounds of a modified Delphi process and then exposed to field-testing for rater agreement.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Evaluation of an Item Pool of \"Movement-Related Body Functions in the Context of Task Performance\".","authors":"M J Mulcahey, Nicole M Gerhardt, Rachel Y Kim, Namrata Grampurohit, Maclain Capron","doi":"10.1016/j.apmr.2025.06.009","DOIUrl":"10.1016/j.apmr.2025.06.009","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to describe the development and evaluation of an item pool for a new performance-based clinical outcome assessment (COA), the Spinal Cord Injury Movement Index (SCI-MovIn).</p><p><strong>Design: </strong>Iterative focus groups, one-on-one consultations and field-testing sessions were used to develop the conceptual model for the SCI-MovIn measurement construct, establish an item pool consisting of candidate items with 5 response categories, and create standardized guidelines for set-up, administration, and scoring. Trained therapists administered 61 items to individuals with spinal cord injury (SCI) for inter- and intrarater reliability testing.</p><p><strong>Setting: </strong>Academic institution in an urban area.</p><p><strong>Participants: </strong>Professionals with measurement/SCI expertise participated in focus groups. Individuals with SCI engaged in field-testing and reliability testing sessions.</p><p><strong>Main outcome measure(s): </strong>Total percent exact agreement between paired raters was calculated. Cronbach's alpha (α) and intraclass correlation coefficient (ICC) with 95% confidence interval (CI) were used to examine internal consistency. Intra- and interrater reliability were measured using ICCs.</p><p><strong>Results: </strong>Through iterative focus groups with 18 SCI/measurement professionals and 24 field-testing sessions with 10 individuals with SCI, 226 items were developed, 132 of which were eliminated. The reliability testing sample consisted of 33 adults who sustained SCI an average of 13.2 years before participation. Of the 1215 paired scores from administration of 61 SCI-MovIn items, raters' scores were identical for 833 (68.6%). Internal consistency was high (α=0.948). Reliability of repeated SCI-MovIn scores was high for both intrarater (ICC=0.992; CI=0.983-0.996) and interrater (ICC=0.887; CI=0.873-0.899) reliability.</p><p><strong>Conclusion: </strong>The next step is a large-scale study to transform the item pool into a calibrated item bank from which tailored short forms can be developed.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144625303","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":"Minimal Clinically Important Difference for Postural Assessment Scale for Stroke Patients (PASS) and Trunk Impairment Scale (TIS) in Persons With Stroke.","authors":"Tugba Aka, Turhan Kahraman, Elif Umay Altas","doi":"10.1016/j.apmr.2025.06.017","DOIUrl":"10.1016/j.apmr.2025.06.017","url":null,"abstract":"<p><strong>Objective: </strong>To determine the minimum clinically important difference (MCID) values for the Postural Assessment Scale for Stroke Patients (PASS) and Trunk Impairment Scale (TIS) in persons with stroke.</p><p><strong>Design: </strong>A pre-post interventional study using anchor-based methods.</p><p><strong>Setting: </strong>Inpatient rehabilitation unit.</p><p><strong>Participants: </strong>Sixty-five (N=65) persons with stroke.</p><p><strong>Interventions: </strong>Twenty-session conventional physiotherapy program.</p><p><strong>Main outcome measures: </strong>The PASS, TIS, and Functional Independence Measure before and after the physiotherapy program. As the anchor measure, both patients and physiotherapists provided a Global Rating of Change scale score to reflect their perceived changes in postural and trunk control after the intervention.</p><p><strong>Results: </strong>For the PASS, the MCID was 3.5, based on the patient as the anchor, with an area under the curve (AUC) of 0.89 (95% confidence interval [CI], 0.82-0.97). For the physiotherapist ratings, the MCID was 4.5, with an AUC of 0.94 (95% CI, 0.88-0.99). The MCID value was 8.5 for TIS, based on both the patient and physiotherapist as anchors, with AUCs of 0.97 (95% CI, 0.93-1.0) and 0.98 (95% CI, 0.95-1.0), respectively. There were strong correlations (ρ>0.70, P<.001) between the PASS, TIS, and global rating of change for both patients and physiotherapists, along with functional independence measure.</p><p><strong>Conclusions: </strong>The suggested MCID values for the PASS and TIS are 4.5 and 8.5, respectively, serving as benchmarks to evaluate the effectiveness of physiotherapy treatment in persons with stroke. These MCID values offer meaningful thresholds for identifying clinically important improvements in postural stability and trunk impairment, guiding therapeutic interventions and enhancing treatment evaluation in stroke rehabilitation.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144599227","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}