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DERMATOLOGY AND VENEREOLOGY (163 journals)                     

Showing 1 - 163 of 163 Journals sorted alphabetically
Acta Dermato-Venereologica     Open Access   (Followers: 12)
Acta Dermatovenerologica Croatica     Open Access   (Followers: 1)
Actas Dermo-Sifiliograficas     Full-text available via subscription   (Followers: 3)
Actas Dermo-Sifiliográficas (English Edition)     Full-text available via subscription   (Followers: 2)
Advances in Dermatology     Full-text available via subscription   (Followers: 16)
Advances in Skin & Wound Care     Hybrid Journal   (Followers: 28)
African Journal of AIDS Research     Hybrid Journal   (Followers: 8)
AIDS     Hybrid Journal   (Followers: 23)
AIDS Care: Psychological and Socio-medical Aspects of AIDS/HIV     Hybrid Journal   (Followers: 9)
AIDS Patient Care and STDs     Hybrid Journal   (Followers: 3)
AIDS Research and Human Retroviruses     Hybrid Journal   (Followers: 9)
AIDS Research and Therapy     Open Access   (Followers: 14)
AIDS Research and Treatment     Open Access   (Followers: 2)
Aktuelle Dermatologie     Hybrid Journal   (Followers: 7)
Allergo Journal     Full-text available via subscription   (Followers: 1)
American Journal of Clinical Dermatology     Full-text available via subscription   (Followers: 26)
American Journal of Dermatopathology     Hybrid Journal   (Followers: 17)
Anais Brasileiros de Dermatologia     Open Access   (Followers: 2)
Anaplastology     Open Access  
Annales de Dermatologie et de Vénéréologie     Full-text available via subscription  
Archives de Pédiatrie     Full-text available via subscription  
Archives de sciences sociales des religions     Open Access   (Followers: 1)
Archives des Maladies du Coeur et des Vaisseaux - Pratique     Hybrid Journal  
Archives of Dermatological Research     Hybrid Journal   (Followers: 7)
Archives of Gerontology and Geriatrics     Hybrid Journal   (Followers: 13)
Archives of Industrial Hygiene and Toxicology     Open Access   (Followers: 8)
Archives of Medical Research     Hybrid Journal   (Followers: 3)
Archives of Physical Medicine and Rehabilitation     Hybrid Journal   (Followers: 55)
Archivio di Ortopedia e Reumatologia     Hybrid Journal  
Asian Journal of Dermatology     Open Access   (Followers: 2)
ästhetische dermatologie & kosmetologie     Full-text available via subscription  
Australasian Journal of Dermatology     Hybrid Journal   (Followers: 8)
Berkala Ilmu Kesehatan Kulit dan Kelamin / Periodical of Dermatology and Venereology     Open Access  
Biomedical Dermatology     Open Access  
BMC Dermatology     Open Access   (Followers: 13)
BMJ Sexual & Reproductive Health     Hybrid Journal   (Followers: 2)
British Journal of Dermatology     Hybrid Journal   (Followers: 55)
Case Reports in Dermatological Medicine     Open Access   (Followers: 2)
Case Reports in Dermatology     Open Access   (Followers: 9)
Clinical and Experimental Dermatology     Hybrid Journal   (Followers: 14)
Clinical Dermatology Review     Open Access   (Followers: 5)
Clinical Skin Cancer     Full-text available via subscription  
Clinical, Cosmetic and Investigational Dermatology     Open Access   (Followers: 9)
Clinics in Dermatology     Hybrid Journal   (Followers: 15)
Contact Dermatitis     Hybrid Journal   (Followers: 8)
Cosmetics     Open Access   (Followers: 5)
Current Dermatology Reports     Hybrid Journal   (Followers: 7)
Current Fungal Infection Reports     Hybrid Journal   (Followers: 5)
Current HIV Research     Hybrid Journal   (Followers: 7)
Current HIV/AIDS Reports     Hybrid Journal   (Followers: 6)
Current Sexual Health Reports     Hybrid Journal   (Followers: 3)
Cutaneous and Ocular Toxicology     Hybrid Journal   (Followers: 10)
Der Hautarzt     Hybrid Journal   (Followers: 2)
Dermatitis     Hybrid Journal   (Followers: 1)
Dermato-Endocrinology     Open Access   (Followers: 2)
Dermatología Venezolana     Open Access  
Dermatologic Clinics     Full-text available via subscription   (Followers: 4)
Dermatologic Reviews     Hybrid Journal  
Dermatologic Surgery     Hybrid Journal   (Followers: 8)
Dermatologic Therapy     Hybrid Journal   (Followers: 2)
Dermatologica Sinica     Open Access  
Dermatological Nursing     Full-text available via subscription   (Followers: 1)
Dermatology     Full-text available via subscription   (Followers: 20)
Dermatology and Cosmetic     Open Access   (Followers: 7)
Dermatology and Therapy     Open Access   (Followers: 4)
Dermatology Online Journal     Open Access   (Followers: 1)
Dermatology Reports     Open Access   (Followers: 3)
Dermatology Research and Practice     Open Access   (Followers: 4)
Dermatology Times     Free  
Dermatopathology     Open Access   (Followers: 3)
Egyptian Journal of Dermatology and Venerology     Open Access   (Followers: 1)
EMC - Cosmetologia Medica e Medicina degli Inestetismi Cutanei     Full-text available via subscription  
EMC - Dermatología     Full-text available via subscription   (Followers: 1)
European Journal of Dermatology     Hybrid Journal   (Followers: 15)
Experimental Dermatology     Hybrid Journal   (Followers: 10)
Expert Review of Dermatology     Hybrid Journal   (Followers: 14)
Forum Dermatologicum     Hybrid Journal  
Graefe's Archive for Clinical and Experimental Ophthalmology     Hybrid Journal   (Followers: 8)
Güncel Dermatoloji Dergisi     Open Access  
HautinForm     Full-text available via subscription  
hautnah     Hybrid Journal  
hautnah dermatologie     Hybrid Journal  
HIV & AIDS Review     Full-text available via subscription   (Followers: 13)
HIV Clinical Trials     Hybrid Journal   (Followers: 5)
HIV Medicine     Hybrid Journal   (Followers: 3)
Indian Dermatology Online Journal     Open Access   (Followers: 3)
Indian Journal of Dermatology     Open Access   (Followers: 2)
Indian Journal of Dermatology, Venereology and Leprology     Open Access   (Followers: 4)
Indian Journal of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian Journal of Drugs in Dermatology     Open Access   (Followers: 1)
Indian Journal of Paediatric Dermatology     Open Access   (Followers: 2)
Indian Journal of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2)
International Archives of Medicine     Open Access   (Followers: 3)
International Journal of Dermatology     Hybrid Journal   (Followers: 15)
International Journal of Research in Dermatology     Open Access   (Followers: 1)
International Journal of STD & AIDS     Hybrid Journal   (Followers: 7)
International Journal of Women's Dermatology     Open Access   (Followers: 1)
International STD Research & Reviews     Open Access   (Followers: 1)
JAAD Case Reports     Open Access   (Followers: 1)
JAIDS : Journal of Acquired Immune Deficiency Syndromes     Hybrid Journal   (Followers: 4)
JAMA Dermatology     Full-text available via subscription   (Followers: 49)
JAMA Facial Plastic Surgery     Full-text available via subscription   (Followers: 10)
JMIR Dermatology     Open Access   (Followers: 1)
Journal of AIDS & Clinical Research     Open Access   (Followers: 3)
Journal of Clinical & Experimental Dermatology Research     Open Access   (Followers: 6)
Journal of Clinical and Investigative Dermatology     Open Access   (Followers: 2)
Journal of Cosmetic Dermatology     Hybrid Journal   (Followers: 9)
Journal of Cosmetics, Dermatological Sciences and Applications     Open Access   (Followers: 7)
Journal of Cutaneous Immunology and Allergy     Open Access  
Journal of Cutaneous Medicine and Surgery     Full-text available via subscription  
Journal of Dermatological Research     Open Access  
Journal of Dermatological Science     Hybrid Journal   (Followers: 2)
Journal of Dermatological Science Supplement     Full-text available via subscription   (Followers: 1)
Journal of Dermatological Treatment     Hybrid Journal   (Followers: 2)
Journal of Dermatology & Dermatologic Surgery     Open Access   (Followers: 1)
Journal of General-Procedural Dermatology & Venereology Indonesia     Open Access  
Journal of HIV/AIDS & Social Services     Hybrid Journal   (Followers: 9)
Journal of Investigative Dermatology     Hybrid Journal   (Followers: 28)
Journal of Investigative Dermatology Symposium Proceedings     Full-text available via subscription  
Journal of Sexual Medicine     Hybrid Journal   (Followers: 6)
Journal of Sexually Transmitted Diseases     Open Access   (Followers: 3)
Journal of Skin and Stem Cell     Open Access   (Followers: 3)
Journal of Skin Cancer     Open Access   (Followers: 3)
Journal of Surgical Dermatology     Open Access   (Followers: 1)
Journal of the American Academy of Dermatology     Full-text available via subscription   (Followers: 37)
Journal of the Dermatology Nurses' Association     Hybrid Journal   (Followers: 2)
Journal of the Egyptian Women’s Dermatologic Society     Partially Free  
Journal of the European Academy of Dermatology and Venereology     Hybrid Journal   (Followers: 15)
Journal of the International AIDS Society     Open Access   (Followers: 10)
Journal of the Saudi Society of Dermatology & Dermatologic Surgery     Open Access   (Followers: 1)
Karger Kompass Dermatologie     Full-text available via subscription  
Karger Kompass Pneumologie     Full-text available via subscription   (Followers: 1)
Langenbeck's Archives of Surgery     Hybrid Journal   (Followers: 4)
Medical and Surgical Dermatology     Hybrid Journal   (Followers: 1)
Medical Mycology     Open Access   (Followers: 4)
Nepal Journal of Dermatology, Venereology & Leprology     Open Access   (Followers: 1)
Neurobehavioral HIV Medicine     Open Access   (Followers: 2)
OA Dermatology     Open Access   (Followers: 1)
Open AIDS Journal     Open Access  
Open Dermatology Journal     Open Access  
Perspectives On Sexual and Reproductive Health     Hybrid Journal   (Followers: 7)
Pigment International     Open Access   (Followers: 1)
Psoriasis : Targets and Therapy     Open Access   (Followers: 3)
Revista Internacional de Ciencias Podológicas     Open Access  
SAHARA : Journal of Social Aspects of HIV / AIDS Research Alliance     Open Access   (Followers: 5)
Scars, Burns & Healing     Open Access  
Serbian Journal of Dermatology and Venereology     Open Access   (Followers: 1)
Sex Education: Sexuality, Society and Learning     Hybrid Journal   (Followers: 5)
Sexual & Reproductive Healthcare     Hybrid Journal   (Followers: 3)
Sexual Health     Hybrid Journal   (Followers: 4)
Sexually Transmitted Diseases     Hybrid Journal   (Followers: 6)
Sexually Transmitted Infections     Hybrid Journal   (Followers: 6)
Skin Appendage Disorders     Full-text available via subscription   (Followers: 1)
Skin Pharmacology and Physiology     Full-text available via subscription   (Followers: 7)
Skin Research and Technology     Hybrid Journal   (Followers: 7)
Southern African Journal of HIV Medicine     Open Access   (Followers: 3)
Sri Lanka Journal of Sexual Health and HIV Medicine     Open Access  
Studies in Gender and Sexuality     Hybrid Journal   (Followers: 21)
Surgical & Cosmetic Dermatology     Open Access   (Followers: 2)
The Journal of Dermatology     Hybrid Journal   (Followers: 5)
The Rose Sheet     Full-text available via subscription   (Followers: 2)
Vestnik dermatologii i venerologii     Open Access  
Veterinary Dermatology     Hybrid Journal   (Followers: 8)

           

Similar Journals
Journal Cover
Archives of Physical Medicine and Rehabilitation
Journal Prestige (SJR): 1.501
Citation Impact (citeScore): 3
Number of Followers: 55  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0003-9993
Published by Elsevier Homepage  [3206 journals]
  • Minimum Competency Recommendations for Programs that Provide
           Rehabilitation Services for Persons with Disorders of Consciousness: A
           Position Statement of the American Congress of Rehabilitation Medicine and
           the National Institute on Disability, Independent Living and
           Rehabilitation Research Traumatic Brain Injury Model Systems
    • Abstract: Publication date: Available online 20 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Joseph T. Giacino, John Whyte, Risa Nakase-Richardson, Douglas I. Katz, David B. Arciniegas, Sonja Blum, Kristin Day, Brian D. Greenwald, Flora M. Hammond, Theresa Bender Pape, Amy Rosenbaum, Ronald T. Seel, Alan Weintraub, Stuart Yablon, Ross D. Zafonte, Nathan ZaslerAbstractPersons who have disorders of consciousness (DoC) require care from multidisciplinary teams with specialized training and expertise in management of the complex needs of this clinical population. The recent promulgation of practice guidelines for patients with prolonged DoC by the American Academy of Neurology (AAN), American Congress of Rehabilitation Medicine (ACRM), and National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) represents a major advance in the development of care standards in this area of brain injury rehabilitation. Implementation of these practice guidelines requires explication of the minimum competencies of clinical programs providing services to persons who have DoC. The Brain Injury Interdisciplinary Special Interest Group of the ACRM, in collaboration with the Disorders of Consciousness Special Interest Group of the NIDILRR-Traumatic Brain Injury Model Systems (TBIMS) convened a multidisciplinary panel of experts to address this need through the present position statement. Content area-specific workgroups reviewed relevant peer-reviewed literature and drafted recommendations which were then evaluated by the expert panel using a modified Delphi voting process. The process yielded 21 recommendations on the structure and process of essential services required for effective DoC-focused rehabilitation, organized into four categories: Diagnostic and Prognostic Assessment (four recommendations), Treatment (eleven recommendations), Transitioning Care/Long Term Care Needs (five recommendations), and Management of Ethical Issues (one recommendation). With few exceptions, these recommendations focus on infrastructure requirements and operating procedures for the provision of DoC-focused neurorehabilitation services across subacute and post-acute settings.
       
  • The Therapeutic Effects of Exercise Training on Elderly Patients with
           Dementia: A Randomized Controlled Trial
    • Abstract: Publication date: Available online 19 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): I-Ting Liu, Wei-Ju Lee, Shih-Yi Lin, Shin-Tsu Chang, Chung-Lan Kao, Yuan-Yang ChengAbstractObjectiveTo investigate whether strength or aerobic training can offer significantly more benefits with regards to the activities of daily living of elderly patients with dementia, as well as to determine the effects of exercise on cognition, depression, and biochemical markers.DesignSingle-blind randomized controlled trialSettingA nursing home for veteransParticipantsA volunteer sample of 80 participants whose scores on the Mini-Mental State Examination were between 15 and 26 were included. Due to cardiopulmonary or orthopedic conditions which prohibit exercise training, along with any cognitive problems that may impede answering the contents of our questionnaires, 11 participants were excluded. During the exercise training period, 8 participants voluntarily dropped out of the study.InterventionsThe participants were randomly assigned to perform either strength or aerobic training for a total of four weeks.Outcome measuresThe main outcome measure was the Barthel Index. Other outcome measures included the Mini-Mental State Examination, Montreal Cognitive Assessment, Geriatric Depression Scale, plasma monocyte chemotactic protein-1 levels, insulin-like growth factor-1 levels, and serum brain-derived neurotrophic factor levels.ResultsAfter completion of the program, we discovered a significant improvement in the patients’ Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, and plasma monocyte chemotactic protein-1 levels in the strength-training group. For the patients who had received aerobic training, their serum brain-derived neurotrophic factor also improved significantly. However, the degree of improvement regarding these outcome measures did not achieve significant statistical difference between the two groups.ConclusionThrough our study, an intensive four-week exercise program, whether it be strength or aerobic training, is evidenced to bring significant benefits to elderly patients with dementia, while the serum brain-derived neurotrophic factor was additionally improved through aerobic training.
       
  • Measurement Characteristics and Clinical Utility of the Frenchay
           Activities Index Among Adults With Limb Loss
    • Abstract: Publication date: Available online 14 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Namrata Grampurohit, Eron Bozec, Linda Ehrlich-Jones
       
  • Muscle strength cutoff-points for men with SCI Muscle strength
           cutoff-points for functional independence and wheelchair ability in men
           with spinal cord injury
    • Abstract: Publication date: Available online 12 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Frederico Ribeiro Neto, Rodrigo Rodrigues Gomes Costa, Ricardo Antônio Tanhoffer, Josevan Cerqueira Leal, Martim Bottaro, Rodrigo Luiz CarregaroAbstractObjectiveDetermine trunk and shoulder muscle strength cutoff-points for functional independence and wheelchair skills, and verify the predictive capacity of relative and absolute peak torque in men with spinal cord injury (SCI).DesignCross-sectional study.SettingRehabilitation Hospital Setting.ParticipantsFifty-four men with SCI were recruited and stratified into high and low paraplegia groups.InterventionsAll subjects performed maximum strength tests for shoulder abduction/adduction (isokinetic) and trunk flexion/extension (isometric) to determine relative and absolute peak torque cutoff-points for the Spinal Cord Independence Measure (SCIM-III) and Adapted Manual Wheelchair Circuit (AMWC).Main outcomesThe primary outcomes were SCIM-III, AMWC-Brazil test, and strength variables (peak torques). Demographic characteristics obtained from participants’ electronic medical records were the secondary outcomes used as predictor variables of functional independence.ResultsThe best predictive model for SCIM-III (R=0.78, P≤0.05) used the sum of trunk flexion and extension relative peak torque values to determine the cutoff-points (1.42 N.m/kg for a score of 70). Relative shoulder abduction peak torque was used in the predictive models for AMWC outcomes: performance score (R=0.77, P≤0.05 and cutoff-points of 0.97 N.m/kg for 300.0 meters) and 3-minute overground wheeling (R=0.72, P≤0.05 and cutoff-points of 0.96 N.m/kg for 18.5 seconds).ConclusionsRelative peak torque showed better predictive capacity compared to absolute peak torque. Cutoff-points were established for relative muscle strength and could help health professionals set appropriate goals for individuals with SCI to achieve high functional independence and wheelchair ability.
       
  • Evaluation tools for assistive technologies: a scoping review
    • Abstract: Publication date: Available online 12 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Gordon Tao, Geoffrey Charm, Katarzyna Kabacińska, William C. Miller, Julie M. RobillardAbstractObjectiveAssistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs) across disparate fields in order to improve the process of AT evaluation and development.Data SourcesWe performed a scoping review of AT-ETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining.Study SelectionArticles explicitly referencing AT-ETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs.Data ExtractionWe extracted five attributes of AT-ETs: AT-category, construct evaluated, conceptual frameworks, type of end-user input used for AT-ET development, and presence of validity testing.Data SynthesisFrom screening 23 434 records, we included 159 AT-ETs. Specificity of tools ranged from single to general ATs across 40 AT-categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end-user input and 80% showed validation testing.ConclusionsWe characterized a wide range of AT-categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future AT-ETs may provide more holistic views of AT usefulness. AT-ET selection may be improved with guidelines for conceptually reconciling results of disparate AT-ETs. Future AT-ET development may benefit from more integrated approaches to end-user engagement.
       
  • Response to Letter to the Editor
    • Abstract: Publication date: Available online 10 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Sofia Straudi, Andrea Baroni, Sonia Mele, Laila Craighero, Fabio Manfredini, Nicola Lamberti, Elisa Maietti, Nino Basaglia
       
  • Treating Military-Connected Children in the Civilian Sector: Information
           and Resources for Health Care Providers
    • Abstract: Publication date: Available online 10 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Alicia Gill Rossiter, Larry Cervelli, Alison M. Cogan, Catherine Ling
       
  • Optimizing Noninvasive Stimulation to Treat Gait Problems in Parkinson
           Disease
    • Abstract: Publication date: Available online 7 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Rubens Gisbert Cury, Rafael Carra, Janaína Reis, Egberto R. Barbosa
       
  • Correction
    • Abstract: Publication date: Available online 7 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s):
       
  • Letter to the Editor Re: “The Effects of a Robot-Assisted Arm Training
           Plus Hand Functional Electrical Stimulation on Recovery After Stroke: A
           Randomized Clinical Trial”
    • Abstract: Publication date: Available online 7 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Sung Ho Jang
       
  • Electrophysiologic changes in the peripheral nervous system after subacute
           spinal cord injury
    • Abstract: Publication date: Available online 5 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Chang-Won Moon, Il-Young Jung, Kang Hee ChoAbstractObjectiveTo assess factors affecting electrophysiological changes in the peripheral nervous system below the neurological level of injury (NLI) in patients with subacute spinal cord injury (SCI).DesignRetrospective observational studySettingAn inpatient rehabilitation center of university hospitalParticipantThrough reviewing the medical records of 151 subjects with SCI, 42 without any other disease inducing peripheral neurological abnormalities were included. They were classified into two groups with or without denervation potentials (DP) in electromyography (EMG) below NLI.InterventionNot applicableMain Outcome MeasuresDemographics and clinical characteristics including NLI, American spinal injury association impairment scale (AIS), and lower extremities motor score (LEMS) were compared. Results of electrophysiologic study (EPS) including nerve conduction study (NCS), somatosensory evoked potential (SSEP), and motor evoked potential (MEP) were compared.ResultsDP in EMG below NLI were observed in 20 subjects, and 10 of them were AIS A or B but there was no in subjects without DP (p < 0.01). The LEMS was 4.35 ± 7.74 in group with DP, lower than 33.64 ± 13.60 of opposite group (p < 0.01). In the analysis of EPS, patients with DP showed a higher proportion of no response than patients without DP (60.0% vs. 11.4% in peroneal NCS, 35.0% vs. 2.3% in tibial NCS, 80.0% vs. 18.2% in SSEP, 87.5% vs. 22.7% in MEP, p < 0.01 respectively). Additionally, greater axonal loss, based on decrease of amplitude without delayed latency on NCS, was observed in the group with DP than opposite group (p < 0.01).ConclusionAmong subjects with subacute SCI, cases of peripheral nervous dysfunction below the injury site occur, possibly associated with the severity of SCI.
       
  • Taking the Next Steps in Regenerative Rehabilitation: Establishment of a
           New Interdisciplinary Field
    • Abstract: Publication date: Available online 5 February 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Nick J. Willett, Michael L. Boninger, Laura J. Miller, Luis Alvarez, Tomoki Aoyama, Marzia Bedoni, Kelley Ann Brix, Carmelo Chisari, George Christ, Christopher L. Dearth, Trevor A. Dyson-Hudson, Christopher H. Evans, Stephen M. Goldman, Kenton Gregory, Alice Gualerzi, Joseph Hart, Akira Ito, Hiroshi Kuroki, M. Terry Loghmani, David L. MackAbstractThe growing field of Regenerative Rehabilitation has great potential to improve clinical outcomes for individuals with disabilities. However, the science to elucidate the specific biological underpinnings of Regenerative Rehabilitation-based approaches is still in its infancy and critical questions regarding clinical translation and implementation still exist. In a recent roundtable discussion from International Consortium for Regenerative Rehabilitation (ICRR) stakeholders, key challenges to progress in the field were identified. The goal of this white paper is to summarize those discussions and to initiate a broader discussion among clinicians and scientists across the fields of regenerative medicine and rehabilitation science to ultimately progress Regenerative Rehabilitation from an emerging field to an established interdisciplinary one. Strategies and case studies from Consortium institutions—including interdisciplinary research centers, formalized courses, degree programs, international symposia, and collaborative grants—are presented. We propose that these strategic directions have the potential to engage and train clinical practitioners and basic scientists, transform clinical practice and, ultimately, optimize patient outcomes.
       
  • Archives of Physical Medicine and Rehabilitation and ACRM Recognize the
           Elizabeth and Sidney Licht Award Winner and Nominees for Excellence in
           Scientific Writing
    • Abstract: Publication date: Available online 30 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Sue Ann Sisto
       
  • ChrOnic pain self-ManagementMent support with pain science EducatioN and
           exerCisE (COMMENCE) for people with chronic pain and multiple
           comorbidities: A randomized controlled trial
    • Abstract: Publication date: Available online 29 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Jordan Miller, Joy C. MacDermid, David M. Walton, Julie RichardsonAbstractObjectiveTo investigate the effectiveness chronic pain self-management support with pain science education and exercise (COMMENCE) on improving function, pain interference, work status, pain intensity, fatigue, psychological factors associated with pain, health care visits, satisfaction, and perceived change compared to usual care.DesignParallel group randomized controlled trial with 1- and 12-week follow-ups.SettingCommunity health centre.ParticipantsAdults (n=102) with chronic non-cancer pain referred for self-management support. Eighty of 102 participants completed 12-week follow-up assessments. No participants withdrew with adverse events.InterventionsParticipants were randomized to COMMENCE or usual care.Main outcome measuresPrimary: Function measured using the Short Musculoskeletal Function Assessment (SMFA) – Dysfunction Index. Secondary: SMFA bother index, PROMIS pain interference, work status, numeric pain and fatigue rating scales, Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Pain Self-Efficacy Scale, Neurophysiology of Pain Questionnaire, number of healthcare visits, satisfaction, and global rating of change.ResultsCOMMENCE resulted in greater improvements in function [mean difference at 12-week follow-up (MD) = -8.0; 95%CI: -14.7 to -1.3), bother with functional difficulties (MD = -12.0; 95%CI: -20.8 to -3.2), pain intensity (MD = -1.0; 95%CI -2.1 to -0.1), catastrophizing (MD = -8.2; 95%CI: -14.5 to -2.0), self-efficacy (MD 7.0; 95%CI 0.8 to 13.2), knowledge (MD = 2.8; 95%CI: 1.6 to 3.9), satisfaction (MD = 1.2; 95%CI: 0.7 to 1.8) and perceived change (MD = 1.4; 95%CI: 0.8 to 2.1). There were no significant between group differences in pain interference, work, fatigue, depressive symptoms, or healthcare visits.ConclusionCOMMENCE is more effective than usual care at improving function, pain, catastrophic thinking, self-efficacy, pain knowledge, satisfaction, and perceived change, but not pain interference, work status, fatigue, depressive symptoms, or health care visits.
       
  • Changes in quality of life during training for the HandbikeBattle and
           associations with cardiorespiratory fitness
    • Abstract: Publication date: Available online 29 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Ingrid Kouwijzer, Sonja de Groot, Christel M.C. van Leeuwen, Linda J.M. Valent, Casper F. van Koppenhagen, Handbikebattle group, Lucas H.V. van der Woude, Marcel W.M. PostAbstractObjectiveTo investigate 1) changes in life satisfaction and mental health during 5 months of training for the HandbikeBattle and 4-months follow-up; 2) associations between changes in handcycling cardiorespiratory fitness and changes in life satisfaction and mental health during the training period.DesignMulticenter prospective cohort study with measurements: the start of the training (T1), after the 5-months training period, before the event (T2), after 4-months follow-up (T3). At T1, T2, and T3 questionnaires were filled out. At T1 and T2 a graded exercise test was performed to measure cardiorespiratory fitness (peak oxygen uptake (VO2peak) and peak power output (POpeak)).SettingTen Dutch rehabilitation centers training for the HandbikeBattle event.ParticipantsFormer rehabilitation patients (N=136) with health conditions such as spinal cord injury, amputation, or multi trauma.InterventionsNot applicable.Main outcome measureLife satisfaction as the sum score of two questions (range 2-13), and SF-36 Mental Health Index (range 0-100).ResultsMultilevel regression analyses showed that life satisfaction increased during the training period and did not significantly change during follow-up (T1: 8.2 ± 2.2, T2: 8.6 ± 2.3, T3: 8.5 ± 2.4). Mental health showed no change over time (T1: 77.7 ± 14.5, T2: 77.8 ± 14.5, T3: 75.7 ± 16.5). An improvement in cardiorespiratory fitness was associated with an increase in life satisfaction (POpeak: ß=0.014, p=0.046, VO2peak: ß=1.068, p=0.04). There were no associations between improvement in cardiorespiratory fitness and an increase in mental health (POpeak: p=0.66, VO2peak: p=0.33).ConclusionsThis study shows a positive course of life satisfaction during training for the HandbikeBattle. An improvement in cardiorespiratory fitness was longitudinally associated with an increase in life satisfaction. Mental health showed no changes over time.
       
  • +in+the+Private+Sector:+Education+Page+and+Resources+for+Health+Care+Providers&rft.title=Archives+of+Physical+Medicine+and+Rehabilitation&rft.issn=0003-9993&rft.date=&rft.volume=">Treating Military Spouses ∗ in the Private Sector: Education Page and
           Resources for Health Care Providers
    • Abstract: Publication date: Available online 28 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Catherine Ling, Larry Cervelli, Alison M. Cogan, Alicia Gill Rossiter
       
  • Post-stroke fatigue and daily activity patterns during outpatient
           rehabilitation: An experience sampling method study
    • Abstract: Publication date: Available online 28 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Bert Lenaert, Mathea Neijmeijer, Nadine van Kampen, Caroline van Heugten, Rudolf PondsAbstractObjectiveTo advance our understanding of post-stroke fatigue by investigating its momentary and time-lagged relationship with daily activitiesDesignLongitudinal observational study using the experience sampling method (ESM)SettingOutpatient rehabilitation careParticipantsThirty individuals with strokeInterventionsNot applicableMain outcome measuresESM is a structured diary method that allows assessing real-time symptoms, behavior, and environment characteristics in the flow of daily life, thereby capturing moment-to-moment variations in fatigue and related factors. Using the mHealth mobile application PsyMateTM, individuals with stroke were followed during six consecutive days, and were prompted at 10 random moments daily to fill in a digital questionnaire about their momentary fatigue and current activity: type of activity, perceived effort and enjoyment, and physical activity levels.ResultsBased on all completed digital questionnaires (N = 1013), multilevel regression analyses showed that fatigue was significantly associated with type of activity and that fatigue was higher when participants had engaged in physical activity. Fatigue was also higher during activities perceived as more effortful and during less enjoyable activities. Time-lagged analyses showed that fatigue was also predicted by physical activity and perceived effort earlier during the day. Importantly, the relationship between these daily activity characteristics and fatigue differed substantially across individuals.ConclusionsThis study illustrates the need for ESM to design personalized rehabilitation programs and to capture fatigue and other patient reported outcomes in daily life.
       
  • Home-based Upper Extremity Stroke Therapy Using a Multiuser Virtual
           Reality Environment: A Randomized Trial
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Kelly O. Thielbar, Kristen M. Triandafilou, Alexander J. Barry, Ning Yuan, Arthur Nishimoto, Joelle Johnson, Mary Ellen Stoykov, Daria Tsoupikova, Derek G. KamperAbstractObjectiveTo compare participation and subjective experience of participants in both home-based multiuser virtual reality (VR) therapy and home-based single-user (SU) VR therapy.DesignCrossover, randomized trial.SettingInitial training and evaluations occurred in a rehabilitation hospital; the interventions took place in participants’ homes.ParticipantsSurvivors of stroke with chronic upper extremity impairment (N=20).InterventionsFour weeks of in-home treatment using a custom, multiuser virtual reality system (VERGE): 2 weeks of both multiuser (MU) and SU versions of VERGE. The order of presentation of SU and MU versions was randomized such that participants were divided into 2 groups, First MU and First SU.Main Outcome MeasuresWe measured arm displacement during each session (m) as the primary outcome measure. Secondary outcome measures include time participants spent using each MU and SU VERGE and Intrinsic Motivation Inventory scores. Fugl-Meyer Assessment of Motor Recovery After Stroke Upper Extremity (FMA-UE) score and compliance with prescribed training were also evaluated. Measures were recorded before, midway, and after the treatment. Activity and movement were measured during each training session.ResultsArm displacement during a session was significantly affected the mode of therapy (MU: 414.6m, SU: 327.0m, P=.019). Compliance was very high (99% compliance for MU mode and 89% for SU mode). Within a given session, participants spent significantly more time training in the MU mode than in the SU mode (P=.04). FMA-UE score improved significantly across all participants (Δ3.2, P=.001).ConclusionsMultiuser VR exercises may provide an effective means of extending clinical therapy into the home.
       
  • Information/Education Pages (I/EPs)
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s):
       
  • The Archives of Physical Medicine and Rehabilitation at 100: Its
           Development Set in Historical Context
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Marcel P. DijkersAbstractThe Archives of Physical Medicine and Rehabilitation was born as a radiology journal, and over its century of existence it has gone through various names and owners while shifting its contents from radiology to physical medicine to physical medicine and rehabilitation. These developments are sketched in light of the growth and eventual merger of physical medicine and rehabilitation in the United States and societal historical developments in the United States and elsewhere.
       
  • Systematic Review and Meta-Analysis of Home-Based Rehabilitation on
           Improving Physical Function Among Home-Dwelling Patients With a Stroke
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Nai-Fang Chi, Yi-Chieh Huang, Hsiao-Yean Chiu, Hsiu-Ju Chang, Hui-Chuan HuangAbstractObjectiveTo evaluate the effects of home-based rehabilitation on improving physical function in home-dwelling patients after a stroke.Data SourcesVarious electronic databases, including PubMed, Cumulative Index to Nursing and Allied Health, Embase, the Cochrane Central Register of Controlled Trials, and 2 Chinese data sets (ie, Chinese Electronic Periodical Services and China Knowledge Resource Integrated) were searched for studies published before March 20, 2019.Study SelectionRandomized controlled trials conducted to examine the effect of home-based rehabilitation on improving physical function in home-dwelling patients with a stroke and published in English or Chinese were included. In total, 49 articles in English (n=23) and Chinese (n=26) met the inclusion criteria.Data ExtractionData related to patient characteristics, study characteristics, intervention details, and outcomes were extracted by 2 independent reviewers.Data SynthesisA random-effects model with a sensitivity analysis showed that home-based rehabilitation exerted moderate improvements on physical function in home-dwelling patients with a stroke (g=0.58; 95% CI, 0.45∼0.70). Moderator analyses revealed that those patients with stroke of a younger age, of male sex, with a first-ever stroke episode, in the acute stage, and receiving rehabilitation training from their caregiver showed greater improvements in physical function.ConclusionsHome rehabilitation can improve functional outcome in survivors of stroke and should be considered appropriate during discharge planning if continuation care is required.
       
  • Conservative Interventions Reduce Fear in Individuals With Chronic Low
           Back Pain: A Systematic Review
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Javier Martinez-Calderon, Mar Flores-Cortes, Jose Miguel Morales-Asencio, Alejandro Luque-SuarezAbstractObjectiveTo systematically review and critically appraise the effectiveness of conservative and surgical interventions to reduce fear in studies of people with chronic low back pain, based on the analysis of randomized controlled trials for which fear was a primary or secondary outcome.Data SourcesElectronic databases PubMed, CINAHL, PsycINFO, PEDro, and CENTRAL, as well as manual searches and grey literature were searched from inception until May 2019.Study SelectionRandomized controlled trials analyzing the effectiveness of conservative and surgical interventions to reduce fear were included.Data ExtractionTwo reviewers independently conducted the search strategy, study selection, data extraction, risk of bias assessment, and quality of the evidence judgment.Data SynthesisSixty-one studies (n=7201) were included. A large number of fear-related search terms were used but only 3 fear constructs (kinesiophobia, fear-avoidance beliefs, fear of falling) were measured in the included studies. Multidisciplinary and psychological interventions as well as exercise reduced kinesiophobia. Fear-avoidance beliefs were reduced by the aforementioned interventions, manual therapy, and electrotherapy. A multidisciplinary intervention reduced the fear of falling. There was moderate evidence of multidisciplinary interventions and exercise to reduce kinesiophobia. There was moderate evidence of manual therapy and electrotherapy to reduce fear-avoidance beliefs.ConclusionsThe present systematic review highlights the potential effectiveness of conservative interventions to reduce kinesiophobia and fear-avoidance beliefs in individuals with chronic low back pain. This information can help health professionals to reduce fear when treating patients with this condition.
       
  • Effects of a Robot-Assisted Arm Training Plus Hand Functional Electrical
           Stimulation on Recovery After Stroke: A Randomized Clinical Trial
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Sofia Straudi, Andrea Baroni, Sonia Mele, Laila Craighero, Fabio Manfredini, Nicola Lamberti, Elisa Maietti, Nino BasagliaAbstractObjectiveTo compare the effects of unilateral, proximal arm robot-assisted therapy combined with hand functional electrical stimulation with intensive conventional therapy for restoring arm function in survivors of subacute stroke.DesignThis was a single-blinded, randomized controlled trial.SettingInpatient rehabilitation university hospital.ParticipantsPatients (N=40) diagnosed as having ischemic stroke (time since stroke
       
  • PROMIS Physical Function Short Forms Display Item- and Scale-Level
           Characteristics at Least as Good as the Roland Morris Disability
           Questionnaire in Patients With Chronic Low Back Pain
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Alessandro Chiarotto, Leo D. Roorda, Martine H. Crins, Maarten Boers, Raymond W. Ostelo, Caroline B. TerweeAbstractObjectiveTo compare dimensionality, item-level characteristics, scale-level reliability, and construct validity of PROMIS Physical Function short forms (PROMIS-PF) and 24-item Roland Morris Disability Questionnaire (RMDQ-24) in patients with chronic low back pain (LBP).DesignCross-sectional study.SettingSecondary care center for rehabilitation and rheumatology.ParticipantsPatients with nonspecific LBP ≥3 months (N=768). Mean age was 49±13 years, 77% were female, and 54% displayed pain for more than 5 years.InterventionsNot applicable.Main Outcome MeasuresDutch versions of the 4-, 6-, 8-, 10-, and 20-item PROMIS-PF and of the RMDQ-24.ResultsPROMIS-PF-6, PROMIS-PF-8, and RMDQ-24 exhibited sufficient unidimensionality (confirmatory factor analysis: comparative fit index>0.950, Tucker-Lewis index>0.950, root means square error of approximation.001). Two-parameter item response theory models found 2 items with low discrimination for RMDQ-24. All other instruments had adequate fit statistics and item parameters. PROMIS-PF-20 displayed the best scale-level reliability. Construct validity was sufficient for all instruments as all hypotheses on expected correlations with other instruments and differences between relevant subgroups were met.ConclusionsPROMIS-PF-6, PROMIS-PF-8, and RMDQ-24 exhibited better unidimensionality, whereas PROMIS-PF-4, PROMIS-PF-6, PROMIS-PF-8, and PROMIS-PF-10 showed superior item-level characteristics. PROMIS-PF-20 was the instrument with the best scale-level reliability. This study warrants assessment of other measurement properties of PROMIS-PF short forms in comparison with disease-specific physical functioning instruments in LBP.
       
  • Assessing the Validity and Reliability of a New Video Goniometer App for
           Measuring Joint Angles in Adults and Children
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Andrea Baraldi Cunha, Iryna Babik, Regina Harbourne, Nathanial J. Cochran, Jaclynn Stankus, Kimberly Szucs, Michele A. LoboAbstractObjectiveTo assess the convergent validity and reliability of joint angle measurements from a new video goniometer iPhone/iPad application separately in adults, older and young children.DesignCross-sectional.SettingChild care and university environments.ParticipantsFifty-four adults (mean ± SD=22.5±4.5y), 20 older children (mean ± SD=10.9±2.2y), 20 younger children (mean ± SD=1.6±0.8y) (N=94).InterventionsAdults and older children performed both standardized static positions and functional activities. Younger children performed only a functional activity protocol.Main Outcome MeasuresJoint angle measurements using the app were validated against a commercially validated two-dimensional goniometric software program. In addition, validity of the app was compared to a standard mechanical goniometer for the measurement of angles drawn on a white board. Intra- and interrater reliability were assessed through independent rescoring of videos.ResultsCorrelations between joint angle estimates obtained from the app and goniometer software or a mechanical goniometer were positive and very strong (r>.900; P.900).ConclusionsHigh correlations for repeated measures and comparison to gold standard angle measurement instruments suggest that the new app is a valid and reliable tool for assessing joint angles during functional activity. This tool may provide clinicians an inexpensive yet accurate method for quantification of movements and immediate feedback on range of motion during tasks in a natural environment.
       
  • Added Value of Gluteus Medius and Quadratus Lumborum Dry Needling in
           Improving Knee Pain and Function in Female Athletes With Patellofemoral
           Pain Syndrome: A Randomized Clinical Trial
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Hanieh Zarei, Soha Bervis, Soraya Piroozi, Alireza MoteallehAbstractObjectiveTo compare the effects of exercise therapy alone and exercise therapy plus gluteus medius (GM) and quadratus lumbarum (QL) dry needling on pain and function in female athletes with patellofemoral pain (PFP).DesignSingle-blind randomized controlled trial with follow-up.SettingPhysiotherapy clinic.ParticipantsConvenience sample of female athletes with PFP (N=40), who were randomly assigned to the exercise therapy (Ex group) or exercise-therapy+dry needling (Ex+DN group) group.InterventionsThe Ex group received exercise therapy for 4 weeks, and the Ex+DN group received exercise therapy in combination with dry needling directed at GM and QL trigger points for 4 weeks.Main Outcome MeasuresIn all participants, pain intensity, function (Kujala score, modified star excursion balance test, step-down test), and QL and GM pressure pain threshold (PPT) were recorded at baseline and at 4 and 6 weeks after the start of treatment. Analysis of variance (2 groups×3 times) was used to compare within- and between-group differences.ResultsThe group versus time interaction effect was significant for all variables (P
       
  • Cerebellar White Matter Damage Is Associated With Postural Sway Deficits
           in People With Multiple Sclerosis
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Geetanjali Gera, Brett W. Fling, Fay B. HorakAbstractObjectiveTo assess how postural sway deficits during eyes open and closed relate to the integrity of cerebellar peduncles in individuals with multiple sclerosis (MS).DesignCross-sectional study.SettingLaboratory based setting.ParticipantsTwenty-nine adults with MS (Expanded Disability Status Scale: 2-4) and 15 adults without MS were recruited (N=44). Inclusion criteria for all participants were ability to maintain balance independently by standing on toes for 3 seconds, and no known biomechanical conditions affecting balance.InterventionsNot applicable.Main Outcome MeasuresPostural sway using body-worn, inertial sensors during quiet standing, integrity of cerebellar peduncles quantified using diffusion-tensor imaging and clinical assessment scales for ataxia and balance.ResultsRadial diffusivity of the inferior cerebellar peduncle was related to postural sway measures during both eyes open and closed. In contrast, radial diffusivity of the superior cerebellar peduncle was related to postural sway only in stance with eyes open.ConclusionsThe inferior cerebellar peduncle, which carries somatosensory information to the cerebellum, contributes to control of standing balance with or without visual inputs, consistent with the high dependence on somatosensory information for posture. The superior cerebellar peduncle, which carries cortical information to the cerebellum, contributes to control of standing posture only when vision is available. Radial diffusivity of the inferior cerebellar peduncle was related to reactive balance control, whereas radial diffusivity of the superior cerebellar peduncle was related to the kinetic component of the ataxia rating scale.
       
  • Effects of the Use of Anchor Systems in the Rehabilitation of Dynamic
           Balance and Gait in Individuals With Chronic Dizziness of Peripheral
           Vestibular Origin: A Single-Blinded, Randomized, Controlled Clinical Trial
           
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Almir R. Coelho, Rafaela C. Fontes, Renato Moraes, Camila de G.C. Barros, Daniela C.C. de AbreuAbstractObjectiveTo assess the effectiveness of the anchors in the balance rehabilitation of participants with chronic peripheral vestibulopathy who failed to respond positively to conventional rehabilitation for dynamic balance and gait.DesignAssessor-blind, randomized controlled trial.SettingDepartment of Otoneurology and Laboratory of Assessment and Rehabilitation of Equilibrium.ParticipantsWomen with chronic dizziness of peripheral vestibular origin (N=42), who continued to show otoneurologic symptoms for more than 6 months after starting classic vestibular rehabilitation, with no clinical improvement observed.InterventionsParticipants were randomly assigned to receive a clinical intervention with the anchor system, a clinical intervention without the anchor system, or no intervention or anchor system. The intervention was based on multi-sensory exercises for 6 weeks, twice a week, totaling 12 sessions, in groups of up to 4 participants, with an average time of 40 minutes per session.Main Outcome MeasuresThe primary outcome was functional balance as assessed by the short version of the Balance Evaluation Systems Test. The secondary outcomes were gait parameters of step width in meters, step length in meters, and gait speed in meters per second. The measures were assessed preintervention and postintervention, and after a 3-month follow-up period.ResultsThe proposed intervention was beneficial for dizziness, balance, and gait for both groups studied. At the 3-month follow-up, only the group that used anchors retained the benefits related to the physical aspects of dizziness, balance, and gait.ConclusionsThe present study found that the proposed intervention protocol, with or without the use of anchors, was beneficial for improving the dizziness, balance, and gait. However, retention of the benefits achieved through the exercise protocol was observed only for those using the anchor system, which promotes the use of haptic information. The use of anchors was effective, in short protocols (12wk), with maintenance of results after 3 months.
       
  • Poststroke Postural Sway Improved by Botulinum Toxin: A Multicenter
           Randomized Double-blind Controlled Trial
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Marjorie Kerzoncuf, Jean-Michel Viton, Frédéric Pellas, Maeva Cotinat, Paul Calmels, Virginie Milhe de Bovis, Alain Delarque, Laurent BensoussanAbstractObjectiveTo assess the effects of injecting botulinum toxin into the lower limb muscles of people with hemiparesis post stroke in terms of their sway areas.DesignA multicenter randomized double-blind trial on the effects of active botulinum toxin treatment vs placebo.SettingClinical examinations and postural sway assessments were performed before botulinum toxin injection and again 4-6 weeks after the injection.ParticipantsPeople with hemiparesis with chronic post stroke lower limb spasticity (N=40).InterventionsIntramuscular injection of a placebo (physiological serum) was performed on the control group, and botulinum toxin injections were performed on the treatment group. Participants and physical and rehabilitation medicine specialists were given no information as to which of the 2 treatments was applied.Main Outcome MeasuresThe sway area of the center of pressure was recorded for 30 seconds in 3 conditions: eyes open, eyes open in a dual task (a postural control task combined with an arithmetic task), and eyes closed. Spasticity was measured using the Modified Ashworth Scale.ResultsForty people post stroke were enrolled and randomized into 2 groups, one of which was treated with botulinum toxin (n=19) and the other with placebo (n=21). Spasticity decreased significantly in the treatment group (−0.7, P=.049 in the soleus muscles; −0.8, P=.035 in the gastrocnemii muscles). The sway area did not differ significantly between the 2 groups before treatment. The most conspicuous effect was observed in the case of the dual task, where a significant decrease (P=.005) in the sway area occurred in the treatment group (−3.11±6.92) in comparison with the placebo group (+0.27±3.57).ConclusionTreating spasticity by injecting botulinum toxin into people’s lower limb muscles post stroke seems to improve their postural sway. The dual task used here to assess sway seems to be a useful, sensitive test for this purpose.
       
  • Video-Based Pairwise Comparison: Enabling the Development of Automated
           Rating of Motor Dysfunction in Multiple Sclerosis
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Jessica Burggraaff, Jonas Dorn, Marcus D'Souza, Cecily Morrison, Christian P. Kamm, Peter Kontschieder, Prejaas Tewarie, Saskia Steinheimer, Abigail Sellen, Frank Dahlke, Ludwig Kappos, Bernard UitdehaagAbstractObjectivesTo examine the feasibility, reliability, granularity, and convergent validity of a video-based pairwise comparison technique that uses algorithmic support to enable automated rating of motor dysfunction in patients with multiple sclerosis (MS).DesignFeasibility and larger cross-sectional cohort study.SettingThe outpatient clinic of 2 specialist university medical centers.ParticipantsSelected sample from a cohort of patients with MS participating in the Assess MS study (N=42). Videos were randomly drawn from each strata of the ataxia severity-degrees as defined in the Expanded Disability Status Scale (EDSS). In Basel: 19 videos of 17 patients (mean age, 43.4±11.6y; 10 women). In Amsterdam: 50 videos of 25 patients (mean age, 50.0±10.0y; 15 women).InterventionsNot applicable.Main Outcome MeasuresIn each center, neurologists (n=13; n=10) viewed pairs of videos of patients performing standardized movements (eg, finger-to-nose test) to assess relative performance. A comparative assessment score was calculated for each video using the TrueSkill algorithm and analyzed for intrarater (test-retest; ratio of agreement) and interrater reliability (intraclass correlation coefficient [ICC] for absolute agreement) and convergent validity (Spearman ρ). Granularity was estimated from the average difference in comparative assessment scores at which 80% of neurologists considered performance to be different.ResultsIntrarater reliability was excellent (median ratio of agreement≥0.87). The comparative assessment scores calculated from individual neurologists demonstrated good-excellent ICCs for interrater reliability (0.89; 0.71). The comparative assessment scores correlated (very) highly with their Neurostatus-EDSS equivalent (ρ=0.78, P
       
  • Subgroups Defined by the Montreal Cognitive Assessment Differ in
           Functional Gain During Acute Inpatient Stroke Rehabilitation
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Abhishek Jaywant, Joan Toglia, Faith M. Gunning, Michael W. O’DellAbstractObjectiveTo validate subgroups of cognitive impairment on the Montreal Cognitive Assessment (MoCA)—defined as normal (score of 25-30), mildly impaired (score of 20-24), and moderately impaired (score less than 19)—by determining whether they differ in rehabilitation gain during inpatient stroke rehabilitation.DesignObservational study. Linear regression models were conducted and predictors included MoCA subgroups and relevant baseline demographic and clinical covariates. Separate models included the cognitive subscale of the FIM instrument as a predictor.SettingInpatient rehabilitation facility of an urban, academic medical center.ParticipantsInpatients (N=334) with mild-moderate strokes who were administered the MoCA on admission.InterventionsNot applicable.Main Outcome MeasuresThe mean relative functional gain (mRFG) and mean relative functional efficiency (mRFE, which adjusts for length of stay) on the FIM total.ResultsMoCA subgroups significantly predicted mRFG and mRFE after accounting for age, sex, education, stroke severity, and recurrent vs first stroke. The normal group exhibited greater mRFG and mRFE than the mildly impaired group, while the moderately impaired group had significantly worse mRFG and mRFE than the mildly impaired group. The moderately impaired group had a significantly smaller proportion of individuals who made a clinically meaningful change on the total-FIM than the mildly impaired and normal groups. MoCA subgroups better accounted for mRFG and mRFE than a standard-of-care cognitive assessment (cognitive-FIM).ConclusionsUse of MoCA-defined subgroups can assist providers in predicting functional gain in survivors of stroke being treated in inpatient rehabilitation.
       
  • Acute and Chronic Pain in Children and Adolescents With Cerebral Palsy:
           Prevalence, Interference, and Management
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Katarina Ostojic, Simon Paget, Maria Kyriagis, Angela MorrowAbstractObjectiveTo determine the prevalence, interference, and management of acute and chronic pain among youth with cerebral palsy (CP) aged 5-18 years attending outpatient rehabilitation services.DesignA cross-sectional study using the Faces Pain Scale-Revised, Patient Reporting Outcomes Measurement Information System Pediatric Pain Interference Scale, and the Cerebral Palsy Quality of Life questionnaire. Where children were unable to self-report, parent or caregiver proxy was obtained.SettingOutpatient rehabilitation.ParticipantsParticipants (N=280) with CP aged 5-18 years and their parent or caregiver. Self-report was obtained by 45.7% (n=128) and proxy-report was obtained by 54.3% (n=152) of the cohort.InterventionsNot applicable.Main Outcome MeasuresPresence or absence of acute pain and chronic pain. Secondary measures were pain intensity, pain interference, pain management, and quality of life.ResultsAcute pain and chronic pain were reported by 67.1% and 31.4% of participants, respectively. Of those reporting acute pain, 42% also experienced chronic pain. Factors that increased the odds of chronic pain were: predominately dyskinesia (odds ratio [OR]=3.52; 95% confidence interval [CI], 1.64-7.55); mixed spasticity-dyskinesia (OR=1.93; 95% CI, 1.07-3.47); bilateral involvement (OR=3.22; 95% CI, 1.844-5.61) and Gross Motor Function Classification System level IV (OR=2.32; 95% CI, 1.02-5.25), and V (OR=3.73; 95% CI, 1.70-8.20). Pain frequently interferes with sleep, attention, ability to have fun, and quality of life. Short-acting pharmacologic analgesics, thermotherapy, hydrotherapy, and massage were commonly used for pain management.ConclusionsRoutine screening for pain is critical for early identification and intervention. Multimodal interventions are needed to address the biopsychosocial model of pain, and should be tailored for all abilities across the CP spectrum.
       
  • Low-Intensity vs High-Intensity Home-Based Treadmill Training and Walking
           Attainment in Young Children With Spastic Diplegic Cerebral Palsy
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Katrin Mattern-Baxter, Julia Looper, Chuan Zhou, Kristie BjornsonAbstractObjectiveTo compare the effect of low-intensity (LI) vs high-intensity (HI) treadmill training (TT) on walking attainment and overall walking activity in children with cerebral palsy (CP).DesignProspective, multisite, randomized controlled trial.SettingHomes of the participants.ParticipantsChildren with spastic diplegic CP, Gross Motor Function Classification System Level I and II, ages 14-32 months (N=19; male, n=8).InterventionsThe children were randomized to LI TT (2×/wk for 6wk) (n=10) and HI TT (10×/wk for 6wk) (n=9). The TT was carried out by the families with weekly instruction by the researchers.Main Outcome MeasuresChildren were assessed at study onset, post intervention, and 1 and 4 months post intervention with the Gross Motor Function Measure Dimension D/E (GMFM D/E), average strides per day and percentage of time spent walking with accelerometers, the Peabody Developmental Motor Scales-2 (PDMS-2), Pediatric Evaluation of Disability Index Mobility Scale, timed 10-m and 1-minute walk test, and Functional Mobility Scale. Blinding was conducted for GMFM D/E and PDMS-2. Linear mixed effects regression models were applied to all outcomes.ResultsNo significant between-group differences were found in any outcome measure at any of the time points. Children in the HI group did not show significant improvement immediately following the intervention in GMFM E (P=.061), while children in the LI group did (P=.003), but no statistically significant differences were detected over time (P=.71). Children in the HI group showed better walking independence on the Functional Mobility Scale at all postintervention assessments.ConclusionsA twice-weekly dosage was equally effective in improving skills related to walking compared with a 10×/wk program and can be more readily implemented into clinical practice.
       
  • Management of Concussion and Mild Traumatic Brain Injury: A Synthesis of
           Practice Guidelines
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Noah D. Silverberg, Mary Alexis Iaccarino, William J. Panenka, Grant L. Iverson, Karen L. McCulloch, Kristen Dams-O’Connor, Nick Reed, Michael McCrea, Alison M. Cogan, Min Jeong Park Graf, Maria Kajankova, Gary McKinney, Christina Weyer JamoraAbstractAt least 3 million Americans sustain a mild traumatic brain injury (mTBI) each year, and 1 in 5 have symptoms that persist beyond 1 month. Standards of mTBI care have evolved rapidly, with numerous expert consensus statements and clinical practice guidelines published in the last 5 years. This Special Communication synthesizes recent expert consensus statements and evidenced-based clinical practice guidelines for civilians, athletes, military, and pediatric populations for clinicians practicing outside of specialty mTBI clinics, including primary care providers. The article offers guidance on key clinical decisions in mTBI care and highlights priority interventions that can be initiated in primary care to prevent chronicity.
       
  • Randomized Controlled Trial of the Lateral Push-Off Skater Exercise for
           High-Intensity Interval Training vs Conventional Treadmill Training
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s): Soo-Hyun Soh, Min Cheol Joo, Na Ri Yun, Min-Su KimAbstractObjectiveTo examine the therapeutic effects of the lateral push-off skater exercise vs conventional treadmill training on health-related quality of life, cardiorespiratory fitness (CRF), and balance.DesignSingle-blinded, randomized controlled trial.SettingOutpatient clinic at a tertiary hospital.ParticipantsPatients after minor stroke (N=36) with National Institutes of Health Stroke Scale scores≤3 between 20 and 65 years of age were randomly assigned to the intervention group (n=18) or the control group (n=18).InterventionsThirty-minute sessions of the skater exercise were performed 3 times weekly for 12 weeks in the intervention group. Conventional treadmill aerobic exercise was conducted in the control group at the same frequency and duration as the experimental group exercise.Main Outcome MeasuresThe primary outcome was measured using the European Quality of Life–5 Dimension (EQ-5D). Secondary outcomes included CRF and balance indicators. Assessments were performed at baseline (T0), 12 weeks from T0 (T1), and 16 weeks from T0 (T2).ResultsSignificant improvements in EQ-5D, peak oxygen uptake (VO2peak), peak oxygen pulse, peak minute ventilation (VE), Dynamic Gait Index (DGI), and Berg Balance Scale (BBS) were found in the intervention group after performing the skater exercise (P
       
  • Editors' Selections From This Issue: Volume 101 / Number 2 / February 2020
    • Abstract: Publication date: February 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 2Author(s):
       
  • Relative Effectiveness of Electroacupuncture and Biofeedback in Treatment
           of Neck and Upper Back Myofascial Pain: a Randomized Clinical Trial"
    • Abstract: Publication date: Available online 16 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Fariba Eslamian, Fatemeh Jahanjou, Neda Dolatkhah, Alireza Pishgahi, Ali PiraniAbstractObjectiveTo determine the differences between clinical effects of electro-acupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical Myofascial Pain Syndrome (MPS).DesignRandomized clinical trial.SettingPhysical medicine and rehabilitation clinic of a university hospital.Participants50 patients aged 25-55 years old of both genders with chronic neck pain diagnosed to have MPS (characterized by trigger points within taut bands) were randomly assigned into two equal groups of 25 individuals.InterventionsThe patients in electroacupuncture group were treated with standard acupuncture concomitant electrical stimulation and those in biofeedback group received visual EMG-biofeedback therapy for muscle activity and relaxation. Both groups received the intervention 2 times a week for a total of 6 sessions. Basic exercise trainings and medicines were administered for all the patients.Outcome MeasuresPain severity based on Visual Analogue Scale (VAS), functional status using Neck Disability Index (NDI), cervical Range of Motion (ROM) using inclinometer and Pressure Pain Threshold (PPT) using algometer were evaluated before and at 3 and 12 weeks after the treatment. Primary outcome was defined as 20% reduction in the 3-month neck pain and dysfunction compared to baseline, assessed through NDI.Results50 patients (39 women, 11 men) with an average age of 39.0 (5.5) years old and neck pain duration of 6.0(2.2) weeks were analyzed. All parameters, except for PPT of lower trapezius and paravertebral muscles were improved significantly in both groups, while baseline values were controlled. Achieving primary outcome was significantly more in acupuncture group compared to biofeedback group: 20 (80.0%) versus 10 (40.0%); RR = 2 with 95% CI = 1.19 to 3.36; NNT = 2.5 with 95% CI = 1.54 to 6.58. Advantages of the acupuncture over biofeedback were observed according to values obtained from NDI,VAS, extension and left lateral bending ROM and PPT on left upper trapezius after the last session of intervention until 3 months (P < 0.05).ConclusionBoth electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters versus biofeedback. Thus, electro-acupuncture seems to be a better complementary modality for treatment of MPS in neck and upper back area.
       
  • A Standard Method for Determining the Minimal Clinically Important
           Difference for Rehabilitation Measures
    • Abstract: Publication date: Available online 15 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): James F. Malec, Jessica M. KetchumAbstractThe Minimal Clinically Important Difference (MCID) is receiving increasing interest and importance in medical practice and research. The MCID is the smallest improvement in scores in the domain of interest which patients perceive as beneficial. In clinical trials, comparing the proportion of individuals between treatment and control groups who obtain a MCID may be more informative than comparisons of mean change between groups since a statistically significant mean difference does not necessarily represent a difference that is perceived as meaningful by treatment recipients. The MCID may also be useful in advancing personalized medicine by characterizing those who are most likely to benefit from a treatment. In clinical practice, the MCID can be used to identify if a participant is experiencing a meaningful change in status.A variety of methods have been used to determine the MCID with no clear agreement on the most appropriate approach. Two major sets of methods are either (1) distribution-based, i.e., referencing the MCID to a measure of variability or effect size in the measure of interest, or (2) anchor-based, i.e., referencing the MCID to an external assessment of change in the condition, ability, or activity represented by the measure of interest. In prior literature, using multiple methods to “triangulate” on the value of the MCID has been proposed. In this commentary, we describe a systematic approach to triangulate on the MCID using both distribution-based and anchor-based methods. Adaptation of a systematic approach for obtaining the MCID in rehabilitation would facilitate communication and comparison of results among rehabilitation researchers and providers.
       
  • Effects of Geriatric Interdisciplinary Home Rehabilitation on Independence
           in Activities of Daily Living in Older People with Hip Fracture: A
           Randomized Controlled Trial.
    • Abstract: Publication date: Available online 11 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Åsa Karlsson, Nina Lindelöf, Birgitta Olofsson, Monica Berggren, Yngve Gustafson, Peter Nordström, Michael StenvallAbstractObjectiveTo evaluate the effects of early discharge followed by geriatric interdisciplinary home rehabilitation for older people with hip fracture on independence in Activities of Daily Living (ADLs) compared with in-hospital geriatric care according to a multifactorial rehabilitation program.DesignPre-planned analysis of a randomized controlled trial with 3 and 12 month follow-ups.SettingGeriatric ward, ordinary housing and residential care facilities.ParticipantsOf 466 people screened for eligibility, 205 participants with acute hip fracture, aged 70 or older, including those with cognitive impairment, and those living in residential care facilities, were randomized to intervention or control groups.InterventionIndividually designed interdisciplinary home rehabilitation for a maximum of 10 weeks. The intervention aimed at early hospital discharge and focused on prevention of falls, independence in daily activities, and walking ability indoors and outdoors.Main Outcome MeasuresIndependence in ADLs was measured using the Barthel ADL Index, and the ADL Staircase including the Katz ADL Index. during hospital stay (pre-fracture performance) and at the follow-ups in the participants’ homes.ResultsThere were no significant differences in ADL performance between the groups, and they recovered their pre-fracture level of independence in personal and instrumental ADLs comparably. At 12 months, 33 (41.3%) in intervention group vs 33 (41.8%) in control group (p = 1.000) had regained or improved their pre-fracture ADL performance according to the Barthel ADL Index, and 27 (37.0%) vs 36 (48.6%) according to the ADL Staircase (p = 0.207).ConclusionsIn older people with hip fracture, early discharge followed by geriatric interdisciplinary home rehabilitation resulted in comparable recovery of independence in ADLs at 3 and 12 months as in-hospital geriatric care and rehabilitation.
       
  • Acute hemodynamic effects of virtual reality based-therapy in patients of
           cardiovascular rehabilitation: cluster randomized crossover trial
    • Abstract: Publication date: Available online 8 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Mayara Moura Alves da Cruz, Ana Laura Ricci-Vitor, Giovanna Lombardi Bonini Borges, Paula Fernanda da Silva, Felipe Ribeiro, Luiz Carlos Marques VanderleiAbstractObjectiveto analyze the acute hemodynamic effects of adding VRBT using exergames for cardiac patients undergoing CR.Designcrossover trial.Settingoutpatient rehabilitation center.Participantspatients (n=27, 63.4±12.7y, 29.0±4.0kg/m2) with a diagnosis of cardiovascular disease or cardiovascular risk factors.Interventions: patients performed one VRBT session and one CR session on two nonconsecutive days. Each session comprised an initial rest, warm-up, conditioning, and recovery. During warm-up, in the VRBT session, games were performed with sensors to reproduce the movements of avatars and in the CR session patients were required to reproduce the movements of the physiotherapists. In the conditioning phase for VRBT, games were also played with motion sensors, dumbbells, and shin guards and the CR session consisted of exercise performed on a treadmill. The intensity of training was prescribed by HR reserve (40-70%).Main Outcome MeasuresThe primary outcomes were heart rate (HR), blood pressure, respiratory rate (RR), rating of perceived exertion (RPE), and peripheral oxygen saturation, evaluated before, during, and after the VRBT or CR session on two non-consecutive days. The secondary outcome was to evaluate whether the patients achieved the prescribed HRR and the percentage of time they maintained this level during the VRBT session.ResultsVRBT produces a physiological similar pattern of acute hemodynamic effects to CR. However, there was greater magnitude of HR, RR, and RPE (p
       
  • Associations of hospital discharge services with potentially avoidable
           readmissions within 30 days among older adults after rehabilitation in
           acute care hospitals in Tokyo, Japan
    • Abstract: Publication date: Available online 7 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Seigo Mitsutake, Tatsuro Ishizaki, Rumiko Tsuchiya-Ito, Kazuaki Uda, Chie Teramoto, Sayuri Shimizu, Hideki ItoAbstractObjectiveTo examine the associations of three major hospital discharge services covered under health insurance (discharge planning, rehabilitation discharge instruction, and coordination with community care) with potentially avoidable readmissions within 30 days (30-day PAR) in older adults after rehabilitation in acute care hospitals in Tokyo, Japan.DesignRetrospective cohort study using a large-scale medical claims database of all Tokyo residents aged ≥75 years.SettingAcute care hospitalsParticipantsPatients who underwent rehabilitation and were discharged to home (n=31,247; mean age: 84.1 years, standard deviation: 5.7 years) between October 2013 and July 2014.InterventionsNone.Main Outcome Measure30-day PAR.ResultsAmong the patients, 883 (2.9%) experienced 30-day PAR. A multivariable logistic generalized estimating equation model (with a logit link function and binominal sampling distribution) that adjusted for patient characteristics and clustering within hospitals showed that the discharge services were not significantly associated with 30-day PAR. The odds ratios were 0.962 (95% confidence interval [CI]: 0.805-1.151) for discharge planning, 1.060 (95% CI: 0.916-1.227) for rehabilitation discharge instruction, and 1.118 (95% CI: 0.817-1.529) for coordination with community care. In contrast, the odds of 30-day PAR among patients with home medical care services were 1.431 times higher than those of patients without these services (P
       
  • The importance of cognitive executive functions in gait recovery after
           total hip arthroplasty
    • Abstract: Publication date: Available online 7 January 2020Source: Archives of Physical Medicine and RehabilitationAuthor(s): Francesco Negrini, Matteo Preti, Eleonora Zirone, Daniele Mazziotti, Marco Biffi, Catia Pelosi, Giuseppe Banfi, Laura ZapparoliAbstractObjectiveTo determine the influence of cognitive functioning on gait recovery after total hip arthroplasty.DesignProspective cohort study.SettingRehabilitation hospital.Participants40 patients who underwent a total hip arthroplasty, with normal cognitive functioning and without any other relevant medical condition were recruited and studied before surgery and at the beginning and the end of the rehabilitation program.Main Outcome MeasuresGait speed (10-Meter Walk Test, 10MWT) and functional mobility (Timed Up and Go test, TUG), measured at the time of discharge from the rehabilitation unit, were the primary outcomes. The candidate predictors were the cognitive and psychological variables collected in the pre-surgery phase, together with other potentially informative measures such as age, education, perceived pain, body mass index, pre-surgical gait speed and functional mobility.ResultsThe results suggest the existence of a direct relationship between cognitive functioning, with specific reference to high-level frontal executive functions, and the post-operative progress: the better the cognitive functioning in the pre-operative phase, the better the course of recovery in terms of gait speed and functional mobility. In particular, the performance at the Frontal Assessment Battery test, together with age, perceived pain and pre-surgical gait speed/functional mobility was the best predictor of recovery of walking measured by 10MWT and TUG.ConclusionsThe present study highlights the importance of cognitive functioning, together with clinical and demographic features, in the post-surgical recovery of walking, even in the absence of cognitive decline.In particular, these data show the crucial role of higher-order cognitive processes, such as executive functions, involved in the formulation of motor plans and their integration with proprioceptive and visual cues.
       
  • Intensive In-hospital Rehabilitation After Hip Fracture Surgery and
           Activities of Daily Living in Patients With Dementia: Retrospective
           Analysis of a Nationwide Inpatient Database
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Takaaki Ikeda, Toru Tsuboya
       
  • Refugees and Rehabilitation: Our Fight Against the “Globalization of
           Indifference”
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Michel D. Landry, Joost van Wijchen, Djenana Jalovcic, Carina Boström, Anna Pettersson, Maria Nordheim Alme
       
  • Editorial: An End to Ordinal Misrule'
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): James F. Malec
       
  • Functional Balance and Postural Control Improvements in Patients With
           Stroke After Noninvasive Brain Stimulation: A Meta-analysis
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Nyeonju Kang, Ru Da Lee, Joon Ho Lee, Moon Hyon HwangAbstractObjectivesThe postural imbalance poststroke limits individuals’ walking abilities as well as increase the risk of falling. We investigated the short-term treatment effects of noninvasive brain stimulation (NIBS) on functional balance and postural control in patients with stroke.Data SourcesWe started the search via PubMed and the Institute for Scientific Information’s Web of Science on March 1, 2019 and concluded the search on April 30, 2019.Study SelectionThe meta-analysis included studies that used either repetitive transcranial magnetic stimulation (rTMS) or transcranial direct current stimulation (tDCS) for the recovery of functional balance and postural control poststroke. All included studies used either randomized controlled trial or crossover designs with a sham control group.Data ExtractionThree researchers independently performed data extraction and assessing methodological quality and publication bias. We calculated overall and individual effect sizes using random effects meta-analysis models.Data SynthesisThe random effects meta-analysis model on the 18 qualified studies identified the significant positive effects relating to NIBS in terms of functional balance and postural control poststroke. The moderator-variable analyses revealed that these treatment effects were only significant in rTMS across patients with acute, subacute, and chronic stroke whereas tDCS did not show any significant therapeutic effects. The meta-regression analysis showed that a higher number of rTMS sessions was significantly associated with more improvements in functional balance and postural control poststroke.ConclusionsOur systematic review and meta-analysis confirmed that NIBS may be an effective option for restoring functional balance and postural control for patients with stroke.
       
  • Effect of Repetitive Transcranial Magnetic Stimulation on Gait and
           Freezing of Gait in Parkinson Disease: A Systematic Review and
           Meta-analysis
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Yun-Juan Xie, Qiang Gao, Cheng-Qi He, Rong BianAbstractObjectiveThe purpose of this review was to systematically assess the effectiveness of repetitive transcranial magnetic stimulation (rTMS) intervention on gait in individuals with Parkinson disease (PD).Data SourcesWe searched online electronic databases up to March 28, 2019, including MEDLINE, Embase, the Cochrane Library, and so on.Study SelectionThe inclusion criteria for this review were randomized controlled trials (RCTs), exploring the effect of rTMS in patients diagnosed with idiopathic PD.Data ExtractionData extraction was performed independently by 2 reviewers based on predefined criteria and the methodologic quality of included studies was quantified by the Physiotherapy Evidence Database scale. The outcome measure was walking performance, including walking time (short term and long term), Timed Up and Go (TUG) test, and so on.Data SynthesisAmong 14 eligible studies, including 298 participants (mean age ± SD [y], 63.24±9.71; 191 [64%] men) were analyzed in this meta-analysis. Walking time was improved with rTMS compared with sham rTMS (standardized mean difference [SMD] -0.30; 95% confidence interval [CI], -0.57 to -0.03; P=.03). The score for the freezing of gait questionnaire did not differ significantly between rTMS and no intervention. Four studies compared TUG between the 2 treatment groups and no significant differences were found between the rTMS and control group (SMD -0.45; 95% CI, -1.32 to 0.41; P=.30). During the off-state, there were no significant differences in estimated effect sizes (SMD=-0.29; 95% CI, -0.79 to 0.21; P=.25), which is significantly different in on-state (SMD -0.98; 95% CI, -1.78 to -0.18; P=.02) evaluation.ConclusionsThe results of the meta-analysis propose the favorable effect of rTMS on walking performance in the short term but not over the long term in individuals with PD.
       
  • Differences in Acute Metabolic Responses to Bionic and Nonbionic
           Ambulation in Spinal Cord Injured Humans and Controls
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Jennifer L. Maher, Carsten Bach Baunsgaard, Jan van Gerven, Anne E. Palermo, Fin Biering-Sorensen, Armando Mendez, Robert W. Irwin, Mark S. NashAbstractObjectivesTo (1) compare energy expenditure during seated rest, standing, and prolonged bionic ambulation or bipedal ambulation in participants with spinal cord injury (SCI) and noninjured controls, respectively, and (2) test effects on postbionic ambulation glycemia in SCI.DesignTwo independent group comparison of SCI and controls.SettingAcademic Medical Center.ParticipantsTen participants with chronic SCI (C7-T1, American Spinal Injury Association Impairment Scale A-C) and 10 controls (N=20).InterventionsA commercial bionic exoskeleton.Main Outcome MeasuresAbsolute and relative (to peak) oxygen consumption, perceived exertion, carbohydrate/fat oxidation, energy expenditure, and postbionic ambulation plasma glucose/insulin.ResultsAverage work intensity accompanying 45 minutes of outdoor bionic ambulation was
       
  • The Safety and Feasibility of Exoskeletal-Assisted Walking in Acute
           Rehabilitation After Spinal Cord Injury
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Kyle McIntosh, Rebecca Charbonneau, Yassine Bensaada, Urchit Bhatiya, Chester HoAbstractObjectiveTo assess safety and feasibility for persons with acute spinal cord injury (SCI) using the robotic exoskeleton.DesignCase series observational study.SettingA level-1 trauma center in Canada with both acute and tertiary inpatient SCI rehabilitation units.ParticipantsEight male and 3 female (N=11) participants were recruited with a mean age of 41 years and with neurologic level of injury (C6-L2) and severity (American Spinal Injury Association Impairment Scale [AIS] A-D). The time since injury is a range of 3-15 weeks at the onset of training.InterventionsUp to 25 one-hour sessions of exoskeletal-assisted walking gait training, with participants less than 6 months from initial SCI.Main Outcome MeasuresCardiopulmonary outcomes including blood pressure, heart rate, and peripheral oxygen saturation; and perceived physical exertion using the Borg CR10 Scale were recorded. Gait parameters were measured by 6-minute walk test (6MWT) and 10-meter walk test (10MWT). Up Time, walk time, and number of steps were detailed longitudinally. Safety was assessed with regard to pain, falls, and skin integrity.ResultsNo serious adverse events occurred. Blood pressure decreased following initial sit to stand and increased during walking. Symptoms of hypotension were rare and improved with increased number of sessions. Perceived exertion was reported on average to be moderate (mean of 3.1). There was no significant increase in pain scores by Visual Analog Scale. On 6MWT, participants covered more distance (mean [m] ± SD, 117.1±11.7) in session 25 compared to session 2 (mean [m] ± SD, 47.6±6.6). On the 10MWT, all participants showed consistently improved gait speed; with participants traveling an average of 3.2 times faster during their last training session (mean [m/s] ± SD, 0.40±0.04) in comparison to session 2 (mean [m/s] ± SD, 0.12±0.01).ConclusionsExoskeletal-assisted walking in acute rehabilitation (
       
  • Effect of Robot-Assisted Gait Training in a Large Population of Children
           With Motor Impairment Due to Cerebral Palsy or Acquired Brain Injury
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Elena Beretta, Fabio Alexander Storm, Sandra Strazzer, Flaminia Frascarelli, Maurizio Petrarca, Alessandra Colazza, Giampietro Cordone, Emilia Biffi, Roberta Morganti, Cristina Maghini, Luigi Piccinini, Gianluigi Reni, Enrico CastelliAbstractObjectiveTo evaluate retrospectively the effect of robotic rehabilitation in a large group of children with motor impairment; an additional goal was to identify the effects in children with cerebral palsy (CP) and acquired brain injury (ABI) and with different levels of motor impairment according to the Gross Motor Function Classification System. Finally, we examined the effect of time elapsed from injury on children’s functions.DesignA cohort, pretest-posttest retrospective study was conducted.SettingHospitalized care.ParticipantsA total of 182 children, 110 with ABI and 72 with CP and with Gross Motor Function Classification System (GMFCS) levels I-IV, were evaluated retrospectively.InterventionsPatients underwent a combined treatment of robot-assisted gait training and physical therapy.Main Outcome MeasuresAll the patients were evaluated before and after the training using the 6-minute walk test and the Gross Motor Function Measure. A linear mixed model with 3 fixed factors and 1 random factor was used to evaluate improvements.ResultsThe 6-minute walk test showed improvement in the whole group and in both ABI and CP. The Gross Motor Function Measure showed improvement in the whole group and in the patients with ABI but not in children with CP. The GMFCS analysis showed that all outcomes improved significantly in all classes within the ABI subgroup, whereas improvements were significant only for GMFCS III in children with CP.ConclusionsChildren with motor impairment can benefit from a combination of robotic rehabilitation and physical therapy. Our data suggest positive results for the whole group and substantial differences between ABI and CP subgroups, with better results for children with ABI, that seem to be consistently related to time elapsed from injury.
       
  • Effect of Rehabilitation Treatments on Disability in Persons With
           Disorders of Consciousness: A Propensity Score Study
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Davide Sattin, Matilde Leonardi, Barbara Nelli, Placido Bramanti, Silvia Marino, Salvatore Ferro, Nino Basaglia, Davide Guido, Consortium on Functioning and Disability in Patients With DOCAbstractObjectiveTo evaluate the effects of rehabilitation (physical and cognitive) treatments on the diagnosis severity and Disability Rating Scale (DRS) scores, adjusted for a number of potential confounders measured at baseline, in a large cohort of patients with disorders of consciousness across time.Design and SettingAn observational, longitudinal (2 evaluations), multicenter project was made in 90 Italian centers.ParticipantsPatients (N=364) with a diagnosis of disorders of consciousness.Main Outcome MeasuresPrimary outcome was the severity of diagnosis, expressed on an ordinal scale (Other
       
  • Frequency of Primary Neck Pain in Mild Traumatic Brain Injury/Concussion
           Patients
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Jeffrey A. King, Michael A. McCrea, Lindsay D. NelsonAbstractObjectivesTo determine (1) the frequency of neck pain overall and relative to other symptoms in patients presenting to a level I trauma center emergency department (ED) with mild traumatic brain injury (mTBI) and (2) the predictors of primary neck pain in this population.DesignCohort study.SettingLevel I trauma center ED.ParticipantsPatients presenting to the ED with symptoms of mTBI having been exposed to an event that could have caused mTBI (N=95).InterventionsNot applicable.Main Outcome MeasuresFrequency of self-reported neck pain as measured by Sport Concussion Assessment Tool 3 (SCAT3) symptom questionnaire at
       
  • Posttraumatic Stress Disorder Symptoms Contribute to Staff Perceived
           Irritability, Anger, and Aggression After TBI in a Longitudinal Veteran
           Cohort: A VA TBI Model Systems Study
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Shannon R. Miles, Lisa A. Brenner, Dawn Neumann, Flora M. Hammond, Susan Ropacki, Xinyu Tang, Blessen C. Eapen, Austin Smith, Risa Nakase-RichardsonAbstractObjectiveTo examine the relationship between staff perceived irritability, anger, and aggression and posttraumatic stress disorder (PTSD) in veterans with traumatic brain injury (TBI) of all severity levels.DesignLongitudinal cohort design.SettingVeterans Affairs Polytrauma Transitional Rehabilitation Programs.ParticipantsVeterans and service members with TBI of all severity levels enrolled in the Veterans Affairs Polytrauma Rehabilitation Centers’ Traumatic Brain Injury Model System national database (N=240).InterventionsNot applicable.Main Outcome MeasureUnivariable and multivariable logistic regression modeling was used to examine the association between irritability, anger, and aggression and potential risk factors, including PTSD symptoms. Irritability, anger, and aggression was measured as a single construct using an item from the Mayo-Portland Adaptability Inventory-4 that was rated by program staff at admission and discharge from the inpatient rehabilitation program. PTSD symptoms were assessed using the PTSD Checklist–Civilian Version.ResultsPTSD symptoms uniquely predicted program staff-rated irritability, anger, and aggression at discharge even after controlling for severity of TBI, age, male sex, education, and annual earnings. The model explained 19% of the variance in irritability, anger, and aggression.ConclusionsWhen TBI severity and PTSD symptoms were considered simultaneously in a sample of veterans, only PTSD symptoms predicted staff-rated irritability, anger, and aggression. Given the negative outcomes linked with irritability, anger, and aggression, veterans may benefit from assessment and treatment of PTSD symptoms within rehabilitation settings.
       
  • Cognitive Reserve Moderates Cognitive Outcome After Mild Traumatic Brain
           Injury
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Jonas Stenberg, Asta K. Håberg, Turid Follestad, Alexander Olsen, Grant L. Iverson, Douglas P. Terry, Rune H. Karlsen, Simen B. Saksvik, Migle Karaliute, John A.N. Ek, Toril Skandsen, Anne VikAbstractObjectiveTo investigate whether cognitive reserve moderates differences in cognitive functioning between patients with mild traumatic brain injury (MTBI) and controls without MTBI and to examine whether patients with postconcussion syndrome have lower cognitive functioning than patients without postconcussion syndrome at 2 weeks and 3 months after injury.DesignTrondheim MTBI follow-up study is a longitudinal controlled cohort study with cognitive assessments 2 weeks and 3 months after injury.SettingRecruitment at a level 1 trauma center and at a general practitioner-run, outpatient clinic.ParticipantsPatients with MTBI (n=160) according to the World Health Organization criteria, trauma controls (n=71), and community controls (n=79) (N=310).Main Outcome MeasuresA cognitive composite score was used as outcome measure. The Vocabulary subtest was used as a proxy of cognitive reserve. Postconcussion syndrome diagnosis was assessed at 3 months with the British Columbia Postconcussion Symptom Inventory.ResultsLinear mixed models demonstrated that the effect of vocabulary scores on the cognitive composite scores was larger in patients with MTBI than in community controls at 2 weeks and at 3 months after injury (P=.001). Thus, group differences in the cognitive composite score varied as a function of vocabulary scores, with the biggest differences seen among participants with lower vocabulary scores. There were no significant differences in the cognitive composite score between patients with (n=29) and without (n=131) postconcussion syndrome at 2 weeks or 3 months after injury.ConclusionCognitive reserve, but not postconcussion syndrome, was associated with cognitive outcome after MTBI. This supports the cognitive reserve hypothesis in the MTBI context and suggests that persons with low cognitive reserve are more vulnerable to reduced cognitive functioning if they sustain an MTBI.
       
  • Conceptual Structure of Health-Related Quality of Life for Persons With
           Traumatic Brain Injury: Confirmatory Factor Analysis of the TBI-QOL
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Mark Sherer, Julia M.P. Poritz, David Tulsky, Pamela Kisala, Luis Leon-Novelo, Esther NganAbstractObjectiveTo determine the factor structure of the Traumatic Brain Injury–Quality of Life (TBI-QOL) measurement system.DesignObservational.Setting3 TBI Model Systems rehabilitation centers.ParticipantsTwenty TBI-QOL item banks were administered to a sample of community-dwelling adults with TBI (N=504) as part of a study of TBI classification. A subsample of participants (n=200) was randomly selected for exploratory factor analyses, while data from the remaining participants (n=304) were used for the confirmatory factor analysis. To examine a wide range of conceptual models, confirmatory factor analyses were conducted on a total of 16 models, ranging from 1 to 7 factors.InterventionsNot applicable.Main Outcome MeasuresNot applicable.ResultsInitial exploratory factor analysis yielded support for a 5-factor model (negative emotion, cognitive impairment, functioning and participation, positive emotion, pain). Confirmatory factor analysis results, however, indicated a 7-factor model including physical function, physical symptoms, cognition, negative emotion, positive emotion, sense of self, and social participation (model 16; robust fit statistics root mean square error of approximation =.063, standardized root mean square residual =.035, comparative fit index =.955, Tucker-Lewis Index =.943, Bayes Information Criterion =40059.44).ConclusionsThe complex 7-factor model of the TBI-QOL provides a more nuanced framework for understanding health-related quality of life for persons with TBI than the commonly used 3-factor model including physical health, mental health, and social health.
       
  • Responsiveness of the Traumatic Brain Injury–Quality of Life
           (TBI-QOL) Measurement System
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Julia M.P. Poritz, Mark Sherer, Pamela A. Kisala, David Tulsky, Luis Leon-Novelo, Esther NganAbstractObjectiveTo assess the responsiveness of the Traumatic Brain Injury–Quality of Life (TBI-QOL) measurement system.DesignParticipants completed the 20 TBI-QOL item banks and the Participation Assessment with Recombined Tools–Objective (PART-O) Productivity Subscale at baseline and 6-month follow-up assessments. Participants were categorized into 4 groups (increased productivity, unchanged productivity, and decreased productivity) based on PART-O Productivity scores. Paired sample t tests were used to compare TBI-QOL scores at baseline and 6 months, and standardized response means and Cohen's d were computed to estimate effect sizes.SettingThree traumatic brain injury (TBI) Model Systems rehabilitation centers in the United States.ParticipantsTwo hundred one community-dwelling adults with TBI.InterventionsNot applicable.Main Outcome Measures20 TBI-QOL item banks.ResultsAs expected, given that there was no intervention, group mean TBI-QOL subdomain scores for the entire sample showed no change or small improvement over the 6-month study period. At the follow-up assessment, 72 participants reported increased productivity, 71 reported decreased productivity, and 58 reported the same level of productivity as they had 6 months prior. When compared with participants who reported unchanged or decreased productivity, participants who reported increased productivity on the PART-O subscale had clinically meaningful (d≥0.30) improvements on 7 TBI-QOL measures. The largest improvement was in the Independence subdomain (mean change, 7.06; df=0.84), with differences also observed in the Mobility, Positive Affect and Well-Being, Resilience, Grief/Loss, Ability to Participate, and Satisfaction with Participation subdomains.ConclusionsThe 20 TBI-QOL item banks demonstrate responsiveness to change and measurement stability in a community-dwelling sample. Researchers may use the TBI-QOL to detect changes in HRQOL after a clinical intervention and clinicians may use it in their daily practices to monitor patient recovery.
       
  • Development of Composite Scores for the TBI-QOL
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Callie E. Tyner, Aaron J. Boulton, Mark Sherer, Pam A. Kisala, Joseph J. Glutting, David S. TulskyAbstractObjectiveTo develop a set of composite scores that can be used for interpreting quality of life (QOL) after traumatic brain injury (TBI) using 9 of the patient-reported outcomes measures from the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system.DesignParticipants completed 20 item banks from the TBI-QOL as part of a larger assessment. Composite index scores were created with normalized transformation with nonlinear area conversion using scores from 9 of the banks, and are expressed in index score units, with higher composite scores indicating better functioning. For descriptive purposes, associations among composites and individual banks were evaluated using regression, along with patterns of composite scores by injury severity groups using analysis of variance.SettingThree medical centers in the United States.ParticipantsCommunity-dwelling adults (n=504) with a history of TBI.InterventionsNot applicable.Main Outcomes MeasureTBI-QOL.ResultsFive composite indices were generated: global QOL, physical health, emotional health, cognitive health, and social health. Lookup tables are provided herein. Composite scores were highly intercorrelated (all r>.60, P.50, P
       
  • Development and Psychometric Characteristics of the TBI-QOL Independence
           Item Bank and Short Form and the TBI-QOL Asking for Help Scale
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Pamela A. Kisala, David S. Tulsky, Aaron J. Boulton, Allen W. Heinemann, David Victorson, Mark Sherer, Angelle M. Sander, Nancy Chiaravalloti, Noelle E. Carlozzi, Robin HanksAbstractObjectiveTo develop an item response theory (IRT)-calibrated, patient-reported outcome measure of subjective independence for individuals with traumatic brain injury (TBI).DesignLarge-scale item calibration field testing; confirmatory factor analysis (CFA) and graded response model IRT analyses.SettingFive TBI Model System centers across the United States.ParticipantsAdults with complicated mild, moderate, or severe TBI (N=556).Outcome MeasuresTraumatic Brain Injury–Quality of Life (TBI-QOL) Independence item bank and the TBI-QOL Asking for Help scale.ResultsA total of 556 individuals completed 44 items in the Independence item pool. Initial factor analyses indicated that items related to the idea of “asking for help” were measuring a different construct from other items in the pool. These 9 items were set aside. Twenty-two other items were removed because of bimodal distributions and/or low item-total correlations. CFA supported unidimensionality of the remaining Independence items. Graded response model IRT analysis was used to estimate slopes and thresholds for the final 13 Independence items. An 8-item fixed-length short form was also developed. The 9 Asking for Help items were analyzed separately. One misfitting item was deleted, and the final 8 items became a fixed-length IRT-calibrated scale. Reliability was high for both measures.ConclusionsThe IRT-calibrated TBI-QOL Independence item bank and short form and TBI-QOL Asking for Help scale may be used to measure important issues for individuals with TBI in research and clinical applications.
       
  • Development and Calibration of the TBI-QOL Ability to Participate in
           Social Roles and Activities and TBI-QOL Satisfaction With Social Roles and
           Activities Item Banks and Short Forms
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Allen W. Heinemann, Pamela A. Kisala, Aaron J. Boulton, Mark Sherer, Angelle M. Sander, Nancy Chiaravalloti, Tamara Bushnik, Robin Hanks, Elliot Roth, David S. TulskyAbstractObjectiveTo develop traumatic brain injury (TBI)-optimized versions of the Quality of Life in Neurological Disorders (Neuro-QoL) Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities item banks, evaluate the psychometric properties of the item banks developed for adults with TBI, develop short form and computer adaptive test (CAT) versions, and report information to facilitate research and clinical applications.DesignWe used a mixed methods design to develop and evaluate Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities items. Focus groups defined the constructs, cognitive interviews guided item revisions, and confirmatory factor analysis and item response theory methods helped calibrate item banks and evaluate differential item functioning related to demographic and injury characteristics.SettingFive TBI Model Systems centers in the United States.ParticipantsCommunity-dwelling adults with TBI (N=556).InterventionsNone.Outcome MeasuresTraumatic Brain Injury–Quality of Life (TBI-QOL) Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction with Social Roles and Activities item banks.ResultsForty-five Ability to Participate in Social Roles and Activities and 41 Satisfaction with Social Roles and Activities items demonstrated good psychometric properties. Although some of the items are new, most were drawn from analogous banks in the Neuro-QoL measurement system. Consequently, the 2 TBI-QOL item banks were linked to the Neuro-QoL metric, and scores are comparable with the general population. All CAT and short forms correlated highly (>0.90) with the full item banks and demonstrate comparable construct coverage and measurement error.ConclusionThe TBI-QOL Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction with Social Roles and Activities item banks are TBI-optimized versions of the Neuro-QoL Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities item banks and demonstrate excellent measurement properties in individuals with TBI. These measures, particularly in CAT or short form format, are suitable for efficient and precise measurement of social outcomes in clinical and research applications.
       
  • Measuring Pain in TBI: Development of the TBI-QOL Pain Interference Item
           Bank and Short Form
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Noelle E. Carlozzi, Pamela A. Kisala, Aaron J. Boulton, Elliot Roth, Anna L. Kratz, Mark Sherer, Angelle M. Sander, Allen W. Heinemann, Nancy D. Chiaravalloti, Tamara Bushnik, David S. TulskyAbstractObjectiveTo develop a pain interference item bank, computer adaptive test (CAT), and short form for use by individuals with traumatic brain injury (TBI).DesignCross-sectional survey study.SettingFive TBI Model Systems rehabilitation hospitals.ParticipantsIndividuals with TBI (N=590).InterventionsNot applicable.Outcome MeasuresTraumatic Brain Injury–Quality of Life (TBI-QOL) Pain Interference item bank.ResultsConfirmatory factor analysis provided evidence of a single underlying trait (χ2 [740]=3254.030; P
       
  • Effects of Motor Skill-Based Training on Wheelchair Propulsion
           Biomechanics in Older Adults: A Randomized Controlled Trial
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Megan K. MacGillivray, Janice J. Eng, Elizabeth Dean, Bonita J. SawatzkyAbstractObjectiveTo identify whether motor skill-based training improves wheeling biomechanics in older adults and whether transfer or retention occurs.DesignRandomized controlled trial.SettingHuman mobility laboratory.ParticipantsAble-bodied older adults 50 years and older deemed ready to participate in physical activity (N=34).InterventionParticipants were randomized to 1 of 3 groups: experimental group with 6 motor skill-based training sessions, active control group with dose-matched uninstructed practice, and the inactive control group (no training or practice).The experimental group's training sessions consisted of two 5-minute blocks of wheelchair propulsion training, separated by a 5-minute break, for a total of 60 minutes of wheeling. Breaks included education and discussion related to wheelchair propulsion. Training focused on increasing push angle, decreasing push frequency, decreasing negative braking forces, and using a circular wheeling pattern with smooth pushes.Main Outcome MeasuresTemporal spatial and kinetic variables (ie, push angle, push frequency, total and tangential forces, negative force) were evaluated during steady-state wheeling and biomechanical variables were assessed with the SmartWheel Clinical Protocol to identify transfer.ResultsThe training group significantly increased push angle and decreased push frequency compared with the practice (P
       
  • Editors' Selections From This Issue: Volume 101 / Number 1 / January 2020
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s):
       
  • Measurement Characteristics and Clinical Utility of the Kohlman Evaluation
           of Living Skills Among Older Adults
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Claire Mercer, Victoria Turnbull, Serena Saake, Ada Terman, Heidi Fischer, Linda Ehrlich-Jones
       
  • Information/Education Pages (I/EPs)
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s):
       
  • Author’s Response to Letter to the Editor
    • Abstract: Publication date: January 2020Source: Archives of Physical Medicine and Rehabilitation, Volume 101, Issue 1Author(s): Kazuaki Uda, Hideo Yasunaga
       
  • Measurement Characteristics and Clinical Utility of the Reintegration to
           Normal Living Index Among Persons With Spinal Cord Injuries
    • Abstract: Publication date: Available online 18 December 2019Source: Archives of Physical Medicine and RehabilitationAuthor(s): Nicholas McCombs, Samuel Curry, Edeth Engel, Linda Ehrlich-Jones
       
 
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