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Clinical Rehabilitation
Journal Prestige (SJR): 1.322
Citation Impact (citeScore): 3
Number of Followers: 78  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 0269-2155 - ISSN (Online) 1477-0873
Published by Sage Publications Homepage  [1166 journals]
  • Introductory paragraph

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      Pages: 1505 - 1505
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1505-1505, November 2021.

      Citation: Clinical Rehabilitation
      PubDate: 2021-10-18T03:30:36Z
      DOI: 10.1177/02692155211053408
      Issue No: Vol. 35, No. 11 (2021)
       
  • Ultrasound-guided local corticosteroid injection for carpal tunnel
           syndrome: A meta-analysis of randomized controlled trials

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      Authors: Hongchen Wang, Yuting Zhu, Hongyu Wei, Chunke Dong
      Pages: 1506 - 1517
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1506-1517, November 2021.
      Objective:This meta-analysis aimed to compare the efficacy and safety of ultrasound-guided (US-guided) versus landmark-guided (LM-guided) local corticosteroid injection for carpal tunnel syndrome (CTS).Methods:Database including Pubmed, Embase, and Cochrane Library were searched to identify relevant randomized controlled trials (RCTs). The outcomes mainly included Boston Carpal Tunnel Questionnaire (BCTQ): Symptom Severity Scale (BCTQs), Functional Status Scale (BCTQf); and electrophysiological indexes: distal motor latency (DML), sensory distal latency (SDL), compound muscle action potential (CAMP), sensory nerve action potential amplitude (SNAP), and sensory nerve conduction velocity (SNCV). Adverse events were also recorded.Results:Overall, nine RCTs were finally screened out with 469 patients (596 injected hands). Pooled analysis showed that US-guided injection was more effective in BCTQs (SMD, −0.69; 95% CI, −1.08 to −0.31; P = 0.0005), BCTQf (SMD, −0.23; 95% CI, −0.39 to −0.07; P = 0.005), CAMP (MD, 0.64; 95% CI, 0.35−0.94; P 
      Citation: Clinical Rehabilitation
      PubDate: 2021-06-07T05:50:32Z
      DOI: 10.1177/02692155211014702
      Issue No: Vol. 35, No. 11 (2021)
       
  • Treatments for sleep disturbances in individuals with acquired brain
           injury: A systematic review

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      Authors: Louise Pilon, Nikita Frankenmolen, Dirk Bertens
      Pages: 1518 - 1529
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1518-1529, November 2021.
      Objective:To systematically review the evidence on the treatments of sleep disturbances in individuals with acquired brain injury.Data sources:PubMed, Embase, Web of Science, and PsycINFO were searched from inception to January 2021.Review method:Eligibility criteria were (1) participants with mild to severe acquired brain injury from traumatic brain injury and stroke (⩾three months post-injury), (2) individuals aged 16 years and older, (3) participants with self-reported sleep disturbances, (4) controlled group studies and single case (experimental) studies, and (5) interventions aimed at treatment of sleep disturbances. Two researchers independently identified relevant studies and assessed their study quality using the revised Cochrane assessment of bias tool (RoB 2.0) and the risk-of-bias in N-of-1 trials (RoBiNT) scale.Results:The search yielded 655 records; 11 studies met the inclusion criteria and were included, with a total of 227 participants (207 individuals with traumatic brain injury, 20 stroke patients). Two studies included pharmacological therapy, six studies examined the effects of cognitive behavioral therapy and three studies investigated alternative interventions such as acupuncture.Conclusion:Although there was heterogeneity in the study quality of the included studies, their outcomes suggest that cognitive behavioral therapy is recommended as treatment of choice for improving sleep in individuals with acquired brain injury, especially for patients with mild to severe traumatic brain injury. Future research should examine the effects of cognitive behavioral therapy in more high-quality randomized controlled designs.
      Citation: Clinical Rehabilitation
      PubDate: 2021-05-20T10:26:38Z
      DOI: 10.1177/02692155211014827
      Issue No: Vol. 35, No. 11 (2021)
       
  • Effect of yoga on health-related quality of life in central nervous system
           disorders: A systematic review

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      Authors: Rita Lenoir dit Caron, Jeremy Coquart, Maxime Gilliaux
      Pages: 1530 - 1543
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1530-1543, November 2021.
      Objective:Investigate the effect of yoga on health-related quality of life (HRQoL) in patients with central nervous system disorders.Methods:A systematic search was conducted on the PubMed-NCBI, EBSCO Host, Cochrane Library, Scopus and ScienceDirect databases until 05 April 2021. Only randomized control trials published in English or French were included and had to compare yoga to another intervention group or a control group. They also had to clearly measure HRQoL. Methodological quality was assessed with the revised Cochrane risk-of-bias tool for randomized trials and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria.Results:Sixteen studies were found, including six for multiple sclerosis, five for Parkinson’s disease, two for stroke, one for dementia, one for epilepsy and one for brain tumour. Only 12 studies performed between-group statistics and 8 found a significant difference between groups after treatment. When yoga was compared to no intervention, the results were generally in favour of the yoga group, but when yoga was compared to another intervention programme, there was generally no significant difference between groups. There were many different HRQoL questionnaires, even within the same disease, which reduces the comparability of studies.Conclusions:With low to moderate quality of the evidence, yoga seems effective to improve HRQoL in people with Parkinson’s disease. For multiple sclerosis, stroke, dementia, epilepsy and brain tumour, the quality of the evidence is still insufficient to conclude of the effectiveness of yoga.
      Citation: Clinical Rehabilitation
      PubDate: 2021-05-29T07:01:06Z
      DOI: 10.1177/02692155211018429
      Issue No: Vol. 35, No. 11 (2021)
       
  • Impacts of tailored, rehabilitation nursing care on functional ability and
           quality of life in hospitalized elderly patients after rib fractures

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      Authors: María Granados Santiago, Marie Carmen Valenza, Esther Prados Román, Laura López López, Natalia Muñoz Vigueras, Irene Cabrera Martos, Maria Àngels Cebrià i Iranzo
      Pages: 1544 - 1554
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1544-1554, November 2021.
      Objectives:We aimed to analyze the effects of a tailored rehabilitation nursing care program on functional ability and quality of life in patients with conservative treatment for rib fractures.Design:Randomized controlled trial.Setting:Inpatient rehabilitation hospital.Subjects:Rib fracture patients treated conservatively were randomized into two groups (experimental and control group).Interventions:Patients in control group received Treatment as Usual (TAU) and patients included in experimental group received TAU and an added tailored rehabilitation nursing care program (RNT).Main measures:At baseline, and end of hospitalization treatment, the functional ability was assessed with the Barthel Index, and the quality of life was evaluated with the EuroQol-5D. Additionally, the outcomes were assessed at six-month follow-up.Results:A total of 80 patients were included in the study, whose mean age was 77.19 SD 7.71 in the RNT group and 75.55 SD 9.46 in the TAU group. Our data showed a significant difference in the post-treatment gains in overall quality of life (74.25 SD 20.62 vs 60.28 SD 20.54), and functional ability (71.79 SD 23.85 vs 69.41 SD 24.30) between the RNT group and the TAU group (P 
      Citation: Clinical Rehabilitation
      PubDate: 2021-06-07T04:33:37Z
      DOI: 10.1177/02692155211022734
      Issue No: Vol. 35, No. 11 (2021)
       
  • Efficacy of whole-body vibration on balance control, postural stability,
           and mobility after thermal burn injuries: A prospective randomized
           controlled trial

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      Authors: Nabil Mahmoud Abdel-Aal, Nesma M Allam, Hadaya Mosaad Eladl
      Pages: 1555 - 1565
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1555-1565, November 2021.
      Objective:To investigate the additive effects of whole-body vibration (WBV) training to the traditional physical therapy program (TPTP) on balance control, postural stability, and mobility after thermal burn injuries.Design:A single-blinded, randomized controlled study.Setting:Outpatient physical therapy setting.Participants:Forty participants, 20–45 years old, with deep second-degree thermal burn involving the lower limbs and trunk, with 35%–40% total body service area, were randomly allocated either into the study group or the control group.Intervention:The study group received WBV plus TPTP while the control group received the TPTP only. Interventions were applied three sessions a week for eight weeks.Outcome measures:Anteroposterior stability index (APSI), mediolateral stability index (MLSI), overall stability index (OSI), timed-up and go (TUG), and Berg balance scale (BBS) were measured at baseline and after eight weeks of interventions.Results:There were statistically significant differences in APSI, MLSI, OSI, BBS, and TUG in favor of the WBV group after eight weeks of intervention (P 
      Citation: Clinical Rehabilitation
      PubDate: 2021-05-31T04:27:34Z
      DOI: 10.1177/02692155211020861
      Issue No: Vol. 35, No. 11 (2021)
       
  • Postural and clinical outcomes of sustained natural apophyseal glides
           treatment in cervicogenic dizziness patients: A randomised controlled
           trial

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      Authors: Alessandro Micarelli, Andrea Viziano, Ivan Granito, Pasquale Carlino, Riccardo Xavier Micarelli, Ivan Augimeri, Marco Alessandrini
      Pages: 1566 - 1576
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1566-1576, November 2021.
      Objective:To evaluate how self-report and posturographic measures could be affected in patients with cervicogenic dizziness undergoing sustained natural apophyseal glides.Design:Randomised controlled single-blind study.Setting:Tertiary rehabilitation centre.Subjects:Patients affected by cervicogenic dizziness, diagnosed by applying accepted criteria. Forty-one patients (19 male, 22 female: mean age 44.3 ± 14.8 years) receiving treatment, and 39 patients (18 male, 21 female: mean age 43.8 ± 13.9 years) receiving placebo were included in the study.Interventions:The treatment group underwent sustained natural apophyseal glides, while the placebo was constituted by a detuned laser. Both groups received their interventions six times over 4 weeks.Main measures:Outcomes were tested by means of self-report measures such as perceived dizziness, neck disability, anxiety and depression. Also, cervical range of motion and posturography testing with power spectra frequency were analysed.Results:When compared to placebo, treated patients demonstrated a significant decrease in perceived dizziness (post-treatment total Dizziness Handicap Inventory score 20.5 ± 5.3 as compared to 26.2 ± 6 baseline), neck disability and pain (Neck Disability Index and Neck Pain Index post-treatment scores 12.5 ± 4.3 and 45.6 ± 15.1, respectively, as compared to baseline scores of 15.1 ± 4.8 and 62.5 ± 14.3), as well as significant improvement in cervical range of motion and some posturographic parameters.Conclusion:Sustained natural apophyseal glides may represent a useful intervention in reaching short-term beneficial effects in patients with cervicogenic dizziness, with respect to self-perceived symptoms, proprioceptive integration and cervical range of motion improvement.
      Citation: Clinical Rehabilitation
      PubDate: 2021-04-26T07:06:53Z
      DOI: 10.1177/02692155211012413
      Issue No: Vol. 35, No. 11 (2021)
       
  • Using a bimanual lever-driven wheelchair for arm movement practice early
           after stroke: A pilot, randomized, controlled, single-blind trial

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      Authors: Brendan W Smith, Joan Lobo-Prat, Daniel K Zondervan, Christopher Lew, Vicky Chan, Cathy Chou, Spencer Toledo, David J Reinkensmeyer, Susan Shaw, Steven C Cramer
      Pages: 1577 - 1589
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1577-1589, November 2021.
      Objective:Many patients with subacute stroke rely on the nonparetic arm and leg to propel manual wheelchairs. We designed a bimanual, lever-driven wheelchair (LARA) to promote overground mobility and hemiparetic arm exercise. This study measured the feasibility of using LARA to increase arm movement, achieve mobility, and improve arm motor recovery (clinicaltrials.gov/ct2/show/NCT02830893).Design:Randomized, assessor-blind, controlled trial.Setting:Two inpatient rehabilitation facilities.Subjects:Nineteen patients with subacute stroke (1 week to 2 months post-stroke) received 30 minutes extra arm movement practice daily, while admitted to inpatient rehabilitation (n = 10) or before enrollment in outpatient therapy (n = 9).Interventions:Patients were randomized to train with the LARA wheelchair (n = 11) or conventional exercises with a rehabilitation therapist (n = 8).Main measures:Number of arm movements per training session; overground speed; Upper Extremity Fugl-Meyer score at three-month follow-up.Results:Participants who trained with LARA completed 254 (median) arm movements with the paretic arm each session. For three participants, LARA enabled wheelchair mobility at practical indoor speeds (0.15–0.30 m/s). Fugl-Meyer score increased 19 ± 13 points for patients who trained with LARA compared to 14 ± 7 points with conventional exercises (P = 0.32). Secondary measures including shoulder pain and increased tone did not differ between groups. Mixed model analysis found significant interaction between LARA training and treatment duration (P = 0.037), informing power analysis for future investigation.Conclusions:Practising arm movement with a lever-driven wheelchair is a feasible method for increasing arm movement early after stroke. It enabled wheelchair mobility for a subset of patients and shows potential for improving arm motor recovery.
      Citation: Clinical Rehabilitation
      PubDate: 2021-05-24T12:08:12Z
      DOI: 10.1177/02692155211014362
      Issue No: Vol. 35, No. 11 (2021)
       
  • Using a cane for one month does not improve walking or social
           

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      Authors: Patrick Roberto Avelino, Lucas Rodrigues Nascimento, Louise Ada, Kênia Kiefer Parreiras de Menezes, Luci Fuscaldi Teixeira-Salmela
      Pages: 1590 - 1598
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1590-1598, November 2021.
      Objective:To examine the effects of the provision of a cane, delivered to ambulatory people with chronic stroke, for improving walking and social participation.Design:Two-arm, randomized trial.Setting:Community-based.Participants:Ambulatory individuals with chronic stroke.Interventions:The experimental intervention was the provision of a single-point cane during one month. The control group received a placebo intervention.Outcome measures:Walking speed, step length, cadence, walking capacity, and walking confidence were measured without the cane to examine its rehabilitative effect. Walking speed was also measured with the cane for inclusiveness, and social participation was measured for examining carry over effects. Outcomes were measured at baseline, and after one and two months.Results:Fifty individuals were included. In the experimental group, mean age was 69 years (SD 14), and walking speed was 0.58 m/s (SD 0.17). In the control group, mean age was 68 years (SD 13), and walking speed was 0.63 m/s (SD 0.15). When walking without the cane, after one and after two months, there were no between-group differences in any measures. When walking with the cane, after one month, the experimental group walked 0.14 m/s (95% CI 0.05–0.23) faster than the control group and after two months, they were still walking 0.18 m/s (95% CI 0.06–0.30) faster.Conclusion:Use of a cane improved walking speed, only when participants walked with the cane. Use of cane for one month did not improve walking outcomes, when walking without the cane. People with stroke would need to continue to use the cane to maintain any benefits in walking speed.
      Citation: Clinical Rehabilitation
      PubDate: 2021-05-31T04:27:43Z
      DOI: 10.1177/02692155211020864
      Issue No: Vol. 35, No. 11 (2021)
       
  • Dual-task walking and automaticity after Stroke: Insights from a secondary
           analysis and imaging sub-study of a randomised controlled trial

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      Authors: Johnny Collett, Melanie K Fleming, Daan Meester, Emad Al-Yahya, Derick T Wade, Andrea Dennis, Piergiorgio Salvan, Andrew Meaney, Janet Cockburn, Joanna Dawes, Heidi Johansen-Berg, Helen Dawes
      Pages: 1599 - 1610
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1599-1610, November 2021.
      Objective:To test the extent to which initial walking speed influences dual-task performance after walking intervention, hypothesising that slow walking speed affects automatic gait control, limiting executive resource availability.Design:A secondary analysis of a trial of dual-task (DT) and single-task (ST) walking interventions comparing those with good (walking speed ⩾0.8 m s−1, n = 21) and limited (walking speed
      Citation: Clinical Rehabilitation
      PubDate: 2021-05-31T04:27:24Z
      DOI: 10.1177/02692155211017360
      Issue No: Vol. 35, No. 11 (2021)
       
  • Why allied health professionals use evidence-based clinical guidelines in
           stroke rehabilitation: A systematic review and meta-synthesis of
           qualitative studies

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      Authors: Dayna Halls, Carolyn Murray, Ben Sellar
      Pages: 1611 - 1626
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1611-1626, November 2021.
      Objective:To capture qualitative research about the perspectives and reasoning of allied health professionals about variability in the use of clinical guidelines in stroke rehabilitation.Data sources:Ovid Medline, Psychinfo, Cochrane, Ovid Emcare, Scopus and Web of Science.Method:The review protocol followed the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) statement. Qualitative or mixed methods research that provided qualitative data about use of clinical guidelines delivered by allied health professionals in stroke rehabilitation was included. Clinical guidelines included any evidence-based documents that guided allied health stroke rehabilitation practice. All studies were screened in duplicate at title and abstract and then at full text. Included studies were appraised using the McMaster Critical Appraisal Tool.Results:Data from 850 allied health professionals in 22 qualitative research studies from seven different countries were analysed and synthesised. Four themes were developed including: context necessitates strategy, all clients are different, systemic changes are needed and need a good reason to change something. The findings aligned with the four arms of evidence-base practice. Allied health professionals use clinical guidelines when they align with their reasoning and match the ‘sweet spot’ for client goals and circumstance. Clinical guideline use is attributed to sufficient resourcing, time and motivation and a strong research culture within health systems.Conclusions:Variabilities in clinical guideline use by allied health professionals are due to their clinical reasoning, contextual factors, client characteristics and enabling health systems.
      Citation: Clinical Rehabilitation
      PubDate: 2021-04-28T08:55:00Z
      DOI: 10.1177/02692155211012324
      Issue No: Vol. 35, No. 11 (2021)
       
  • Perceptions and experiences of older patients and healthcare professionals
           regarding shared decision-making in pulmonary rehabilitation: A
           qualitative study

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      Authors: Yuyu Jiang, Jianlan Guo, Pingping Sun, Zhongyi Chen, Fenglan Liu, Shanshan Wang, Zhaosheng Ding
      Pages: 1627 - 1639
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1627-1639, November 2021.
      Objective:To understand the perceptions and experiences of older patients with chronic obstructive pulmonary disease (COPD) and healthcare professionals (HCPs) regarding shared decision-making in pulmonary rehabilitation (PR).Design:A qualitative study using single, semi-structured interviews, and thematic analysis.Setting:Face-to-face interviews were conducted in the Jiangnan University, in hospital and in patients’ homes.Participants:Twenty-two older patients with COPD and 29 HCPs.Methods:An initial codebook and semi-structured interview guide were developed based on the shared decision-making 3-circle conceptual model. Thematic analysis was used to analyze data.Results:The study identified 10 themes that describe the perceptions and experiences of patients and HCPs involved in PR decision-making: (1) patients’ confidence, (2) patients’ perceptions of the cost-benefit of decisions, (3) patients’ perceived stress about the consequences of decision-making, (4) HCPs’ perceived stress on shared decision-making, (5) cognitive biases of patients toward illness and rehabilitation, (6) shared decision-making as a knowledge gap, (7) the knowledge gap between patients and HCPs, (8) authority effect, (9) family support, (10) human resources. These themes were then divided into three groups according to their characteristics: (1) the feelings of the participants, (2) knowledge barriers, and (3) support from the social system.Conclusion:Patients and HCPs described their negative perceptions and experiences of participating in decision-making in PR. The implementation of shared decision-making in PR is currently limited; therefore, health education for patients and families should be strengthened and a training system for HCPs in shared decision-making should be established.
      Citation: Clinical Rehabilitation
      PubDate: 2021-05-12T10:47:47Z
      DOI: 10.1177/02692155211010279
      Issue No: Vol. 35, No. 11 (2021)
       
  • Risk-of-bias rating is incorrect in systematic review by Van der Gucht and
           colleagues

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      Authors: Daniel L Riddle
      Pages: 1640 - 1641
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1640-1641, November 2021.

      Citation: Clinical Rehabilitation
      PubDate: 2021-04-30T06:01:37Z
      DOI: 10.1177/02692155211013627
      Issue No: Vol. 35, No. 11 (2021)
       
  • Reply to letter from Dan Riddle

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      Authors: Elien Van der Gucht, Lore Dams, Vincent Haenen, Lode Godderis, Bart Morlion, Koen Bernar, Margaux Evenepoel, Tessa De Vrieze, Thomas Vandendriessche, Anne Asnong, Inge Geraerts, Nele Devoogdt, An De Groef, Mira Meeus
      Pages: 1642 - 1643
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1642-1643, November 2021.

      Citation: Clinical Rehabilitation
      PubDate: 2021-05-04T06:05:32Z
      DOI: 10.1177/02692155211014100
      Issue No: Vol. 35, No. 11 (2021)
       
  • Reply to Letter to the Editor concerning the article: The effectiveness of
           blood-flow restricted resistance training in the musculoskeletal
           rehabilitation of patients with lower limb disorders: A systematic review
           and meta-analysis

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      Authors: Nico Nitzsche, Alexander Stäuber, Samuel Tiede, Henry Schulz
      Pages: 1644 - 1645
      Abstract: Clinical Rehabilitation, Volume 35, Issue 11, Page 1644-1645, November 2021.

      Citation: Clinical Rehabilitation
      PubDate: 2021-05-03T05:51:44Z
      DOI: 10.1177/02692155211014110
      Issue No: Vol. 35, No. 11 (2021)
       
  • Self-administered acupressure and exercise for patients with
           osteoarthritis: A randomized controlled trial

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      Authors: Donghui Guo, Shiqiang Ma, Yunchao Zhao, Jun Dong, Binfang Guo, Xiaoming Li
      Abstract: Clinical Rehabilitation, Ahead of Print.
      ObjectiveKnee osteoarthritis is a prevalent degenerative joint disease and seriously affects the athletic abilities of middle-aged and elderly patients. Acupressure is a traditional non-pharmacological intervention that promotes blood circulation and muscle activity. Self-administrated acupressure and exercise can be potential management for knee osteoarthritis.DesignIt is a randomized and controlled trial for knee osteoarthritis self-treatment.SettingsCangzhou Hospital.Interventions221 patients with knee osteoarthritis were recruited and randomly divided into 4 groups: control group (n = 55), exercise group (n = 56), acupressure group (n = 55) and exercise & acupressure group (n = 55). In the first eight weeks, corresponding training courses were provided to different groups of patients. The patients were asked to carry out their own corresponding interventions for 16 weeks. The patient‘s condition was evaluated in the sixteenth week.Main measuresThe Western Ontario and McMaster Universities global scores of knee osteoarthritis patients were assessed at the 8th and 16th week of our trial.ResultsSelf-administered acupressure and exercise significantly decreased visual analogue scale (3.75 ± 1.89 versus 2.93 ± 1.73, p 
      Citation: Clinical Rehabilitation
      PubDate: 2021-10-18T12:14:53Z
      DOI: 10.1177/02692155211049155
       
  • Physical therapies in the decongestive treatment of lymphedema: A
           randomized, non-inferiority controlled study

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      Authors: Isabel Forner-Cordero, José Muñoz-Langa, Juan María DeMiguel-Jimeno, Pilar Rel-Monzó
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To assess whether the treatment with intermittent pneumatic compression plus multilayer bandages is not inferior to classical trimodal therapy with manual lymphatic drainage in the decongestive lymphedema treatment.Study Design:Randomized, non-inferiority, controlled study to compare the efficacy of three physical therapies’ regimens in the Decongestive Lymphatic Therapy.Participants:194 lymphedema patients, stage II–III with excess volume > 10% were stratified within upper and lower limb and then randomized to one of the three treatment groups. Baseline characteristics were comparable between the groups.Intervention:all patients were prescribed 20 sessions of the following regimens: Group A (control group): manual lymphatic drainage + Intermittent Pneumatic Compression + Bandages; Group B: pneumatic lymphatic drainage + Intermittent Pneumatic Compression + Bandages; and Group C: only Intermittent Pneumatic Compression + Bandages.End-point:Percentage reduction in excess volume (PREV).Results:All patients improved after treatment. Global mean of PREV was 63.9%, without significant differences between the groups. The lower confidence interval of the mean difference in PREV between group B and group A, and between group C and group A were below 15%, thus meeting the non-inferiority criterion. Most frequent adverse events were discomfort and lymphangitis, without differences between groups. A greater baseline edema, an upper-limb lymphedema and a history of dermatolymphangitis were independent predictive factors of worse response in the multivariate analysis.Conclusions:Decongestive lymphatic therapy performed only with intermittent pneumatic compression plus bandages is not inferior to the traditional trimodal therapy with manual lymphatic drainage. This approach did not increase adverse events.
      Citation: Clinical Rehabilitation
      PubDate: 2021-09-13T11:14:39Z
      DOI: 10.1177/02692155211032651
       
  • The effectiveness of pre- and post-operative rehabilitation for lung
           cancer: A systematic review and meta-analysis on postoperative pulmonary
           complications and length of hospital stay

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      Authors: Xinyi Xu, Denise Shuk Ting Cheung, Robert Smith, Agnes Yuen Kwan Lai, Chia-Chin Lin
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To investigate the effects of rehabilitation either before or after operation for lung cancer on postoperative pulmonary complications and the length of hospital stay.Data sources:MEDLINE, Cochrane Central Register of Controlled Trials, Web of Science, CINAHL Plus, SPORTDiscus, PsycInfo and Embase were searched from inception until June 2021.Review methods:Inclusion criteria were patients scheduled to undergo or had undergone operation for lung cancer, randomised controlled trials comparing rehabilitative interventions initiated before hospital discharge to usual care control. Two reviewers independently assessed eligibility, extracted data and risks of bias. Pooled odds ratios (ORs) or standardised mean differences (SMDs) with 95% Confidence Intervals (CI) were estimated using random-effects meta-analyses.Results:Twenty-three studies were included (12 preoperative, 10 postoperative and 1 perioperative), with 2068 participants. The pooled postoperative pulmonary complication risk and length of hospital stay were reduced after preoperative interventions (OR = 0.32; 95% CI = 0.22, 0.47; I2 = 0.0% and SMD = −1.68 days, 95% CI = −2.23, −1.13; I2 = 77.8%, respectively). Interventions delivered during the immediate postoperative period did not have any significant effects on either postoperative pulmonary complication or length of hospital stay (OR = 0.85; 95% CI = 0.56, 1.29; I2 = 0.0% and SMD = −0.23 days, 95% CI = −1.08, 0.63; I2 = 64.6%, respectively). Meta-regression showed an association between a higher number of supervised sessions and shorter hospital length of stay in preoperative studies (β = −0.17, 95% CI = −0.29, −0.05).Conclusion:Preoperative rehabilitation is effective in reducing postoperative pulmonary complications and length of hospital stay associated with lung cancer surgery. Short-term postoperative rehabilitation in inpatient settings is probably ineffective.
      Citation: Clinical Rehabilitation
      PubDate: 2021-09-09T05:35:08Z
      DOI: 10.1177/02692155211043267
       
  • The effect of trunk training on trunk control, upper extremity, and
           pulmonary function in children with Duchenne muscular dystrophy: A
           randomized clinical trial

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      Authors: Gökçe Yağmur Güneş Gencer, Öznur Yilmaz
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objectives:To investigate the effect of trunk training on trunk control, arm, and pulmonary function in children with Duchenne muscular dystrophy.Design:A randomised controlled trial.Settings:Neuromuscular diseases clinic of university hospital.Subjects:Twenty-six children with Duchenne muscular dystrophy aged 5–16 were included in the study.Intervention:Participants were randomly allocated into two groups. The study group (N = 13) exercised with the trunk-oriented exercise program and the conventional exercise program, whereas the control group (N = 13) underwent the conventional exercise program for eight weeks.Main measures:The primary outcomes were trunk control was assessed using the Trunk Control Measurement Scale, the arm function was assessed using Performance of Upper Limb, and respiratory function using the pulmonary function test. Data collection was conducted at baseline, and eighth week. The differences in trunk control scores, arm function scores, and respiratory function values before and after the training were calculated for the intergroup comparison.Results:The mean age of the participants was 11.6 (2.6) in the study group and 10.6 (3.4) in the control group. The changes between trunk control score, arm function score (total and distal level score), and respiratory function value (Forced Vital Capacity, Forced Expiratory Volume in one second, and Peak Expiratory Flow Volume percentage values) were compared and significant differences were found after eight week periods in the study and control groups.Conclusions:Trunk-oriented exercise program in Duchenne muscular dystrophy might be effective for trunk control, arm, and respiratory function.
      Citation: Clinical Rehabilitation
      PubDate: 2021-09-03T05:07:27Z
      DOI: 10.1177/02692155211043265
       
  • Lumbar motor control training as a complementary treatment for chronic
           neck pain: A randomized controlled trial

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      Authors: Zohre Khosrokiani, Amir Letafatkar, Amy Gladin
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:We investigated whether adding lumbar motor control training with a pressure biofeedback unit improves outcomes of a conservative deep cervical flexor motor control program on neck pain, neck disability, deep cervical flexor endurance, and health status in middle-aged patients with chronic neck pain and forward head posture after eight weeks of interventions.Design:Randomized controlled trial.Setting:Outpatient setting.Subjects and interventions:A total of 113 males and females (mean age 39 ± 5 years) with chronic neck pain were randomized to three treatment groups, group 1 (n = 38) combined deep cervical flexor motor-control training and lumbar motor control exercise, group 2 (n = 37) deep cervical flexor motor control training alone, and group 3 (n = 38) passive treatment and education.Main outcome measures:Pain, neck disability, deep cervical flexor muscular endurance, and health status.Results:There were significant improvements in the combination group compared with the deep cervical flexor motor-control group alone (d = 2.03, 95% confidence interval (CI): −2.8 to −1.27, P = 0.021) for pain (d = −0.99, 95% CI = −1.75 to −0.23, P = 0.023), disability (d = 1.92, 95% CI = 0.86 to 2.98, P = 0.001), deep cervical flexor endurance, and (d = −2.75, 95% CI = −8.81 to −1.68, P = 0.037) for health status favoring the combination group. There were significant between-group differences favoring both active groups versus the passive control in all out comes.Conclusion:The addition of Lumbar motor control training as a complementary treatment may enhance effectiveness of deep cervical flexor motor control training on neck pain, neck disability, and deep cervical flexor endurance in patients with chronic moderate neck pain and forward head posture.
      Citation: Clinical Rehabilitation
      PubDate: 2021-09-03T04:55:07Z
      DOI: 10.1177/02692155211038099
       
  • Letter to the editor concerning the article: “A prospective study to
           establish the minimal clinically important difference of the Mini-BESTest
           in individuals with stroke”

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      Authors: Antonio Caronni, Michela Picardi
      Abstract: Clinical Rehabilitation, Ahead of Print.

      Citation: Clinical Rehabilitation
      PubDate: 2021-09-02T12:56:33Z
      DOI: 10.1177/02692155211040733
       
  • Why we need an internationally shared rehabilitation definition for
           clinical research purposes

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      Authors: Stefano Negrini, William Mark Magnus Levack, Thorsten Meyer, Carlotte Kiekens
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Purpose:Responding to a recent editorial arguing against defining rehabilitation, we discuss the reasons for developing a classification of rehabilitation for research purposes, its philosophical background and some of the possible risks.Why define:Science requires the definition and classification of phenomena to allow replication of experiments and studies, and to allow interpretation and use of the findings. As understanding increases, the definitions can be refined. Defining rehabilitation does run the risk of excluding some interventions or practices that are either considered rehabilitation (perhaps wrongly) or are rehabilitation interventions; when identified, these errors in definition can be remedied. Defining rehabilitation for research purposes should not inhibit but could (possibly) orient research.Risk of not:Without a definition, rehabilitation will remain in a permanent limbo. Experts will (apparently) know what it is, while others are left guessing or failing to comprehend or recognise it. This uncertainty may reassure some people, because all possible interventions are included; we argue that it downgrades the understanding of our field because interventions that are not rehabilitation are, nonetheless, called rehabilitation. In an era of international collaboration, and of undertaking systematic reviews with metanalysis, we need a shared definition.Conclusion:Terminology is often controversial, but definition enables progress in understanding such that terms themselves can evolve over time.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-31T07:30:03Z
      DOI: 10.1177/02692155211043215
       
  • Construct validity of the enfranchisement scale of the community
           participation indicators

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      Authors: Jessica Kersey, Lauren Terhorst, Allen W Heinemann, Joy Hammel, Carolyn Baum, Michael McCue, Elizabeth R Skidmore
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:This study examined the construct validity of the Enfranchisement scale of the Community Participation Indicators.Design:We conducted a secondary analysis of data collected in a cross-sectional study of rehabilitation outcomes.Subjects:The parent study included 604 community-dwelling adults with chronic traumatic brain injury, stroke, or spinal cord injury. The sample had a mean age of 64.1 years, was two-thirds male, and included a high proportion of racial minorities (n = 250, 41.4%).Main measures:The Enfranchisement scale contains two subscales: the Control subscale and the Importance subscale. We examined correlations between each Enfranchisement subscale and measures of participation, environment, and impairments. The current analyses included cases with at least 80% of items completed on each subscale (Control subscale: n = 391; Importance subscale: n = 219). Missing values were imputed using multiple imputation.Results:The sample demonstrated high scores, indicating poor enfranchisement (Control subscale: M = 51.7; Importance subscale: M = 43.0). Both subscales were most strongly associated with measures of participation (Control subscale: r = 0.56; Importance subscale: r = 0.52), and least strongly associated with measures of cognition (Control subscale: r = 0.03; Importance subscale: r = 0.03). The Importance subscale was closely associated with depression (r = 0.54), and systems, services, and policies (r = 0.50). Both subscales were associated with social attitudes (Control subscale: r = 0.44; Importance subscale: r = 0.44) and social support (Control subscale: r = 0.49; Importance subscale: r = 0.41).Conclusions:We found evidence of convergent validity between the Enfranchisement scale and measures of participation, and discriminant validity between the Enfranchisement scale and measures of disability-related impairments. The analyses also revealed the importance of the environment to enfranchisement outcomes.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-20T11:35:20Z
      DOI: 10.1177/02692155211040930
       
  • Economic analysis of the ‘Take Charge’ intervention for people
           following stroke: Results from a randomised trial

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      Authors: Braden Te Ao, Matire Harwood, Vivian Fu, Mark Weatherall, Kathryn McPherson, William J Taylor, Anna McRae, Tom Thomson, John Gommans, Geoff Green, Annemarei Ranta, Carl Hanger, Judith Riley, Harry McNaughton
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To undertake an economic analysis of the Take Charge intervention as part of the Taking Charge after Stroke (TaCAS) study.Design:An open, parallel-group, randomised trial comparing active and control interventions with blinded outcome assessmentSetting:Community.Participants:Adults (n = 400) discharged to community, non-institutional living following acute stroke.Interventions:The Take Charge intervention, a strengths based, self-directed rehabilitation intervention, in two doses (one or two sessions), and a control intervention (no Take Charge sessions).Measures:The cost per quality-adjusted life year (QALY) saved for the period between randomisation (always post hospital discharge) and 12 months following acute stroke. QALYs were calculated from the EuroQol-5D-5L. Costs of stroke-related and non-health care were obtained by questionnaire, hospital records and the New Zealand Ministry of Health.Results:One-year post hospital discharge cost of care was mean (95% CI) $US4706 (3758–6014) for the Take Charge intervention group and $6118 (4350–8005) for control, mean (95% CI) difference $ −1412 (−3553 to +729). Health utility scores were mean (95% CI) 0.75 (0.73–0.77) for Take Charge and 0.71 (0.67–0.75) for control, mean (95% CI) difference 0.04 (0.0–0.08). Cost per QALY gained for the Take Charge intervention was $US −35,296 (=£ −25,524, € −30,019). Sensitivity analyses confirm Take Charge is cost-effective, even at a very low willingness-to-pay threshold. With a threshold of $US5000 per QALY, the probability that Take Charge is cost-effective is 99%.Conclusion:Take Charge is cost-effective and probably cost saving.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-20T11:34:20Z
      DOI: 10.1177/02692155211040727
       
  • Joint mobilization and therapeutic exercises in the hands of patients with
           systemic sclerosis: A preliminary randomized controlled trial

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      Authors: Letticia Cristina Santos Cardozo Roque, Angélica da Silva Tenório, Lígia Tomaz de Aquino, Renata dos Santos Ferreira, Angela Luzia Branco Pinto Duarte, Andréa Tavares Dantas
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To investigate the effectiveness of Maitland’s joint mobilization and therapeutic exercises on the functionality of the hands in patients with systemic sclerosis.Design:Randomized controlled trial.Setting:Tertiary university hospital.Subjects:Twenty-four patients diagnosed with systemic sclerosis according to ACR/EULAR 2013 criteria; age ⩾18 years and Cochin Hand Functional Scale (COCHIN) score ⩾10. They were randomized to physical therapy group (n = 12) or control group (n = 12).Interventions:The physical therapy group received joint mobilization and undertook therapeutic exercises, twice a week, for 12 weeks, and received a booklet with information about the disease. The control group only received the booklet about the disease.Main measures:The primary outcome measure was functionality of the hands (COCHIN). The secondary outcomes measures were disability (SHAQ), pain (visual analogic scale), range of motion (HAMIS and Delta finger-to-palm), grip strength (JAMAR dynamometer), and quality of life (SF12).Results:Twenty-two patients were female, with a mean age of 47.4 ± 11.1 years and 18 had limited cutaneous form. The physical therapy group showed a decrease of 11.33 points in the COCHIN in comparison with the control group (P = 0.09). There was a significant increase in range of motion by HAMIS (3.00 ± 1.48 vs 5.42 ± 2.64, P = 0.008), reduction in pain VAS (3.42 ± 2.78 vs 7.75 ± 2.53, P < 0.001), and increase in the physical component of SF12 (38.51 ± 9.60 vs 32.65 ± 9.10, P = 0.038).Conclusion:Maitland’s joint mobilization and therapeutic exercises improved the functionality of the hands, reduced pain in the hands and wrists, increased range of motion, and improved quality of life in patients with systemic sclerosis.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-20T11:33:21Z
      DOI: 10.1177/02692155211038728
       
  • Effect of muscle strength training in children and adolescents with
           spastic cerebral palsy: A systematic review and meta-analysis

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      Authors: Javier Merino-Andrés, Agustín García de Mateos-López, Diane L Damiano, Alberto Sánchez-Sierra
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:This systematic review and meta-analysis investigates the effects of strength training program in children and adolescents with cerebral palsy to improve function, activity, and participation.Data sources:Five electronic databases (MEDLINE-Pubmed, Cochrane Library, PEDro, CINAHL, and SPORTDiscus) were systematically searched for full-text articles published from inception to 30 June 2021.Review methods:Randomized controlled trials were included, who compared: (i) child population with spastic cerebral palsy population between 0 and 22 years; (ii) studies in which a muscle strength training program was performed and included dosing information; (iii) studies comparing strength training with other physical therapy technique(s) or untreated control group. Studies with similar outcomes were pooled by calculating standardized mean differences. Risk of bias was assessed with Cochrane Collaboration’s tool for assessing the risk of bias and PROSPERO’s registration number ID: CRD42020193535.Results:Twenty-seven studies, comprising 847 participants with spastic cerebral palsy. The meta-analyses demonstrated significant standardized mean differences in favor of strength training program compared to other physical therapy technique(s) or untreated control group(s) for muscle strength at the knee flexors, at the knee extensor, at the plantarflexors, maximum resistance, balance, gait speed, GMFM (global, D and E dimension) and spasticity.Conclusion:A strength training program has positive functional and activity effects on muscle strength, balance, gait speed, or gross motor function without increasing spasticity for children and adolescents with cerebral palsy in Gross Motor Function Classification System levels I, II, and III when adequate dosage and specific principles are utilized.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-19T04:46:26Z
      DOI: 10.1177/02692155211040199
       
  • Exercise therapy for sarcopenia in rheumatoid arthritis: A meta-analysis
           and meta-regression of randomized controlled trials

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      Authors: Chun-De Liao, Hung-Chou Chen, Shih-Wei Huang, Tsan-Hon Liou
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:Rheumatoid arthritis and age are associated with high sarcopenia risk. Exercise is an effective treatment for preventing muscle mass loss in older adult populations. It remains unclear whether exercise affects muscle mass in people with rheumatoid arthritis. Thus, this meta-analysis investigated the effect of exercise on muscle mass gain in patients with rheumatoid arthritis.Data sources:PubMed, EMBASE, the Cochrane Library, the Physiotherapy Evidence Database (PEDro), the China Knowledge Resource Integrated Database, and Google Scholar were systematically searched until June 2021.Methods:The present study was conducted according to the guidelines recommended by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Randomized controlled trials (RCTs) that reported the effects of exercise on muscle mass for rheumatoid arthritis were identified. The included RCTs were subject to meta-analysis and risk of bias assessment. Subgroup and random-effects meta-regression analyses were performed to identify any heterogeneity (I2) of treatment effects across studies.Results:We included nine RCTs with a median PEDro score of 6/10 (range: 4/10–8/10). The weighted mean effect size for muscle mass was 0.77 (95% CI: 0.30–1.24; P = 0.001; I2 = 77%). Meta-regression analyses indicated that the disease duration significantly explained variance of treatment effects across studies (β = −0.006, R2 = 69.7%, P = 0.005).Conclusions:Exercise therapy effectively increased muscle mass in patients with rheumatoid arthritis. Treatment effects may be attenuated in those who have had rheumatoid arthritis for a relatively long time.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-18T09:01:56Z
      DOI: 10.1177/02692155211035539
       
  • Efficacy and safety of transcranial direct current stimulation for
           post-stroke spasticity: A meta-analysis of randomised controlled trials

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      Authors: Jiapeng Huang, Yun Qu, Lini Liu, Kehong Zhao, Ziqi Zhao
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objectives:To evaluate the efficacy and safety of transcranial direct current stimulation for post-stroke spasticity and to assess its evidence using a meta-analysis.Methods:We searched the Cochrane Library, EMBASE, MEDLINE (via PubMed), PEDro, CBM, CNKI and Wan Fang Data from their inception to June 2021 for randomised clinical trials published in English or Chinese, which aimed to explore the effects of transcranial direct current stimulation on post-stroke spasticity. Two reviewers independently extracted the data and evaluated the methodological quality and overall evidence quality.Results:Thirteen randomised clinical trials comprising 924 patients were included, 12 of which were included in the meta-analysis. The results showed that anodal stimulation (standard mean difference = −0.91; [95% CI; −1.63 to −0.19]) combined with other therapies was more effective in improving upper limb spasticity. More than 20 minutes of stimulation were found to be effective in improving spasticity. Transcranial direct current stimulation was superior to the control treatments for subacute (standard mean difference = −1.16; −1.75 to −0.57) and chronic stroke (standard mean difference = −0.68; −1.13 to −0.22) patients aged under 60 (standard mean difference = −1.07; −1.54 to −0.60). No severe adverse events were reported in any of the included studies.Conclusions:Low-quality evidence demonstrates that anodal transcranial direct current stimulation as an adjunct is effective and safe in reducing upper limb post-stroke spasticity when applied for more than 20 minutes in subacute and chronic stroke survivors aged under 60. Further high-quality studies are needed to explore its long-term efficacy and safety.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-13T11:13:41Z
      DOI: 10.1177/02692155211038097
       
  • Anti-gravity treadmill rehabilitation improves gait and muscle atrophy in
           patients with surgically treated ankle and tibial plateau fractures after
           one year: A randomised clinical trial

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      Authors: Lisa Palke, Sebastian Schneider, Bernhard Karich, Meinhard Mende, Christoph Josten, Jörg Böhme, Ralf Henkelmann
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To compare the one-year postoperative outcomes of anti-gravity treadmill rehabilitation with those of standard rehabilitation in patients with ankle or tibial plateau fractures.Design:An open-label prospective randomised study.Setting:Three trauma centres.Subjects:Patients were randomised into the intervention (anti-gravity treadmill) or control (standard protocol) rehabilitation group.Main measures:The primary endpoint was changes in the Foot and Ankle Outcome Score for ankle fractures and Knee Injury and Osteoarthritis Outcome Score for tibial plateau fractures from baseline to 12 months after operation. Secondary endpoints were the subscores of these scores, muscle atrophy (leg circumference at 20 cm above and 10 cm below the knee joint) and the Dynamic Gait Index.Results:Initially, 73 patients (37 vs 36) underwent randomisation. After 12 months, 29 patients in the intervention group and 24 patients in the control group could be analysed. No significant difference was noted in the Foot and Ankle Outcome Score (80.8 ± 18.4 and 78.4 ± 21.1) and Knee Injury and Osteoarthritis Outcome Score (84.8 ± 15.2 and 81.7 ± 17.0). The change in the Dynamic Gait Index from 12 weeks to 12 months differed significantly between the groups (P = 0.04). Patients with tibial plateau fractures had a 3 cm wider thigh circumference in the intervention group than those in the control group (95% confidence interval: −0.2 to 6.3 cm, P = 0.08).Conclusion:One year after surgery, patients who had undergone anti-gravity treadmill rehabilitation showed better gait than patients in the control group, and those with tibial plateau fractures had less muscle atrophy.
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-06T09:09:46Z
      DOI: 10.1177/02692155211037148
       
  • Evaluation of the predictive validity of the Hessisch Oldendorf Risk of
           Falling Scale (HOSS)

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      Authors: Simone B Schmidt, Melanie Boltzmann, Jens D Rollnik
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:This study aims to further validate the Hessisch Oldendorf Risk of Falling Scale (HOSS) for neurological rehabilitation patients.Design:The overall scale performance and fall rate was calculated in a retrospective data analysis.Setting:The study was performed in a subacute care facility during inpatient neurological rehabilitation.Subjects:The study population (n = 512) included neurological and neurosurgical patients with heterogeneous levels of disability.Main measures:The HOSS total score and the suspected risk of falling were compared with the number of falls. Characteristics of fallers and non-fallers were compared using non-parametric group comparisons. Overall scale performance was assessed by calculating the area under the receiver operating characteristic curve of the HOSS as well as by calculating the sensitivity and specificity.Results:A total of 82 (16%) patients experienced at least one fall. Fallers were characterized by an older age, a longer length of stay, a more severe impairment in the activities of daily living upon admission, a hemiparesis, an orientation disorder, a need of a walking aid device and an urinary incontinence. The number of falls was associated with the HOSS total score. Sixty-four fallers and two hundred seventy-four non-fallers were correctly categorized leading to a sensitivity of 78.0% and a specificity of 63.7%. The area under the receiver operating characteristic curve of the HOSS was 0.778 ± 0.25 (CI = 0.729–0.828, P 
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-04T09:00:10Z
      DOI: 10.1177/02692155211034149
       
  • Comparative effectiveness study of low versus high-intensity aerobic
           training with resistance training in community-dwelling older men with
           post-COVID 19 sarcopenia: A randomized controlled trial

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      Authors: Gopal Nambi, Walid Kamal Abdelbasset, Saud M. Alrawaili, Shereen H. Elsayed, Anju Verma, Arul Vellaiyan, Marwa M. Eid, Osama R. Aldhafian, Naif Bin Nwihadh, Ayman K. Saleh
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To find and compare the clinical and psychological effects of low and high-intensity aerobic training combined with resistance training in community-dwelling older men with post-COVID-19 sarcopenia symptoms.Design:Randomized control trial.Setting:University physiotherapy clinic.Participants:Men in the age range of 60–80 years with post-COVID-19 Sarcopenia.Intervention:All participants received resistance training for whatever time of the day that they received it, and that in addition they were randomized into two groups like low-intensity aerobic training group (n = 38) and high-intensity aerobic training group (n = 38) for 30 minutes/session, 1 session/day, 4 days/week for 8 weeks.Outcomes:Clinical (muscle strength and muscle mass) and psychological (kinesiophobia and quality of life scales) measures were measured at the baseline, fourth week, the eighth week, and at six months follow-up.Results:The 2 × 4 group by time repeated measures MANOVA with corrected post-hoc tests for six dependent variables shows a significant difference between the groups (P 
      Citation: Clinical Rehabilitation
      PubDate: 2021-08-04T05:48:55Z
      DOI: 10.1177/02692155211036956
       
  • A study of the accuracy of the Fitbit Zip in measuring steps both indoors
           and outdoors in a mixed rehabilitation population

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      Authors: Craig Farmer, Maayken EL van den Berg, Sally Vuu, Christopher J Barr
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To assess (1) step count accuracy of the Fitbit Zip, compared to manual step count, in people receiving outpatient rehabilitation, in indoor and outdoor conditions, and (2) impact of slow walking speed on Fitbit accuracy.Design:Observational study.Setting:A metropolitan rehabilitation hospital.Subjects:Adults (n = 88) attending a subacute rehabilitation outpatient clinic with walking speeds of between 0.4 and 1.0 m/s.Interventions:Two 2-minute walk tests, one indoors and one outdoors, completed in random order.Main measures:Step count recorded manually by observation and by a Fitbit Zip, attached to the shoe on the dominant or non-affected side. Subgroup analysis included assessment accuracy for those considered limited community walkers (slower than 0.8 m/s) and those considered community walkers (faster than 0.8 m/s).Results:The Fitbit significantly (P < 0.05) undercounted steps compared to manual step count, indoors and outdoors, with percentage agreement slightly higher outdoors (mean 92.4%) than indoors (90.1%). Overall, there was excellent consistent agreement between the Fitbit and manual step count for both indoor (ICC 0.83) and outdoor (ICC 0.88) walks. The accuracy of the Fitbit was significantly (P < 0.05) reduced in those who walked slower than 0.8 m/s outdoors (ICC 0.80) compared to those who walk faster than 0.8 m/s (ICC 0.90).Conclusions:The Fitbit Zip shows high step count accuracy with manual step count in a mixed subacute rehabilitation population. However, accuracy is affected by walking speed, with decreased accuracy in limited community walkers.
      Citation: Clinical Rehabilitation
      PubDate: 2021-07-27T11:13:21Z
      DOI: 10.1177/02692155211035293
       
  • Effects of mirror therapy on phantom limb sensation and phantom limb pain
           in amputees: A systematic review and meta-analysis of randomized
           controlled trials

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      Authors: Fengyi Wang, Rengang Zhang, Jiaqi Zhang, Dinggen Li, Yu Wang, Yong-Hong Yang, Quan Wei
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:This systematic review and meta-analysis aimed to evaluate the effects of mirror therapy on phantom limb sensation and phantom limb pain in amputees.Data sources:Nine electronic databases (PubMed, EMBASE, MEDLINE, Web of Science, the Cochrane Library, CINAHL, PsycInfo, PreQuest, PEDro) were searched from their inception to May 10th, 2021.Methods:Two authors independently selected relevant studies and extracted the data. The effect sizes were calculated under a random-effects model meta-analysis, and heterogeneity was assessed using the I2 test. The risk of bias was evaluated by the Cochrane risk of bias tool, and the methodological quality was appraised by the PEDro scale. The GRADE approach was applied to assess the confidence of the effect.Results:A total of 11 RCTs involving 491 participants were included in this review and nine RCTs involving 372 participants were included in meta-analysis. The quality of these studies was from poor to good with scores ranging from 2 to 8 points according to PEDro scale. The pooled SMD showed that mirror therapy reduced the pain with a large effect size (−0.81; 95% CI = −1.36 to −0.25; P = 0.005; I2 = 82%; n = 372) compared with other methods (four covered mirror, one phantom exercise, three mental visualization, one sensorimotor exercise, one transcutaneous electrical nerve stimulation, one tactile stimuli). The quality of evidence for the outcome pain intensity was determined to be fair according to GRADE approach.Conclusion:There is fair-quality evidence that MT is beneficial for reducing phantom limb pain.
      Citation: Clinical Rehabilitation
      PubDate: 2021-07-24T09:35:09Z
      DOI: 10.1177/02692155211027332
       
  • Effects of adding neural mobilization to traditional physical therapy on
           pain, functional disability, and H-reflex in patients after lumbar
           laminectomy: A randomized controlled trial

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      Authors: Moussa A Sharaf, Soheir S Rezkallah, Khalid Z Fouda, Nevein MM Gharib
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To investigate whether adding neural mobilization to a standard postoperative physical therapy program could improve the outcomes of patients after lumbar laminectomy.Design:A single blinded randomized controlled trial.Setting:Outpatient setting.Participants:Sixty participants of both sexes who had undergone lumbar laminectomy.Interventions:Participants were allocated randomly to two groups; study and control groups. All patients received a standard postoperative physical therapy program. Those in the study group received additional neural mobilization in the form of straight leg raising and dorsiflexion with two-ended slider. Treatment was administered three times/week for six successive weeks.Outcome measures:Visual analog scale (VAS), Oswestry disability index (ODI), and H-reflex latency were measured pre and post-treatment.Results:The mean age of participants was 44.23 ± 4.64 and 45.3 ± 5.3 in study and control groups respectively (P > 0.05). There were statistically significant differences in VAS, ODI, and H-reflex latency in favor of the study group (P 
      Citation: Clinical Rehabilitation
      PubDate: 2021-07-23T10:25:50Z
      DOI: 10.1177/02692155211034154
       
  • A novel model of home-based, patient-tailored and mobile
           application-guided cardiac telerehabilitation in patients with atrial
           fibrillation: A randomised controlled trial

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      Authors: Cheng Cai, Zhipeng Bao, Nan Wu, Fengming Wu, Guozhen Sun, Gang Yang, Minglong Chen
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To assess the effectiveness of tele-monitored cardiac rehabilitation in patients who have undergone ablation for atrial fibrillation.Design:Single-centre, prospective, assessment-blinded, randomised controlled trial.Setting:Domiciliary rehabilitation with support from a tertiary care hospital.Subjects:One hundred patients who underwent ablation for atrial fibrillation were recruited.Interventions:Participants were randomly allocated to a 12-week standard rehabilitation treatment (control group) or a comprehensive, domiciliary, mobile application-guided and tele-monitored cardiac rehabilitation program (intervention group) in a 1:1 fashion.Main outcome measures:The primary endpoint was the improvement in VO2peak. The secondary outcomes included adherence, physical activity, beliefs related to cardiovascular disease and exercise self-efficacy.Results:Ninety-seven patients completed follow-up. The mean VO2peak increased significantly in both the intervention group (n = 49) (baseline vs 12 weeks: 19.1 ± 4.7 vs 27.3 ± 5.6 ml/(min kg), P 
      Citation: Clinical Rehabilitation
      PubDate: 2021-07-16T08:55:20Z
      DOI: 10.1177/02692155211032372
       
  • Effect of patient education on quality-of-life, pain and fatigue in breast
           cancer survivors: A systematic review and meta-analysis

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      Authors: Patricia Martínez-Miranda, María Jesús Casuso-Holgado, José Jesús Jiménez-Rejano
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To synthesise the existing evidence about the effect of patient education, either used alone or as adjunctive therapy, on the improvement of quality of life, pain and fatigue in adult breast cancer survivors.Data sources:We searched PubMed, Web of Science, CINAHL, SCOPUS, Cochrane Plus, PEDro, Dialnet and Clinicaltrials.gov databases.Methods:We conducted this systematic review in accordance with the PRISMA statement. Only randomised controlled trials with adult breast cancer survivors were included. We assessed the methodological quality of the studies using the PEDro scale and the Cochrane risk-of-bias tool. We synthesised evidence using the GRADE tool.Results:We included 14 studies (PEDro 4–8 points) comprising 1749 adult women who survived breast cancer, of which we included 12 in the quantitative analysis. There were statistically significant short-term benefits for improved global quality-of-life (standardised mean difference [SMD] = 0.43, P = 0.05, 95% CI [0.00, 0.85]; GRADE: low certainty; not important), emotional quality-of-life (SMD = 0.32, P = 0.04, 95% CI [0.02, 0.62]) and fatigue (SMD = 0.24, P = 0.0004, 95% CI [0.11, 0.37]; GRADE: low certainty; not important). However, there were not statistically significant for pain severity (SMD = −0.05, P = 0.67, 95% CI [−0.26, 0.17]; GRADE: low certainty; not important) and fear to recurrence (SMD = −0.05, P = 0.68, 95% CI [−0.31, 0.20]; GRADE: moderate certainty; not important).Conclusion:Patient education have a significative effect in short-term global quality-of-life, emotional quality-of-life and fatigue, though all the results were classified as ‘not important’.
      Citation: Clinical Rehabilitation
      PubDate: 2021-07-16T08:54:24Z
      DOI: 10.1177/02692155211031081
       
  • Effects of a progressive resistance exercise program in patients with hand
           osteoarthritis: A randomized, controlled trial with a blinded assessor

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      Authors: Michele Nery, Jamil Natour, Fabio Jennings, Artur da Rocha Corrêa Fernandes, Marcelo C Souza, Anamaria Jones
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To assess the effectiveness of a progressive resistance strength program on pain, function and strength in hand osteoarthritis patients.Design:Randomized controlled trial.Settings:Outpatients, University Hospital.Subjects:Sixty hand osteoarthritis patients were randomly allocated to exercise group (n = 30) or control group (n = 30).Intervention:The exercise group performed a progressive resistance strength program for hand muscles over 12 weeks. Both groups had a single education session.Main measures:The primary outcome was pain intensity (numeric pain scale). The secondary outcomes were – AUSCAN Hand Osteoarthritis Index, Cochin Hand Functional Scale for function and grip and pinch strength. A blinded evaluator performed the evaluations at baseline, 6 and 12 weeks.Results:The mean age were 68.9 (8.8) and 64.7 (8.9) for control and exercise groups, respectively. No significant differences between-group was observed for pain after 12 weeks (mean difference between groups was −1.30 (−0.02 to 2.62) for dominant hand and −1.33 (0.01–2.65) for non-dominant hand at T12, with P = 0.085 and 0.295, respectively). Regarding secondary outcomes, statistically significant differences between groups were found in exercise group: AUSCAN index – total score (P = 0.005), pain (P = 0.006), function (P = 0.047), and Cochin scale (P = 0.042) with the following mean difference between groups: −9.9 (4.07–15.73), −3.26 (1.06–5.46), −5.03 (1.20–8.86), and −6.27 (0.18–12.36), respectively.Conclusion:No difference was observed for pain (numerical pain scale) after the progressive resistance exercise program performed, however in exercise group, an improvement was observed on secondary outcomes such as pain during activities and function for patients with hand osteoarthritis.Level of evidence:1b
      Citation: Clinical Rehabilitation
      PubDate: 2021-07-09T09:54:13Z
      DOI: 10.1177/02692155211030622
       
  • Exploration of interventions to enhance return-to-work for cancer
           patients: A scoping review

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      Authors: Yu-Jie Guo, Jue Tang, Jia-Mei Li, Ling-Li Zhu, Jia-Shuo Xu
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:With the increasing incidence and earlier onset of cancer, more and more cancer patients are facing the problems of return-to-work. This review is to explore the types, contents, and results of return-to-work interventions for cancer patients.Methods:This scoping review followed Arksey and O’Malley’s framework and PRISMA-ScR List. Three Chinese databases and five English databases were searched from the establishment of databases to 31 March, 2021. Article selection and data extraction were conducted by two researchers.Results:Thirty-two studies and 1916 cancer patients with mainly breast and gastrointestinal cancer were included. According to the contents, interventions could be divided into four types: (1) physical interventions (n = 6), including high-intensity exercise, low-to-moderate intensity exercise, yoga, and upper limb functional training, (2) psychological interventions (n = 2), including early active individualized psychosocial support and mindfulness-based recovery, (3) vocational interventions (n = 14), including making work plans, educational leaflets, vocational consultations, electronic health intervention, and interventions targeting at employers, (4) multidisciplinary interventions (n = 10), including any combination of above interventions. Physical exercises, making working plans, vocational consultations, educational leaflets, two combinations of vocational and physical interventions were validated to have positive results in enhancing cancer patients’ return-to-work.Conclusions:Return-to-work interventions for cancer patients are diversified and can be divided into physical, psychological, vocational, and multidisciplinary interventions. Medical staffs can utilize physical exercises, making working plans, vocational consultation, educational leaflets, combinations of vocational and physical interventions to enhance cancer patients’ return-to-work. Other interventions still need to be developed and validated.
      Citation: Clinical Rehabilitation
      PubDate: 2021-07-06T09:35:50Z
      DOI: 10.1177/02692155211021706
       
  • Defining rehabilitation: An exploration of why it is attempted, and why it
           will always fail

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      Authors: Derick T Wade
      Abstract: Clinical Rehabilitation, Ahead of Print.
      The problem:Over 187 definitions of rehabilitation exist, none widely agreed or used. Why'The word:Words represent a core concept, with a penumbra of associated meanings. A word means what is agreed among those who use it. The precise meaning will vary between different groups. Words evolve, the meaning changing with use. Other words may capture some of the concepts or meanings.A definition:A definition is used to control the unstable, nebulous meaning of a word. It delineates, creating a boundary. A non-binary spectrum of meaning is transformed into binary categories: rehabilitation, or not rehabilitation. In clinical terms, it is a diagnostic test to identify rehabilitation. There are many different reasons for categorising something as rehabilitation. Each will need its own definition.Categorisation:The ability of a definition to distinguish cases accurately must be validated by comparison with ‘the truth’. If there were an external ‘true’ test to identify rehabilitation, a definition would not be needed. As with most concepts, the only truth is agreement by people familiar with the required distinction. Any definition will generate misclassification. People familiar with the required distinction will also need to resolve mis-categorisation.Description:An alternative is a ‘descriptive definition’, listing features over several domains which must be present. This fails logically. Rehabilitation is an emergent concept, more than the sum of its parts.Conclusion:A useful definition cannot be achieved because no definition will cover all needs, and a specific definition for a purpose will misclassify some cases.
      Citation: Clinical Rehabilitation
      PubDate: 2021-06-29T05:08:29Z
      DOI: 10.1177/02692155211028018
       
  • Practical guidance on use of TEARS-Q to diagnose post-stroke emotionalism

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      Authors: Niall M Broomfield, Robert West, Mark Barber, David C Gillespie, Allan House, Matthew Walters
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To evaluate, using a classification tree methodology, the ability of the Testing Emotionalism After Recent Stroke – Questionnaire (TEARS-Q) to determine the need for further assessment of post-stroke emotionalism and to identify those whose emotionalism is sufficiently clear that they need assessment for potential intervention.Setting:Acute stroke units of nine Scottish hospitals in the context of a longitudinal cohort study of post-stroke emotionalism.Subjects:A total of 228 stroke survivors recruited between October 1st 2015 and September 30th 2018, within two weeks of stroke.Measures:The measure was the self-report questionnaire TEARS-Q, constructed based on recognised diagnostic features of post-stroke tearful emotionalism. The reference standard was presence/absence of emotionalism on a diagnostic, semi-structured post-stroke emotionalism interview, administered at the same assessment point.Results:Nine of 159 subjects scoring 0 or 1 on TEARS-Q were diagnosed with post-stroke emotionalism on the reference standard, compared to 11 of 21 subjects scoring 2 to 5 on TEARS-Q and 42 of 48 participants scoring 6 and above. Adding age, sex, deprivation, stroke type, stroke severity, mood, cognition, daily functioning and education did not improve the prediction accuracy sufficiently to change the classification tree.Conclusion:TEARS-Q reliably identifies those who need no further post-stroke emotionalism assessment, those who need further assessment to clarify diagnosis, and those who almost certainly have post-stroke emotionalism and may benefit from intervention.
      Citation: Clinical Rehabilitation
      PubDate: 2021-06-17T08:58:10Z
      DOI: 10.1177/02692155211024801
       
  • Objectively-assessed physical activity and self-reported activity pacing
           in adults with multiple sclerosis: A pilot study

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      Authors: Ulric S Abonie, John Saxton, Katherine Baker, Florentina J Hettinga
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To examine the association between self-reported activity pacing (a strategy to manage fatigue symptoms) and objectively-measured physical activity behaviours in adults with multiple sclerosis.Design:Single cross-sectional studySetting:Multiple sclerosis rehabilitation centre in Colchester, United Kingdom.Subjects:Twenty-one adults (59 ± 9 years) with multiple sclerosis.Main measures:Physical activity behaviours (activity level: activity counts per minute; activity variability: highest activity counts per minute each day divided by activity counts per minute on that day) were measured with accelerometers. Self-reported activity pacing (Activity Pacing and Risk of Overactivity Questionnaire), fatigue severity (Fatigue Severity Scale) and health-related quality of life (RAND-12-Item Short-Form Health Survey) were measured. Scatter plots were used to explore associations between measures.Results:Activity level was 258 ± 133 counts per minutes, activity variability was 4 ± 1, self-reported activity pacing was 3 ± 1, fatigue severity was 5 ± 2 and health-related quality of life was 43 ± 8. Increased self-reported activity pacing was associated with lower activity levels and less variability in daily activities.Conclusion:This investigation suggests that people with multiple sclerosis who have low physical activity levels could be inappropriately using activity pacing as a reactionary response to their multiple sclerosis symptoms.
      Citation: Clinical Rehabilitation
      PubDate: 2021-06-16T09:56:54Z
      DOI: 10.1177/02692155211024135
       
  • Brazilian version of the Neck Bournemouth Questionnaire does not have a
           well-defined internal structure in patients with chronic neck pain

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      Authors: Gabriel Gardhel Costa Araujo, Cid André Fidelis-de-Paula-Gomes, André Pontes-Silva, Jocassia Silva Pinheiro, Leticia Padilha Mendes, Maria Cláudia Gonçalves, Almir Vieira Dibai-Filho
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To investigate the structural validity of the Brazilian version of the Neck Bournemouth Questionnaire in patients with chronic neck pain.Design:Cross-sectional study.Setting:Community participants collected via online platform.Subjects:Participants with neck pain (minimal pain intensity of 3 points at rest on 11-point Numerical Rating Scale), both genders and aged ⩾18 years old.Main measure:The Numerical Rating Scale, Neck Disability Index, Pain-Related Catastrophizing Thoughts Scale, Tampa Scale of Kinesiophobia and the Neck Bournemouth Questionnaire were completed. Exploratory and confirmatory factor analyses were used to identify dimensionality and to compare different structures of the Neck Bournemouth Questionnaire.Results:We included 103 participants. The sample consisted mostly of adults (mean age = 33.64 years, standard deviation = 10.48 years), females (n = 82, 79.6%), lean, single and with higher education. The exploratory factor analysis with implementation of the parallel analysis identified the one-dimensional structure of the Neck Bournemouth Questionnaire, with a Kaiser-Meyer-Olkin value of 0.80 and Bartlett’s test significant (P  0.08 and chi-square/degree of freedom > 3.00.Conclusion:The internal structure of the Brazilian version of the Neck Bournemouth Questionnaire is not clear and well-defined. It was not possible to identify the construct measured by the instrument in individuals with chronic neck pain.
      Citation: Clinical Rehabilitation
      PubDate: 2021-06-10T08:44:25Z
      DOI: 10.1177/02692155211024034
       
  • Effects of balance training on functionality, ankle instability, and
           dynamic balance outcomes in people with chronic ankle instability:
           Systematic review and meta-analysis

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      Authors: Sara Mollà-Casanova, Marta Inglés, Pilar Serra-Añó
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Aim:To identify the effects of balance and strength training on function, ankle instability and dynamic balance in people with chronic ankle instability.Method:The search was conducted on randomized controlled trials that investigated the effects of balance training or strength training in people with chronic ankle instability compared to a control group. Therefore, a systematic electronic search was performed until April 2021 in Pubmed/MEDLINE, Cochrane, and Embase databases. Moreover, an additional search was further performed checking the reference lists of the selected articles. The main outcomes were ankle instability, functionality, and dynamic balance. Finally, a qualitative and quantitative synthesis was performed.Results:Fifteen randomized controlled trials with 457 volunteers were included. Compared to regular exercise, balance training demonstrated to be more effective in terms of improving functionality (0.81 (0.48, 1.14)), ankle instability (0.77 (0.27, 1.26)), and dynamic balance (0.83 (0.57, 1.10)) outcomes. However, when compared to strength training, the effectiveness of balance training was only greater in terms of the functionality outcome (0.49 (0.06, 0.92)), since no differences were found for instability (0.43 (0.00, 0.85)) and dynamic balance (0.21 (−0.15, 0.58)).Conclusions:Based on fair-to-high quality evidence, balance training significantly improves functionality, instability, and dynamic balance outcomes in people with chronic ankle instability Moreover, results of the comparison between balance training versus strength training suggest that the former achieves greater benefits for functionality, but not for instability and dynamic balance.Systematic review registration number: CRD42021224179.
      Citation: Clinical Rehabilitation
      PubDate: 2021-06-01T04:06:59Z
      DOI: 10.1177/02692155211022009
       
  • Conservative treatment of partial-thickness rotator cuff tears and
           tendinopathy with platelet-rich plasma: A systematic review and
           meta-analysis

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      Authors: Xiao-Na Xiang, Jie Deng, Yan Liu, Xi Yu, Biao Cheng, Hong-Chen He
      Abstract: Clinical Rehabilitation, Ahead of Print.
      Objective:To assess the effect of platelet-rich plasma as a conservative therapy in individuals with partial-thickness rotator cuff tears or tendinopathy on pain, and function.Data sources:Embase, MEDLINE, CENTRAL, Web of Science, CINAHL, PEDro, and the grey literature (to 31 March 2021).Methods:Randomized controlled trials in English that reported short-term (6 ± 1 months), or long-term (⩾1 year) outcomes (shoulder pain or function) were conducted. Two independent reviewers screened the literature, completed the assessment of the Cochrane’s risk of bias and extracted the data. Mean difference or standardized mean difference was used for continuous data. Heterogeneity was identified with I2 test.Results:A total of 11 studies were eligible, and nine studies (n = 629) were included in this meta-analysis, that showed statistically significant short-term effects of platelet-rich plasma on pain relief (MD = −1.56; 95% CI −2.82 to −0.30), Constant-Murley score (MD = 16.48; 95% CI 12.57 to 20.40), and Shoulder Pain and Disability Index (MD = −18.78; 95% CI −36.55 to −1.02). Nonetheless, no long-term effect was observed on pain and function, except Constant-Murley score (MD = 24.30; 95% CI 23.27 to 25.33). The results of minimal important difference reached the minimal clinically important difference, except American Shoulder and Elbow Surgeons. For subgroup analysis, differences of pain relief were statistically significant in platelet-rich plasma-treated groups with double centrifugation, single injection, and post-injection rehabilitation.Conclusion:Our results suggested platelet-rich plasma had positive effects on pain relief and functional improvement for partial-thickness rotator cuff tears and rotator cuff tendinopathy, although the effects may not last for a long time.
      Citation: Clinical Rehabilitation
      PubDate: 2021-04-26T07:02:13Z
      DOI: 10.1177/02692155211011944
       
 
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