Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Effectiveness of therapeutic exercise programs on balance and gait in children and adolescents with unilateral cerebral palsy: A systematic review and meta-analysis of randomized controlled trials.
Martínez-Olagüe Jácome M, Domínguez-López P, Rodrigo-Masanet R … +3 more , Palomo-Carrión R, López-Muñoz P, Coello-Villalón M
Clin Rehabil · 2026 Mar · PMID 41879099 · Publisher ↗
ObjectiveUnilateral cerebral palsy causes motor impairments affecting upper and lower limbs; compromising balance and gait. Although therapeutic exercise is commonly used, heterogeneity in interventions and outcomes hind...
ObjectiveUnilateral cerebral palsy causes motor impairments affecting upper and lower limbs; compromising balance and gait. Although therapeutic exercise is commonly used, heterogeneity in interventions and outcomes hinders interpretation. This systematic review evaluated the effects of exercise programs on balance and gait in children and adolescents with unilateral cerebral palsy.Data SourcesSearches were conducted in PubMed, Cochrane CENTRAL, PEDro, SPORTDiscus, and Scopus from inception to January 2026. Reference lists of eligible studies were also screened.MethodsRandomized controlled trials including participants aged 2-18 years with unilateral cerebral palsy, assessing exercise programs targeting balance or gait were eligible. Independent reviewer pairs conducted screening, data extraction, and risk-of-bias assessments, resolving disagreements with a third reviewer. Standardized mean differences (SMD) were pooled using a random-effects model. Subgroup, sensitivity, and meta-regression analyses were performed. Certainty of evidence was rated with GRADE.ResultsThirteen trials were included. Exercise programs produced a significant moderate effect on balance (SMD = 0.61; 95% CI: 0.38 to 0.83; = 0.003%). The pooled effect on gait was moderate (SMD = 0.51; 95% CI: -0.22 to 1.23) but not significant, with high heterogeneity ( = 91.1%). Subgroup analyses suggested larger effects with non-plyometric training for balance and with plyometric training for gait. Meta-regression indicated a positive dose-response relationship for balance.ConclusionTherapeutic exercise programs improve balance in youths with unilateral cerebral palsy with evidence of a dose-response effect. Effects on gait remain uncertain. Structured balance-focused interventions should be integrated into rehabilitation programs.
The road to a new normal - A qualitative study on relatives' needs and roles in amputation rehabilitation.
Støvring KR, Rottmann N, Rasmussen A … +1 more , Madsen UR
Clin Rehabil · 2026 Mar · PMID 41873506 · Publisher ↗
ObjectiveTo explore the roles, experiences and support needs of relatives of individuals who have undergone major lower extremity amputation during the early post-amputation period (0-2 years).DesignQualitative study usi...
ObjectiveTo explore the roles, experiences and support needs of relatives of individuals who have undergone major lower extremity amputation during the early post-amputation period (0-2 years).DesignQualitative study using focus group interviews and a Research-Driven Photo Elicitation approach.SettingA 5-day psychosocial residential rehabilitation program for individuals with lower extremity amputation.ParticipantsThirty-three relatives of individuals with a major lower extremity amputation recruited through participating patients.InterventionParticipation in focus group interviews informed by photo elicitation to facilitate reflection and discussion of caregiving experiences.Main MeasuresData were analysed using Reflexive Thematic Analysis to identify patterns and themes related to relatives' roles and needs.ResultsOne overarching theme, , described relatives' adaptive processes following amputation. Three subthemes were identified: (a) a gradual realisation of the long-term emotional and practical consequences of amputation; (b) challenges in supporting patients' emotional reactions, including grief and altered identity; and (c) shifting relationship dynamics, where relatives assumed caregiving roles while striving to maintain their original relational identity. Many relatives adopted a shared 'we-perspective', emphasising joint adaptation and coping.ConclusionsRelatives play a central role in post-amputation rehabilitation, and the findings highlight the complexity of relatives' adaptation following amputation. Their experiences highlight the importance of systematically involving relatives in rehabilitation through support for dyadic coping, emotional preparedness and shared goal setting to enhance outcomes for both patients and caregivers.
The effectiveness of prehabilitation on post-operative recovery from lumbar spinal stenosis surgery - A systematic review and intervention component analysis.
Heine P, Hunter R, Booth A … +6 more , Lamb SE, Williamson E, Sahota O, Phillips BE, Hendrick P, Wood L
Clin Rehabil · 2026 Jul · PMID 41830622 · Full text
ObjectiveTo evaluate prehabilitation interventions evaluated in randomised controlled trials for people undergoing lumbar spinal stenosis surgery and determine which individual intervention components are associated with...
ObjectiveTo evaluate prehabilitation interventions evaluated in randomised controlled trials for people undergoing lumbar spinal stenosis surgery and determine which individual intervention components are associated with successful interventions.Data sourcesEnglish language papers from 2011 until December 2025 from PubMed, Cumulative Index of Nursing and Allied Health, Scopus and Web of Science.Review methodsWe searched for randomised controlled trials comparing prehabilitation to other non-active interventions for people undergoing surgery for lumbar spinal stenosis. Two authors independently screened, selected and performed quality assessments of the studies. Relevant study details were extracted, tabulated and synthesised using intervention component analysis.ResultsNine papers describing five randomised control trials involving 466 participants and 28 outcomes measured pre- and/or post-surgery were found. Overall, the interventions consisted of 47 individual components. Fifteen of these components (including psychological/behavioural approaches, and cardiovascular, strength and trunk/core exercise) featured in successful interventions that resulted in greater improvement in 16 outcomes (including back pain, disability, walking and hospital stay) in prehabilitation compared to usual care participants. The results of further evaluation of individual outcomes at each time point was inconsistent and unreliable.PROSPERO registration numberCRD42025645253, https://www.crd.york.ac.uk/PROSPERO/view/CRD42025645253ConclusionOnly five small trials of low-to-moderate quality report common outcomes at similar timepoints. There is high uncertainty regarding the importance of individual intervention components in successful prehabilitation interventions for people undergoing lumbar spinal stenosis surgery.
Inspiratory muscle training for people with spinal cord injury: An implementation study.
Tranter KE, Harvey LA, Chen LW … +7 more , Blecher L, White J, Li J, Boswell-Ruys CL, Graco M, Berlowitz DJ, Glinsky JV
Clin Rehabil · 2026 Jul · PMID 41816822 · Full text
ObjectiveAustralian and New Zealand Guidelines for the Physiotherapy Management of People with Spinal Cord Injury recommend the use of inspiratory muscle training for people with spinal cord injury and respiratory muscle...
ObjectiveAustralian and New Zealand Guidelines for the Physiotherapy Management of People with Spinal Cord Injury recommend the use of inspiratory muscle training for people with spinal cord injury and respiratory muscle weakness. The aim of this study was to evaluate if tailored implementation strategies increased provision of inspiratory muscle training by physiotherapists.DesignA pre-post implementation study with baseline, post and follow-up measures.SettingThree spinal units in Sydney, Australia.ParticipantsTwenty-one physiotherapist-participants and 68 patient-participants across three spinal units.InterventionTailored, evidence-based, multi-faceted implementation strategies to improve physiotherapists' provision of inspiratory muscle training, delivered over a 6-week period (the implementation phase).Main measuresPhysiotherapists' provision of inspiratory muscle training was measured via a standardised audit tool. Medical records were audited at baseline, immediately after the implementation phase and then two months later to determine whether patients had been provided inspiratory muscle training.ResultsNinety-four medical records were audited of 68 patient-participants over the study period. Data at baseline indicated that inspiratory muscle training was only provided to 20% of eligible patient-participants. This improved to 91% immediately post the 6-week implementation phase but reduced to 72% two months later.ConclusionsTailored, evidence-based implementation strategies increased the provision of inspiratory muscle training by physiotherapists. These strategies can be adapted to different health care settings to improve physiotherapists' provision of inspiratory muscle training for the respiratory management of people with spinal cord injury.The study was prospectively registered with the Australian New Zealand Clinical Trials Registry (https://www.anzctr.org.au/. ACTRN: 12623001106628).
The effect of breathing exercises and mindset with or without cold exposure on mental and physical health in persons with a spinal cord injury-Results of a randomized controlled trial.
de Groot S, Ettema FW, van der Bijll M … +4 more , Janssen TW, Achterberg-Warmer WJ, WHM study group, Hoekstra SP
Clin Rehabil · 2026 Mar · PMID 41810770 · Publisher ↗
ObjectiveTo examine the effects of the Wim Hof Method (WHM), with cold exposure (WHM-C) and without (WHM-NC), on mental and physical health in individuals with chronic spinal cord injury (SCI).DesignRandomized-controlled...
ObjectiveTo examine the effects of the Wim Hof Method (WHM), with cold exposure (WHM-C) and without (WHM-NC), on mental and physical health in individuals with chronic spinal cord injury (SCI).DesignRandomized-controlled trial.SettingRehabilitation center.ParticipantsSixty-two adults with chronic SCI (37% tetraplegia, 41% motor complete) were randomized into three groups: WHM-C, WHM-NC, and usual care (UC).InterventionThe intervention groups participated in a 7-week program involving weekly supervised sessions and daily home practice. WHM-NC included breathing exercises and mindset training, while WHM-C also incorporated cold exposure. UC participants received no intervention.Main measuresThe primary outcome was the Mental Health Inventory (MHI-5) score. Secondary outcomes included inflammatory and metabolic markers, pulmonary function, body composition, sleep quality, spasticity, chronic pain, and psychological stress.ResultsWHM-NC had eight dropouts, mostly due to motivation or unrelated medical issues, while WHM-C and UC had one dropout each. No significant differences in MHI-5 scores were observed between groups. However, WHM-C participants reported reduced pain interference in daily activities compared to UC (p=0.027). WHM-C also showed improvements in inspiratory parameters FIV1 (+27%, p=0.02) and PIF (+23%, p=0.02) and a significant reduction in fasting glucose concentration (-6%, p=0.006) compared to UC.ConclusionsWhile 44% of WHM-NC dropped out, WHM-C appears to be a feasible, effective intervention for improving aspects of physical health and pain perception in a broad group of individuals with chronic SCI, although no significant mental health benefits were observed.
Self-directed and caregiver-assisted technology-based interventions in inpatient stroke rehabilitation: A scoping review.
Pogrebnoy D, Jones JR, Alsawaf S … +3 more , Joseph L, Lau PY, Bower KJ
Clin Rehabil · 2026 Mar · PMID 41789604 · Publisher ↗
ObjectiveTechnology-based interventions may enhance self-directed or caregiver-assisted activity during inpatient stroke rehabilitation, yet effective implementation strategies for technology-based tools remain unclear....
ObjectiveTechnology-based interventions may enhance self-directed or caregiver-assisted activity during inpatient stroke rehabilitation, yet effective implementation strategies for technology-based tools remain unclear. This scoping review synthesises existing evidence on acceptability, feasibility and effectiveness of technology-based interventions in inpatient stroke rehabilitation, and maps barriers and enablers to implementation through the Capability, Opportunity, Motivation and Behaviour model.Data sourcesComprehensive searches of MEDLINE, Embase, CINAHL and Google Scholar were conducted through to December 2025.Review methodsStudies involving adult stroke survivors using self-directed technology-based interventions during inpatient rehabilitation were included. Arksey and O'Malley's scoping review framework guided data extraction. Analysis focused on acceptability, feasibility, effectiveness and behaviour change strategies.ResultsEighteen high-moderate quality studies (20 papers) from 13 countries, involving 1081 participants, were included (10 pilot randomised controlled trials, 6 feasibility studies, 1 non-randomised and 1 observational study). Interventions were upper limb exergaming or robotics devices ( = 4) and tablet/smartphone applications with exercise videos ( = 14). Acceptability, feasibility and effectiveness outcomes were reported in 12 studies (63%), with rates of recruitment, safety and retention being reported in eight (67%), eight (67%) and six (50%) studies, respectively. All studies reported on at least one construct relating to barriers or enablers. Key enablers were caregiver involvement and additional support for more impaired individuals. Common barriers were stroke-related impairments and reduced staffing.ConclusionThis review offers an integrated overview of the acceptability, feasibility and effectiveness of technology-based interventions in inpatient stroke rehabilitation, with identified strategies to support clinicians with implementation. Further research is needed on long-term outcomes.
Optimizing exercise interventions for motor skills enhancement in attention deficit hyperactivity disorder: Evidence from meta-analysis.
Zhang Y, Che X, Dong Z … +4 more , Shen J, Tao Y, Cui B, Zhu F
Clin Rehabil · 2026 Mar · PMID 41787869 · Publisher ↗
ObjectiveThis meta-analysis aimed to evaluate effects of physical exercises on gross and fine motor skills in children and adolescents with attention deficit hyperactivity disorder (ADHD), and to explore the influencing...
ObjectiveThis meta-analysis aimed to evaluate effects of physical exercises on gross and fine motor skills in children and adolescents with attention deficit hyperactivity disorder (ADHD), and to explore the influencing factors and dose-response relationships for optimizing exercise parameters.Data sourcesSix electronic databases were searched from inception to 20 June 2025, with an updated search performed on 27 January 2026.MethodsThe effect sizes were estimated using Hedge's within three-level random-effects modeling frameworks. Subgroup analyses were performed to examine potential moderators, while restricted cubic splines were employed to characterize dose-response relationships.ResultsTwenty-one studies with 850 participants were included. Physical exercises showed moderate positive effects on both gross motor skills (Hedge's = 0.62, 95% CI: 0.48-0.76) and fine motor skills (Hedge's = 0.72, 95% CI: 0.54-0.90). Significant improvements were observed in subcomponents of gross motor skills (locomotion, object control, body coordination, and strength) and fine motor skills (manual dexterity, hand-eye coordination, and handwriting). Moderator analyses indicated that longer session durations (>45 min) and higher frequencies (≥3 sessions/week) were associated with greater benefits. Fine motor skills (∼1350 min) appeared to require greater cumulative exercise exposure than gross motor skills (∼810 min) to achieve substantial gains.ConclusionPhysical exercise is an effective intervention for improving motor skills in children and adolescents with ADHD. However, the effectiveness of interventions appears to be moderated by motor subcomponents and dose parameters. Tailored programs, specific motor skill targets and dose parameters, should be integrated into clinical and educational practices to maximize outcomes.
Development of an easy-read version of the Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ).
Hepworth LR, Howard C, Rockliffe J … +3 more , Kirkham JJ, Pearl G, Rowe FJ
Clin Rehabil · 2026 Mar · PMID 41784473 · Publisher ↗
ObjectiveThe Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to measure the impact of post-brain injury visual impairment. Communication and cognitive impairments are common brain...
ObjectiveThe Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to measure the impact of post-brain injury visual impairment. Communication and cognitive impairments are common brain injury sequelae and a barrier to completing standard patient reported outcome measures. The objective of this study was to develop and refine an easy-read version in order to meet recommendations to promote self-reporting.DesignEasy-read version development involved stakeholder input at several meetings. An iterative refinement process was used, involving a cognitive interview, until no new issues were identified.ParticipantsStroke survivors with visual impairment and/or aphasia and relevant healthcare professional were involved in the development stage. The clinical study recruited 12 stroke survivors with visual impairment.Main measuresParticipants completed the easy-read and standard versions. The researcher documented observations and time taken. Analysis assessed association and agreement between the two versions.ResultsDevelopment considered the structure, image selection and key words. Four iterations were used before five consecutive participants reported no new issues. Image amendments involved replacing four, revising four and adding three across eight of the 13 items. A preference for the easy-read version was reported by 45.5% completing both questionnaires (n = 11). A significant, strong positive correlation was found between the easy-read and standard version total scores. Weighted Kappa found significant agreement between 12 items.ConclusionsThe easy-read version, using images to support the question wording, will increase accessibility for brain injury survivors with communication and/or cognitive difficulties. It is acceptable and further evaluation of this version is now required.
Problematic smartphone use as a modifiable factor in cervicogenic headache: Effects on pain, function, mood, and sleep.
Karakılıç GD, Ünlüel H
Clin Rehabil · 2026 Mar · PMID 41784100 · Publisher ↗
ObjectiveTo examine whether problematic smartphone use is associated with pain intensity, functional disability, emotional distress, sleep quality, and health-related quality of life in individuals with cervicogenic head...
ObjectiveTo examine whether problematic smartphone use is associated with pain intensity, functional disability, emotional distress, sleep quality, and health-related quality of life in individuals with cervicogenic headache compared with healthy adults.DesignCase-control study.SettingOutpatient clinics of Physical Medicine and Rehabilitation and Neurology at a university hospital.ParticipantsA total of 158 adults, including 78 individuals diagnosed with cervicogenic headache and 80 age- and sex-matched healthy controls.Main measuresSmartphone Addiction Scale-Short Form, Headache Impact Test-6, Neck Disability Index, Hospital Anxiety and Depression Scale, Jenkins Sleep Scale, and Short Form-12 Health Survey.ResultsIndividuals with cervicogenic headache reported significantly higher levels of smartphone-related behavioural problems, headache impact, neck-related disability, anxiety, depressive symptoms, and sleep disturbance than healthy controls (all < 0.05). Physical and mental health-related quality of life scores were significantly lower in the cervicogenic headache group. Problematic smartphone use was positively associated with depressive symptoms ( = 0.224) and poor sleep quality ( = 0.369), and negatively associated with mental health-related quality of life ( = -0.277). Neck-related disability ( = 0.327) and mental health-related quality of life ( = 0.551) were independent predictors of problematic smartphone use, explaining 31% of the variance.ConclusionsProblematic smartphone use is associated with greater symptom burden, emotional distress, sleep problems, and reduced quality of life in individuals with cervicogenic headache. Smartphone-related behavioural patterns may represent a modifiable factor to be considered within comprehensive rehabilitation and lifestyle-based management strategies.
Rehabilitation interventions for the management of treatment-induced trismus in people with head and neck cancer: A scoping review.
Anarte-Lazo E, Bravo-Vazquez A, Bernal-Utrera C … +3 more , Torres-Lagares D, Rodriguez-Blanco C, Falla D
Clin Rehabil · 2026 Feb · PMID 41744420 · Publisher ↗
ObjectiveTrismus is a common and debilitating complication following head and neck cancer treatment, with significant consequences for quality of life, nutrition and oral function. Although several rehabilitation strateg...
ObjectiveTrismus is a common and debilitating complication following head and neck cancer treatment, with significant consequences for quality of life, nutrition and oral function. Although several rehabilitation strategies have been proposed, their design and effectiveness remain poorly systematized. This review aimed to summarize evidence from randomized controlled trials on rehabilitation interventions for treatment-induced trismus in HNC.Data sourcesA scoping review was performed using PubMed, PEDro, Web of Science, Scopus and EMBASE, covering publications up to May 2025.Review methodsWe included randomized controlled trials in English or Spanish evaluating any rehabilitation intervention in adults with trismus following HNC treatment. One author conducted the search, and two authors independently screened articles for inclusion.ResultsFrom 2215 records identified, 25 randomized controlled trials met the inclusion criteria. Twelve investigated preventions during or shortly after cancer treatment, while 13 addressed established trismus. Most interventions were based on exercise therapy, delivered in hospitals, private clinics or at home. Only a minority incorporated manual therapy or physical agents. Devices such as TheraBite or JawTrainer were evaluated in several studies. While most trials reported improvements in maximal mouth opening, few assessed condition-specific patient-reported outcomes. Rehabilitation interventions were predominantly implemented by physiotherapists.ConclusionExercise therapy, often combined with devices, is the most frequently studied approach for treatment-induced trismus. Evidence for manual therapy and physical modalities remains limited. Considerable heterogeneity across studies hinders comparison and replication, underlining the need for standardized protocols and outcomes in future trials.
Emergent motion capture technology for upper extremity assessment in stroke: A systematic scoping review.
Fisher J, Makroglou K, Tinker J … +8 more , Shiner CT, Hurden A, Weston J, Li L, Rauniyar C, Lannin NA, Anderson CS, Chen X
Clin Rehabil · 2026 Feb · PMID 41739542 · Publisher ↗
ObjectiveTo systematically appraise motion capture technologies used for clinical assessment of upper limb function in adults post stroke, focusing on applicability, strengths, limitations, and research gaps.Data Sources...
ObjectiveTo systematically appraise motion capture technologies used for clinical assessment of upper limb function in adults post stroke, focusing on applicability, strengths, limitations, and research gaps.Data SourcesA systematic scoping review was conducted in accordance with PRISMA-ScR guidelines. PubMed, MEDLINE, CINAHL, CENTRAL, and IEEE Xplore were searched for studies published between January 2014 and December 2025.Review MethodsEligible studies quantitatively evaluated motion capture systems in adult stroke populations. Data extracted included technology type, technical specifications, outcomes, and reported strengths and limitations.ResultsFrom 3217 screened studies, 204 were included. Inertial measurement units were most common (71) followed by markerless optical motion capture (43), electromyography (39), marker-based optical motion capture (33), fusion systems (10), and smart devices (8). Marker-based systems provided high precision but were costly and complex. Markerless systems reduced setup requirements and supported clinical use but were prone to tracking errors. Inertial measurement units enabled portable monitoring, though accuracy decreased for slow or fine movements. Electromyography offered insights into neuromuscular activity but was expensive and sensitive to placement. Fusion systems allowed multidimensional assessment but were resource intensive. Smart devices provided accessible options but lacked precision. Most studies focused on chronic stroke, with limited evaluation in acute or home contexts. Reporting of stroke severity was inconsistent, and protocols were rarely standardised.ConclusionMotion capture technologies show promise for upper limb assessment after stroke but face challenges of cost, accessibility, and standardisation. Research in acute and home settings, along with predictive modelling, is needed to support clinical translation.
Enhancing participation with power-assist device: An exploratory study in manual wheelchair users.
Bouazzaoui D, Leynaert V, Gallien P … +4 more , Leffray A, Chaldaureille C, Homs A, Gelis A
Clin Rehabil · 2026 Feb · PMID 41719103 · Publisher ↗
ObjectiveTo evaluate the impact of acquiring a power-assist device on participation.DesignProspective multicenter cohort study.SettingThree physical medicine and rehabilitation outpatient centers.ParticipantsEighteen ind...
ObjectiveTo evaluate the impact of acquiring a power-assist device on participation.DesignProspective multicenter cohort study.SettingThree physical medicine and rehabilitation outpatient centers.ParticipantsEighteen individuals with neurological impairments who primarily use manual wheelchairs for mobility.InterventionParticipants were followed throughout the process of acquiring a power-assisted mobility device, with assessments conducted at delivery, 3 months, and 6 months post-acquisition.Main outcome measuresParticipation (Wheelchair Outcome Measure), shoulder pain (Wheelchair User's Shoulder Pain Index), wheelchair skills (Wheelchair Skills Test Questionnaire), and satisfaction with the device (Quebec User Evaluation of Satisfaction with Assistive Technology). Evaluations were performed at baseline (pre-acquisition), delivery, and at 3 and 6 months.ResultsThirty-six participants were enrolled. Eighteen did not complete the study mostly due to funding difficulties and 18 completed the acquisition. Participation significantly increased, with WHOM scores rising from 19.33 ± 15.02 at baseline to 36.55 ± 17.06 at 3 months ( = 0.0001). WST-Q scores improved from 21.1 [19.9-23.7] at baseline to 25.2 [23.6-27.6] at 6 months ( = 0.0001). Although the overall WUSPI score did not change significantly, the mobility sub-score improved from 4.5 [0-9.2] at baseline to 0 [0-0] at 6 months ( = 0.03). Satisfaction with the device remained stable over time, with a consistent QUEST score of 3.3.ConclusionThe acquisition of a power-assist device may enhance participation, wheelchair skills, and reduce mobility-related shoulder pain in manual wheelchair users. Further comparative studies are needed to confirm these findings.
Effects of high-intensity interval training on cardiorespiratory fitness and metabolic outcomes in type 2 diabetes: A systematic review and meta-analysis.
Vieira JPB, Carvalho VO, Aguiar LA … +6 more , Smart NA, Monteiro CN, Weege MH, da Silva RP, Rangel BN, Gomes-Neto M
Clin Rehabil · 2026 Jul · PMID 41712410 · Publisher ↗
ObjectiveThis study aimed to investigate the effects of high-intensity interval training (HIIT) versus different types of exercise or no exercise on peak oxygen consumption, muscle strength, health-related quality of lif...
ObjectiveThis study aimed to investigate the effects of high-intensity interval training (HIIT) versus different types of exercise or no exercise on peak oxygen consumption, muscle strength, health-related quality of life, and cardiometabolic risk factors in people with type 2 diabetes mellitus.Data SourcesWe searched in EMBASE, PubMed, Cochrane Central, Physiotherapy Evidence Database (PEDro), and SciELO for randomized controlled trials assessing the impact of HIIT in people with type 2 diabetes mellitus.Review MethodsStudy quality was evaluated using the PEDro scale, and certainty of evidence. We calculated mean differences, standardized mean difference and 95% confidence intervals.ResultsSixty-two studies (2204 participants) were included. Compared to control, HIIT increased peak oxygen consumption by 4.56 mL·kg·min (95% confidence interval 3.54 to 5.58) and reduced glycosylated hemoglobin by 0.70% (95% confidence interval -0.88 to -0.51). Improvements were also observed in insulin resistance, systolic and diastolic blood pressure, lipid profile, body mass index, and fat mass. When compared with moderate-intensity continuous training, HIIT improved peak oxygen consumption (1.30 mL·kg·min; 95% confidence interval 0.28 to 2.43) and glycosylated hemoglobin (-0.12%; 95% confidence interval -0.24 to -0.01).ConclusionsHigh-intensity interval training improves peak oxygen consumption, glycosylated hemoglobin, insulin resistance, and various cardiometabolic risk factors in people with type 2 diabetes mellitus.
The effect of robot-assisted gait training on physical activity outcomes in people with spinal cord injury: A systematic review.
Belsey J, Reid A, Hannah S … +2 more , Johnson L, Faulkner J
Clin Rehabil · 2026 Jun · PMID 41706608 · Full text
ObjectiveTo summarise the evidence for changes in physical activity outcomes during robot-assisted gait training in patients with spinal cord injury.Data sourcesThe Web of Science, Physiotherapy Evidence Database, Centra...
ObjectiveTo summarise the evidence for changes in physical activity outcomes during robot-assisted gait training in patients with spinal cord injury.Data sourcesThe Web of Science, Physiotherapy Evidence Database, Central, Medline, Scopus and SportDiscus databases were searched in August 2025 for studies that recorded ≥1 physical activity outcome during robot-assisted gait training.Review methodsData were synthesised according to the Synthesis Without Meta-analysis guidelines. Risk of bias was assessed using the Physiotherapy Evidence Database scale or the Revised Risk of Bias Assessment Tool for Non-Randomised Studies. Certainty of evidence was established following the Grading of Recommendations, Assessment, Development and Evaluations framework. The report followed the Preferring Reporting Items for Systematic Reviews and Meta-Analyses guidelines.ResultsThirty studies (638 participants) were eligible for inclusion. Quality of the randomised studies ranged from 'Fair' to 'Good', while there was high risk of bias for all non-randomised studies in ≥1 domain. Robot-assisted gait training significantly improved physical activity outcomes (up time, walk time, walk distance, walk speed and number of steps) over time, though these findings were constrained by very low certainty of evidence.ConclusionUp time, walk time, walk distance, walk speed, and number of steps were significantly improved across the robot-assisted gait training period for patients with spinal cord injury. Robot-assisted gait training during rehabilitation for people following spinal cord injury is a useful adjunct to support independence and improved walking ability.
A clinical roadmap for lateropulsion after stroke based on a realist review strategy.
Babyar S, Sheehan N, Nolan J … +4 more , Edwards TGS, Bergmann J, Meyer A, O'Dell MW
Clin Rehabil · 2026 Feb · PMID 41700998 · Publisher ↗
ObjectiveTo generate a clinical roadmap for managing lateropulsion after supratentorial stroke which integrates theory and practice using a realist review strategy.Data SourcesMedline Complete, CINAHL Complete, PEDro, Ac...
ObjectiveTo generate a clinical roadmap for managing lateropulsion after supratentorial stroke which integrates theory and practice using a realist review strategy.Data SourcesMedline Complete, CINAHL Complete, PEDro, Academic Search Complete, Health and Psychosocial Instruments, Health Source: Nursing/Academic Edition, and Embase were searched until December 2025.Review MethodsTwo searches included review and non-review articles about people with contralesional lateropulsion after supratentorial stroke. We excluded articles about people with ipsilesional lateropulsion resulting from brainstem or cerebellar stroke and non-English articles. Guided by , pairs of authors independently screened titles and abstracts, determining final lists by consensus. Pairs of authors independently extracted data, ranked levels of evidence, and collaborated to synthesise findings following the context-mechanism-outcome configuration of realist reviews. All authors used this foundation to generate the Lateropulsion Clinical Roadmap and clinical recommendations.ResultsThe review article search yielded four systematic reviews and one scoping review (of 19 screened). The non-review article search yielded 39 articles (of 167 screened), categorised as neuroimaging, epidemiology, assessment and intervention. Clinical recommendations and a Lateropulsion Clinical Roadmap integrated this information.ConclusionA Lateropulsion Clinical Roadmap integrated theory with neuroimaging, epidemiology, assessment and interventions based upon a realist review. Thorough assessment of severity of lateropulsion and neurological impairments should guide clinical decisions about how to leverage sensorimotor systems while considering task difficulty and environment during interventions for lateropulsion. A new hypothesis linking patient presentation with interventions directed at improving sensorimotor performance of the paretic extremities requires further study.
Perceptions and experiences of mind-body therapies among stroke survivors with pain: A qualitative interview study.
Prideaux N, Dorstyn D, Haslam B … +1 more , Oxlad M
Clin Rehabil · 2026 Feb · PMID 41697174 · Publisher ↗
ObjectiveTo explore the perceptions and experiences of stroke survivors with pain regarding the use of mind-body therapies.DesignQualitative.SettingCommunity.ParticipantsFifteen Australian stroke survivors with pain; 11...
ObjectiveTo explore the perceptions and experiences of stroke survivors with pain regarding the use of mind-body therapies.DesignQualitative.SettingCommunity.ParticipantsFifteen Australian stroke survivors with pain; 11 women and four men, aged 28-84 years, and 5 months to 24 years post-stroke.Main MeasuresSemi-structured, one-to-one qualitative interviews, transcribed verbatim and analysed using reflexive thematic analysis.ResultsFour themes described participants' perceptions and experiences of mind-body therapies. Theme 1 detailed our stroke survivors' determination to improve, openness to mind-body therapies and desire to have these therapies provided in rehabilitation. Theme 2 collated suggestions and reasons for individualising/tailoring mind-body therapy use, including having a range of formats/modes available. Theme 3 described reported benefits of mind-body therapies for pain post-stroke, while Theme 4 summarised perceived benefits for pain-related biopsychosocial wellbeing.ConclusionsPeople with pain post-stroke are open to using mind-body therapies when ready/able in order to improve ongoing post-stroke symptoms. If used, healthcare professionals should tailor mind-body therapy format and delivery to individual stroke survivors' needs and preferences to maximise treatment benefits, which stroke survivors with pain report to include improved pain management and physical and psychosocial functioning.
Tailored circuit training and an educational programme reduce pain sensitivity in patients with knee osteoarthritis: A feasibility study.
Venturini PJ, da Silva MG, Casonato NA … +3 more , Sette FE, Lluch E, Mattiello SM
Clin Rehabil · 2026 Feb · PMID 41697166 · Publisher ↗
The primary objective of this study was to evaluate the feasibility of tailored circuit training associated with patient education versus patient education alone in individuals with knee osteoarthritis. randomised contr...
The primary objective of this study was to evaluate the feasibility of tailored circuit training associated with patient education versus patient education alone in individuals with knee osteoarthritis. randomised controlled parallel-group feasibility study. one centre. 30 participants with a clinical diagnosis of knee osteoarthritis and a primary symptom of knee pain (≥4). The participants were randomly allocated to two groups for the 14-week intervention. The experimental group performed exercises three times a week and had an individualised progression of exercise duration and intensity. Both groups participated in an educational programme with health professionals. feasibility and acceptability rates. Physical performance tests, muscle strength, quantitative sensory testing, and self-administered questionnaires were used to assess the impact of the interventions. The rates of recruitment (2.73 participants/week), eligibility (31.50%), long-term retention (80% at 14 weeks and 73% at 26 weeks), and adherence to educational sessions (80% attended most lectures) were adequate, whereas the adherence to the exercise programme (60% completion of exercise sessions) was partially adequate. Acceptability and perceived usefulness were high in both groups, and the main barriers were related to accessing programmes via the Internet. Changes in physical performance tests, muscle strength, quantitative sensory testing, and self-administered questionnaires for both groups have been reported. This study demonstrated good feasibility and acceptability rates. The results will guide strategies to improve adherence and retention in clinical trials.
Efficacy of botulinum toxin for poststroke lower limb: a systematic review and meta-analysis.
Fernandes CS, Lima AMN, Moreira MT … +2 more , Sousa SS, Ferreira MS
Clin Rehabil · 2026 Jul · PMID 41685871 · Full text
ObjectiveThis review aims to conduct a systematic review and meta-analysis on the effectiveness of botulinum toxin in the treatment of spasticity and the improvement of lower limb function in adult stroke survivors, base...
ObjectiveThis review aims to conduct a systematic review and meta-analysis on the effectiveness of botulinum toxin in the treatment of spasticity and the improvement of lower limb function in adult stroke survivors, based on randomized clinical trials.Data sourcesSearches were conducted across multiple databases, including Medline, Scopus, CINAHL, SPORTDiscus, Psychology and Behavioral Sciences Collection, and Cochrane, from inception until September 2025.Review MethodThis systematic review and meta-analysis was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses recommendations. The meta-analysis was performed using Review Manager 5 software, with mean differences pooled using a random-effects model.ResultsThe analysis included 11 studies, with a total of 1740 adult participants. The results confirm that botulinum toxin is effective in reducing spasticity; however, the benefits on other outcomes, namely gait and balance, were limited and inconsistent. Considerable heterogeneity was also observed in intervention protocols, participant characteristics, dosing regimens, and the selection of target muscle groups.ConclusionIt is recommended that future studies prioritize the inclusion of subgroups and medium- and long-term follow-up. Only in this way will it be possible to clarify the true efficacy of botulinum toxin in different patient profiles and to contribute to the optimization of lower limb rehabilitation strategies after stroke.
The interaction between knee osteoarthritis and multimorbidity with fall risk: A longitudinal study using data from the osteoarthritis initiative.
Alenazi AM
Clin Rehabil · 2026 Feb · PMID 41678400 · Publisher ↗
ObjectiveTo examine the interaction between baseline Multiple Long-term Conditions (multimorbidity) and baseline knee osteoarthritis with longitudinal fall risk and fall counts.DesignA longitudinal study using publicly a...
ObjectiveTo examine the interaction between baseline Multiple Long-term Conditions (multimorbidity) and baseline knee osteoarthritis with longitudinal fall risk and fall counts.DesignA longitudinal study using publicly available data from the osteoarthritis initiative.SettingMultisite centres.ParticipantsParticipants (45-79 years) with or without knee osteoarthritis at baseline were included (4449).Main outcome measuresMultimorbidity was categorised as having ≥ two chronic conditions using the Charlson Comorbidity Index at baseline and having knee osteoarthritis (Kellgren and Lawrence grade ≥ two) or without knee osteoarthritis (Kellgren and Lawrence grades < two) were the main predictor variables. The occurrence of falls was the main dependent outcome variables as evaluated at the initial visit, 12, 24, 36, 48, 72, and 96 months.ResultsAfter adjustments for false discovery rate using Benjamini-Hochberg correction for p-values, having one chronic disease with knee osteoarthritis (odds ratio 1.21, 016) and without knee osteoarthritis (odds ratio 1.29, 004) were significantly associated with over time increased risk of fall. Having multimorbidity (≥ two chronic conditions) with knee osteoarthritis (odds ratio 1.21, 010) was associated with increased over time number of falls. Having one chronic disease with knee osteoarthritis (Incidence Rate Ratio: 1.28, 001) and without knee osteoarthritis (Incidence Rate Ratio: 1.33, 001) were associated with increased over time number of falls.ConclusionsThe interaction between baseline one chronic disease and the presence or absence of baseline knee osteoarthritis was associated with a longitudinal increased risk of fall. Multimorbidity with knee osteoarthritis was linked with number of falls.
Prenatal rehabilitation: A concept analysis.
Mengmei Y, Ke Z, Tieying Z
Clin Rehabil · 2026 Jun · PMID 41678392 · Publisher ↗
AimTo establish and clarify the concept of 'prenatal rehabilitation' within maternal health management by identifying its defining attributes, antecedents and consequences.DesignA concept analysis.MethodsWalker and Avant...
AimTo establish and clarify the concept of 'prenatal rehabilitation' within maternal health management by identifying its defining attributes, antecedents and consequences.DesignA concept analysis.MethodsWalker and Avant's concept analysis method was employed to identify the antecedents, attributes and consequences of prenatal rehabilitation.Data sourcesComprehensive searches were conducted in PubMed, Web of Science, Embase, Medline, CINAHL, CNKI, VIP, WanFang and CBM databases from their inception to November 2024. Dictionary sources, grey literature and manual reference checks were also utilised to capture diverse perspectives related to 'prenatal rehabilitation'.ResultsA total of 34 studies were included. Five defining attributes of prenatal rehabilitation were identified: (1) dual therapeutic and preventive functions, (2) proactive and dynamic integrated interventions, (3) focus on specific physiological needs during pregnancy, (4) goal-oriented towards functional recovery and birth readiness and (5) foundation and facilitation for postpartum rehabilitation. Antecedents included pregnancy-induced dysfunction and discomfort, individual characteristics and external resources. Consequences were improved maternal outcomes, better neonatal health indicators and decreased utilisation of healthcare resources.ConclusionA clarifying definition and conceptual model of prenatal rehabilitation was developed, highlighting its proactive, personalised and multidisciplinary nature in promoting maternal health management. These findings provide a theoretical foundation for clinical practice and future research.
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