Archives of physical medicine and rehabilitation最新文献

{"title":"Using Integrated Clinical Data and Work-related Traumatic Brain Injury Narratives to Inform Sex-specific Injury Prevention: A Concurrent Mixed Methods Study 8253","authors":"Sarah Trick, Thaisa Tylinski Sant'Ana, Angela Colantonio, Tatyana Mollayeva","doi":"10.1016/j.apmr.2025.01.018","DOIUrl":"10.1016/j.apmr.2025.01.018","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine sex differences in preinjury Person-Environment-Occupation (PEO) factors and provide recommendations for primary prevention of work-related traumatic brain injury (wrTBI).</div></div><div><h3>Design</h3><div>Concurrent mixed methods study. The PEO model served as a theoretical framework for analyses of clinical and injury narratives data. We applied a theme-based approach to analyze qualitative data and calculated the proportion of male versus female workers for each PEO factor stratifying by external cause of injury in quantitative data analyses.</div></div><div><h3>Setting</h3><div>Rehabilitation research—teaching hospital.</div></div><div><h3>Participants</h3><div>Adult participants (n=93, 51% women, 67% aged >40y) who sustained a wrTBI at least 3 months prior and were referred to a rehabilitation research-teaching hospital for brain injury assessment and management.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>PEO factors implicated in wrTBI.</div></div><div><h3>Results</h3><div>Qualitative analysis of injury events revealed distinct patterns between male and female workers within 2 themes: (1) nature of occupational activity and (2) physical and/or social load of activity performed at the time of injury. Regarding the nature of occupational activity, more male workers were engaged in direct work activities, and more female workers were engaged in indirect work activities at the time of injury. Regarding the physical and/or social load of activity, male workers sustained injury while operating heavy machinery, and female workers during tasks requiring frequent changes in head position or when interacting with others. Quantitative analysis of injury data enhanced our understanding of these sex differences across PEO factors. We identified statistically significant differences between sexes in terms of employment in specific industries, hours worked per week, and supervisor-worker relationships.</div></div><div><h3>Conclusions</h3><div>The integration of qualitative and quantitative methodologies in analyzing clinical and injury narrative data facilitated a comprehensive exploration of injury events and enhanced the quantification of sex differences observed across PEO factors. Our results suggest the importance of prevention strategies that address sex-specific occupational hazards, especially in industries that remain predominantly male- or female-dominated, as they expose workers to distinct risks of wrTBI.</div><div>This research received funding support from the Ontario Ministry of Labour Research Opportunities Program: Research for Workplace (R4W), the CIHR Institute for Health and Sex (CGW-126580), and in part from Canada Research Chairs Programs (CRC-2021-00074, CRC-2019-00019) and the Global Brain Health Institute (GBHI), Alzheimer's Association, and the Alzheimer's Society UK Pilot Award for Global Brain Health Leaders (GBHI ALZ","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e7"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the Content Validity of an Activity-based Therapy Tracking Tool Using Cognitive Debriefing Interviews","authors":"Kristin Musselman, Anita Kaiser, Hanan Idd, Katherine Chan, Alexander Djuric, Sandi Marshall, Heather Cairns-Mills, Jennifer Leo","doi":"10.1016/j.apmr.2025.01.078","DOIUrl":"10.1016/j.apmr.2025.01.078","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the content validity of a prototype activity-based therapy (ABT) tracking tool to be used by clinicians and people living with spinal cord injury or disease (SCI/D) who participate in ABT.</div></div><div><h3>Design</h3><div>A qualitative study involving cognitive debriefing interviews.</div></div><div><h3>Setting</h3><div>Three community-based ABT clinics in Canada. Interviews were held over web conferencing.</div></div><div><h3>Participants</h3><div>A volunteer sample of 9 clinicians (1 physical therapist, 7 kinesiologists, 1 exercise physiologist; 2 men, 7 women; mean age, 27.8±3.9y) and 5 persons with SCI/D (5 traumatic tetraplegia; 2 complete, 3 incomplete; 2 men, 3 women; mean age, 32.4±7.8y) were recruited through a poster campaign at 3 community-based ABT clinics in Canada. To be eligible, clinicians and individuals with traumatic or nontraumatic SCI/D (>6mo) had to participate in ABT at least once a week for 2 months.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Participants used a paper-based ABT tracking tool over 3 ABT sessions, and then completed an individual, semistructured interview that used cognitive debriefing. The interview guide followed recommendations by Brod and colleagues for determining content validity by probing the appropriateness, comprehensiveness and comprehensibility of the tool. Participants were also probed on how the tool was used and perceived barriers and facilitators of tool use and implementation into practice. A deductive followed by an inductive content analysis was used.</div></div><div><h3>Results</h3><div>The ABT tracking tool demonstrated content validity. Three themes were identified. (1) Content validity of the ABT tracking tool. The tool was comprehensive and appropriate for all levels and severities of injury. Recommendations, such as adding a comment section and additional parameters to each activity were provided to improve the tool. (2) Facilitators of tool use, dissemination and implementation. Participants perceived using the tool during rest breaks to maximize therapy time or immediately after the session to avoid recall issues. Education and training on use of the tool in an app form would support implementation. Social media and community clinics could aid in dissemination. (3) Barriers of tool use, dissemination and implementation. Anticipated barriers included the paper format, language barrier for nonnative English speakers, learning curve, added workload and adapting a new documentation system.</div></div><div><h3>Conclusions</h3><div>A validated ABT tracking tool may provide a convenient and standardized approach to document the details of ABT sessions within a community-based setting. Addressing anticipated barriers, such as creating an app and developing learning resources to support its use, are important next steps.</div><div>Supported by Praxis Spinal Cord Institute.</div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Pages e30-e31"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761308","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":"Preliminary Assessment of Novel Upper Extremity Robotic Rehabilitation Tool on Upper Extremity Motor Control in Individuals with Chronic Neurologic Injuries: A Case Series Study","authors":"Hannah Ferry, Robert McIver, Gina Brunetti, Mark Bowden, Kenneth Ngo","doi":"10.1016/j.apmr.2025.01.080","DOIUrl":"10.1016/j.apmr.2025.01.080","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate feasibility, safety, and clinical outcomes in individuals with chronic neurologic injuries with the use of the Harmony ScapuloHumeral Rhythm robotic device.</div></div><div><h3>Design</h3><div>Case Series.</div></div><div><h3>Setting</h3><div>Outpatient Rehabilitation Clinic.</div></div><div><h3>Participants</h3><div>The first 3 individuals with chronic neurologic injuries enrolled in an ongoing clinic research project were assessed: 1 with stroke, 1 with traumatic brain injury (TBI), and 1 with Guillain-Barre syndrome (GBS).</div></div><div><h3>Interventions</h3><div>The Harmony ScapuloHumeral Rhythm (SHR) robotic is a therapeutic robotic device to facilitate upper extremity motor return, while providing adjustable parameters for speed, amount of assistance, and body weight support. The device allows for full upper extremity movement, including scapular movement, and encourages appropriate scapulo-thoracic rhythm. Participants underwent 8-10 sessions, each including 40 minutes of physical therapy incorporating the SHR device. During the sessions, participants used 3 different SHR treatment modes: predefined exercise (passive or active-assisted), consisting of preprogrammed movement patterns; bilateral sync (passive or active-assisted) where the unaffected upper extremity drives the affected upper extremity's movement; and active freeform (active or active-assisted), where the participant moves both arms freely with machine support and adjustable assist level.</div></div><div><h3>Main Outcome Measures</h3><div>Assessments included: a 10-point Likert pain scale; goniometer-measured active range of motion (ROM) consisting of shoulder flexion and abduction and elbow flexion and extension; and the Modified Ashworth Scale (MAS) for all upper extremity (UE) joints. Outcomes were assessed at baseline and postintervention.</div></div><div><h3>Results</h3><div>For stroke-1, active ROM increased by 85° for shoulder flexion, 75° for abduction, 10° for elbow flexion, 55° for extension, and total MAS decreased from 3 to 1 for all joints in the affected UE. For TBI-1, active ROM increased by 6° for right UE shoulder flexion and 10° for left UE elbow extension and total MAS decreased 8 to 4 for left UE and 18 to 15 for right UE. For GBS-1, total active ROM increased by 1° for right UE and 5° for left UE shoulder flexion, 16° for left UE elbow extension, and no change in MAS because no spasticity reported. Only GBS-1 reported average pain with a decrease from 4 of 10 to 3 of 10 after intervention.</div></div><div><h3>Conclusions</h3><div>The Harmony SHR demonstrates promise in the treatment of persistent upper extremity dysfunction after neurologic injury. Data collection is ongoing, and the results of this pilot study will be used to develop a larger proposal assessing clinical efficacy. Future exploration should assess the ability to limit maladaptive plasticity and secondary complications associated with long-term d","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e31"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761310","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":"Multiple Long-Term Chronic Conditions Are Associated with Long-term Declined Physical Quality of Life in Older Adults with or at Risk of Knee Osteoarthritis 8257","authors":"Aqeel Alenazi,&nbsp;Badr Alqahtani","doi":"10.1016/j.apmr.2025.01.041","DOIUrl":"10.1016/j.apmr.2025.01.041","url":null,"abstract":"<div><h3>Objectives</h3><div>To examine the association of baseline multiple long-term chronic conditions (MLTCs) with physical and mental health-related quality of life (HRQOL) over time among older adults with or at risk of knee osteoarthritis.</div></div><div><h3>Design</h3><div>This study is a prospective longitudinal cohort design over 96 months of follow-up.</div></div><div><h3>Setting</h3><div>This study used multisite data from the Osteoarthritis Initiatives.</div></div><div><h3>Participants</h3><div>For the current study, only older adults from the Osteoarthritis Initiative were selected who were 60 years and older at baseline. Based on Charlson comorbidity index, all participants were classified into 3 groups: no chronic condition (n=1828), one chronic condition (n=417), and MLTCs (having ≥2 chronic conditions) (n=315).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Physical and mental component summaries for HRQOL were assessed over 96 months of follow-up using the 12-item Short Form Health Survey.</div></div><div><h3>Results</h3><div>A total of 2560 older adults were included with 12.2% prevalence of MLTC. The results showed that participants with 1 chronic disease (beta [<em>B</em>]=−2.42, <em>P</em>&lt;.001) and MLTCs (<em>B</em>=−3.58, <em>P</em>&lt;.001) were associated with significantly declined physical component summary for HRQOL over time after adjustments for age, sex, race, educational level, body mass index, depressive symptoms, physical activity, KL for the right knee, and KL for the left knee. Mental component summary for HRQOL was not significantly associated with MLTC.</div></div><div><h3>Conclusions</h3><div>Older adults with or at risk of knee osteoarthritis who had baseline one chronic disease and MLTCs had significantly overtime declined physical HRQOL. Future work is needed to investigate the potential treatment strategies to improve physical HRQOL in this population.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e16"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761109","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":"Decline in Physical Function Is Associated with Cognitive Impairment and Quality of Life in Pancreatic Cancer Patients Undergoing Chemotherapy 4359","authors":"Amornthep Jankaew,&nbsp;Po See Chen,&nbsp;Cheng-Feng Lin","doi":"10.1016/j.apmr.2025.01.042","DOIUrl":"10.1016/j.apmr.2025.01.042","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;(1) To investigate changes in physical function among older patients with pancreatic cancer receiving chemotherapy at baseline, 2-, 4-, and 6-month intervals, and (2) to observe the associations among physical function, cognitive function, and quality of life (QoL) in patients with pancreatic cancer.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A 6-month longitudinal follow-up study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;Medical Center at National Cheng Kung University, Tainan, Taiwan.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;A total of 117 patients with pancreatic cancer (N=117; 57 men, 60 women) with a mean age of 72.20±5.95 years and body mass index of 22.65±3.37 were enrolled.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Not applicable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Physical functional tests, including maximum grip strength, the 2-Minute Step Test, and the Timed Up and Go (TUG), were conducted by a licensed physical therapist at baseline (before chemotherapy), 2-, 4-, and 6-month during chemotherapy. Cognitive function and QoL were assessed using the total score of the Montreal Cognitive Assessment and the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire, respectively. One-way analysis of variance and Pearson correlation coefficient were employed to detect changes in physical function and assess correlations among the primary outcomes with a significance level of &lt;em&gt;P&lt;/em&gt;&lt;.05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Throughout the chemotherapy course, a decline in physical functions was observed in maximum grip strength (F=4.410, &lt;em&gt;P&lt;/em&gt;=.005) and Timed Up and Go (F=11.055, &lt;em&gt;P&lt;/em&gt;&lt;.001), with no significant changes in 2-Minute Step Test (F=1.248, &lt;em&gt;P&lt;/em&gt;=.292). Additionally, we noted that reduced maximum grip strength is associated with Montreal Cognitive Assessment scores at baseline and 4 months (&lt;em&gt;r&lt;/em&gt;=0.327 and 0.340, respectively) and QoL at 6 months of chemotherapy (&lt;em&gt;r&lt;/em&gt;=0.260). Meanwhile, an increased Timed Up and Go time exhibited a correlation with both Montreal Cognitive Assessment scores and QoL at baseline (&lt;em&gt;r&lt;/em&gt;=−0.432 and −0.256), 4 months (&lt;em&gt;r&lt;/em&gt;=−0.349 and −0.245), and 6 months of chemotherapy (&lt;em&gt;r&lt;/em&gt;=−0.289 and −0.373).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;This study presents evidence of decreased physical function in older adults with pancreatic cancer undergoing chemotherapy. Furthermore, we identified an association between declined physical function and cognitive impairment as well as QoL in patients with pancreatic cancer. Therefore, monitoring physical status, cognitive function, and QoL is crucial in clinical rehabilitation, particularly in the early stages of chemotherapy. Additionally, we recommend integrating rehabilitation strategies that combine both physical and cognitive training into cancer rehabilitation programs. This approach may contribute to enhancing coping mechanisms and the overal","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Pages e16-e17"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761110","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":"Co-development of a Toolkit to Improve Medication Self-management for Persons with Spinal Cord Injury: A Concept Mapping Approach 4350","authors":"Lauren Cadel,&nbsp;Rasha El-Kotob,&nbsp;Sander Hitzig,&nbsp;Lisa McCarthy,&nbsp;Shoshana Hahn-Goldberg,&nbsp;Tanya Packer,&nbsp;Chester Ho,&nbsp;Tejal Patel,&nbsp;Stephanie Cimino,&nbsp;Aisha Lofters,&nbsp;Sara Guilcher","doi":"10.1016/j.apmr.2025.01.034","DOIUrl":"10.1016/j.apmr.2025.01.034","url":null,"abstract":"<div><h3>Objectives</h3><div>To explore what content should be included in a medication self-management toolkit for adults with spinal cord injury/dysfunction, as well as considerations for delivery.</div></div><div><h3>Design</h3><div>Mixed methods, concept mapping study.</div></div><div><h3>Setting</h3><div>General community across Canada.</div></div><div><h3>Participants</h3><div>Participants were recruited between October 2022 and October 2023 using purposive and convenience sampling strategies. Participants included 21 adults with spinal cord injury/dysfunction, 12 health care providers, and 11 caregivers from 6 provinces across Canada (Ontario, Alberta, British Columbia, Manitoba, Saskatchewan, Nova Scotia).</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Perspectives on content to include in a medication self-management toolkit and considerations for the delivery of the toolkit.</div></div><div><h3>Results</h3><div>The final map contained 79 statements, which were organized into 8 clusters: (1) information-sharing and communication; (2) health care provider interactions and involvement; (3) peer and community connections; (4) supports and services for accessing prescription medications and medication information; (5) information on nonprescription medication and medication supplies; (6) safety and lifestyle considerations; (7) general medication information; and (8) practical information and strategies related to medication-taking. All statements were rated highly on importance and feasibility to include in the toolkit. Only 2 statements had a mean rating below neutral (moderate importance or feasibility). Safety and lifestyle considerations was rated as the most important and feasible cluster to include in the toolkit.</div></div><div><h3>Conclusions</h3><div>In the subsequent phases of this study, the toolkit will be refined through cognitive interviews and a mixed methods pilot evaluation will be conducted to assess the feasibility, acceptability, and appropriateness of the toolkit, as well medication knowledge, self-efficacy, and quality of life. Given the limited tools to help adults with spinal cord injury/dysfunction with managing their medications, there is great potential to better support this population across all areas of medication self-management.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e13"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761185","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":"Restoration of Upper-extremity Function After Intention-driven Functional Electrical Stimulation Using a Wearable Sleeve in 2 Adults with Chronic Stroke: A Case Series 4352","authors":"Eric Meyers,&nbsp;Michael Darrow,&nbsp;Bryan Schlink,&nbsp;Nicholas Tacca,&nbsp;Sam Colachis,&nbsp;Collin Dunlap,&nbsp;Philip Putnam,&nbsp;David Friedenberg,&nbsp;Lauren Wengerd","doi":"10.1016/j.apmr.2025.01.038","DOIUrl":"10.1016/j.apmr.2025.01.038","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To investigate the feasibility of using a wearable, high-density electrode sleeve to provide intention-driven functional electrical stimulation (FES) therapy, and to evaluate the preliminary effects on recovery in 2 adult chronic stroke survivors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;During the 8-week intervention period, therapy was administered using the intention-driven FES sleeve during three 2-hour sessions. After the 8-week intervention period, subjects were monitored in a 10-week follow-up period during which task-oriented training was not administered. However, FES was delivered during this period to enable continued engineering development of the sleeve.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;This study was performed at Battelle Memorial Institute..&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;This study enrolled adults with upper limb hemiparesis, stroke-related hand impairment that interferes with the ability to complete activities of daily life, and who were classified as stage 1-6 on the hand subscale of the Chedoke McMaster Stroke assessment. Individuals actively participating in stroke-related upper limb rehabilitation, co-occurring neurological or neuromuscular conditions, or implanted electronic devices were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;The intervention was comprised of using an investigational device composed of a high-density grid of electrodes embedded in a sleeve to deliver FES during therapist (occupational therapist)-guided therapy. FES was delivered either (1) by an operator that matched FES to the subject's intention, or (2) by the wearer's own electromyographic signals. The operator-controlled FES system was used twice per week, and the electromyographic-controlled FES system used once per week. At each session, the occupational therapist chose functional tasks, graded them to an appropriate difficulty, and administered practice for approximately 20 minutes before moving on to a new task.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;Main outcome measures include the Action Research Arm Test, the Fugl-Meyer Assessment Upper Extremity, and the Box and Blocks test.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;At the conclusion of the 8-week therapy schedule, both subjects demonstrated improvements that exceeded the minimal clinically important difference on the Action Research Arm Test, Fugl-Meyer Assessment Upper Extremity, and the Box and Blocks test. These improvements were sustained during the 10-week follow-up period.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;These results provide an initial, preliminary demonstration in 2 stroke survivors of using intention-driven FES therapy incorporating multiple FES-enabled movements using a wearable forearm sleeve. Larger studies are needed to validate these findings. This device has not been approved or cleared as safe or effective by US Food and Drug Administration. This device is limited by US federal law to investigational use.&lt;/div&gt;","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e15"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761189","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":"Exploring Geospatial Barriers and Facilitators to Community Integration Among Burn Injury Survivors 4354","authors":"Pyung Kim,&nbsp;Karen Kowalske,&nbsp;Dohyeong Kim","doi":"10.1016/j.apmr.2025.01.049","DOIUrl":"10.1016/j.apmr.2025.01.049","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Objectives&lt;/h3&gt;&lt;div&gt;To explore the spatial disparities in community integration (CI) of burn injury survivors in North Texas and identify barriers and facilitators to inclusion.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Design&lt;/h3&gt;&lt;div&gt;A cross-sectional study analyzing data from the National Institute on Disability, Independent Living, and Rehabilitation Research, this study conducted geographical information system mapping to assess neighborhood characteristics for better CI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Setting&lt;/h3&gt;&lt;div&gt;The study is set in the general community of North Texas, using outpatient medical data records to analyze the environmental context of CI among burn injury survivors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Participants&lt;/h3&gt;&lt;div&gt;Participants include burn injury survivors from North Texas, managed by the UT Southwestern Medical Center. We studied 285 adult patients hospitalized between 2015 and 2022.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Interventions&lt;/h3&gt;&lt;div&gt;Not applicable as this study is observational, focusing on existing data analysis rather than implementing new interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Measures&lt;/h3&gt;&lt;div&gt;The primary variable under examination in this study is the CI score, provided by the BMS database. These scores are derived from questionnaires that assess various dimensions of community engagement, including financial support, shopping habits, participation in leisure activities, visits to friends and relatives, social interactions during leisure activities, and the presence of a best friend. The CI score, ranging from 0 to 12, serves as an indicator of the level of CI, with higher scores indicating stronger integration. To analyze changes in CI over time, we computed the average CI score for each county in North Texas at the time of discharge and 6 months after discharge. The difference between the CI score at discharge and 6 months later was then calculated to determine whether integration scores increased or decreased. Subsequently, we visualized these changes at the county level before and after community reentry.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Counties with improved CI scores display higher levels of educational attainment, enhanced health care access, superior transportation infrastructure, and increased availability of nutritious food, alongside improved public safety measures. Additionally, these counties demonstrate lower levels of racial segregation and reduced exposure to environmental stressors such as extreme heat, sunlight, and UV radiation.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;Enhanced community-based interventions and policies are recommended to improve CI for burn injury survivors in North Texas. Additional research is needed to further refine these recommendations.&lt;/div&gt;&lt;div&gt;The authors received funding from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). However, the opinions presented in this document do not necessarily coincide with the policies of NIDILRR, nor do they automat","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e19"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761192","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":"Long-term Comparative Effectiveness of Surgical Versus Non-surgical Treatment for Rotator Cuff Tears: 5-Year Follow-up of a Prospective Cohort Study 8265","authors":"Xiaoyu Pan,&nbsp;Wenting Liu,&nbsp;Folefac Atem,&nbsp;Nitin Jain","doi":"10.1016/j.apmr.2025.01.014","DOIUrl":"10.1016/j.apmr.2025.01.014","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate the long-term effect of operative versus conservative treatments for rotator cuff tears (RCTs), because insufficient long-term evidence exists for the decision-making process.</div></div><div><h3>Design</h3><div>A multicenter prospective longitudinal cohort study with a follow-up of over 5 years. Follow-up visits were set at 3, 6, 12, 18, 24, 36, 48, and 60 months. Inverse probability weighting was used to balance differences in baseline characteristics of the operative and nonoperative groups. Generalized linear mixed model and 3-way interaction were applied in the main and subgroup analysis.</div></div><div><h3>Setting</h3><div>Sports or shoulder clinics in 3 academic settings and 1 community setting between March 2011 and February 2015.</div></div><div><h3>Participants</h3><div>Patients over 45 years of age who were diagnosed with RCTs.</div></div><div><h3>Interventions</h3><div>Not applicable because it is a prospective cohort study.</div></div><div><h3>Main Outcome Measures</h3><div>Assessments included the Shoulder Pain and Disability Index, the American Shoulder and Elbow Surgeons form, magnetic resonance imaging, and a detailed health history questionnaire.</div></div><div><h3>Results</h3><div>After Inverse probability weighting, both groups (operative, n=50; nonoperative, n=77) displayed similar baseline demographics. Outcomes were comparable between groups until 18 months after intervention. Beyond this period, the operative group demonstrated significantly improved outcomes in both Shoulder Pain and Disability Index and American Shoulder and Elbow Surgeons scores. Adjusted mean differences in Shoulder Pain and Disability Index scores were −11.6 (95% confidence interval [CI], −23.3 to 0.137; <em>P</em>=.0527) at 12 months, −12.75 (95% CI, −22.6 to −2.957; <em>P</em>=.0107) at 18 months, and −9.48 (95% CI, −14.5 to −4.41; <em>P</em>&lt;.0001) at the 5-year mark. Subgroup analyses revealed that women (<em>P</em>=.0126) and patients with traumatic RCTs (<em>P</em>&lt;.0001) benefitted more from surgical interventions than from nonoperative treatment.</div></div><div><h3>Conclusions</h3><div>Surgical intervention for RCTs leads to more substantial functional improvement than nonoperative methods after 18 months and remains stable up to 5 years. Female patients and those with traumatic RCTs are more likely to experience better long-term functional outcomes after surgery. This research provides insights into recovery timelines, which can support patient-centered decision making.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e5"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761239","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":"“Slipping Away”: A Qualitative Study of Gender in Lived Experiences of Community Integration After Traumatic Brain Injury 1140","authors":"Rachael Coupland,&nbsp;Lulu (Guangjia) Lian,&nbsp;Thaisa Tylinski Sant'Ana,&nbsp;Angela Colantonio,&nbsp;Tatyana Mollayeva","doi":"10.1016/j.apmr.2025.01.016","DOIUrl":"10.1016/j.apmr.2025.01.016","url":null,"abstract":"<div><h3>Objectives</h3><div>To investigate community integration challenges after traumatic brain injury (TBI) through a gender lens.</div></div><div><h3>Design</h3><div>A reflexive thematic analysis of semistructured interview data with men and women with a primary diagnosis of mild or moderate-severe TBI, in the acute or chronic stages after injury. The data were coded and analyzed according to Braun and Clarke's thematic analysis.</div></div><div><h3>Setting</h3><div>The largest rehabilitation research-teaching hospital in North America.</div></div><div><h3>Participants</h3><div>Adult participants (22 men and 20 women) undergoing rehabilitation after TBI.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Expression of gender in community reintegration after TBI.</div></div><div><h3>Results</h3><div>Three overarching themes emerged: (1) lack of a “graduated home plan”: difficulty enacting gendered roles and responsibilities at home, (2) “Something that I can't handle”: mismatch between occupational demands and abilities, and (3) “Slipping away”: disrupted connections with self and others. The transformative nature of gender was particularly evident in the home domain of community reintegration, with inabilities to fulfill household tasks traditionally assigned to men and women on the basis of their sex. In the productivity domain, more women reported an inability to meet work demands and more men indicated a limited ability to do so. Both genders encountered disruptions in recreational and leisure activities, but women tended to emphasize obstacles related to social engagement, whereas men leaned toward withdrawal due to anticipated stigma or shame. Across all themes, a pervasive sense of diminished community contributions was observed.</div></div><div><h3>Conclusions</h3><div>The results emphasize the importance of raising awareness among researchers and practitioners on gender as a transformative process in community reintegration after brain injury. The challenges with community reintegration and critical needs based on gender call for rehabilitation approaches that consider changes in socially created roles, responsibilities, and relationships after TBI.</div><div>This research was supported by the Canadian Institutes of Health Research (CIHR) Institute of Gender and Health (#CGW-126580) and in part Canada Research Chairs Programs (CRC-2021-00074, CRC-2019-00019) and the Global Brain Health Institute (GBHI), Alzheimer's Association, and the Alzheimer's Society UK Pilot Award for Global Brain Health Leaders (GBHI ALZ UK-23-971123). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.</div></div><div><h3>Disclosures</h3><div>none.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 4","pages":"Page e6"},"PeriodicalIF":3.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761241","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}