Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Responsiveness and interpretability of the Italian version of the Knee Outcome Survey - Activities of Daily Living Scale in patients with knee disorders.
Tortoli E, La Marca R, Ugolini A … +1 more , Pellicciari L
Clin Rehabil · 2026 Jan · PMID 41130913 · Publisher ↗
ObjectiveTo assess the responsiveness and interpretability (by the minimal important change [MIC]) of the Knee Outcome Survey - Activities of Daily Living Scale (KOS-ADLS) in patients with knee disorders and to evaluate...
ObjectiveTo assess the responsiveness and interpretability (by the minimal important change [MIC]) of the Knee Outcome Survey - Activities of Daily Living Scale (KOS-ADLS) in patients with knee disorders and to evaluate potential differences between samples with surgical and with non-surgical history using both patient- and physiotherapist-reported perspectives.Study designClinimetric longitudinal study.SettingThree private physiotherapy clinics.Participants115 patients with knee disorders undergoing physiotherapy.InterventionParticipants completed the KOS-ADLS and other measurement instruments at baseline and after the treatment.Main measuresResponsiveness was assessed through hypothesis testing using effect sizes (ESs), standardised response means (SRM), change score correlations between KOS-ADLS and other measurement instruments, and area under the curve (AUC) values. Interpretability was assessed with MIC, determined using receiver operating characteristic (ROC)-based anchor methods via patient- and physiotherapist-reported Global Rating of Change. Responsiveness and MIC were provided for the total sample, sample with surgical history and sample with non-surgical history.ResultsKOS-ADLS demonstrated large ES (0.90) and SRM (1.03) values in the total sample, with better responsiveness in sample with surgical history patients. AUC values exceeded 0.70 across groups. Responsiveness was satisfactory as 91.7% hypotheses were confirmed. MIC values ranged from 8.5 to 18 points, with the highest estimates in the sample with surgical history patients and from the physiotherapist's perspective.ConclusionThe KOS-ADLS is a responsive and interpretable instrument for assessing change in knee-related function. Its findings vary by sample (sample with surgical history, sample with non-surgical history) rather than perspective (patient, physiotherapist).
Long-term home-based physical exercise, pain, and use of pain medication over a year after hip fracture - A secondary analysis of a randomised controlled trial.
Suikkanen S, Soukkio P, Kantola M … +4 more , Kautiainen H, Haanpää M, Hupli MT, Kukkonen-Harjula K
Clin Rehabil · 2026 Feb · PMID 41130912 · Full text
ObjectiveTo study the effects of a year-long, supervised home-based exercise training on perceived pain, pain interference, and use of pain medication over 12 months after hip fracture.DesignRandomised clinical trial, se...
ObjectiveTo study the effects of a year-long, supervised home-based exercise training on perceived pain, pain interference, and use of pain medication over 12 months after hip fracture.DesignRandomised clinical trial, secondary analysisSettingHomeParticipantsParticipants ( = 121) had surgical repair of a hip fracture, were ≥60 years old, and community-living.InterventionParticipants were allocated into 12-month home-based Physical Exercise ( = 61) or Usual Care ( = 60). Exercise sessions (60 minutes/twice a week) at participants' home under physiotherapist supervision including strength, balance, and functional exercises.Main measuresPain intensity, interference, and locations, and information of the pain medication were queried at baseline, 3, 6 and 12 months.ResultsThe mean age was 81 (SD 7) years, 91 (75%) were women, and 74 (61%) had fractured femoral neck. At baseline, in Physical Exercise 46 (75%) and in Usual Care 43 (72%) reported some sort of pain. After discharge, 118 (98%) used pain medication: 116 (96%) paracetamol and 41 (34%) opioids. At 12 months, there was no difference between groups in global pain prevalence, or in pain intensity, but the prevalence of hip pain ( = .047, effect size -0.38 (95% CI -0.51 to -0.22)) and pain interference ( = .042, effect size -0.18 (95% CI -0.52 to -0.05)) were lower in Physical Exercise than in Usual Care. At 12 months, there was no difference in medication use between the groups.ConclusionThe year-long supervised home-exercise reduced pain interference, and the prevalence of hip pain compared to usual care. Over 12 months the use of pain medication decreased in both groups.RegistrationClinicalTrials.gov (NCT02305433).
Early effects of a microprocessor-controlled knee joint on functional mobility and user satisfaction in veterans with limb loss.
Kuzu C, Topuz S, Aydemir K
Clin Rehabil · 2026 Feb · PMID 41124353 · Publisher ↗
ObjectiveTo evaluate the effects of a polycentric microprocessor-controlled knee joint on functional mobility and user satisfaction.DesignBefore-after pilot trial.SettingTertiary-level physical therapy and rehabilitation...
ObjectiveTo evaluate the effects of a polycentric microprocessor-controlled knee joint on functional mobility and user satisfaction.DesignBefore-after pilot trial.SettingTertiary-level physical therapy and rehabilitation hospital.ParticipantsTen adults with unilateral transfemoral or through-knee amputations due to trauma.InterventionTransition from various monocentric microprocessor-controlled knees to a polycentric microprocessor-controlled hydraulic knee.Main measuresFunctional performance assessed using the Timed Up and Go, 6-Minute Walk Test, Hill Assessment Index, Stair Assessment Index, and user satisfaction measured by the Satisfaction with Prosthesis Questionnaire.ResultsThe Time Up and Go and 6-Minute Walk Test showed nonsignificant improvements with moderate effect sizes (Cohen's d = 0.43 and 0.58; = .205 and .098, respectively). No significant change was observed in the Stair Assessment Index. A statistically significant improvement was found in the descend-specific Hill Assessment Index, accompanied by a significant reduction in task duration ( = 0.95; = .034; Cohen's d = 0.85; = .025, respectively). User satisfaction demonstrated a positive trend, with a moderate-to-large effect size (Cohen's d = 0.68; = .059), although this did not reach statistical significance.ConclusionsTransitioning to the polycentric microprocessor-controlled knee joint may enhance incline-related mobility in active prosthesis users. The positive trend in user satisfaction suggests potential benefits; however, this requires confirmation in larger studies. Outcomes may be influenced by learning effects and socket comfort variability. These preliminary findings support the need for individualized prosthetic prescriptions and warrant larger, controlled trials with extended follow-up.
Healthcare professionals' perceptions in regards to chronic obstructive pulmonary disease.
Swift E, O'Brien MR, Peters S … +1 more , Kelly C
Clin Rehabil · 2026 Jan · PMID 41124301 · Full text
ObjectiveTo identify healthcare professionals' perceptions of pulmonary rehabilitation as a management strategy for people with chronic obstructive pulmonary disease (COPD).DesignA qualitative interview study which adopt...
ObjectiveTo identify healthcare professionals' perceptions of pulmonary rehabilitation as a management strategy for people with chronic obstructive pulmonary disease (COPD).DesignA qualitative interview study which adopted an interpretive phenomenological approach.MethodsTwenty-seven healthcare professionals were recruited from general practices in the North West of England and two hospital trusts, consisting of: general practitioners, practice nurses, and doctors and nurses working on general medical wards. Audio recorded semi-structured interviews investigated healthcare professionals' perceptions and knowledge of pulmonary rehabilitation; interpretive phenomenological analysis was conducted on the transcribed interviews.ResultsThree themes were identified: , , and . Commonalities and disparities were identified between primary and secondary care and amongst the different professional groups. Healthcare professionals held negative COPD illness perceptions including stigmatising beliefs in relation to the disease. These beliefs impacted their referral practice. Beliefs about pulmonary rehabilitation included views about patient suitability for the pulmonary rehabilitation programme. A lack of knowledge of pulmonary rehabilitation and the referral process was evident. Surprisingly, many working on general medical wards had not heard of pulmonary rehabilitation and none in their current role had referred to the programme. Organisational and referral pathway perceptions revealed barriers and facilitators to referral.ConclusionReferral to pulmonary rehabilitation programmes is influenced by healthcare professionals' perceptions and knowledge of pulmonary rehabilitation, referral pathways and how COPD affects patients. Together health professional perceptions could act as a predictor of referral practice and inform strategies for increasing referral rates.
The effect of acute intermittent hypoxia on enhancing motor functions in adults with incomplete spinal cord injury: A systematic review and meta-analysis.
Sogbossi ES, Bouffanet B, Pincede J … +2 more , Ribon-Demars A, Everard G
Clin Rehabil · 2026 Jan · PMID 41117316 · Publisher ↗
ObjectiveThis systematic review aimed to assess the safety and effectiveness of acute intermittent hypoxia to improve motor outcomes in individuals with incomplete spinal cord injury.Data sourcePubmed, Embase, Scopus, an...
ObjectiveThis systematic review aimed to assess the safety and effectiveness of acute intermittent hypoxia to improve motor outcomes in individuals with incomplete spinal cord injury.Data sourcePubmed, Embase, Scopus, and Cochrane Library databases were searched.Review methodsWe only included randomized controlled trials (published up to September 2025) that met the following criteria: participants were adults with incomplete spinal cord injury; the intervention involved acute intermittent hypoxia with or without motor training; the control group received sham acute intermittent hypoxia with or without motor training; outcomes included motor functions. Risk of bias was evaluated using RoB2 tool. Risk and mean differences were computed, with a random-effects model.ResultsNine randomized controlled trials ( = 114) were included. Overall risk of bias was with some concerns. The review indicates that acute intermittent hypoxia is safe and has good treatment adherence, with low drop-out rates for acute intermittent hypoxia alone (RD = 0.08; 95% confidence interval (CI): -0.11-0.26; = 0%; = 66) or with gait training (RD = 0.04; 95% CI: -0.11-0.18; = 0%; = 57). Acute intermittent hypoxia was found to have beneficial effects on walking speed (MD = 5.97; 95% CI: 1.4-10.54; = 0%; = 53), endurance (MD = 39.39; 95% CI: 1.92-76.86; = 50%; = 54), muscle strength, and manual dexterity. However, no significant effects were observed on balance functions.ConclusionAcute intermittent hypoxia may be a promising adjunctive therapy to enhance motor function in individuals with incomplete spinal cord injury. Further research with standardized protocols and larger sample sizes is needed to optimize its use in clinical practice.
Feasibility of home-based high-intensity balance training in persons with multiple sclerosis: A pretest-posttest study.
Bae M, Gell NM, Ramsey C … +1 more , Kasser SL
Clin Rehabil · 2026 Jan · PMID 41105745 · Publisher ↗
ObjectiveTo examine the feasibility of a home-based high-intensity balance training programme (HBBT-MS) and its preliminary efficacy in individuals with multiple sclerosis (MS).DesignA single-group pretest-posttest desig...
ObjectiveTo examine the feasibility of a home-based high-intensity balance training programme (HBBT-MS) and its preliminary efficacy in individuals with multiple sclerosis (MS).DesignA single-group pretest-posttest design.SettingCommunity.SubjectsTwenty-eight individuals with MS (23 female (82%); mean age: 55.2 ± 11.9).InterventionsParticipants performed the program for 30 minutes per session, 3 days per week for 12 weeks, with the support of a family member to ensure safety while maintaining a high balance challenge.Main measuresFeasibility was assessed using four domains of process, resources, management, and scientific outcomes. Physical function (static balance, lower-extremity function, and mobility), dual-tasking, cognitive function (processing speed, verbal memory, and visuospatial memory), and self-reported outcomes (fatigue, dual-task difficulty, ambulation difficulty, and fear of falling) were assessed at baseline and post-intervention.ResultsTwenty-six out of 28 participants completed both the pretest and posttest (adherence rate: 92.9%). No severe adverse events attributed to this program were reported. There were significant and small-to-medium improvements in static balance ( = 0.74, < 0.001), lower-extremity function ( = 0.70, < 0.001), and mobility ( = 0.34, = 0.004), with no improvement observed in dual-tasking. Participants showed significant and medium improvement in processing speed ( = 0.71, = 0.007) and visuospatial memory ( = 0.55, = 0.22), but not verbal memory ( = 0.02, = 0.22). We observed significant improvements in all self-reported outcomes.ConclusionsThe HBBT-MS was feasible, safe, and acceptable. Further evaluation using a controlled design is warranted to examine the effectiveness of the programme. clinicaltrials.gov; NCT06412003.
Rehabilitation in oncological palliative care, does it exist? A qualitative and multicentre study of healthcare professionals' perceptions.
Rezende G, Morais Xavier Dos Santos G, Bacon I … +1 more , Rodrigues do Prado De-Carlo MM
Clin Rehabil · 2026 Jan · PMID 41100889 · Publisher ↗
ObjectiveTo investigate how health professionals working in palliative care services understand rehabilitation related to oncology palliative care in England and Brazil, according to different health system contexts.Desi...
ObjectiveTo investigate how health professionals working in palliative care services understand rehabilitation related to oncology palliative care in England and Brazil, according to different health system contexts.DesignQualitative study.SettingHospices, hospitals, community-based palliative care centre, palliative care units, nursing care homes in different areas of Brazil and England.ParticipantsThirty-six nurses and occupational therapists experienced in providing palliative care interventions from England and Brazil.InterventionsIndividual interviews with open-ended questions.Main MeasuresIndividual semi-structured, in-depth interviews, analysed using Braun and Clarke's reflexive thematic analysis.ResultsProfessionals in England demonstrated a consolidated and integrated understanding of rehabilitation as part of palliative care, often supported by structured services such as hospices. In contrast, many Brazilian participants expressed uncertainty or perceived rehabilitation as incompatible with end-of-life care, reflecting conceptual misunderstandings, limited training and a lack of service infrastructure. The findings revealed divergence in how rehabilitation in palliative care is conceptualised and implemented in these countries. This divergence is reflected in structural, educational and cultural differences in how palliative care is organised and delivered. However, there is a growing recognition that rehabilitation and palliative care are not separate but complementary approaches.ConclusionsThe findings underscore the urgent need to clarify definitions, develop unified conceptual models and invest in policy and education to ensure that rehabilitation is no longer seen as contradictory to palliative goals, but as a complementary strategy to enhance quality of life in advanced cancer care.
Breathing interventions for spinal pain: A systematic review and meta-analysis.
Van Wesemael S, Janssens L, Amerijckx C … +4 more , Goossens N, Klaps S, Vlemincx E, Bogaerts K
Clin Rehabil · 2025 Dec · PMID 41099211 · Publisher ↗
ObjectiveIndividuals with spinal pain often show breathing dysfunctions. Although the effects of breathing interventions in general have been studied, no distinctions regarding types of breathing interventions were made....
ObjectiveIndividuals with spinal pain often show breathing dysfunctions. Although the effects of breathing interventions in general have been studied, no distinctions regarding types of breathing interventions were made. Therefore, we summarized the effects of different types of breathing interventions on spinal pain and disability.Data sourcesPubMed, Web of Science, PEDro, Cochrane, PsycArticles, and Embase were systematically searched till September 2, 2025.Review methodsStudies that described therapies using active instructions to modulate breathing or increase breathing awareness in adults with spinal pain were eligible. Breathing interventions were categorized into slow deep breathing, respiratory resistive breathing, and breathing awareness. Effects were subdivided into additional (breathing intervention + other intervention vs. other intervention) and comparative effects (breathing intervention vs. other intervention). The Downs and Black checklist was used to assess methodological quality. Meta-analyses were performed with standardized mean differences, and certainty of evidence was evaluated based on the GRADE assessment.ResultsTwenty studies involving 814 participants were included. Seventeen were of fair to good quality, three of poor quality. Meta-analyses revealed that slow deep breathing positively affected spinal pain ( = 223; SMD = -1.03; low certainty of evidence) and disability ( = 132; SMD = -1.34; very low certainty of evidence) when added to other interventions. Moreover, respiratory resistive breathing decreased spinal pain compared to other interventions ( = 75; SMD = -1.31; low certainty of evidence).ConclusionBreathing interventions may be valuable for the management of patients with spinal pain. Clinicians should be aware of, and consider, the various types of breathing interventions and their underlying mechanisms to tailor them to the treatment goals of their patients.
Reflections on the assessment and sustainability of quality-of-Life improvements following intensive upper limb stroke rehabilitation.
Cen Z, Ye J, Feng Y … +1 more , Liu S
Clin Rehabil · 2025 Dec · PMID 41061116 · Publisher ↗
Abstract loading — click title to view on PubMed.
Tailored implementation of a behaviour change intervention for post-stroke physical activity: A mixed-methods feasibility study.
Moore SA, Calder J, Potthoff S
Clin Rehabil · 2025 Dec · PMID 41042942 · Full text
ObjectiveTo explore the feasibility of tailored implementation of a stroke physical activity behaviour change intervention (Physical Activity Routines After Stroke (PARAS)) and the feasibility of the intervention.DesignF...
ObjectiveTo explore the feasibility of tailored implementation of a stroke physical activity behaviour change intervention (Physical Activity Routines After Stroke (PARAS)) and the feasibility of the intervention.DesignFeasibility study applying mixed methods.SettingUK stroke services.ParticipantsFour stroke rehabilitation teams comprising 34 healthcare professionals.InterventionWe applied a tailored implementation process informed by the Integrated Theory-based Framework for Intervention Tailoring Strategies to the PARAS intervention. Teams each attended two facilitated workshops (face-to-face/hybrid/online) identifying barriers and facilitators (determinants) to PARAS implementation to enable development of tailored implementation plans. Plans were applied and reviewed.Main measuresFeasibility of the tailored implementation process and intervention was explored via analysis of online questionnaire responses and thematic analysis of workshop and review session content. Inductive analysis identified determinants to implementation plan completion and enabled mapping of promising implementation strategies and their operationalisation and intervention development needs.ResultsThirty-four healthcare professionals participated across four teams. The facilitated, tailored implementation process was deemed feasible. All teams reported partially achieving implementation plans. Factors influencing implementation plan success included: motivation; stakeholder involvement; leadership and planning; intervention delivery skills. Implementation strategies mapped to factors included: assess for readiness; build a coalition; identify champions; train for leadership; and develop an implementation plan and ongoing training. Intervention adaptations identified included intervention tailoring and digitising resources.ConclusionOur implementation process and the PARAS intervention were feasible with moderate amendments. Our findings enabled development of a model to support tailored implementation of PARAS and identified intervention development needs to guide future evaluation.
Health economic studies in clinical rehabilitation: A new collection of papers and a discussion of issues involved in research.
Wade DT
Clin Rehabil · 2026 Jan · PMID 41042939 · Full text
ObjectiveTo review challenges associated with health economic studies in rehabilitation, providing a context for the new Clinical Rehabilitation collection of papers concerned with health economics.RehabilitationAnalysis...
ObjectiveTo review challenges associated with health economic studies in rehabilitation, providing a context for the new Clinical Rehabilitation collection of papers concerned with health economics.RehabilitationAnalysis of the health economic effects associated with rehabilitation must recognise that rehabilitation consists of both a problem-solving process that facilitates the person's adaptation by providing information, advice, and sometimes specific interventions targeting multiple areas. Second, it operates within a complex, adaptive system, specifically the biopsychosocial model of illness. Third, its goals are to enhance well-being and quality of life through its effects on lower-level systems. Consequently, the effects of rehabilitation are unpredictable and typically manifest in several domains. Comprehensive single or multiple focused outcome measures are needed. As evidence-based selection of people who might benefit from rehabilitation is impossible, evaluative studies should have broad inclusion criteria.SystemsRehabilitation is a healthcare service. Traditionally, it is delivered in series, after the biomedical treatment has ended. This allows researchers, including health economists, to isolate the influence of rehabilitation. However, it will be more effectively delivered in parallel, with biomedical care from the outset, as happens, for example, in trauma and intensive care units. Evaluating individual components of healthcare in isolation is unnecessary. Rehabilitation will always involve non-healthcare services. Conversely, the effects of rehabilitation may significantly reduce non-healthcare costs. This close interrelationship necessitates a societal perspective on the economics of rehabilitation.ConclusionsUsing a combination of a global, comprehensive clinical outcome measure and societal-level health economic data will increase the likelihood of detecting effects.
A systematic review and meta-analysis of randomized controlled trials on the effects of high-intensity interval training in breast cancer survivors.
Huang CC, Chu YC, Chen WD … +2 more , Lee HC, Yang FA
Clin Rehabil · 2025 Dec · PMID 41042936 · Publisher ↗
ObjectiveExercise is a well-recognized, safe, and effective strategy for breast cancer survivors. This study aimed to evaluate the effects of high-intensity interval training on multiple clinical outcomes in this populat...
ObjectiveExercise is a well-recognized, safe, and effective strategy for breast cancer survivors. This study aimed to evaluate the effects of high-intensity interval training on multiple clinical outcomes in this population.Data sourcesWe conducted a search of the PubMed, EMBASE, and Cochrane Library databases from their inception through June 30, 2025, and updated on September 6, 2025.Review MethodsThis systematic review and meta-analysis included randomized controlled trials that compared high-intensity interval training with usual care, moderate-intensity continuous training, or resistance training for breast cancer survivors on multiple clinical outcomes.ResultsFifteen trials were included. High-intensity interval training significantly improved cardiorespiratory fitness compared to usual care, moderate-intensity continuous training, and resistance training. It was also superior to usual care for improving quality of life and reducing high-sensitivity C-reactive protein, and superior to moderate-intensity continuous training for reducing Interleukin-6. However, according to the GRADE assessment, the certainty of evidence for these outcomes was low, primarily due to the risk of bias and imprecision from small sample sizes. No major exercise-related adverse events were reported. A framework (Frequency, Intensity, Time, and Type) typically recommends three 30--40-minute sessions per week for a duration of 8-12 weeks, with adaptable protocols featuring various interval structures and exercise types.ConclusionsHigh-intensity interval training is a safe and effective modality for breast cancer survivors, demonstrating superior improvements in cardiorespiratory fitness over various control interventions. Its benefits for quality of life and inflammation support its use in clinical rehabilitation.
Promoting financial empowerment after brain injury: Findings from focus groups.
Engel L, Adedotun K, Ewesesan R … +1 more , Arowolo I
Clin Rehabil · 2025 Dec · PMID 41026828 · Full text
ObjectiveTo cocreate and synthesize financial empowerment ideas for people living with acquired brain injury from multiple perspectives.DesignWe completed a qualitative descriptive study using focus-group methods. Conten...
ObjectiveTo cocreate and synthesize financial empowerment ideas for people living with acquired brain injury from multiple perspectives.DesignWe completed a qualitative descriptive study using focus-group methods. Content analysis was guided by deductive categorization across overlapping idea areas of educational products, human-interaction services, and advocacy approaches, followed by inductive idea subcategorization.SettingWe held seven focus groups, five online and two in-person. Participants were recruited via community organization advertisements and convenience sampling. Four researchers analyzed transcripts using a triangulation approach.ParticipantsTwenty-five adults (ages 18+) participated in seven different focus groups: 15 individuals living with acquired brain injury (five groups); 2 close others (one group); and 8 project advisory members (one group). Demographics varied across age, education, and time since injury; most were women.ResultsWe generated 20 idea subcategories for financial empowerment after brain injury. Participants discussed ideas related to advocacy and service ideas more than products, but noted the salience of varied option availability to meet different needs across individuals. Participants living with brain injury identified seven unique ideas compared to the close other group and project advisory group.ConclusionsFinancial empowerment to address economic factors of financial capability and financial well-being after brain injury is important to brain injury rehabilitation, health, and well-being. Including lived experience voices provided unique ideas for addressing financial empowerment. Providing a spectrum of options and addressing contextualization factors could enhance the financial well-being of adults living with brain injury, which can contribute to brain injury recovery and improve community participation.
Feasibility of delivering TeleCHAT: A comprehensive high-dose aphasia treatment via telerehabilitation.
Vuong G, Dignam J, Burns C … +4 more , Copland D, Wedley H, O'Brien K, Hill AJ
Clin Rehabil · 2025 Dec · PMID 41004645 · Full text
ObjectiveTo evaluate the feasibility of delivering 50 h of comprehensive, high-dose aphasia treatment via telerehabilitation (TeleCHAT) to people with aphasia and their support people.DesignA non-randomised one-armed qua...
ObjectiveTo evaluate the feasibility of delivering 50 h of comprehensive, high-dose aphasia treatment via telerehabilitation (TeleCHAT) to people with aphasia and their support people.DesignA non-randomised one-armed quasi-experimental pre-post feasibility study.SettingTeleCHAT was delivered from dedicated tele-suites in university spaces within a tertiary hospital. Participants received therapy in their homes via telerehabilitation using a configured telerehabilitation system which used videoconferencing software Zoom.ParticipantsThree cohorts of people with aphasia ( = 12), support people ( = 11), and speech-language pathologists ( = 2) participated.InterventionParticipants completed technology training, goal setting, and clinical treatment planning prior to the intervention. The TeleCHAT intervention included 50 h of goal-directed aphasia therapy, delivered 3-5 days per week over 8 weeks.Main measuresMixed-methods data was collected on participant demographics, aphasia profiles, achievement of dose, comprehensiveness of therapy, and support people participation.ResultsA diverse group of people with aphasia completed TeleCHAT. Nine participants received the intended dose of 50 h, with the remaining three closely approaching dose. A high proportion of sessions were spent actively engaged in therapeutic tasks (94-100%). A comprehensive array of 42 therapy activities was delivered and tailored to goals across the International Classification of Functioning, Disability and Health Framework. All participants had a support person participate actively in at least one session.ConclusionsIt was feasible to deliver the core components of the TeleCHAT programme via telerehabilitation. As intended, a heterogeneous group of people with aphasia received a high-dose of tailored, comprehensive aphasia therapy, with the active participation of support people.
Response to letter to the editor regarding 'Investigating changes in quality-of-life after high-dose high-intensity upper limb rehabilitation in chronic stroke survivors: A mixed-methods analysis of the Queen Square Programme'.
Strawson A, Francis JJ, Brander F … +3 more , Kelly K, Haddad M, Ward NS
Clin Rehabil · 2025 Dec · PMID 40990875 · Publisher ↗
Abstract loading — click title to view on PubMed.
Exploring lived experiences of body image after stroke and the impact on wellbeing and recovery: A qualitative study.
Davidson CE, Gordon C, Hackett M … +2 more , Watkins C, Lightbody L
Clin Rehabil · 2025 Dec · PMID 40990873 · Publisher ↗
ObjectiveTo explore post-stroke body image experience and enhance understanding of its impacts on wellbeing and recovery.DesignCross-sectional qualitative semi-structured interview study with an interpretative phenomenol...
ObjectiveTo explore post-stroke body image experience and enhance understanding of its impacts on wellbeing and recovery.DesignCross-sectional qualitative semi-structured interview study with an interpretative phenomenological approach.SettingInterviews conducted in participants' homes, using video-calls, telephone or in-person.ParticipantsPeople treated for acute stroke at two UK hospitals were identified at six months post-stroke and purposively sampled for diversity. Participants were 22 adults (55% male), on average 6.3 months post-stroke and aged 48 to 82 years (median 66 years).ResultsTwo main themes were identified: (1) 'Body now perceived as an 'obstacle' to normality', comprising three subthemes around altered trust in the body, outward presentation of body image and the likening of body image to that of an older person and; (2) 'Responses to a new body image experience', comprising five subthemes around the importance of body image, societal pressures, acceptance/adjustment to a changed body image and positivity through experiencing improvements towards a perceived 'normal' body image.ConclusionsRegaining perceived pre-stroke 'normal' body image and ability to adjust to a new one is reported as important in recovery. We have demonstrated negative changes in body image experience, and it is possible this is a normal part of post-stroke adjustment. Further research is required to determine whether body image experience can be positively influenced by brief interventions such as guided self-help or psychological support to ensure that they do not persist long term.
A pilot randomised controlled trial of an online self-management programme for people with persistent pain post-knee replacement (Kneed).
Johns N, McKenzie D, Brady B … +2 more , Naylor J, Olver J
Clin Rehabil · 2025 Nov · PMID 40990623 · Full text
ObjectiveModerate to severe persistent pain can affect up to 25% of people after a knee replacement for osteoarthritis. The aim of the trial was to test the feasibility of implementing Kneed, a novel digital pain rehabil...
ObjectiveModerate to severe persistent pain can affect up to 25% of people after a knee replacement for osteoarthritis. The aim of the trial was to test the feasibility of implementing Kneed, a novel digital pain rehabilitation self-management programme.DesignProspective, two group parallel randomised pilot study.SettingOnline in Australia.ParticipantsAdults with persistent pain rated as ≥4/10 in the operated knee more than 3 months post-knee replacement for osteoarthritis.InterventionThe Kneed group were provided with 8 weeks of access to a digital pain rehabilitation self-management programme and compared to usual care.Main measuresRecruitment, acceptability, usability and limited efficacy with descriptive statistics.ResultsSixty participants, mean age 68.7 years, 75% female, 66.7% retired and 43% living outside metropolitan areas, were recruited between 15 October and 19 December, 2024 via social media advertising with 418 online eligibility surveys performed. There were 190 (45.5%) deemed potentially eligible; 82 (19.6%) left contact details and 60 (14.4%) consented. At 8 weeks, there were 48 (80%) participants remaining in the trial (20 Kneed (64.5%), 28 usual care (96.6%)). A majority of the Kneed group found the Kneed programme acceptable, would use it again and found that it helped them effectively manage pain and function.ConclusionIt is feasible to recruit and retain older Australians with moderate to severe knee pain post-knee replacement for a trial testing a digital pain rehabilitation self-management programme. A larger trial is indicated to further test the clinical effectiveness of Kneed to reduce pain and improve function.
Psychometric properties and clinical usability of the cognition in daily life scale in patients with acquired brain injury in clinical care settings.
Domensino AF, Visser-Meily JM, Spikman JM … +2 more , van Heugten C, CDL Study Group †
Clin Rehabil · 2025 Nov · PMID 40986292 · Full text
ObjectiveEvaluate the internal consistency, inter-rater and test-retest reliability, convergent and divergent validity and clinical usability of the Cognition in Daily Life scale for patients with acquired brain injury.D...
ObjectiveEvaluate the internal consistency, inter-rater and test-retest reliability, convergent and divergent validity and clinical usability of the Cognition in Daily Life scale for patients with acquired brain injury.DesignValidation study.ParticipantsA total of 75 patients with acquired brain injury (mostly male [ = 47, 68%]; mean age 67 years) were recruited from inpatient care facilities. Sixty participants (81%) had sustained a stroke.Main measures Cognition in Daily Life scale. Utrecht Scale for Rehabilitation-Cognition subscale, Montreal Cognitive Assessment, Barthel Index, Hospital Anxiety and Depression Scale and Fatigue Severity Scale.ResultsAfter removing redundant items, all subscales of the Cognition in Daily Life scale demonstrated satisfactory internal consistency. Test-retest reliability was good (intraclass correlation coefficient [ICC] = 0.847), and inter-rater reliability was moderate (ICC = 0.615). Convergent validity was confirmed through moderately strong correlations between most subscales of the Cognition in Daily Life Scale and other measures of cognition. Cognition in Daily Life subscales generally did not correlate with the Hospital Anxiety and Depression Scale and Fatigue Severity Scale, indicating divergent validity. Moderate correlations with the Barthel Index suggested related, but distinct constructs. Clinicians found the Cognition in Daily Life scale easy to administer and relevant for practice, though time-consuming. They suggested layout improvements for greater usability.ConclusionThe Cognition in Daily Life scale is adequately valid, reliable and clinically usable for assessing cognition in daily life in patients with acquired brain injury in a clinical setting. Future research needs to evaluate the scale's sensitivity to change and its performance in other settings and populations.
Outcome measures in prehabilitation interventions for total hip and knee arthroplasty: A scoping review.
Burgess N, Voelker SN, Phillips B … +4 more , Graco M, Berney S, Denehy L, Edbrooke L
Clin Rehabil · 2026 Jan · PMID 40971560 · Full text
ObjectiveThis scoping review aimed to map outcome measures collected in randomised controlled trials investigating prehabilitation interventions in total hip and knee arthroplasty, and timepoints of collection.Data sourc...
ObjectiveThis scoping review aimed to map outcome measures collected in randomised controlled trials investigating prehabilitation interventions in total hip and knee arthroplasty, and timepoints of collection.Data sourcesA systematic search of MEDLINE, EMBASE, Web of Science, Cochrane, and CINAHL was conducted.MethodsThis review followed the Joanna Briggs Institute Scoping Review methodology. Outcome domains, concepts of interest and assessment tools were characterised using the International Society for Pharmacoeconomics and Outcomes Research Framework, and timepoints for data collection were extracted.ResultsNinety-two trials (published between June 2001 and March 2025) were included. Most delivered unimodal prehabilitation, with exercise the most common intervention ( = 37). The review identified 36 outcome concepts measured with 219 assessment tools. Patient-reported outcomes were collected in 92% of trials ( = 85), and was the most heterogenous domain with 102 assessment tools. Performance-based outcomes, most commonly muscle strength, were collected in 66% of trials ( = 61) and utilised 47 different tools. Observer-reported outcomes were reported in 60% of trials ( = 55), with healthcare utilisation (e.g. hospital length of stay) the most common concept. Clinician-reported outcomes were reported in 48% of trials ( = 44) and most frequently included post-operative complications. Biomarker outcomes were rare ( = 7, 8%). Timing of outcome collection varied, with just over half the trials collecting both a pre-operative and post-operative timepoint.ConclusionThis review identified significant variability in outcome measures collected in prehabilitation trials for total hip and knee arthroplasty, highlighting the need for a core set of assessments to facilitate consistent reporting and robust meta-analyses of prehabilitation efficacy.
Effect of median nerve neural mobilisation and cervical lateral glide on pain, disability and function in patients with nerve-related neck and arm pain: A systematic review and meta-analysis.
Gillot T, Lefebvre D, Michalak A … +3 more , Miossec L, Combret Y, Prum G
Clin Rehabil · 2025 Nov · PMID 40968604 · Publisher ↗
ObjectiveThis systematic review and meta-analysis aimed to evaluate the effects of cervical lateral glide and median nerve neural mobilisation compared to no treatment and other physical therapy treatments on pain, funct...
ObjectiveThis systematic review and meta-analysis aimed to evaluate the effects of cervical lateral glide and median nerve neural mobilisation compared to no treatment and other physical therapy treatments on pain, function and disability in patients with nerve-related neck and arm pain.Data sourcesElectronic searches were conducted in MEDLINE, Science Direct, Cochrane Library, PEDro and Google Scholar up to 30 June 2025.Review methodsRandomised controlled trials were included following PRISMA guidelines. Two authors independently selected relevant studies, extracted data, assessed risk of bias (RoB2 tool), and rated evidence quality. Meta-analysis was performed using random-effects models due to expected heterogeneity. The study was registered on PROSPERO (CRD42020216739).ResultsOverall, 20 studies with 953 patients met the inclusion criteria. Cervical lateral glide reduced pain compared to no treatment (3 studies, MD -2.47; 95%CI: -3.41, -1.53; < .001) and other physical therapy techniques (2 studies, MD -1.29; 95%CI: -2.54, -0.05; = .04). Median nerve neural mobilisation also reduced pain compared to no treatment (4 studies, MD -3.07; 95%CI: -3.78, -2.37; < .001). Both interventions had modest effects on disability (12 studies, SMD -0.50 to -1.22), with moderate-to-high heterogeneity in analyses. The certainty of evidence was low to very low.ConclusionCervical lateral glide and median nerve neural mobilisation are clinically effective for reducing nerve-related neck and arm pain as part of multimodal management strategies. The quality of evidence remains low as the level of certainty. Targeting a population with a clear nociceptive, increased neural mechanosensitivity or neuropathic component should lead to better clinical outcomes.
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