Archives of physical medicine and rehabilitation最新文献

{"title":"Measuring Health-Related Quality of Life in Upper Extremity Vascularized Composite Allotransplantation: Development of New Patient-Reported Outcome Items for Hand Transplant.","authors":"Callie E Tyner, Jerry Slotkin, L Scott Levin, Scott M Tintle, Christina L Kaufman, Pamela A Kisala, David S Tulsky","doi":"10.1016/j.apmr.2025.05.014","DOIUrl":"10.1016/j.apmr.2025.05.014","url":null,"abstract":"<p><strong>Objective: </strong>To develop patient-reported outcome (PRO) items tailored for upper extremity vascularized composite allotransplantation (UE VCA), a procedure that can restore physical functioning and independence and improve psychosocial functioning after hand or arm loss.</p><p><strong>Design: </strong>Based on prior grounded theory-based qualitative and theoretical work, item development was led by recognized experts in psychometrics and outcomes measurement. Item refinement included item review by 17 experts in the field of UE VCA. Cognitive debriefing interviews were conducted by trained, impartial interviewers with 6 English-speaking UE VCA recipients. A professional translatability review was completed on the items.</p><p><strong>Setting: </strong>Academic research center.</p><p><strong>Participants: </strong>Experts (n = 17) and patient stakeholders (n = 6).</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Not applicable.</p><p><strong>Results: </strong>Fifty-six items were finalized in 7 content areas: Expectations and Perceived Outcomes; Posttransplant Challenges and Complications; Integration and Assimilation of the Transplant; Fitting In; Satisfaction with Hand Function; Satisfaction with Hand Aesthetics; and Hand Function: Sensation.</p><p><strong>Conclusions: </strong>These PRO items offer a structured way to measure health-related quality of life outcomes for UE VCA from the perspective of the recipients, offering an opportunity to collect reliable and quantifiable information on transplant outcomes as a path to move the field forward.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191414","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":"Does Orthosis Improve Outcomes of Conservative Treatment in Trigger Fingers? A 3-Arm Prospective Randomized Controlled Trial.","authors":"Kathryn Minkhorst, Alexandra Munn, Joy MacDermid, Ruby Grewal","doi":"10.1016/j.apmr.2025.05.015","DOIUrl":"10.1016/j.apmr.2025.05.015","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate whether the addition of an orthosis improved the efficacy of cortisone injection for the nonoperative management of trigger finger.</p><p><strong>Design: </strong>Block randomized controlled trial.</p><p><strong>Setting: </strong>Outpatient hand clinic.</p><p><strong>Participants: </strong>Individuals presenting to our center with Green severity grade 1-3 trigger finger, aged 18-80, were eligible for inclusion (N=226). Exclusion criteria were previous treatment with either a splint or cortisone injection, trigger thumb, >2 digits involved, grade 4 trigger, or an allergy to cortisone (N=118).</p><p><strong>Interventions: </strong>Patients' hands were randomized to nighttime extension orthosis, cortisone injection, or combined treatment, stratified by the Green severity score and comorbid diabetes.</p><p><strong>Main outcome measures: </strong>Patient-reported outcome measures and the number of triggering occurrences with 10 repeated grips were collected at 6 weeks and 3, 6, and 12 months.</p><p><strong>Results: </strong>The study included 104 patients representing 122 trigger fingers in 115 hands, with an average follow-up of 29 months. At 6 weeks, there was no significant difference in the incidence of triggering, symptom relief, or the Patient-Reported Wrist and Hand Evaluation score between injection or combined treatment groups. The overall success rate with conservative treatment was high, with 68.9% experiencing resolution or improvement of their symptoms. Grade 3 trigger fingers had a significantly higher rate of surgical release compared with lower-grade trigger fingers (39.1% vs 22.4%, P=.05).</p><p><strong>Conclusions: </strong>Our study shows no significant benefit of adding an orthosis to cortisone injection in all trigger grades. Overall success with conservative treatment was high (68.9%) in this cohort. Conservative management of grade 1 and 2 triggers is successful in about 75% of patients, regardless of whether treatment is an orthosis, injection, or both, compared with a 60% success rate for grade 3.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191412","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":"Correction.","authors":"","doi":"10.1016/j.apmr.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.05.009","url":null,"abstract":"","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144156036","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":"Effects of Synchronous Versus Asynchronous Telerehabilitation Programs for Chronic Nonspecific Low Back Pain: A Three-Arm Randomized Controlled Trial.","authors":"Rayan Ahmed Tawfek, Elif Tuğçe Çil","doi":"10.1016/j.apmr.2025.05.012","DOIUrl":"10.1016/j.apmr.2025.05.012","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effectiveness of synchronous and asynchronous telerehabilitation programs in managing chronic nonspecific low back pain (CNLBP).</p><p><strong>Design: </strong>A three-arm parallel group randomized trial SETTING: University Hospital, Department of Orthopedics and Traumatology PARTICIPANTS: This randomized controlled trial was carried out on individuals (N=72) (31 women, 41 men; mean age, 41.26±10.97y) with CNLBP.</p><p><strong>Interventions: </strong>Participants were randomly assigned to 3 groups: (1) a synchronous telerehabilitation group (STG) (n=24), (2) an asynchronous telerehabilitation group (ASTG) (n=24), and (3) a control group (CG) (n=24). A structured exercise program was delivered in real-time to the STG via prerecorded videos to the ASTG and through a digital book to the CG (12wk).</p><p><strong>Main outcome measures: </strong>Pain levels as the prespecified primary outcome were measured using the visual analog scale. Disability was assessed with the Roland Morris Disability Questionnaire and Oswestry Disability Index. Fear of movement was evaluated with the Tampa Scale, and quality of life was determined using the SF-12.</p><p><strong>Results: </strong>Pain levels, disability status, fear of movement, and quality of life showed improvement at week 12 in all groups (P<0.05). In addition, the STG showed greater improvements than the CG in the visual analog scale (mean difference, 1.28; 95% CI, 0.50-2.05). Moreover, the ASTG obtained more significant results than the CG group only in the subparameters of SF-12 (physical component summary and mental component summary).</p><p><strong>Conclusions: </strong>A real-time synchronous telerehabilitation program was superior in improving pain, disability, fear of movement, and quality of life, whereas the asynchronous group was superior compared with an unsupervised home exercise program in improving quality of life only. These results imply that remote therapy could be introduced in clinical practice to improve patient outcomes and resource utilization and eventually be used more broadly.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149037","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":"Relationships Between Wheelchair-Provision Time for Hospital Inpatients and Their Lengths of Stay and Costs of Hospitalization: A Cohort Study.","authors":"Ronald Lee Kirby, Kim Parker, Alistair Lloyd Maksym, Suzanne Patricia Frances Salsman, Christopher John Theriault, Bahareh Yavarizadeh, Fitsum Hadgu Woldeyohannes","doi":"10.1016/j.apmr.2025.04.019","DOIUrl":"10.1016/j.apmr.2025.04.019","url":null,"abstract":"<p><strong>Objectives: </strong>To test the hypotheses that wheelchair-provision time (WPT) (from when a loaner wheelchair was ordered to when the wheelchair arrived at the hospital site) has a significant relationship with length of stay (LOS) and total cost of hospitalization (COH).</p><p><strong>Design: </strong>Cohort study.</p><p><strong>Setting: </strong>Hospital inpatient units.</p><p><strong>Participants: </strong>Hospital inpatients (N=97).</p><p><strong>Intervention: </strong>Order for loaner wheelchair placed during their admissions.</p><p><strong>Main outcome measures: </strong>Demographic, clinical, and process data from 4 available databases, from which we derived WPT, LOS, and COH. To test the hypotheses, we used Spearman correlation coefficients, negative binomial regression for LOS (n=90), and linear regression for COH (n=69).</p><p><strong>Results: </strong>The median values for WPT, LOS, and total COH were 3.8 days, 51.0 days, and $43,062 Canadian dollars. Multivariable regression revealed that WPT was associated to a statistically significant extent with LOS (P=.0049) (a 18% increase in LOS for each additional day in WPT), but not with COH. However, LOS was associated to a statistically significant extent with COH (P<.0001). The Spearman correlation between LOS and COH was 0.8915 (P<.0001).</p><p><strong>Conclusions: </strong>Statistically significant associations exist between WPT and LOS and between LOS and COH. Although this study does not establish causality and further research is needed, our findings suggest that more rapid provision of loaner wheelchairs to hospital inpatients could have a positive effect on the health care system.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143960038","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":"Association of Sleep Quality With Activity and Participation in Older Adults.","authors":"Jessie M VanSwearingen, Caitlan A Tighe, Subashan Perera, Daniel E Forman, Daniel J Buysse, Jennifer S Brach","doi":"10.1016/j.apmr.2025.05.010","DOIUrl":"10.1016/j.apmr.2025.05.010","url":null,"abstract":"<p><strong>Objective: </strong>To explore the relation of self-reported sleep quality with the International Classification of Functioning domains of activity (eg, physical functioning) and participation (eg, disability).</p><p><strong>Design: </strong>Descriptive, secondary, cross-sectional data analysis SETTING: General community PARTICIPANTS: Community-dwelling older adults, volunteers, n=249 INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: The Pittsburgh Sleep Quality Index, self-reported measures of activity and participation by the Late-Life Function and Disability Instrument, the Modified Gait Efficacy Scale for confidence in walking, and performance-based measures of physical functioning (gait speed, 6-minute Walk Test, Figure-of-8 Walk Test, and Short Physical Performance Battery). Measures of function were regressed on sleep quality adjusted for age, sex, and comorbidities.</p><p><strong>Results: </strong>Older adults with good (Pittsburgh Sleep Quality Index ≤5) compared with poor (>5) sleep quality reported better function and disability across almost all considered domains (P<.05). Effect sizes for self-reported and performance-based measures were comparable and in the small to moderate range.</p><p><strong>Conclusions: </strong>Among older adults with mild to moderate functional limitations and disability, self-reported sleep quality related broadly to activity and participation. Experimental studies are needed to assess the effects of sleep interventions on activity and participation and understand if sleep quality may represent a novel treatment target in future intervention trials to improve function in older adults.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141211","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 a Pain Informed Movement Program in Individuals With Post-COVID-19 Condition: A Randomized Controlled Trial.","authors":"Andrés Calvache-Mateo, Alba Navas-Otero, Julia Raya-Benítez, Javier Martín-Núñez, Alejandro Heredia-Ciuró, Araceli Ortiz-Rubio, Marie Carmen Valenza","doi":"10.1016/j.apmr.2025.05.008","DOIUrl":"10.1016/j.apmr.2025.05.008","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the early effect of the Pain Informed Movement (PIM) program in patients with post-COVID-19 condition experiencing new-onset persistent pain.</p><p><strong>Design: </strong>A single-blind, two-arm, parallel-group, randomized controlled trial.</p><p><strong>Setting: </strong>Public health sciences faculty.</p><p><strong>Participants: </strong>Fifty-seven patients (N=57) with post-COVID-19 condition were randomized into the PIM (n=27) and the control (usual care and educational booklet) groups (n=30).</p><p><strong>Interventions: </strong>Patients in the intervention group received an 8-week PIM program. Each week, participants attended 2 face-to-face sessions of 1 hour per week. The first session was group-based and focused on pain neuroscience education. The second session was individual and consisted of functional exercises and relaxation techniques. Additionally, patients were required to perform these exercises and techniques at home twice a week, recording their compliance and progress.</p><p><strong>Main outcome measures: </strong>Measured outcomes include pain intensity and interference measured with the Brief Pain Inventory (BPI), catastrophizing assessed with the Pain Catastrophizing Scale (PCS), kinesiophobia measured with the Tampa Kinesiophobia Scale (TSK) and functionality assessed using World Health Organization Disability Assessment Schedule (WHODAS 2.0). Participants were assessed at baseline and postintervention.</p><p><strong>Results: </strong>The intervention group showed a significant reduction in all variables with respect to baseline values. In addition, the intervention group showed significant differences with respect to the control group in pain intensity (MD=2.84±0.62; P<.001; Cohen's d=.21), pain interference (MD=3.10±0.70; P<.001; Cohen's d=1.18), catastrophizing (MD=12.52±2.48; P<.001; Cohen's d=1.34), kinesiophobia (MD=8.07±1.34; P<.001; Cohen's d=1.56) and functionality (MD=16.16±6.92; P= .039; Cohen's d=0.62).</p><p><strong>Conclusions: </strong>In conclusion, the PIM program appears to be an effective intervention for reduction of new-onset persistent pain and improvement of functionality in patients with post-COVID-19 condition. This study underscores the importance of multidimensional and personalized approaches to persistent pain management, although more research is needed to confirm its applicability in clinical practice.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141217","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":"Characteristics of Dysphagia in Medullary and Cerebellar Stroke: An Observational Study Based on HRPM and FEES.","authors":"Zitong He, Mengshu Xie, Chunqing Xie, Delian An, Meng Dai, Hongmei Wen, Yilong Shan","doi":"10.1016/j.apmr.2025.05.003","DOIUrl":"10.1016/j.apmr.2025.05.003","url":null,"abstract":"<p><strong>Objective: </strong>To explore and compare the distinct characteristics of poststroke dysphagia in patients with cerebellar and different medullary lesions using flexible endoscopic evaluation of swallowing (FEES) and high-resolution pharyngeal manometry (HRPM), by comparing with healthy controls.</p><p><strong>Design: </strong>Observational study.</p><p><strong>Setting: </strong>Department of rehabilitation medicine of an academic hospital.</p><p><strong>Participants: </strong>Healthy individuals and stroke patients were enrolled (N=64). 20 healthy individuals and 44 stroke patients {31 medullary stroke [10 medial medullary infarction (MMI), 21 lateral medullary stroke (LMS-S: nucleus tractus solitaries involvement; LMS-A: only affecting nucleus ambiguous; 13 cerebellar stroke)]} within 2 weeks to 3 months poststroke. All patients remained tube-fed (Functional Oral Intake Scale score≤3) without prior swallowing rehabilitation.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Outcome measures were assessed using FEES and HRPM, including Murray secretion scale, pharyngeal sensation test, swallow reflex, Rosenbek penetration-aspiration scale (PAS), Yale pharyngeal residue severity rating scale, upper esophageal sphincter (UES) relaxation pressure and relaxation duration, pharyngeal peak pressure and contraction duration, and pharyngeal sequencing.</p><p><strong>Results: </strong>FEES results showed LMS-S has reduced pharyngeal sensation and delayed pharyngeal swallow initiation, but no significant differences in PAS score, residue, or secretions among the groups. Medullary stroke patients had higher UES residual pressure and shorter UES relaxation duration than cerebellar stroke patients. Subgroup analysis revealed that the UES residual pressure in LMS-S group was significantly higher and the UES relaxation duration shorter compared to the cerebellar stroke group, whereas the UES relaxation duration, velopharyngeal peak pressure, and constriction duration were all shorter in the LMS-A group than the cerebellar stroke group. Both LMS-S and cerebellar stroke patients had pharyngeal missequencing.</p><p><strong>Conclusions: </strong>Dysphagia characteristics are different in different lesions of medullary stroke and cerebellar stroke. Specific instrumental assessments based on lesions facilitates early intervention in individualized dysphagia rehabilitation.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126445","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":"Psychometric Properties of Free-Living Step-Based Metrics (Daily Steps and Peak Cadence) in Multiple Sclerosis.","authors":"Peixuan Zheng, Robert W Motl","doi":"10.1016/j.apmr.2025.05.005","DOIUrl":"10.1016/j.apmr.2025.05.005","url":null,"abstract":"<p><strong>Objective: </strong>We examined the reliability, precision, and clinically detectable change of step-based metrics (daily steps, peak 30-min cadence [Peak-30_CAD], and peak 1-min cadence [Peak-1_CAD]) over 6 months in the absence of intervention and evaluated the construct validity through correlations with laboratory-assessed walking and gait performance among persons with multiple sclerosis (MS).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>University-based laboratory.</p><p><strong>Participants: </strong>Seventy-eight ambulatory adults (18-64y) with MS.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>Free-living physical activity (via ActiGraph GT3X accelerometer), the Timed 25-Foot Walk, 6-minute walk, gait assessment (gait velocity, step length, and time), and disability status (the 12-item MS Walking Scale, Patient-Determined Disease Steps, and Self-Report Expanded Disability Status Scale) were measured before and after 6 months without any intervention.</p><p><strong>Results: </strong>Step-based metrics were stable with no significant changes across time (P>.05) and demonstrated good test-retest reliability (intraclass correlation coefficients: 0.80-0.85) and acceptable precision (SEM%s:14.4%∼24.3%). The minimal detectable changes at 95% CIs (MDC₉₅) values for Peak-30_CAD, Peak-1_CAD, and daily steps were 25.6 steps/min, 31.0 steps/min, and 2909.2 steps/d, respectively. There were consistent, strong associations between peak cadence with walking tests, gait parameters, and disability status at both time points (|r_s|=.52-.79), even after controlling for daily steps (|pr_s|=.25-.58; P<.05).</p><p><strong>Conclusions: </strong>Walking represents an important clinical endpoint in people with MS, yet it is often measured in controlled settings using performance-based tests that might not reflect real-world status. Our findings support step-based metrics via accelerometry as reliable and valid measures of free-living ambulatory performance and may inform the inclusion of these metrics in clinical trials among people with MS.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144118664","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 Validation of a Prognostic Model for Independent Walking in Children With Cerebral Palsy Based on Machine Learning.","authors":"Wang Yiwen, Yang Yonghui","doi":"10.1016/j.apmr.2025.05.006","DOIUrl":"10.1016/j.apmr.2025.05.006","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate machine learning-based models for predicting independent walking ability in children with cerebral palsy (CP).</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Setting: </strong>Data were collected from a national CP registry platform and follow-up assessments were conducted through telephone interviews.</p><p><strong>Participants: </strong>Children with CP (n=807) registered between January 2016 and December 2020, with follow-up data collected from October 2022 to March 2023.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>The primary outcome was independently walking before the age of 6 years.</p><p><strong>Results: </strong>Among the 807 participants, 561 (69.5%) achieved independent walking. Univariate Cox regression identified several predictive factors, including neonatal asphyxia, bilirubin encephalopathy, Gross Motor Function Classification System level before age of 2 years, age of independent sitting, type of CP, magnetic resonance imaging classification, Gross Motor Function Measure-88 scores, epilepsy, intellectual disability, early preterm birth, and very low birth weight (P<.05). Machine learning models demonstrated excellent predictive performance, with logistic regression achieving the highest area under the curve (AUC=0.947), followed by XGBoost (AUC=0.946) and multilayer perceptron (AUC=0.945). Cox proportional hazard models identified key predictors for the timing of independent walking, with a nomogram constructed for clinical application. Internal validation confirmed model reliability, although calibration curves indicated potential overestimation for ages 5-6 years.</p><p><strong>Conclusions: </strong>Machine learning models accurately predict independent walking ability in children with CP, although calibration analyses indicated potential overestimation for children aged 5-6 years. The proposed nomogram provides clinicians with an interpretable tool for personalized prognosis. Although internal validation demonstrated excellent performance, future external validation in multicenter cohorts will be critical to confirm generalizability.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101039","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}