Archives of physical medicine and rehabilitation最新文献

{"title":"Implementing Goal Attainment Scaling as a Person-Centered Measurement Tool to Direct Care and Evaluate Outcomes in Neurorehabilitation Settings.","authors":"Tracey D Wallace, Bridget A Cotner, Daniel Klyce, Amber Walter, April T Hodge, Russell K Gore, Katy H O'Brien","doi":"10.1016/j.apmr.2025.07.018","DOIUrl":"10.1016/j.apmr.2025.07.018","url":null,"abstract":"<p><p>The purpose of this Special Communication is to describe barriers and facilitators to implementing goal attainment scaling (GAS) as a patient-centered measurement tool in neurorehabilitation settings. The experiences of 3 distinct neurorehabilitation settings that implemented GAS to enhance person-centered care and measure person-centered goal attainment are described: a neurorehabilitation service at an inpatient rehabilitation facility; an intensive outpatient program serving military service members, veterans, and first responders with a history of mild to moderate traumatic brain injury; and an outpatient clinic serving adolescents and adults with recent history of mild traumatic brain injury. Each setting instituted different methods to implement GAS yet experienced commonalities in barriers and facilitators to implementation and adoption. Experiences were thematically organized using the normalization process theory (NPT), a framework that supports the design and evaluation of clinical process implementation. Barriers clustered in the NPT domains of coherence and cognitive participation, including factors such as staff training requirements, time required to implement, and challenges related to shifting program philosophies. Implementation was facilitated by actions taken in collective action and reflexive monitoring domains, such as integrating processes into workflows, leveraging technology for team communication and measurement, and completing regular audits and staff feedback. Patient-centered measurement tools, such as GAS, provide a framework for capturing patient priorities, enhancing the relevance of care plans, and ensuring treatment goals align with individual patient needs. Evaluating GAS implementation using the NPT provides direction to future clinical implementation efforts, which should continue to integrate clinical experiences with those of the persons served.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820433","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 Hyperbaric Oxygen Therapy on Exercise-Induced Muscle Injury and Soreness: A Systematic Review and Meta-analysis.","authors":"Xiaoqin Luo, Ying Yu, Shibin Zhang, Fengxue Qi","doi":"10.1016/j.apmr.2025.07.017","DOIUrl":"10.1016/j.apmr.2025.07.017","url":null,"abstract":"<p><strong>Objective: </strong>To assess the efficacy of hyperbaric oxygen therapy (HBOT) in facilitating recovery from exercise-induced muscle injury and soreness.</p><p><strong>Data sources: </strong>China Knowledge Network, Embase, Web of Science, Cochrane Library, PubMed, and Scopus database inception until September 28, 2024.</p><p><strong>Study selection: </strong>A randomized controlled trial to assess the effects on patients with exercise-induced muscle damage and soreness.</p><p><strong>Data extraction: </strong>Mean difference and 95% CI for all outcome indicators were estimated using a fixed-effects model, adjusting for (1) first author, (2) year of publication, (3) sample size, (4) age, (5) method of injury induction, (6) parameters of hyperbaric oxygen intervention, (7) outcome measure, and (8) risk of bias indicators.</p><p><strong>Data synthesis: </strong>A total of 10 articles comprising 299 subjects were included in the analysis. The meta-analysis identified that HBOT significantly accelerated recovery from exercise-induced muscle injury (95% CI, -76.19 to -33.11; P<.0001). Subgroup analyses further revealed that both higher (>2.0 atmosphere absolute [ATA]; 95% CI, -89.45 to -19.06; P=.003) and lower (≤2.0 ATA; 95% CI, -82.12 to -27.65; P<.0001) atmospheric pressures, as well as intervention durations of 60 minutes (95% CI, -76.87 to -25.51; P<.0001) and 100 minutes (95% CI, -102.41 to -23.29; P=.002), were effective in alleviating muscle injury. These beneficial effects were observed in both college students (95% CI, -82.00 to -9.56; P=.01) and elite athletes (95% CI, -86.28 to -32.71; P<.0001). In contrast, HBOT did not provide a significant therapeutic benefit for exercise-induced muscle soreness (95% CI, -0.91 to 0.48; P=.54). However, subgroup analyses revealed that muscle soreness was significantly reduced with an atmospheric pressure above 2.0 ATA (95% CI, -1.58 to -0.00; P=.05), a pressure ≤2.0 ATA (95% CI, 0.17to 1.28; P=.01), and with a 100-minute intervention (95% CI, -2.05 to -0.26; P=.01), whereas a 60-minute intervention did not show a significant effect (95% CI, -0.17 to 0.92; P=.17).</p><p><strong>Conclusions: </strong>The HBOT was statistically effective in promoting recovery from exercise-induced muscle injury. However, it did not enhance recovery from exercise-induced muscle soreness.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815739","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":"Clinical Utility of Remote Teleassessment of Motor Performance in Individuals With Neurologic Disabilities: A COSMIN Systematic Review.","authors":"Andrea Baroni, Gabriele Perachiotti, Andrea Carpineto, Giulia Fregna, Annibale Antonioni, Maria E Flacco, Sofia Straudi","doi":"10.1016/j.apmr.2025.07.013","DOIUrl":"10.1016/j.apmr.2025.07.013","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the feasibility and measurement properties of measurement tools for remote evaluation of motor performance in people with neurologic conditions requiring only synchronous or asynchronous video conferencing without sensors or other complex technological tools.</p><p><strong>Data sources: </strong>A systematic search was conducted in PubMed, Embase, the Cumulative Index for Nursing and Allied Health Literature (CINHAL), and ScienceDirect. The search strategy included keywords related to any neurologic population, telerehabilitation, and motor performance outcome measure; papers in Italian or English language on adults were included, without time restrictions.</p><p><strong>Study selection: </strong>We included studies reporting data of at least one measurement property between reliability, validity, feasibility, or acceptability of measurement tools for remote motor assessment in neurologic disorders. We excluded studies that used wearable technologies, smartphones, or mobile applications. After duplicate removal, 2530 records were screened. Of the 461 remaining papers, 26 met the inclusion criteria and were included in the systematic review.</p><p><strong>Data extraction: </strong>Two independent reviewers extracted data from the included records, evaluated the risk of bias of the studies using the Consensus-based Standards for the selection of health Measurement Instruments tool, and applied the criteria for good measurement properties and clinical utility. Discordance was solved through discussion with a third reviewer.</p><p><strong>Data synthesis: </strong>Twenty-nine measurement tools were identified, and a narrative synthesis was conducted because of the heterogeneity of the included studies. The Fugl-Meyer Assessment for the Lower and Upper Extremity and the Tinetti Performance-Oriented Mobility Assessment Balance were suggested for the remote evaluation of people with stroke, whereas the Five Times Sit-to-Stand Test, the Nine-Hole Peg Test, and the Timed 25-Foot Walk Test were suggested for people with multiple sclerosis.</p><p><strong>Conclusions: </strong>Several measurement tools have been identified for remote evaluation of motor performance in people with neurologic disorders, but few of them can be suggested for clinical and scientific purposes. A higher methodological quality of studies would support the use of these tools in clinical practice.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788145","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":"Fraud, Deception, and Subversion: Recommendations for Maintaining Data Integrity.","authors":"Aditya Dhariwal, Somayyeh Mohammadi, Katherine Golden, Ellyn Pier, Joseph T Giacino, William C Miller","doi":"10.1016/j.apmr.2025.07.016","DOIUrl":"10.1016/j.apmr.2025.07.016","url":null,"abstract":"<p><p>Researchers increasingly use online tools to advertise studies, recruit participants, and collect data, enabling access to individuals in remote or rural areas, those with limited mobility, and participants facing time constraints. While online platforms offer significant advantages, online research remains vulnerable to fraudulent activity, which can compromise the validity of study findings and deplete both funding and human resources. This special communication describes the real-world experiences of 2 research groups, 1 in Canada and 1 in the United States, who encountered fraudsters in both randomized controlled trials and observational studies. We conducted a literature review and identified 32 peer-reviewed articles addressing fraudulent participation and deceptive behaviors in online research. Drawing from both our experiences and the literature, we synthesize actionable strategies to prevent, detect, and manage fraud throughout the research process, including study design (eg, community involvement), advertisement (eg, limited information), recruitment and screening (eg, knowledge-based eligibility questions), assessment (eg, embedding repeated questions), data analysis (eg, removing fraudulent data), and remuneration (eg, clarifying reimbursement conditions). Despite the availability of these strategies, each study design presents unique vulnerabilities, and not all approaches are universally applicable. Researchers are encouraged to assess the specific risks associated with their study design and select strategies that align with their study objectives, balancing the need to minimize fraud, recruit genuine participants, and maintain data integrity.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144811658","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 Frequency of the Mechanical Vibration Matter? Evaluating the Impact of Whole-Body Vibration Training on Older Adults Strength, Balance, and Gait Performance: A Systematic Review and Network Meta-analysis.","authors":"Kailin Xing, Ran Duan, Zhu Fang, Xiangyang Sun, Dohoon Koo, Siddhartha Bikram Panday","doi":"10.1016/j.apmr.2025.07.015","DOIUrl":"10.1016/j.apmr.2025.07.015","url":null,"abstract":"<p><strong>Objective: </strong>To identify the optimal whole-body vibration training (WBVT) mechanical vibration frequency for enhancing muscle strength, static balance, dynamic balance, and gait performance among older adults through systematic review and network meta-analysis.</p><p><strong>Data sources: </strong>PubMed, Web of Science, Cochrane Library, Embase, and Scopus databases were systematically searched for randomized controlled trials (RCTs) up to December 2024.</p><p><strong>Study selection: </strong>The RCTs comparing low-frequency WBVT (LF-WBVT, frequency of the mechanical vibration, f<20 Hz), medium-frequency WBVT (MF-WBVT, 20 Hz≤f<30 Hz), and high-frequency WBVT (HF-WBVT, 30 Hz≤f≤40 Hz), and traditional training regarding their effects on strength, balance, and gait in healthy older adults were included.</p><p><strong>Data extraction: </strong>Methodological quality was assessed using the Physiotherapy Evidence Database scale, and evidence quality was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Continuous data were analyzed as mean differences (MD) or standardized mean differences (SMD) with 95% confidence intervals (CI) using Stata MP 15.1 (StataCorp).</p><p><strong>Data synthesis: </strong>Twenty-seven RCTs (1608 participants) were included. Ranking probability analysis indicated MF-WBVT was most effective for static balance (surface under the cumulative ranking curve [SUCRA]=98.5%; SMD=2.55; 95% CI, 0.85-4.24), HF-WBVT ranked highest for dynamic balance (SUCRA=75.8%; MD=0.60; 95% CI, 0.12-1.07) and gait performance (SUCRA=85.1%; MD=0.45; 95% CI, 0.15-0.75), and traditional training was optimal for improving muscle strength (SUCRA=80.1%; SMD=0.61; 95% CI, 0.27-0.95).</p><p><strong>Conclusions: </strong>Among the 3 mechanical vibration frequency types examined, HF-WBVT is optimal for improving dynamic balance and gait performance, MF-WBVT is recommended for static balance, and traditional training is preferable for enhancing muscle strength.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803303","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":"Psychological Transdiagnostic Processes in Mild Traumatic Brain Injury Recovery: A Scoping Review.","authors":"Caitlin Courchesne, Medha Amarnath Nair, Marc Gelineau, Liam McCloskey, Josh Faulkner, Molly Cairncross","doi":"10.1016/j.apmr.2025.07.014","DOIUrl":"10.1016/j.apmr.2025.07.014","url":null,"abstract":"<p><strong>Objectives: </strong>To examine the extent to which psychological transdiagnostic processes have been investigated in relation to mild traumatic brain injury (mTBI) recovery outcomes, summarize methodological approaches, and evaluate consistency among transdiagnostic processes and outcome measures.</p><p><strong>Data sources: </strong>Five databases (Ovid MEDLINE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Scopus, and Web of Science) were searched from inception to October 2024. Eleven transdiagnostic processes were identified for inclusion based on a review of existing systematic reviews and meta-analyses establishing transdiagnostic relevance across a range of psychological disorders: attentional bias, avoidance, emotion regulation, flexibility, interpretation bias, intolerance of uncertainty, neuroticism, perfectionism, repetitive negative thinking, self-discrepancy, and shame.</p><p><strong>Study selection: </strong>Peer-reviewed, empirical studies published in English were included if they involved human participants with mTBI predominantly aged ≥18 years and reported ≥1 association between a transdiagnostic process and an mTBI recovery outcome.</p><p><strong>Data extraction: </strong>Three reviewers extracted data on study design, sample characteristics, transdiagnostic processes and their associated mTBI outcome measures, and analytical approaches using a standardized extraction form.</p><p><strong>Data synthesis: </strong>Sixty-seven studies published between 1995 and 2024 were included, yielding 118 transdiagnostic process-outcome associations. Avoidance (29%), flexibility (29%), and interpretation bias (25%) were the most frequently investigated transdiagnostic processes; symptom severity (36%) and disability (18%) were the most frequently reported outcomes. No studies examined associations involving attentional bias, emotion regulation, or perfectionism. Substantial heterogeneity in transdiagnostic processes and outcome measurement was observed. While most studies employed quantitative analysis methods, qualitative approaches uniquely captured less represented transdiagnostic process-outcome associations (eg, intolerance of uncertainty, self-discrepancy, shame).</p><p><strong>Conclusions: </strong>Although interest in transdiagnostic processes and mTBI recovery is growing, current investigations are centered on a narrow range of psychological constructs. Broader investigation of transdiagnostic processes known to maintain psychopathology and greater methodological consistency are needed.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798040","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":"Health Care Utilization in Veterans With Tetraplegia in the First Year After Cervical Spinal Cord Injury: Identifying Opportunities for Dissemination of Treatment Information.","authors":"Katharine Tam, Daniel Eaton, Amanda Mayo, Aimee James, Candace Tefertiller, Katherine C Stenson, Catherine Curtin, Doug Ota, Flora Laurent, Michael J Berger, Jana Dengler, Ida K Fox","doi":"10.1016/j.apmr.2025.07.011","DOIUrl":"10.1016/j.apmr.2025.07.011","url":null,"abstract":"<p><strong>Objective: </strong>To describe Veterans Affairs (VA) utilization patterns by Veterans with tetraplegia during the first year after cervical spinal cord injury (SCI) and explore differences among subpopulations. A secondary objective of this study was to develop a process map to guide targeted clinician education about upper limb treatment information.</p><p><strong>Design: </strong>Retrospective cohort study using the Veterans Health Administration (VHA) Spinal Cord Injury and Disorders (SCI/D) Registry and the VHA Corporate Data Warehouse.</p><p><strong>Setting: </strong>Outpatient setting in the VHA.</p><p><strong>Participants: </strong>Veterans (N=884) with traumatic, C5-C8 neurologic level of injury, and American Spinal Injury Association Impairment Scale A-C classification who received care at a regional VA SCI/D Center between October 1, 2012, and September 30, 2019.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Main outcome measures: </strong>VA health care utilization as defined by ≥1 VA outpatient visit within the first year of SCI using VHA administrative data. We also examined predictors of care interactions using multivariate logistic regression models.</p><p><strong>Results: </strong>In total, 489 Veterans (55%) had ≥1 VA outpatient visit in the first year after SCI whereas 395 Veterans (45%) did not receive outpatient VA care within their first year after SCI. Veterans who used VA health care received a median of 41 outpatient visits in the first year after SCI. Veterans had the highest median number of visits and shortest time interval from SCI to initial visit with therapists (physical, occupational, and recreational) compared to other health care providers. No significant predictors of care were identified with adjusted and unadjusted multivariate logistic regression.</p><p><strong>Conclusions: </strong>Health care utilization patterns of Veterans with tetraplegia identified physical, occupational, and recreational therapists as the health care providers who had visits early and often with these Veterans. Therapists are uniquely positioned in health care systems to facilitate communication of treatment opportunities to persons with tetraplegia.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774560","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":"Pain Catastrophization and Fear of Movement Are Potential Moderators for Response to Treatment in Women With Fibromyalgia: Secondary Analyses of Randomized Controlled Trial.","authors":"Felipe Araya-Quintanilla, Héctor Gutiérrez-Espinoza, Joaquín Salazar-Méndez, Erick Atenas-Nuñez, Mayte Serrat, Robinson Ramírez-Vélez","doi":"10.1016/j.apmr.2025.07.012","DOIUrl":"10.1016/j.apmr.2025.07.012","url":null,"abstract":"<p><strong>Objective: </strong>To examine whether psychological and behavioral factors-specifically pain intensity, pain catastrophizing, fear of movement, and sleep quality at the end of the intervention-as well as baseline characteristics including physical activity levels, age, and nutritional status, moderate the effects of a multicomponent treatment on health-related quality of life and functional status in individuals with fibromyalgia (FM).</p><p><strong>Design: </strong>Secondary analysis of randomized clinical trial.</p><p><strong>Setting: </strong>The study was conducted in RehabilitarCenter.</p><p><strong>Participants: </strong>Women (N=65) with a clinical diagnosis of FM were randomly allocated (1:1) into 2 groups.</p><p><strong>Interventions: </strong>The experimental group (n=33) received a novel multicomponent treatment combining graded motor imagery and therapeutic neuroscience education, whereas the control group (n=32) received standard treatment, including pharmacotherapy and standard physician education.</p><p><strong>Main outcome measures: </strong>The primary outcome was health-related quality of life and functional status, assessed using the Fibromyalgia Impact Questionnaire (FIQ). Potential moderators included pain catastrophizing, assessed with the Pain Catastrophizing Scale (PCS); kinesiophobia, assessed with the 17-item Tampa Scale of Kinesiophobia (TSK-17); sleep quality, assessed with the Pittsburgh sleep quality index; pain intensity, assessed with a visual analog scale; and physical activity levels, assessed with the global physical activity.</p><p><strong>Results: </strong>The analysis revealed a significant relationship between the intervention effect and FIQ change when the PCS and TSK-17 scores decreased by more than -14.0 points and -11.4 points. Therefore, when the PCS and TSK-17 score changes exceeded -14.0 and -11.4 points, the effect of the intervention on FIQ was statistically significant. By contrast, baseline measurements did not moderate the intervention effects.</p><p><strong>Conclusions: </strong>Pain catastrophizing and kinesiophobia are moderators of health-related quality of life and functional status in women with FM, whereas pain intensity and sleep quality do not show statistically significant interactions. Additionally, baseline measurements are not significant moderators. Further long-term studies are needed to confirm these findings.</p>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144783351","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":"Risk Factors for Dysphagia After Traumatic Cervical Spinal Cord Injury: A Retrospective Study","authors":"Iris Meißner BSc ,&nbsp;Stephanie Dietmann ,&nbsp;Gerrit Hüller MSc ,&nbsp;Orpheus Mach MSc ,&nbsp;Matthias Vogel MD ,&nbsp;Matthias Ehret ,&nbsp;Anke Scheel-Sailer MD ,&nbsp;Ludwig Aigner PhD ,&nbsp;Doris Maier MD ,&nbsp;Iris Leister PhD","doi":"10.1016/j.apmr.2024.12.014","DOIUrl":"10.1016/j.apmr.2024.12.014","url":null,"abstract":"<div><h3>Objective</h3><div>To identify risk factors for dysphagia in individuals who sustained traumatic cervical SCI. The pathophysiologic mechanisms of dysphagia in individuals with traumatic cervical spinal cord injury (SCI) are not well understood yet. Several risk factors for developing dysphagia after SCI were postulated including mechanical ventilation, tracheostomy, age, female sex, anterior surgical approach, SCI severity, and multilevel spinal fusion.</div></div><div><h3>Design</h3><div>Retrospective analysis: Candidate explanatory variables, including injury severity, age, neurological level of injury, surgical approach, number of fused spinal segments, and tracheostomy including its type, were analyzed using univariate and multivariable statistical analyses.</div></div><div><h3>Setting</h3><div>We included patients, who were treated at the BG Trauma Center Murnau between 2013 and 2022.</div></div><div><h3>Participants</h3><div>Datasets of a total of 407 patients with traumatic cervical SCI were included.</div></div><div><h3>Main Outcome Measures</h3><div>Dysphagia prevalence and identification of associated risk factors.</div></div><div><h3>Results</h3><div>Our analysis included 407 individuals, of whom 22.6% had dysphagia. Tracheostomy and age were identified as the main risk factors for dysphagia after traumatic cervical SCI. Contrary to previous literature, injury severity, an anterior surgical approach, the type of tracheostomy, a higher neurological level of SCI, and multilevel spinal fusion did not show an increased risk after accounting for other factors.</div></div><div><h3>Conclusions</h3><div>Our study identifies age and tracheostomy as primary risk factors for dysphagia after SCI, allowing to identify patients at risk and inform early-stage clinical management.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1189-1197"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142906328","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":"Lower Limb Strength Differentiates Between Fallers and Nonfallers With Multiple Sclerosis","authors":"Heather M. DelMastro MS ,&nbsp;Tracy Wall PT, PhD ,&nbsp;Deirdre J. McPartland PT, DPT ,&nbsp;Erik S. Plaia PT, DPT ,&nbsp;Naomi J. Trimble PT, DPT ,&nbsp;Jennifer A. Ruiz PT, DPT ,&nbsp;Katherine Harris PT, PhD ,&nbsp;Elizabeth S. Gromisch PhD","doi":"10.1016/j.apmr.2025.01.001","DOIUrl":"10.1016/j.apmr.2025.01.001","url":null,"abstract":"<div><h3>Objective</h3><div>To determine whether hip flexion (HF), extension (HE), abduction (HA), knee flexion (KF) and extension (KE), and ankle plantarflexion (APF) and dorsiflexion maximum voluntary contraction (MVC) differentiates between nonfall and fall history in persons with multiple sclerosis (PwMS) after accounting for age, gender, fatigue, disability, and disease duration.</div></div><div><h3>Design</h3><div>Secondary analysis of a cross-sectional study.</div></div><div><h3>Setting</h3><div>Community-based comprehensive MS center.</div></div><div><h3>Participants</h3><div>A total of 172 PwMS who completed a 1-time visit.</div></div><div><h3>Interventions</h3><div>Not applicable.</div></div><div><h3>Main Outcome Measures</h3><div>Lower limb (LL) MVC was measured for each muscle group as isometric peak torque (Newton-meter: Nm) of both limbs (Strongest: S; Weakest: W) using a Biodex Dynamometer and normalized by body weight (Nm/kg). Falls in the past 6 months were retrospectively collected and participants were classified as nonfall history (0 falls [nonfallers]; n=78) or fall history (≥1 falls [fallers]; n=94). Fall history was further categorized as occasional (1-2 falls [occasional fallers]; n=51) and recurrent (≥3 falls [recurrent fallers]; n=43).</div></div><div><h3>Results</h3><div>Overall differences between participants with and without a fall history were noted on both limbs, with post-hoc analyses showing that those with a fall history had significantly lower strength (<em>P</em>&lt;.05) on all LL-W and HF-S, HE-S, HA-S, KF-S, and APF-S. When separated out by fall frequency, recurrent fallers had diminished strength on all LL-W and HF-S, HE-S, HA-S, and APF-S, whereas occasional fallers exhibited reductions on HA-W, KE-W, and KF-W compared with nonfallers. Recurrent and occasional fallers differed on HE-W.</div></div><div><h3>Conclusion</h3><div>All LL-W and aspects of LL-S differentiated between fallers and nonfallers, with further differences observed when fall history was separated by frequency. These findings provide the necessary information to clinicians to inform their plans of care to address falls in MS and provide education on the importance of maintaining LL strength.</div></div>","PeriodicalId":8313,"journal":{"name":"Archives of physical medicine and rehabilitation","volume":"106 8","pages":"Pages 1207-1216"},"PeriodicalIF":3.7,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969259","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}