Mention de date : 2016
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Dépouillements
Ajouter le résultat dans votre panierCaregiver Factors in Stroke: Are They the Missing Piece of the Puzzle? / Peck-Hoon Ong in Archives of Physical Medicine and Rehabilitation, 2016/8 (2016)
Titre : Caregiver Factors in Stroke: Are They the Missing Piece of the Puzzle? Type de document : Article Auteurs : Peck-Hoon Ong ; Gerald Choon-Huat Koh Article en page(s) : pp. 1223–1225 Langues : Anglais (eng) Descripteurs : HE Vinci
Aidants ; Rééducation et réadaptationMots-clés : Caregivers Résumé : Stroke is a major global health problem and a leading cause of long-term disability. As health care professionals working with these patients, we work closely with their caregivers because we recognize the crucial role they play in our patients' recovery. Increasingly, the effect of patient factors on caregiver outcomes is being studied. However, the effect of the reverse relationship of caregiver factors on patient outcomes has received much less attention, although there is evidence that social and family support can positively (and sometimes negatively) affect patient outcomes. A better understanding of this relationship may have implications for rehabilitation research, professional practice, and policy directions in terms of resource allocation. DOI : https://doi.org/10.1016/j.apmr.2016.02.001 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117981
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1223–1225[article]
Titre : Safety and Efficacy of an Early Home-Based Walking Program After Receipt of an Initial Implantable Cardioverter-Defibrillator Type de document : Article Auteurs : Emily T. Lau ; Elaine A. Thompson ; Robert L. Burr Article en page(s) : pp. 1228–1236 Langues : Anglais (eng) Descripteurs : HE Vinci
Electrochoc ; Exercice physique ; Rééducation et réadaptationMots-clés : Defibrillators Implantable Défibrillateurs implantables Early Ambulation Lever précoce Exercise Electroshock Self Efficacy Auto-efficacité Résumé : Objective
To assess the safety and efficacy of an early home-based walking program for first-time implantable cardioverter-defibrillator (ICD) recipients.
Design
Pre-post intervention trial.
Setting
Institutional and private practice.
Participants
Cardiac patients (N=301) with an initial ICD implantation for primary or secondary prevention; able to read, speak, and write English; and having access to telephone.
Interventions
Early home-based walking protocol implemented 1-month post-ICD implant. Exercise tolerance monitored by study nurses via telephone.
Main Outcome Measures
Safety assessment was based on the frequency of ICD therapies and hospitalizations, and efficacy assessment was based on pedometer measures and self-report of ICD self-efficacy and physical activity.
Results
ICD recipients were on average 64.1+11.9 years old, predominantly men, and white, with an ejection fraction of Conclusions
Early ambulation after an initial ICD was safe and effective, with few ICD shocks and improved efficacy.DOI : https://doi.org/10.1016/j.apmr.2016.02.007 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117982
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1228–1236[article]
Titre : Home-Based Versus Laboratory-Based Robotic Ankle Training for Children With Cerebral Palsy: A Pilot Randomized Comparative Trial Type de document : Article Auteurs : Kai Chen ; Yi-Ning Wu ; Yupeng Ren Article en page(s) : pp. 1237–1243 Langues : Anglais (eng) Descripteurs : HE Vinci
Cheville ; Mouvement du corps ; Paralysie cérébrale ; Rééducation et réadaptation ; RobotiqueMots-clés : Ankle Cerebral palsy Movement Muscle hypertonia Hypertonie musculaire Robotics Résumé : Objective
To examine the outcomes of home-based robot-guided therapy and compare it to laboratory-based robot-guided therapy for the treatment of impaired ankles in children with cerebral palsy.
Design
A randomized comparative trial design comparing a home-based training group and a laboratory-based training group.
Setting
Home versus laboratory within a research hospital.
Participants
Children (N=41) with cerebral palsy who were at Gross Motor Function Classification System level I, II, or III were randomly assigned to 2 groups. Children in home-based and laboratory-based groups were 8.7+2.8 (n=23) and 10.7+6.0 (n=18) years old, respectively.
Interventions
Six-week combined passive stretching and active movement intervention of impaired ankle in a laboratory or home environment using a portable rehabilitation robot.
Main Outcome Measures
Active dorsiflexion range of motion (as the primary outcome), mobility (6-minute walk test and timed Up and Go test), balance (Pediatric Balance Scale), Selective Motor Control Assessment of the Lower Extremity, Modified Ashworth Scale (MAS) for spasticity, passive range of motion (PROM), strength, and joint stiffness.
Results
Significant improvements were found for the home-based group in all biomechanical outcome measures except for PROM and all clinical outcome measures except the MAS. The laboratory-based group also showed significant improvements in all the biomechanical outcome measures and all clinical outcome measures except the MAS. There were no significant differences in the outcome measures between the 2 groups.
Conclusions
These findings suggest that the translation of repetitive, goal-directed, biofeedback training through motivating games from the laboratory to the home environment is feasible. The benefits of home-based robot-guided therapy were similar to those of laboratory-based robot-guided therapy.DOI : https://doi.org/10.1016/j.apmr.2016.01.029 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117983
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1237–1243[article]
Titre : Effects of Twice-Weekly Intense Aerobic Exercise in Early Subacute Stroke: A Randomized Controlled Trial Type de document : Article Auteurs : Klas Sandberg ; Marie Kleist ; Lars Falk Article en page(s) : pp. 1244–1253 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Exercice physique ; Qualité de vie ; Rééducation et réadaptationMots-clés : Exercise Quality of life Randomized controlled trial Essai contrôlé randomisé Stroke Résumé : Objective
To examine the effects of 12 weeks of twice-weekly intensive aerobic exercise on physical function and quality of life after subacute stroke.
Design
Randomized controlled trial.
Setting
Ambulatory care.
Participants
Patients (N=56; 28 women) aged ≥50 years who had a mild stroke (98% ischemic) and were discharged to independent living and enrolled 20 days (median) after stroke onset.
Interventions
Sixty minutes of group aerobic exercise, including 2 sets of 8 minutes of exercise with intensity up to exertion level 14 or 15 of 20 on the Borg rating of perceived exertion scale, twice weekly for 12 weeks (n=29). The nonintervention group (n=27) received no organized rehabilitation or scheduled physical exercise.
Main Outcome Measures
Primary outcome measures included aerobic capacity on the standard ergometer exercise stress test (peak work rate) and walking distance on the 6-minute walk test (6MWT). Secondary outcome measures included maximum walking speed for 10m, balance on the timed Up and Go (TUG) test and single leg stance (SLS), health-related quality of life on the European Quality of Life Scale (EQ-5D), and participation and recovery after stroke on the Stroke Impact Scale (SIS) version 2.0 domains 8 and 9. Participants were evaluated pre- and postintervention. Patient-reported measures were also evaluated at 6-month follow-up.
Results
The following improved significantly more in the intervention group (pre- to postintervention): peak work rate (group * time interaction, P=.006), 6MWT (P=.011), maximum walking speed for 10m (P<.001 tug test sls right and left open p=".022," respectively closed aerobic exercise was associated with improved eq-5d scores analog scale perceived recovery domain these patient-reported improvements persisted at follow-up.> Conclusions
Intensive aerobic exercise twice weekly early in subacute mild stroke improved aerobic capacity, walking, balance, health-related quality of life, and patient-reported recovery.DOI : https://doi.org/10.1016/j.apmr.2016.01.030 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117984
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1244–1253[article]
Titre : Thalamic Functional Connectivity in Mild Traumatic Brain Injury: Longitudinal Associations With Patient-Reported Outcomes and Neuropsychological Tests Type de document : Article Auteurs : Sarah D. Banks ; Rogelio A. Coronado ; Lori R. Clemons Article en page(s) : pp. 1254–1261 Langues : Anglais (eng) Descripteurs : HE Vinci
Imagerie par résonance magnétique ; Rééducation et réadaptation ; ThalamusMots-clés : Brain injuries Lésions encéphaliques Functional neuroimaging Neuroimagerie fonctionnelle Magnetic resonance imaging Neuropsychological tests Tests neuropsychologiques Résumé : Objectives
(1) To examine differences in patient-reported outcomes, neuropsychological tests, and thalamic functional connectivity (FC) between patients with mild traumatic brain injury (mTBI) and individuals without mTBI and (2) to determine longitudinal associations between changes in these measures.
Design
Prospective observational case-control study.
Setting
Academic medical center.
Participants
A sample (N=24) of 13 patients with mTBI (mean age, 39.3+14.0y; 4 women [31%]) and 11 age- and sex-matched controls without mTBI (mean age, 37.6+13.3y; 4 women [36%]).
Interventions
Not applicable.
Main Outcome Measures
Resting state FC (3T magnetic resonance imaging scanner) was examined between the thalamus and the default mode network, dorsal attention network, and frontoparietal control network. Patient-reported outcomes included pain (Brief Pain Inventory), depressive symptoms (Patient Health Questionnaire-9), posttraumatic stress disorder ([PTSD] Checklist – Civilian Version), and postconcussive symptoms (Rivermead Post-Concussion Symptoms Questionnaire). Neuropsychological tests included the Delis-Kaplan Executive Function System Tower test, Trails B, and Hotel Task. Assessments occurred at 6 weeks and 4 months after hospitalization in patients with mTBI and at a single visit for controls.
Results
Student t tests found increased pain, depressive symptoms, PTSD symptoms, and postconcussive symptoms; decreased performance on Trails B; increased FC between the thalamus and the default mode network; and decreased FC between the thalamus and the dorsal attention network and between the thalamus and the frontoparietal control network in patients with mTBI as compared with controls. The Spearman correlation coefficient indicated that increased FC between the thalamus and the dorsal attention network from baseline to 4 months was associated with decreased pain and postconcussive symptoms (corrected P<.05> Conclusions
Findings suggest that alterations in thalamic FC occur after mTBI, and improvements in pain and postconcussive symptoms are correlated with normalization of thalamic FC over time.DOI : https://doi.org/10.1016/j.apmr.2016.03.013 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117985
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1254–1261[article]
Titre : Adherence of Individuals in Upper Extremity Rehabilitation: A Qualitative Study Type de document : Article Auteurs : Enrique V. Smith-Forbes ; Dana M. Howell ; Jason Willoughby Article en page(s) : pp. 1262–1268 Langues : Anglais (eng) Descripteurs : HE Vinci
Membre supérieur ; Observance par le patient ; Recherche qualitative ; Rééducation et réadaptationMots-clés : Patient satisfaction Satisfaction du patient Qualitative research Upper extremity Résumé : Objective
To describe the rehabilitation experiences, expectations, and treatment adherence of patients receiving upper extremity (UE) rehabilitation who demonstrated discrepancy between functional gains and overall improvement.
Design
Qualitative (phenomenologic) interviews and analysis.
Setting
Outpatient UE rehabilitation.
Participants
Patients with acute UE injuries (N=10).
Interventions
Not applicable.
Main Outcome Measure
Concerns related to UE rehabilitation patients demonstrating discrepancy between outcome measures.
Results
Five key themes emerged from the interviews of patients demonstrating discrepancy in their self-reported patient outcomes: (1) desire to return to normal, (2) initial anticipation of brief recovery, (3) trust of therapist, (4) cannot stop living, and (5) feelings of ambivalence. Challenges included living with the desire to move back into life. Multiple factors affected patient adherence: cost of treatment, patient-provider relation (difference between therapist and patient understanding on what is important for treatment), and patients expecting the treating therapists to be an expert and fix their problem.
Conclusions
Patient adherence to UE rehabilitation presents many challenges. Patients view themselves as laypersons and seek the knowledge of a dedicated therapist who they trust to spend time with them to understand what they value as important and clarify their injury, collaboratively make goals, and explain the intervention to get them in essence, back into life, in the minimal required time. When categorized according to the World Health Organization's multidimensional adherence model, domains identified in this model include social and economic, health care team and system, condition-related, therapy-related, and patient-related dimensions. Assessing factors identified to improve efficiency and effectiveness of clinical management can enhance patient adherence.DOI : https://doi.org/10.1016/j.apmr.2015.11.008 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117986
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1262–1268[article]
Titre : Swimming Improves Pain and Functional Capacity of Patients With Fibromyalgia: A Randomized Controlled Trial Type de document : Article Auteurs : Giovana Fernandes ; Fabio Jennings ; Michele Vieira Nery Cabral Article en page(s) : pp. 1269–1275 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Fibromyalgie ; Natation ; Rééducation et réadaptation ; ThérapeutiqueMots-clés : Exercise Fibromyalgia Swimming Therapeutics Résumé : Objective
To evaluate the effect of swimming on pain, functional capacity, aerobic capacity, and quality of life in patients with fibromyalgia (FM).
Design
Randomized controlled trial.
Setting
Rheumatology outpatient clinics of a university hospital.
Participants
Women with FM (N=75; age range, 18–60y) randomly assigned to a swimming group (SG) (n=39) or a walking group (WG) (n=36).
Intervention
The SG performed 50 minutes of swimming 3 times a week for 12 weeks, with a heart rate at 11 beats under the anaerobic threshold. The WG performed walking with a heart rate at the anaerobic threshold, with the same duration and frequency as the SG.
Main Outcome Measures
Participants were evaluated before the exercise protocols (t0), at 6 weeks (t6), and at 12 weeks (t12) after the onset of the protocols. The primary outcome measure was the visual analog scale for pain. The secondary measurements were the Fibromyalgia Impact Questionnaire and the Medical Outcomes Study 36-Item Short-Form Health Survey for quality of life; a spiroergometric test for cardiorespiratory variables; and the timed Up & Go test for functional performance.
Results
Patients in both groups experienced improvement in pain after the 12-week program, with no difference between groups (P=.658). The same results were found regarding functional capacity and quality of life. Moreover, no statistical difference between groups was found regarding aerobic capacity over time.
Conclusions
Swimming, like walking, is an effective method for reducing pain and improving both functional capacity and quality of life in patients with FM.DOI : https://doi.org/10.1016/j.apmr.2016.01.026 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117987
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1269–1275[article]
Titre : What Are the Determinants of Specialized Outpatient and Dental Care Use in Adults With Disabilities Living in Institutions: Findings From a National Survey in France Type de document : Article Auteurs : Diane Naouri ; Clémence Bussière ; Nathalie Pelletier-Fleury Article en page(s) : pp. 1276–1283 Langues : Anglais (eng) Descripteurs : HE Vinci
Accessibilité des services de santé ; Etablissements de santé ; Facteurs socioéconomiques ; Personnes handicapées ; Recherche sur les services de santé ; Rééducation et réadaptationMots-clés : Disabled persons Health facilities Health services accessibility Health services research Socioeconomic factors Résumé : Objective
To explore the determinants of specialized outpatient care use (general practitioners excluded) in people with disabilities living in institutions.
Design
Cross-sectional study.
Setting
National health and disability survey.
Participants
People (N=2528) living in institutions for adults with cognitive, sensory, and mobility disabilities.
Interventions
Not applicable.
Main Outcome Measures
We used different measures of disability severity available in the survey: (1) the continuous score of limitations based on a measure we constructed according to self-reported level of difficulty performing 18 tasks without aid; (2) the Katz Index; and (3) the respondent's self-reported perception of functional limitations. Logistic regressions were performed to examine the determinants of the likelihood of having consulted a specialized outpatient care physician or a dentist at least once in the previous year.
Results
Of the 2528 individuals, 45% (1141) and 28% (697) had respectively consulted a specialized outpatient care physician or a dentist at least once in the previous year. After adjusting for health care needs, higher functional limitation scores, dependency in all 6 activities of daily living, and self-reported perceptions of severe functional limitations were significantly associated with a lower likelihood of having consulted a specialized outpatient care physician (adjusted odds ratio [AOR], .95 [95% confidence interval {CI}, .94–.96]; AOR, .29 [95% CI, .23–.38]; and AOR, .51 [95% CI, .42–.62], respectively) or a dentist (AOR, .95 [95% CI, .94–.96]; AOR, .29 [95% CI, .21–.39]; AOR, .55 [95% CI, .44–.67], respectively) at least once in the previous year. Being a man, reporting a lack of family support, and having a low socioeconomic status also significantly affected specialized outpatient care use.
Conclusions
Regardless of the method used to define and measure disability, a high degree of disability negatively affects specialized outpatient care use after adjusting for health care need. Further studies are needed to better understand the reasons why this association between the degree of functional limitation and unmet medical needs is also a reality for people with disabilities living in institutions.DOI : https://doi.org/10.1016/j.apmr.2016.01.028 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117988
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1276–1283[article]
Titre : Measuring Access to Information and Technology: Environmental Factors Affecting Persons With Neurologic Disorders Type de document : Article Auteurs : Elizabeth A. Hahn ; Sofia F. Garcia ; Jin-Shei Lai Article en page(s) : pp. 1284–1294 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptationMots-clés : Access to information Accès à l'information Attitude to computers Attitude devant l'ordinateur Patient outcome assessment Évaluation des résultats des patients Résumé : Objective
To develop and validate a patient-reported measure of access to information and technology (AIT) for persons with spinal cord injury, stroke, or traumatic brain injury.
Design
A mixed-methods approach was used to develop items, refine them through cognitive interviews, and evaluate their psychometric properties. Item responses were evaluated with the Rasch rating scale model. Correlational and analysis-of-variance methods were used to evaluate construct validity.
Setting
Community-dwelling individuals participated in telephone interviews or traveled to the academic medical centers where this research took place.
Participants
Individuals with a diagnosis of spinal cord injury, stroke, or traumatic brain injury (aged ≥18y, English speaking) participated in cognitive interviews (n=12 persons), field testing of the items (n=305 persons), and validation testing of the final set of items (n=604 persons).
Interventions
Not applicable.
Main Outcome Measures
A set of items to measure AIT for people with disabilities.
Results
A user-friendly multimedia touchscreen was used for self-administration of the items. A 23-item AIT measure demonstrated good evidence of internal consistency reliability, and content and construct validity.
Conclusions
This new AIT measure will enable researchers and clinicians to determine to what extent environmental factors influence health outcomes and social participation in people with disabilities. The AIT measure could also provide disability advocates with more specific and detailed information about environmental factors to lobby for elimination of barriers.DOI : https://doi.org/10.1016/j.apmr.2016.01.027 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117989
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1284–1294[article]
Titre : Detection and Interpretation of Impossible and Improbable Coma Recovery Scale-Revised Scores Type de document : Article Auteurs : Camille Chatelle ; Yelena G. Bodien ; Cecilia Carlowicz Article en page(s) : pp. 1295–1300 Langues : Anglais (eng) Descripteurs : HE Vinci
Évaluation de résultat (soins) ; Rééducation et réadaptationMots-clés : Brain injuries Lésions encéphaliques Consciousness disorders Troubles de la conscience Outcome assessment (health care) Résumé : Objective
To determine the frequency with which specific Coma Recovery Scale-Revised (CRS-R) subscale scores co-occur as a means of providing clinicians and researchers with an empirical method of assessing CRS-R data quality.
Design
We retrospectively analyzed CRS-R subscale scores in hospital inpatients diagnosed with disorders of consciousness (DOCs) to identify impossible and improbable subscore combinations as a means of detecting inaccurate and unusual scores. Impossible subscore combinations were based on violations of CRS-R scoring guidelines. To determine improbable subscore combinations, we relied on the Mahalanobis distance, which detects outliers within a distribution of scores. Subscore pairs that were not observed at all in the database (ie, frequency of occurrence=0%) were also considered improbable.
Setting
Specialized DOC program and university hospital.
Participants
Patients diagnosed with DOCs (N=1190; coma: n=76, vegetative state: n=464, minimally conscious state: n=586, emerged from minimally conscious state: n=64; 794 men; mean age, 43+20y; traumatic etiology: n=747; time postinjury, 162+568d).
Interventions
Not applicable.
Main Outcome Measure
Impossible and improbable CRS-R subscore combinations.
Results
Of the 1190 CRS-R profiles analyzed, 4.7% were excluded because they met scoring criteria for impossible co-occurrence. Among the 1137 remaining profiles, 12.2% (41/336) of possible subscore combinations were classified as improbable.
Conclusions
Clinicians and researchers should take steps to ensure the accuracy of CRS-R scores. To minimize the risk of diagnostic error and erroneous research findings, we have identified 9 impossible and 36 improbable CRS-R subscore combinations. The presence of any one of these subscore combinations should trigger additional data quality review.DOI : https://doi.org/10.1016/j.apmr.2016.02.009 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117990
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1295–1300[article]
Titre : Acute Trauma Factor Associations With Suicidality Across the First 5 Years After Traumatic Brain Injury Type de document : Article Auteurs : Matthew R. Kesinger ; Shannon B. Juengst ; Hillary Bertisch Article en page(s) : pp. 1301–1308 Langues : Anglais (eng) Descripteurs : HE Vinci
Idéation suicidaire ; Polytraumatisme ; Rééducation et réadaptation ; SuicideMots-clés : Brain injuries Lésions encéphaliques Injury Severity Score Score de gravité des lésions traumatiques Multiple trauma Suicidal ideation attempted Tentative de suicide Résumé : Objective
To determine whether severity of head and extracranial injuries (ECI) is associated with suicidal ideation (SI) or suicide attempt (SA) after traumatic brain injury (TBI).
Design
Factors associated with SI and SA were assessed in this inception cohort study using data collected 1, 2, and 5 years post-TBI from the National Trauma Data Bank and Traumatic Brain Injury Model Systems (TBIMS) databases.
Setting
Level I trauma centers, inpatient rehabilitation centers, and the community.
Participants
Participants with TBI from 15 TBIMS Centers with linked National Trauma Data Bank trauma data (N=3575).
Interventions
Not applicable.
Main Outcome Measures
SI was measured via the Patient Health Questionnaire 9 (question 9). SA in the last year was assessed via interview. ECI was measured by the Injury Severity Scale (nonhead) and categorized as none, mild, moderate, or severe.
Results
There were 293 (8.2%) participants who had SI without SA and 109 (3.0%) who had SA at least once in the first 5 years postinjury. Random effects logit modeling showed a higher likelihood of SI when ECI was severe (odds ratio=2.73; 95% confidence interval, 1.55–4.82; P=.001). Drug use at time of injury was also associated with SI (odds ratio=1.69; 95% confidence interval, 1.11–2.86; P=.015). Severity of ECI was not associated with SA.
Conclusions
Severe ECI carried a nearly 3-fold increase in the odds of SI after TBI, but it was not related to SA. Head injury severity and less severe ECI were not associated with SI or SA. These findings warrant additional work to identify factors associated with severe ECI that make individuals more susceptible to SI after TBI.DOI : https://doi.org/10.1016/j.apmr.2016.02.017 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117991
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1301–1308[article]
Titre : Relative Importance of Baseline Pain, Fatigue, Sleep, and Physical Activity: Predicting Change in Depression in Adults With Multiple Sclerosis Type de document : Article Auteurs : Karlyn A. Edwards ; Ivan R Molton ; Amanda E. Smith Article en page(s) : pp. 1309–1315 Langues : Anglais (eng) Descripteurs : HE Vinci
Dépression ; Douleur chronique ; Fatigue ; Rééducation et réadaptation ; Sclérose en plaques ; SommeilMots-clés : Chronic pain Multiple sclerosis Sleep Résumé : Objective
To determine whether baseline levels of pain, fatigue, sleep disturbance, and physical activity measured at the initial assessment predicted the development of or improvement of depression 3.5 years later, while controlling for sex, age, and disease severity.
Design
Observational, longitudinal survey study.
Setting
A community-based population sample.
Participants
Adults with multiple sclerosis (MS) (N=489).
Interventions
Not applicable.
Main Outcome Measure
Primary outcome was classification of depression group measured using a Patient Health Questionnaire-9 cutoff score ≥10, indicating probable major depression.
Results
Fatigue severity (odds ratio, 1.19; 95% confidence interval, 1.12–1.26; P<.0001 and sleep disturbance ratio confidence interval p=".001)" predicted probable major depression years later among those not depressed at the initial assessment. an effect of age .96 .92 was found who developed indicating that younger adults were more likely to develop depression. pain fatigue physical activity baseline significantly associated with recovery from> Conclusions
Fatigue and sleep may contribute to the development of depression. Clinical trial research targeting these variables to determine their influence on depression is warranted.DOI : https://doi.org/10.1016/j.apmr.2016.02.025 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117992
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1309–1315[article]
Titre : Neuromuscular Impairments Contributing to Persistently Poor and Declining Lower-Extremity Mobility Among Older Adults: New Findings Informing Geriatric Rehabilitation Type de document : Article Auteurs : Rachel E. Ward ; Marla K. Beauchamp ; Nancy K. Latham Article en page(s) : pp. 1316–1322 Langues : Anglais (eng) Descripteurs : HE Vinci
Force musculaire ; Mobilité réduite ; Rééducation et réadaptation ; Sujet âgéMots-clés : Aged Mobility limitation Muscle strength Range of Motion Articular Amplitude articulaire Résumé : Objective
To identify neuromuscular impairments most predictive of unfavorable mobility outcomes in late life.
Design
Longitudinal cohort study.
Setting
Research clinic.
Participants
Community-dwelling primary care patients aged ≥65 years (N=391) with self-reported mobility modifications, randomly selected from a research registry.
Interventions
Not applicable.
Main Outcome Measures
Categories of decline in and persistently poor mobility across baseline, 1 and 2 years of follow-up in the Lower-Extremity Function scales of the Late-Life Function and Disability Instrument. The following categories of impairment were assessed as potential predictors of mobility change: strength (leg strength), speed of movement (leg velocity, reaction time, rapid leg coordination), range of motion (ROM) (knee flexion/knee extension/ankle ROM), asymmetry (asymmetry of leg strength and knee flexion/extension ROM measures), and trunk stability (trunk extensor endurance, kyphosis).
Results
The largest effect sizes were found for baseline weaker leg strength (odds ratio [95% confidence interval]: 3.45 [1.72–6.95]), trunk extensor endurance (2.98 [1.56–5.70]), and slower leg velocity (2.35 [1.21–4.58]) predicting a greater likelihood of persistently poor function over 2 years. Baseline weaker leg strength, trunk extensor endurance, and restricted knee flexion motion also predicted a greater likelihood of decline in function (1.72 [1.10–2.70], 1.83 [1.13–2.95], and 2.03 [1.24–3.35], respectively).
Conclusions
Older adults exhibiting poor mobility may be prime candidates for rehabilitation focused on improving these impairments. These findings lay the groundwork for developing interventions aimed at optimizing rehabilitative care and disability prevention, and highlight the importance of both well-recognized (leg strength) and novel impairments (leg velocity, trunk extensor muscle endurance).DOI : https://doi.org/10.1016/j.apmr.2016.03.003 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117993
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1316–1322[article]
Titre : Episode-Based Payment for the Medicare Outpatient Therapy Benefit Type de document : Article Auteurs : Peter Amico ; Gregory C. Pope ; Ann Meadow Article en page(s) : pp. 1323–1328 Langues : Anglais (eng) Descripteurs : HE Vinci
Kinésithérapie (spécialité) ; Recherche sur les services de santéMots-clés : Episode of care Épisode de soins Health services research Physical therapy specialty Prospective payment system Système de paiements préétablis Résumé : Objective
To conduct an analysis of Medicare outpatient therapy episodes of care and associated payment implications.
Design
Retrospective observational design using Medicare claims data. To descriptively analyze the composition of outpatient therapy episodes, both variable- and fixed-length episodes are explored. The variable-length episode definition organizes services into episodes based on the time pattern of therapy service utilization, using 60-day clean periods. Fixed-length episodes are also examined, beginning with the first therapy utilization in calendar year 2010 and extending 30, 60, and 90 days.
Setting
The study is focused on community-dwelling users of outpatient therapy.
Participants
The sample includes all Medicare patients who used outpatient therapy beginning at any point in 2010.
Interventions
Not applicable.
Main Outcome Measures
Mean episode payments and episode lengths in calendar days.
Results
Variable-length outpatient therapy episodes have a mean payment of $881. On average, outpatient therapy episodes last 43 calendar days. Mean therapy durations for the 30-, 60-, and 90-day fixed-length episodes are 20, 31, and 38 calendar days, respectively. The 30-, 60-, and 90-day fixed-length initial episodes account for 40%, 55%, and 63%, respectively, of total Medicare payments. Simulations of episode-based payment illustrate the difficulty of avoiding a large number of substantial underpayments, because of the right-skewed distribution of total actual payments.
Conclusions
A strength of episode payment is that it reduces cost and potentially wasteful variation within episodes. Given the substantial variation in therapy episode expenditures, absent improvements in available data and in predictive information, a pure lump sum episode payment would result in substantial revenue changes for many episodes. Additional data are needed to better explain the wide variation in episode expenditures.DOI : https://doi.org/10.1016/j.apmr.2016.02.028 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117994
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1323–1328[article]
Titre : Longitudinal Association Between Gross Motor Capacity and Neuromusculoskeletal Function in Children and Youth With Cerebral Palsy Type de document : Article Auteurs : Rimke C. Vos ; Jules G. Becher ; Jeannine M. Voorman Article en page(s) : pp. 1329–1337 Langues : Anglais (eng) Descripteurs : HE Vinci
Adolescent ; Enfant (6-12 ans) ; Paralysie cérébrale ; Rééducation et réadaptationMots-clés : Cerebral palsy Child Motor disorders Troubles moteurs Résumé : Objective
To examine associations over longitudinal measurements between neuromusculoskeletal function and gross motor capacity in children and youth with cerebral palsy (CP).
Design
A prospective cohort study.
Setting
Rehabilitation departments of university medical centers and rehabilitations centers.
Participants
A sample (N=327) consisting of 148 children (aged 5–9y) and 179 youth (aged 11–20y) with CP, Gross Motor Function Classification System level I (n=180), level II (n=44), level III (n=36), level IV (n=34), and level V (n=33).
Interventions
Not applicable.
Main Outcome Measures
Gross motor capacity was assessed with the Gross Motor Function Measure-66 over a period of 2 to 4 years in different age cohorts. Neuromusculoskeletal function included selective motor control (SMC), muscle strength, spasticity, and range of motion (ROM) of the lower extremities.
Results
Multilevel analyses showed that SMC was significantly associated with gross motor capacity in children and youth with CP, showing higher values and a more favorable course of gross motor capacity in those with better SMC. Strength was only associated with gross motor capacity in youth. Reduced ROM of hip (children) and knee extension (youth) and spasticity of the hip adductors (youth) were additionally—but more weakly—associated with lower values and a less favorable course of gross motor capacity.
Conclusions
Results indicate that children and youth with more severely impaired SMC and youth with reduced muscle strength have a less favorable course of gross motor capacity, while spasticity and reduced ROM are less determinative.DOI : https://doi.org/10.1016/j.apmr.2016.03.012 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117995
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1329–1337[article]
Titre : Perceptions of Person-Centered Care Following Spinal Cord Injury Type de document : Article Auteurs : Allen W. Heinemann ; Sherri L. LaVela ; Bella Etingen Article en page(s) : pp. 1338–1344 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptation ; Soins centrés sur le patient ; Traumatismes de la moelle épinièreMots-clés : Patient-centered care Spinal cord injuries Résumé : Objectives
To (1) evaluate perceptions of person-centered care (PCC) in individuals with traumatic spinal cord injury (SCI); and (2) examine perceived differences in PCC concepts between patients continuing to receive any services from a Spinal Cord Injury Model Systems (SCIMS) facility and those who are not.
Design
We used a cross-sectional design, mailed a paper survey, and followed up with a second mailing to nonrespondents after 4 weeks.
Setting
Community.
Participants
Individuals (N=326) who received initial rehabilitation at an SCIMS facility and agreed to participate in this research study. We distinguished respondents who received any SCIMS outpatient services in the past 2 years (SCIMS users, n=137) or longer ago (SCIMS nonusers, n=189).
Interventions
Not applicable.
Main Outcome Measures
Participants completed the Patient Activation Measure (PAM), the Patient Assessment of Chronic Illness Care, the Global Practice Experience measure, and 5 Press-Ganey questions that assessed key elements of patient- and family-centered care.
Results
Patient perspectives of chronic illness care were more positive in the SCIMS users than nonusers (3.15 vs 2.91, P<.05 the difference is attributable primarily to higher subscale scores on goal setting and tailoring. scims users nonusers did not differ in terms of pam overall score or activation stage global practice experience press-ganey scores.> Conclusions
SCIMS users and nonusers differed on perceptions of chronic illness care (largely the goal-setting and tailoring component), which were more favorable for Model System users than nonusers. Results can guide strategies to enhance PCC practices after inpatient rehabilitation.DOI : https://doi.org/10.1016/j.apmr.2016.03.016 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117996
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1338–1344[article]
Titre : Rehabilitation of Swallowing and Cough Functions Following Stroke: An Expiratory Muscle Strength Training Trial Type de document : Article Auteurs : Karen Wheeler Hegland ; Paul W. Davenport ; Alexandra E. Brandimore Article en page(s) : pp. 1345–1351 Langues : Anglais (eng) Descripteurs : HE Vinci
Accident vasculaire cérébral (AVC) ; Exercices respiratoires ; Rééducation et réadaptation ; Toux ; Troubles de la déglutitionMots-clés : Breathing exercises Cough Deglutition disorders Stroke Résumé : Objective
To determine the effect of expiratory muscle strength training (EMST) on both cough and swallow function in stroke patients.
Design
Prospective pre-post intervention trial with 1 participant group.
Setting
Two outpatient rehabilitation clinics.
Participants
Adults (N=14) with a history of ischemic stroke in the preceding 3 to 24 months.
Intervention
EMST. The training program was completed at home and consisted of 25 repetitions per day, 5 days per week, for 5 weeks.
Main Outcome Measures
Baseline and posttraining measures were maximum expiratory pressure, voluntary cough airflows, reflex cough challenge to 200μmol/L of capsaicin, sensory perception of urge to cough, and fluoroscopic swallow evaluation. Repeated measures and 1-way analyses of variance were used to determine significant differences pre- and posttraining.
Results
Maximum expiratory pressure increased in all participants by an average of 30cmH2O posttraining. At baseline, all participants demonstrated a blunted reflex cough response to 200μmol/L of capsaicin. After 5 weeks of training, measures of urge to cough and cough effectiveness increased for reflex cough; however, voluntary cough effectiveness did not increase. Swallow function was minimally impaired at baseline, and there were no significant changes in the measures of swallow function posttraining.
Conclusions
EMST improves expiratory muscle strength, reflex cough strength, and urge to cough. Voluntary cough and swallow measures were not significantly different posttraining. It may be that stroke patients benefit from the training for upregulation of reflex cough and thus improved airway protection.DOI : https://doi.org/10.1016/j.apmr.2016.03.027 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117997
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1345–1351[article]
Titre : Systematic Review of Behavioral Interventions Targeting Social Communication Difficulties After Traumatic Brain Injury Type de document : Article Auteurs : Emma Finch ; Anna Copley ; Petrea Cornwell Article en page(s) : pp. 1352–1365 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptation ; Revue de la littératureMots-clés : Brain injuries Lésions encéphaliques Communication disorders Troubles de la communication Review Social communication disorder Trouble de la communication sociale Résumé : Objective
To determine whether behavioral interventions are beneficial for adults with social communication difficulties after traumatic brain injury (TBI).
Data Sources
Electronic databases were searched through October 2013 to find behavioral intervention trials. Keywords used in our search were intervention, therapy, treatment, and program combined with pragmatic disorder, pragmatic impairment, social communication disorder/impairment, conversation disorder/impairment, social disorder/impairment, cognitive-linguistic and cognitive-communication deficit; adult; and traumatic brain injury, head injury, and brain injury. Hand searches of the reference lists of relevant articles were also conducted.
Study Selection
To be selected for detailed review, articles found in the initial search were assessed by 2 reviewers and had to meet the following criteria: (1) population (adults with TBI); (2) intervention (behavioral intervention); and (3) outcomes (changes in social communication). Articles needed to describe interventions that were delivered directly to adults with TBI with or without other people (such as significant others) involved. Of the 2181 articles initially identified, 15 were selected for detailed review.
Data Extraction
Data were independently extracted by members of the research team, then collated and reviewed by the team.
Data Synthesis
Of the 15 publications that met the study criteria, 7 were single-case design studies, 3 were randomized controlled trials, 1 was a nonrandomized controlled trial, and 4 were cohort studies. The methodological qualities of eligible articles were examined using the Physiotherapy Evidence Database and Single-Case Experimental Design rating scales. The interventions described in the studies fell into 2 broad categories: those addressing a specific impairment in social communication, and context-specific interventions with a holistic focus on social communication skills. Studies using context-sensitive approaches had been published more recently and were generally group studies with higher methodological quality.
Conclusions
Overall, interventions addressing social communication skills for people with TBI were found to be beneficial irrespective of treatment approach used. While the evidence base is small and with varying levels of scientific rigor, there is a body of quality evidence that supports the use of context-sensitive approaches. Further research is still required to determine the role of impairment-specific versus context-specific interventions when treating individuals with social communication difficulties after TBI to inform clinical decision-making.DOI : https://doi.org/10.1016/j.apmr.2015.11.005 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117998
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1352–1365[article]
Titre : Comparison of the Effectiveness of Suprascapular Nerve Block With Physical Therapy, Placebo, and Intra-Articular Injection in Management of Chronic Shoulder Pain: A Meta-Analysis of Randomized Controlled Trials Type de document : Article Auteurs : Ke-Vin Chang ; Chen-Yu Hung ; Wei-Ting Wu Article en page(s) : pp. 1366–1380 Langues : Anglais (eng) Descripteurs : HE Vinci
Échographie ; Rééducation et réadaptationMots-clés : Pulsed radiofrequency treatment Traitement par radiofréquence pulsée Shoulder pain Scapulalgie Ultrasonography Résumé : Objective
To explore the effectiveness of suprascapular nerve block (SSNB) at different timing after administration compared with physical therapy, placebo, and intra-articular injections in patients with chronic shoulder pain.
Data Source
Two electronic data sources, PubMed and Scopus, were mainly searched from the earliest record to September 2015.
Study Selection
Eleven randomized controlled trials that compared SSNB with physical therapy, placebo, and intra-articular injections were included, comprising 591 patients.
Data Extraction
Patient demographics, regimens for SSNB and intra-articular injections, use of fluoroscopy or ultrasound guidance, conjunction with physical therapy, methods of randomization, and measurements of functional change and pain improvement were retrieved. The standardized mean differences (SMDs) of pain relief and functional improvement were calculated 1, 4, and 12 weeks after intervention.
Data Synthesis
Regarding pain relief, SSNB provided better pain relief for 12 weeks compared with physical therapy (SMD=.75; 95% confidence interval [CI], .35–1.14) and placebo injections (SMD=.70; 95% CI, .40–1.00), but was not superior to intra-articular injections. Differences in patient populations and use of pulsed radiofrequency did not cause a significant variation in therapeutic efficacy, but guidance using ultrasound showed consistently better effectiveness than guidance using surface landmarks and fluoroscopy.
Conclusions
This meta-analysis demonstrated the superiority of SSNB to placebo and physical therapy and a similar efficacy of SSNB compared with intra-articular injection for treatment of chronic shoulder pain. Ultrasound was the most preferable guidance tool, and future studies are advised to integrate physical therapy in order to improve the long-term effectiveness of SSNB.DOI : https://doi.org/10.1016/j.apmr.2015.11.009 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117999
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1366–1380[article]
Titre : Systematic Review of Pharmacologic Treatments of Pain After Spinal Cord Injury: An Update Type de document : Article Auteurs : Swati Mehta ; Amanda McIntyre ; Shannon Janzen Article en page(s) : pp. 1381–1391 Langues : Anglais (eng) Descripteurs : HE Vinci
Douleur ; Pain ; Rééducation et réadaptation ; Traumatismes de la moelle épinièreMots-clés : Spinal cord injuries Résumé : Objective
To update a systematic review of published research on pharmacotherapy for pain post-spinal cord injury (SCI).
Data Sources
PubMed/MEDLINE, CINAHL, Embase, and PsycINFO databases were searched for articles from 2009 to September 2015 examining treatment of pain post-SCI.
Study Selection
Studies were included for analysis if they met the following 4 a priori criteria: (1) written in the English language; (2) ≥50% of subjects had an SCI, unless results were stratified by population type; (3) participants included ≥3 subjects with an SCI; and (4) any intervention involving pharmacologic treatment for the improvement of pain.
Data Extraction
Randomized controlled trials were assessed for methodologic quality using the Physiotherapy Evidence Database scoring system. All research designs were given a level of evidence according to a modified Sackett Scale.
Data Synthesis
Seven new studies met our inclusion criteria. The new studies fell into the following categories: analgesics (n=1), anticonvulsants (n=2), antidepressants (n=2), antispastics (n=1), and cannabinoids (n=1). There was evidence for 5 new pharmacotherapies among the SCI population; these included the following: oxycodone, duloxetine, venlafaxine, phenol block, and dronabinol. Levels of evidence for all therapy modalities were updated based on the new evidence.
Conclusions
Anticonvulsants remain the most studied and supported pharmacotherapy for neuropathic pain post-SCI. Antidepressants showed reduction in pain only among those with comorbid depression. Botulinum toxin and phenol blocks were supported for the reduction of mixed pain post-SCI.DOI : https://doi.org/10.1016/j.apmr.2015.12.023 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118000
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1381–1391[article]
Titre : Independent, Community-Based Aerobic Exercise Training for People With Moderate-to-Severe Traumatic Brain Injury Type de document : Article Auteurs : Jennifer M. Devine ; Bonnie M. Wong ; Ernest Gervino Article en page(s) : pp. 1392–1397 Langues : Anglais (eng) Descripteurs : HE Vinci
Exercice physique ; Rééducation et réadaptationMots-clés : Brain injuries Lésions encéphaliques Exercise Résumé : Objective
To determine whether people with moderate-to-severe traumatic brain injury (TBI) can adhere to a minimally supervised, community-based, vigorous aerobic exercise program.
Design
Prospective trial.
Setting
Young Men's Christian Association (YMCA) facilities.
Participants
Community-dwelling volunteers (N=10; 8 men, 2 women; age range, 22–49y) 6 to 15 months after moderate-to-severe TBI.
Intervention
Participants received memberships to local YMCAs and brief orientations to exercise. They were then asked to independently complete ≥12 weeks of ≥3 training sessions per week, performed at 65% to 85% of maximum heart rate for ≥30 minutes per session. Participants could self-select exercise modality, provided they met intensity and duration targets. Programmable heart rate monitors captured session intensity and duration.
Main Outcome Measures
Independence with equipment and facility use and compliance with training goals (session frequency, duration, intensity, total weeks of training).
Results
All participants achieved independence with equipment and facility use. All met at least 2 of 4 training goals; half met all 4 goals. Participants averaged (+SD) 3.3+0.7 sessions per week for 13 weeks (range, 6–24). Average + SD session duration was 62+23 minutes, of which 51+22 minutes occurred at or above individuals' heart rate training targets.
Conclusions
People in recovery from moderate-to-severe TBI can, with minimal guidance, perform vigorous, community-based exercise. This suggests that decentralized exercise may be logistically and economically sustainable after TBI, expanding its potential therapeutic utility and rendering longer-duration exercise studies more feasible.DOI : https://doi.org/10.1016/j.apmr.2016.04.015 Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118001
in Archives of Physical Medicine and Rehabilitation > 2016/8 (2016) . - pp. 1392–1397[article]
