Archives of physical medicine and rehabilitation最新文献

{"title":"Overground Robotic Exoskeleton Gait Training in People With Incomplete Spinal Cord Injury During Inpatient Rehabilitation: A Randomized Control Trial","authors":"Chad Swank PT, PhD ,&nbsp;Jaime Gillespie PT, DPT ,&nbsp;Dannae Arnold PT, DPT ,&nbsp;Lindsey Wynne PT, DPT ,&nbsp;Monica Bennett PhD ,&nbsp;Faith Meza MPH ,&nbsp;Christa Ochoa MPH ,&nbsp;Librada Callender PhD, MPH ,&nbsp;Seema Sikka MD ,&nbsp;Simon Driver PhD","doi":"10.1016/j.apmr.2025.04.015","DOIUrl":"10.1016/j.apmr.2025.04.015","url":null,"abstract":"<div><h3>Objective</h3><div><span>To examine the efficacy of a stakeholder-informed overground robotic exoskeleton (ORE) intervention to improve walking function after </span>spinal cord injury (SCI) compared with usual care gait training.</div></div><div><h3>Design</h3><div>Randomized Controlled Trial.</div></div><div><h3>Setting</h3><div>Inpatient Rehabilitation Facility.</div></div><div><h3>Participants</h3><div>Patients (N=106; age, 51.5±18.5y; men, 78.3%; White, 65.1%) with subacute incomplete SCI.</div></div><div><h3>Interventions</h3><div>ORE compared with usual care gait training approaches including body-weight support treadmill training and traditional overground modalities.</div></div><div><h3>Main Outcome Measures</h3><div><span>Our primary outcome was walking performance defined by function [Walking Index for Spinal Cord Injury-Revised (WISCI-II)] and gait speed [10-m walk test (10MWT)]. Secondary outcomes were functional independence [Spinal Cord Independence Measure (SCIM) and CARE Tool] and patient-reported outcomes of pain, fatigue, spasticity, depression, anxiety, and </span>quality of life.</div></div><div><h3>Results</h3><div><span><span>Patients were tetraplegia (56.6%) and </span>ASIA Impairment Scale (AIS) B (17.9%), AIS C (28.3%), and AIS D (53.8%). Although improvement was observed in both the ORE and usual care groups across WISCI-II, 10MWT, and SCIM measures (all </span><em>P</em><span>&lt;.001), there were no significant differences between ORE and usual care gait training on primary and secondary outcomes. Injury severity distinctions were observed for AIS C where the ORE group improved in WISCI-II and SCIM (</span><em>P</em>=.008 and <em>P</em>&lt;.001, respectively) and the usual care group improved in SCIM (<em>P</em>=.002) only. For AIS D, both groups improved in the WISCI-II, 10MWT, and SCIM (all <em>P</em><span><span>&lt;.001). Moderate effects sizes between ORE and usual care gait training were detected for transfer and walking CARE Tool items for people with AIS C </span>injuries.</span></div></div><div><h3>Conclusions</h3><div>Corollary to our overall equivalence findings between ORE and usual care gait training, ORE may be a more appropriate gait training intervention for patients with AIS C to promote recovery of walking function during inpatient rehabilitation.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1320-1330"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966141","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":"Parenting After Stroke: A Practical Guide for Parents With Young Children","authors":"Olivia Crozier BHSc,&nbsp;Anahita Amirpour RNA, MSc,&nbsp;Pooja Jethani OTD, OTR/L,&nbsp;Mark Bayley MD,&nbsp;Urvashy Gopaul PT, MSc, PhD","doi":"10.1016/j.apmr.2025.04.006","DOIUrl":"10.1016/j.apmr.2025.04.006","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1463-1466"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143966891","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":"Conservative Treatments of Carpal Tunnel Syndrome: A Systematic Review and Network Meta-analysis","authors":"Yuanhao Chen Msc ,&nbsp;Bing Han Msc ,&nbsp;Xin Zhang Msc ,&nbsp;Chao Guo Msc ,&nbsp;Qinghui Han Msc ,&nbsp;Zhanjia Zhang PhD ,&nbsp;Shilun Hou PhD","doi":"10.1016/j.apmr.2025.04.002","DOIUrl":"10.1016/j.apmr.2025.04.002","url":null,"abstract":"<div><h3>Objective</h3><div><span>To evaluate the comparative efficacy of various conservative treatments for carpal tunnel syndrome (CTS), including manual therapy (MT), local steroid injections, platelet-rich plasma (PRP) injections, </span>extracorporeal shock wave therapy, and low-level laser therapy, through a comprehensive network meta-analysis.</div></div><div><h3>Data Sources</h3><div>PubMed, Web of Science, Cochrane Library, Embase, SPORTDiscus, and China National Knowledge Infrastructure databases were searched to identify published studies until April 2024.</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials comparing the efficacy of conservative CTS treatments in individuals with CTS were included.</div></div><div><h3>Data Extraction</h3><div>Data from the included articles were extracted independently by 2 researchers, with any disagreements resolved through consultation with a third author. The extracted data included the first author’s name, country/region, publication year, sample size, participants’ age, disease severity, symptom duration, intervention parameters, follow-up period, and reported outcomes.</div></div><div><h3>Data Synthesis</h3><div>A total of 49 randomized controlled trials involving 11 conservative treatments and 3323 participants were included. The network meta-analysis showed that MT demonstrated the highest efficacy in both short-term and medium-term pain relief with surface under the cumulative ranking curve values of 87.6% and 99.3%, respectively. Dextrose 5% in water and PRP were closely followed in terms of efficacy. Compared to control groups, low-level laser therapy (standardized mean difference=−1.45; 95% CI, −2.16 to −0.74) and extracorporeal shock wave therapy (standardized mean difference=−1.03; 95% CI, −1.86 to −0.20) also showed significant benefits.</div></div><div><h3>Conclusions</h3><div>This study provides robust evidence that MT and dextrose 5% in water injections are the most effective conservative treatments for CTS which offer valuable insights for clinical decision-making. Further research is needed to assess the long-term efficacy and cost-effectiveness of these interventions.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1447-1458"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975203","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 High-Intensity Focused Electromagnetic Therapy on Balance and Quality of Life in Elderly Type 2 Diabetic Men: A Randomized Controlled Trial","authors":"Saher Lotfy Elgayar PhD ,&nbsp;Ahmed M.N. Tolba PhD ,&nbsp;Mohammed Youssef Elhamrawy PhD","doi":"10.1016/j.apmr.2025.04.010","DOIUrl":"10.1016/j.apmr.2025.04.010","url":null,"abstract":"<div><h3>Objective</h3><div>To assess the effect of high-intensity focused electromagnetic therapy (HIFEMT) on balance, core strength, fall risk, and quality of life (QoL) in elderly men with type 2 diabetes.</div></div><div><h3>Design</h3><div>A prospective randomized controlled trial with a single-center focus.</div></div><div><h3>Setting</h3><div>This study was conducted at a private geriatric rehabilitation unit from April to December 2024.</div></div><div><h3>Participants</h3><div>Eighty elderly men (N=80) with type 2 diabetes were randomly allocated into 2 equal groups.</div></div><div><h3>Interventions</h3><div>For 12 weeks, the HIFEMT group received HIFEMT in addition to balance training, whereas the control group received balance training only.</div></div><div><h3>Main Outcome Measures</h3><div>Balance was assessed using the Berg Balance Scale (BBS), core strength was assessed using the double-leg lowering test (DLLT), fall risk was evaluated using the Fall Risk Questionnaire (FRQ), and QoL was measured using the Scale of Older People’s Quality of Life-brief (OPQoL-brief).</div></div><div><h3>Results</h3><div>At post-study, the HIFEMT group demonstrated significantly greater BBS scores (mean difference between groups=4.84; 95% CI, 2.6-7.05; <em>P</em>=.001), DLLT scores (mean difference between groups=0.59; 95% CI, 0.17-1.02; <em>P</em>=.007), and OPQoL-brief scores (mean difference between groups=4.18; 95% CI, 0.99-7.35; <em>P</em>=.01), along with significantly lower FRQ scores (mean difference between groups=−1.07; 95% CI, −1.83 to −0.31; <em>P</em>=.006), compared to the control group.</div></div><div><h3>Conclusions</h3><div>In elderly type 2 diabetic men, HIFEMT could enhance balance control, core strength, and QoL, while also reducing the risk of falls.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1312-1319"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975411","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":"Reporting of Sex and Gender in Randomized Controlled Trials of Rehabilitation Treated Distal Radius Fractures: A Systematic Review","authors":"Christina Ziebart PT, PhD ,&nbsp;Armaghan Dabbagh PT, PhD ,&nbsp;Stephanie Reischl PT, PhD ,&nbsp;Rochelle Furtado PT, PhD ,&nbsp;Joy C. MacDermid PT, PhD","doi":"10.1016/j.apmr.2024.12.023","DOIUrl":"10.1016/j.apmr.2024.12.023","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the extent to which sex and gender are considered in the design and reporting of distal radius fracture rehabilitation randomized controlled trials (RCTs).</div></div><div><h3>Data Sources</h3><div>PubMed, Embase, CINAHL, and Pedro databases were searched in March 2022, and an updated search was conducted in July 2023.</div></div><div><h3>Study Selection</h3><div>All RCTs with a rehabilitation intervention and any comparison were included.</div></div><div><h3>Data Extraction</h3><div>We extracted information on the study characteristics and sex and gender reporting in the articles. We extracted whether the studies complied with the sex and gender equity in research (SAGER) guidelines and a reporting tool for sex and gender.</div></div><div><h3>Data Synthesis</h3><div>A total of 77 studies were included in this review. All studies were published between 1987 and 2021. Two were in children, and the rest were in adults. This systematic review found that sex and gender were adequately considered in only 6 of the 77 RCTs investigating rehabilitation interventions after distal radius fracture. Three of those studies were published before the SAGER guidelines were published in 2016, and 3 were published after 2016.</div></div><div><h3>Conclusions</h3><div>Overall, sex and gender were inadequately defined, and poorly addressed in the study design, conduct, and interpretation. Unfortunately, there was no evidence of improvement after 2016 when the SAGER guidelines became available.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1402-1421"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143482239","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":"Technology-Based Physical Rehabilitation for Balance in Patients With Multiple Sclerosis: A Systematic Review and Meta-analysis","authors":"Cristina Lirio-Romero PhD ,&nbsp;Sara Reina-Gutiérrez PhD ,&nbsp;Purificación López-Muñoz PhD ,&nbsp;Elisabeth Bravo-Esteban PhD ,&nbsp;Ana Torres-Costoso PhD ,&nbsp;María José Guzmán-Pavón PhD","doi":"10.1016/j.apmr.2025.02.011","DOIUrl":"10.1016/j.apmr.2025.02.011","url":null,"abstract":"<div><h3>Objective</h3><div>To synthesize the current evidence on technology-based physical rehabilitation for balance in people with multiple sclerosis and to compare its effectiveness with that of conventional physical therapy.</div></div><div><h3>Data Sources</h3><div>A comprehensive search of databases including CENTRAL Scopus, CINAHL, PsycINFO, PubMed, and PEDro was conducted up to March 2024.</div></div><div><h3>Study Selection</h3><div>Studies were selected based on predefined inclusion criteria.</div></div><div><h3>Data Extraction</h3><div>Data extraction and quality assessment were performed independently by 2 reviewers. Statistical analyses were conducted using a random effects model.</div></div><div><h3>Data Synthesis</h3><div>A total of 24 studies involving 985 participants were included. The meta-analysis revealed that compared with conventional physical therapy, technology-based physical rehabilitation significantly improved balance outcomes by 0.16 (95% CI, 0.04- 0.29; <em>P</em>=.027) with moderate heterogeneity (I²=39.1%). Subgroup analyses were performed by intervention modality (robotic assistive gait training, exergaming, and telerehabilitation), and only exergaming interventions had a medium effect on balance in this population of 0.29 (95% CI, 0.08-0.251; <em>P</em>=.03).</div></div><div><h3>Conclusions</h3><div>Among technology-based physical rehabilitation approaches, exergaming interventions have shown promising effectiveness in improving balance in people with multiple sclerosis. Despite the moderate heterogeneity, the findings support the use of exergaming as a viable option. Further high-quality randomized controlled trials are needed to confirm these results.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1437-1446"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143571928","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":"Trajectories of Global Functioning Over the 10 Years After Traumatic Brain Injury in Black Individuals: A Model System Study","authors":"Chimdindu Ohayagha PhD ,&nbsp;Bridget Xia MS ,&nbsp;Shawn C.T. Jones PhD ,&nbsp;Daniel W. Klyce PhD ,&nbsp;Juan Carlos Arango-Lasprilla PhD ,&nbsp;Paul B. Perrin PhD","doi":"10.1016/j.apmr.2025.03.034","DOIUrl":"10.1016/j.apmr.2025.03.034","url":null,"abstract":"<div><h3>Objective</h3><div>This study examined longitudinal global functioning trajectories over the 10 years after traumatic brain injury (TBI) in a group of Black individuals, and demographic and injury-related predictors of those trajectories.</div></div><div><h3>Design</h3><div>Participants completed follow-up data collections at 1, 2, 5, and 10 years after TBI and being discharged from acute rehabilitation.</div></div><div><h3>Setting</h3><div>TBI Model System (TBIMS) hospitals.</div></div><div><h3>Participants</h3><div>This study included a subsample of Black individuals (N=2523) in the TBIMS National Database who had a completed global functioning scores at 1 or more follow-up time points.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measure</h3><div>Glasgow Outcome Scale-Extended (GOS-E).</div></div><div><h3>Results</h3><div>GOS-E scores across the full sample tended to increase slightly between years 1 and 2 and then plateaued for the successive years such that a quadratic, or U-shaped, trend best fit the data. Younger age (<em>P&lt;</em>.001), higher level of education (<em>P&lt;</em>.001), private insurance (<em>P=</em><span>.007), and shorter posttraumatic amnesia (PTA) duration (</span><em>P&lt;</em>.001) were significant predictors of higher GOS-E trajectories. There was also a significant time<span><span>²</span></span> × age effect (<em>P&lt;</em>.001), such that younger adults improved slightly over the first 5 years and plateaued between years 5 and 10 relative to a general decline for older adults.</div></div><div><h3>Conclusions</h3><div>These findings suggest that age, education, insurance status, and PTA are important predictors of long-term global functional outcomes for Black individuals with TBI. Identifying baseline risk factors for Black individuals who may experience lower global functioning trajectories can inform development of targeted interventions and be a first step in working to reduce health disparities in functional outcomes in this group.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1359-1366"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143661931","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 Effect of Preinjury Psychiatric Difficulties on Caregiving Needs and Postinjury Emotional Distress in Care Partners of Persons With Traumatic Brain Injury","authors":"Fedora Biney PhD ,&nbsp;Jennifer H. Marwitz MA ,&nbsp;Yue Zhang PhD ,&nbsp;Richard Kennedy MD, PhD ,&nbsp;Flora M. Hammond MD ,&nbsp;Katherine Abbasi MA","doi":"10.1016/j.apmr.2025.03.035","DOIUrl":"10.1016/j.apmr.2025.03.035","url":null,"abstract":"<div><h3>Objective</h3><div>To examine differences in postinjury needs in traumatic brain injury<span> (TBI) care partners with and without a preinjury psychiatric history<span> (positive preinjury psychiatric history [PH+] vs negative preinjury psychiatric history [PH−]).</span></span></div></div><div><h3>Design</h3><div>A multisite, prospective, observational cohort study.</div></div><div><h3>Setting</h3><div>Community.</div></div><div><h3>Participants</h3><div>Two hundred fifty-eight care partners (N=258) for persons with TBI meeting the following criteria: ≥18 years old; nonpaid caregiver; TBI care recipient criteria: ≥16 years old at time of injury, TBI requiring inpatient rehabilitation; acute hospitalization/admission at Traumatic Brain Injury Model System–approved inpatient rehabilitation site.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Family Needs Questionnaire-Revised assessed percentage of emotional, instrumental, professional, and community support needs met at 6 months after injury. Secondary Outcome Measures: Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 assessed care partner depression and anxiety at 6, 12, and 24 months after injury.</div></div><div><h3>Results</h3><div>At 6 months after injury, care partners reported more met needs for community support relative to instrumental support needs (estimates, 7.30; 95% confidence interval [CI], 3.91-10.69; <em>P</em><span>&lt;.001). PH+ care partners did not differ from PH− care partners in the percentage of met needs across any need category. Number of psychiatric diagnoses (0 vs 1 vs 2 vs 3+) was not associated with differences in met needs. PH+ care partners endorsed more depression and anxiety symptoms than PH− care partners from 6 to 24 months after injury (depression: estimates, 3.78; 95% CI, 2.55-5.00; </span><em>P</em>&lt;.001; anxiety: estimates, 2.91; 95% CI, 1.58-4.24; <em>P</em>&lt;.001).</div></div><div><h3>Conclusions</h3><div>While PH+ TBI care partners do not appear to have differing needs compared to PH− care partners at 6 months after injury, they do experience persistent emotional distress. Evaluating care partners’ psychiatric history is warranted to identify caregivers vulnerable to developing post-TBI emotional distress.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1375-1383"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143673359","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":"Shear Wave Elastography for Measuring the Stiffness of Latent Trigger Points and Surrounding Areas in the Infraspinatus Muscle: Intra- and Interexaminer Reliability Analysis","authors":"Mateusz D. Kobylarz PT, PhD ,&nbsp;Juan Antonio Valera-Calero PT, PhD ,&nbsp;Sandra Sánchez-Jorge PT, PhD ,&nbsp;Jorge Buffet-García PT, PhD ,&nbsp;María José Díaz-Arribas PT, PhD ,&nbsp;Ricardo Ortega-Santiago PT, PhD ,&nbsp;Sebastian Klich PT, PhD","doi":"10.1016/j.apmr.2025.03.036","DOIUrl":"10.1016/j.apmr.2025.03.036","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore the intra- and interexaminer reliability of shear wave elastograhy (SWE), (an objective alternative to highly subjective procedures with poor inter-rater reliability such as manual palpation) in measuring the stiffness of latent myofascial trigger points (MTrPs) and healthy surrounding areas in the infraspinatus muscle, pressure pain threshold (PPT), interexaminer reliability, and mean differences in SWE and PPTs between MTrPs and control points.</div></div><div><h3>Design</h3><div>Longitudinal observational study: Intra- and interexaminer reliability study.</div></div><div><h3>Setting</h3><div>A university laboratory.</div></div><div><h3>Participants</h3><div>Forty participants (N=40) with latent MTrPs within the infraspinatus muscle.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>One experienced examiner identified and classified latent MTrPs and selected an asymptomatic control point within the infraspinatus muscle. Later, 2 blinded examiners assessed once the PPTs (blinded to the scores) and acquired 2 SWE images of each location. Reliability estimates were calculated for assessing PPT<span> interexaminer reliability and SWE intra- and interexaminer reliability. PPT and SWE scores were compared by location (MTrP and control) and gender (male/female).</span></div></div><div><h3>Results</h3><div>PPTs were significantly lower in MTrPs than control points in males (<em>P=</em>.003) and females (<em>P=</em>.006), and lower in females than males (MTrP <em>P&lt;</em>.001; control point <em>P=</em>.001). Good interexaminer reliability was found for PPTs (intraclass correlation coefficient [ICC]&gt;0.84) and SWE (ICC&gt;0.82). Intraexaminer reliability for SWE was excellent (ICC&gt;0.95) in both the novice and experienced examiners.</div></div><div><h3>Conclusions</h3><div>This study demonstrated excellent SWE intraexaminer reliability (ICCs&gt;0.9) and good interexaminer reliability (ICCs&gt;0.82). Although PPT scores indicated significant differences in hyperirritability between latent MTrPs and control points, SWE measurements revealed no significant differences in muscle stiffness.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1384-1391"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690957","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 5-Year Longitudinal Retrospective Cohort Study of Health Care Use and Costs Before and After Incident Traumatic Spinal Cord Injury","authors":"Paul Lin MS ,&nbsp;Adit Doza PhD ,&nbsp;Zoe C. Gurney BS ,&nbsp;Gianna M. Rodriguez MD ,&nbsp;Elham Mahmoudi PhD","doi":"10.1016/j.apmr.2025.02.012","DOIUrl":"10.1016/j.apmr.2025.02.012","url":null,"abstract":"<div><h3>Objective</h3><div><span>To examine trends in health care use and cost before and after incident </span>traumatic spinal cord injury (TSCI) in the United States.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Setting</h3><div>Using 2012-2019 claims data from the Health Care Cost Institute, we identified adults (45+) with a diagnosis of incident TSCI (n=251). Using age, sex, and a set of chronic conditions, we matched 2480 adults without TSCI (controls) with our cases. Health care use and costs were analyzed for cases and controls for 5 years. We used 2-part generalized estimating equations to predict any health care use/costs and positive use/costs in inpatient, outpatient, professional, and prescription drug settings, as well as total and out-of-pocket health care costs.</div></div><div><h3>Participants</h3><div>Adults with and without TSCI.</div></div><div><h3>Intervention</h3><div>Not applicable.</div></div><div><h3>Main Outcomes Measures</h3><div>Health care use and costs.</div></div><div><h3>Results</h3><div>Incident TSCI was associated with an increase in total and out-of-pocket costs of health care (excluding the month of injury) during the first year of injury compared with the matched controls by odds ratio=7.72 (95% CI: 5.86, 10.16) and odds ratio=2.02 (95% CI: 1.59, 2.55), respectively. Higher costs were mainly attributed to inpatient ($55,494; 95% CI: $40,230, $76,549) and professional services ($17,973; 95% CI: $13,525, $23,885). TSCI was associated with a decrease in health care costs in the 3 years after the incident but was also associated with higher costs than those of controls. TSCI was associated with an increase in the number of outpatient (7.44-9.01) and inpatient services (1.25-1.96) during the fifth year. Health care use and costs remained stable among controls throughout the 5-year study period.</div></div><div><h3>Conclusions</h3><div>TSCI was associated with a higher total and out-of-pocket cost of health care in the year of incident compared with controls. After the first year, the associated costs of TSCI sharply declined but remained slightly higher than those of controls.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 9","pages":"Pages 1331-1338"},"PeriodicalIF":3.7,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143522566","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}