Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Post-stroke cognitive impairment is associated with poorer return-to-work outcomes in working-aged stroke survivors: A systematic review.
Cunningham LJ, Stapleton T, Walsh K … +1 more , Horgan F
Clin Rehabil · 2026 Feb · PMID 41666123 · Publisher ↗
ObjectivesTo examine the relationship between post-stroke cognitive impairment and return-to-work outcomes in working-aged stroke survivors and evaluate cognitive assessment methods used in included studies.Data sourcesM...
ObjectivesTo examine the relationship between post-stroke cognitive impairment and return-to-work outcomes in working-aged stroke survivors and evaluate cognitive assessment methods used in included studies.Data sourcesMEDLINE, EMBASE, CINAHL, and APA PsycINFO databases were searched from 2003 to October 2025 according to PRISMA guidelines.Review methodsTwo reviewers independently screened titles and abstracts for inclusion. Data extraction and quality appraisal was completed by two reviewers. Narrative synthesis was completed due to substantial heterogeneity across studies.ResultsThirty-nine studies met inclusion criteria (observational studies ( = 33), qualitative ( = 5) and randomised control trial ( = 1)). Stroke severity was predominantly mild. Post-stroke cognitive impairment prevalence across study cohorts ranged from 17.5% at 28 days to 89% at 7 years with considerable variance in assessments and timing (range 2 days to 7 years). Concentration, memory and processing speed impairments were most frequently reported. Return-to-work rates ranged from 7.5% to 100%, with no clear trends for time post-stroke or stroke sub-type. Cognition was the most commonly associated variable influencing return-to-work outcomes followed by stroke severity, mood and functional status. The invisible nature of post-stroke cognitive impairment and limited awareness among employers and clinicians was highlighted.ConclusionPost-stroke cognitive impairment is commonly associated with poorer return-to-work outcomes even following milder stroke. Despite high detection, post-stroke cognitive impairment often remains hidden. This review highlights the substantial variation in post-stroke cognitive assessment practices and lack of intervention studies. Findings emphasise the need for consistent assessment and management of post-stroke cognitive impairment and increased awareness of its considerable negative impact on employment outcomes.PROSPERO: CRD42023462322.
Exploring the meaning and establishment of the therapeutic relationship in physiotherapy through reflective practice: A qualitative study.
Alba-Pérez E, Rodríguez-Nogueira Ó, Álvarez-Álvarez MJ … +1 more , Moreno-Poyato AR
Clin Rehabil · 2026 Feb · PMID 41666108 · Publisher ↗
ObjectiveTo explore, through reflective practice, physiotherapists' perspectives on the meaning and establishment of the therapeutic relationship with patients.DesignThe study formed part of a broader mixed-methods imple...
ObjectiveTo explore, through reflective practice, physiotherapists' perspectives on the meaning and establishment of the therapeutic relationship with patients.DesignThe study formed part of a broader mixed-methods implementation study based on participatory action research and corresponded to the initial stages of recognition, analysis, action and observation, framed within a constructivist paradigm aimed at improving the therapeutic relationship. A qualitative study was conducted.SettingThe study was carried out at the Rehabilitation Service of El Bierzo Hospital (Ponferrada, Spain).ParticipantsAll physiotherapists were invited to participate. Of the 19 physiotherapists and one physiotherapist manager invited, 18 consented to take part in the study.Main measuresFocus groups and self-observation through reflective diaries were undertaken. Focus groups were audio-recorded, and data from both methods were transcribed, coded, and thematically analysed.ResultsSix key categories were identified that provide insight into how physiotherapists understand, construct, and experience the therapeutic relationship: (1) meaning of the therapeutic relationship, (2) importance of the therapeutic relationship, (3) purpose of the therapeutic relationship, (4) establishment of the therapeutic relationship, (5) bi-directionality in the therapeutic relationship, and (6) the environment of the therapeutic relationship.ConclusionThis study highlights physiotherapists' perceptions regarding the therapeutic relationship and how these are transferred to daily clinical practice. The therapeutic relationship is centred on accompaniment and trust. Participants emphasised the importance of initial patient contact, during which the therapeutic bond is established through a friendly and cordial approach. Subsequently, physiotherapists lack a structured process for the development of the therapeutic relationship.
Evaluating the benefit of performing two 6-min walk tests after pulmonary rehabilitation to improve assessment of functional capacity.
Pirou M, Beaumont M
Clin Rehabil · 2026 May · PMID 41662211 · Publisher ↗
ObjectiveThe 6-min walk test (6MWT) is an essential test during pulmonary rehabilitation. The significant learning effect of the 6MWT involves performing two tests. However, when tests are repeated three months later, th...
ObjectiveThe 6-min walk test (6MWT) is an essential test during pulmonary rehabilitation. The significant learning effect of the 6MWT involves performing two tests. However, when tests are repeated three months later, the learning effect appears smaller in magnitude. Consequently, in clinical practice, only one test is performed after a pulmonary rehabilitation program. The aim of this study was to determine whether there is a benefit of performing two 6MWTs after pulmonary rehabilitation.DesignProspective, single center, noninterventional study.SettingPulmonary Rehabilitation Unit of the Centre Hospitalier des Pays de Morlaix (Morlaix, France) from 24 March 2023 to 19 March 2024.ParticipantsPatients aged 18 and older with moderate to very severe chronic obstructive pulmonary disease (COPD), admitted to a four-week pulmonary rehabilitation program.InterventionSubjects performed two 6MWTs at the end of the program.Main measuresThe primary outcome was the distance covered during the walk test. Secondary outcomes included oxygen saturation, heart rate, and lower limb fatigue.ResultsOne hundred seventy-six patients were included. Results revealed a significant difference ( < .05) in distance walked between the two 6MWT. Seventy-eight percent of patients ( = 135) walked further on the second test with a mean improvement of 14 m. The second test allowed an additional 15% ( = 26) to be classified as "responders" to the program regarding exercise capacity.ConclusionThe significant improvement in distance on the second test supports the value of performing two 6MWTs at the end of pulmonary rehabilitation in patients with COPD. Research is needed to extend findings to populations other than COPD.
I am not my self: Reconceiving identity in rehabilitation care.
Gryspeerdt L
Clin Rehabil · 2026 Jul · PMID 41615850 · Full text
ProblemHow does someone altered by illness adjust their view of themselves and how could rehabilitation help?BackgroundRehabilitation is expanding its scope to become more holistic, beyond a preoccupation with physical f...
ProblemHow does someone altered by illness adjust their view of themselves and how could rehabilitation help?BackgroundRehabilitation is expanding its scope to become more holistic, beyond a preoccupation with physical functioning, which requires an understanding of the concept of personal identity. One currently employed approach defines the self as expressed through the physical.PhilosophySuch a view risks reifying the self into something owned. Instead, the change a person experiences with illness or injury is not a shift within themselves but reflects alterations in their interactions with the world. A person is not an internal self, mediated by the form of a body. Instead, a person is a body existing in and experiencing the world, particularly through interactions with others.ApplicationThis revised understanding is significant in rehabilitation because it increases conceptual clarity, removing the perceived challenge associated with defining the self or personal identity. Moreover, by moving towards an integrated view of self, our perspective shifts, such that when a person says, 'I have changed', what we can appreciate is 'things have changed', thus reducing the blame on them. Consequently, there is increased hopefulness and better acknowledgement of patients' social situations.ImplicationsThe purpose of this is not to police colloquial language but to heed against over-interpreting certain common expressions in ways that lead to increased alienation.ConclusionRehabilitation should understand that no self is lost or transformed, but that there is a social identity which changes with altered circumstances and challenges around a person, who remains themselves.
A validated framework to guide therapists in arm-hand rehabilitation for individuals with cervical spinal cord injury.
Bertels N, Janssen-Potten Y, Delooz E … +1 more , Spooren A
Clin Rehabil · 2026 Jun · PMID 41603584 · Publisher ↗
ObjectiveTo develop and validate an evidence-based framework guiding therapists in arm-hand rehabilitation in individuals with cervical spinal cord injury, to enhance performance and activities of daily living.DesignThe...
ObjectiveTo develop and validate an evidence-based framework guiding therapists in arm-hand rehabilitation in individuals with cervical spinal cord injury, to enhance performance and activities of daily living.DesignThe framework was developed using a mixed-method approach: (1) item generation based on the UK Medical Research Council's guidelines for complex interventions; (2) four-round e-Delphi study with Likert scales and qualitative input; and (3) expert panel discussion.ParticipantsThe e-Delphi panel comprised 24 international rehabilitation professionals (16 occupational therapists and eight physiotherapists) with mostly ≥5 years of clinical and/or scientific experience in spinal cord injury rehabilitation. A separate expert panel included seven individuals with cervical spinal cord injury.Main measurese-Delphi consensus for each item was predefined as ≥70% agreement or inclusion across four rounds, with content analysis for qualitative input. Items were further discussed and validated during the expert panel and analyzed by content analysis.Results65 initially generated items were included in the e-Delphi; 36 were added from qualitative input; consensus was reached on 100 of the 101 items. The expert panel confirmed these items, added five, and reprioritized personal load capacity and motivation. The validated framework comprises three interrelated phases: (a) knowledge gathering-assessing personal needs, load capacity, and environment; (b) goal setting-collaboratively formulating person-centered, realistic goals; and (c) acting-a task- and goal-oriented training targeting meaningful activities and daily life integration. Motivation plays a key role across all phases.ConclusionsThis evidence-based framework provides guidance for therapists to deliver person-centered arm-hand rehabilitation tailored to patients' needs.
Letter to the editor on a recent paper on transcranial Direct Current Stimulation and clinical practice guidelines.
Hayward KS, Christie L, Lannin NA
Clin Rehabil · 2026 May · PMID 41575979 · Publisher ↗
Abstract loading — click title to view on PubMed.
Response to letter to the editor regarding 'transcranial direct current stimulation for upper extremity motor dysfunction in poststroke patients: A systematic review and meta-analysis'.
Tang X, Xing Y, Zhang N … +4 more , Shen Z, Guo X, Xing J, Tian S
Clin Rehabil · 2026 May · PMID 41575977 · Publisher ↗
Abstract loading — click title to view on PubMed.
Effectiveness of an ambulatory interprofessional rehabilitation on occupational performance of persons with chronic pain. A registry-based longitudinal cohort study.
Bertschi F, Andresen M, Gantschnig BE
Clin Rehabil · 2026 Jun · PMID 41575386 · Publisher ↗
ObjectiveTo examine to what extent the Bern Ambulatory Interprofessional Rehabilitation results in statistically significant and clinically meaningful changes in self-rated quality of and satisfaction with occupational p...
ObjectiveTo examine to what extent the Bern Ambulatory Interprofessional Rehabilitation results in statistically significant and clinically meaningful changes in self-rated quality of and satisfaction with occupational performance, health-related quality of life, pain intensity, and burden of suffering of persons with chronic pain.DesignRegistry-based longitudinal cohort study.SettingDepartment of Rheumatology and Immunology at the Bern University Hospital, Switzerland.ParticipantsA total of 172 participants with chronic musculoskeletal pain.InterventionThe Bern Ambulatory Interprofessional Rehabilitation is a biopsychosocial intervention for persons with chronic pain.Main measuresCanadian Occupational Performance Measure, Pictorial Representation of Illness and Self Measure, European Quality of Life and Health Measure Visual Analogue Scale, and Visual Analogue Scale for pain intensity.ResultsChanges over time were statistically significant and clinically meaningful for quality of occupational performance (post-treatment ≤ 0.001, 95% confidence interval (CI) [1.62-2.31], = 0.8; follow-up ≤ 0.001, 95% CI [1.23-2.20], = 0.70), satisfaction with occupational performance (post-treatment ≤ 0.001, 95% CI [2.35-3.22], = 0.95; follow-up ≤ 0.001, 95% CI [1.95-3.14], = 0.87), burden of suffering (post-treatment ≤ 0.001, 95% CI [0.25 to -0.42], = 0.61; follow-up ≤ 0.001, 95% CI [0.20-0.40], = 0.55), and health-related quality of life (post-treatment ≤ 0.001, 95% CI [6.30-15.66], = 0.43; follow-up ≤ 0.001, 95% CI [3.08-15.28], = 0.36). Changes for pain intensity were not statistically significant nor clinically meaningful (post-treatment = 0.676, 95% CI [-3.85 to 5.45], = 0.03; follow-up = 0.243, 95% CI [-8.91 to 1.72], = -0.09).ConclusionsThis study confirms the short- and mid-term effectiveness of the Bern Ambulatory Interprofessional Rehabilitation on occupational performance, burden of suffering, and health-related quality of life of persons with chronic pain.
Home-based video-guided exercise programme enhances functional and psychological recovery after lumbar spine surgery: A quasi-randomized controlled trial.
Nishiyama R, Hashizume H, Minamide A … +3 more , Murata S, Yoshida M, Yamada H
Clin Rehabil · 2026 Jun · PMID 41574905 · Publisher ↗
ObjectiveTo evaluate the long-term effects of a structured, home-based, video-guided exercise programme on disability, health-related quality of life, fear of movement, and depressive symptoms after lumbar spine surgery....
ObjectiveTo evaluate the long-term effects of a structured, home-based, video-guided exercise programme on disability, health-related quality of life, fear of movement, and depressive symptoms after lumbar spine surgery.DesignQuasi-randomized controlled trial.SettingSingle university-affiliated spine centre in Japan.ParticipantsOne hundred ninety-six patients (mean age 70 years, 62% male) who underwent posterior decompression surgery for lumbar disc herniation or spinal canal stenosis. Of these, 168 patients (84 per group) completed the 24-month follow-up.InterventionParticipants were assigned by hospital registration number to a video-guided exercise group ( = 103) or a control group ( = 93). The intervention group performed a 15-min daily home exercise routine for 2 years. The control group received standard post-operative care.Main measuresPrimary outcomes were disability (Oswestry disability index), fear of movement (Tampa Scale for Kinesiophobia), and Physical Function and General Health (36-Item Short Form Survey). Secondary outcomes included depressive symptoms (Zung Self-Rating Depression Scale) and pain (10-cm Visual Analogue Scale). Assessments occurred pre-operatively and at 1, 3, 6, 12, and 24 months. Longitudinal analysis used mixed-effects models.ResultsThe intervention group had significantly lower disability and fear of movement scores throughout ( < 0.05). Physical Function and General Health were higher, and depressive symptoms were significantly lower at 1, 6, and 12 months. Pain did not differ at 12 or 24 months.ConclusionsA home-based video-guided exercise programme improved long-term physical and psychological outcomes after lumbar spine surgery. This low-cost, scalable method may enhance standard rehabilitation.
Test-retest reliability and responsiveness of the Self-Regulation Assessment in a rehabilitation population: A prospective multicentre validation study.
Mourits BMP, Scholten EWM, de Graaf JA … +9 more , Oberink S, Smeets RJEM, Stegeman P, Passier PECA, de Rooij AM, Riemens MMR, Stolwijk J, Visser-Meily JMA, Post MWM
Clin Rehabil · 2026 Jun · PMID 41574842 · Publisher ↗
ObjectiveThis study aimed to examine the test-retest reliability and responsiveness of the Self-Regulation Assessment, a recently developed patient-reported outcome measure designed to evaluate self-regulation in a multi...
ObjectiveThis study aimed to examine the test-retest reliability and responsiveness of the Self-Regulation Assessment, a recently developed patient-reported outcome measure designed to evaluate self-regulation in a multi-diagnostic rehabilitation population.DesignA prospective cohort study following COSMIN guidelines. Participants completed the Self-Regulation Assessment and other measurements at start of rehabilitation (T0), 6 months later (T1), and 2 weeks after T1 (T2). Test-retest reliability (T1-T2) was quantified by intraclass correlation coefficient values, Bland-Altman plots, and the smallest detectable change. Responsiveness (T0-T1) was quantified by hypothesis testing, effect size, area under the curve, and minimal important change based on the anchor Global Rating of Change scale of self-regulation.Setting and participantsInpatients and outpatients of 14 Dutch rehabilitation institutions with various diagnosis.Main measureThe Self-Regulation Assessment.ResultsIn total, 555 patients completed the Self-Regulation Assessment at T0 and T1 and 167 patients at T1 and T2. In inpatients and outpatients, the Self-Regulation Assessment showed adequate to good reliability, with smallest detectable changes ranging from 16.0 to 22.9 points at individual level and 1.5 to 3.3 at group level for outpatients and inpatients, respectively. Significant changes (T0-T1) were observed in both groups, with a small effect size for inpatients and large for outpatients. Hypothesis testing indicated near sufficient responsiveness in both groups (67% confirmed). Minimal important change values ranged from 6.25 to 9.8 points for outpatients.ConclusionThe Self-Regulation Assessment demonstrated sufficient reliability and detected changes at group level, but was not suitable for detecting changes at individual level in outpatient rehabilitation.
Exercise prescriptions for older adults with different degrees of cognitive impairment: A dose-response network meta-analysis.
Zang W, Fang M, Xiao N … +3 more , Wu J, Zhang Q, Mao X
Clin Rehabil · 2026 Feb · PMID 41556956 · Publisher ↗
ObjectiveThis study aims to determine the optimal exercise types and dosages for improving cognitive function in older adults with mild cognitive impairment or dementia.Data sourcesPubMed, Web of Science, Scopus, PsycINF...
ObjectiveThis study aims to determine the optimal exercise types and dosages for improving cognitive function in older adults with mild cognitive impairment or dementia.Data sourcesPubMed, Web of Science, Scopus, PsycINFO, and SPORTDiscus databases were searched from inception to August 26, 2025.Review methodsTwo reviewers independently screened studies, extracted data, and assessed the risk of bias using the revised Cochrane risk-of-bias tool. A dose-response network meta-analytic model was applied to explore how exercise dosage within different exercise modalities influences cognitive outcomes in older adults with varying degrees of cognitive impairment.ResultsOur search identified 10,721 records, from which 68 studies comprising 6544 participants were included in the final analysis. A nonlinear dose-response relationship between physical activity and cognitive function was observed. A minimum threshold of 336 Metabolic Equivalent of Task minutes per week was required to yield cognitive benefits, while 934 Metabolic Equivalent of Task minutes per week was the minimum dose for clinically meaningful improvements. However, substantial variability was observed, particularly between individuals with mild cognitive impairment and those with dementia. The dose-response relationship varied by exercise modalities, with some modalities showing significant effects at lower doses. Aerobic exercise combined with resistance training exhibited superior efficacy compared to other modalities.ConclusionFor older adults with mild cognitive impairment or dementia, combining aerobic exercise with resistance training is most effective for boosting cognitive function, even with modest activity levels. It is important to choose specific exercise modalities and adjust their amounts to maximize cognitive gains in rehabilitation programs.
Comparing inpatient stroke rehabilitation care and outcomes for people with and without aphasia in Australia.
Stone M, Wallace SJ, Copland DA … +5 more , Burns C, Purvis T, Cadilhac DA, Hill K, Kilkenny MF
Clin Rehabil · 2026 Jun · PMID 41553847 · Full text
ObjectiveTo investigate whether presence of aphasia is associated with differences in inpatient stroke rehabilitation care and outcomes.DesignObservational study of cross-sectional data from hospitals participating in th...
ObjectiveTo investigate whether presence of aphasia is associated with differences in inpatient stroke rehabilitation care and outcomes.DesignObservational study of cross-sectional data from hospitals participating in the biennial National Stroke Audit - Rehabilitation Services (Stroke Foundation, 2016, 2018 and 2020). Descriptive statistics and multi-level multi-variable logistic regression were used to examine associations between aphasia status, processes of care, and patient outcomes, with level defined as hospital.SettingAustralian inpatient rehabilitation hospitals.ParticipantsAll patients with stroke who had aphasia status recorded.Main measuresAdherence to processes of care recommended in the Australian and New Zealand Clinical Guidelines for Stroke Management. In-hospital outcomes included complications, independence, survival, and discharge destination.ResultsOverall, 9960 audits were included; 3160 (33%) patients had aphasia (56% male; median age 75; no aphasia: 56% male; median age 76). Patients with aphasia were more likely to have a mood impairment (54% vs. 44%) and less likely to be assessed by a psychologist (40% vs. 49%). Fewer patients with aphasia were involved in goal setting (84% vs. 88%) or development of care plans (91% vs. 96%); or asked about returning to work (67% vs. 74%) or driving (41% vs. 45%). Patients with aphasia had a longer length of stay (median 26 vs. 21 days, p≤0.001) and were less independent on discharge (adjusted odds ratio (aOR) 0.80, 95% CI 0.71, 0.90).ConclusionsIdentified differences in stroke rehabilitation highlight the need for equitable access to care and effective patient-provider communication enabling people with aphasia to more fully participate in their rehabilitation.
Stakeholder perspectives on a return-to-work cognitive intervention after stroke.
Chen NYC, Chee A, Dong Y
Clin Rehabil · 2026 Jul · PMID 41549470 · Publisher ↗
ObjectiveTo investigate stakeholder experiences on return-to-work after stroke and preferences to co-design a return-to-work cognitive intervention, addressing a gap in post-stroke rehabilitation.DesignIn-depth semi-stru...
ObjectiveTo investigate stakeholder experiences on return-to-work after stroke and preferences to co-design a return-to-work cognitive intervention, addressing a gap in post-stroke rehabilitation.DesignIn-depth semi-structured interviews were conducted and reflexive thematic analysis guided by Braun and Clarke's six-phase approach was employed to analyse transcribed data, with iterative coding to identify themes until thematic saturation was achieved.SettingCommunity, work, and healthcare settings.ParticipantsTwenty purposively sampled participants across four stakeholder groups: stroke survivors ( = 7), caregivers ( = 4), healthcare professionals ( = 5), and employers ( = 4).Main measuresStakeholder perspectives on (i) the return-to-work process after stroke and (ii) preferences for the design and delivery of a return-to-work cognitive intervention after stroke.ResultsThree core themes emerged: (i) barriers to return-to-work, (ii) intervention content, and (iii) intervention delivery. Each theme comprised several subthemes and dimensions that offered deeper insight into participants' perspectives. Barriers to return-to-work encompassed lack of awareness of resources, ineligibility of support schemes, and lack of understanding from workplace. Intervention content comprised subthemes of awareness, acceptance and adjustment, goal setting, strategies for self-management, and navigating the return-to-work journey. Intervention delivery included programme structure, social support, format and accessibility. While there was broad agreement, stakeholders also expressed divergent priorities shaped by their roles and experiences.ConclusionsThis study synthesises lived experiences, clinical expertise, and employer insights from stakeholders to inform the co-design of a return-to-work cognitive intervention. This work advances a paradigm shift towards a patient-centred and ecological approach to improve post-stroke workforce reintegration.
Prediction for prospective falls via gait evaluation using mobile devices for stroke survivors: A markerless motion analysis study.
Lam WW, Ang WT, Fong KN
Clin Rehabil · 2026 Jul · PMID 41544186 · Publisher ↗
ObjectiveStroke survivors often experience hemiparetic lower extremity impairment, which increases fall risk. This study investigates prospective fall risk prediction using gait kinematic markers analyzed through a marke...
ObjectiveStroke survivors often experience hemiparetic lower extremity impairment, which increases fall risk. This study investigates prospective fall risk prediction using gait kinematic markers analyzed through a markerless motion capture system on mobile devices for participants with chronic stroke.DesignA prospective cohort study.SettingLaboratory setting, with three iPad Pros positioned at the start, end, and lateral points along a 3-meter walkway. Participants: Adults with hemiplegic stroke (Modified Functional Ambulation Classification ≥ III) and age-matched healthy controls, all without a recent fall.Main measuresGait parameters including stride length, cadence, step width, stance/swing time, double support time at baseline, and fall history interview over the 18-month period following the walking experiment.ResultsFifty healthy adults and 46 participants with chronic stroke were recruited. The 18-month prevalence for fallers in participants with stroke was 13%. Participants with stroke demonstrated a slower walking speed, a shorter step width, and a longer standing time than the healthy adults. Cadence, stride length, stance time, and swing time were strong predictors of fallers among participants with chronic stroke. The relative risks for low cadence, low swing phase, and high stance phase were 2.163, 2.002, and 2.142, respectively.ConclusionOur findings support the importance of using gait parameters obtained from the markerless motion capture system on mobile devices to predict prospective fall risk in the stroke population. Future research with larger, diverse cohorts of the stroke population using markerless motion capture is recommended to validate and refine the fall prediction models.
The Planning Strategies for Driving on a Map test (COMAP): Initial validation in stroke patients.
Laffarga L, Szot AC, Castro C … +3 more , Salazar-Frías D, Clavijo-Ruiz J, Rodríguez-Bailón M
Clin Rehabil · 2026 May · PMID 41544113 · Publisher ↗
ObjectiveTo validate a novel off-road assessment tool-the Planning Strategies for Driving on a Map (COMAP)-designed to evaluate strategic predriving planning in individuals with stroke.DesignCross-sectional observational...
ObjectiveTo validate a novel off-road assessment tool-the Planning Strategies for Driving on a Map (COMAP)-designed to evaluate strategic predriving planning in individuals with stroke.DesignCross-sectional observational study following COSMIN and STROBE guidelines.SettingResearch conducted at a university-affiliated research facility.ParticipantsA total of 41 stroke survivors (≥6 months poststroke) and 42 age- and gender-matched healthy controls. Participants with significant language or cognitive impairments (Mini-Mental State Examination < 24) were excluded.Main measuresParticipants completed the COMAP and a battery of cognitive tests including tests of attention, executive functions, working memory, and visuospatial organization.ResultsThe COMAP total performance showed good internal consistency (α = .885) and significant correlations with cognitive measures of executive function and memory. A cutoff score of 59 demonstrated strong diagnostic utility (area under the curve = .829; sensitivity = 78%; specificity = 87%) in identifying stroke-related cognitive impairments. Strategy use and planning time were associated with better task performance. The COMAP was more sensitive to within-group variability among stroke participants than between-group differences with healthy controls.ConclusionsThe COMAP is a valid and reliable tool for assessing strategic predriving planning after stroke. It offers clinically relevant insights into executive functioning and compensatory strategies, with potential applications in rehabilitation and driving-related decision-making.
Defining the content of interdisciplinary rehabilitation for people with chronic low back pain: An international Delphi study.
Ceulemans D, Goudman L, Reneman M … +7 more , Moens M, De Smedt A, Godderis L, Callens J, Lavreysen O, Van Puyenbroeck H, Van De Velde D
Clin Rehabil · 2026 May · PMID 41533711 · Publisher ↗
ObjectiveInterdisciplinary interventions for chronic low back pain are diverse, and there is a need to reach consensus on the content of rehabilitation.DesignA three-round Delphi survey was conducted across international...
ObjectiveInterdisciplinary interventions for chronic low back pain are diverse, and there is a need to reach consensus on the content of rehabilitation.DesignA three-round Delphi survey was conducted across international networks, a world physiotherapy specialty group, and the research team. The first round contained a checklist, based on previous research on interdisciplinary rehabilitation for people with chronic low back pain. Participants rated all items, subitems, clarifications, and questions on three content-validity indicators: (a) clarity and comprehensibility, (b) unique value, and (c) alignment with the goal. General questions were asked, together with qualitative feedback and missing items. A sensitivity analysis was conducted in anticipation of a possible overrepresentation of participants from a specific region.SettingClinical practice and research.ParticipantsClinicians or researchers with knowledge and/or experience in the field of chronic low back pain and/or rehabilitation.Main measuresConsensus scores and qualitative feedback.ResultsAfter three rounds, consensus was reached on all subitems. There was an overrepresentation of Belgian participants. The sensitivity analysis, removing Belgian responses, showed no or little differences in consensus scores. Consensus was reached on a comprehensive checklist comprising 11 items essential to rehabilitation for people with chronic low back pain. Additionally, 32 subitems with corresponding questions were identified, ensuring coverage of all aspects of rehabilitation for people with chronic low back pain.ConclusionThis study developed an evidence- and consensus-based checklist for interdisciplinary rehabilitation in people with chronic low back pain. Future work should assess implementation and uptake in research and clinical practice.
Validation of the Stroke Drivers' Screening Assessment in people with stroke in the Spanish context.
Clavijo-Ruiz J, Szot AC, Laffarga L … +2 more , Castro C, Rodriguez-Bailón M
Clin Rehabil · 2026 Jul · PMID 41529065 · Publisher ↗
ObjectiveTo culturally adapt the Stroke Drivers' Screening Assessment (SDSA) and evaluate its construct and predictive validity in a Spanish stroke population.DesignCultural adaptation and validation study.SettingHospita...
ObjectiveTo culturally adapt the Stroke Drivers' Screening Assessment (SDSA) and evaluate its construct and predictive validity in a Spanish stroke population.DesignCultural adaptation and validation study.SettingHospitals and neurorehabilitation clinics in Spain.ParticipantsForty-five stroke patients completed the SDSA-Spain, a neuropsychological battery, and a road test.Adaptation processA panel of experts (two occupational therapists, a psychologist specializing in driving, and a driving instructor) adapted the SDSA to the Spanish context.Main measuresThe correlations of the SDSA-Spain with attention and memory tests, its ability to discriminate between fit and unfit drivers according to the instructor's judgment, and its predictive validity for the road test were analyzed.ResultsThe SDSA-Spain correlated significantly with the Useful Field of View subtests 2 and 3, and with the Trail Making Test-part B time. No significant differences were observed in discriminative ability alone between pass and fail participants. A logistic regression was performed selecting Dot Cancellation-time, Dot Cancellation-errors, Road Sign Recognition from the Spanish SDSA, and Useful Field of View-subtest 2. The model achieved an area under the curve of 0.81, accuracy of 0.73, specificity of 0.75, and sensitivity of 0.714.ConclusionsThe SDSA-Spain is an off-road tool that can be useful for assessing fitness to drive in stroke patients, especially when combined with other tests.
Physiotherapy practice with mechanically ventilated spinal cord injury patients in the intensive care unit (ICU): A qualitative study of physiotherapists' experiences and perspectives.
Camilo SM, La W, Mirbaha S … +3 more , Cooper N, Anthony T, Wasilewski MB
Clin Rehabil · 2026 Jun · PMID 41529047 · Full text
ObjectiveTo explore physiotherapists' experiences with and perspectives on providing care to acute mechanically ventilated spinal cord injury patients in intensive care units to better understand physiotherapy practice w...
ObjectiveTo explore physiotherapists' experiences with and perspectives on providing care to acute mechanically ventilated spinal cord injury patients in intensive care units to better understand physiotherapy practice with this patient population.DesignQualitative descriptive study.SettingLevel 1 intensive care units in hospitals across Ontario.ParticipantsEleven physiotherapists working in level 1 intensive care units who had experience treating at least one mechanically ventilated spinal cord injury patients within the year prior to recruitment.MethodsSemistructured interviews were conducted with participants. Interviews lasted approximately 60 minutes, were transcribed verbatim and anonymised. Interview transcripts were analyzed using an inductive thematic analysis approach.ResultsThree overarching themes with several subthemes were identified: (1) spinal cord injury care provision is improved by physiotherapist presence and collaboration with patients' circle of care in the intensive care unit; (2) increased access to resources, specialized education and training could address challenges in physiotherapist treatments and assessments; and (3) physiotherapist involvement in acute spinal cord injury patients' care can optimize safety.ConclusionsOur findings suggest that integrating physiotherapist into intensive care unit spinal cord injury care may support early mobilization and improved patient outcomes. Physiotherapist presence enhanced interprofessional collaboration and communication. Physiotherapists faced challenges such as training gaps and limited autonomy, but informal mentorship improved physiotherapist integration. This qualitative study of 11 intensive care unit physiotherapists from one region suggests that greater physiotherapist involvement may improve care processes and warrants larger multisite studies.
Randomised controlled trials (RCTs) in rehabilitation: Looking backwards, looking forwards.
Drummond A
Clin Rehabil · 2026 Jun · PMID 41529045 · Publisher ↗
Abstract loading — click title to view on PubMed.
Do people with preoperative mental health diagnoses experience poorer pain and functional outcomes after total knee replacement? A systematic review and meta-analysis.
Mehta SP, Wassinger CA, Zahed M … +6 more , Blevins EW, Calloway SB, Bunner J, Johnson LE, Riddle M, Moaf VK
Clin Rehabil · 2026 May · PMID 41529042 · Publisher ↗
ObjectiveThis systematic review explored whether individuals with preoperative mental health diagnoses undergoing total knee replacement experience worse outcomes compared to patients without such diagnoses.Data SourcesM...
ObjectiveThis systematic review explored whether individuals with preoperative mental health diagnoses undergoing total knee replacement experience worse outcomes compared to patients without such diagnoses.Data SourcesMEDLINE, CINAHL, PSYCINFO, SPORT Discus, and PEDro databases were searched from inception to October 2025 to identify relevant articles.Review MethodsTwo independent reviewers screened and extracted data from relevant studies. The risk of bias for each study was assessed using the Quality in Prognostic Studies Tool. Meta-analysis using the standardized mean differences was employed to analyse associations between preoperative mental health diagnoses and pain and function at six months and ≥one year after total knee replacement. Certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation tool.ResultsThe literature search yielded 53 articles eligible for the review, of which 13 were rated as low risk of bias. Preoperative mental health diagnoses were not associated with worse pain at six months (standardized mean differences = -0.68, = .21) or ≥ one year (standardized mean differences = -0.48, = .08) post-total knee replacement. Similarly, preoperative mental health diagnoses were also not associated with functional outcomes at six months (standardized mean differences = -0.34, = .07) or ≥one year (standardized mean differences = -0.56, = .32). Considerable heterogeneity and imprecise estimates limited the certainty of these findings.ConclusionFindings suggest that preoperative mental health conditions alone may not predict poor pain and function outcomes post-total knee replacement. Given the heterogeneity and low certainty of evidence, further research should explore associations between mental health and other risk factors to guide personalized preoperative interventions.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe