Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Response letter to "Letter to the editor on a recent paper on acupuncture with pelvic floor rehabilitation training".
Chu W, Deng X, Gao L … +1 more , Gao X
Clin Rehabil · 2025 Nov · PMID 40956869 · Publisher ↗
Abstract loading — click title to view on PubMed.
Letter to the editor on a recent paper on acupuncture with pelvic floor rehabilitation training.
Li C, Wang Q, Zhang K
Clin Rehabil · 2025 Nov · PMID 40953189 · Publisher ↗
Abstract loading — click title to view on PubMed.
Validity, inter-rater reliability and responsiveness of the modified Iowa Level of Assistance (mILOA) for acutely hospitalised general medical patients.
D'Souza AN, Burke A, Soh SE … +4 more , Said CM, Pogrebnoy D, Cobbledick J, Peiris CL
Clin Rehabil · 2025 Dec · PMID 40953186 · Publisher ↗
ObjectiveTo evaluate the psychometric properties of the modified Iowa Level of Assistance (mILOA) in general medical patients aged ≥65 years.DesignProspective observational psychometric measurement study.: The mILOA was...
ObjectiveTo evaluate the psychometric properties of the modified Iowa Level of Assistance (mILOA) in general medical patients aged ≥65 years.DesignProspective observational psychometric measurement study.: The mILOA was completed at hospital admission (246) and discharge (121). A second measure was completed within 24-h to establish inter-rater reliability and measurement error (50). Criterion predictive validity for discharge destination, floor and ceiling effects, responsiveness, and construct validity, via convergent validity (with the de Morton Mobility Index, DEMMI) and known group validity (discharge home), were assessed using standard psychometric techniques.ResultsThere were 246 included participants (median age = 83.2; interquartile range = 46.1-88.0 years; 47% female). The mILOA took a median of 12.5 [interquartile range = 8.0-18.0] minutes to complete. There were no systematic differences across the range of scores (mean difference = 1.1) with limits of agreement of 7.7 and -5.4 (variability due to measurement error = 2.36). It was able to predict discharge destination (area under the curve = 0.74; 95% CI = 0.66-0.81). No floor or ceiling effects were observed, and it was highly responsive to change (effect size = 0.80). Scores correlated significantly and positively with DEMMI scores (Spearman's rho = 0.86, 95% confidence interval = 0.81-0.90, < .001) and showed a median difference of 8 points between known groups.ConclusionThe mILOA has good inter-rater reliability, no floor or ceiling effects, strong responsiveness, high correlation with the DEMMI, and the ability to discriminate between known groups in older general medical patients.
Predicting walking capacity, walking performance, and life space mobility using socket comfort in lower-limb prosthesis users.
Tao G, Singh J, Rapaport M … +2 more , Payne M, Miller WC
Clin Rehabil · 2025 Dec · PMID 40953184 · Full text
ObjectiveTo determine if socket comfort predicts walking capacity, walking performance, and life-space mobility.DesignObservational exploratory study involving a secondary cross-sectional analysis using multiple regressi...
ObjectiveTo determine if socket comfort predicts walking capacity, walking performance, and life-space mobility.DesignObservational exploratory study involving a secondary cross-sectional analysis using multiple regression of data collected from an exercise intervention trial.SettingLaboratory setting for clinical assessments; community setting for walking performance.ParticipantsCommunity-dwelling lower-limb prosthesis users over 50 years old ( = 72).Main measuresSocket Comfort Score, 2-Minute Walk Test, step count, Life Space Assessment, and control variables including demographics, Short Physical Performance Battery, Four Square Step Test, and Walking While Talking.ResultsRegression modeling showed Socket Comfort Score as a statistically significant predictor of 2-Minute Walk Test ( = 6.9 m, 95% CI [2.7, 11.1] m) alongside amputation level, Walking While Talking test, and Short Physical Performance Battery (greatest contribution to the model); the model accounted for 61% of the variance. Socket Comfort Score was not a statistically significant predictor of step count. Socket Comfort Score was the only statistically significant predictor of Life Space Assessment ( = 4.9, 95% CI [1.1, 8.8]); the model accounted for 12% of the variance.ConclusionsSocket comfort played a notable role in predicting walking capacity and life space mobility, but not in walking performance. Improving lower extremity function may have greater impact on walking overall. While this study provides context regarding socket comfort that clinicians may consider when planning holistic prosthetic rehabilitation, mixed findings in the literature suggest that further research on how socket comfort relates to walking outcomes in the community is warranted.
Patients' perspectives and experiences on physiotherapy care for knee osteoarthritis: A qualitative study.
Al Zoubi FM, Wong AY, Kan MM … +2 more , Thomas A, Bussières AE
Clin Rehabil · 2025 Nov · PMID 40953091 · Publisher ↗
ObjectiveTo explore the perspectives and experiences of patients with knee osteoarthritis regarding physiotherapy care management in Hong Kong.DesignQualitative study using semi-structured, individual interviews.SettingC...
ObjectiveTo explore the perspectives and experiences of patients with knee osteoarthritis regarding physiotherapy care management in Hong Kong.DesignQualitative study using semi-structured, individual interviews.SettingCommunity.ParticipantsPatients age 50 years or older with knee osteoarthritis, purposively recruited.InterventionFace-to-face semi-structured interviews were conducted with patients who had completed a physiotherapy rehabilitation programme in the past six months.Main MeasuresA 21-question interview guide encouraged participants to discuss their physiotherapy management, experiences, and recommended interventions, covering all non-pharmacological treatments outlined in local clinical guidelines. Questions also explored factors influencing adherence to care during and after physiotherapy. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.ResultsFourteen patients participated. Five key themes emerged: (a) navigating pain and management strategies; (b) adapting daily life and the impact of knee osteoarthritis on activities; (c) complexities of treatment and the need for personalised care; (d) the role of exercise and mobility; and (e) barriers to access and resources. While patients reported receiving various physiotherapy interventions, gaps were noted in aquatic therapy, neuromuscular training, weight management, and assistive devices. Barriers included limited access, financial constraints, and lack of home exercise equipment. Although participants valued physical activity, maintaining an exercise routine was challenging.ConclusionsA comprehensive, patient-centred approach is essential for effective physiotherapy care for knee osteoarthritis in Hong Kong. Addressing practical barriers and integrating patient feedback can enhance the accessibility and impact of evidence-based interventions.
Expert-driven weighting of pressure injury risk factors for wheelchair users: A Delphi study.
Paquin C, Lamontagne MÈ, Routhier F
Clin Rehabil · 2025 Dec · PMID 40953084 · Full text
ObjectiveTo identify and prioritize personal risk factors for pressure injuries in wheelchair users.DesignA Delphi survey was conducted with clinicians specializing in pressure injury prevention and care.SettingThe study...
ObjectiveTo identify and prioritize personal risk factors for pressure injuries in wheelchair users.DesignA Delphi survey was conducted with clinicians specializing in pressure injury prevention and care.SettingThe study was conducted online using LimeSurvey software.ParticipantsIn the first round, 90 clinicians participated and completed the survey; in the second round, 68 continued their involvement.ResultsAcross all rounds, 39 risk factors were identified by the experts. These factors were weighted according to expert consensus. Immobility, current or past pressure injuries, malnutrition, and sensory perception impairment are ranked among the highest important.ConclusionThese findings underscore the importance of considering both physiological and behavioral factors when assessing pressure injurie risk. The weighted list of expert-validated factors offers clinicians a practical foundation for more targeted and individualized prevention strategies, ultimately supporting improved care and quality of life for this population.
Exploring allied health professionals' perceptions and practice in Ireland regarding guideline recommendations for intensity of multidisciplinary therapy for stroke survivors: A qualitative study.
Foley G, Galvin R, Horgan F
Clin Rehabil · 2025 Nov · PMID 40938631 · Publisher ↗
ObjectiveTo explore the attitudes and practice of allied health professionals working in stroke care in Ireland regarding recommended amounts of therapy set out in the National Clinical Guideline for Stroke (2023).Design...
ObjectiveTo explore the attitudes and practice of allied health professionals working in stroke care in Ireland regarding recommended amounts of therapy set out in the National Clinical Guideline for Stroke (2023).DesignQualitative descriptive study using one-to-one semi-structured interviews. Data were analysed using reflexive thematic analysis.SettingFive large acute teaching hospitals in Dublin, Ireland.ParticipantsThe 11 participants were allied health professionals working in acute and subacute stroke care in Dublin, and were recruited using a combination of purposive and snowball sampling.ResultsTwo main themes emerged: 'Barriers and enablers to achieving guideline recommended therapy time' and 'Methods of increasing therapeutic time'. Patient factors and clinical resources impact on the provision of therapy post-stroke. Overall, participants felt positive about the recent guideline recommendation for increased therapeutic time. Various methods are employed to augment patient therapeutic time, including technology and semi-supervised practice. Participants perceived that Therapy Assistants play an important role in achieving greater amounts of therapy.ConclusionsAllied health professionals view the new Stroke Guidelines recommendation for increased therapy intensity as challenging but are generally positive in trying to achieve it, citing the benefits of increased therapy time for patient outcomes. They utilise a wide range of methods to optimise therapeutic time for stroke survivors. The role of the therapy assistant in supporting the delivery of larger amounts of therapy time warrants further evaluation.
Adapting and implementing a staff-led sleep intervention in an acute rehabilitation setting.
Ramos BA, Ram K, Martinez M … +13 more , Sunderrajan A, Sindorf J, O'Brien MK, Prokup S, Siddiqui S, Morris LL, Knutson KL, Mokhlesi B, Prabhakaran S, Wolfe LF, Zee PC, Jayaraman A, Arora VM
Clin Rehabil · 2025 Nov · PMID 40924822 · Full text
ObjectiveTo adapt and modify the successful SIESTA (Sleep for Inpatients: Empowering Staff to Act) sleep-promoting hospital protocol to an acute stroke rehabilitation setting.DesignThis study utilized a mixed methods des...
ObjectiveTo adapt and modify the successful SIESTA (Sleep for Inpatients: Empowering Staff to Act) sleep-promoting hospital protocol to an acute stroke rehabilitation setting.DesignThis study utilized a mixed methods design, involving qualitative surveys and interviews. Needs assessment and staff interviews informed the development of the adapted protocol, SIESTA-Rehab.SettingInpatient unit treating persons with neurological injury, primarily stroke, in an acute rehabilitation hospital.ParticipantsNursing staff on the inpatient unit where SIESTA-Rehab was implemented.InterventionAfter identifying needs, we adapted the SIESTA protocol with relevant modifications to SIESTA-Rehab. Protocol adaptations were guided by the Culture, Oversight, Systems Change, Training framework, with a focus on developing nursing education and sleep-enhancing tools. The protocol was implemented over a four-year period, sustained through periodic staff re-education, and nursing staff perceptions of the intervention were evaluated using fidelity interviews.Main MeasuresQualitative assessments were conducted from a convenience sample of nurses to gauge understanding, recall, ease of implementation, and individual re-education needs for SIESTA-Rehab.ResultsInitial staff feedback indicated limited awareness of sleep disorder screening and sleep optimization practices, highlighting the absence of sleep-based assessments during standard care. Initial unit-wide training was conducted on SIESTA-Rehab for nursing staff ( = 29), with ongoing education for new staff and periodic re-education for existing staff over 4 years of implementation. Fidelity interviews revealed high understanding, recall, and ease of implementing the intervention over survey periods.ConclusionsSIESTA-Rehab can be successfully implemented in an acute rehabilitation setting, as indicated through positive staff responses.
Interventions for post-stroke apathy and their effects: A scoping review.
Hijikuro S, Kaneko T, Ikeda K
Clin Rehabil · 2025 Nov · PMID 40910508 · Publisher ↗
ObjectiveThis scoping review aimed to comprehensively map interventions for post-stroke apathy and their effects.Data sourcesThe literature search for this review was performed using PubMed, Cumulative Index to Nursing a...
ObjectiveThis scoping review aimed to comprehensively map interventions for post-stroke apathy and their effects.Data sourcesThe literature search for this review was performed using PubMed, Cumulative Index to Nursing and Allied Health Literature, and Web of Science, targeting studies published until August 7, 2025.Review methodsThis scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews. The population included patients with post-stroke apathy; the concept focused on post-stroke apathy assessment and interventions and their effects. The context covered both general and community healthcare settings. Controlled vocabulary (e.g., MeSH terms) such as "post-stroke apathy," "intervention," and "effect" was used to formulate the search strategy. The eligible studies were independently screened by three reviewers, and final inclusion was determined through discussion.ResultsOf the 565 studies identified, 13 met the inclusion criteria ( = 13). The mapping revealed that pharmacological interventions not only improved and prevented post-stroke apathy symptoms but also alleviated emotional blunting, reduced loss of motivation and interest, and enhanced social behavior and participation. Non-pharmacological interventions were associated with symptom relief and recovery over time. Furthermore, combined pharmacological and non-pharmacological approaches contributed to improvements not only in post-stroke apathy but also in depression, language function, and behavioral aspects.ConclusionThe findings suggest that appropriate treatment for post-stroke apathy may lead to symptom relief, improvement, and prevention while enhancing language function, behavior, and social participation. Future research should focus on systematic reviews and meta-analyses to establish evidence-based recommendations for post-stroke apathy treatment strategies and their optimal combinations.
Lessons learned: Clinicians' perspectives, knowledge and attitudes towards a stroke-integrated cardiac rehabilitation programme.
Machado N, Sutherland E, Hill B … +4 more , Lawford BJ, Williams G, Olver J, Johnson L
Clin Rehabil · 2025 Nov · PMID 40891750 · Publisher ↗
ObjectiveTo evaluate the perceptions, knowledge, and attitudes of multidisciplinary clinicians within a healthcare organisation completing a stroke-integrated cardiac rehabilitation research programme in addition to usua...
ObjectiveTo evaluate the perceptions, knowledge, and attitudes of multidisciplinary clinicians within a healthcare organisation completing a stroke-integrated cardiac rehabilitation research programme in addition to usual care neurorehabilitation.DesignA qualitative study based on a phenomenological approach.SettingOne-on-one, semi-structured, qualitative interview completed either face-to-face or over the telephone.ParticipantsFourteen multidisciplinary clinicians (e.g., physical therapists, occupational therapists, psychologists, speech therapists, cardiac nurses and a physician) working in usual care neuro- and cardiac-rehabilitation.Main measuresTwo independent researchers completed line-by-line coding and thematic analysis and derived relevant themes and sub-themes addressing the research question. To enhance trustworthiness and transparency of findings, a third researcher reviewed final themes.ResultsThree main themes emerged with 3-4 relevant sub-themes. The first theme was clinicians' knowledge. Participants were aware of exercise recommendations within the clinical stroke guidelines, but their knowledge of the content of the recommendations, and the stroke-integrated cardiac rehabilitation programme, varied. The second theme was clinicians' attitudes and beliefs towards the stroke-integrated cardiac rehabilitation programme. All participants described exercise as being important and believed the stroke-integrated cardiac rehabilitation programme was a good idea. However, clinicians highlighted numerous barriers and suggested programme adaptations (third theme) to the stroke-integrated cardiac rehabilitation programme. Increased awareness of the stroke-integrated cardiac rehabilitation programme, and a more flexible and adaptable programme, may enhance future implementation.ConclusionClinicians believed the stroke-integrated cardiac rehabilitation programme was important and had clinical utility. Increased awareness of evidence-based recommendations, and a more flexible and adaptable programme may aid uptake and future implementation.
Validity, safety, usability, and user experience of virtual reality gamified home-based exercises in stroke.
Lazem H, Harris D, Hall A … +6 more , Mansoubi M, Pontes RG, de Mello Monteiro CB, Vieira de Araújo L, Lamb SE, Dawes H
Clin Rehabil · 2025 Nov · PMID 40891724 · Full text
ObjectiveThis study adopted a novel approach to exploring the content validity, safety, usability, and user experiences of different games for telerehabilitation purposes from the perspective of physiotherapists and stro...
ObjectiveThis study adopted a novel approach to exploring the content validity, safety, usability, and user experiences of different games for telerehabilitation purposes from the perspective of physiotherapists and stroke survivors.DesignA cross-sectional content validity and usability study.SettingLab and online.Participants23 participants were recruited; 11 neuro-physiotherapists and 12 chronic stroke survivors.OutcomesContent validity and safety were assessed using a bespoke state evaluation questionnaire. The usability was evaluated using the system usability scale (SUS) and user experience questionnaire (UEQ). House of Quality analysis was conducted to identify the priority aspects for improvement.ResultsPhysiotherapists perceived the usability of the games as good to excellent for three games, median SUS = 80%, and poor for two games SUS < 68%. Three games had a mean average content validity index (CVI) > 0.8, and all games were safe to be administrated at home; mean CVI-safety item = 0.90. Stroke survivors with Fugl-Meyer Assessment of Upper Extremity function mean (SD) = 41(19.4), and mild to moderate spasticity perceived usability as very good to excellent for four games (median SUS = 85%). UEQ scale showed good to excellent acceptance among most of the games. House of Quality analysis revealed that clear instructions, avatar quality, motivational exercise scenarios, and clinical assessment tools are important criteria that should be considered throughout the development.ConclusionThis study demonstrated the value of exploring patient and physiotherapist perspectives for better telerehabilitation interventions co-development. Clinical trials should be conducted after further refinement of the games to investigate their feasibility and potential efficacy as a telerehabilitation tool for arm and balance training.
Perceived barriers and facilitators to high-intensity gait training in stroke rehabilitation: A Delphi study.
Tapp A, Griswold D, Bent J … +1 more , Linder S
Clin Rehabil · 2025 Oct · PMID 40853351 · Publisher ↗
ObjectiveTo identify common barriers and facilitators among physical therapists to implementing high-intensity gait training for patients post-stroke during inpatient rehabilitation.DesignA three-round Delphi study using...
ObjectiveTo identify common barriers and facilitators among physical therapists to implementing high-intensity gait training for patients post-stroke during inpatient rehabilitation.DesignA three-round Delphi study using free text responses and five-point Likert scales for agreement.Participants60 physical therapists with expertise treating patients with stroke in inpatient rehabilitation were invited. 33 participants completed all three rounds of surveys.Main MeasuresRound 1 consisted of two free text questions. Qualitative responses from round one were coded using the Theoretical Domains Framework and used to generate Likert scale survey items for rounds two and three. Consensus was defined a priori as ≥75% agreement. Response stability was evaluated with the Wilcoxon rank sum test.ResultsAnalysis identified 24 themes (12 facilitators, 12 barriers). Seven facilitators reached consensus: access to equipment (84.9%), built environment (78.8%), administrative support (78.8%), peer support (75.8%), team commitment to evidence-based practice (75.8%), high-intensity gait training-specific training (75.8%), and observable patient improvement (75.8%). Only one barrier reached consensus: treatment time interruptions (97.9%), including delays from toileting, hygiene, and medication administration. Other themes ranged from 18.2% to 57.6% agreement. No significant change in responses was found between rounds (p > 0.05).ConclusionsMore facilitators than barriers reached consensus, with treatment time interruptions as the primary agreed-upon barrier. Despite knowledge of high-intensity gait training and supportive factors, fewer than half of participants reported daily use. Targeted implementation strategies addressing time and workflow disruptions are needed to increase high-intensity gait training adoption in inpatient rehabilitation.
Intermittent pneumatic compression therapy for patients after arthroscopic release of post-traumatic elbow stiffness: A randomised controlled trial.
Huang L, Ma Y, Wang Y … +4 more , Yu S, Ding J, Yao Y, Lu S
Clin Rehabil · 2025 Oct · PMID 40853347 · Publisher ↗
ObjectiveTo evaluate the efficacy of intermittent pneumatic compression therapy after arthroscopic release for post-traumatic elbow stiffness.DesignRandomised controlled trial.SettingSingle-centre trial conducted in Shan...
ObjectiveTo evaluate the efficacy of intermittent pneumatic compression therapy after arthroscopic release for post-traumatic elbow stiffness.DesignRandomised controlled trial.SettingSingle-centre trial conducted in Shanghai Sixth People's Hospital, Shanghai, China.ParticipantsA total of 197 patients undergoing arthroscopic elbow release were randomised into intervention ( = 99) and control ( = 98) groups; 176 completed the study (intervention: = 89, control: = 87).InterventionThe intervention group received intermittent pneumatic compression therapy (GameReady™) for 2 weeks plus four-week standard rehabilitation; the control group had rehabilitation alone.Main measuresThe primary outcome was improvement in elbow flexion-extension range-of-motion at 12 weeks. Secondary outcomes included forearm rotation range-of-motion, elbow strength (measured by Baltimore Therapeutic Equipment), and patient-reported outcomes at 4, 12, and 24 weeks.ResultsAt 12 weeks, elbow flexion-extension range-of-motion did not differ significantly between groups. Secondary objective outcomes (forearm rotation and elbow strength) were also similar. However, the Intervention group reported significantly better elbow function at 24 weeks (American Shoulder and Elbow Surgeons Shoulder Score function subscore: 95% confidence intervals: 0.186-1.719; = 0.015). Pain and disabilities of the arm, shoulder, and hand questionnaire scores showed no significant differences between groups.ConclusionsIntermittent pneumatic compression therapy did not significantly improve early elbow mobility or strength following arthroscopic release, but enhanced patient-reported elbow function at longer-term follow-up. Intermittent pneumatic compression therapy may be beneficial as an adjunct to standard rehabilitation. Further studies with larger samples and extended follow-up are needed.Trial registration numberChiCTR2500101221 (Chinese Clinical Trial Registry, https://www.chictr.org.cn/, date of registration: 2025-04-22).
Effectiveness of interventions in increasing physical activity of inpatients after stroke: A systematic review and meta-analysis.
Hartley P, Bond K, Dance R … +3 more , Kuhn I, McPeake J, Forsyth F
Clin Rehabil · 2025 Oct · PMID 40790996 · Full text
ObjectiveTo synthesise the evidence of the effectiveness of interventions to increase levels of physical activity or reduce levels of sedentary activity of inpatients after a new stroke.Data sourcesMedline, PsychINFO, AM...
ObjectiveTo synthesise the evidence of the effectiveness of interventions to increase levels of physical activity or reduce levels of sedentary activity of inpatients after a new stroke.Data sourcesMedline, PsychINFO, AMED and CINAHL were search between inception and June 2025 for randomised controlled studies of in-hospital interventions for adults after stroke which measured physical activity.Review methodsInterventions were grouped by common components. For each intervention group, the outcomes of physical activity (primary outcome), physical functional ability, and quality of life were analysed with meta-analysis. Adverse events were synthesised narratively.ResultsTen studies (696 participants) were included in the review. General activity feedback (SMD = 0.52, 95% CI: -0.07 to 1.10; = 76.7%, 4 trials, = 272) and additional physiotherapy (SMD = 0.89, 95% CI: -0.02 to 0.99; = 94.2%, 4 trials, = 246) may result in moderate to large increases of in-hospital physical activity (very low certainty). Patient-directed activity programmes (one study) may have no effect on physical activity (low certainty). Upper-limb activity feedback (one study) may increase upper-limb activity (very low certainty).The evidence regarding the secondary outcomes demonstrated no effect (very low to moderate certainty), with the exception that additional physiotherapy may increase the risk of falls (low certainty).ConclusionsInterventions incorporating activity feedback or additional physiotherapy are promising, but further evidence is required for all interventions to increase the certainty in their estimates of effect.PROSPERO ID: CRD42024611456.
What components and formats of rehabilitation interventions are more effective to reduce pain in patients with cervical radiculopathy? A Systematic review and component network meta-analysis.
Núñez de Arenas-Arroyo S, Mavridis D, Martínez-Vizcaíno V … +5 more , Torres-Costoso A, Reina-Gutiérrez S, Rodríguez-Gutiérrez E, Cavero-Redondo I, Sequí-Domínguez I
Clin Rehabil · 2025 Oct · PMID 40776625 · Publisher ↗
ObjectivesTo estimate the comparative efficacy of rehabilitation interventions for pain reduction in cervical radiculopathy and evaluate the individual components of combined treatments to support clinical decision-makin...
ObjectivesTo estimate the comparative efficacy of rehabilitation interventions for pain reduction in cervical radiculopathy and evaluate the individual components of combined treatments to support clinical decision-making.Data sourcesA systematic search was conducted across the Cochrane, PubMed, Scopus, WOS, and PEDro databases up to 1 July 2025, for randomized controlled trials comparing rehabilitation interventions against no intervention or other rehabilitation approaches for cervical radiculopathy-related pain.Review methodsWe conducted a frequentist random effects network meta-analysis and a component network meta-analysis to isolate the effects of individual treatment components. We used CINeMA software to assess the confidence in our estimates.ResultsWe included 36 trials comparing 25 interventions composed by eight active components. The components associated with a decrease in pain were neurodynamic techniques (SMD = -1.45; 95%CI: -1.88 to -1.02), cervical traction(SMD = -0.66; 95%CI: -1.08 to -0.25), articular treatment (SMD = -0.72; 95%CI:-1.29 to -0.15), and dry needling(SMD = -3.40; 95%CI: -5.40 to -1.39). The most promising interventions for reducing pain in cervical radiculopathy patients were a combination of the above components (except dry needling) with analgesic electrotherapy and strengthening exercises with a moderate confidence rating.ConclusionsA combination of articular treatment, analgesic electrotherapy neurodynamic techniques strengthening exercises and cervical traction appears to offer the most effective pain relief for patients with cervical radiculopathy, with a moderate confidence rating. Individually, neurodynamic techniques, cervical traction, and articular treatment were the components associated with a significant reduction in pain. Although dry needling showed encouraging results, its limited presence in the network prevents drawing firm conclusions about its effectiveness.
Acceptability of a programme for safer mobility (INTEGRATE): Perspectives of people with Parkinson's disease and their care-partners.
Allen NE, Darmali A, Koch C … +9 more , Tran S, Paul SS, Canning CG, Edwards S, Harkness S, Savage R, Webster L, Zelma G, Goh L
Clin Rehabil · 2025 Oct · PMID 40770967 · Full text
ObjectiveThis study aimed to explore the acceptability and factors that influenced implementation of a multidomain, home-based fall prevention programme () for people with Parkinson's disease who fall recurrently, and th...
ObjectiveThis study aimed to explore the acceptability and factors that influenced implementation of a multidomain, home-based fall prevention programme () for people with Parkinson's disease who fall recurrently, and their care-partners.DesignQualitative, inductive thematic analysis of semi-structured interviews.SettingHomes of participants in Sydney, Australia.ParticipantsEighteen interviews with people with Parkinson's disease and/or their care-partner who were purposively sampled after completing .Intervention was delivered by occupational therapists and physiotherapists and included personally tailored home fall-hazard reduction, exercise (leg muscle strength, balance and freezing of gait) and safer mobility strategies delivered over 6 months.ResultsFive themes were identified: (a) the importance of personalisation, (b) a collaborative effort, (c) capacity building, (d) navigating fall risk with Parkinson's is complex and (e) the ease (or not) of making changes. Participants and their care-partners appreciated the personalised, home-based programme that involved shared decision-making and was delivered by expert therapists. They developed increased safety awareness and problem-solving skills. Making improvements, receiving ongoing support from therapists and care-partners and making change easier promoted sustained engagement. However, some participants faced emotional and psychological barriers to engagement including fatalistic beliefs about disease progression and a desire to avoid appearing 'disabled'. The reality of Parkinson's disease motivated participants to make changes but Parkinson's-related impairments such as apathy and motor fluctuations hindered this.ConclusionsPeople with Parkinson's disease who are recurrent fallers, and their care-partners, found the programme acceptable and were able to engage with it with guidance and support from therapists.
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 Oct · PMID 40770957 · Publisher ↗
ObjectiveTo evaluate changes in quality-of-life and explore psychosocial influences on social participation and recovery in chronic stroke survivors following intensive upper limb neurorehabilitation.DesignMixed-methods...
ObjectiveTo evaluate changes in quality-of-life and explore psychosocial influences on social participation and recovery in chronic stroke survivors following intensive upper limb neurorehabilitation.DesignMixed-methods design with quantitative (pre-post design with follow-up) and qualitative (semi-structured interview) phases.SettingThree-week Queen Square upper limb neurorehabilitation programme.Participants65 stroke survivors who participated in the programme from July 2016 to March 2018.Main measuresStroke Impact Scale (3.0) (SIS) and Action Research Arm Test, collected on admission, discharge, 6-week and 6-month follow-up (n = 65). Beliefs and psychosocial factors influencing quality-of-life were investigated through thematic analysis of semi-structured interviews in two subgroups, based whether the SIS-participation domain change from admission to follow-up was high (> 20, n = 5) or low (<-24, n = 5).ResultsSeven out of eight SIS domains, overall self-rated recovery ( < 0.001) and Action Research Arm Test ( < 0.001) improved from admission to discharge. The emotion domain improved from admission to discharge ( < 0.001) and reduced from discharge to 6-month follow-up ( < 0.001). Interviews highlighted four key psychosocial themes with contrasting positive and negative perspectives between higher change and lower change groups; themes 'hidden negative effects' and 'loneliness' were evident in the lower change group and 'getting on with my life' in the higher change group.ConclusionThe Queen Square upper limb neurorehabilitation programme led to measurable therapeutic benefits on physical and non-physical quality-of-life outcomes. However, the lack of sustained improvement in self-reported emotion contrasts with the clear benefits in other domains. This indicates a need for ongoing psychosocial support for some stroke survivors, supported by the qualitative findings.
Lower limb proprioception and postural control strategies in people with non-specific low back pain: A systematic review and meta-analysis.
Chen Z, Shi X, Tirosh O … +4 more , El-Ansary D, Adams R, Han J, Pranata A
Clin Rehabil · 2025 Sep · PMID 40765243 · Publisher ↗
ObjectiveTo investigate whether lower limb proprioception and postural control strategies are impaired in people with non-specific low back pain.Data sourcesA literature search was performed in the Cochrane Library, Web...
ObjectiveTo investigate whether lower limb proprioception and postural control strategies are impaired in people with non-specific low back pain.Data sourcesA literature search was performed in the Cochrane Library, Web of Science, PubMed, Embase and Cumulative Index to Nursing and Allied Health Literature, between January 2000 and June 2025.Review methodsStudies comparing lower limb proprioception and postural control strategies in adults with non-specific low back pain versus asymptomatic controls were included. Postural control was assessed through relative proprioception weighting, with higher values indicating greater reliance on ankle strategies and lower values indicating reliance on hip strategies. Quality appraisal utilised the Newcastle-Ottawa scale, while evidence certainty was evaluated using the grading of recommendations assessment, development and evaluation system.ResultsSeventeen studies with 1187 participants were included, of which 14 had Newcastle-Ottawa Scale scores above five. The pooled analysis showed that the non-specific low back pain group had significantly decreased ankle proprioception compared to the control group (standardised mean difference = -0.710). People with non-specific low back pain relied more on ankle strategies for postural control on both stable (weighted mean difference = 0.086) and unstable surfaces (weighted mean difference = 0.195). However, the three pooled outcome measures showed very low level of evidence due to research design and heterogeneity.ConclusionVery low level of evidence showed that people with non-specific low back pain had impaired lower limb proprioception and a higher reliance on an ankle strategy compared to asymptomatic controls, suggesting potential benefits of assessing and improving lower limb function in this population.
The added value of sensor-based tests in explaining the variance in walking and ADL independency after stroke: An exploratory study.
Wouda NC, Geerars M, Pisters MF … +2 more , Visser-Meily JMA, Punt M
Clin Rehabil · 2025 Oct · PMID 40754839 · Full text
ObjectiveTo evaluate the added value of sensor-based tests over conventional tests in explaining the variance in independence in activities of daily living (ADL) and independent walking in patients during inpatient strok...
ObjectiveTo evaluate the added value of sensor-based tests over conventional tests in explaining the variance in independence in activities of daily living (ADL) and independent walking in patients during inpatient stroke rehabilitation.DesignCross-sectional designSettingInpatient stroke rehabilitationParticipantsData were collected from 115 patients with stroke admitted to inpatient rehabilitation.InterventionNo intervention has been applied.Main measuresConventional measures and sensor-based tests in which postural sway and gait variables were measured using inertial measurement units. Outcome measures were ADL independence (determined by Barthel Index [BI]) and independent walking (determined by Functional Ambulation Categories [FAC]).ResultsWith univariable linear regression analyses showed that the Berg Balance Scale (BBS) explained most variance in ADL independence (² .527) and independent walking (² .727). In hierarchical multivariable regression analyses, symmetry during walking without a walking aid contributed most (Δ²=18.6%) in explaining variance in ADL independency, resulting in a model explaining 15.7% ( = .029) of the variance in the BI. Tempo during walking with a walking aid contributed most (Δ 20.1%) in explaining variance in independent walking, resulting in a model explaining 23.3% ( = .002) of the variance in the FAC. Adding sensor-based variables to models with the BBS did not significantly improve variance explanation.ConclusionsThe added value of variables measured with an inertial measurement unit in explaining ADL independence and walking ability after stroke is limited. These findings contribute to understanding the use of inertial measurement units in stroke rehabilitation, but caution is needed when applying them to predict physical recovery.
Exploring availability of physiotherapy service for people with Parkinson's Disease in Europe: An cross-sectional study.
Smilowska K, Domingos J, Carvalho V … +4 more , Siuda A, Dean J, Capato T, Bloem BR
Clin Rehabil · 2025 Sep · PMID 40746233 · Publisher ↗
DesignA cross-sectional study.SettingNational-level physiotherapy care for Parkinson's Disease across European countries.ParticipantsOne physiotherapist from each of the 26 European countries was invited to provide natio...
DesignA cross-sectional study.SettingNational-level physiotherapy care for Parkinson's Disease across European countries.ParticipantsOne physiotherapist from each of the 26 European countries was invited to provide national-level information based on availability of physiotherapy for Parkinson's Disease, based on a questionnaire.Main measuresNational-level information was collected on accessibility and conditions of physiotherapy specialized in Parkinson's Disease across European countries.ResultsData from 24 countries were collected. Parkinson's Disease-specific physiotherapy was offered in 20 countries. The number of hours of physiotherapy per year available for people with Parkinson's Disease varied widely across countries, from none to an unlimited number of sessions. Treatment was typically provided free of charge through public or government-financed national health systems, with treatment frequency informed by national insurance. Only eight countries reported formal Parkinson's Disease training programs for physiotherapy, which were available only as a separate, external program not integrated with the standard physiotherapy curriculum at a university.ConclusionsPhysiotherapy for people with Parkinson's Disease in European countries varies significantly across countries that completed the questionnaire, with differences in the number of hours and treatment settings. It is crucial to standardize training and care for people with Parkinson's Disease and prioritize the development and implementation of policies to facilitate access to evidence-based physiotherapy services.
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