Archives of physical medicine and rehabilitation最新文献

{"title":"Inclusion of Racially and Ethnically Diverse Samples in Cognitive Rehabilitation Research: An Ethnographic Study of Recruitment and Retention Practices.","authors":"Jessica Kersey, Christian Le, Emily Evans, Zaccheus J Ahonle, Patricia Garcia, Anthony H Lequerica, Devina Kumar, Devan Parrott","doi":"10.1016/j.apmr.2025.03.043","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.043","url":null,"abstract":"<p><strong>Objective: </strong>To describe the recruitment and retention practices of brain injury rehabilitation researchers and factors affecting the inclusion of racially and ethnically diverse research participants.</p><p><strong>Design: </strong>Ethnographic study using surveys and qualitative interviews.</p><p><strong>Setting: </strong>Virtual.</p><p><strong>Participants: </strong>Eleven investigators who published cognitive rehabilitation intervention studies.</p><p><strong>Interventions: </strong>N/A MAIN OUTCOMES: Participants completed a survey describing strategies that have shown promise for the recruitment and retention of diverse participants. They then completed a qualitative interview to describe their priorities, the perceived effectiveness of their practices, and the challenges to recruiting representative samples. Interviews were analyzed using thematic analysis.</p><p><strong>Results: </strong>Investigators reported moderate confidence in their knowledge of promising recruitment strategies but low confidence in implementing those strategies. Qualitative themes were 1) balancing competing recruitment and retention priorities, 2) building relationships with participants and communities, and 3) research infrastructure and policies. Key factors influencing recruitment and retention practices included research study and research team characteristics, institutional infrastructure and policies, local contextual factors, and national academic community infrastructure and norms.</p><p><strong>Conclusions: </strong>Brain injury rehabilitation research faces significant challenges in achieving representation of racially and ethnically diverse participants. Systemic changes are needed at the study, institutional, and national levels to support more equitable clinical trial enrollment and reduce health disparities for marginalized brain injury survivors.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750873","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":"Predictors of Response to Cognitive Behavioural Therapy for Sleep Disturbance and Fatigue After Acquired Brain Injury: A Secondary Analysis of a Randomised Controlled Trial.","authors":"Lucy Ymer, Adam McKay, Dana Wong, Kate Frencham, Natalie Grima, Monique Roper, Jennie Ponsford","doi":"10.1016/j.apmr.2025.03.040","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.040","url":null,"abstract":"<p><strong>Objective: </strong>To investigate factors associated with response to cognitive behavioural therapy for sleep disturbance and fatigue (CBT-SF) in individuals with acquired brain injury.</p><p><strong>Setting: </strong>Community dwelling.</p><p><strong>Participants: </strong>Eighty-six participants with a traumatic brain injury (TBI) or stroke who received CBT-SF in a parent randomised controlled trial.</p><p><strong>Design: </strong>Participants took part in a parent randomized controlled trial comparing an 8-week CBT-SF program with a health education control, face-to-face or via videoconferencing, and adapted for cognitive impairments. They were assessed at baseline, post-treatment, 2-months post-treatment, and 4-months post-treatment. A secondary analysis was conducted to identify which demographic, injury-related, neuropsychological and pre-treatment variables, as well as mode of treatment delivery, were associated with response to CBT-SF.</p><p><strong>Intervention: </strong>Cognitive Behavioural Therapy for Sleep Disturbance and Fatigue MAIN OUTCOME MEASURES: Pittsburgh Sleep Quality Index and Fatigue Severity Scale.</p><p><strong>Results: </strong>Greater improvements in sleep after CBT-SF were associated with higher baseline sleep disturbance, less time since injury, and telehealth mode of delivery. Larger reductions in fatigue were associated with less time since injury and with higher education. Injury type (TBI, stroke) and cognitive variables were not associated with treatment outcomes.</p><p><strong>Conclusion: </strong>These findings highlight that an adapted CBT-SF intervention can be equally effective for individuals with TBI and stroke, however, gains are greater earlier after injury. Although individuals with severe symptoms at baseline show greatest benefit, the intervention can be effective across a range of symptom presentations.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742074","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":"Assessment and Evaluation of a Crosswalk between the Functional Independence Measure and the Continuity Assessment Record and Evaluation: a NIDILRR-funded TBI Model Systems Study.","authors":"David Mellick, Cynthia Harrison-Felix, Gale Whiteneck, Jessica M Ketchum, Therese M O'Neil-Pirozzi, Flora M Hammond, Jennifer H Marwitz, Kristen Dams-O'Connor, Shannon B Juengst, Amanda R Rabinowitz","doi":"10.1016/j.apmr.2025.03.037","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.037","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate crosswalks between the Continuity Assessment Record and Evaluation (CARE) measure and the Functional Independence Measure (FIM™) Motor subscale scores in a sample of persons with traumatic brain injury (TBI), given the CARE measure's development by the Centers for Medicare and Medicaid Services in 2005 to assess motor function in all post-acute rehabilitation settings and its intended continuity with previous measures DESIGN: Crosswalks were created using three methodologies (Expert Opinion, Equipercentile, Rasch). The dataset was split into training and validation datasets. Each crosswalk was evaluated using reduction in uncertainty, percent of each crosswalked score falling within ½ standard deviation (SD) of the reference measure, population invariance, comparison of statistical moments and effect size.</p><p><strong>Setting: </strong>Record Abstraction PARTICIPANTS: 982 persons who were hospitalized and received inpatient rehabilitation after TBI and had both FIM and CARE collected at inpatient rehabilitation admission and discharge.</p><p><strong>Interventions: </strong>NA MAIN OUTCOME MEASURES: Crosswalk between the FIM and CARE RESULTS: In the training dataset, the Expert Opinion crosswalk met all criteria except the direction of population invariance within the race category. The Equipercentile methodology satisfied all criteria. The Rasch model met all criteria except for a difference in directionality in the skewness of the distributions and 80% of scores not falling within ½ SD of the reference assessment. Results from the validation sample differed from the population invariance criteria, in which the age categories were in opposite directions and had observed differences between standardized mean difference for age that exceeded the threshold of 0.08 for both the Equipercentile and Rasch crosswalks.</p><p><strong>Conclusion: </strong>All three crosswalk methods produced acceptable criteria for use, indicating that motor/physical functional outcome can be compared between cohorts assessed using CARE and FIM measures. Researchers can compare cohorts that have been assessed using these instruments using any of these crosswalks. However, we do not recommend using these crosswalks for longitudinal analyses.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742072","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":"Common Data Elements for Rehabilitation Research in Neurological Disorders (NeuroRehab CDEs).","authors":"Noelle E Carlozzi, M Carolina Mendoza-Puccini, Sue Marden, Deborah Backus, Linda Bambrick, Carolyn Baum, Jonathan F Bean, Steven C Cramer, Theresa Hayes Cruz, Anne Deutsch, Kimberly Frey, Katelyn Gay, James E Graham, Robert K Heaton, Shannon Juengst, Claire Z Kalpakjian, Allan J Kozlowski, Catherine E Lang, Jon Pearlman, Adam Politis, Sharon Ramey, Elizabeth Rasch, Angelle M Sander, Heidi Schambra, Marcia J Scherer, Beth S Slomine, Elizabeth W Twamley, Steven L Wolf, Allen W Heinemann","doi":"10.1016/j.apmr.2025.03.039","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.039","url":null,"abstract":"<p><strong>Objective: </strong>Common data elements (CDEs) help harmonize data collection across clinical trials and observational studies, allowing for cross-study and cross-condition comparisons. While CDEs exist for multiple clinical conditions and diseases, this work was extended only recently to neurorehabilitation research.</p><p><strong>Design: </strong>Subgroups of clinical neurorehabilitation investigators operationalized a domain definition, selected applicable CDEs from 23 existing National Institute of Neurological Disorders and Stroke (NINDS) CDE projects and NIH CDE repositories, and identified areas needing further development. The subgroups also reviewed public comments on the NeuroRehab specific CDEs, which were provided from 01 September 2021 to 07 October 2021. In March 2022, version 1.0 of the NeuroRehab CDEs was completed and can be found on the NINDS CDE website: https://www.commondataelements.ninds.nih.gov/.</p><p><strong>Setting: </strong>NINDS and the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)/National Center for Medical Rehabilitation Research (NCMRR) identified NeuroRehab CDEs across 12 different research domains: 1) assessments and examinations; 2) comorbid and behavioral conditions; 3) motor function; 4) treatment/intervention data: therapies; 5) treatment/intervention data: devices; 6) cognitive; 7) communication; 8) emotion/behavior/neuropsychology; 9) activities of daily living/instrumental activities of daily living; 10) quality of life; 11) participation; and 12) infant and pediatrics. Within each domain, corresponding subdomain experts identified instruments with good psychometric measurement properties.</p><p><strong>Participants: </strong>120 experts in rehabilitation across the 12 identified research domains and two Co-Chairs with rehabilitation and measurement expertise provided oversight.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Main outcome measures: </strong>CDEs from 23 existing NINDS CDE projects and NIH CDE repositories RESULTS: Clinical investigators recommended NeuroRehab CDEs within three dimensions of the NINDS CDE Classifications: Core, [Disease] Core, and Supplemental - Highly Recommended. Most measures were categorized as Supplemental - Highly Recommended; few were identified as Core or Disease Core. The subgroups also identified measurement gap areas to guide future initiatives as NeuroRehab CDEs are developed in the future.</p><p><strong>Conclusions: </strong>These efforts are designed to accelerate rehabilitation research in neurological disorders by allowing for cross-study and cross-condition comparisons and to encourage new CDE development.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742073","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":"Behavioral fluctuation in disorders of consciousness: a retrospective analysis.","authors":"Alice Barra, Yelena G Bodien, Can Ozan Tan, Geraldine Martens, Christopher Malone, Joseph T Giacino","doi":"10.1016/j.apmr.2025.03.038","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.038","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the frequency of behavioral fluctuations in patients with prolonged disorders of consciousness (DoC), characterize the stability of consciousness ratings, and characterize the stability of behavioral signs of consciousness.</p><p><strong>Design: </strong>Prospective observational analysis.</p><p><strong>Setting: </strong>Specialized DoC Program in an inpatient rehabilitation facility and a long-term acute care hospital.</p><p><strong>Participants: </strong>Patients in vegetative state/unresponsive wakefulness state (VS/UWS), minimally conscious state and emerged from MCS followed weekly on the Coma Recovery Scale- Revised (CRS-R) between 28 and 90 days post-injury (N=241).</p><p><strong>Main outcome measure: </strong>Change in CRS-R subscale scores and consciousness ratings.</p><p><strong>Results: </strong>Behavioral fluctuation was observed in more than 80% of patients, and was most common on the CRS-R Motor subscale and least common on the Communication subscale (83% and 54% of patients experienced ≥1 fluctuation over the 3-week study period, respectively, with a 1-point change observed most frequently). Among patients who were conscious on baseline assessment, 25% were subsequently rated as unconscious at least once. Localization to pain and object manipulation were the most stable signs of consciousness, recurring at least 3 times after the first occurrence in ≥ 97% of the sample. Reproducible command-following and intelligible verbalization were the least stable, recurring at least 3 times after the first occurrence in ≤ 27% of the sample.</p><p><strong>Conclusions: </strong>Patients with prolonged DoC who undergo serial assessment demonstrate a high rate of fluctuation in behavioral signs of consciousness. These findings highlight that repeated assessments are essential in this population, both to capture the highest level of consciousness and to help distinguish spontaneous fluctuation from response to treatment in interventional studies.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727521","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 Inter-Examiner Reliability Analysis.","authors":"Mateusz D Kobylarz, Juan Antonio Valera-Calero, Sandra Sánchez-Jorge, Jorge Buffet-García, María José Díaz-Arribas, Ricardo Ortega-Santiago, Sebastian Klich","doi":"10.1016/j.apmr.2025.03.036","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.036","url":null,"abstract":"<p><strong>Objective: </strong>To explore the intra- and inter-examiner 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), inter-examiner reliability and mean differences in SWE and PPTs between MTrPs and control points DESIGN: Longitudinal observational study: Intra- and inter-examiner reliability study.</p><p><strong>Setting: </strong>A University lab.</p><p><strong>Participants: </strong>Forty participants with latent MTrPs within the infraspinatus muscle.</p><p><strong>Interventions: </strong>None.</p><p><strong>Main outcome measures: </strong>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 inter-examiner reliability and SWE intra- and inter-examiner reliability. PPT and SWE scores were compared by location (MTrP and control) and gender (male/female).</p><p><strong>Results: </strong>PPTs were significantly lower in MTrPs compared with control points in males (p=0.003) and females (p=0.006), and lower in females compared with males (MTrP p<0.001; control point p=0.001). Good inter-examiner reliability was found for PPTs (ICC>0.84) and SWE (ICC>0.82). Intra-examiner reliability for SWE was excellent (ICC>0.95) in both the novice and experienced examiners.</p><p><strong>Conclusion: </strong>This study demonstrated excellent SWE intra-examiner reliability (ICCs>0.9) and good inter-examiner reliability (ICCs>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.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-21","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":"The Impact of Pre-injury Psychiatric Difficulties on Caregiving Needs and Post-injury Emotional Distress in Care Partners of Persons with TBI.","authors":"Fedora Biney, Jennifer Marwitz, Yue Zhang, Richard Kennedy, Flora M Hammond, Katherine Abbasi","doi":"10.1016/j.apmr.2025.03.035","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.035","url":null,"abstract":"<p><strong>Objective: </strong>To examine differences in post-injury needs in traumatic brain injury (TBI) care partners with and without a pre-injury psychiatric history (PH+ vs. PH-).</p><p><strong>Design: </strong>A multi-site, prospective, observational cohort study.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>258 care partners for persons with TBI meeting these criteria: ≥18 years old; non-paid caregiver; TBI care recipient criteria: ≥ 16 years old at time of injury, TBI requiring inpatient rehabilitation; acute hospitalization/admission at TBIMS-approved inpatient rehabilitation site.</p><p><strong>Interventions: </strong>Not applicable, Main Outcome Measures: Family Needs Questionnaire-Revised (FNQ-R) assessed proportion of emotional (ES), instrumental (IS), professional (PS), and community (CS) support needs met at 6-months post-injury.</p><p><strong>Secondary outcome measures: </strong>Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) assessed care partner depression and anxiety at 6, 12, and 24-months post-injury.</p><p><strong>Results: </strong>At 6-months post-injury, care partners reported more met needs for community support relative to instrumental support needs (Estimates; 95% CI: 7.30; 3.91-10.69, p<.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 post-injury (Estimates; 95% CI: depression: 3.78; 2.55-5.00 p<.001; anxiety: 2.91; 1.58-4.24, p<.001).</p><p><strong>Conclusions: </strong>PH+ TBI care partners do not appear have differing needs than PH- care partners at 6 months post-injury, but do experience persistent emotional distress. Evaluating care partners' psychiatric history is warranted to identify caregivers vulnerable to developing post-TBI emotional distress.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-19","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":"Trajectories of Global Functioning over the 10 Years after Traumatic Brain Injury in Black Individuals: A Model System Study.","authors":"Chimdindu Ohayagha, Bridget Xia, Shawn C T Jones, Daniel W Klyce, Juan Arango-Lasprilla, Paul B Perrin","doi":"10.1016/j.apmr.2025.03.034","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.034","url":null,"abstract":"<p><strong>Objective: </strong>This study examined: (a) longitudinal global functioning trajectories over the 10 years after traumatic brain injury (TBI) in a group of Black individuals, and (b) demographic and injury-related predictors of those trajectories.</p><p><strong>Design: </strong>Participants completed follow-up data collections at 1, 2, 5, and 10 years after TBI and being discharged from acute rehabilitation.</p><p><strong>Setting: </strong>TBI Model System (TBIMS) hospitals.</p><p><strong>Participants: </strong>This study included a subsample of 2,523 Black individuals in the TBIMS National Database who had a completed global functioning scores at one or more follow-up time points.</p><p><strong>Interventions: </strong>None MAIN OUTCOME MEASURE: Glasgow Outcome Scale-Extended (GOS-E).</p><p><strong>Results: </strong>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 that best fit the data. Younger age (p < .001), higher level of education (p < .001), private insurance (p = .007), and shorter posttraumatic amnesia (PTA) duration (p < .001) were significant predictors of higher GOS-E trajectories. There was also a significant time²*age effect (p < .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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-17","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":"Assessing sensor-derived features from a wrist-worn wearable device as indicators of upper extremity function in individuals with cervical spinal cord injury.","authors":"Tessa C Johnson, Cole Hagen, Donna L Coffman, Melissa Nunn, Mary Schmidt-Read, Kelly M Heath, Ralph J Marino, Shivayogi V Hiremath","doi":"10.1016/j.apmr.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.003","url":null,"abstract":"<p><strong>Objective: </strong>To assess the relationship between sensor-derived features and upper extremity function in individuals with acute and chronic cervical spinal cord injury (cSCI) and to assess the reproducibility of these features in chronic cSCI.</p><p><strong>Design: </strong>Prospective, longitudinal study. Participants completed the Capabilities of Upper Extremity Test (CUE-T) - a measure of upper extremity function - at two time points, four weeks apart, while wearing a wrist-worn inertial measurement unit (IMU) device on their most-used upper extremity. The IMU recorded 3-axis accelerometer and gyroscope data from which metrics (features) were derived. Distance correlations (dCorr) assessed associations between features and CUE-T hand and arm function scores. Intraclass correlation coefficients (ICCs) assessed the reproducibility of CUE-T scores and features in the chronic subgroup.</p><p><strong>Setting: </strong>Inpatient rehabilitation facility (acute cSCI) and community (chronic cSCI).</p><p><strong>Participants: </strong>Forty adults with cSCI were enrolled, and 33 provided data.</p><p><strong>Intervention: </strong>None.</p><p><strong>Main outcome measures: </strong>Correlations between CUE-T scores and features; ICCs of CUE-T scores and features (chronic group).</p><p><strong>Results: </strong>At Time 1, two features showed strong correlations with CUE-T hand score (dCorr=0.53-0.58), while nine showed strong correlations with CUE-T arm score (dCorr=0.54-0.62). At Time 2, three features showed strong correlations with CUE-T hand score (dCorr=0.53-0.57), while 29 showed strong correlations with CUE-T arm score (dCorr=0.50-0.72). Types of features were distinct for hand and arm conditions. For the chronic subgroup, CUE-T scores showed excellent reproducibility (ICC=0.94-0.99), and 16 features demonstrated moderate to good reproducibility (ICC=0.50-0.77).</p><p><strong>Conclusions: </strong>Sensor-derived features can indicate upper extremity function in cSCI, supporting their use for monitoring recovery and functional outcomes. Future research should focus on validating features of upper extremity function to support digital biomarker development and clinical adoption.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633327","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":"Randomized Trial Assessing Prospective Surveillance and Exercise for Preventing Breast Cancer-Related Lymphedema in High-Risk Patients.","authors":"Karol Ramírez-Parada, Cesar Sánchez, Irene Cantarero-Villanueva, Álvaro Reyes, Mauricio P Pinto, M Loreto Bravo, Denise Montt-Blanchard, Francisco Acevedo, Benjamín Walbaum, Margarita Alfaro-Barra, Margarita Barra-Navarro, Scarlet Muñoz-Flores, Constanza Pinto, Sabrina Muñiz, Felipe Contreras-Briceño, Tomás Merino, Gina Merino","doi":"10.1016/j.apmr.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.apmr.2025.03.002","url":null,"abstract":"<p><strong>Objective: </strong>to evaluate if combining prospective surveillance model (PSM) with a supervised multimodal exercise program prevents breast cancer-related lymphedema (BCRL) and its impact on the functional capacity and quality of life (QoL) of high-risk breast cancer (BC) patients undergoing treatment.</p><p><strong>Design: </strong>two-arm parallel superiority randomized controlled trial.</p><p><strong>Setting: </strong>outpatient physical therapy service in a public hospital.</p><p><strong>Participants: </strong>116 adult women (≥18-year-old) diagnosed with stage I-III BC were enrolled. Inclusion criteria included recent surgery and indication for adjuvant chemotherapy. Exclusion criteria were significant arm volume difference, previous cancer, exercise contraindications, and extreme BMI values.</p><p><strong>Interventions: </strong>participants were randomized into experimental (n=61) or control groups (n=55) in a 1:1 ratio. The experimental group received PSM with a supervised multimodal exercise program for 12 weeks. The control group received PSM alone.</p><p><strong>Main outcome measures: </strong>arm volume, grip strength, 6-minute walk test, and QoL were blindly assessed at baseline, 3, 6, and 9 months.</p><p><strong>Results: </strong>the combination of PSM with a supervised multimodal exercise program significantly reduced arm volume and body weight and improved grip strength, functional capacity, and the QoL of patients.</p><p><strong>Conclusion: </strong>combining PSM and physical exercise reduces arm volume, prevents BCRL, and improves physical performance and QoL in high-risk patients. The combination of PSM and STRONG-B was superior to PSM alone, validating the study's superiority design.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143623349","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}