Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Shoulder irritability differs by standardised measures of movement-evoked pain.
Anderson AW, Hanney WJ
Clin Rehabil · 2025 Aug · PMID 40485267 · Publisher ↗
ObjectiveIrritability utilises pain behaviour during movement to inform examination and treatment intensity. Standardised measures of movement-evoked pain have not previously been applied to irritability. This study exam...
ObjectiveIrritability utilises pain behaviour during movement to inform examination and treatment intensity. Standardised measures of movement-evoked pain have not previously been applied to irritability. This study examined whether shoulder pain during standard movements differed by irritability category and level.DesignObservational studySettingResearch laboratoryParticipantsParticipants with shoulder pain (n=40)InterventionIrritability was assessed followed by psychological questionnaires (Fear of Pain Questionnaire, Pain Catastrophizing Scale, Tampa Scale of Kinesiophobia, Center for Epidemiologic Studies-Depression, State-Trait Anger Expression Inventory, Pain Anxiety Symptoms Scale, Pain Self-Efficacy Questionnaire), quantitative sensory testing (pressure pain threshold, heat pain threshold, conditioned pain modulation, temporal summation), and movement-evoked pain (lifting, functional movements, repetitive movements, self-selected task).Main measuresShoulder pain intensity was assessed before, during, and after each task. A t-test and ANOVA examined differences in each movement task by irritability.ResultsPain during the standardised lifting task was significantly higher in individuals categorised as irritable (p=0.03) than not irritable, as well as high irritability compared to moderate (p<0.01). Pain during functional movements was significantly higher in individuals categorised as irritable (p<0.01) compared to not, as well as high compared to low irritability (p<0.01). Performance on repetitive tasks did not significantly differ by irritability category (p=0.63) or level (p=0.44). Change in pain ratings during the self-selected task did not differ by irritability category (p=0.67) or level (p=0.95).ConclusionsPain during standardised, functional movements may differentiate irritability. Clinicians may want to consider functional testing in which pain is assessed during movement for patients with irritable shoulder pain.
Factors associated with functional recovery after intensive care unit discharge in patients with mechanical ventilation: A multi-centre prospective observational study.
Yamauchi K, Watanabe S, Naito Y … +7 more , Goto K, Tanaka S, Shinya T, Fujino Y, Ogawa K, Yoshikawa T, Hirota Y
Clin Rehabil · 2025 Jul · PMID 40474648 · Publisher ↗
ObjectiveThe rehabilitation of patients with disabilities post-intensive care unit (ICU) discharge is gaining importance and we aimed to identify factors associated with recovery in this study.DesignThis study was a seco...
ObjectiveThe rehabilitation of patients with disabilities post-intensive care unit (ICU) discharge is gaining importance and we aimed to identify factors associated with recovery in this study.DesignThis study was a secondary analysis of a multi-centre cohort study.SettingNine centres in Japan.ParticipantsA total of 121 patients admitted to the ICU who used an invasive ventilator for >48 h were the participants of this study.Main measuresThe relative functional gain and rehabilitation efficiency index, based on the Barthel Index, were calculated from the time of ICU discharge to hospital discharge. Factors related to the relative functional gain and rehabilitation efficiency index were analysed using multiple regression analysis.ResultsThe median relative functional gain value was 85% and the median rehabilitation efficiency index value was 1.61 points/day. Multiple regression analysis showed that relative functional gain was significantly associated with ventilator duration (β = -1.420, < 0.001), the Medical Research Council score at ICU discharge (β = 1.557, < 0.001), the Barthel Index at ICU discharge (β = 0.501, p < 0.001) and rehabilitation hours in general wards (β = 0.591, = 0.008). The rehabilitation efficiency index was significantly associated with ventilator duration (β = -0.089, = 0.022) and Medical Research Council score at ICU discharge (β = 0.098, < 0.001).ConclusionsOur findings highlight the importance of post-ICU rehabilitation, particularly in patients with prolonged ventilation or reduced muscle strength, and support the clinical utility of rehabilitation impact indices in monitoring recovery trajectories.
Retraction notice: "Acceptance and commitment therapy for the treatment of depression in persons with physical disability: A randomized controlled trial".
Clin Rehabil · 2025 Jun · PMID 40473438 · Publisher ↗
Abstract loading — click title to view on PubMed.
Home-based self-training: A qualitative exploration of the experiences of individuals with chronic-stroke.
Loubani K, Bachar Kirshenboim Y, Maman R … +2 more , Levin C, Rand D
Clin Rehabil · 2025 Jul · PMID 40457990 · Full text
ObjectiveTo explore how individuals with chronic-stroke experience and engage in home-based self-training, aiming to highlight factors related to their adherence and overall experience of self-training.DesignA qualitativ...
ObjectiveTo explore how individuals with chronic-stroke experience and engage in home-based self-training, aiming to highlight factors related to their adherence and overall experience of self-training.DesignA qualitative study.SettingCommunity.SubjectsIndividuals with chronic-stroke.InterventionsParticipants underwent a structured 5-week home-based upper-extremity self-training via videogames or the Graded Repetitive Arm Supplementary Intervention which includes activities using everyday objects.Main measuresParticipants were interviewed following their participation in the self-training intervention, using a semi-structured interview. Interviews were transcribed verbatim and then analyzed using thematic analysis. Findings were validated through author discussions.ResultsTwenty-two participants (63% men) were included, aged 33 to 80, 6-36 months post-stroke. Participants had preserved cognitive ability, were mostly independent in daily living, and had a moderate upper-extremity motor ability (median (interquartile range (IQR)) Fugl-Meyer Motor Assessment score: 41 (29-47)/66 points). Three main themes were identified: 1) personal factors (e.g. devotion to perform self-training, commitment to the study, and personal roles), 2) self-training factors (e.g. experience and its influence on general condition), 3) environment-related factors (e.g. training equipment, home environment, and family support). The structured intervention and family support led to motivation and commitment. Challenges included time constraints, pain, and fatigue.ConclusionsThis qualitative study deepens understanding of home-based self-training experiences among individuals with chronic-stroke, highlighting how motivational, environmental, and self-training factors interact to shape long-term adherence. These insights can guide clinicians tailor interventions to promote long-term adherence and engagement by addressing individual, environmental, and task-related factors, and by identifying participants who may require additional support.
Clinical utility, validity and reliability of the IPad application for goal-setting: The aid for decision-making in occupation choice-2.
Tomori K, Sawada T, Okita Y … +1 more , Levack WW
Clin Rehabil · 2025 Jul · PMID 40457883 · Publisher ↗
ObjectiveTo evaluate the clinical utility, reliability, and validity of the second-generation aid for decision-making in occupation choice-2 (ADOC2), an iPad application designed for client-centred and occupation-centred...
ObjectiveTo evaluate the clinical utility, reliability, and validity of the second-generation aid for decision-making in occupation choice-2 (ADOC2), an iPad application designed for client-centred and occupation-centred goal setting.DesignThis study consisted of two components: (1) The development and refinement of the ADOC2 application, focusing on user interface design and structured goal-setting functionality; and (2) the clinical evaluation of its utility, validity, and reliability.SettingEleven rehabilitation facilities in Japan (10 hospitals, 1 home-based setting).ParticipantsA total of 116 occupational therapy clients and 56 occupational therapists participated in the study.Main measuresClinical utility was assessed using a structured questionnaire previously validated for the original ADOC. Validity was examined through correlations with the Canadian Occupational Performance Measure (COPM) and the EuroQol 5-Dimension 5-Level (EQ-5D-5L). Test-retest reliability of satisfaction and performance scores was analysed using weighted kappa coefficients.ResultsOver 90% of participants reported positive experiences with ADOC2 during the goal-setting process. The COPM scores showed strong correlations with ADOC2 ratings, while EQ-5D-5L scores showed weaker but expected correlations. Weighted kappa analyses indicated substantial to almost perfect agreement for test-retest reliability.ConclusionsADOC2 is a clinically useful, valid, and reliable tool for facilitating client-centred goal setting in occupational therapy practice.
Validation of the work functioning assessment for epilepsy - An ICF-based instrument for measuring work functioning of individuals with epilepsy.
Fernandes PDS, Nickel R, Ferreira GB … +4 more , Barboza E, Sabariego C, Taconeli CA, Silvado C
Clin Rehabil · 2025 Jul · PMID 40443356 · Publisher ↗
ObjectiveTo validate the Work Functioning Assessment for Epilepsy.DesignMethodological and cross-sectional research in which the Work Functioning Assessment for Epilepsy was applied to a sample of individuals with epilep...
ObjectiveTo validate the Work Functioning Assessment for Epilepsy.DesignMethodological and cross-sectional research in which the Work Functioning Assessment for Epilepsy was applied to a sample of individuals with epilepsy.SettingThe field test was conducted through in-person and online interviews with individuals treated in public and private services in two epilepsy outpatient clinics.Participants120 individuals with epilepsy.Main measuresExploratory Factor Analysis, Confirmatory Factor Analysis, Cronbach's alpha coefficient analysis, and Pearson's linear correlation coefficient were used to measure the validity and reliability of the instrument.ResultsThe Work Functioning Assessment for Epilepsy final version contains 30 items divided into two dimensions. The Exploratory Factor Analysis and Confirmatory Factor Analysis confirmed the plausibility of the factor structure established. The Cronbach's alpha (95% IC) coefficient was 0.94 and there was a significative linear correlation (p-value: <0.001) between the Work Functioning Assessment for Epilepsy, WHO Disability Assessment Schedule -12 items, and Seizure Severity Questionnaire scores.ConclusionsThe Work Functioning Assessment for Epilepsy is a brief, valid and reliable tool for measuring the work functioning of individuals with epilepsy and has the potential to be a basis for a unified system of work functioning assessment to be used throughout Brazil and translated and adapted for other countries and cultures.
Effectiveness of non-pharmacological interventions for post-stroke depression in stroke survivors: A systematic review with meta-analysis.
Shi D, Chong YY, Li Y … +1 more , Cheng HY
Clin Rehabil · 2025 Aug · PMID 40405736 · Publisher ↗
ObjectivesTo evaluate the effectiveness of non-pharmacological interventions for managing post-stroke depression and identify the characteristics of optimal interventions.Data SourcesEight English databases and two Chine...
ObjectivesTo evaluate the effectiveness of non-pharmacological interventions for managing post-stroke depression and identify the characteristics of optimal interventions.Data SourcesEight English databases and two Chinese databases were searched from inception to February 2025, alongside grey literature.MethodsTwo reviewers independently screened studies and extracted data from randomised controlled trials (RCTs) or pilot/feasibility RCTs. Study quality was evaluated with the Cochrane Risk of Bias 2 tool. Meta-analyses used Review Manager 5.3 when feasible; otherwise, narrative syntheses were conducted. Certainty of evidence was assessed via the Grading of Recommendations Assessment, Development, and Evaluation system.ResultsSeventeen studies (1297 stroke survivors) were included. Two had a low risk of bias, two had a high risk, and 13 had some concerns. Meta-analyses showed cognitive-behavioural intervention had significant short-term effects (< one month) on depressive symptoms versus control (standardised mean difference SMD: -0.63, 95% CI: -1.00 to -0.26, < 0.001, = 81%; 7 studies; 693 participants). Cognitive-behavioural interventions without cognitive restructuring showed significant short-term (effect size = 0.52-1.08) and medium-term (1-6 months) effects ( = 0.73-1.71). Preliminary evidence suggested that exercise with music, acceptance and commitment therapy, mindfulness meditation, and aromatherapy also improve depressive symptoms versus control.ConclusionNon-pharmacological interventions, including cognitive-behavioural intervention, exercise, acceptance and commitment therapy, mindfulness meditation, and aromatherapy, could improve post-stroke depressive symptoms. However, with very low evidence certainty, further rigorous RCTs are needed.
Expert consensus on the application of dry needling in stroke patients: A modified delphi method.
Velázquez-Saornil J, Abuín-Porras V, Frutos-Llanes R … +3 more , Barragan-Casas JM, Campón-Chekroun A, Sánchez-Milá Z
Clin Rehabil · 2025 Jul · PMID 40396979 · Publisher ↗
ObjectiveThis study aimed to establish an expert consensus on the use of dry needling for treating spasticity in stroke patients via the Delphi method.DesignA modified Delphi technique was conducted over four rounds.Sett...
ObjectiveThis study aimed to establish an expert consensus on the use of dry needling for treating spasticity in stroke patients via the Delphi method.DesignA modified Delphi technique was conducted over four rounds.SettingThe study was guided by the NEUMUSK Group Research, Department of Physiotherapy, Faculty of Health Sciences. Ávila Catholic University, following the Checklist for Reporting of Survey Studies (CROSS).ParticipantsA total of 102 international experts in stroke rehabilitation and dry needling collaborated on this consensus study.InterventionPanellists rated 35 key questions across rounds via a 6-point Likert scale. Questions that failed to reach 70% consensus were eliminated.Main measurementsValidated Likert scale responses to carry out the expert consensus.ResultsThere was a high level of consensus regarding the use of dry needling in the early spasticity and hypertonia phases of stroke rehabilitation (early spasticity defined as the first few weeks after stroke when increased muscle tone begins to appear), with 87% and 91% agreement, respectively. However, less consensus has been reached for its application in hypotonia. Local twitch responses have been identified as critical indicators of treatment success, and ultrasound-guided dry needling has been widely endorsed for its precision. The effects of dry needling were reported to last between 48 and 72 h.ConclusionThis study provides clear recommendations for the use of dry needling in stroke patients, particularly during the early stages of spasticity. While the short-term benefits are evident, further research is needed to optimize the treatment frequency and explore its role in different stages of recovery, such as hypotonia. This consensus will aid healthcare professionals in integrating dry needling into comprehensive stroke rehabilitation programmes.
The Vellore Pain Impact Questionnaire (V-PIQ): Initial validation of a tool for assessing the impact of low back pain based on the brief ICF core set.
Abijithgeorge M, Samuelkamaleshkumar S, Annpatriciacatherine S … +3 more , Aruna R, Ronaldthomvicmaradona J, Ganesan MP
Clin Rehabil · 2025 Jun · PMID 40370083 · Publisher ↗
ObjectiveTo develop and validate the Vellore Pain Impact Questionnaire to assess the impact of low back pain in the Indian context.DesignA cross-sectional, quantitative study with two phases: development and validation o...
ObjectiveTo develop and validate the Vellore Pain Impact Questionnaire to assess the impact of low back pain in the Indian context.DesignA cross-sectional, quantitative study with two phases: development and validation of the Vellore Pain Impact Questionnaire. Content validity was ensured through a Delphi process involving five occupational therapists, while reliability and criterion validity were assessed.SettingThe study was conducted at the Occupational Therapy outpatient unit of a tertiary care teaching hospital in South India.ParticipantsSixty-five patients aged 18 years and above with nonspecific low back pain persisting for at least 12 weeks were recruited through convenience sampling.InterventionNot applicable.Main MeasuresThe Vellore Pain Impact Questionnaire underwent inter-rater and test-retest reliability using the intraclass correlation coefficient. Criterion validity was evaluated against the Oswestry disability index.ResultsThe Vellore Pain Impact Questionnaire showed excellent content validity (content validity index: 0.96). It demonstrated high reliability, with inter-rater (intraclass correlation coefficient: 0.985) and test-retest (intraclass correlation coefficient: 0.973) scores. The receiver operating characteristic analysis indicated moderate criterion validity (area under the curve: 0.628) compared to the Oswestry disability index. The questionnaire's broader coverage of ICF categories, including psychological and environmental factors, highlights its ability to capture the multidimensional impact of low back pain.ConclusionsThe Vellore Pain Impact Questionnaire shows promise as a reliable and culturally relevant tool for assessing low back pain impact in India, addressing physical, psychological, and social factors. However, further studies are necessary to establish its validity across diverse populations and settings.
The effect of cognitive retraining after stroke on everyday living: A systematic review and meta-analysis.
White J, Lockwood KJ
Clin Rehabil · 2025 Jul · PMID 40350762 · Publisher ↗
ObjectiveTo determine if the addition of cognitive retraining to rehabilitation following stroke results in better everyday living outcomes.Data sourcesElectronic databases MEDLINE, EMBASE, PsycINFO, CINAHL, OT Seeker an...
ObjectiveTo determine if the addition of cognitive retraining to rehabilitation following stroke results in better everyday living outcomes.Data sourcesElectronic databases MEDLINE, EMBASE, PsycINFO, CINAHL, OT Seeker and Cochrane Library were searched until January 2025.Review methodsRandomised controlled trials were included if they measured change in function and investigated a cognitive retraining intervention aimed at restoration of impaired cognition in one or more specific cognitive domains in the adult stroke population. Papers were excluded if they exclusively provided interventions that were not restorative, such as compensatory approaches or direct task retraining. Two independent reviewers extracted data and assessed study quality.ResultsTwenty-one studies involving 1476 participants were included. There was very low-quality evidence that basic activity of daily living (ADL) was not improved by the addition of cognitive retraining (standardised mean difference (SMD) 0.48, 95% confidence interval (CI) -0.04 to 1.01). There was moderate quality evidence that cognitive retraining had no effect on Instrumental ADL (IADL) (SMD -0.19, 95% CI -0.65 to 0.27) or other measures of functional performance (SMD -0.03, 95% CI -0.31 to 0.24).ConclusionsCognitive retraining focusing on restoration of one or more cognitive domains after stroke did not show an impact in basic ADL performance, IADL performance, or other measures of functional performance. Results were complicated by low-quality evidence and methodological factors including variations in study populations, interventions provided and outcome measures. Further research that includes suitable measures of everyday living is needed to provide more robust evidence and guide clinical practice.
Response to "comments on the article "physiotherapy-led care versus physician-led care for persons with Low back pain: A systematic review" by severijns et al. (clin rehabil. 2024 dec;38(12):1571-1589)".
Severijns P, Goossens N, Dankaerts W … +7 more , Pitance L, Roussel N, Denis C, Fourré A, Verschueren P, Timmermans A, Janssens L
Clin Rehabil · 2025 Jun · PMID 40340596 · Publisher ↗
Abstract loading — click title to view on PubMed.
Intra- and inter-rater reliability of anterior and posterior drawer tests for the assessment of people with shoulder instability.
Aldon-Villegas R, Chamorro-Moriana G, Lopez-Tarrida P … +1 more , Benitez-Lugo ML
Clin Rehabil · 2025 Jul · PMID 40340595 · Full text
BackgroundThe well-known drawer tests to assess glenohumeral laxity and instability have shown appropriate reliability, although analysed mainly in healthy subjects.ObjectiveTo evaluate the intra- and inter-rater reliabi...
BackgroundThe well-known drawer tests to assess glenohumeral laxity and instability have shown appropriate reliability, although analysed mainly in healthy subjects.ObjectiveTo evaluate the intra- and inter-rater reliability of anterior and posterior drawer tests in subjects with symptoms of shoulder instability.DesignClinometric study of intra- and inter-rater reliability of drawer tests was carried out following COSMIN recommendations and GRRAS checklist.SettingCentres with equipped facilities for assessments.ParticipantsThere were 105 participants (69 male/36 female) aged 18 to 60 years with instability symptoms in at least one shoulder. Each participant underwent bilateral assessments. The sample consists of 210 shoulders, unstable and healthy.InterventionAnterior and posterior drawer tests.Main measuresHumeral translations were assessed using drawer tests and graded with Hawkins scale, modified Hawkins and dichotomising (positive/negative). Two sessions were performed (seven to fourteen-day washout period): Each patient was evaluated by two examiners in the first session and by one of them in the second. Weighted Kappa analysed the reliability.ResultsThe intra-rater reliability of the anterior and posterior drawer tests was = 1) with the Hawkins scale. Inter-rater reliability was for the anterior drawer: = 0.76 (95%confidence interval: 0.67-0.85) with the Hawkins scale, = 0.78 (95%confidence interval: 0.69-0.87) with modified Hawkins, and = 0.80 (95%confidence interval: 0.71-0.89) dichotomising; and for the posterior drawer: = 0.62 (95%confidence interval: 0.52-0.72), = 0.67 (95%confidence interval: 0.57-0.78), and = 0.70 (95%confidence interval: 0.59-0.80), respectively.ConclusionDrawer tests demonstrated intra-rater and inter-rater reliability in subjects with symptoms of shoulder instability.
The Modified Ashworth and Modified Tardieu Scales differ in their classification of lower limb spasticity.
Beard J, Williams G, Kahn M … +1 more , Banky M
Clin Rehabil · 2025 Jun · PMID 40296589 · Publisher ↗
ObjectiveTo investigate agreement in spasticity classification between the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS) when performed on four lower limb muscles in adults following neurological inj...
ObjectiveTo investigate agreement in spasticity classification between the Modified Ashworth Scale (MAS) and the Modified Tardieu Scale (MTS) when performed on four lower limb muscles in adults following neurological injury.DesignObservational trial.SettingInpatient and outpatient neurological rehabilitation unit.ParticipantsNinety adults with lower limb spasticity.Main MeasuresNinety participants underwent a spasticity assessment of their hamstrings at 40° and 90° of hip flexion, quadriceps, gastrocnemius and soleus using the MAS and MTS. Assessment findings were dichotomised into spastic (MAS ≥ 1 or MTS X ≥ 2) or not spastic (MAS = 0 or MTS X ≤ 1) categories. To evaluate agreement, 2 × 2 contingency tables were generated to calculate positive, negative and overall agreement. Statistical association was calculated using the Fisher's Exact Test.ResultsThe MAS classified the presence of spasticity more frequently than the MTS. The proportion of trials with agreement in spasticity classifications according to both scales and their Fishers exact test were hamstrings at 90° hip flexion (17.6%; p = 0.009); hamstrings at 40° hip flexion (75.0%; p = 0.166); quadriceps (67.1%; p = 0.020); gastrocnemius (77.9%; p = 0.586); and soleus (67.8%; p = 0.113).ConclusionThe MAS and MTS demonstrated a level of disparity in their classification of lower limb spasticity across all four muscles, particularly the more proximal muscle groups.
Changes in mobility after community-based prosthesis fitting and rehabilitation in people with major lower limb amputations: a cohort study.
Mechlenburg I, Tønning LU, Ørholst R … +3 more , Iversen C, Lindberg K, Kristensen MT
Clin Rehabil · 2025 Jul · PMID 40289604 · Publisher ↗
ObjectiveTo investigate changes in mobility in adults with recent major lower limb amputation participating in community-based rehabilitation. Second, to assess the impact of amputation level (transtibial versus transfem...
ObjectiveTo investigate changes in mobility in adults with recent major lower limb amputation participating in community-based rehabilitation. Second, to assess the impact of amputation level (transtibial versus transfemoral) on mobility changes.DesignCohort study.SettingRehabilitation Centre in Copenhagen Municipality.SubjectsA total of 265 individuals with recent major lower limb amputations were prospectively recruited into a cohort from 2008 to 2022 as part of routine practice.MethodsFour physiotherapists collected data on age, sex, level of amputation (transtibial/transfemoral) and assessed mobility at start of walking out of parallel handrail (baseline) and at the end (follow-up) of rehabilitation. Mobility was assessed with the Timed-Up-and-Go test, 10-Meter Walk test, and 2-Minute Walk test. The impact of amputation level was analyzed using multivariable linear regression adjusted for age and sex.ResultsA total of 199 individuals (153 men) mean age of 64.9 (standard deviation 12.2) years had baseline and follow-up mobility data and were eligible for the study. Mobility significantly improved on all tests for individuals with both amputation levels after community rehabilitation. Multivariable analysis showed that individuals with transfemoral amputations on average improved with 17.9 seconds more (95% confidence interval: 12.7-23.1) than transtibial completing the Timed-Up-and-Go test. Contrary, transtibial walked 0.11 meter/second faster (95% confidence interval: 0.02-0.20) and 7.2 meters (95% confidence interval: -1.4 to 15.8) longer in the 10-Meter Walk test and 2-Minute Walk test respectively than transfemoral amputees.ConclusionAdults with lower limb amputations improved their mobility significantly from baseline to follow-up. Individuals with transfemoral amputations improved more than transtibial amputations on functional mobility.
Recommending 24-hour attendant care: A qualitative study exploring the clinical decision-making process of occupational therapists in Ontario, Canada.
Long BS, Balakrishnar K, Mazur M … +4 more , Maria E, Hennessy K, Rose M, Nowrouzi-Kia B
Clin Rehabil · 2025 Jun · PMID 40289528 · Full text
ObjectiveThis study aims to explore how occupational therapists working in private practices in Canada use clinical indicators and tools to determine if clients require 24-hour attendant care.DesignA qualitative research...
ObjectiveThis study aims to explore how occupational therapists working in private practices in Canada use clinical indicators and tools to determine if clients require 24-hour attendant care.DesignA qualitative research study.SettingThe setting involved semi-structured, one-on-one interviews with occupational therapists in Canada.ParticipantsOccupational therapists were selected through purposive sampling: (1) registered Canadian occupational therapists, (2) with over 10 years of private practice experience, and (3) who have assessed the need for 24-hour attendant care at least once before the study.Main measuresThe interviews were conducted, transcribed, coded, and thematically analyzed by two researchers using Braun and Clarke's protocol. The paper is also reported based on the consolidated criteria for reporting qualitative research guidance.ResultsThe study involved nine occupational therapists (eight women and one man), with 14 to 24 years of private practice experience in Ontario. Three main themes in the decision-making process for 24-hour attendant care were identified: (1) Individualized and Holistic Assessments; (2) Clinical Expertise-Based Decision-making; and (3) Risk Assessment in Decision-Making.ConclusionsThis study provides a greater understanding of the decision-making process of occupational therapists working in Canada when recommending 24-hour attendant care. However, further research and development of guidelines are needed to support occupational therapists in this area.
The association between frailty and stroke rehabilitation outcomes: A cohort study.
Cho TYJ, Hanger HC, Wilkinson TJ
Clin Rehabil · 2025 Jun · PMID 40289524 · Publisher ↗
ObjectiveTo assess the independent effect of pre-morbid frailty on stroke rehabilitation outcomes, including mortality, function, and discharge destination.DesignObservational cohort study.SettingInpatient stroke rehabil...
ObjectiveTo assess the independent effect of pre-morbid frailty on stroke rehabilitation outcomes, including mortality, function, and discharge destination.DesignObservational cohort study.SettingInpatient stroke rehabilitation.ParticipantsTwo hundred consecutive stroke patients, 65 years or older, admitted during 2021.Main measuresLogistic regression models analysed binary outcomes (mortality, discharge destination, and significant functional gain), and multiple linear regression models analysed normally distributed continuous outcomes (function, measured by Functional Independence Measure (FIM)). The confounders of age, stroke severity, and pre-morbid dementia/cognitive impairment, were accounted for. Clinical Frailty Scale was the predictor (considered as categorical and dichotomous) for these models.ResultsAfter accounting for the confounders, increased frailty was independently associated with lower discharge FIM (B = -11.32; 95% confidence interval (CI) -14.46-8.18, p < 0.001), smaller FIM change (B = -4.21; 95% CI -6.58-1.84, p < 0.001) and smaller FIM improvements over time (B = -2.36; 95% CI -3.40-1.32, p < 0.001). Frailer patients were less likely to return home (Odds Ratio 0.26; 95% CI 0.17-0.41, p < 0.001). Most patients improved function, at all levels of frailty. Stroke severity (Odds Ratio 1.13; 95% CI 1.06-1.20, p < 0.001), but not frailty, was independently associated with 6-month mortality.ConclusionsPre-morbid frailty was independently associated with lower functional improvement and lower likelihood of discharge back home after stroke rehabilitation, but not with mortality up to 6 months. Measuring both pre-morbid frailty and stroke severity may be useful to provide prognostic information and set realistic expectations.
Letter to the Editor: Comments on 'Physiotherapy-led Care Versus Physician-led Care for Persons with low Back Pain: A Systematic Review' by Severijns et al.
Kaux JF, Schiltz M, Linden P … +3 more , Brands G, Schoonejans B, Lejeune T
Clin Rehabil · 2025 Jun · PMID 40276914 · Publisher ↗
Abstract loading — click title to view on PubMed.
Immediate effect of extracorporeal shockwave therapy in patients with chronic nonspecific low back pain: A randomized placebo-controlled triple-blind trial.
Back CGN, Peron R, Lopes CVR … +2 more , de Souza JVE, Liebano RE
Clin Rehabil · 2025 May · PMID 40276911 · Publisher ↗
Abstract loading — click title to view on PubMed.
Physiological and perceptual demand of gait training on inpatient physiotherapists.
Bosteder KD, Arnold D, Gillespie J … +8 more , Chand N, Merkle S, McCorkle M, Bennett M, Sikka S, Dubiel R, Driver S, Swank C
Clin Rehabil · 2025 Jul · PMID 40267293 · Publisher ↗
ObjectiveTo describe the physiological and perceptual demand among physiotherapists delivering gait training interventions using usual care and overground robotic exoskeleton approaches for patients with neurological inj...
ObjectiveTo describe the physiological and perceptual demand among physiotherapists delivering gait training interventions using usual care and overground robotic exoskeleton approaches for patients with neurological injuries during inpatient rehabilitation.DesignSingle-centre, prospective observational study.SettingInpatient Rehabilitation Hospital.ParticipantsPhysiotherapists trained in neurorehabilitation.InterventionPhysiotherapists conducted two gait training sessions (one usual care and one overground robotic exoskeleton) while physiological and perceptual demand was assessed.Main measuresPhysiological (oxygen consumption, metabolic equivalents and heart rate) and perceptual demand were measured using a wearable metabolic system and the National Aeronautics and Space Administration Task Load Index, respectively.ResultsPhysiotherapists ( = 4) were female, median (min-max) age = 35(34-44) years, non-Hispanic, 50% White, with 11(5-19) years of experience. Physiological demand was lower in overground robotic exoskeleton than usual care in oxygen consumption [13.5(11.3-15.3) versus 16.4(13.5-18.6) millilitres of oxygen/minute/kilogramme of body mass], metabolic equivalents [3.9(3.2-4.4) versus 4.7(3.8-5.3)], average heart rate [111(90-136) versus 119(103-145) beats per minute], peak heart rate [121(101-149) versus 149(116-162) beats per minute] and recovery heart rate [113(88-148) versus 123(105-161) beats per minute]. Perceptual demand was lower in overground robotic exoskeleton than usual care in mental [7(5-16) versus 12(6-17)], physical [10(8-12) versus 16.5(14-21)] and temporal demand [3.5(1-9) versus 12.5(2-16)], performance [5(3-16) versus 11(4-17)], effort [9(6-15) versus 16.5(13-17)] and frustration [3(1-7) versus 5.5(3-8)].ConclusionsDelivery of overground robotic exoskeleton gait training was associated with lower physiological and perceptual demand compared to usual care gait training in patients with neurological injuries during inpatient rehabilitation. Identifying modalities with low demand may reduce physiotherapist burnout and workplace injuries.
What is the level of work and societal participation in patients with pelvic ring injuries? A two-year prospective cohort study.
Therrien CC, Ten Duis K, Banierink H … +4 more , Trouwborst NM, de Vries JP, IJpma FF, Reininga IH
Clin Rehabil · 2025 Jun · PMID 40266570 · Full text
ObjectiveTo provide insight into the impact of pelvic ring injuries on patients' work and school activities and participation in society.DesignProspective-cohort study.SettingA level-1 trauma center in the Netherlands.Pa...
ObjectiveTo provide insight into the impact of pelvic ring injuries on patients' work and school activities and participation in society.DesignProspective-cohort study.SettingA level-1 trauma center in the Netherlands.Participants195 patients with a pelvic ring injury.Main measuresThe work or school activities and participation in society domains of the World Health Organization Disability Assessment Score II (WHO-DAS II) were administered at admission (pre-injury score), 3 months, 6 months, 1 year and 2 years following the injury.ResultsBefore the injury, the median scores were 80 for both work or school activities and participation in society. The scores 3 months after the injury were 40 and 60, respectively, but both improved to 75 after 2 years. The percentage of non-recovered patients decreased over time, from 45% to 35% for work or school activities and from 34% to 18% for participation in society between 6 months and 2 years. At work or school, patients struggled to complete daily tasks and important activities as efficiently and effectively as needed. Regarding participation in society, patients struggled with the amount of time spent managing their injuries, joining community activities, and doing things for relaxation. No relationships between patients or injury characteristics and recovery were identified one year following the injury.ConclusionsPelvic ring injuries greatly impact patients' work or school activities and participation in society. However, these domains greatly improve within the first two years, with many individuals regaining their pre-injury capabilities. Still, some continue to experience long-term difficulties in participation.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe