Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Cross-cultural adaptation, reliability, and validity of the Arabic version of the Speech, Spatial, and Qualities of Hearing Scale.
Alqudah S, Shatarah A, Milhem A … +7 more , ALHarbi MF, Alenzi HM, Zuriekat M, Rababah R, Alazzam S, Alhawamdh E, Saleem I
Clin Rehabil · 2025 Sep · PMID 40740067 · Publisher ↗
ObjectiveTo translate the full version of the Speech, Spatial, and Qualities of Hearing Scale into Arabic, assess its reliability and validity, and evaluate the listening ability scores of Arabic-speaking individuals wit...
ObjectiveTo translate the full version of the Speech, Spatial, and Qualities of Hearing Scale into Arabic, assess its reliability and validity, and evaluate the listening ability scores of Arabic-speaking individuals with hearing impairments.DesignCross-sectional study involving linguistic adaptation and psychometric evaluation of a self-reported hearing questionnaire.SettingConducted in audiology clinics and university research facilities, where participants were assessed and followed-up under standardized testing conditions.ParticipantsTwo hundred twenty participants, including 110 with hearing loss and 110 age- and gender-matched individuals with normal hearing. All were native Arabic speakers.InterventionParticipants underwent audiological assessments and completed the translated full version of the Speech, Spatial, and Qualities of Hearing Scale. A subset completed the questionnaire again after 3 months to assess test-retest reliability.Main measuresInternal consistency was evaluated using Cronbach's alpha, while test-retest reliability was assessed through the intraclass correlation coefficient comparing baseline and follow-up scores. Discriminant validity was established by comparing the scores of individuals with and without hearing loss, and the relationships between scale scores and the percentage of hearing loss were also examined.ResultsThe Arabic version demonstrated excellent internal consistency (Cronbach's alpha = 0.974). Test-retest reliability was confirmed with a high intraclass correlation coefficient (0.958; p < 0.001). The scale distinguished between participants with hearing loss and those with normal hearing (p < 0.001). Total scores showed significant negative correlations with hearing loss (r = 0.609; p < 0.001).ConclusionsThe Arabic full version of the Speech, Spatial, and Qualities of Hearing Scale is a valid and reliable tool for assessing auditory perception, spatial hearing, and communication challenges among Arabic-speaking individuals with hearing impairments.
Psychometric evaluation of the Spanish version of the physiotherapy critical thinking in clinical practice questionnaire.
Hernández-Méndez B, Ginés-Puertas À, Jerez-Roig J … +6 more , Martí-Romeu JD, Cámara-Menoyo D, Cuartero-Archs J, Piqueras-Céspedes M, Llaberia-Marcual M, Zuriguel-Pérez E
Clin Rehabil · 2025 Oct · PMID 40739927 · Publisher ↗
ObjectiveThe aim was to adapt and validate the Nursing Critical Thinking in Clinical Practice Questionnaire of 109 items in four dimensions, for its application in physiotherapists in Spain.DesignDescriptive, cross-secti...
ObjectiveThe aim was to adapt and validate the Nursing Critical Thinking in Clinical Practice Questionnaire of 109 items in four dimensions, for its application in physiotherapists in Spain.DesignDescriptive, cross-sectional, multicenter psychometric study carried out in two phases: phase 1, adaptation of the Nursing Critical Thinking in Clinical Practice Questionnaire to the physiotherapy setting and analysis of its content validity; phase 2, evaluation of the psychometric properties of the new instrument.SettingPhysiotherapists from a variety of work environments (public and private hospitals, geriatric institutions, home care services, clinics, and primary care, social health, educational and sports centers).ParticipantsA sample of 235 physiotherapists participated, of whom 108 completed the questionnaire for a second time after a two-week interval.Main measuresConstruct validity was analyzed using Confirmatory Factor Analysis, convergent validity and discriminant validity; reliability was analyzed using internal consistency and temporal stability (test-retest method).ResultsThe Average Scale Content Validity Index of 0.96 indicated high content validity. Confirmatory Factor Analysis confirmed the four-dimensional structure on which the original questionnaire is based, with acceptable model fit indices. Cronbach's alpha for the total questionnaire was 0.97, reaching values above 0.70 in each of the dimensions. Lin's Intraclass Correlation Coefficient was 0.71.ConclusionsThe Physiotherapy Critical Thinking in Clinical Practice Questionnaire showed appropriate psychometric properties. Its use among Spanish physiotherapists is recommended.ClinicalTrials.gov IdentifierNCT05059483.URLhttps://clinicaltrials.gov.
Virtual reality for total hip arthroplasty rehabilitation: Kinect versus Nintendo Wii, a single-blind randomised controlled trial.
Zavala-Gonzalez J, López-Alarcón G, Martinez D … +3 more , Jara S, Cigarroa I, Gutiérrez-Espinoza H
Clin Rehabil · 2025 Oct · PMID 40739904 · Publisher ↗
ObjectiveCompare the effectiveness of integrating virtual reality systems, Nintendo Wii and Microsoft Kinect, integrated with conventional physiotherapy versus conventional physiotherapy alone, in improving lower limb ph...
ObjectiveCompare the effectiveness of integrating virtual reality systems, Nintendo Wii and Microsoft Kinect, integrated with conventional physiotherapy versus conventional physiotherapy alone, in improving lower limb physical function in people over 60 years of age undergoing total hip arthroplasty.DesignRandomised, single-blind clinical trial.SettingSan Borja Arriaran Clinical Hospital, Santiago, Chile.Participants111 individuals over 60 years of age, divided into three groups (n = 37 each).InterventionsFor six weeks, the control group received conventional physiotherapy. The Wii and Kinect groups received the same physiotherapy programme plus 15 min of exercise using virtual reality platforms.Outcome measuresThe primary outcome was the function subscale of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Secondary outcomes included WOMAC pain, Berg Balance Scale, Six-Minute Walk Test, and weight-bearing.ResultsAll groups improved. For WOMAC function, the Wii group surpassed the Kinect group (mean difference: 40.48 points; < 0.001; minimum clinically important difference MCID: 11.9 points) but not the control group. The Wii group also led in balance (Berg Balance Scale mean difference: 19.41 points; < 0.001; MCID: 11.5 points). The Kinect group was superior in the Six-Minute Walk Test (mean difference: 133.10 metres; = 0.001) and WOMAC pain reduction (mean difference: 11.45 points; < 0.003) exceeding the MCID of 2.2 points. No significant changes were observed in weight-bearing.ConclusionVirtual reality combined with physiotherapy improves clinically meaningful outcomes following hip arthroplasty. The Wii favours balance, while Kinect enhances pain and gait, supporting personalised rehabilitation.Trial registrationThis research was registered in the Clinical Trials Registry of Australia and New Zealand (ACTRN12618001252202).
Safety of videoconferencing for physical rehabilitation and exercise: A systematic review and meta-analysis.
Brown RC, Simmich J, Cuthbert R … +3 more , Ross MH, Molina-Garcia P, Russell TG
Clin Rehabil · 2025 Sep · PMID 40734486 · Full text
ObjectiveInvestigate the safety of physical rehabilitation and/or exercise interventions conducted via videoconferencing.DesignSystematic review/meta-analysis.Data sourcesPubMed, Web of Science, Embase and CINAHL from in...
ObjectiveInvestigate the safety of physical rehabilitation and/or exercise interventions conducted via videoconferencing.DesignSystematic review/meta-analysis.Data sourcesPubMed, Web of Science, Embase and CINAHL from inception until 12 June 2025.Review methodsTrials including participants with chronic disease or history of restorative or reconstructive surgery implementing a physical rehabilitation or exercise intervention via videoconferencing compared to an in-person exercise comparator and reporting adverse events were included. Meta-analyses were conducted for between-group comparisons of adverse events using incidence rate ratios. Risk of bias was assessed using the Cochrane Risk of Bias 2 tool and the certainty of the evidence with Grading of Recommendations, Assessment, Development and Evaluation.ResultsOut of 3436 records, 22 trials were included in this review (28 otherwise eligible trials were excluded for not reporting adverse events). No significant differences were observed between groups for minor/moderate [incidence rate ratio (IRR): 1.00, 95% CI: 0.71-1.41, = 1.00] or major (IRR: 1.77, 95% CI: 0.55-5.70, = 0.98) adverse events. Incidence was low for both videoconferencing (one every 410 sessions) and in-person (one every 414 sessions). Eighteen trials (82%) were graded 'some concerns' or 'high' on overall risk of bias score, primarily due to bias arising from measurement and selection of the reported adverse events. Certainty grading was 'low' for adverse event outcomes.ConclusionThis study suggests that there is no clear evidence of a difference in adverse event incidence between in-person and videoconferencing physical rehabilitation or exercise interventions. Future studies must improve transparency of defining and reporting to improve certainty in these findings.
How important are working relationships for stroke self-management? A qualitative study with healthcare professionals in community stroke teams.
Lucas L, Peters S, Cotterill S … +1 more , Bowen A
Clin Rehabil · 2025 Sep · PMID 40686244 · Full text
ObjectiveTo understand healthcare professionals' experiences of developing therapeutic alliances (working relationships) with stroke survivors, and their views on how alliance relates to self-management in community sett...
ObjectiveTo understand healthcare professionals' experiences of developing therapeutic alliances (working relationships) with stroke survivors, and their views on how alliance relates to self-management in community settings.DesignQualitative study.SettingCommunity.ParticipantsHealthcare professionals recruited purposively from four National Health Service community stroke teams in England.Main measuresSemi-structured, one-to-one qualitative interviews, transcribed verbatim and analysed using Braun and Clarke's reflexive thematic analysis.ResultsNineteen clinicians (six physiotherapists, four occupational therapists, two speech and language therapists, two nurses, one psychologist and four people in assistant/trainee roles) were included in the study. Three main themes were developed from the data. (1) : alliances were shaped by the time-limited nature of community rehabilitation and relied on trust, buy-in, and clearly defined roles and expectations. (2) : whilst alliances supported motivation and engagement, complicated power dynamics sometimes undermined self-management. (3) : participants often equated self-management with self-directed rehabilitation and described a lack of clarity, confidence and training in supporting emotional and long-term adjustment needs. Strong alliances were viewed as essential for self-management, but formal support strategies were rarely used.ConclusionsCommunity-based healthcare professionals consider therapeutic alliance to be the foundation for stroke self-management in the community. However, a limited understanding of self-management among clinicians, combined with unbalanced power dynamics, may restrict patient autonomy. Relationship-based training (e.g. Bridges) and the development of self-management champion roles within organisations may enhance clinicians' confidence and consistency in delivering self-management support in the community.
A personalised, gait training telerehabilitation programme for people with Parkinson's Disease: A long-term pilot study.
Lopane G, D'Ascanio I, Corzani M … +13 more , Petrone V, Calandra-Buonaura G, La Porta F, Cortelli P, Gazit E, Brozgol M, Thumm Cornejo P, Giladi N, Ferrari A, Tacconi C, Chiari L, Palmerini L, Hausdorff JM
Clin Rehabil · 2025 Aug · PMID 40660084 · Full text
ObjectiveTo assess the feasibility and, preliminarily, the effectiveness of long-term, personalized gait training using a digital wearable system (Gait Tutor) that provides real-time audio biofeedback to correct or reinf...
ObjectiveTo assess the feasibility and, preliminarily, the effectiveness of long-term, personalized gait training using a digital wearable system (Gait Tutor) that provides real-time audio biofeedback to correct or reinforce gait behaviour.DesignOpen-label and non-controlled, with assessments before and after intervention.SettingReal-world.ParticipantsTwenty persons with Parkinson's disease.InterventionParticipants performed home-based gait training in their ON medication state for 30 minutes, 3 times per week, for 9 months using a Gait Tutor.Main measuresWe evaluated adherence (% of expected sessions), usability, and, preliminarily, efficacy by assessing the motor performance of the participants before and after the intervention.ResultsSeventeen participants (85%) completed the study, performing an average of 83 sessions. Adherence was higher for persons with an intermediate disease stage (80.5% of expected training sessions), compared to those with a more advanced disease stage (46.2%). All participants reported extremely positive scores on the questionnaire about ease of use and effectiveness (4.37 ± 0.42). The Movement Disorders Unified Parkinson's Disease Rating Scale motor scores remained stable after the training (mean 9 months). In people with an intermediate disease stage, clinical scores and physical capacity tended to improve.ConclusionsFor the first time, this study shows the feasibility of long-term real-world gait training for people with Parkinson's disease, providing preliminary evidence that personalized, technology-driven rehabilitation strategies can be sustained over extended periods and can assist clinicians in objectively assessing gait performance in the real world.
Effect of robot-assisted rehabilitation of patients with Parkinson's disease: A meta-analysis.
Wu D, Yang Z, Liu S … +3 more , Guan S, Liu X, Luo J
Clin Rehabil · 2025 Sep · PMID 40629925 · Publisher ↗
ObjectiveThis meta-analysis evaluates the effectiveness of robot-assisted rehabilitation on various functional outcomes in patients with Parkinson's disease.Data sourcesA comprehensive search was conducted in databases i...
ObjectiveThis meta-analysis evaluates the effectiveness of robot-assisted rehabilitation on various functional outcomes in patients with Parkinson's disease.Data sourcesA comprehensive search was conducted in databases including PubMed, Embase, Cochrane Central Register of Controlled Trials, Scopus, Web of Science, and Google Scholar up to April 2025.Review methodsRandomized controlled trials assessing the impact of robot-assisted rehabilitation were included. Pooled standardized mean differences (SMD) were calculated using a random-effects model, with heterogeneity assessed via and tau statistics. Sensitivity analyses and publication bias assessments were also performed.ResultsThe meta-analysis included 22 studies with 819 participants. Significant improvements were observed in the Six-Minute Walk Test (SMD = 1.304, 95%CI: 0.387-2.221, = 0.005, = 93.1%), timed up-and-go test (SMD = -0.302, 95%CI: -0.490 to -0.114, = 0.002, = 0.0%), Unified Parkinson's Disease Rating Scale Part-III (SMD = -0.924, 95% CI: -1.330 to -0.518, < 0.0001, = 79.9%), Berg Balance Scale (SMD = 0.986, 95% CI: 0.546-1.425, < 0.0001, = 76.3%), and gait speed (SMD = 0.772, 95%CI: 0.290-1.255, = 0.002, = 73.1%). Step length showed significant improvement (SMD = 0.848; 95%CI: 0.196-1.501, = 0.011, = 87%).ConclusionRobot-assisted rehabilitation significantly improves functional outcomes in patients with Parkinson's disease, particularly in walking distance, balance, and gait speed. These findings support the integration of robot-assisted rehabilitation into clinical practice for enhancing mobility and reducing motor symptoms in Parkinson's disease.
Optimal Tai Chi dose for improving anxiety, depression, and sleep quality in older adults: A Bayesian meta-analysis.
Chen S, Luo L, Yuan Y
Clin Rehabil · 2025 Sep · PMID 40625025 · Publisher ↗
ObjectiveAs the population ages, an increasing proportion of older adults experience mental health problems. Although Tai Chi ameliorates these negative outcomes, the required dosage remains unknown. This study aimed to...
ObjectiveAs the population ages, an increasing proportion of older adults experience mental health problems. Although Tai Chi ameliorates these negative outcomes, the required dosage remains unknown. This study aimed to determine the optimal dose of Tai Chi to improve anxiety, depressive symptoms, and sleep quality.Data sourcesA systematic search using MEDLINE, Embase, Cochrane Library, and Web of Science was conducted from the beginning of the respective database information until June 5, 2025.Review methodsA pairwise and dose-response meta-analysis using Bayesian hierarchical random-effects models to analyse the effects of a Tai Chi intervention on anxiety, depression, and sleep quality in older adults. In addition, the quality of the literature was assessed using the Cochrane Risk of Bias Tool 2.ResultsA total of 2843 older adults were enrolled in 37 randomised controlled trials, including 1424 (50.1%) in the Tai Chi group. Tai Chi intervention improved anxiety (standardized mean difference (SMD) : -0.47, 95% credible interval (CrI): -0.65 to -0.30), depressive symptoms (SMD: -0.41, 95% CrI: -0.50 to -0.33). However, while Tai Chi improved sleep quality in older adults, the effect, though statistically significant, was small in magnitude (SMD: -0.12, 95% CrI: -0.20 to -0.04), with large heterogeneity.ConclusionTai Chi is an effective intervention for improving mental health and sleep in older adults, with dose-dependent benefits. Our findings establish an optimal therapeutic target of 500-700 MET-minutes/week, transforming Tai Chi from a general recommendation into a specific, evidence-based prescription for clinical practice.
Novel brace with long-duration neuromuscular electrical stimulation in patients with full-thickness rotator cuff tears: A randomized controlled trial.
Weng YH, Wong CK, Chien YT … +3 more , Yang JL, Chang CH, Lin JJ
Clin Rehabil · 2025 Sep · PMID 40619923 · Publisher ↗
ObjectiveTo evaluate the efficacy of exercise with a long-duration neuromuscular electrical stimulation brace compared to exercise alone in patients with full-thickness rotator cuff tears.DesignA prospective randomized c...
ObjectiveTo evaluate the efficacy of exercise with a long-duration neuromuscular electrical stimulation brace compared to exercise alone in patients with full-thickness rotator cuff tears.DesignA prospective randomized controlled trial.SettingResearch laboratory.ParticipantsPatients with full-thickness rotator cuff tears were randomized into the experimental ( = 21) or exercise-only group ( = 21).InterventionBoth groups completed exercises daily for 6 weeks, with the experimental group receiving neuromuscular electrical stimulation during exercises.Main measuresFunction, pain, strength, and scapular biomechanics (arm raising and lowering).ResultsThe principal outcome showed no differences between groups in function, pain, or strength at 3 and 6 weeks. However, the experimental group exhibited significantly less posterior tilt (6.3 ± 2.9°, = 0.006) at week 3 and reduced upper trapezius (6.0%-19.0%, = 0.017) and serratus anterior (15.3%-20.4%, = 0.009-0.016) activation at weeks 3 and 6. The within-group comparison showed pain (1.8 ± 0.4, < 0.001) and strength (6.5-9.4%, < 0.007) improved in the experimental group by week 3, while the exercise-only group showed strength gains (3.4-10.1%, < 0.01) from weeks 3 to 6. Both groups demonstrated decreased upward rotation (2.1° ± 0.8°, = 0.042), whereas the experimental group showed decreased muscle activation (2.0-10.5%, < 0.03) after training.ConclusionsDespite a 6-week exercise program with long-duration neuromuscular electrical stimulation, no significant group differences were observed in function, pain, or strength at 3 or 6 weeks. However, secondary analyses indicated reduced scapular compensation and early pain and strength improvements in the experimental group.
A scoping review: POEMS syndrome (Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal plasma cell disorder and Skin Changes), physical recovery, and rehabilitation.
Johnson L, D'Sa S, Ramdharry G … +5 more , Walumbe J, Lunn M, Tomkins O, Sive J, McCourt O
Clin Rehabil · 2025 Sep · PMID 40611693 · Publisher ↗
ObjectivePOEMS syndrome is a rare and treatable plasma cell disorder. Although medical advances have improved survival, polyneuropathy - which impairs both sensory and motor function in the limbs - continues to be the pr...
ObjectivePOEMS syndrome is a rare and treatable plasma cell disorder. Although medical advances have improved survival, polyneuropathy - which impairs both sensory and motor function in the limbs - continues to be the predominant contributor to reduced mobility and quality of life. Multidisciplinary teams can offer rehabilitation during the disease progression and recovery, but there is limited guidance on appropriate types, intensity, and timing of intervention. This scoping review aims to answer the question: "What is known about physical recovery and rehabilitation in POEMS syndrome?"Data sourcesMEDLINE, CINAHL, EMBASE, PEDRO and EMCARE databases. Additional studies were identified from grey literature and handsearching of citations.Review methodsA scoping review was conducted. Included papers focused on POEMS syndrome with details on physical outcomes pre and post treatment and rehabilitation intervention. Data was extracted into tables, and a narrative summary was produced for each paper.ResultsIn total 21 papers were included and analysed through narrative summaries across three themes: 1) physical and functional deficits, 2) physical recovery and 3) rehabilitation interventions. There were no studies evaluating rehabilitation intervention and limited detail on intervention specifics and timings. Most studies focused on the outcome of medical intervention on physical impairments, with little attention to disability, function and quality of life.ConclusionsThere is a need for expert-led recommendations, standardised rehabilitation guidelines and further research into effective interventions including timing, intensity and the patient's preferences.
Patient experiences of shared decision-making following a displaced collarbone injury: A qualitative interview study.
Maher N, Moffatt MC, Astin F … +1 more , Littlewood C
Clin Rehabil · 2025 Aug · PMID 40589166 · Full text
ObjectiveTo explore the patient experience of shared decision-making following a displaced collarbone injury, focusing on how patients understand their injury and how this influences decisions.DesignDescriptive qualitati...
ObjectiveTo explore the patient experience of shared decision-making following a displaced collarbone injury, focusing on how patients understand their injury and how this influences decisions.DesignDescriptive qualitative study design using individual semi-structured interviews.SettingParticipants recruited from three United Kingdom National Health Service hospitals.ParticipantsPatients with a displaced collarbone injury were interviewed about their experiences of shared decision-making.Main measuresInterviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis.ResultsThree themes emerged: (1) Understanding of the injury, (2) Factors influencing treatment decision and (3) Experience of shared decision-making. Patients' interpretation of their injury, including the language used by clinicians, shaped their understanding and decisions. Factors such as previous injuries, employment, clinician advice and expectations also influenced treatment choices. Some patients described uncertainty during decision-making conversations and felt unsupported in choosing the option that best suited them. Others felt steered towards specific treatments without fully grasping their implications.ConclusionThis is the first qualitative interview study exploring patients' perspectives of shared decision-making following a displaced collarbone injury. While patients considered several factors when deciding between treatment options, many described limited involvement in decision-making and felt directed towards clinician-preferred treatments without fully understanding the implications. This highlights inconsistency in the implementation of shared decision-making in practice. Despite the United Kingdom National Health Service emphasis on shared decision-making, further efforts are needed to ensure that patients are actively supported in making informed, preference-sensitive decisions, in line with the goals of personalised care.
Fatigue and recovery assessed by repetitive handgrip strength measurement as predictors of fall risk in older adults: A cross-sectional study.
Kapan A, Ristic M, Felsinger R … +1 more , Waldhoer T
Clin Rehabil · 2025 Aug · PMID 40589163 · Full text
DesignA cross-sectional study assessing the utility of repetitive handgrip strength measurements for predicting fall risk in older adults.SettingConducted in two residential care homes in Vienna, Austria.Participants217...
DesignA cross-sectional study assessing the utility of repetitive handgrip strength measurements for predicting fall risk in older adults.SettingConducted in two residential care homes in Vienna, Austria.Participants217 older adults (mean age: 80.2 years, 65.9% female) participated. Those with significant cognitive impairments Mini-Mental State Examination ≤17, severe neuromuscular disorders, or recent hand injuries were excluded.InterventionParticipants underwent a repetitive handgrip strength protocol, comprising 10 maximal grips (3-second contractions, 5-second rest intervals) performed twice, with a one-hour interval. Fatigability and recovery ratios were calculated. Functional assessments included the Short Physical Performance Battery, the Physical Activity Scale for the Elderly, the Falls Efficacy Scale-International, and the Multidimensional Fatigue Inventory. Retrospective and prospective fall data were also collected.Main MeasuresHandgrip strength parameters (maximum, fatigue ratio, recovery ratio) and fall events (retrospective and prospective) were analysed alongside physical and functional assessments.ResultsFallers (39.6%) had higher fatigue ratios (median: 1.4 vs. 1.2) and lower recovery ratios (median: 0.9 vs. 1.0) compared to non-fallers ( < .001). Fatigue ratio was a strong predictor of prospective falls (incidence rate ratio: 1.14, 95% confidence interval: 1.09-1.41). Recovery ratio showed marginal significance. Functional measures were also strongly associated with fall risk.ConclusionsRepetitive maximum handgrip strength measurements dynamically assess neuromuscular performance and offer superior predictive power for fall risk compared to standard single maximum handgrip strength. Fatigue and recovery ratios should be incorporated into fall risk assessment to improve prevention strategies in older adults.
Translation, cross-cultural adaptation and validation of the Pain Attitudes Questionnaire - revised into Brazilian Portuguese in patients with chronic cancer pain.
Guedes CLR, Mendes LP, Coutinho SM … +7 more , Nunes Morais D, Pinheiro JS, Guedes JBS, Sousa JC, Santos JS, Leal PDC, Dibai-Filho AV
Clin Rehabil · 2025 Aug · PMID 40576991 · Publisher ↗
ObjectiveTo translate, culturally adapt, and validate the Pain Attitudes Questionnaire - Revised (PAQ-R) into Brazilian Portuguese for patients with chronic cancer pain.DesignQuestionnaire validation study.SettingMaranhã...
ObjectiveTo translate, culturally adapt, and validate the Pain Attitudes Questionnaire - Revised (PAQ-R) into Brazilian Portuguese for patients with chronic cancer pain.DesignQuestionnaire validation study.SettingMaranhão Oncology Hospital and Aldenora Bello Hospital (São Luís, Maranhão, Northeast Brazil).Participants165 patients with chronic cancer pain, of both sexes, aged 18 years or older.Main MeasuresThe Barthel Index, Hospital Anxiety and Depression Scale (HADS), and Pain Catastrophizing Scale (PCS) were used for clinimetric evaluation. The Edmonton Symptom Assessment System (ESAS) was used to characterize the sample. The measurement properties evaluated in this study included cross-cultural validity, structural validity, construct validity, reliability, and internal consistency.ResultsThe study included 165 cancer patients. The internal structure of the PAQ-R, consisting of five domains and 23 items, was adequate (comparative fit index = 0.95, Tucker-Lewis index = 0.94, root mean square error of approximation = 0.08, chi-square/degrees of freedom = 2.04). Test-retest reliability was satisfactory (ICC = 0.82 to 0.89), as was internal consistency (Cronbach's alpha = 0.70 to 0.94). Expected correlation magnitudes (rho ≤ 0.384, p < 0.05) were observed between all PAQ-R domains and functional independence, between the stoic-fortitude domain and depression, and between catastrophizing and the stoic-fortitude, stoic-superiority, and cautious-self-doubt domains of the PAQ-R.ConclusionThe Brazilian Portuguese version of the PAQ-R, with five domains and 23 items, demonstrated adequate construct validity, reliability, and internal consistency for use in patients with chronic cancer pain.
Accuracy of screening for symptoms of anxiety and depression among patients with fibromyalgia in physiotherapy.
Vancampfort D, de Bruin ED, Bernar K … +2 more , Hemmings L, Van Damme T
Clin Rehabil · 2025 Aug · PMID 40576987 · Publisher ↗
ObjectivesThis study compares the accuracy of physiotherapists' screening for anxiety and depression in fibromyalgia patients using observer-report versions of the Patient Health Questionnaire-2 for depression and the Ge...
ObjectivesThis study compares the accuracy of physiotherapists' screening for anxiety and depression in fibromyalgia patients using observer-report versions of the Patient Health Questionnaire-2 for depression and the Generalized Anxiety Disorder-2 for anxiety versus the 0-10 numeric rating scale.DesignObservational cross-sectional study.SettingPrivate physiotherapy practices in Flanders, Belgium.ParticipantsFifty-three physiotherapists (37.6 (10.3) years; 24 male; 12.9 (11.0) years of experience) assessed 169 newly referred fibromyalgia patients (mean age = 49.6 (13.6); 33 male; illness duration = 96.3 (91.6) months) after two weeks of treatment.Main outcome measuresPhysiotherapists screened for anxiety and depression using observer-report versions of the Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 and 0-10 numeric rating scales. Patients reported anxiety and depression levels using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9, respectively. The area under the curve values, calculated with DeLong's method, were used to compare the accuracy of the screening tools.ResultsThe prevalence of at least mild, moderate, and severe anxiety was 79.3%, 40.2%, and 3.0%, respectively; for depression, this was 75.1%, 50.9%, and 9.5%, respectively. The brief screening tools showed higher accuracy than the numeric rating scales in all cases except for severe depression.ConclusionsPhysiotherapists can effectively use the Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 in routine assessments for fibromyalgia patients, facilitating timely interventions and improving physiotherapy adherence.
Intensity of task-specific training for functional ability post-stroke: Systematic review and meta-analysis.
Ibrahim R, Abdullahi A, Salihu AT … +1 more , Lawal IU
Clin Rehabil · 2025 Sep · PMID 40576954 · Publisher ↗
ObjectivesTo evaluate the effectiveness of intensities of task-specific training on upper and lower limbs functions, balance, and quality of life post-stroke.Data sourcesSix electronic databases (Cochrane Central Registe...
ObjectivesTo evaluate the effectiveness of intensities of task-specific training on upper and lower limbs functions, balance, and quality of life post-stroke.Data sourcesSix electronic databases (Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, CINAHL, PsycINFO, and Clinical trials.gov registries) were searched up to 19 April 2025.Review methodsWe selected randomized controlled trials with at least one group involving an active repetitive motor sequence. Using an online systematic review application (Covidence), two reviewers screened the studies and extracted the data. Risk of bias was appraised using the standard Cochrane tool. Review Manager 5.4 was used for analysis.ResultsTwenty-six randomized controlled trials involving 1431 stroke survivors were included, with moderate to high risk of bias. Subgroup analyses across most outcomes (arm/hand function, lower limb function, balance, quality of life) showed no significant effects of task-specific training based on dosage variables (frequency, sessions, duration, and repetitions). Although some trends favored higher-dose task-specific training or control, only hand function improved significantly in studies with >20 sessions (SMD = 0.57, p = 0.02; I = 69). A significant effect on arm function was seen with >50 repetitions (p = 0.001), but evidence quality was very low.ConclusionsThere is insufficient evidence to determine whether higher-intensity task-specific training leads to improved functional outcomes in stroke rehabilitation. Future well-designed trials are needed to explore optimal training intensities and their impact on recovery.International prospective register of systematic reviews ID CRD42020130991.
What is the effect of education on fatigue in adults with neurological conditions? A systematic review and meta-analysis.
Delbridge A, Howlett O, English C … +1 more , Simpson DB
Clin Rehabil · 2025 Aug · PMID 40545627 · Full text
ObjectiveTo determine the effect of education programs on fatigue outcomes in people with neurological conditions.Data sourcesMEDLINE, CINAHL, EMBASE, PEDRO until May 2025, according to PRISMA guidelines.Review methodsSy...
ObjectiveTo determine the effect of education programs on fatigue outcomes in people with neurological conditions.Data sourcesMEDLINE, CINAHL, EMBASE, PEDRO until May 2025, according to PRISMA guidelines.Review methodsSystematic review with meta-analysis of randomised controlled trials comparing education versus no education/other intervention on the outcome of fatigue for people with neurological conditions. Methodological quality and risk of bias were assessed using the Cochrane Risk of Bias Tool. Pooled effects were calculated using standard mean difference (SMD).ResultsWe included 19 clinical trials of education for fatigue ( = 1970 participants) in five different neurological conditions. Education duration ranged from 4 to 12 weeks, 79% ( = 15) of trials included people with multiple sclerosis and 18% ( = 3) included people with stroke. Most education (11 trials, 58%) was delivered in a group setting. Education reduced fatigue compared with usual care by a SMD -0.28, 95% CI [-0.45 to -0.11]. Greater benefits for fatigue were observed when education was delivered one-to-one (SMD -0.44, 95% CI [-0.77 to -0.12]) than in group sessions (SMD -0.17, 95% CI [-0.36 to 0.01]). Mode of delivery (in-person versus telehealth) did not appear to influence the effect of education for fatigue.ConclusionsFatigue education programs may improve fatigue for people with neurological conditions. One-to-one delivered sessions may have greater benefits than group programs and remote delivery could improve accessibility for people living in regional and rural locations.
How do patients with musculoskeletal pain define success with physical therapy? A mixed-methods study.
Morretta M, Junkin JC, Rentmeester C … +2 more , Young JL, Rhon DI
Clin Rehabil · 2025 Aug · PMID 40545609 · Publisher ↗
ObjectiveTo identify how individuals seeking care for a musculoskeletal condition define success, understand the patients' perspectives regarding why they define success as they do, and identify if there were health hist...
ObjectiveTo identify how individuals seeking care for a musculoskeletal condition define success, understand the patients' perspectives regarding why they define success as they do, and identify if there were health history factors associated with patients' definitions of success.DesignA mixed-methods convergent parallel cohort design.SettingOutpatient physical therapy clinics.ParticipantsIndividuals aged 18-89 years seeking musculoskeletal physical therapy.Main MeasuresOnline surveys and one-on-one virtual interviews. Ordinal logistic regression was used to model the relationship between demographic and health history variables on survey scores. Thematic coding of qualitative data identified common themes. Integration of quantitative and qualitative data was performed to infer the influence of factors on definitions of success.ResultsA total of 463 surveys and 20 interviews were completed. A shorter symptom duration and previous positive experience with physical therapy are associated with how participants defined success. The most common success theme was a desire to return to the previous level of function or accomplish a specific functional goal. Symptom improvement and greater mobility were identified as the primary criteria for success. Integration of results indicates that the survey item with the highest mean score, the need to have a thorough understanding of the condition, is independent of any of the main interview themes. However, it also can be inferred that the most common theme was influenced by the survey items with the third and fourth highest mean scores: the need to improve the current quality of life and the need to return to all previous activities.ConclusionReturning to a previous level of function or achieving a specific functional goal was the most common pretreatment determinant of patient-defined success. Shorter symptom duration and a previous positive experience with physical therapy are the only covariates that have a statistically significant association with specific criteria for success.
Co-designing and testing a management programme with peer support for post-stroke fatigue: Nottingham fatigue after stroke study (NotFAST3).
Ablewhite J, Thomas S, das Nair R … +4 more , Jones F, Sprigg N, Wharrad H, Drummond A
Clin Rehabil · 2025 Aug · PMID 40538201 · Full text
ObjectiveTo develop and test a novel programme to support post-stroke fatigue management for testing in a future clinical trial.DesignStaged approach to development and preliminary testing. Phases 1 and 2: co-design grou...
ObjectiveTo develop and test a novel programme to support post-stroke fatigue management for testing in a future clinical trial.DesignStaged approach to development and preliminary testing. Phases 1 and 2: co-design groups held to agree programme content and resources. Phase 3: training for facilitators developed and delivered. Phase 4: feasibility of programme delivery tested with questionnaires completed at beginning and end, and feedback interviews conducted.SettingCommunity, online.ParticipantsStroke survivors with post-stroke fatigue, carers and healthcare professionals.InterventionPost-stroke fatigue management programme supported by 'buddies' with lived or professional experience of managing fatigue.Main measuresIn phase 4, we examined feasibility of programme delivery (recruitment, retention, engagement and acceptability) and preliminary signals of efficacy.ResultsIn phases 1 and 2 we recruited 23 participants (16 stroke survivors, 2 carers and 5 healthcare professionals) and designed resources. In phase 3, 10 people supported training development: 7 received training to be buddies. In phase 4 we recruited 15 people with fatigue; 13 completed the programme. Of these, 13 completed baseline and 12 follow-up questionnaires. All buddies (7/7) and 12/13 participants were interviewed. Mean number of sessions delivered was 9 (SD 3.24; range 3-13) and ranged from 10 to 60 minutes (mean 28 minutes; SD 10.04). Overall, mean fatigue severity reduced, activity increased, and mood measures improved. Participants and buddies were positive about the programme and believed it was worthwhile.ConclusionsThe programme was acceptable and feasible, with preliminary evidence of efficacy, but some issues need to be addressed in future trial design.
Cost-effectiveness of the My Therapy self-directed therapy program for rehabilitation patients: A stepped wedge cluster randomised trial.
Brusco NK, Whittaker SL, Ekegren CL … +9 more , Morris ME, Taylor NF, Lee AL, Somerville L, Lannin NA, Abdelmotaleb R, Callaway L, Hill KD, My Therapy Consortium
Clin Rehabil · 2025 Jul · PMID 40509561 · Full text
ObjectiveTo determine if the My Therapy self-management program could be implemented without increasing the rehabilitation admission cost, from a health service perspective.DesignEconomic evaluation, including a cost-eff...
ObjectiveTo determine if the My Therapy self-management program could be implemented without increasing the rehabilitation admission cost, from a health service perspective.DesignEconomic evaluation, including a cost-effectiveness analysis.SettingAustralian rehabilitation wards ( = 9).ParticipantsRehabilitation inpatients with any diagnosis.InterventionMy Therapy: a self-directed therapy program shown to increase daily inpatient rehabilitation participation dosage time by 38%.Main MeasuresOutcomes included cost (rehabilitation admission and all-cause 30-day readmissions), and effect (minimal clinically important difference in functional independence (FIM), and quality-adjusted life years (EQ-5D-5L)), to estimate incremental cost-effectiveness ratios (ICERs).ResultsThere were 2363 participants, with a mean age of 77 (SD 13) years, 62% female, and 27% with cognitive impairment. My Therapy costs $5 (SD $2) per patient/day to implement, excluding opportunity costs. Estimated differences in effect were non-significant for the proportion of participants achieving a minimal clinically important difference in function (control 31%, intervention 36%; OR: 1.08, 95% CI: 0.77, 1.53), and quality-adjusted life years (mean difference -0.01, 95% CI: -0.04 to 0.02). Estimated differences in cost were also non-significant (OR: 1.06, 95% CI: 0.97, 1.16). ICERs were also non-significant. Post hoc, it was determined that the cost/minute of daily therapy participation was $14/minute for control and $11/minute for intervention conditions.ConclusionsThe My Therapy self-management program was implemented without increasing rehabilitation admission and all-cause 30-day readmission costs. However, clinical differences were not detected. There may have been a small reduction in cost/minute for daily therapy participation.
Conceptualisation of financial capability in adults with acquired cognitive impairment: A qualitative evidence synthesis.
Swan S, Patterson F, Bredy TM … +1 more , Fleming J
Clin Rehabil · 2025 Jul · PMID 40501270 · Full text
ObjectiveTo explore definitions, theoretical models and conceptual frameworks related to financial capability in adults with acquired cognitive impairment from acquired brain injury or other neurological disease, includi...
ObjectiveTo explore definitions, theoretical models and conceptual frameworks related to financial capability in adults with acquired cognitive impairment from acquired brain injury or other neurological disease, including dementia.Data sourcesA systematic search of PubMed (inclusive of Medline), CINAHL, EMBASE, PsycINFO, ABI-inform, SCOPUS and the Cochrane database for papers published until May 2025.Review methodsA qualitative evidence synthesis approach was utilised in conjunction with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. Eligible papers articulated an original comprehensive definition and/or theoretical model or conceptual framework focused on financial capability in the target population. Papers were screened by two researchers, with methodological quality of included papers critically appraised. Data were extracted for tabulation and thematic synthesis, which was completed via coding and categorisation into descriptive and analytical themes.ResultsThe final analysis included 21 papers from the initial screening of 6516 papers. Fifteen discrete models were identified, with results indicating inconsistency in terminology use and meanings. Models that consider real-world performance within an individual's contextual environment are increasingly utilising economics related terminology such as financial capability. The majority of papers related to people with dementia and were multidisciplinary in authorship, or from the psychology literature. Themes found in the literature include the multi-dimensionality of financial capability, financial decision-making ability and exploitation risk for legal capacity, and the neuropathological cause of declining financial capability.ConclusionFurther research with the inclusion of the consumer lived experience is recommended to inform models of care for this complex area of practice.
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