Clinical Rehabilitation[JOURNAL]
Sun
200 papers
Effect of oral nutritional supplements on physical functional performance in older patients at nutritional risk discharged with a rehabilitation plan: A randomised controlled trial.
Jensen A, Ninh ED, Darlem BB … +6 more , Haack LM, Møller CM, Knudsen AW, Pudselykke FE, Petersen PB, Beck AM
Clin Rehabil · 2026 Jul · PMID 42383884 · Publisher ↗
ObjectiveTo investigate if post-discharge oral nutritional supplementation improves physical functional performance and other outcomes in older hip fracture patients at nutritional risk.SettingDepartment of Orthopaedic S...
ObjectiveTo investigate if post-discharge oral nutritional supplementation improves physical functional performance and other outcomes in older hip fracture patients at nutritional risk.SettingDepartment of Orthopaedic Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.ParticipantsHip fracture patients aged ≥65 years and identified as being at nutritional risk. Of 768 individuals screened, 123 were randomised and 109 (89%) completed the 12-week follow-up.InterventionParticipants were randomised to receive either two cans of high energy, high protein oral nutritional supplementation enriched with vitamin D and omega 3 fatty acids daily for 12 weeks after discharge or standard care.Main measuresThe primary outcome was physical functional performance assessed by the 30-s chair-stand test. Secondary outcomes included muscle mass, hand grip strength, activities of daily living, hydration status, inflammation, appetite, quality of life, energy and protein intake, and omega-3 fatty acid status.ResultsPhysical functional performance improved in both groups, with no significant between-group difference in the number of repetitions performed in the intention-to-treat analysis. Protein intake increased in the intervention group (p = 0.003), while no between-group differences were observed for other outcomes. In the per-protocol analysis, the intervention group showed greater improvement in physical functional performance compared with the control group (p = 0.040). Energy and protein intake were also higher in the intervention group (p = 0.003, p = <.001),ConclusionsPost-discharge oral nutritional supplementation increased protein intake but did not improve physical functional performance. Per-protocol findings suggest that high adherence may be necessary to achieve functional benefits.
Prioritising fall prevention strategies in Parkinson's disease: A multi-method evaluation.
Bahramian F, Bahramian A, Mousavi SA … +2 more , Ahmadinejad B, Jalali A
Clin Rehabil · 2026 Jun · PMID 42377090 · Publisher ↗
ObjectiveFalls are a serious complication of Parkinson's disease, leading to functional decline, psychological distress, and substantial economic burden. Although multiple interventions have been proposed, structured qua...
ObjectiveFalls are a serious complication of Parkinson's disease, leading to functional decline, psychological distress, and substantial economic burden. Although multiple interventions have been proposed, structured quantitative guidance on prioritising fall-prevention strategies for clinical implementation in Parkinson's disease remains limited.DesignA multi-method study integrating a structured narrative review, expert consensus via a two-round Delphi process with 15 multidisciplinary Parkinson's disease experts, and multi-criteria decision-making using the Best-Worst Method to identify and quantitatively prioritise fall-prevention strategies for people with Parkinson's disease.SettingExpert-based consensus and decision-analysis study.ParticipantsFifteen multidisciplinary experts with clinical and research expertise in Parkinson's disease and neurorehabilitation.InterventionFall-prevention interventions identified through a structured narrative review and refined through a two-round Delphi process, followed by prioritisation using the Best-Worst Method.Main measuresRelative priority weights of intervention categories and sub-criteria derived using the Best-Worst Method based on expert judgements.ResultsThe Delphi process yielded three main criteria (exercise, dance-based interventions, and neuroscience-based interventions) and 14 sub-criteria. Best-Worst Method weighting showed that exercise had the highest priority (weight=0.49), followed by dance-based interventions (weight=0.32) and neuroscience-based interventions (weight=0.19). Within exercise, balance training and resistance strength training received the greatest weights, whereas Tai Chi and transcranial direct current stimulation received the highest expert-derived priority weights within the dance-based and neuroscience-based categories, respectively.ConclusionThis integrative framework provides an evidence-informed hierarchy of expert-derived priorities for fall-prevention interventions and may support clinical decision-making and programme design, while highlighting the need for further effectiveness and implementation research.
Determinants of out-of-home activity in older adults with cognitive impairment following inpatient rehabilitation: A secondary cross-sectional analysis of a randomised controlled trial using location-based and accelerometer-derived measures.
Ullrich P, Buchner T, Bongartz M … +5 more , Eckert T, Jansen CP, Bauer JM, Werner C, Hauer K
Clin Rehabil · 2026 Jun · PMID 42345512 · Publisher ↗
ObjectiveTo examine physical activity and its spatial context after geriatric rehabilitation and to identify determinants of out-of-home activity in older adults with cognitive impairment.DesignCross-sectional observatio...
ObjectiveTo examine physical activity and its spatial context after geriatric rehabilitation and to identify determinants of out-of-home activity in older adults with cognitive impairment.DesignCross-sectional observational study.SettingCommunity, following discharge from geriatric rehabilitation.Participants113 geriatric patients (mean age 82.1 ± 6.0 years; 76.1% female) with cognitive impairment following geriatric rehabilitation.Main MeasuresPhysical activity was assessed over 48 h using a body-worn accelerometer (PamSys) and location-based tracking derived from the Global Positioning System (Qstarz BT-Q1000XT). Group differences between participants with and without out-of-home activity were analysed. Multivariable logistic regression identified predictors across physical, psycho-social, cognitive, environmental, financial, and personal domains.ResultsOnly 36 (31.9%) of the 113 participants (82.1 ± 6.0 years; 76.1% female) left their homes. Those with out-of-home activity accumulated significantly more daily steps, walking episodes, active time, and less sedentary time than those staying in-home (all 01). Receiver operating characteristic analyses identified thresholds of 2140 steps/day (area under the curve 0.81) and 29.6 s mean walking episode duration (area under the curve 0.73) for discriminating between participants with and without out-of-home activity. Physical capacity (OR: 1.30, 95% CI: 1.02-1.65) and cognitive function (OR: 1.29, 95% CI: 1.02-1.62) were independent predictors of out-of-home activity.ConclusionOut-of-home activity is infrequent after rehabilitation in older adults with cognitive impairment and closely reflects overall physical activity. It may serve as a practical marker of mobility and highlights the need for targeted interventions to support community mobility during this vulnerable phase.
Implementation and evaluation of a stroke sexual health practice profile for rehabilitation in Ontario, Canada.
Giurleo C, McIntyre A, Kras-Dupuis A … +2 more , Lala D, Wolfe D
Clin Rehabil · 2026 Jun · PMID 42334258 · Publisher ↗
ObjectiveThis study aimed to implement and evaluate a structured, team-based approach to integrating sexual health into stroke rehabilitation using the Permission-Limited Information-Specific Suggestions-Intensive Therap...
ObjectiveThis study aimed to implement and evaluate a structured, team-based approach to integrating sexual health into stroke rehabilitation using the Permission-Limited Information-Specific Suggestions-Intensive Therapy model, operationalized through the Stroke Sexual Health Practice Profile.DesignQuality Improvement Initiative.SettingOntario, Canada.ParticipantsPatients attending inpatient or outpatient stroke rehabilitation.InterventionThe Stroke Sexual Health Practice Profile was developed collaboratively by an interprofessional team and implemented within a stroke rehabilitation program. It outlined standardized practices across the Permission-Limited Information-Specific Suggestions-Intensive Therapy framework, including scripts, educational materials, and documentation protocols.Main measuresOutcomes included staff knowledge, comfort, and approaches to addressing sexual health, participation in educational activities, patient awareness and comfort discussing sexual health, and documentation of sexual health practices in clinical charts.ResultsPreimplementation surveys identified gaps in patients' awareness of poststroke sexual health and providers' confidence in addressing it. Among eligible staff, 86.3% completed online modules and 62.1% attended workshops, which were associated with significant improvements in knowledge and comfort. These gains were partially sustained at 6 months. Postimplementation patient surveys demonstrated improved awareness and comfort discussing sexual health. Chart audits showed increased documentation of sexual health discussions over time.ConclusionsThe Stroke Sexual Health Practice Profile supported integration of sexual health into stroke rehabilitation by improving clinician knowledge and confidence and increasing documentation of care. Sustained improvements may require ongoing reinforcement and system-level supports.
Sex and gender differences in technology-based rehabilitation for people with stroke: A scoping review.
Rahmaniharedasht R, Andò M, Lando A … +7 more , Ferri N, Konika V, Leo MR, Piperno R, Turolla A, Pillastrini P, Tramontano M
Clin Rehabil · 2026 Jun · PMID 42317122 · Publisher ↗
ObjectivesThis scoping review maps evidence on sex and gender differences in technology-assisted stroke rehabilitation and identifies gaps to inform equitable approaches.Data sourcesSearches were conducted in two rounds...
ObjectivesThis scoping review maps evidence on sex and gender differences in technology-assisted stroke rehabilitation and identifies gaps to inform equitable approaches.Data sourcesSearches were conducted in two rounds (up to March 2025 and April 2025-March 2026) on MEDLINE, CINAHL, Scopus, Web of Science, Cochrane Library, and Google Scholar.Review methodsFollowing PRISMA-ScR guidelines, we included primary studies reporting sex and gender outcomes in adults with stroke receiving technological interventions, guided by the PCC framework.ResultsFrom 7071 records, 11 studies (1626 stroke survivors, 39.9% female) met inclusion criteria. Interventions included robotic exoskeletons, soft robotic gloves, virtual reality, exergaming, functional electrical stimulation, and biofeedback. Five studies found no significant sex differences. However, others reported female advantages in robotic gait training ( = 0.007), functional electrical stimulation (OR = 3.92), soft robotic glove hand function (3.43-fold greater improvement), and Virtual Reality-based balance recovery ( = 0.03). Younger women (<62 years) outperformed men in fine motor tasks, a pattern reversing with age.ConclusionGender and sex disparities in rehabilitation outcomes vary by technology type, underscoring the need for inclusive device designs and improved female representation in trials. Future research must integrate biological and sociocultural perspectives and standardize outcome measures to optimize tailored rehabilitation for all stroke survivors.
Trajectories of physical fitness following paediatric burn injury: A two-year longitudinal and predictive analysis.
Basha MA, Elnaggar RK, Aloraini SM … +6 more , Alsultan F, Alharbi A, Alqahtani A, El-Keblawy MM, Azab AR, Kamel FH
Clin Rehabil · 2026 Jun · PMID 42299688 · Publisher ↗
ObjectiveTo analyse physical fitness trajectories in paediatric burn survivors from discharge to 2 years post-injury, compare them with an age- and gender-matched control group, and identify baseline demographic and clin...
ObjectiveTo analyse physical fitness trajectories in paediatric burn survivors from discharge to 2 years post-injury, compare them with an age- and gender-matched control group, and identify baseline demographic and clinical determinants.DesignProspective and longitudinal cohort study.ParticipantsThe study included participants with burn injuries (burn group, n = 45), aged 10-17 years, with burns involving ≥25% of total body surface area, and an age- and gender-matched group of healthy children (control group, n = 45).Main measuresParticipants underwent standardised fitness assessments at discharge and 24 months later. Health-related physical fitness was quantitatively assessed using the validated EUROFIT physical fitness test battery.ResultsLongitudinal analysis revealed significant improvements in seven of nine fitness domains for participants with burn injuries over two years (pFDR < 0.001). Despite these gains, these participants exhibited persistent fitness deficits compared to healthy controls across all domains at follow-up (all p < 0.001). Among those with burn injuries, greater total body surface area (β = -0.007, p = 0.03) and third-degree burn percentage (β = -0.57, p < 0.001) predicted lower overall fitness, while longer rehabilitation predicted higher fitness (β = 0.50, p < 0.001). No baseline clinical factors significantly predicted the rate of fitness change over time (all interaction p > 0.05).ConclusionPaediatric burn survivors demonstrated significant improvements in physical fitness over 2 years but failed to close the performance gap with their healthy peers. Injury severity and rehabilitation duration were strong determinants of fitness level, but they did not predict the rate of improvement.
Effect of oral nutritional supplements on mortality and hospital admissions in older hip fracture patients at nutritional risk: secondary analysis of a randomised controlled trial.
Jensen A, Ninh ED, Knudsen AW … +2 more , Munk T, Beck AM
Clin Rehabil · 2026 Jun · PMID 42299674 · Publisher ↗
ObjectiveTo examine the association between increased energy and protein intake through oral nutritional supplements and mortality and hospital admissions in older hip fracture patients at nutritional risk, using a prepl...
ObjectiveTo examine the association between increased energy and protein intake through oral nutritional supplements and mortality and hospital admissions in older hip fracture patients at nutritional risk, using a preplanned secondary analysis of a randomised controlled trial.SettingDepartment of Orthopaedic Surgery, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark.ParticipantsHip fracture patients aged ≥65 at nutritional risk.InterventionParticipants were randomised to receive two cans daily of high-energy, high-protein oral nutritional supplements enriched with vitamin D and omega-3 fatty acids for 12 weeks after discharge or standard care.Main MeasuresAll-cause mortality and hospital admissions during a pre-planned 38-week follow-up after discharge, including time to first admission and length of hospital stay.ResultsAll-cause mortality was low, with no difference between intervention and control groups 2 (3%) versus 3 (5%). During follow-up, 31% ( = 19) of intervention participants was admitted to hospital compared with 47% ( = 29) in the control group. The difference approached significance in the intention-to-treat analysis (Risk ratio 0.72, 95% CI 0.51-1.03, = 0.075) and was statistically significant in the per-protocol analysis (18% vs. 44%; Risk ratio 0.69, 95% CI 0.52-0.92, = 0.019). No significant differences were observed in admissions frequency, length of hospital stay, or time to first admission.ConclusionPost-discharge oral nutritional supplementation was associated with a trend towards fewer hospital admission, with the strongest effect among adherent participants. No significant effects were observed in mortality, admission frequency, length of hospital stay or time to admission.ClinicalTrials.gov: NCT05556876. Date of registration: 2022-09-23.URL: https://clinicaltrials.gov/study/NCT05556876.
How do people with multiple sclerosis who have walking difficulties perceive participation? A qualitative analysis.
Brütt AL, Dilger EM, Reeck N … +2 more , Hoekstra D, Thiele A
Clin Rehabil · 2026 Jun · PMID 42283196 · Publisher ↗
ObjectiveParticipation plays a pivotal role in rehabilitation for people with multiple sclerosis. In clinical practice, the International Classification of Functioning, Disability and Health serves as a basis for charact...
ObjectiveParticipation plays a pivotal role in rehabilitation for people with multiple sclerosis. In clinical practice, the International Classification of Functioning, Disability and Health serves as a basis for characterizing participation. However, this framework lacks the subjective perception of participation. This study examines the perceived participation of people with multiple sclerosis and gait impairment through a sense of connection, efficacy, and meaning.DesignQualitative research design with focus group and individual interviews.SettingParticipants were interviewed using an online conference tool.ParticipantsTranscripts from four online focus group interviews with people with multiple sclerosis and gait impairment (4-6 participants each, totaling N = 19, aged 33 to 76, with 12 females) and from 12 individual interviews with participants from these focus groups were analyzed.InterventionNone.Main measuresTwo researchers coded transcripts using qualitative content analysis by Kuckartz.ResultsA sense of connection was about common activities, a sense of inclusion, sameness, familiarity, and contributing to a social system. Experiences of exclusion, otherness, and foreignness were reported. A sense of efficacy ranged from a sense of competence, influence, and independence to a sense of dependence, a lack of spontaneity, and helplessness, leading to refraining from activities. Meaningful activities, sensual experience, a sense of purpose, identity, and equality were related to a sense of meaning.ConclusionsPerceived participation goes beyond the ability of being involved in life situations. Clinicians following a patient-centered approach can incorporate the presented perspective of people with multiple sclerosis and gait impairment on participation into their clinical action.
Motor excitability in painful musculoskeletal shoulder conditions: A scoping review.
Paskewitz JS, Safford DW, Shah KM … +1 more , McClure PW
Clin Rehabil · 2026 Jun · PMID 42274190 · Publisher ↗
ObjectiveAltered motor excitability is a proposed mechanism of musculoskeletal shoulder pain. This scoping review aims to summarise studies examining motor excitability in individuals with painful musculoskeletal shoulde...
ObjectiveAltered motor excitability is a proposed mechanism of musculoskeletal shoulder pain. This scoping review aims to summarise studies examining motor excitability in individuals with painful musculoskeletal shoulder conditions, identify research gaps, and suggest clinical and research insights from these studies.Data SourcesPubMed, EMBASE, CINAHLReview methodsDatabases were searched for studies from January 2004 to April 2026. Studies were included if they assessed motor excitability in participants with painful musculoskeletal shoulder conditions or healthy participants with experimentally induced shoulder pain.ResultsA total of 19 studies were included. Shoulder pain condition, target muscle selection, participant positioning, and measures of motor excitability varied between studies. Moreover, 11 of 16 studies comparing shoulder motor excitability in those with clinical or experimental shoulder pain to controls reported decreases in motor excitability in those with shoulder pain. Two of three studies reporting intervention effects describe increased excitability following interventions in at least one measure.ConclusionShoulder motor excitability appears decreased in those with clinical shoulder pain. Mixed effects of experimental shoulder pain models on motor excitability suggest that more work clarifying the effect of pain on motor excitability changes is warranted. Preliminary studies report increased excitability following interventions, yet the clinical significance of these improvements is unclear. In order to minimise nervous system maladaptations in those with shoulder pain, clinicians may emphasise pain management and consider interventions that enhance motor excitability of the shoulder musculature. Because of heterogeneity in methodology and experimental pain models, further exploration of motor excitability as a mechanism and treatment target in musculoskeletal shoulder pain appears warranted.
Barriers and facilitators to leisure-time physical activity among individuals with spinal cord injury in China: A qualitative study.
Jin W, Wang Y, Wang W … +3 more , He Y, Xie S, Li K
Clin Rehabil · 2026 Jun · PMID 42267922 · Publisher ↗
ObjectiveTo explore the barriers and facilitators to leisure-time physical activity among community-dwelling adults with spinal cord injury in China, using the Capability, Opportunity, Motivation-Behaviour model as a the...
ObjectiveTo explore the barriers and facilitators to leisure-time physical activity among community-dwelling adults with spinal cord injury in China, using the Capability, Opportunity, Motivation-Behaviour model as a theoretical framework.DesignA qualitative study employing semi-structured interviews.SettingTwo rehabilitation centres in Guangzhou, China.ParticipantsTwenty community-dwelling adults with spinal cord injury, purposively sampled for diversity in gender, age, injury level and severity.ResultsThe analysis identified multifaceted factors across the Capability, Opportunity and Motivation-Behaviour domains. Within the Capability domain, barriers included limited physical function and a pessimistic mindset, whereas facilitators encompassed strong psychological resilience, high self-efficacy and positive beliefs in rehabilitation. Opportunity was constrained by limited social resources, inadequate rehabilitation facilities and financial constraints, but was enhanced by diverse social support. Within the Motivation domain, engagement in leisure-time physical activity was hindered by low self-discipline, fear of physical activity and motivational conflict, while motivation was strengthened by reflection on the benefits of physical activity, a desire for social reintegration and return to work.ConclusionsPromoting leisure-time physical activity among this population requires a theory-informed, multi-level intervention strategy. Interventions should simultaneously strengthen individual capability, expand opportunity and foster motivation. Crucially, such interventions must be contextually adapted to address China-specific socioeconomic constraints and cultural norms.
Nurse-initiated transitional care interventions to support the transition from hospital to home amongst older stroke survivors and caregivers: A systematic review and meta-analysis.
Ankanawin U, Kidd L, Skelton DA
Clin Rehabil · 2026 Jun · PMID 42267682 · Publisher ↗
ObjectiveTo explore and describe the components and underpinning theories of nurse-initiated transitional (hospital-to-home) care and to evaluate the effects of interventions on activities of daily living (ADLs), quality...
ObjectiveTo explore and describe the components and underpinning theories of nurse-initiated transitional (hospital-to-home) care and to evaluate the effects of interventions on activities of daily living (ADLs), quality of life (QoL), depression, anxiety, self-efficacy, stroke-related knowledge, patient satisfaction and healthcare service utilisation in older stroke survivors and self-efficacy, caregiver burden, QoL and satisfaction with care in caregivers.Data sourcesMEDLINE, CINAHL, Cochrane Library, Health and Medical Collection, Nursing and Allied Health, Web of Science, Health Source: Nursing/Academic Edition and Scopus databases were searched in February 2024 and updated in March 2026.Review methodsRandomised controlled trials (RCTs) and cluster-RCTs were included. Risk of bias was assessed using the Cochrane Risk of Bias tool, and evidence quality was rated with GRADE. Meta-analysis was undertaken using random-effects models.ResultsSeventeen trials were included. Transitional care interventions were guided by various theoretical frameworks and had multiple components. Interventions improved ADLs at 1 month (standardised mean difference (SMD) 0.54; 95% CI 0.12-0.97, four studies) and 3 months (SMD 0.43; 95% CI 0.12-0.74, seven studies), increased patient satisfaction and reduced hospital readmissions up to 3 months. Interventions may improve the Mental Component Score at 1 month, Role Limitations due to Physical Problems and General Health of QoL at 6 months. The certainty of evidence was low to very low.ConclusionNurse-initiated transitional care can improve ADLs and QoL, while reducing hospital readmissions among older stroke survivors during the hospital-to-home transition. Multicomponent interventions combining home visits and follow-up phone calls may enhance improvements in ADLs. High-quality studies are needed to clarify long-term effects.PROSPERO IDCRD42024517619.
Towards a core outcome set for post-stroke facial palsy: Results from an international e-Delphi study and online consensus meeting with professionals.
Eroglu HS, Bowen A, Checketts M … +1 more , Mitchell C
Clin Rehabil · 2026 Jun · PMID 42262153 · Publisher ↗
ObjectiveTo initiate the development of an agreed core outcome set for post-stroke facial palsy, identifying which outcome domains should be measured in research and may inform clinical practice.DesignTwo online e-Delphi...
ObjectiveTo initiate the development of an agreed core outcome set for post-stroke facial palsy, identifying which outcome domains should be measured in research and may inform clinical practice.DesignTwo online e-Delphi rounds followed by an online consensus meeting.SettingInternational, multi-disciplinary.ParticipantsClinicians and researchers working in post-stroke facial palsy.MethodsDelphi items were developed from existing literature, qualitative interviews with stroke survivors and patient/public involvement, then aligned with ICF levels. Participants completed two e-Delphi rounds rating outcome domains on a 1 to 9 GRADE scale: 7 to 9 'critical'; 1 to 3 'least important'. All domains were discussed at the consensus meeting and included in the final list if ≥70% of participants voted 'yes' to include the domain in the core outcome set.ResultsIn total, 156 Delphi questionnaires (round one, 101 participants from 16 countries; round two, 55 from 12 countries) were completed. Fifteen participants from 6 countries attended the consensus meeting. Three outcome domains were agreed for inclusion in the initial core outcome set: (1) facial movement and sensation, (2) everyday function, and (3) living with facial palsy.ConclusionsWe report the first internationally informed consensus between clinicians and researchers on 'what' outcome domains are important to measure for post-stroke facial palsy. We share these findings to encourage their measurement and to guide next steps. Our future work includes a separate consensus study, using a more inclusive methodology, on 'what' to measure with lived-experience stakeholders, and a systematic review on 'how' to measure these outcomes. COMET Initiative registration (December 2024): https://www.comet-initiative.org/Studies/Details/3295.
Exploring family caregivers' needs and influencing factors of mobile health in older adults with hip fractures rehabilitation: A qualitative study.
Song J, Yang B, Yang J … +3 more , Wang Q, Tao Z, Peng L
Clin Rehabil · 2026 Jun · PMID 42249790 · Publisher ↗
ObjectiveTaking family caregivers as the main users of mobile health applications, comprehensively examine their needs and the influencing factors of using applications to support the rehabilitation of older patients wit...
ObjectiveTaking family caregivers as the main users of mobile health applications, comprehensively examine their needs and the influencing factors of using applications to support the rehabilitation of older patients with hip fractures.DesignA qualitative descriptive study employing semi-structured interviews was conducted to collect data between April 2025 and June 2025. The data was analysed using content analysis.SettingThe orthopaedic ward of a 3000-bed tertiary comprehensive teaching hospital in Hunan Province, China.ParticipantsPurposive sampling was conducted to select participants. A total of 21 family caregivers were finally interviewed.ResultsThe study identified two key dimensions: user needs and influencing factors, each containing six themes. User needs included content requirements (information and knowledge) and features and functionality (user information management, communication with orthopaedic surgeons, cross-platform and interdisciplinary collaboration, information delivery modalities and task reminders). Influencing factors comprised user-related (user characteristics, patient recovery outcomes, previous experiences and attitudes towards mobile health applications resources, concerns about privacy and information); technology-related (user-friendly and functional, information quality and personalisation).ConclusionThe findings of this study contribute to the development of mobile health applications tailored for family caregivers. Healthcare providers and researchers should recognise and address caregivers' needs and influencing factors to optimise application functionality, thereby enhancing patient recovery outcomes and reducing caregiver burden.
Effect of Femoral Nerve Neurodynamic Techniques on Pain in Patellofemoral Pain Syndrome: A Randomised Controlled Trial.
Gerami R, Abbaszadeh-Amirdehi M, Talebi G … +2 more , Sepidarkish M, Tavassoli M
Clin Rehabil · 2026 Jun · PMID 42223246 · Publisher ↗
DesignA randomised controlled trial was designed to evaluate the added value of femoral nerve neurodynamic techniques on knee pain and function in patients with patellofemoral pain syndrome. University Physiotherapy Clin...
DesignA randomised controlled trial was designed to evaluate the added value of femoral nerve neurodynamic techniques on knee pain and function in patients with patellofemoral pain syndrome. University Physiotherapy Clinic. 71 patients with unilateral patellofemoral pain syndrome aged 18-45 years were randomised. Patients were assigned to either the treatment group, receiving femoral nerve neurodynamic techniques and standard physiotherapy, or the control group, receiving standard physiotherapy alone, for 10 sessions. Outcome measures include visual analogue scales at rest and during activity, functional ability measured with the Kujala patellofemoral score, and the range of hip extension recorded at baseline and immediately post-intervention.ResultsAfter 10 sessions, the combined effect of femoral nerve neurodynamic techniques and standard physiotherapy showed significantly greater improvements in pain scores compared with the standard physiotherapy alone: pain at squat (adjusted mean difference: -6.12, 95% CI: -10.37, -1.87), pain at stair (adjusted mean difference: -7.76, 95% CI: -12.01, -3.53), pain at kneel (adjusted mean difference: -6.57, 95% CI: -9.97, -3.17), and pain at sitting (adjusted mean difference: -5.31, 95% CI: -8.88, -1.74). Additional benefits were observed in knee function (adjusted mean difference: 7.06, 95% CI: 4.56, 9.55) and hip extension (adjusted mean difference: 2.09, 95% CI: 1.27, 2.90).ConclusionsThe combination of femoral nerve neurodynamic techniques with standard physiotherapy demonstrated promising short-term reductions in knee pain and improvements in function among patients with patellofemoral pain syndrome. These findings suggest that femoral nerve neurodynamic techniques may offer additional benefits as an adjunct therapy, although further research with longer follow-up is needed to confirm the durability of these effects.
Patient and Public Involvement in Prehabilitation: A Systematic Review.
Muir R, Rattray M, Zimmerman PA … +2 more , Carlini J, Lin FF
Clin Rehabil · 2026 Jun · PMID 42223196 · Publisher ↗
ObjectiveTo systematically evaluate the extent and quality of patient and public involvement (PPI) reporting in prehabilitation programmes and research.Data SourcesKeyword searches were conducted in MEDLINE, EMBASE, CINA...
ObjectiveTo systematically evaluate the extent and quality of patient and public involvement (PPI) reporting in prehabilitation programmes and research.Data SourcesKeyword searches were conducted in MEDLINE, EMBASE, CINAHL, PsycINFO and the Cochrane Central Register of Controlled Trials from 1 January 1994 to 22 October 2025.Review methodsUsing an a priori protocol registered with PROSPERO, a systematic review was conducted in accordance with PRISMA guidelines. A narrative synthesis approach was used to interpret findings across heterogeneous studies. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT). A patient representative contributed to the study design and co-authored the review.ResultsFrom 14,078 records, 16 studies reporting PPI were included from the UK, Australia, Canada, USA and Spain. Most studies involved patients at multiple stages, using varied approaches including experience-based co-design. Reporting quality was suboptimal; only three studies met all items of the GRiPP2-SF checklist criteria, and none used a formal PPI reporting checklist tool.ConclusionFew prehabilitation programmes are designed with patient and public involvement; highlighting the need for collaborative approaches to improve acceptability and adherence. Although evidence of PPI is limited, several studies demonstrated sustained and meaningful involvement. Reporting remains inconsistent, underscoring the need for clearer reporting to strengthen the evidence base and support wider adoption. The findings highlight substantial opportunities for collaboration in future programmes, and further research should examine how PPI influences adherence, patient experience and the overall effectiveness of prehabilitation interventions.
Improving work outcomes in people with multiple sclerosis: A scoping review of non-pharmacological interventions.
Saddal SR, De Dios Perez B, Machado A … +8 more , Friberg E, das Nair R, Radford K, Daams JG, Hulst HE, de Groot V, van der Hiele K, Schaafsma F
Clin Rehabil · 2026 May · PMID 42183671 · Publisher ↗
ObjectiveTo evaluate the effectiveness of non-pharmacological intervention studies on work outcomes in people with multiple sclerosis (MS).Data sourcesWe searched three electronic databases (MEDLINE, PsycINFO, and Web of...
ObjectiveTo evaluate the effectiveness of non-pharmacological intervention studies on work outcomes in people with multiple sclerosis (MS).Data sourcesWe searched three electronic databases (MEDLINE, PsycINFO, and Web of Science: Conference Proceeding Citation Index) and included studies reporting on having/returning to paid employment, work productivity, or factors related to work ability.Review methodsThe Cochrane Handbook for Systematic Reviews of Interventions and the PRISMA extension for scoping reviews checklist were followed. All steps were conducted by two reviewers.ResultsThe search (inception-April 2026) yielded 10449 articles. Sixteen studies were included: four vocational, seven psychological, one exercise, and four combining these intervention types. Reported work outcomes included employment status, work difficulties, workplace accommodations, promotions, impact on work and education, work productivity and impairment, and work and social adjustment. Eight studies aimed to improve work outcomes. Five interventions demonstrated significant improvement: two targeting fatigue with cognitive behavioral therapy (β = -0.34, 95% CI: -0.66 to -0.03; β = -3.68, 95% CI: -5.82 to -1.537), one on conscientiousness (effect size not reported), one on information processing speed (2 = 0.04, = 0.044), and one on job seeking (career goals and appraisal of potential work difficulties ( = -2.68, = 0.009), self-esteem ( = 2.47, = 0.016), relations ( = 2.44, = 0.017), finances ( = 2.14, = 0.036)).ConclusionFew non-pharmacological interventions evaluate work outcomes. Cognitive behavioral therapy targeting MS-related fatigue shows promise for improving work outcomes. The heterogeneity of MS and variability in work contexts add challenges, indicating that personalized interventions may ultimately prove more effective than generic approaches.
Psychometric properties of the Minnesota manual dexterity test in people with multiple sclerosis.
Eldemir K, Eldemir S, Gökçe ŞF
Clin Rehabil · 2026 May · PMID 42183667 · Publisher ↗
ObjectiveThe loss of manual dexterity significantly an impact is a key determinant directly influencing quality of life, social participation, and interaction in people with multiple sclerosis, making its assessment vita...
ObjectiveThe loss of manual dexterity significantly an impact is a key determinant directly influencing quality of life, social participation, and interaction in people with multiple sclerosis, making its assessment vital. This study aimed to determine the validity and reliability of the Minnesota Manual Dexterity Test in people with multiple sclerosis and the cut-off times that differentiate from healthy controls.DesignA cross-sectional study.SettingOutpatient clinic.ParticipantsSixty people with multiple sclerosis and thirty-five healthy controls. Forty PwMS performed the Minnesota Manual Dexterity Test on two occasions 1 week apart for reliability.Main measuresThe Minnesota Manual Dexterity Test was administered along with the 9-Hole Peg Test, Jebsen Taylor Hand Function Test, ABILHAND questionnaire, and disability level.ResultsThe Minnesota Manual Dexterity Test demonstrated excellent test-retest reliability (Intraclass correlation coefficients = 0.91-0.99). The minimum detectable change values of subtests ranged from 3.66-19.97. The Minnesota Manual Dexterity Test showed a fair to excellent positive correlation with the 9-Hole Peg Test, Jebsen Taylor Hand Function Test, and disability level ( = 0.38- = 0.76, < 0.05), and fair to moderate negative correlations with the ABILHAND questionnaire ( = -0.29 to -0.59). Cut-off times were established ranging from 39.05 to 66.87 s depending on the subtest of Minnesota Manual Dexterity Test.ConclusionsThe Minnesota Manual Dexterity Test has advantages such as evaluating bilateral hand functions, hand-eye coordination, and gross motor skills that are not found in many other manual dexterity assessment tools. The test is adequately valid, reliable and clinically usable for assessing manual dexterity in people with multiple sclerosis. ClinicalTrials.gov (NCT06704464).
Validation and fidelity testing of a screening tool to identify patients' communication needs during mental capacity assessments: The Mental Capacity Assessment Support Toolkit Communication Screening Tool (MCAST CST).
Jayes M, Baines K, Beech P … +4 more , Demeyere N, Heal C, Pearl G, Palmer R
Clin Rehabil · 2026 May · PMID 42183651 · Publisher ↗
ObjectiveTo establish the validity, reliability and fidelity of use of a screening tool for stroke survivors' communication support needs during mental capacity assessments.DesignCross-sectional psychometric study and mu...
ObjectiveTo establish the validity, reliability and fidelity of use of a screening tool for stroke survivors' communication support needs during mental capacity assessments.DesignCross-sectional psychometric study and multiple methods case series.SettingParticipants' homes and stroke units in north-west England.ParticipantsPsychometrics: 47 community-dwelling stroke survivors; 10 speech and language therapists experienced in stroke. Fidelity: four nurses and one occupational therapist working in stroke; eight inpatients diagnosed with stroke.Main measuresPsychometrics: Stroke survivors were tested using the new communication screening tool and subtests from the Western Aphasia Battery Revised and Comprehensive Aphasia Test to measure convergent and discriminant validity, test-retest and interrater reliability. Data were analysed using Kendall's Tau, Goodman-Kruskal's Gamma and Cohen's Kappa.FidelityThe nurses and occupational therapist were videorecorded using the screening tool with inpatients. An observational checklist and semi-structured interviews were used to investigate adherence to predefined administration behaviours. Data were analysed using descriptive statistics and qualitative content analysis.ResultsPsychometrics: Screening tool subtests demonstrated moderate-to-strong convergent validity ( = 0.41-0.72) but poor discriminant validity ( = 0.27-0.58). Criterion validity was strong ( = 0.77, 95%CI 0.57-0.98). Test-retest reliability ranged from substantial to near-perfect ( = 0.68-0.95). Interrater agreement ranged from substantial to perfect ( = 0.65-1.00).FidelityParticipants adhered to a mean of 85.79% (SD = 10.33) administration behaviours. User errors related to task instruction delivery and scoring. All participants found the tool easy to use and useful.ConclusionsThis unique screening tool for stroke survivors' communication support needs during mental capacity assessments is valid and reliable. Minor refinements to administration training will improve fidelity of use.
Prehabilitation before hip arthroscopy for femoroacetabular impingement syndrome: A randomised controlled trial.
Li M, Jiang C, Wang R … +5 more , Huang L, Ma Y, Shen Y, Yin J, Lu S
Clin Rehabil · 2026 May · PMID 42159265 · Publisher ↗
DesignPragmatic, two-arm, parallel-group, superiority randomised controlled trial with assessor-blinding and statistician-blinding.SettingSingle orthopaedic centre in Shanghai, China.ParticipantsOne hundred and eighty ad...
DesignPragmatic, two-arm, parallel-group, superiority randomised controlled trial with assessor-blinding and statistician-blinding.SettingSingle orthopaedic centre in Shanghai, China.ParticipantsOne hundred and eighty adults (aged 18-50 years) with femoroacetabular impingement syndrome scheduled for hip arthroscopy were randomised to prehabilitation ( = 90) or usual care ( = 90).InterventionThe prehabilitation group received 6 weeks of supervised exercise, education and home activity before surgery. Controls received standard preoperative advice. All patients received identical postoperative rehabilitation.Main measuresThe primary outcome was the Harris Hip Score at 24 weeks. Secondary outcomes included pain, maximal hip muscle strength, range of motion, dynamic balance, quality of life, mental health and cost.ResultsAt 24 weeks, the Harris Hip Score did not differ significantly between groups (adjusted between-group difference 0.98 points [95% CI -0.11 to 2.07], p = 0.08). At 4 and 12 weeks, differences numerically favoured prehabilitation (1.52 points, uncorrected p = 0.02; 1.14 points, uncorrected p = 0.04) but did not reach significance after Bonferroni correction (threshold p < 0.0167). Secondary outcomes favoured prehabilitation, including pain, maximal hip strength, range of motion and dynamic balance, though all between-group differences were below published thresholds for clinically important change.ConclusionsPrehabilitation before hip arthroscopy for femoroacetabular impingement syndrome was associated with small early improvements that did not reach statistical significance for the primary outcome after correction for multiple comparisons and were below clinically important thresholds. Total costs did not differ significantly between groups.Trial registration numberChiCTR2500113298 (Chinese Clinical Trial Registry, https://www.chictr.org.cn/, date of registration: 26 November 2025). This trial was registered retrospectively.
Association between postoperative rehabilitation pathway, dose, and three-year mortality in older adults with hip fracture: A nationwide retrospective cohort study.
Huang CC, Chu YC, Chen LH … +3 more , Chen WD, Yang FA, Lee HC
Clin Rehabil · 2026 May · PMID 42153996 · Publisher ↗
ObjectiveTo quantify the long-term survival associations of different rehabilitation pathways and dosages in older adults after hip fracture within a health system characterised by ultra-short hospital stays (seven to 10...
ObjectiveTo quantify the long-term survival associations of different rehabilitation pathways and dosages in older adults after hip fracture within a health system characterised by ultra-short hospital stays (seven to 10 days).DesignA nationwide, population-based, retrospective cohort study.SettingTaiwan's National Health Insurance Research Database (2005-2013).ParticipantsA total of 10,142 older adults [mean age 79.8 (SD 7.0) years; 62.7% (n = 6361) female] undergoing first surgical repair for fragility hip fracture.InterventionsParticipants were categorised based on postoperative rehabilitation receipt (users versus non-users), delivery pathway (inpatient only, outpatient only, or integrated inpatient-to-outpatient), and intensity (dosage, defined as administrative billing sessions: one to three sessions versus four or more sessions).Main measuresThe primary outcome was three-year all-cause mortality (33.2%, = 3363 out of 10,142). Multivariable Cox proportional hazards models were used to estimate adjusted hazard ratios, controlling for potential confounders.ResultsA substantial care gap was identified, with 55.8% ( = 5659) of participants receiving no postoperative rehabilitation. Any rehabilitation was associated with a 17% lower mortality risk (adjusted hazard ratio 0.83; 95% confidence interval 0.77 to 0.89). The strongest association was observed in the integrated inpatient-to-outpatient pathway (0.67; 0.57-0.79). A dose-response pattern was observed, with participants receiving four or more sessions achieving a significantly lower mortality risk (0.71; 0.64-0.80) compared to those receiving no rehabilitation.ConclusionsIn a system emphasising early discharge, lack of rehabilitation is common and associated with higher mortality. Integrated, higher-dose rehabilitation was consistently associated with lower mortality.
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