Archives of physical medicine and rehabilitation最新文献

{"title":"What Shapes Satisfaction With Daily Life Participation? Insights Into Functional Outcomes After Pediatric Bone Sarcoma Treatment","authors":"Leonie G. Tigelaar MD,&nbsp;Willem P. Bekkering PhD,&nbsp;Lianne M. Haveman PhD,&nbsp;Irene L.B. Oude Lansink MD,&nbsp;Christel D. Rohrich MD,&nbsp;Harm Van Tinteren PhD,&nbsp;Hinke Van der Hoek MSc,&nbsp;Martha A. Grootenhuis PhD,&nbsp;Lizz Van der Heijden PhD,&nbsp;Jos AM Bramer PhD,&nbsp;Michiel A.J. Van de Sande PhD,&nbsp;Hendrik W.B. Schreuder PhD,&nbsp;Johannes H.M. Merks PhD","doi":"10.1016/j.apmr.2026.03.023","DOIUrl":"10.1016/j.apmr.2026.03.023","url":null,"abstract":"<div><h3>Objective</h3><div>To structurally evaluate functional outcomes in a nationwide cohort of pediatric patients with bone sarcoma after local therapy, including stratification of outcomes by tumor location and surgical approach for tumors around the knee, and to explore factors related to satisfaction with participation.</div></div><div><h3>Design</h3><div>Survey.</div></div><div><h3>Setting</h3><div>Multidisciplinary follow-up clinic at a tertiary referral center.</div></div><div><h3>Participants</h3><div>A total of 122 pediatric patients with bone sarcoma, ≥2 years postdiagnosis, had completed treatment for pelvic or lower-extremity tumors and attended the multidisciplinary follow-up clinic. Mean age at assessment was 20.0 years (SD, 5.4), 44% were female, and median time since local therapy was 5.8 years (Q1-Q3, 3.0-10.3).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>PedsQL Multidimensional Fatigue Scale (PedsQL Fatigue), numeric rating scale (pain), 10-meter walk test (10-MWT), 6-minute walk test (6-MWT), lateral step-up test, timed up and down stairs, Toronto Extremity Salvage Score, Patient-Reported Outcomes Measurement Information System (PROMIS)-Physical Functioning (PF), Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-P) Frequency, Restrictions and Satisfaction scales, and PROMIS-Pain Interference (PI). Assessments were structured according to the International Classification of Functioning, Disability, and Health (ICF).</div></div><div><h3>Results</h3><div>Patients demonstrated worse outcomes compared with reference values for the PedsQL Fatigue, 10-MWT, 6-MWT, and PROMIS-PF (all <em>P</em>≤.007). PI scores were comparable with reference scores (<em>P</em>=.912), despite 57% of patients reporting pain. No surgical approach emerged consistently superior across measures. Satisfaction with participation (USER-P Satisfaction) was significantly associated with restrictions and fatigue (<em>P</em>&lt;.001).</div></div><div><h3>Conclusion</h3><div>Functional outcomes in pediatric patients with bone sarcoma vary across ICF domains, each providing distinct insights. Satisfaction with participation in daily life was associated with restrictions and fatigue. However, no clear association was observed with surgical approach for bone sarcoma around the knee, suggesting that other factors, such as personal and psychosocial characteristics, may play a crucial role. These findings underscore the need for patient-centered care and targeted support, and inform both local therapy counseling and follow-up care.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2682-2692"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653446","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":"Artificial Intelligence–Driven Elucidation of Mechanistic Links Between Proximal Joint Strength and Tibial Loading in Runners With Medial Tibial Stress Syndrome: Implications for Precision Rehabilitation","authors":"Zeyi Zhang PhD,&nbsp;Ting Fan PhD,&nbsp;Youping Sun MSc","doi":"10.1016/j.apmr.2026.05.023","DOIUrl":"10.1016/j.apmr.2026.05.023","url":null,"abstract":"<div><h3>Objectives</h3><div>This study leveraged machine learning algorithms to observationally elucidate how proximal joint muscle activation patterns—particularly those involving the trunk and hip—are associated with the modulation of tibial loading during running. These findings may provide preliminary theoretical insights into reducing tibial loading during running in individuals with medial tibial stress syndrome (MTSS) and in preventing recurrence.</div></div><div><h3>Design</h3><div>Cross-sectional design.</div></div><div><h3>Setting</h3><div>Biomechanics laboratory with musculoskeletal modeling and machine learning.</div></div><div><h3>Participants</h3><div>A total of 174 recreational runners diagnosed with MTSS underwent biomechanical assessment during running, during which tibial loading was quantified. OpenSim modeling was subsequently performed to estimate muscle-force production of proximal joints throughout the gait cycle.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Three machine learning models—extreme gradient boosting, random forest, and support vector regression—were developed and integrated with the SHapley Additive exPlanations framework to characterize the relationships between proximal muscle force and tibial loading.</div></div><div><h3>Results</h3><div>Among the 3 models, extreme gradient boosting demonstrated the highest predictive accuracy. The SHapley Additive exPlanations dependence plots further identified several model-derived inflection features, indicating that tibial loading increased markedly when ipsilateral external oblique muscle force exceeded 10.417 N/kg, gluteus minimus force decreased below 0.776 N/kg, or piriformis muscle force exceeded 1.952 N/kg. These values should be interpreted as exploratory, model-dependent reference points rather than definitive clinical thresholds.</div></div><div><h3>Conclusion</h3><div>Excessive force generated by the ipsilateral external oblique and piriformis, coupled with insufficient gluteus minimus force, markedly elevates tibial loading during running in individuals with MTSS. Based on these observational findings, we speculate that restoring bilateral balance in external oblique force and strengthening the hip abductors and internal rotators may help reduce tibial loading and thereby mitigate the risk of MTSS. However, this hypothesis requires confirmation in future intervention studies.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2860-2868"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148175121","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":"The Comparative Effectiveness of Inpatient Versus Skilled Nursing Facility Rehabilitation Using Linked Acute Stroke Registry Data","authors":"Raed S. Hailat MD, PhD,&nbsp;Michael P. Thompson PhD,&nbsp;John Adam Oostema MD, MS,&nbsp;Gustavo de los Campos PhD,&nbsp;Mathew J. Reeves BVSc, PhD","doi":"10.1016/j.apmr.2026.05.024","DOIUrl":"10.1016/j.apmr.2026.05.024","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the comparative effectiveness of rehabilitation at inpatient rehabilitation facilities (IRFs) versus skilled nursing facilities (SNFs) on home time—a proxy of functional recovery among patients with acute stroke.</div></div><div><h3>Design</h3><div>A retrospective comparative effectiveness cohort of hospitalized acute stroke (International Classification of Disease-10 I61-I63) cases identified by the Michigan Stroke Registry and probabilistically linked to Medicare fee-for-service (FFS) data. We quantified the comparative effectiveness of IRF versus SNF using inverse probability treatment weighted multivariable linear models.</div></div><div><h3>Setting</h3><div>IRF and SNF admissions from 31 registry hospitals between 2016 and 2020.</div></div><div><h3>Participants</h3><div>FFS Medicare patients with acute stroke.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Ninety-day and 1-year home time (number of days alive and outside of inpatient care) calculated at 2 different starting points: from the time of discharge from acute hospital care (traditional home time) or the time of discharge from IRF or SNF care (referred to as amended home time).</div></div><div><h3>Results</h3><div>We identified 5943 hospitalized Medicare FFS beneficiaries discharged to IRF (n=2995) or SNF (n=2948). After inverse probability treatment weighted adjustment, the mean traditional home time for patients in IRF was 11.1 days (95% confidence interval [CI], 9.5-12.57) longer at 90 days, and 46.3 days (95% CI, 39.8-52.9) longer at 1 year, compared with patients in SNF. However, when amended home time was used, the mean difference in 90-day home time disappeared (0.5d; 95% CI, −1.1 to 2.1) but remained significant at 1 year (35.7d; 95% CI, 29.1-42.2).</div></div><div><h3>Conclusions</h3><div>IRF care was associated with longer traditional home time both at 90 days and 1 year. However, amended home time showed that the difference at 90 days was explained by the longer length of stay at SNF facilities. Future studies should avoid using traditional home time as a means of comparing patient outcomes between IRF and SNF settings.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2869-2878"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148197305","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":"Measurement Characteristics and Clinical Utility of the Contextual Memory Test Among Children & Adults with Memory Impairment","authors":"","doi":"10.1016/j.apmr.2025.12.019","DOIUrl":"10.1016/j.apmr.2025.12.019","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 3055-3056"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149095329","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":"Increasing Access to Quality Health Care for the Deaf Community: A Guide for Clinicians","authors":"John V. Rider PhD, OTR/L, BCG, BCPR, ATP,&nbsp;Jared M. Allebest JD, Esq","doi":"10.1016/j.apmr.2026.03.002","DOIUrl":"10.1016/j.apmr.2026.03.002","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 3037-3040"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147969740","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":"Supervised Physiotherapy vs Home Exercise After Rotator Cuff Repair: A Meta-Analysis","authors":"Marc Boutros,&nbsp;Guy Awad,&nbsp;Jean-Pierre Saad,&nbsp;Zina Smadi MD,&nbsp;Raphael Bou Rached MD,&nbsp;Bassem Elhassan MD","doi":"10.1016/j.apmr.2026.05.001","DOIUrl":"10.1016/j.apmr.2026.05.001","url":null,"abstract":"<div><h3>Objective</h3><div>To compare supervised physiotherapy with structured home exercise programs after rotator cuff repair as rehabilitation delivery strategies, evaluating their relative effectiveness on postoperative pain, functional outcomes, and shoulder range of motion.</div></div><div><h3>Data Sources</h3><div>A systematic search of PubMed, Scopus, Cochrane Library, and Google Scholar was conducted through November 2025 to identify clinical studies comparing supervised physiotherapy with home-based rehabilitation after rotator cuff repair.</div></div><div><h3>Study Selection</h3><div>Six studies met the inclusion criteria. Eligible studies compared supervised physiotherapy with home exercise programs and reported postoperative outcomes, including pain scores, functional measures, and shoulder range of motion (ROM).</div></div><div><h3>Data Extraction</h3><div>Extracted outcomes included visual analog scale (VAS) pain, functional scores such as subjective shoulder value, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, and ROM parameters (external rotation and forward flexion). Mean differences (MD) with 95% CIs were pooled where appropriate.</div></div><div><h3>Data Synthesis</h3><div>Postoperative pain showed no significant difference between supervised physiotherapy and home exercise programs (<em>P</em>=.41). No statistically significant differences were identified in functional outcomes, including subjective shoulder value (<em>P</em>=.73), ASES (<em>P</em>=.07), or Constant-Murley score (<em>P</em>=.27). External rotation ROM was comparable between groups (<em>P</em>=.50), whereas forward flexion demonstrated a statistically significant advantage in favor of supervised physiotherapy (MD=5.87°, 95% CI, 2.92-8.81; <em>P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>Supervised physiotherapy did not demonstrate superior pain reduction compared with structured home exercise programs after rotator cuff repair. Functional outcomes were comparable between delivery models, while supervised physiotherapy showed a modest advantage in forward flexion ROM. Structured home rehabilitation represents a safe and effective alternative for many patients, although supervised therapy may be appropriate for individuals requiring closer monitoring or at increased risk of postoperative stiffness. Further standardized, long-term studies are needed to refine patient selection and optimize rehabilitation strategies.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 3002-3012"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147980057","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":"Correlates of Loneliness in Persons With Spinal Cord Injury","authors":"Alexander Barry MS,&nbsp;Linda Lovell BS,&nbsp;Elliot Roth MD","doi":"10.1016/j.apmr.2026.06.021","DOIUrl":"10.1016/j.apmr.2026.06.021","url":null,"abstract":"<div><h3>Objective</h3><div>To determine self-reported psychosocial factors that may be associated with loneliness in persons with spinal cord injury (SCI).</div></div><div><h3>Design and Setting</h3><div>Convergent parallel virtual structured interviews and quantitative questionnaires.</div></div><div><h3>Participants</h3><div>People with traumatic spinal cord injury &gt;1 year prior (questionnaire data from n=20).</div></div><div><h3>Main Outcome Measures</h3><div>Three-Item Loneliness Scale, Craig Hospital Inventory of Environmental Factors (CHIEF), Patient Health Questionnaire (PHQ-9), Short Form-12 (SF-12).</div></div><div><h3>Results</h3><div>Higher levels of loneliness correlated with increased environmental barriers (CHIEF <em>r</em>=0.7, <em>P</em>=.001) and more depressive symptoms (PHQ-9 <em>r</em>=0.67, <em>P</em>=.001), whereas environmental barriers also contributed to worse mental health outcomes (SF-12, Mental Component Score [MCS] <em>r</em>=−0.7, <em>P</em>=.004).</div></div><div><h3>Conclusions</h3><div>Loneliness in people with traumatic spinal cord injury is likely related to both internal and external factors.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 3013-3015"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148374301","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":"Convergent and Predictive Validity of the 1-Minute Sit-to-Stand Test in Patients With Acute Decompensated Heart Failure","authors":"Xiu Zhang MSc,&nbsp;Zeruxin Luo MSc,&nbsp;Ting Liu MD,&nbsp;Yu Kang MD,&nbsp;Mengxuan Yang MSc,&nbsp;Yuqiang Wang PhD,&nbsp;Martijn A. Spruit PhD,&nbsp;Pengming Yu PhD,&nbsp;Qing Zhang MD","doi":"10.1016/j.apmr.2026.05.009","DOIUrl":"10.1016/j.apmr.2026.05.009","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the convergent validity and prognostic validity of the 1-minute sit-to-stand test (1-min STST) as a practical functional assessment tool in patients hospitalized with acute decompensated heart failure (ADHF) during the early postdischarge period.</div></div><div><h3>Design</h3><div>Prospective cohort study</div></div><div><h3>Setting</h3><div>West China Hospital of Sichuan University.</div></div><div><h3>Participants</h3><div>A total of 153 patients hospitalized with ADHF.</div></div><div><h3>Interventions</h3><div>At hospital discharge, participants underwent assessment with the 1-min STST, Short Physical Performance Battery (SPPB), and 6-minute walk test (6MWT). All patients were followed for 180 days after discharge.</div></div><div><h3>Main Outcome Measures</h3><div>The primary outcome was a 180-day composite endpoint of all-cause mortality or HF-related readmission. Pearson correlation was used to examine associations between 1-min STST repetitions, SPPB score, and 6-minute walk distance. Receiver operating characteristic analysis assessed their ability to predict 180-day composite events (rehospitalization or death), with optimal cutoffs from the Youden Index and area under the curve values (AUCs) compared by DeLong’s test. Receiver operating characteristic thresholds were used in Kaplan-Meier analyses (log-rank test), and Cox models estimated adjusted hazard ratios. Statistical significance was set at <em>P</em>≤.05.</div></div><div><h3>Results</h3><div>A total of 153 patients completed the 1-min STST, SPPB, and 6MWT, with mean values of 19.9 repetitions, 10.3 points, and 356.4 m, respectively. The 1-min STST demonstrated strong convergent validity with 6-minute walk distance (<em>r</em>=.727; <em>P</em>&lt;.001). The 1-min STST showed good predictive performance for the 180-day composite endpoint (AUC=0.786), comparable to 6MWT (AUC=0.708). Patients achieving ≥16 repetitions had significantly higher cumulative survival and better functional capacity.</div></div><div><h3>Conclusions</h3><div>The 1-min STST is a field exercise test that strongly correlates with the 6MWT and provides prognostic insight in patients with ADHF. A threshold of ≥16 repetitions identifies patients with better survival/less hospitalizations, supporting its utility in clinical risk stratification.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"107 10","pages":"Pages 2766-2772"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148013239","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":"Repeated subgroup partitions preclude factor-specific inference for vagus nerve stimulation after stroke.","authors":"Jin Yan, Weicheng Lai, Wenlong Zhao, Xixin Wang, Boyan Su","doi":"10.1016/j.apmr.2026.09.010","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.09.010","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103330","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 the Letter to the Editor: \"Repeated subgroup partitions preclude factor-specific inference for vagus nerve stimulation after stroke\".","authors":"Min Yu, Shuna Wang","doi":"10.1016/j.apmr.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.apmr.2026.09.011","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":4.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149103337","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}