Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Social media as a bridge between science and practice? Physiotherapists' perceptions from a qualitative study.
Fernandes MM, Mello ER, Fanfa MS … +9 more , Silveira AC, Peixoto ML, Melchior ACP, Correa VA, de Oliveira VF, Aliano GB, Dangui AJM, Wageck B, Nunes GS
Clin Rehabil · 2026 Jul · PMID 41525426 · Publisher ↗
ObjectiveTo explore physiotherapists' perceptions of integrating scientific knowledge into clinical practice and the role of social media in supporting evidence-based rehabilitation.DesignQualitative exploratory study.Se...
ObjectiveTo explore physiotherapists' perceptions of integrating scientific knowledge into clinical practice and the role of social media in supporting evidence-based rehabilitation.DesignQualitative exploratory study.SettingOnline interviews.ParticipantsTwenty-eight physiotherapists representing a range of clinical specialities.MethodsSemi-structured interviews were conducted via Google Meet, lasting on average 25 minutes. Sessions were recorded, transcribed verbatim and analysed using Braun and Clarke's thematic analysis. Coding was performed independently by two researchers, with triangulation to ensure trustworthiness. Data collection continued until thematic saturation was reached.ResultsTwo overarching themes were identified, comprising 10 sub-themes. (1) Application of scientific knowledge in clinical practice: participants recognised the importance of research evidence but reported barriers such as limited time, complex academic language and lack of institutional support. Strategies to overcome these challenges included targeted reading, continuing professional development and peer exchange. (2) Social media as a source of scientific information: platforms such as Instagram and YouTube were valued for accessibility, brevity and opportunities to share knowledge, but concerns were raised regarding superficiality, misinformation and commercial interests.ConclusionPhysiotherapists value scientific knowledge in clinical decision making but face persistent obstacles to its systematic use. Social media was perceived as a complementary resource for professional development, provided it is approached critically. Enhancing scientific and media literacy may improve the safe integration of digital content into evidence-based practice.
Quantitative clinical assessment of wrist proprioception with stroke survivors.
Mak-Yuen YY, Matyas TA, Lockwood K … +1 more , Carey LM
Clin Rehabil · 2026 Apr · PMID 41490166 · Full text
ObjectiveThe aims of this study were to characterise proprioceptive impairment in individuals after stroke using the Wrist Position Sense Test (WPST) in a relatively large pooled sample, to re-establish the criterion of...
ObjectiveThe aims of this study were to characterise proprioceptive impairment in individuals after stroke using the Wrist Position Sense Test (WPST) in a relatively large pooled sample, to re-establish the criterion of abnormality of the WPST, and to determine the sensitivity and specificity of a briefer test version for use in clinical settings.DesignCross-sectional observation study with pooling of data across studies.SettingRehabilitation or outpatient settings.SubjectsStroke survivors (n = 205) and neurologically healthy controls (n = 93) were assessed at baseline.Main measureWrist proprioception assessed using the WPST.MethodsBaseline data from stroke survivors and healthy controls assessed on the WPST was extracted from six studies. Raw data were pooled and analysed to determine an updated criterion of impairment and ability of a brief 10-trial version to detect proprioceptive impairment.ResultsProprioceptive impairment was common for the contralesional wrist (66%) and present in the ipsilesional wrist (21%). The new criterion of abnormality was established as 11.1 average error. High sensitivity and specificity were found for the brief 10-trial version, with 85.3% sensitivity and 95.7% specificity.ConclusionClinicians can quantitatively and confidently identify proprioceptive impairment in the upper limb after stroke using either the original or brief version of the WPST. Routine use of this quantitative, standardised clinical assessment can contribute to improved identification, monitoring, and access to targeted intervention for proprioceptive impairment following stroke.
Impact of early balance training on recovering following coronary artery bypass grafting. A randomized trial.
Atef H, Marques-Sule E, Moreno-Segura N … +5 more , Maged A, ELSayed SH, Pengelly J, Ali HF, Ghaffar HAE
Clin Rehabil · 2026 Jun · PMID 41468033 · Publisher ↗
OBJECTIVE: To investigate the effect of early balance training combined with traditional Phase I cardiac rehabilitation (based on circulatory, respiratory and progressive aerobic exercises) compared to Phase I cardiac re...
OBJECTIVE: To investigate the effect of early balance training combined with traditional Phase I cardiac rehabilitation (based on circulatory, respiratory and progressive aerobic exercises) compared to Phase I cardiac rehabilitation alone, on balance, functional capacity, quality of life, length of hospital stay and adverse events in patients post coronary artery bypass graft surgery. DESIGN: Randomized controlled trial. SETTING: Cardiothoracic surgery departments from the Cairo University Hospitals. PARTICIPANTS: Adults (≥55 years) undergoing coronary artery bypass graft were randomly allocated to either an early balance training plus Phase I cardiac rehabilitation group or a Phase I cardiac rehabilitation alone group. Both groups commenced within 48 hours postoperatively and performed 30 minutes of moderate-intensity Phase I cardiac rehabilitation, thrice daily for 7 days. The cardiac rehabilitation Balance group performed an additional 5 minutes of balance training each session. MAIN MEASURES: Balance (Berg Balance Scale), functional capacity (5-Repetition-Sit-to-Stand test), quality of life (Short Form-36 Health Survey Questionnaire), length of hospital stay (number of days hospitalized) and adverse events were evaluated. RESULTS: Sixty coronary artery bypass graft patients completed the study. When compared to cardiac rehabilitation Alone group, the cardiac rehabilitation balance group significantly improved balance (39.77 ± 4.73 vs 34.03 ± 4.94, respectively, < .001) functional capacity (11.93 ± 1.70 vs 15.97 ± 2.01, respectively, < .001), quality of life (71.87 ± 3.21 vs 66.17 ± 2.94, respectively, < .001) and hospital length stay (11.47 ± 1.22 vs 14.93 ± 1.36, respectively, < .01). Additionally, both groups showed significant improvements in balance, functional capacity and quality of life. No adverse events were registered in any of the groups. CONCLUSIONS: Phase I cardiac rehabilitation plus early balance training improves balance, functional capacity, quality of life, and decreases length of hospital stay beyond that of Phase I cardiac rehabilitation alone, without an increase in adverse events.Institutional Research Committee:No: P.T.REC/012/004372Registration:clinicaltrails.gov NCT06490458).
Cardiorespiratory fitness in kidney transplant recipients: A pilot randomised controlled trial of structured home-based rehabilitation and a nested case-control analysis.
Billany RE, Vadaszy N, Burns S … +12 more , Chowdhury R, Ford EC, Mubaarak Z, Sohansoha GK, Yeo JL, Dattani A, Cowley AC, Gulsin GS, Bishop NC, Smith AC, McCann GP, Graham-Brown MP
Clin Rehabil · 2026 May · PMID 41468011 · Full text
Objectives(1) Explore the effects of a 12-week home-based rehabilitation programme on cardiorespiratory fitness in kidney transplant recipients; (2) Compare cardiorespiratory fitness parameters in kidney transplant recip...
Objectives(1) Explore the effects of a 12-week home-based rehabilitation programme on cardiorespiratory fitness in kidney transplant recipients; (2) Compare cardiorespiratory fitness parameters in kidney transplant recipients and age-sex matched healthy volunteers to aid the justification for routine rehabilitation programmes.DesignPilot randomised controlled trial with nested case-control.SettingHome-based rehabilitation; hospital-based outcome assessments.ParticipantsPilot randomised controlled trial: 50 stable kidney transplant recipients (>1 year post-transplant) (randomised 1:1; = 25 control and = 25 intervention). Nested case-control: 30 kidney transplant recipients and 30 healthy volunteers.InterventionA 12-week home-based aerobic and resistance rehabilitation programme or guideline-directed care control.Main measuresCardiorespiratory fitness measured by cardiopulmonary exercise testing.ResultsPilot randomised controlled trial: After adjusting for baseline, follow-up values were significantly greater in intervention compared to control for peak oxygen uptake (V̇O) mL/kg/min, (+1.50, = .03) and maximum workload (+8 W, = .04) but not V̇O L/min or variables at the gas exchange threshold. Higher frequency of aerobic exercise sessions was associated with greater improvements in cardiorespiratory fitness ( = .252, = .040).Nested case-control: V̇O was reduced in kidney transplant recipients compared to healthy volunteers (18.81 ± 4.61 vs 24.06 ± 5.72 mL/kg/min; < .01), as was V̇O at the gas exchange threshold (11.70 ± 2.67 vs 14.47 ± 3.39 mL/kg/min; < .01).ConclusionsA 12-week home-based rehabilitation programme induced a significant improvement in some cardiorespiratory fitness variables and higher frequency of aerobic exercise associated with greater improvements. Cardiorespiratory fitness is significantly impaired in kidney transplant recipients compared to age-sex-matched healthy volunteers. Together, these findings highlight the clinical importance of promoting aerobic exercise and the integration of rehabilitation programmes into routine care for this population.Trial registrationClinicalTrials.gov, NCT04123951 (https://clinicaltrials.gov/study/NCT04123951).
Nurse-Administered Yale Swallow Protocol in High-Risk Hospitalised Adults for Dysphagia: Feasibility and Refinement.
Chang YC, Chang CH, Wang TG … +5 more , Lou PJ, Feng MC, Wang HP, Kuo YW, Chen CC
Clin Rehabil · 2026 May · PMID 41460684 · Publisher ↗
ObjectiveTo assess the feasibility of the Yale Swallow Protocol and refine it for parsimony.DesignCross-sectional study.SettingFour diverse units at a medical centre.ParticipantsHospitalised adults at high risk of dyspha...
ObjectiveTo assess the feasibility of the Yale Swallow Protocol and refine it for parsimony.DesignCross-sectional study.SettingFour diverse units at a medical centre.ParticipantsHospitalised adults at high risk of dysphagia (i.e., those aged over 65 years, admitted for stroke, Parkinson's disease, or head and neck cancer treatment) using consecutive sampling.Main MeasuresA research nurse administered the protocol, recording adverse events, administration time, and failure rates, with an 85% failure rate threshold to assess the ceiling effect. The protocol consists of contraindications, cognitive screenings, oral motor examinations, and a 3-ounce water swallow challenge, but pass/fail decisions are based solely on contraindications and the water challenge. Parsimonious combinations of items were explored to refine and potentially shorten the protocol. The measurement precision of the refined and shortened protocols was evaluated using the Rasch model.ResultsOf the 502 patients enrolled (mean age 71; 59.8% male), no adverse events occurred, and the protocol took under 3 min. The failure rate was 41.8%, indicating no ceiling effect. Five well-fitting items were retained from cognitive screenings and oral motor examinations: location, year, tongue sticking out, lingual motion, and facial symmetry. Both refined protocol (contraindications, five well-fitting items and water challenge) and shortened protocol (contraindications and five well-fitting items) enhanced measurement precision beyond the original version.ConclusionThe Yale Swallow Protocol is a safe, quick, and ceiling-effect-free screening for identifying dysphagia, even among diverse high-risk hospitalised patients. Our study also refined the protocol, achieving better measurement precision than the original protocol.
Cross-cultural adaptation, reliability, and validity of the Turkish version of the Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL).
Turhan A, Özcelep ÖF, Dursun S … +1 more , Ceylan İ
Clin Rehabil · 2026 Mar · PMID 41460682 · Publisher ↗
ObjectiveTo adapt the Outpatient Physical Therapy Improvement in Movement Assessment Log questionnaire into Turkish and to evaluate its cultural adaptation, validity, and reliability.DesignA cross-sectional study involvi...
ObjectiveTo adapt the Outpatient Physical Therapy Improvement in Movement Assessment Log questionnaire into Turkish and to evaluate its cultural adaptation, validity, and reliability.DesignA cross-sectional study involving cross-cultural adaptation and psychometric validation.SettingOutpatient physiotherapy clinics at a university hospital in Turkey.Participants272 adult patients receiving outpatient physiotherapy.InterventionParticipants completed the Turkish version of the scale, along with the Tampa Kinesiophobia Scale, Katz Activities of Daily Living Scale, and the International Physical Activity Questionnaire-Short Form. A subgroup of 84 participants completed the questionnaire again after two weeks to assess test-retest reliability.Main measuresContent validity was assessed using the Davis technique; structural validity was examined using exploratory factor analysis and confirmed using confirmatory factor analysis. Internal consistency was determined using Cronbach's alpha coefficient; test-retest reliability was evaluated using the intraclass correlation coefficient; and parallel-forms reliability was assessed.ResultsThe Content Validity Index of the scale was 0.92. Confirmatory factor analysis fit indices for the three-factor structure were acceptable: chi-square/degrees of freedom = 1.672; root mean square error of approximation = 0.047; comparative fit index = 0.953; Tucker-Lewis index = 0.945. Cronbach's alpha was .859, and the intraclass correlation coefficient was 0.856, indicating high internal consistency and reliability.ConclusionsThe Turkish version of the scale is a culturally adapted, valid, and reliable tool for assessing movement-related confidence in adult outpatients receiving physiotherapy. It can guide clinical decisions and support patient-centered rehabilitation.
Perspectives of early mobility in the cardiac surgery intensive care unit: an interpretive description study.
Phillips EK, Abegglen A, Hay JL … +12 more , Gregora A, Smith K, Shaski C, Bozek G, Gilchrist S, Fagan A, Chudyk AM, Ashe MC, Schultz ASH, O'Keefe-McCarthy S, Arora RC, Duhamel TA
Clin Rehabil · 2026 May · PMID 41450161 · Full text
ObjectiveEarly mobility after cardiac surgery in the intensive care unit improves patient outcomes, yet implementation by clinicians remains inconsistent. To inform interventions to increase adoption, this study sought t...
ObjectiveEarly mobility after cardiac surgery in the intensive care unit improves patient outcomes, yet implementation by clinicians remains inconsistent. To inform interventions to increase adoption, this study sought to explore clinicians' perspectives on the definition of early mobility in the cardiac surgery intensive care unit and describe perceived barriers and facilitators to implementation.DesignThis qualitative study was guided by interpretive description.SettingA tertiary hospital that performs 1000 cardiac surgeries annually.ParticipantsA total of 26 clinicians, including nurses, physicians, healthcare aides, respiratory therapists, and physiotherapists, participated.Main MeasuresThe nine focus groups and four individual interviews were audio-recorded, transcribed verbatim, and analyzed using thematic analysis.ResultsThree themes and 13 categories were created from the data: (1) Incongruent operationalization and conceptualization (across micro, meso, and macro levels), (2) uncertainty, and (3) inconsistency in mobilization practices. Themes were rooted in ambiguous definitions of "early" and "mobility," discrepancy between conceptualization and implementation of timing, varied interpretations of success, and perceived safety concerns. In addition, 4 barriers and 4 facilitators were identified and categorized into patient-care and clinician-related.ConclusionDeveloping early mobility protocols and education informed by clinicians may enhance its implementation in the cardiac surgery intensive care unit. Incorporating the perspectives of clinicians into early mobility protocol development is essential to support behaviour change and provide this beneficial care.
The role of personal social networks in social participation for adult burn survivors: A cohort study.
Deng H, Abouzeid CA, Ni P … +7 more , Rothfeld-Wehrwein ZR, Dhand A, Slavin MD, Herrera-Escobar JP, Kazis LE, Ryan CM, Schneider JC
Clin Rehabil · 2026 May · PMID 41411188 · Full text
ObjectiveTo describe the structure and composition of personal social networks in burn survivors and examine their associations with social participation.DesignA 6-month cohort study.SettingCommunity.Participants23 adult...
ObjectiveTo describe the structure and composition of personal social networks in burn survivors and examine their associations with social participation.DesignA 6-month cohort study.SettingCommunity.Participants23 adult burn survivors.Main MeasuresParticipants completed the Personal Network Survey and Life Impact Burn Recovery Evaluation Social Interactions and Social Activities short forms at baseline, 3-month, and 6-month. Personal Network Survey assesses individual social network in two categories: network structure depicts the architecture of social connections, while network composition describes the characteristics of network members. Life Impact Burn Recovery Evaluation measures social participation after burn injury.ResultsThe average age of the 23 participants was 49.1 (SD 12.5) years, with an average of 45.0% (SD 25.9%) total body surface area burned. Friends and family were the major relationship types, while camaraderie, emotion, and advice were the major support types. Multilevel models results showed that within-person smaller (β=-0.91; 95% CI = -1.48, -0.33; .004) and more close-knit (β=-1.29; 95% CI = -2.22, -0.37; .009) networks, as well as between-person networks in which burn survivors had fewer advisors (β=-40.97; 95% CI = -69.56, -12.38; .008) and received less health support (β=-20.35; 95% CI = -37.91, -2.79; .030), were significantly associated with better social participation.ConclusionThe findings advance the current understanding of burn survivors' social networks and their impact on social participation and lay the foundation for developing targeted strategies to promote social engagement and well-being by optimizing network composition and the balance of received support.
Rationale and description of Tied by Tiredness: A blended care intervention for fatigue after acquired brain injury.
Lazeron-Savu E, Smejka T, Lenaert B … +5 more , Dijkstra J, Wolfs C, Schepers V, Ponds R, van Heugten C
Clin Rehabil · 2026 May · PMID 41400937 · Full text
AimThe development of a new intervention designed to reduce persistent fatigue following acquired brain injury through personalised support.RationaleFatigue is a common and long-lasting consequence after brain injury. Ev...
AimThe development of a new intervention designed to reduce persistent fatigue following acquired brain injury through personalised support.RationaleFatigue is a common and long-lasting consequence after brain injury. Evidence indicates that tailored, multimodal interventions targeting individual experiences are more effective than standardised approaches.Materials and proceduresThe intervention combines real-time data collection using the Experience Sampling Method via a dedicated mHealth app with a workbook containing practical instructions and an online secure feedback environment. Patients complete eight short daily assessments for three consecutive days each week, collecting detailed information on fatigue and contextual factors such as mood, physical activities and social situations.Providers, setting, and deliveryTied by Tiredness is delivered by psychologists or occupational therapists in rehabilitation or outpatient settings to adults with acquired brain injuries aged 18 and over. In face-to-face therapy sessions, patient-collected data are used to tailor personalised feedback and advice on strategies, emphasising collaborative decision-making and active engagement.Dose and personalisationPatients attend six weekly 1-h sessions. Intervention strategies are adjusted to individual needs and goals throughout the programme, based on ongoing assessment data.Unique featuresContinuous personalisation and the integration of real-time data into therapy sessions distinguish this intervention.Purpose and implicationsThe programme aims to provide insight into the personal and environmental factors that contribute to a person's fatigue, enabling patients to implement cognitive and behavioural strategies for effective daily fatigue management. Tied by Tiredness represents a novel, practical approach to supporting self-management after brain injury.Trial registrationOverview of Medical Research in the Netherlands (OMON), ID: NL-OMON21265.
Perceptions and experiences of self-initiated discontinuation of home-based exercise rehabilitation in people with coronary artery disease.
Zhai S, Wei L, Xu D … +3 more , Sun H, Sun L, Zhang X
Clin Rehabil · 2026 May · PMID 41396036 · Publisher ↗
ObjectiveTo qualitatively explore the perceptions and experiences of patients with coronary artery disease regarding discontinuation of home-based exercise rehabilitation.DesignA qualitative, descriptive design was utili...
ObjectiveTo qualitatively explore the perceptions and experiences of patients with coronary artery disease regarding discontinuation of home-based exercise rehabilitation.DesignA qualitative, descriptive design was utilized in this study.SettingThis study focused on home-based exercise rehabilitation.ParticipantsA purposive sample of 24 patients who had voluntarily participated in the home-based exercise rehabilitation program was recruited.Main measuresSemistructured interviews were undertaken. Data were analyzed using a framework approach.ResultsA total of 24 participants (13 males and 11 females) from 28 to 77 years were recruited for this study to examine the endogenous and exogenous factors that influence withdrawal from exercise rehabilitation. The four major themes identified were (1) "exercise inertia," (2) "perception deviation," (3) "disruption of habit loop," and (4) "weakness in exercise literacy." These themes were further divided into 12 subthemes.ConclusionsSustained implementation of home-based exercise rehabilitation is crucial for patients with coronary heart disease. Discontinuation of exercise regimens frequently stems from patients' internal perceptions, including exercise inertia, cognitive biases, disruptions in established habit loops, and insufficient exercise literacy. Consequently, enhancing patient awareness of exercise rehabilitation and strengthening supervision of exercise routines are imperative. Establishing a multidisciplinary home-based exercise management system would further facilitate the optimization of exercise-related benefits.
Assessing functional communication in patients emerging from a disorder of consciousness: Impact of task and stimuli on response accuracy.
Pundole A, Duport S, Fleming V … +2 more , Beeke S, Varley R
Clin Rehabil · 2026 Apr · PMID 41385249 · Publisher ↗
ObjectiveTo explore how task and stimuli influence response accuracy in assessing functional communication in adults emerging from a Prolonged Disorder of Consciousness (PDOC).SettingSpecialist post-acute brain injury as...
ObjectiveTo explore how task and stimuli influence response accuracy in assessing functional communication in adults emerging from a Prolonged Disorder of Consciousness (PDOC).SettingSpecialist post-acute brain injury assessment centre.SubjectsTwelve adults (7 male; 5 female) emerging from PDOC, recruited consecutively between June 2021 and August 2023.MethodsA prospective study exploring the impact of task and stimuli on response accuracy. Yes/no questions and spoken word-to-referent (colour/object) matching tasks were presented. Stimuli were controlled for psycholinguistic variables to reduce linguistic confounds in the assessment of consciousness. Accuracy was compared to a standard measure (visually based situational yes/no questions from the Coma Recovery Scale-Revised).ResultsResponses were most accurate for word-to-referent matching tasks compared to yes/no questions ((23) = -6.49, < 0.001, = 1.33), with greater accuracy to colour than object stimuli (23) = 2.79, = 0.01, = 0.57). Participants also responded with greater accuracy to word-to-referent matching and yes/no questions involving colours and objects compared to the Coma Recovery Scale-Revised situational yes/no questions.ConclusionTask influences accuracy of responses in assessing return of consciousness. The advantage of colours over objects can be attributed to simpler visual processing and higher lexical frequency of these words. The current standard situational yes/no tasks from the Coma Recovery Scale-Revised resulted in lowest scores and should not be relied upon as the only measure of functional communication.
ADAPT-NMD: A hybrid II feasibility study of a co-designed self-management support intervention for people living with neuromuscular disorders.
Lee LE, Kulnik ST, Boaz A … +1 more , Ramdharry GM
Clin Rehabil · 2026 Apr · PMID 41369929 · Publisher ↗
ObjectiveTo examine the feasibility and acceptability of Neuromuscular Bridges, a personalised self-management support intervention adapted for people with neuromuscular disorders, and to explore contextual factors influ...
ObjectiveTo examine the feasibility and acceptability of Neuromuscular Bridges, a personalised self-management support intervention adapted for people with neuromuscular disorders, and to explore contextual factors influencing its implementation in specialist care.DesignA hybrid type II feasibility study employing mixed methods to evaluate clinical and implementation feasibility, incorporating quantitative outcomes with qualitative process evaluation.SettingA specialist neuromuscular tertiary centre in the United Kingdom.ParticipantsThirty-three adults with diverse neuromuscular disorders and six trained clinicians (physiotherapists and clinical nurse specialists).InterventionNM-Bridges, a co-designed, person-centred self-management support intervention delivered in a single clinical consultation, underpinned by the Bridges approach and Social Cognitive Theory.Main measuresRecruitment, retention, fidelity, and patient-reported outcomes were collected at baseline, post-intervention, and 3-month follow-up. Implementation was assessed using validated instruments and qualitative interviews.ResultsOf 106 eligible patients invited, 33 (31.1%) enrolled, with full retention and no missing data. Quantitative outcomes showed moderate pre- and post-improvements in patient-centred care, especially goal setting and activation. Small positive changes were noted in social participation, emotional well-being, mood, and self-efficacy, with effects generally sustained at follow-up. Fidelity was high, and implementation measures indicated strong clinician engagement. Qualitative data reinforced these findings, highlighting collaboration, relevance, and acceptability within routine care.ConclusionNM-Bridges was feasible and acceptable within specialist neuromuscular care. By integrating clinical outcomes with implementation learning, this hybrid feasibility study provides early evidence and a foundation for future evaluation of self-management support as a relational and sustainable component of neuromuscular rehabilitation.
Reliability and concurrent validity of the Courage Kenny-Fibrosis Grading Scale for breast or head and neck cancer-related fibrosis.
Gilchrist L, Franco L, Heinen M … +2 more , Holm C, Weightman M
Clin Rehabil · 2026 May · PMID 41364489 · Publisher ↗
ObjectiveFibrosis can develop after surgical or radiation treatments for cancer and is often seen in rehabilitation settings, yet few measures exist for standardized assessment. The aims of this study are to describe the...
ObjectiveFibrosis can develop after surgical or radiation treatments for cancer and is often seen in rehabilitation settings, yet few measures exist for standardized assessment. The aims of this study are to describe the validity and reliability of a new measure for cancer treatment-related fibrosis in survivors of breast or head/neck cancer.DesignFace validity of the Courage Kenny-Fibrosis Grading Scale was established using an iterative survey process. Reliability and concurrent validity were assessed using repeated measures by blinded raters and concurrent assessment with the Common Terminology Criteria for Adverse Events, Late Effects Normal Tissue-Subjective, Objective, Management, Analytic scales, and adheremeter rating of skin mobility.SettingOutpatient rehabilitation clinic.ParticipantsQuestionnaires were completed by 43 clinicians and researchers in the first round of face validation and 21 in the second. For reliability and concurrent validity, 41 cancer survivors, including 26 post-breast cancer and 15 post-head/neck cancer, were assessed by four physical therapists.ResultsAdequate face validity of the final version was established using responses from 21 clinicians. Inter-rater and intra-rater reliability of the final scale was adequate at ICC = 0.810 and 0.941, respectively. Associations between the Fibrosis Grading Scale and the Common Terminology Criteria for Adverse Events and Late Effects Normal Tissue scales were moderately significant (r = 0.290-0.574, p < 0.05), indicating concurrent validity.ConclusionAfter development of the Fibrosis Grading Scale using an iterative survey process, sufficient reliability and validity was established to use as an assessment in breast and head/neck cancer survivors.
Exploring the digital landscape: A scoping review of Achilles tendinopathy education on public websites and in randomised controlled trials.
Malliaras P, Mallows A, McAullife S … +15 more , Chimenti RL, Chen W, Deng J, Jiang J, Sharma S, Potter M, Smitheman H, Sancho I, Tavakkoli Oskouei S, Nicklen P, Bourke J, Fleagle T, Ruffino D, Silbernagel K, de Vos RJ
Clin Rehabil · 2026 Apr · PMID 41358871 · Full text
ObjectivesThe aims of this scoping review were to (i) map education from randomised controlled trials and public websites for Achilles tendinopathy to pre-defined categories and (ii) appraise the quality of education ava...
ObjectivesThe aims of this scoping review were to (i) map education from randomised controlled trials and public websites for Achilles tendinopathy to pre-defined categories and (ii) appraise the quality of education available.Data sourcesSources were extracted via a search of multiple databases and from the first three pages of targeted Google searches in English, Chinese, and Spanish (websites).Review methodsThe frequency of sources that reported on each pre-defined category (n = 15) was reported, and the content within each category was summarised descriptively. Quality and reliability were assessed with the DISCERN tool (1-5 points, higher score means higher quality and trustworthiness). Understandability and actionability of education was assessed using Patient Education Materials Assessment tool (0-100%, higher scores indicate more comprehensible information with clearer messages and more identifiable actions). Alignment with current international guidelines was reported.Results119 randomised controlled trials and 385 websites were included. Education coverage was better in websites compared to trials, particularly related to pathology and management. Conflicting advice was found on websites (e.g. when treatment should be sought). Quality (1.6 ± 0.5) and reliability (2.1 ± 0.7) of education were poor, with low scores for treatment risks and shared decision-making. Understandability was moderate (59%) and actionability was poor (28%). Alignment with clinical guidelines was low, with key information commonly omitted.ConclusionEducational sources found in randomised controlled trials and public websites on Achilles tendinopathy are poorly aligned with clinical guidelines. The information gaps in these sources mean that they are unhelpful to patients and may steer them towards inappropriate decisions. The review highlights the need for the development of accurate, meaningful, and evidence-based educational resources for individuals with Achilles tendinopathy.
Prioritizing quality of geriatric rehabilitation from the older adults' perspective: A nominal group technique study.
Lubbe AL, Groen WG, van Rijn M … +4 more , Mittelmeijer DC, Hertogh CM, Buurman BM, Pol MC
Clin Rehabil · 2026 Apr · PMID 41342675 · Full text
ObjectiveTo identify and prioritize aspects of quality in geriatric rehabilitation from the perspective of older adults.DesignQualitative study using a structured Nominal Group Technique.SettingThree nominal group techni...
ObjectiveTo identify and prioritize aspects of quality in geriatric rehabilitation from the perspective of older adults.DesignQualitative study using a structured Nominal Group Technique.SettingThree nominal group technique sessions were conducted in geriatric rehabilitation settings in the Netherlands.ParticipantsWe included older adults admitted to geriatric rehabilitation, Dutch proficiency, the ability to communicate and engage in group discussions, and an intention to return to independent living.InterventionParticipants engaged in structured nominal group technique sessions. Each session included five steps: introduction, idea generation, exchange of ideas, discussion, and ordering and rankingMain measuresAudio-recorded sessions were transcribed verbatim and analyzed using a combined inductive and deductive coding. Quality aspects were prioritized based on their summed ranking scores, relative importance, and selection frequency.ResultsEighteen older adults were included. Participants identified five key priorities for quality in geriatric rehabilitation: (1) good preparation with clear expectations, (2) well-organized therapy and care, (3) relationships with healthcare professionals that acknowledge individual needs, (4) clear, respectful communication, and (5) autonomy in treatment decision-making. The qualitative analysis supported these priorities with three overarching themes: the value of a supportive environment, feeling heard and understood, and the need for guidance and involvement.ConclusionThis study provides priorities for improving quality in geriatric rehabilitation, according to the experiences of older adults and offers direction for implementation in clinical practice.
Letter to the editor on methodological considerations in the study of post-stroke facial palsy recovery patterns.
Zhang H, Fu H
Clin Rehabil · 2026 Apr · PMID 41334906 · Publisher ↗
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What are the characteristics of patients requiring reconditioning admitted to tertiary care inpatient rehabilitation services? An exploratory audit.
Willis A, Hanly C, Ballingall A … +1 more , Brandis S
Clin Rehabil · 2026 Apr · PMID 41334746 · Full text
ObjectiveTo determine the characteristics of patients admitted to inpatient rehabilitation services for reconditioning to inform clinical care.DesignAn exploratory audit.SettingA major tertiary hospital service in Austra...
ObjectiveTo determine the characteristics of patients admitted to inpatient rehabilitation services for reconditioning to inform clinical care.DesignAn exploratory audit.SettingA major tertiary hospital service in Australia providing 48 inpatient beds across two facilities.ParticipantsPatients admitted to a rehabilitation service over two years (2019-2020) and categorised under Australasian Rehabilitation Outcomes Centre impairment codes for reconditioning.Main measuresDemographic and clinical service data.MethodsDescriptive analysis of data from the hospital admissions data base.ResultsOf the 368 patients in the study sample (432 admissions), the age range was 22-100 years of age (mean75 years). Data on smoking, language and age groups was trended and identified a younger group of patients with 16% (58 of 368 patients) being aged 60 and under. The gender split was 54.2% male and 45.8% female. Admissions of Indigenous people was higher than the recorded population with females being disproportionately categorised as deconditioned, and an overall mean age 24 years younger than the sample mean. Identified for increased attention were nephology patients and a group of 58 people (15.7%) with two or more admissions for reconditioning rehabilitation in the two-year period. This group were older (aged over 80) and male.ConclusionLiterature on reconditioning programs has a predominant focus on the older, more frail population. Patients admitted to inpatient rehabilitation for reconditioning are a diverse population and further study is required to determine effective interventions for specific groups of patients, particularly younger cohorts, and those with frequent readmissions.
Long-term outcomes of non-surgical treatment in first-time anterior shoulder dislocation: Does immobilisation duration and rehabilitation timing affect functional results and recurrence rates?
Sülek Y, Yahşi Y, Çakirtürk S … +1 more , Ertoğrul R
Clin Rehabil · 2026 Apr · PMID 41325168 · Publisher ↗
ObjectiveTo investigate whether immobilisation duration and rehabilitation initiation influence functional recovery, recurrence, and treatment failure in first-time anterior shoulder dislocation managed conservatively.De...
ObjectiveTo investigate whether immobilisation duration and rehabilitation initiation influence functional recovery, recurrence, and treatment failure in first-time anterior shoulder dislocation managed conservatively.DesignRetrospective multicentre cohort study.SettingOrthopaedic departments of multiple hospitals, data were collected between 2015 and 2021.ParticipantsA total of two hundred and one patients with first-time anterior shoulder dislocation were managed non-surgically. Patients were divided into three groups: Group 1 (early mobilisation; = 61) - one to two weeks of immobilisation with rehabilitation starting in week two; Group 2 (standard protocol; = 76) - three to four weeks of immobilisation with rehabilitation starting in week four; and Group 3 (delayed rehabilitation; = 64) - more than four weeks of immobilisation with rehabilitation starting in week six.InterventionNon-surgical treatment with varying immobilisation durations followed by rehabilitation.Main MeasuresFunctional outcomes were the Rowe, Disabilities of the Arm, Shoulder and Hand, American Shoulder and Elbow Surgeons, and Western Ontario Shoulder Instability Scores. Clinical outcomes included shoulder range of motion, recurrence, return-to-activity time, and treatment failure.ResultsFunctional scores and range of motion did not differ significantly between groups. Recurrence occurred in 18.0% (Group 1), 23.7% (Group 2), and 23.4% (Group 3), with no statistically significant difference ( = .135). However, treatment failure - defined as persistent instability or the need for surgical stabilisation - was significantly higher in Group 3 (23.4%) compared with Group 1 (16.4%) and Group 2 (18.4%) ( = .022). Mean follow-up was 42.1 ± 10.2 months.ConclusionsImmobilisation duration and rehabilitation timing were not associated with statistically significant differences in functional recovery or recurrence. Prolonged immobilisation appeared to increase the risk of treatment failure. Early or standard protocols may therefore represent reasonable options, and prospective randomised studies are needed to define optimal management.Level of Evidence: Level Three.
Does radial shockwave therapy lead to immediate improvements in pain in people with insertional Achilles tendinopathy? A randomised controlled trial.
Alsulaimani B, Perraton L, Bourke J … +2 more , Powers T, Malliaras P
Clin Rehabil · 2026 Feb · PMID 41308020 · Full text
ObjectivesTo investigate the immediate effects of radial shockwave therapy versus sham on movement evoked pain in people with insertional Achilles tendinopathy.DesignRandomised controlled trial.SettingPrivate clinic.Part...
ObjectivesTo investigate the immediate effects of radial shockwave therapy versus sham on movement evoked pain in people with insertional Achilles tendinopathy.DesignRandomised controlled trial.SettingPrivate clinic.ParticipantsPeople diagnosed with insertional Achilles tendinopathy who were over 18 years old with a symptom duration of greater than 3 months.InterventionSeventy-six participants (53% female, mean age 51 years) were randomly allocated to a radial shockwave (n = 38) or sham (n = 38) group. Three sessions of radial shockwave or sham (no pressure) to the most affected side in 5-to-10-day intervals. All participants received identical education and exercises.Main measuresThe primary outcome measure was movement evoked pain (measured on a 100 mm visual analogue scale) at the first, second and third session immediately after each application.ResultsThere was 96% follow up of participants at the third session. Over half of the participants believed they were receiving the 'real' treatment (average 58%). The mean movement evoked pain scores improved each session by 0.6 points for the radial shockwave therapy and 0.7 points for the sham group. There was no difference between the groups after the first (-0.4, 95% confidence interval (CI) -1.6 to 0.8), second (0.4, 95% CI -0.8 to 1.6) or third session (-0.4, 95% CI -1.6 to 0.8).ConclusionsIn adults with insertional Achilles tendinopathy, radial shockwave therapy demonstrated no more efficacy than a sham in reducing immediate movement evoked pain. These results do not support the use of radial shockwave therapy for immediate pain relief among people with this condition.Clinical trial registrationACTRN12620000035921.
Standardisation in acute stroke research: A scoping review of upper limb assessments against Stroke Recovery and Rehabilitation Roundtable (SRRR) benchmarks.
Doric M, Tedesco Triccas L, Xiong M … +5 more , Tabone F, Knorz AL, Downar N, Ward NS, Zich C
Clin Rehabil · 2026 Apr · PMID 41295549 · Full text
ObjectiveTo examine how well acute stroke studies assessing upper limb sensorimotor capacity align with the Stroke Recovery and Rehabilitation Roundtable (SRRR) recommendations, focussing on the type of assessment tools...
ObjectiveTo examine how well acute stroke studies assessing upper limb sensorimotor capacity align with the Stroke Recovery and Rehabilitation Roundtable (SRRR) recommendations, focussing on the type of assessment tools used, study and participant characteristics, follow-up timings, and the use of clinical and multimodal data.DesignScoping review.Data sourcesEmbase, MEDLINE, PubMed, CINAHL, PsycINFO, Google Scholar, and Web of Science were searched for relevant studies published between 01 August 2017 and 30 September 2025.MethodsThis review included studies involving adults with stroke who underwent upper limb assessment during the acute phase. Data were extracted on clinical, structural, and functional assessments, as well as follow-up timing, study, and participant characteristics. Of the 3628 identified articles, 132 met the inclusion criteria.ResultsWhile global assessments (e.g. NIH stroke scale [NIHSS]) and impairment-level upper limb assessments (e.g. Upper-extremity Fugl-Meyer Assessment) were widely used, activity-level tools (e.g. Action Research Arm Test) were underrepresented. Structural brain imaging was common, though often used only diagnostically, while functional brain imaging and multimodal approaches were rare. Follow-up timing varied, with limited long-term tracking. Demographic reporting was inconsistent, with underrepresentation of young adults and women.ConclusionDespite progress, significant gaps remain in the standardisation and comprehensiveness of upper limb assessment in acute stroke research. Future studies should better align with SRRR recommendations to improve data comparability and scientific rigour.
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