Vol. 99, n° 5 2018 Vol. 99, n° 6 2018 Vol. 99, n° 7 2018 Vol. 99, n° 8 2018 Vol. 99, n° 9 2018 Vol. 99, n° 10 2018 Vol. 99, n° 11 2018 Archives of Physical Medicine and Rehabilitation . Vol. 99, n° 8 Mention de date :  2018 Paru le :  01/08/2018

Dépouillements

Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study / Stephanie Hyeyoung Lee in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1447-1453 Titre : Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study Type de document : Article Auteurs : Stephanie Hyeyoung Lee ; Ji-Yeong Lee ; Mi-Young Kim Article en page(s) : p. 1447-1453 Langues : Anglais (eng) Descripteurs : HE Vinci Accident vasculaire cérébral (AVC) ; Membre supérieur ; Rééducation et réadaptation Mots-clés : Electric stimulation  Stimulation électrique  Stroke  Upper extremity  Virtual Reality Exposure Therapy  Thérapie par réalité virtuelle Résumé : Objective To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke. Design A pilot, randomized, single-blind, controlled trial. Setting Stroke rehabilitation inpatient unit. Participants Participants (N=48) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3. Interventions FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity–based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period. Main Outcome Measures Primary outcome measures were changes in Fugl-Meyer Assessment–Upper Extremity and Wolf Motor Function Test scores. Secondary outcome measures were changes in Box and Block Test, Jebsen-Taylor Hand Function Test, and Stroke Impact Scale scores. Assessments were performed at baseline (t0) and at 2 weeks (t1), 4 weeks (t4), and 8 weeks (t8). Between-group comparisons were evaluated using a repeated-measures analysis of variance. Results Forty-one participants were included in the analysis. Compared with FES alone, VR-FES produced a substantial increase in Fugl-Meyer Assessment–distal score (P=.011) and marginal improvement in Jebsen-Taylor Hand Function Test–gross score (P=.057). VR-FES produced greater, although nonsignificant, improvements in all other outcome measures, except in the Stroke Impact Scale–activities of daily living/instrumental activities of daily living score. Conclusions FES with VR-based rehabilitation may be more effective than cyclic FES in improving distal upper extremity gross motor performance poststroke. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study [Article] / Stephanie Hyeyoung Lee ; Ji-Yeong Lee ; Mi-Young Kim . - p. 1447-1453. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1447-1453 Descripteurs : HE Vinci Accident vasculaire cérébral (AVC) ; Membre supérieur ; Rééducation et réadaptation Mots-clés : Electric stimulation  Stimulation électrique  Stroke  Upper extremity  Virtual Reality Exposure Therapy  Thérapie par réalité virtuelle Résumé : Objective To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke. Design A pilot, randomized, single-blind, controlled trial. Setting Stroke rehabilitation inpatient unit. Participants Participants (N=48) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3. Interventions FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity–based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period. Main Outcome Measures Primary outcome measures were changes in Fugl-Meyer Assessment–Upper Extremity and Wolf Motor Function Test scores. Secondary outcome measures were changes in Box and Block Test, Jebsen-Taylor Hand Function Test, and Stroke Impact Scale scores. Assessments were performed at baseline (t0) and at 2 weeks (t1), 4 weeks (t4), and 8 weeks (t8). Between-group comparisons were evaluated using a repeated-measures analysis of variance. Results Forty-one participants were included in the analysis. Compared with FES alone, VR-FES produced a substantial increase in Fugl-Meyer Assessment–distal score (P=.011) and marginal improvement in Jebsen-Taylor Hand Function Test–gross score (P=.057). VR-FES produced greater, although nonsignificant, improvements in all other outcome measures, except in the Stroke Impact Scale–activities of daily living/instrumental activities of daily living score. Conclusions FES with VR-based rehabilitation may be more effective than cyclic FES in improving distal upper extremity gross motor performance poststroke. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Functional Electrical Stimulation—A New Therapeutic Approach to Enhance Exercise Intensity in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Crossover Trial / Clément Medrinal in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1454-1461 Titre : Functional Electrical Stimulation—A New Therapeutic Approach to Enhance Exercise Intensity in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Crossover Trial Type de document : Article Auteurs : Clément Medrinal ; Guillaume Prieur ; Yann Combret Article en page(s) : p. 1454-1461 Langues : Anglais (eng) Descripteurs : HE Vinci Broncho-pneumopathie chronique obstructive ; Exercice physique ; Maladies pulmonaires ; Métabolisme ; Rééducation et réadaptation Mots-clés : Exercise  Metabolism  Lung Diseases  Pulmonary Disease  Chronic Obstructive Résumé : Objective To evaluate the effect of quadriceps functional electrical stimulation (FES)-cycling on exertional oxygen uptake ( o2) compared with placebo FES-cycling in patients with chronic obstructive pulmonary disease (COPD). Design A randomized, single-blind, placebo-controlled crossover trial. Setting Pulmonary rehabilitation department. Participants Consecutive patients (N=23) with COPD Global Initiative for Chronic Obstructive Lung Disease stage 2, 3, or 4 (mean forced expiratory volume during the first second, 1.4+0.4L [50.3% predicted]) who had recently begun a respiratory rehabilitation program. Intervention Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-cycling. Main Outcome Measures The primary outcome was mean o2 during the 30-minute exercise session. The secondary outcomes were respiratory gas exchange and hemodynamic parameters averaged over the 30-minute endurance session. Lactate values, dyspnea, and perceived muscle fatigue were evaluated at the end of the sessions. Results FES-cycling increased the physiological response more than the placebo, with a greater o2 achieved of 36.6mL/min (95% confidence interval [CI], 8.9–64.3mL/min) (P=.01). There was also a greater increase in lactate after FES-cycling (+1.5mmol/L [95% CI, .05–2.9mmol/L]; P=.01). FES-cycling did not change dyspnea or muscle fatigue compared with the placebo condition. Conclusions FES-cycling effectively increased exercise intensity in patients with COPD. Further studies should evaluate longer-term FES-cycling rehabilitation programs. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Functional Electrical Stimulation—A New Therapeutic Approach to Enhance Exercise Intensity in Chronic Obstructive Pulmonary Disease Patients: A Randomized, Controlled Crossover Trial [Article] / Clément Medrinal ; Guillaume Prieur ; Yann Combret . - p. 1454-1461. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1454-1461 Descripteurs : HE Vinci Broncho-pneumopathie chronique obstructive ; Exercice physique ; Maladies pulmonaires ; Métabolisme ; Rééducation et réadaptation Mots-clés : Exercise  Metabolism  Lung Diseases  Pulmonary Disease  Chronic Obstructive Résumé : Objective To evaluate the effect of quadriceps functional electrical stimulation (FES)-cycling on exertional oxygen uptake ( o2) compared with placebo FES-cycling in patients with chronic obstructive pulmonary disease (COPD). Design A randomized, single-blind, placebo-controlled crossover trial. Setting Pulmonary rehabilitation department. Participants Consecutive patients (N=23) with COPD Global Initiative for Chronic Obstructive Lung Disease stage 2, 3, or 4 (mean forced expiratory volume during the first second, 1.4+0.4L [50.3% predicted]) who had recently begun a respiratory rehabilitation program. Intervention Two consecutive 30-minute sessions were carried out at a constant load with active and placebo FES-cycling. Main Outcome Measures The primary outcome was mean o2 during the 30-minute exercise session. The secondary outcomes were respiratory gas exchange and hemodynamic parameters averaged over the 30-minute endurance session. Lactate values, dyspnea, and perceived muscle fatigue were evaluated at the end of the sessions. Results FES-cycling increased the physiological response more than the placebo, with a greater o2 achieved of 36.6mL/min (95% confidence interval [CI], 8.9–64.3mL/min) (P=.01). There was also a greater increase in lactate after FES-cycling (+1.5mmol/L [95% CI, .05–2.9mmol/L]; P=.01). FES-cycling did not change dyspnea or muscle fatigue compared with the placebo condition. Conclusions FES-cycling effectively increased exercise intensity in patients with COPD. Further studies should evaluate longer-term FES-cycling rehabilitation programs. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Home-based Neuromuscular Electrical Stimulation as an Add-on to Pulmonary Rehabilitation Does Not Provide Further Benefits in Patients With Chronic Obstructive Pulmonary Disease: A Multicenter Randomized Trial / Tristan Bonnevie in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1462-1470 Titre : Home-based Neuromuscular Electrical Stimulation as an Add-on to Pulmonary Rehabilitation Does Not Provide Further Benefits in Patients With Chronic Obstructive Pulmonary Disease: A Multicenter Randomized Trial Type de document : Article Auteurs : Tristan Bonnevie ; Francis-Edouard Gravier ; David Debeaumont Article en page(s) : p. 1462-1470 Langues : Anglais (eng) Descripteurs : HE Vinci Broncho-pneumopathie chronique obstructive ; Electrotherapie ; Exercice physique ; Rééducation et réadaptation Mots-clés : Electric Stimulation Therapy  Exercise  Physical Therapy Modalities  Techniques de physiothérapie  Pulmonary Disease  Chronic Obstructive Résumé : Objective To assess the additional effect of a home-based neuromuscular electrical stimulation (NMES) program as an add-on to pulmonary rehabilitation (PR), on functional capacity in subjects with chronic obstructive pulmonary disease (COPD). Design Single-blind, multicenter randomized trial. Setting Three PR centers. Participants Subjects with severe to very severe COPD (N=73; median forced expiratory volume in 1 second, 1L (25th–75th percentile, 0.8–1.4L) referred for PR. Twenty-two subjects discontinued the study, but only 1 dropout was related to the intervention (leg discomfort). Intervention Subjects were randomly assigned to either PR plus quadricipital home-based NMES (35Hz, 30min, 5 time per week) or PR without NMES for 8 weeks. Main Outcome Measure The 6-minute walk test (6MWT) was used to assess functional capacity. Results Eighty-two percent of the scheduled NMES sessions were performed. In the whole sample, there were significant increases in the distance walked during the 6MWT (P<.01 peak oxygen consumption maximal workload modified medical research council dyspnea scale and saint george respiratory questionnaire total score there was no significant difference in the magnitude of change for any outcome between groups.> Conclusions Home-based NMES as an add-on to PR did not result in further improvements in subjects with severe to very severe COPD; moreover, it may have been a burden for some patients. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Home-based Neuromuscular Electrical Stimulation as an Add-on to Pulmonary Rehabilitation Does Not Provide Further Benefits in Patients With Chronic Obstructive Pulmonary Disease: A Multicenter Randomized Trial [Article] / Tristan Bonnevie ; Francis-Edouard Gravier ; David Debeaumont . - p. 1462-1470. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1462-1470 Descripteurs : HE Vinci Broncho-pneumopathie chronique obstructive ; Electrotherapie ; Exercice physique ; Rééducation et réadaptation Mots-clés : Electric Stimulation Therapy  Exercise  Physical Therapy Modalities  Techniques de physiothérapie  Pulmonary Disease  Chronic Obstructive Résumé : Objective To assess the additional effect of a home-based neuromuscular electrical stimulation (NMES) program as an add-on to pulmonary rehabilitation (PR), on functional capacity in subjects with chronic obstructive pulmonary disease (COPD). Design Single-blind, multicenter randomized trial. Setting Three PR centers. Participants Subjects with severe to very severe COPD (N=73; median forced expiratory volume in 1 second, 1L (25th–75th percentile, 0.8–1.4L) referred for PR. Twenty-two subjects discontinued the study, but only 1 dropout was related to the intervention (leg discomfort). Intervention Subjects were randomly assigned to either PR plus quadricipital home-based NMES (35Hz, 30min, 5 time per week) or PR without NMES for 8 weeks. Main Outcome Measure The 6-minute walk test (6MWT) was used to assess functional capacity. Results Eighty-two percent of the scheduled NMES sessions were performed. In the whole sample, there were significant increases in the distance walked during the 6MWT (P<.01 peak oxygen consumption maximal workload modified medical research council dyspnea scale and saint george respiratory questionnaire total score there was no significant difference in the magnitude of change for any outcome between groups.> Conclusions Home-based NMES as an add-on to PR did not result in further improvements in subjects with severe to very severe COPD; moreover, it may have been a burden for some patients. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

What Are the Determinants of Dental Care Expenditures in Institutions for Adults With Disabilities? Findings From a National Survey / Diane Naouri in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1471-1478 Titre : What Are the Determinants of Dental Care Expenditures in Institutions for Adults With Disabilities? Findings From a National Survey Type de document : Article Auteurs : Diane Naouri ; Clémence Bussière ; Nathalie Pelletier-Fleury Article en page(s) : p. 1471-1478 Langues : Anglais (eng) Descripteurs : HE Vinci Institutionnalisation ; Personnes handicapées ; Recherche sur les services de santé ; Rééducation et réadaptation ; Soins dentaires Mots-clés : Dental care  Disabled persons  Health services research  Institutionalization Résumé : Objective To analyze the determinants of dental care expenditures in institutions for adults with disabilities. Design Health and disability survey and insurance database. Setting Institutional setting. Participants Adults (N=2222) living in institutions for people with cognitive, sensory, and mobility disabilities. Interventions Not applicable. Main Outcome Measures We used a Heckman selection model to correct for potential sample selection bias due to the high percentage of non–dental care users. The Heckman selection model is a 2-step statistical approach based on the simultaneous estimation of 2 multiple regression models–a selection equation (step 1) and an outcome equation (step 2)–offering a means of correcting for nonrandomly selected samples. The selection equation modeled whether the individual had consulted a dentist at least once, whereas the outcome equation explained the dental care expenditures. Disability severity was assessed by scoring mobility and cognitive functional limitations. Regressions also included sociodemographic characteristics and other health-related variables. Results Individuals with the highest cognitive limitation scores, without family visits, without supplementary health insurance, and with poor oral health status were less likely to consult a dentist. After controlling for potential selection bias, the only variable that remained statistically significant in the outcome equation was the oral health status: when individuals with poor health status had consulted at least once, they had a higher level of dental care expenditure. Conclusions Functional limitations were barriers to accessing dental care even in institutions for adult with disabilities. These barriers should be overcome because they may worsen their oral health status and well-being. Given the lack of literature on this specific topic, our results are important from a policy perspective. Health authorities should be alerted by these findings. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] What Are the Determinants of Dental Care Expenditures in Institutions for Adults With Disabilities? Findings From a National Survey [Article] / Diane Naouri ; Clémence Bussière ; Nathalie Pelletier-Fleury . - p. 1471-1478. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1471-1478 Descripteurs : HE Vinci Institutionnalisation ; Personnes handicapées ; Recherche sur les services de santé ; Rééducation et réadaptation ; Soins dentaires Mots-clés : Dental care  Disabled persons  Health services research  Institutionalization Résumé : Objective To analyze the determinants of dental care expenditures in institutions for adults with disabilities. Design Health and disability survey and insurance database. Setting Institutional setting. Participants Adults (N=2222) living in institutions for people with cognitive, sensory, and mobility disabilities. Interventions Not applicable. Main Outcome Measures We used a Heckman selection model to correct for potential sample selection bias due to the high percentage of non–dental care users. The Heckman selection model is a 2-step statistical approach based on the simultaneous estimation of 2 multiple regression models–a selection equation (step 1) and an outcome equation (step 2)–offering a means of correcting for nonrandomly selected samples. The selection equation modeled whether the individual had consulted a dentist at least once, whereas the outcome equation explained the dental care expenditures. Disability severity was assessed by scoring mobility and cognitive functional limitations. Regressions also included sociodemographic characteristics and other health-related variables. Results Individuals with the highest cognitive limitation scores, without family visits, without supplementary health insurance, and with poor oral health status were less likely to consult a dentist. After controlling for potential selection bias, the only variable that remained statistically significant in the outcome equation was the oral health status: when individuals with poor health status had consulted at least once, they had a higher level of dental care expenditure. Conclusions Functional limitations were barriers to accessing dental care even in institutions for adult with disabilities. These barriers should be overcome because they may worsen their oral health status and well-being. Given the lack of literature on this specific topic, our results are important from a policy perspective. Health authorities should be alerted by these findings. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles / Steve R. Fisher in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1479-1482 Titre : Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles Type de document : Article Auteurs : Steve R. Fisher ; Addie Middleton ; James E. Graham Article en page(s) : p. 1479-1482 Langues : Anglais (eng) Descripteurs : HE Vinci Gériatrie ; Rééducation et réadaptation Mots-clés : Geriatrics  Medicare  Medicare (USA) Résumé : Objective To examine how similar summary scores of physical functioning using the FIM can represent different patient clinical profiles. Design Retrospective cohort study. Setting Inpatient rehabilitation facilities. Participants Medicare fee-for-service beneficiaries (N=765,441) discharged from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures We used patients’ scores on items of the FIM to quantify their level of independence on both self-care and mobility domains. We then identified patients as requiring “no physical assistance” at discharge from inpatient rehabilitation by using a rule and score–based approach. Results In those patients with FIM self-care and mobility summary scores suggesting no physical assistance needed, we found that physical assistance was in fact needed frequently in bathroom-related activities (eg, continence, toilet and tub transfers, hygiene, clothes management) and with stairs. It was not uncommon for actual performance to be lower than what may be suggested by a summary score of those domains. Conclusions Further research is needed to create clinically meaningful descriptions of summary scores from combined performances on individual items of physical functioning. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Same But Different: FIM Summary Scores May Mask Variability in Physical Functioning Profiles [Article] / Steve R. Fisher ; Addie Middleton ; James E. Graham . - p. 1479-1482. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1479-1482 Descripteurs : HE Vinci Gériatrie ; Rééducation et réadaptation Mots-clés : Geriatrics  Medicare  Medicare (USA) Résumé : Objective To examine how similar summary scores of physical functioning using the FIM can represent different patient clinical profiles. Design Retrospective cohort study. Setting Inpatient rehabilitation facilities. Participants Medicare fee-for-service beneficiaries (N=765,441) discharged from inpatient rehabilitation. Interventions Not applicable. Main Outcome Measures We used patients’ scores on items of the FIM to quantify their level of independence on both self-care and mobility domains. We then identified patients as requiring “no physical assistance” at discharge from inpatient rehabilitation by using a rule and score–based approach. Results In those patients with FIM self-care and mobility summary scores suggesting no physical assistance needed, we found that physical assistance was in fact needed frequently in bathroom-related activities (eg, continence, toilet and tub transfers, hygiene, clothes management) and with stairs. It was not uncommon for actual performance to be lower than what may be suggested by a summary score of those domains. Conclusions Further research is needed to create clinically meaningful descriptions of summary scores from combined performances on individual items of physical functioning. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Predictors for Employment Status in People With Multiple Sclerosis: A 10-Year Longitudinal Observational Study / Mia Forslin in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1483-1490 Titre : Predictors for Employment Status in People With Multiple Sclerosis: A 10-Year Longitudinal Observational Study Type de document : Article Auteurs : Mia Forslin ; Katharina Fink ; Ulf Hammar Article en page(s) : p. 1483-1490 Langues : Anglais (eng) Descripteurs : HE Vinci Emploi ; Etudes longitudinales ; Rééducation et réadaptation ; Sclérose en plaques Mots-clés : Employment  Longitudinal studies  Multiple sclerosis  Work-life balance  Équilibre entre travail et vie personnelle Résumé : Objective To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance. Design A 10-year longitudinal observational cohort study. Setting University hospital. Participants A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased. Interventions Not applicable. Main Outcome Measures Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables. Results Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years. Conclusions This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Predictors for Employment Status in People With Multiple Sclerosis: A 10-Year Longitudinal Observational Study [Article] / Mia Forslin ; Katharina Fink ; Ulf Hammar . - p. 1483-1490. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1483-1490 Descripteurs : HE Vinci Emploi ; Etudes longitudinales ; Rééducation et réadaptation ; Sclérose en plaques Mots-clés : Employment  Longitudinal studies  Multiple sclerosis  Work-life balance  Équilibre entre travail et vie personnelle Résumé : Objective To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance. Design A 10-year longitudinal observational cohort study. Setting University hospital. Participants A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased. Interventions Not applicable. Main Outcome Measures Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables. Results Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years. Conclusions This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users / Andrew Sawers in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1491-1498 Titre : Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users Type de document : Article Auteurs : Andrew Sawers ; Brian Hafner Article en page(s) : p. 1491-1498 Langues : Anglais (eng) Descripteurs : HE Vinci Amputés ; Rééducation et réadaptation Mots-clés : Accidental falls  Chutes accidentelles  Amputees  Patient outcome assessment  Évaluation des résultats des patients  Postural balance  Équilibre postural Résumé : Objective To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. Design Cross-sectional study. Setting Research laboratory and prosthetics clinic. Participants Unilateral transtibial and transfemoral prosthesis users (N=40). Interventions Not applicable. Main Outcome Measures Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (ie, ceiling and floor effects). Convergent construct validity was examined using correlations between participants’ NBWT scores and scores or times on existing clinical balance tests regularly administered to lower limb prosthesis users. Known-groups construct validity was examined by comparing NBWT scores between groups of participants with different fall histories, amputation levels, amputation etiologies, and functional levels. Discriminant validity was evaluated by analyzing the area under each test’s receiver operating characteristic (ROC) curve. Results No minimum or maximum scores were recorded on the NBWT. NBWT scores demonstrated strong correlations (ρ=.70‒.85) with scores/times on performance-based balance tests (timed Up and Go test, Four Square Step Test, and Berg Balance Scale) and a moderate correlation (ρ=.49) with the self-report Activities-specific Balance Confidence scale. NBWT performance was significantly lower among participants with a history of falls (P=.003), transfemoral amputation (P=.011), and a lower mobility level (P<.001 the nbwt also had largest area under roc curve and was only test to exhibit an that statistically significantly>.50 (ie, chance). Conclusions The results provide strong evidence of content, construct, and discriminant validity for the NBWT as a performance-based test of balance ability. The evidence supports its use to assess balance impairments and fall risk in unilateral transtibial and transfemoral prosthesis users. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Validation of the Narrowing Beam Walking Test in Lower Limb Prosthesis Users [Article] / Andrew Sawers ; Brian Hafner . - p. 1491-1498. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1491-1498 Descripteurs : HE Vinci Amputés ; Rééducation et réadaptation Mots-clés : Accidental falls  Chutes accidentelles  Amputees  Patient outcome assessment  Évaluation des résultats des patients  Postural balance  Équilibre postural Résumé : Objective To evaluate the content, construct, and discriminant validity of the Narrowing Beam Walking Test (NBWT), a performance-based balance test for lower limb prosthesis users. Design Cross-sectional study. Setting Research laboratory and prosthetics clinic. Participants Unilateral transtibial and transfemoral prosthesis users (N=40). Interventions Not applicable. Main Outcome Measures Content validity was examined by quantifying the percentage of participants receiving maximum or minimum scores (ie, ceiling and floor effects). Convergent construct validity was examined using correlations between participants’ NBWT scores and scores or times on existing clinical balance tests regularly administered to lower limb prosthesis users. Known-groups construct validity was examined by comparing NBWT scores between groups of participants with different fall histories, amputation levels, amputation etiologies, and functional levels. Discriminant validity was evaluated by analyzing the area under each test’s receiver operating characteristic (ROC) curve. Results No minimum or maximum scores were recorded on the NBWT. NBWT scores demonstrated strong correlations (ρ=.70‒.85) with scores/times on performance-based balance tests (timed Up and Go test, Four Square Step Test, and Berg Balance Scale) and a moderate correlation (ρ=.49) with the self-report Activities-specific Balance Confidence scale. NBWT performance was significantly lower among participants with a history of falls (P=.003), transfemoral amputation (P=.011), and a lower mobility level (P<.001 the nbwt also had largest area under roc curve and was only test to exhibit an that statistically significantly>.50 (ie, chance). Conclusions The results provide strong evidence of content, construct, and discriminant validity for the NBWT as a performance-based test of balance ability. The evidence supports its use to assess balance impairments and fall risk in unilateral transtibial and transfemoral prosthesis users. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Interrater and Intrarater Reliability of the Balance Computerized Adaptive Test in Patients With Stroke / Hsin-Yu Chiang in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1499-1506 Titre : Interrater and Intrarater Reliability of the Balance Computerized Adaptive Test in Patients With Stroke Type de document : Article Auteurs : Hsin-Yu Chiang ; Wen-Shian Lu ; Wan-Hui Yu Article en page(s) : p. 1499-1506 Langues : Anglais (eng) Descripteurs : HE Vinci Accident vasculaire cérébral (AVC) ; Rééducation et réadaptation Mots-clés : Postural balance  Équilibre postural  Reproducibility of results  Reproductibilité des résultats  Stroke Résumé : Objective To examine the interrater and intrarater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions. Design Repeated assessments design (1wk apart). Setting Seven teaching hospitals. Participants A pooled sample (N=102) including 2 independent groups of outpatients (n=50 for the interrater reliability study; n=52 for the intrarater reliability study) with chronic stroke. Interventions Not applicable. Main Outcome Measures Balance CAT. Results For the interrater reliability study, the values of intraclass correlation coefficient, minimal detectable change (MDC), and percentage of MDC (MDC%) for the Balance CAT were .84, 1.90, and 31.0%, respectively. For the intrarater reliability study, the values of intraclass correlation coefficient, MDC, and MDC% ranged from .89 to .91, from 1.14 to 1.26, and from 17.1% to 18.6%, respectively. Conclusions The Balance CAT showed sufficient intrarater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. Although the Balance CAT may have good interrater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Interrater and Intrarater Reliability of the Balance Computerized Adaptive Test in Patients With Stroke [Article] / Hsin-Yu Chiang ; Wen-Shian Lu ; Wan-Hui Yu . - p. 1499-1506. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1499-1506 Descripteurs : HE Vinci Accident vasculaire cérébral (AVC) ; Rééducation et réadaptation Mots-clés : Postural balance  Équilibre postural  Reproducibility of results  Reproductibilité des résultats  Stroke Résumé : Objective To examine the interrater and intrarater reliability of the Balance Computerized Adaptive Test (Balance CAT) in patients with chronic stroke having a wide range of balance functions. Design Repeated assessments design (1wk apart). Setting Seven teaching hospitals. Participants A pooled sample (N=102) including 2 independent groups of outpatients (n=50 for the interrater reliability study; n=52 for the intrarater reliability study) with chronic stroke. Interventions Not applicable. Main Outcome Measures Balance CAT. Results For the interrater reliability study, the values of intraclass correlation coefficient, minimal detectable change (MDC), and percentage of MDC (MDC%) for the Balance CAT were .84, 1.90, and 31.0%, respectively. For the intrarater reliability study, the values of intraclass correlation coefficient, MDC, and MDC% ranged from .89 to .91, from 1.14 to 1.26, and from 17.1% to 18.6%, respectively. Conclusions The Balance CAT showed sufficient intrarater reliability in patients with chronic stroke having balance functions ranging from sitting with support to independent walking. Although the Balance CAT may have good interrater reliability, we found substantial random measurement error between different raters. Accordingly, if the Balance CAT is used as an outcome measure in clinical or research settings, same raters are suggested over different time points to ensure reliable assessments. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services? / Vicki A. Freedman in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1507-1513 Titre : Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services? Type de document : Article Auteurs : Vicki A. Freedman ; Judith D. Kasper ; Alan Jette Article en page(s) : p. 1507-1513 Langues : Anglais (eng) Descripteurs : HE Vinci Enquêtes de santé ; Méthodes ; Rééducation et réadaptation ; Vieillissement Mots-clés : Aging  Health surveys  Methods Résumé : Objective To explore the accuracy of rehabilitation service use reports by older adults as well as variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). Design Longitudinal observational study. Setting Participants' homes. Participants Community-dwelling adults ages 65 and older (N=4228) in the 2015 National Health and Aging Trends Study who were enrolled in Medicare Parts A and B for 12 months before their interview. Interventions Not applicable. Main Outcome Measures Respondents were asked whether they received rehabilitation services in the past year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. Results Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the past year. Self-reported measures had high sensitivity (77%) and positive predictive value (80%) and even higher specificity and negative predictive value (approaching 95%). However, in adjusted models, sensitivity was lower for black enrollees, the very old, and those with lower education levels. Conclusions Survey-based measures of rehabilitation accurately captured use over the past year, but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Can Older Adults Accurately Report Their Use of Physical Rehabilitation Services? [Article] / Vicki A. Freedman ; Judith D. Kasper ; Alan Jette . - p. 1507-1513. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1507-1513 Descripteurs : HE Vinci Enquêtes de santé ; Méthodes ; Rééducation et réadaptation ; Vieillissement Mots-clés : Aging  Health surveys  Methods Résumé : Objective To explore the accuracy of rehabilitation service use reports by older adults as well as variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). Design Longitudinal observational study. Setting Participants' homes. Participants Community-dwelling adults ages 65 and older (N=4228) in the 2015 National Health and Aging Trends Study who were enrolled in Medicare Parts A and B for 12 months before their interview. Interventions Not applicable. Main Outcome Measures Respondents were asked whether they received rehabilitation services in the past year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. Results Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the past year. Self-reported measures had high sensitivity (77%) and positive predictive value (80%) and even higher specificity and negative predictive value (approaching 95%). However, in adjusted models, sensitivity was lower for black enrollees, the very old, and those with lower education levels. Conclusions Survey-based measures of rehabilitation accurately captured use over the past year, but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Mandated Quality of Care Metrics for Medicare Patients: Examining New or Worsened Pressure Ulcers and Rehabilitation Outcomes in United States Inpatient Rehabilitation Facilities / Margaret A. DiVita in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1514-1524 Titre : Mandated Quality of Care Metrics for Medicare Patients: Examining New or Worsened Pressure Ulcers and Rehabilitation Outcomes in United States Inpatient Rehabilitation Facilities Type de document : Article Auteurs : Margaret A. DiVita ; Carl V. Granger ; Richard Goldstein Article en page(s) : p. 1514-1524 Langues : Anglais (eng) Descripteurs : HE Vinci Évaluation de résultat (soins) ; Indicateurs qualité santé ; Politique de santé ; Rééducation et réadaptation Mots-clés : Health policy  Outcome assessment (health care)  Quality indicators  health care Résumé : Objective To examine the association between the Medicare pressure ulcer quality indicator (the development of new or worsened pressure ulcers) and rehabilitation outcomes among Medicare patients seen in an inpatient rehabilitation facility (IRF). Design Retrospective descriptive study. Setting IRFs subscribed to the Uniform Data System for Medical Rehabilitation. Participants Nearly 500,000 IRF Medicare patients who were discharged between January 2013 and September 2014 were examined. Interventions Not applicable. Main Outcome Measures Functional independence, functional change (gain), and discharge destination. Results The pressure ulcer quality indicator was associated with poorer rehabilitation outcomes; patients were less likely to achieve functional independence (odds ratio [OR], .47; 95% confidence interval [CI], .44–.51), were less likely to be discharged to a community setting (OR, .88; 95% CI, .82–.95), and made less functional gain during their IRF stay (a difference of 6 FIM points). Conclusions These results support that the pressure ulcer quality indicator is associated with lower quality of rehabilitation outcomes; however, given that those patients with a new or worsened pressure injury still made functional gains and most were discharged to the community, the risk of pressure injury development should not preclude the admission of these cases to an IRF. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Mandated Quality of Care Metrics for Medicare Patients: Examining New or Worsened Pressure Ulcers and Rehabilitation Outcomes in United States Inpatient Rehabilitation Facilities [Article] / Margaret A. DiVita ; Carl V. Granger ; Richard Goldstein . - p. 1514-1524. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1514-1524 Descripteurs : HE Vinci Évaluation de résultat (soins) ; Indicateurs qualité santé ; Politique de santé ; Rééducation et réadaptation Mots-clés : Health policy  Outcome assessment (health care)  Quality indicators  health care Résumé : Objective To examine the association between the Medicare pressure ulcer quality indicator (the development of new or worsened pressure ulcers) and rehabilitation outcomes among Medicare patients seen in an inpatient rehabilitation facility (IRF). Design Retrospective descriptive study. Setting IRFs subscribed to the Uniform Data System for Medical Rehabilitation. Participants Nearly 500,000 IRF Medicare patients who were discharged between January 2013 and September 2014 were examined. Interventions Not applicable. Main Outcome Measures Functional independence, functional change (gain), and discharge destination. Results The pressure ulcer quality indicator was associated with poorer rehabilitation outcomes; patients were less likely to achieve functional independence (odds ratio [OR], .47; 95% confidence interval [CI], .44–.51), were less likely to be discharged to a community setting (OR, .88; 95% CI, .82–.95), and made less functional gain during their IRF stay (a difference of 6 FIM points). Conclusions These results support that the pressure ulcer quality indicator is associated with lower quality of rehabilitation outcomes; however, given that those patients with a new or worsened pressure injury still made functional gains and most were discharged to the community, the risk of pressure injury development should not preclude the admission of these cases to an IRF. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Engineering Improved Balance Confidence in Older Adults With Complex Health Care Needs: Learning From the Muscling Up Against Disability Study / Sharon Hetherington in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1525-1532 Titre : Engineering Improved Balance Confidence in Older Adults With Complex Health Care Needs: Learning From the Muscling Up Against Disability Study Type de document : Article Auteurs : Sharon Hetherington ; Tim Henwood ; Paul Swinton Article en page(s) : p. 1525-1532 Langues : Anglais (eng) Descripteurs : HE Vinci Exercice physique ; Rééducation et réadaptation ; Vieillissement Mots-clés : Aging  Exercise Résumé : Objective To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change. Design Intervention study. Setting Community-based older adult–specific exercise clinic. Participants Older adults (N=245) with complex care needs who were receiving government-funded aged care support. Interventions Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. Main Outcome Measures The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level. Results At baseline, better physical performance (r=.54; P<.01 and quality of life p predicted better balance confidence. in contrast at baseline higher levels frailty worse confidence change after the exercise intervention was accompanied by improved physical performance reduced identified as most consistent negative predictor scores across intervention.> Conclusions This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Engineering Improved Balance Confidence in Older Adults With Complex Health Care Needs: Learning From the Muscling Up Against Disability Study [Article] / Sharon Hetherington ; Tim Henwood ; Paul Swinton . - p. 1525-1532. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1525-1532 Descripteurs : HE Vinci Exercice physique ; Rééducation et réadaptation ; Vieillissement Mots-clés : Aging  Exercise Résumé : Objective To investigate the associations of balance confidence with physical and cognitive markers of well-being in older adults receiving government-funded aged care services and whether progressive resistance plus balance training could positively influence change. Design Intervention study. Setting Community-based older adult–specific exercise clinic. Participants Older adults (N=245) with complex care needs who were receiving government-funded aged care support. Interventions Twenty-four weeks of twice weekly progressive resistance plus balance training carried out under the supervision of accredited exercise physiologists. Main Outcome Measures The primary measure was the Activity-specific Balance Confidence Scale. Secondary measures included the Short Physical Performance Battery; fall history gathered as part of the health history questionnaire; hierarchical timed balance tests; Geriatric Anxiety Index; Geriatric Depression Scale; Fatigue, Resistance, Ambulation, Illness, Loss of Weight scale; and EuroQoL-5 dimension 3 level. Results At baseline, better physical performance (r=.54; P<.01 and quality of life p predicted better balance confidence. in contrast at baseline higher levels frailty worse confidence change after the exercise intervention was accompanied by improved physical performance reduced identified as most consistent negative predictor scores across intervention.> Conclusions This study shows that reduced physical performance and quality of life and increased frailty are predictive of worse balance confidence in older adults with aged care needs. However, when a targeted intervention of resistance and balance exercise is implemented that reduces frailty and improves physical performance, balance confidence will also improve. Given the influence of balance confidence on a raft of well-being determinants, including the capacity for positive physical and cognitive change, this study offers important insight to those looking to reduce falls in older adults. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting / Pradeep Suri in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1533-1539 Titre : Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting Type de document : Article Auteurs : Pradeep Suri ; Kristin Delaney ; Sean D. Rundell Article en page(s) : p. 1533-1539 Langues : Anglais (eng) Descripteurs : HE Vinci Appareil locomoteur ; Évaluation de résultat (soins) ; Evaluation des risques ; Lombalgie ; Pronostic Mots-clés : Low back pain  Musculoskeletal System  Outcome Assessment (Health Care)  Decision Support Techniques  Techniques d'aide à la décision  Prognostic  Psychosocial Support Systems  Systèmes de soutien psychosocial  Risk Assessment Résumé : Objective To examine the predictive validity of the Subgrouping for Targeted Treatment (STarT Back) tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain in U.S. primary care. Design Secondary analysis of data from participants receiving usual care in a randomized clinical trial. Setting Primary care clinics. Participants Adults (N = 1109) ≥18 years of age with back pain. Those with specific causes of back pain (pregnancy, disc herniation, vertebral fracture, spinal stenosis) and work-related injuries were not included. Interventions Not applicable. Main Outcome Measures The original 9-item version of the STarT Back tool, administered at baseline, stratified patients by their risk (low, medium, high) of persistent disabling back pain (STarT Back risk group). Persistent disabling back pain was defined as Roland-Morris Disability Questionnaire scores of ≥7 at 6-month follow-up. Results The STarT Back risk group was a significant predictor of persistent disabling back pain (P<.0001 at follow-up. the proportion of individuals with persistent disabling back pain follow-up was confidence interval in low-risk group ci medium-risk and high-risk group. relative risk compared to> Conclusions The STarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care. These results were very similar to those in the original STarT Back validation study. This validation study is a necessary first step toward identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the United States. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Predictive Validity of the STarT Back Tool for Risk of Persistent Disabling Back Pain in a U.S. Primary Care Setting [Article] / Pradeep Suri ; Kristin Delaney ; Sean D. Rundell . - p. 1533-1539. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1533-1539 Descripteurs : HE Vinci Appareil locomoteur ; Évaluation de résultat (soins) ; Evaluation des risques ; Lombalgie ; Pronostic Mots-clés : Low back pain  Musculoskeletal System  Outcome Assessment (Health Care)  Decision Support Techniques  Techniques d'aide à la décision  Prognostic  Psychosocial Support Systems  Systèmes de soutien psychosocial  Risk Assessment Résumé : Objective To examine the predictive validity of the Subgrouping for Targeted Treatment (STarT Back) tool for classifying people with back pain into categories of low, medium, and high risk of persistent disabling back pain in U.S. primary care. Design Secondary analysis of data from participants receiving usual care in a randomized clinical trial. Setting Primary care clinics. Participants Adults (N = 1109) ≥18 years of age with back pain. Those with specific causes of back pain (pregnancy, disc herniation, vertebral fracture, spinal stenosis) and work-related injuries were not included. Interventions Not applicable. Main Outcome Measures The original 9-item version of the STarT Back tool, administered at baseline, stratified patients by their risk (low, medium, high) of persistent disabling back pain (STarT Back risk group). Persistent disabling back pain was defined as Roland-Morris Disability Questionnaire scores of ≥7 at 6-month follow-up. Results The STarT Back risk group was a significant predictor of persistent disabling back pain (P<.0001 at follow-up. the proportion of individuals with persistent disabling back pain follow-up was confidence interval in low-risk group ci medium-risk and high-risk group. relative risk compared to> Conclusions The STarT Back risk groups successfully separated people with back pain into distinct categories of risk for persistent disabling back pain at 6-month follow-up in U.S. primary care. These results were very similar to those in the original STarT Back validation study. This validation study is a necessary first step toward identifying whether the entire STarT Back approach, including matched/targeted treatment, can be effectively used for primary care in the United States. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease / Cheng-Ya Huang in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1540-1546 Titre : Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease Type de document : Article Auteurs : Cheng-Ya Huang ; Yu-An Chen ; Ing-Shiou Hwang Article en page(s) : p. 1540-1546 Langues : Anglais (eng) Descripteurs : HE Vinci Attention ; Maladie de Parkinson ; Rééducation et réadaptation Mots-clés : Parkinson disease  Postural balance  Équilibre postural Résumé : Objective To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. Design Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). Setting University research laboratory. Participants Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. Interventions Not applicable. Main Outcome Measures Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. Results Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. Conclusions Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease [Article] / Cheng-Ya Huang ; Yu-An Chen ; Ing-Shiou Hwang . - p. 1540-1546. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1540-1546 Descripteurs : HE Vinci Attention ; Maladie de Parkinson ; Rééducation et réadaptation Mots-clés : Parkinson disease  Postural balance  Équilibre postural Résumé : Objective To examine the task prioritization effects on postural-suprapostural dual-task performance in patients with early-stage Parkinson disease (PD) without clinically observed postural symptoms. Design Cross-sectional study. Participants performed a force-matching task while standing on a mobile platform, and were instructed to focus their attention on either the postural task (posture-first strategy) or the force-matching task (posture-second strategy). Setting University research laboratory. Participants Individuals (N=16) with early-stage PD who had no clinically observed postural symptoms. Interventions Not applicable. Main Outcome Measures Dual-task change (DTC; percent change between single-task and dual-task performance) of posture error, posture approximate entropy (ApEn), force error, and reaction time (RT). Positive DTC values indicate higher postural error, posture ApEn, force error, and force RT during dual-task conditions compared with single-task conditions. Results Compared with the posture-first strategy, the posture-second strategy was associated with smaller DTC of posture error and force error, and greater DTC of posture ApEn. In contrast, greater DTC of force RT was observed under the posture-second strategy. Conclusions Contrary to typical recommendations, our results suggest that the posture-second strategy may be an effective dual-task strategy in patients with early-stage PD who have no clinically observed postural symptoms in order to reduce the negative effect of dual tasking on performance and facilitate postural automaticity. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Windmill-task as a New Quantitative and Objective Assessment for Mirror Movements in Unilateral Cerebral Palsy: A Pilot Study / Ingar Marie Zielinski in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1547-1552 Titre : Windmill-task as a New Quantitative and Objective Assessment for Mirror Movements in Unilateral Cerebral Palsy: A Pilot Study Type de document : Article Auteurs : Ingar Marie Zielinski ; Bert Steenbergen ; Anna Schmidt Article en page(s) : p. 1547-1552 Langues : Anglais (eng) Descripteurs : HE Vinci Enfant ; Membre supérieur ; Mouvement ; Rééducation et réadaptation Mots-clés : Child  Movement  Upper extremity Résumé : Objective To introduce the Windmill-task, a new objective assessment tool to quantify the presence of mirror movements (MMs) in children with unilateral cerebral palsy (UCP), which are typically assessed with the observation-based Woods and Teuber scale (W&T). Design Prospective, observational, cohort pilot study. Setting Children’s hospital. Participants Prospective cohort of children (N=23) with UCP (age range, 6–15y, mean age, 10.5+2.7y). Interventions Not applicable. Main Outcome Measures The concurrent validity of the Windmill-task is assessed, and the sensitivity and specificity for MM detection are compared between both assessments. To assess the concurrent validity, Windmill-task data are compared with W&T data using Spearman rank correlations (ρ) for 2 conditions: affected hand moving vs less affected hand moving. Sensitivity and specificity are compared by measuring the mean percentage of children being assessed inconsistently across both assessments. Results Outcomes of both assessments correlated significantly (affected hand moving: ρ=.520; P=.005; less affected hand moving: ρ=.488; P=.009). However, many children displayed MMs on the Windmill-task, but not on the W&T (sensitivity: affected hand moving: 27.5%; less affected hand moving: 40.6%). Only 2 children displayed MMs on the W&T, but not on the Windmill-task (specificity: affected hand moving: 2.9%; less affected hand moving: 1.4%). Conclusions The Windmill-task seems to be a valid tool to assess MMs in children with UCP and has an additional advantage of sensitivity to detect MMs. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Windmill-task as a New Quantitative and Objective Assessment for Mirror Movements in Unilateral Cerebral Palsy: A Pilot Study [Article] / Ingar Marie Zielinski ; Bert Steenbergen ; Anna Schmidt . - p. 1547-1552. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1547-1552 Descripteurs : HE Vinci Enfant ; Membre supérieur ; Mouvement ; Rééducation et réadaptation Mots-clés : Child  Movement  Upper extremity Résumé : Objective To introduce the Windmill-task, a new objective assessment tool to quantify the presence of mirror movements (MMs) in children with unilateral cerebral palsy (UCP), which are typically assessed with the observation-based Woods and Teuber scale (W&T). Design Prospective, observational, cohort pilot study. Setting Children’s hospital. Participants Prospective cohort of children (N=23) with UCP (age range, 6–15y, mean age, 10.5+2.7y). Interventions Not applicable. Main Outcome Measures The concurrent validity of the Windmill-task is assessed, and the sensitivity and specificity for MM detection are compared between both assessments. To assess the concurrent validity, Windmill-task data are compared with W&T data using Spearman rank correlations (ρ) for 2 conditions: affected hand moving vs less affected hand moving. Sensitivity and specificity are compared by measuring the mean percentage of children being assessed inconsistently across both assessments. Results Outcomes of both assessments correlated significantly (affected hand moving: ρ=.520; P=.005; less affected hand moving: ρ=.488; P=.009). However, many children displayed MMs on the Windmill-task, but not on the W&T (sensitivity: affected hand moving: 27.5%; less affected hand moving: 40.6%). Only 2 children displayed MMs on the W&T, but not on the Windmill-task (specificity: affected hand moving: 2.9%; less affected hand moving: 1.4%). Conclusions The Windmill-task seems to be a valid tool to assess MMs in children with UCP and has an additional advantage of sensitivity to detect MMs. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Seasonal Patterns of Community Participation and Mobility of Wheelchair Users Over an Entire Year / Jaimie F. Borisoff in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1553-1560 Titre : Seasonal Patterns of Community Participation and Mobility of Wheelchair Users Over an Entire Year Type de document : Article Auteurs : Jaimie F. Borisoff ; Jacquie Ripat ; Franco Chan Article en page(s) : p. 1553-1560 Langues : Anglais (eng) Descripteurs : HE Vinci Participation sociale Mots-clés : Cold temperature  Basse température  Geographic Information Systems  Systèmes d'information géographique  Social participation  Wheelchairs  Fauteuils roulants Résumé : Objective To describe how people who use wheelchairs participate and move at home and in the community over an entire yearlong period, including during times of inclement weather conditions. Design Longitudinal mixed-methods research study. Setting Urban community in Canada. Participants People who use a wheelchair for home and community mobility (N=11). Intervention Not applicable. Main Outcome Measures Use of a global positioning system (GPS) tracker for movement in community (number of trips per day), use of accelerometer for bouts of wheeling mobility (number of bouts per day, speed, distance, and duration), prompted recall interviews to identify supports and barriers to mobility and participation. Results More trips per day were taken during the summer (P= .03) and on days with no snow and temperatures above 0°C. Participants reliant on public transportation demonstrated more weather-specific changes in their trip patterns. The number of daily bouts of mobility remained similar across seasons; total daily distance wheeled, duration, and speed were higher on summer days, days with no snow, and days with temperatures above 0°C. A higher proportion of outdoor wheeling bouts occurred in summer (P=.02) and with temperatures above 0°C (P=.03). Inaccessible public environments were the primary barrier to community mobility and participation; access to social supports and private transportation were the primary supports. Conclusions Objective support is provided for the influence of various seasonal weather conditions on community mobility and participation for people who use a wheelchair. Longitudinal data collection provided a detailed understanding of the patterns of, and influences on, wheelchair mobility and participation within wheelchair users’ own homes and communities. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Seasonal Patterns of Community Participation and Mobility of Wheelchair Users Over an Entire Year [Article] / Jaimie F. Borisoff ; Jacquie Ripat ; Franco Chan . - p. 1553-1560. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1553-1560 Descripteurs : HE Vinci Participation sociale Mots-clés : Cold temperature  Basse température  Geographic Information Systems  Systèmes d'information géographique  Social participation  Wheelchairs  Fauteuils roulants Résumé : Objective To describe how people who use wheelchairs participate and move at home and in the community over an entire yearlong period, including during times of inclement weather conditions. Design Longitudinal mixed-methods research study. Setting Urban community in Canada. Participants People who use a wheelchair for home and community mobility (N=11). Intervention Not applicable. Main Outcome Measures Use of a global positioning system (GPS) tracker for movement in community (number of trips per day), use of accelerometer for bouts of wheeling mobility (number of bouts per day, speed, distance, and duration), prompted recall interviews to identify supports and barriers to mobility and participation. Results More trips per day were taken during the summer (P= .03) and on days with no snow and temperatures above 0°C. Participants reliant on public transportation demonstrated more weather-specific changes in their trip patterns. The number of daily bouts of mobility remained similar across seasons; total daily distance wheeled, duration, and speed were higher on summer days, days with no snow, and days with temperatures above 0°C. A higher proportion of outdoor wheeling bouts occurred in summer (P=.02) and with temperatures above 0°C (P=.03). Inaccessible public environments were the primary barrier to community mobility and participation; access to social supports and private transportation were the primary supports. Conclusions Objective support is provided for the influence of various seasonal weather conditions on community mobility and participation for people who use a wheelchair. Longitudinal data collection provided a detailed understanding of the patterns of, and influences on, wheelchair mobility and participation within wheelchair users’ own homes and communities. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Impact of Regular Physical Activity on Adipocytokines and Cardiovascular Characteristics in Spinal Cord–Injured Subjects / Roberto Schreiber in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1561-1567 Titre : Impact of Regular Physical Activity on Adipocytokines and Cardiovascular Characteristics in Spinal Cord–Injured Subjects Type de document : Article Auteurs : Roberto Schreiber ; Cristiane M. Souza ; Layde R. Paim Article en page(s) : p. 1561-1567 Langues : Anglais (eng) Descripteurs : HE Vinci Adiponectine ; Exercice physique ; Leptine ; Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Adiponectin  Carotid arteries  Artères carotides  Exercise  Leptin  Spinal Cord Injuries Résumé : Objective To investigate the relationship of carotid artery intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically active (PA-SCI) subjects with spinal cord injury (SCI). Design Cross-sectional observational study. Setting Academic medical center. Participants Men with chronic (>1y) SCI (N=41; 16 S-SCI, 25 PA-SCI) were evaluated. S-SCI subjects did not perform labor that required physical effort, recreational physical activity, or sports, while PA-SCI subjects included competing athletes who were regularly performing adapted sports. Interventions Not applicable. Main Outcome Measures Clinical, laboratory, carotid ultrasonography, and echocardiography analysis. Plasma leptin, adiponectin, and plasminogen activating inhibitor-1 (PAI-1) levels were determined. Results PA-SCI subjects had similar levels of adipocytokines, but lower carotid IMT and carotid IMT/diameter, and better left ventricular diastolic function than S-SCI participants. Bivariate analysis showed that adiponectin was inversely correlated with triglycerides (r=–.85, P<.001 low-density lipoprotein cholesterol p and carotid imt in s-sci but not pa-sci participants. additionally the leptin-adiponectin ratio showed a direct correlation with triglycerides individuals. by contrast studied adipocytokines did correlate cardiac structure function> Conclusions Lower adiponectin levels and higher leptin-adiponectin ratio are related to adverse vascular and/or metabolic characteristics in individuals with SCI. This relationship, however, appears to be mitigated by regular physical activity. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Impact of Regular Physical Activity on Adipocytokines and Cardiovascular Characteristics in Spinal Cord–Injured Subjects [Article] / Roberto Schreiber ; Cristiane M. Souza ; Layde R. Paim . - p. 1561-1567. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1561-1567 Descripteurs : HE Vinci Adiponectine ; Exercice physique ; Leptine ; Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Adiponectin  Carotid arteries  Artères carotides  Exercise  Leptin  Spinal Cord Injuries Résumé : Objective To investigate the relationship of carotid artery intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically active (PA-SCI) subjects with spinal cord injury (SCI). Design Cross-sectional observational study. Setting Academic medical center. Participants Men with chronic (>1y) SCI (N=41; 16 S-SCI, 25 PA-SCI) were evaluated. S-SCI subjects did not perform labor that required physical effort, recreational physical activity, or sports, while PA-SCI subjects included competing athletes who were regularly performing adapted sports. Interventions Not applicable. Main Outcome Measures Clinical, laboratory, carotid ultrasonography, and echocardiography analysis. Plasma leptin, adiponectin, and plasminogen activating inhibitor-1 (PAI-1) levels were determined. Results PA-SCI subjects had similar levels of adipocytokines, but lower carotid IMT and carotid IMT/diameter, and better left ventricular diastolic function than S-SCI participants. Bivariate analysis showed that adiponectin was inversely correlated with triglycerides (r=–.85, P<.001 low-density lipoprotein cholesterol p and carotid imt in s-sci but not pa-sci participants. additionally the leptin-adiponectin ratio showed a direct correlation with triglycerides individuals. by contrast studied adipocytokines did correlate cardiac structure function> Conclusions Lower adiponectin levels and higher leptin-adiponectin ratio are related to adverse vascular and/or metabolic characteristics in individuals with SCI. This relationship, however, appears to be mitigated by regular physical activity. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Rehabilitation Utilization for Falls Among Community-Dwelling Older Adults in the United States in the National Health and Aging Trends Study / Briana L. Moreland in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1568-1575 Titre : Rehabilitation Utilization for Falls Among Community-Dwelling Older Adults in the United States in the National Health and Aging Trends Study Type de document : Article Auteurs : Briana L. Moreland ; Laura L. Durbin ; Judith D. Kasper Article en page(s) : p. 1568-1575 Langues : Anglais (eng) Descripteurs : HE Vinci Rééducation et réadaptation ; Sujet âgé Mots-clés : Accidental falls  Chutes accidentelles  Aged Résumé : Objective To determine the characteristics of community-dwelling older adults receiving fall-related rehabilitation. Design Cross-sectional analysis of the fifth round (2015) of the National Health and Aging Trends Study (NHATS). Fall-related rehabilitation utilization was analyzed using weighted multinomial logistic regression with SEs adjusted for the sample design. Setting In-person interviews of a nationally representative sample of community-dwelling older adults. Participants Medicare beneficiaries from NHATS (N=7062). Interventions Not applicable. Main Outcomes Measures Rehabilitation utilization categorized into fall-related rehabilitation, other rehabilitation, or no rehabilitation. Results Fall status (single fall: odds ratio [OR]=2.96; 95% confidence interval [CI], 1.52–5.77; recurrent falls: OR=14.21; 95% CI, 7.45–27.10), fear of falling (OR=3.11; 95% CI, 1.90–5.08), poor Short Physical Performance Battery scores (score 0: OR=6.62; 95% CI, 3.31–13.24; score 1–4: OR=4.65; 95% CI, 2.23–9.68), and hip fracture (OR=3.24; 95% CI, 1.46–7.20) were all associated with receiving fall-related rehabilitation. Lower education level (less than high school diploma compared with 4-y college degree: OR=.21; 95% CI, .11–.40) and Hispanic ethnicity (OR=.37; 95% CI, .15–.87) were associated with not receiving fall-related rehabilitation. Conclusions Hispanic older adults and older adults who are less educated are less likely to receive fall-related rehabilitation. Recurrent fallers followed by those who fell once in the past year were more likely to receive fall-related rehabilitation than are older adults who have not had a fall in the past year. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Rehabilitation Utilization for Falls Among Community-Dwelling Older Adults in the United States in the National Health and Aging Trends Study [Article] / Briana L. Moreland ; Laura L. Durbin ; Judith D. Kasper . - p. 1568-1575. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1568-1575 Descripteurs : HE Vinci Rééducation et réadaptation ; Sujet âgé Mots-clés : Accidental falls  Chutes accidentelles  Aged Résumé : Objective To determine the characteristics of community-dwelling older adults receiving fall-related rehabilitation. Design Cross-sectional analysis of the fifth round (2015) of the National Health and Aging Trends Study (NHATS). Fall-related rehabilitation utilization was analyzed using weighted multinomial logistic regression with SEs adjusted for the sample design. Setting In-person interviews of a nationally representative sample of community-dwelling older adults. Participants Medicare beneficiaries from NHATS (N=7062). Interventions Not applicable. Main Outcomes Measures Rehabilitation utilization categorized into fall-related rehabilitation, other rehabilitation, or no rehabilitation. Results Fall status (single fall: odds ratio [OR]=2.96; 95% confidence interval [CI], 1.52–5.77; recurrent falls: OR=14.21; 95% CI, 7.45–27.10), fear of falling (OR=3.11; 95% CI, 1.90–5.08), poor Short Physical Performance Battery scores (score 0: OR=6.62; 95% CI, 3.31–13.24; score 1–4: OR=4.65; 95% CI, 2.23–9.68), and hip fracture (OR=3.24; 95% CI, 1.46–7.20) were all associated with receiving fall-related rehabilitation. Lower education level (less than high school diploma compared with 4-y college degree: OR=.21; 95% CI, .11–.40) and Hispanic ethnicity (OR=.37; 95% CI, .15–.87) were associated with not receiving fall-related rehabilitation. Conclusions Hispanic older adults and older adults who are less educated are less likely to receive fall-related rehabilitation. Recurrent fallers followed by those who fell once in the past year were more likely to receive fall-related rehabilitation than are older adults who have not had a fall in the past year. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Association of Posttraumatic Stress Symptom Severity With Health-Related Quality of Life and Self-Reported Functioning Across 12 Months After Severe Traumatic Brain Injury / Colin M. Bosma in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1576-1583 Titre : Association of Posttraumatic Stress Symptom Severity With Health-Related Quality of Life and Self-Reported Functioning Across 12 Months After Severe Traumatic Brain Injury Type de document : Article Auteurs : Colin M. Bosma ; Nashwa Mansoor ; Chiara S. Haller Article en page(s) : p. 1576-1583 Langues : Anglais (eng) Descripteurs : HE Vinci Qualité de vie ; Rééducation et réadaptation ; Troubles de stress post-traumatique Mots-clés : Quality of life  Stress disorders  post-traumatic  Brain Injuries  Traumatic  Lésions traumatiques de l'encéphale Résumé : Objective To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI). Design Longitudinal prospective multicenter, cohort study on severe TBI in Switzerland (2007–2011). Setting Hospital, rehabilitation unit, and/or patient’s living facility. Participants Patients with severe TBI (N=109) were included in the analyses. Injury severity was determined using the Abbreviated Injury Score of the head region after clinical assessment and initial computed tomography scan. Interventions Not applicable. Main Outcome Measures HRQoL (Medical Outcomes Study 12-Item Short-Form Health Survey Physical and Mental Component Summaries) and self-reported emotional, cognitive, and interpersonal functioning (Patient Competency Rating Scale for Neurorehabilitation). Results Multilevel models for patients >50 and ≤50 years of age revealed significant negative associations between PTS symptom severity and interpersonal functioning (P<.001 and p=".002)," respectively. among patients years of age pts symptom severity was significantly associated with total functioning emotional all cognitive mental hrqol> Conclusions Findings indicate that PTS symptoms after severe TBI are negatively associated with HRQoL and emotional, cognitive, and interpersonal functioning. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Association of Posttraumatic Stress Symptom Severity With Health-Related Quality of Life and Self-Reported Functioning Across 12 Months After Severe Traumatic Brain Injury [Article] / Colin M. Bosma ; Nashwa Mansoor ; Chiara S. Haller . - p. 1576-1583. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1576-1583 Descripteurs : HE Vinci Qualité de vie ; Rééducation et réadaptation ; Troubles de stress post-traumatique Mots-clés : Quality of life  Stress disorders  post-traumatic  Brain Injuries  Traumatic  Lésions traumatiques de l'encéphale Résumé : Objective To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI). Design Longitudinal prospective multicenter, cohort study on severe TBI in Switzerland (2007–2011). Setting Hospital, rehabilitation unit, and/or patient’s living facility. Participants Patients with severe TBI (N=109) were included in the analyses. Injury severity was determined using the Abbreviated Injury Score of the head region after clinical assessment and initial computed tomography scan. Interventions Not applicable. Main Outcome Measures HRQoL (Medical Outcomes Study 12-Item Short-Form Health Survey Physical and Mental Component Summaries) and self-reported emotional, cognitive, and interpersonal functioning (Patient Competency Rating Scale for Neurorehabilitation). Results Multilevel models for patients >50 and ≤50 years of age revealed significant negative associations between PTS symptom severity and interpersonal functioning (P<.001 and p=".002)," respectively. among patients years of age pts symptom severity was significantly associated with total functioning emotional all cognitive mental hrqol> Conclusions Findings indicate that PTS symptoms after severe TBI are negatively associated with HRQoL and emotional, cognitive, and interpersonal functioning. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado / Lenore A. Hawley in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1584-1590 Titre : Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado Type de document : Article Auteurs : Lenore A. Hawley ; Jessica M. Ketchum ; Clare Morey Article en page(s) : p. 1584-1590 Langues : Anglais (eng) Descripteurs : HE Vinci Cannabis ; Traumatismes de la moelle épinière Mots-clés : Spinal Cord Injuries  Brain Injuries  Traumatic  Lésions traumatiques de l'encéphale Résumé : Objectives To describe the prevalence of cannabis use in an adult sample with spinal cord injury (SCI) or traumatic brain injury (TBI) in Colorado, and to describe the self-reported reasons and side effects of cannabis use in this sample. Design Mixed-methods observational study, using focus group data and telephone survey. Setting Community. Participants Colorado adults who sustained SCI or moderate to severe TBI and received services through Craig Hospital. Interventions None. Main Outcome Measures Survey. Results Focus group participants identified issues that were then included in the survey development. Seventy percent of the 116 participants surveyed reported cannabis use before their injury (67% SCI, 74% TBI) and 48% reported use after their injury (53% SCI, 45% TBI). Overall, the most common reason for use was recreational (67%), followed by reducing stress/anxiety (62.5%) and improving sleep (59%). Among the respondents with SCI, the most common reasons for use were to reduce spasticity (70%), recreation (63%), and to improve sleep (63%). Among those with TBI, reasons endorsed were recreational (72%), reducing stress/anxiety (62%), and improving sleep (55%). Smoking was the most common method of use. Conclusions A majority of this sample reported using cannabis before injury, and approximately half reported using cannabis after injury. Both groups reported recreational use, whereas the group with SCI also highly endorsed using cannabis to address chronic medical conditions. Clinicians should be aware of the high prevalence of cannabis use in these populations and the impact such use may have on the individual’s medical management. Further research in this area is needed. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Cannabis Use in Individuals With Spinal Cord Injury or Moderate to Severe Traumatic Brain Injury in Colorado [Article] / Lenore A. Hawley ; Jessica M. Ketchum ; Clare Morey . - p. 1584-1590. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1584-1590 Descripteurs : HE Vinci Cannabis ; Traumatismes de la moelle épinière Mots-clés : Spinal Cord Injuries  Brain Injuries  Traumatic  Lésions traumatiques de l'encéphale Résumé : Objectives To describe the prevalence of cannabis use in an adult sample with spinal cord injury (SCI) or traumatic brain injury (TBI) in Colorado, and to describe the self-reported reasons and side effects of cannabis use in this sample. Design Mixed-methods observational study, using focus group data and telephone survey. Setting Community. Participants Colorado adults who sustained SCI or moderate to severe TBI and received services through Craig Hospital. Interventions None. Main Outcome Measures Survey. Results Focus group participants identified issues that were then included in the survey development. Seventy percent of the 116 participants surveyed reported cannabis use before their injury (67% SCI, 74% TBI) and 48% reported use after their injury (53% SCI, 45% TBI). Overall, the most common reason for use was recreational (67%), followed by reducing stress/anxiety (62.5%) and improving sleep (59%). Among the respondents with SCI, the most common reasons for use were to reduce spasticity (70%), recreation (63%), and to improve sleep (63%). Among those with TBI, reasons endorsed were recreational (72%), reducing stress/anxiety (62%), and improving sleep (55%). Smoking was the most common method of use. Conclusions A majority of this sample reported using cannabis before injury, and approximately half reported using cannabis after injury. Both groups reported recreational use, whereas the group with SCI also highly endorsed using cannabis to address chronic medical conditions. Clinicians should be aware of the high prevalence of cannabis use in these populations and the impact such use may have on the individual’s medical management. Further research in this area is needed. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Gait Training in Acute Spinal Cord Injury Rehabilitation—Utilization and Outcomes Among Nonambulatory Individuals: Findings From the SCIRehab Project / Stephanie Rigot in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1591-1598 Titre : Gait Training in Acute Spinal Cord Injury Rehabilitation—Utilization and Outcomes Among Nonambulatory Individuals: Findings From the SCIRehab Project Type de document : Article Auteurs : Stephanie Rigot ; Lynn Worobey ; Michael L. Boninger Article en page(s) : p. 1591-1598 Langues : Anglais (eng) Descripteurs : HE Vinci Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Early ambulation  Lever précoce  Gait  Démarche  Spinal cord injuries Résumé : Objectives To investigate the relation of gait training (GT) during inpatient rehabilitation (IPR) to outcomes of people with traumatic spinal cord injury (SCI). Design Prospective observational study using the SCIRehab database. Setting Six IPR facilities. Participants Patients with new SCI (N=1376) receiving initial rehabilitation. Interventions Patients were divided into groups consisting of those who did and did not receive GT. Patients were further subdivided based on their primary mode of mobility as measured by the FIM. Main Outcome Measures Pain rating scales, Patient Health Questionnaire Mood Subscale, Satisfaction With Life Scale, and Craig Handicap Assessment and Reporting Technique (CHART). Results Nearly 58% of all patients received GT, including 33.3% of patients who were primarily using a wheelchair 1 year after discharge from IPR. Those who used a wheelchair and received GT, received significantly less transfer and wheeled mobility training (P<.001 chart physical independence mobility and occupation scores were significantly worse in patients who used a wheelchair at year received gt compared with those did not receive ipr. older age was also significant predictor of participation as measured by the chart.> Conclusions A significant percentage of individuals who are not likely to become functional ambulators are spending portions of their IPR stays performing GT, which is associated with less time allotted for other functional interventions. GT in IPR was also associated with participation deficits at 1 year for those who used a wheelchair, implying the potential consequences of opportunity costs, pain, and psychological difficulties of receiving unsuccessful GT. Clinicians should consider these data when deciding to implement GT during initial IPR. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Gait Training in Acute Spinal Cord Injury Rehabilitation—Utilization and Outcomes Among Nonambulatory Individuals: Findings From the SCIRehab Project [Article] / Stephanie Rigot ; Lynn Worobey ; Michael L. Boninger . - p. 1591-1598. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1591-1598 Descripteurs : HE Vinci Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Early ambulation  Lever précoce  Gait  Démarche  Spinal cord injuries Résumé : Objectives To investigate the relation of gait training (GT) during inpatient rehabilitation (IPR) to outcomes of people with traumatic spinal cord injury (SCI). Design Prospective observational study using the SCIRehab database. Setting Six IPR facilities. Participants Patients with new SCI (N=1376) receiving initial rehabilitation. Interventions Patients were divided into groups consisting of those who did and did not receive GT. Patients were further subdivided based on their primary mode of mobility as measured by the FIM. Main Outcome Measures Pain rating scales, Patient Health Questionnaire Mood Subscale, Satisfaction With Life Scale, and Craig Handicap Assessment and Reporting Technique (CHART). Results Nearly 58% of all patients received GT, including 33.3% of patients who were primarily using a wheelchair 1 year after discharge from IPR. Those who used a wheelchair and received GT, received significantly less transfer and wheeled mobility training (P<.001 chart physical independence mobility and occupation scores were significantly worse in patients who used a wheelchair at year received gt compared with those did not receive ipr. older age was also significant predictor of participation as measured by the chart.> Conclusions A significant percentage of individuals who are not likely to become functional ambulators are spending portions of their IPR stays performing GT, which is associated with less time allotted for other functional interventions. GT in IPR was also associated with participation deficits at 1 year for those who used a wheelchair, implying the potential consequences of opportunity costs, pain, and psychological difficulties of receiving unsuccessful GT. Clinicians should consider these data when deciding to implement GT during initial IPR. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury / Carolyn E. Schwartz in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1599-1608 Titre : Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury Type de document : Article Auteurs : Carolyn E. Schwartz ; Brian Stucky ; Carly S. Rivers Article en page(s) : p. 1599-1608 Langues : Anglais (eng) Descripteurs : HE Vinci Adaptation ; Adaptation psychologique ; Qualité de vie ; Rééducation et réadaptation ; Résilience psychologique ; Traumatismes de la moelle épinière Mots-clés : psychological  Psychological Phenomena and Processes  Phénomènes et processus psychologiques  Psychological theory  Théorie psychologique  Psychology  applied  Psychologie appliquée  Quality of life  Résilience psychologique  Spinal cord injuries Résumé : Objective To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury. Design Prospective cohort study observed at 1, 2, and 5 years post-SCI. Setting Specialized SCI centers. Participants Sample included 1125, 760, and 219 participants at 1, 2, and 5 years post-SCI (N = 2104). The study sample was 79% men; 39% were motor/sensory complete (mean age, 44.6+18.3y). Interventions Not applicable. Main Outcome Measures Patient-reported outcomes included the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 and the Life Satisfaction-11 Questionnaire. Participant latent variable scores were adjusted for (1) potential attrition bias and (2) propensity scores reflecting risk of worse outcomes. The Oort structural equation modeling approach for detecting and accounting for response shift effects was used to test the hypothesis that people with SCI would undergo response shifts over follow-up. Results The study data comprised the time after FIM scores, an objective measure of motor and cognitive function, had improved and stabilized. Three latent variables (Physical, Mental, and Symptoms) were modeled over time. The response shift model indicated uniform recalibration and reconceptualization response shift effects over time. When adjusted for these response shift effects, Physical showed small true change improvements at 2- and 5-year follow-up, despite FIM stability. Conclusions We detected recalibration and reconceptualization response shift effects in 1- to 5-year follow-up of people with SCI. Despite stable motor and cognitive function, people with SCI are adapting to their condition. This adaptation reflects a progressive disconnection between symptoms and physical or mental health, and a real improvement in the Physical latent variable. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury [Article] / Carolyn E. Schwartz ; Brian Stucky ; Carly S. Rivers . - p. 1599-1608. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1599-1608 Descripteurs : HE Vinci Adaptation ; Adaptation psychologique ; Qualité de vie ; Rééducation et réadaptation ; Résilience psychologique ; Traumatismes de la moelle épinière Mots-clés : psychological  Psychological Phenomena and Processes  Phénomènes et processus psychologiques  Psychological theory  Théorie psychologique  Psychology  applied  Psychologie appliquée  Quality of life  Résilience psychologique  Spinal cord injuries Résumé : Objective To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury. Design Prospective cohort study observed at 1, 2, and 5 years post-SCI. Setting Specialized SCI centers. Participants Sample included 1125, 760, and 219 participants at 1, 2, and 5 years post-SCI (N = 2104). The study sample was 79% men; 39% were motor/sensory complete (mean age, 44.6+18.3y). Interventions Not applicable. Main Outcome Measures Patient-reported outcomes included the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 and the Life Satisfaction-11 Questionnaire. Participant latent variable scores were adjusted for (1) potential attrition bias and (2) propensity scores reflecting risk of worse outcomes. The Oort structural equation modeling approach for detecting and accounting for response shift effects was used to test the hypothesis that people with SCI would undergo response shifts over follow-up. Results The study data comprised the time after FIM scores, an objective measure of motor and cognitive function, had improved and stabilized. Three latent variables (Physical, Mental, and Symptoms) were modeled over time. The response shift model indicated uniform recalibration and reconceptualization response shift effects over time. When adjusted for these response shift effects, Physical showed small true change improvements at 2- and 5-year follow-up, despite FIM stability. Conclusions We detected recalibration and reconceptualization response shift effects in 1- to 5-year follow-up of people with SCI. Despite stable motor and cognitive function, people with SCI are adapting to their condition. This adaptation reflects a progressive disconnection between symptoms and physical or mental health, and a real improvement in the Physical latent variable. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Effectiveness of Oral Pain Medication and Corticosteroid Injections for Carpal Tunnel Syndrome: A Systematic Review / Bionka M. Huisstede in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1609-1622 Titre : Effectiveness of Oral Pain Medication and Corticosteroid Injections for Carpal Tunnel Syndrome: A Systematic Review Type de document : Article Auteurs : Bionka M. Huisstede ; Manon S. Randsdorp ; Janneke van den Brink Article en page(s) : p. 1609-1622 Langues : Anglais (eng) Descripteurs : HE Vinci Hormones corticosurrénaliennes ; Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Adrenal Cortex Hormones  Medication Reconciliation  Bilan comparatif des médicaments  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To present an evidence-based overview of the effectiveness of oral pain medication and corticosteroid injections to treat carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database were searched for relevant systematic reviews and randomized controlled trials (RCTs). Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data on pain (visual analog scale), function or recovery, and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies. Four reviews and 9 RCTs were included. For oral pain medication, strong and moderate evidence was found for the effectiveness of oral steroids versus placebo in the short term. Moderate evidence was found in favor of oral steroids versus splinting in the short term. No evidence was found for the effectiveness of oral steroids in the long term. For corticosteroid injections, strong evidence was found in favor of a corticosteroid injection versus a placebo injection and moderate evidence was found in favor of corticosteroid injection versus oral steroids in the short term. Also, in the short term, moderate evidence was found in favor of a local versus a systematic corticosteroid injection. Higher doses of corticosteroid injections seem to be more effective in the midterm; however, the benefits of corticosteroid injections were not maintained in the long term. Conclusions The reviewed evidence supports that oral steroids and corticosteroid injections benefit patient with CTS particularly in the short term. Although a higher dose of steroid injections seems to be more effective in the midterm, the benefits of oral pain medication and corticosteroid injections were not maintained in the long term. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Effectiveness of Oral Pain Medication and Corticosteroid Injections for Carpal Tunnel Syndrome: A Systematic Review [Article] / Bionka M. Huisstede ; Manon S. Randsdorp ; Janneke van den Brink . - p. 1609-1622. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1609-1622 Descripteurs : HE Vinci Hormones corticosurrénaliennes ; Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Adrenal Cortex Hormones  Medication Reconciliation  Bilan comparatif des médicaments  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To present an evidence-based overview of the effectiveness of oral pain medication and corticosteroid injections to treat carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database were searched for relevant systematic reviews and randomized controlled trials (RCTs). Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data on pain (visual analog scale), function or recovery, and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies. Four reviews and 9 RCTs were included. For oral pain medication, strong and moderate evidence was found for the effectiveness of oral steroids versus placebo in the short term. Moderate evidence was found in favor of oral steroids versus splinting in the short term. No evidence was found for the effectiveness of oral steroids in the long term. For corticosteroid injections, strong evidence was found in favor of a corticosteroid injection versus a placebo injection and moderate evidence was found in favor of corticosteroid injection versus oral steroids in the short term. Also, in the short term, moderate evidence was found in favor of a local versus a systematic corticosteroid injection. Higher doses of corticosteroid injections seem to be more effective in the midterm; however, the benefits of corticosteroid injections were not maintained in the long term. Conclusions The reviewed evidence supports that oral steroids and corticosteroid injections benefit patient with CTS particularly in the short term. Although a higher dose of steroid injections seems to be more effective in the midterm, the benefits of oral pain medication and corticosteroid injections were not maintained in the long term. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials / Bionka M. Huisstede in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1623-1634 Titre : Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials Type de document : Article Auteurs : Bionka M. Huisstede ; Peter Hoogvliet ; Thierry P. Franke Article en page(s) : p. 1623-1634 Langues : Anglais (eng) Descripteurs : HE Vinci Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Physical therapy modalities  Techniques de physiothérapie  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To review scientific literature studying the effectiveness of physical therapy and electrophysical modalities for carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database. Study Selection Two reviewers independently applied the inclusion criteria to select potential eligible studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality using the Cochrane Risk of Bias Tool. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies (2 reviews and 22 randomized controlled trials [RCTs]). For physical therapy, moderate evidence was found for myofascial massage therapy versus ischemic compression on latent, or active, trigger points or low-level laser therapy in the short term. For several electrophysical modalities, moderate evidence was found in the short term (ultrasound vs placebo, ultrasound as single intervention vs other nonsurgical interventions, ultrasound vs corticosteroid injection plus a neutral wrist splint, local microwave hyperthermia vs placebo, iontophoresis vs phonophoresis, pulsed radiofrequency added to wrist splint, continuous vs pulsed vs placebo shortwave diathermy, and interferential current vs transcutaneous electrical nerve stimulation vs a night-only wrist splint). In the midterm, moderate evidence was found in favor of radial extracorporeal shockwave therapy (ESWT) added to a neutral wrist splint, in favor of ESWT versus ultrasound, or cryo-ultrasound, and in favor of ultrasound versus placebo. For all other interventions studied, only limited, conflicting, or no evidence was found. No RCTs investigating the long-term effects of physical therapy and electrophysical modalities were found. Because of heterogeneity in the treatment parameters used in the included RCTs, optimal treatment parameters could not be identified. Conclusions Moderate evidence was found for several physical therapy and electrophysical modalities for CTS in the short term and midterm. Future studies should concentrate on long-term effects and which treatment parameters of physical therapy and electrophysical modalities are most effective for CTS. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Carpal Tunnel Syndrome: Effectiveness of Physical Therapy and Electrophysical Modalities. An Updated Systematic Review of Randomized Controlled Trials [Article] / Bionka M. Huisstede ; Peter Hoogvliet ; Thierry P. Franke . - p. 1623-1634. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1623-1634 Descripteurs : HE Vinci Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Physical therapy modalities  Techniques de physiothérapie  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To review scientific literature studying the effectiveness of physical therapy and electrophysical modalities for carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database. Study Selection Two reviewers independently applied the inclusion criteria to select potential eligible studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality using the Cochrane Risk of Bias Tool. Data Synthesis A best-evidence synthesis was performed to summarize the results of the included studies (2 reviews and 22 randomized controlled trials [RCTs]). For physical therapy, moderate evidence was found for myofascial massage therapy versus ischemic compression on latent, or active, trigger points or low-level laser therapy in the short term. For several electrophysical modalities, moderate evidence was found in the short term (ultrasound vs placebo, ultrasound as single intervention vs other nonsurgical interventions, ultrasound vs corticosteroid injection plus a neutral wrist splint, local microwave hyperthermia vs placebo, iontophoresis vs phonophoresis, pulsed radiofrequency added to wrist splint, continuous vs pulsed vs placebo shortwave diathermy, and interferential current vs transcutaneous electrical nerve stimulation vs a night-only wrist splint). In the midterm, moderate evidence was found in favor of radial extracorporeal shockwave therapy (ESWT) added to a neutral wrist splint, in favor of ESWT versus ultrasound, or cryo-ultrasound, and in favor of ultrasound versus placebo. For all other interventions studied, only limited, conflicting, or no evidence was found. No RCTs investigating the long-term effects of physical therapy and electrophysical modalities were found. Because of heterogeneity in the treatment parameters used in the included RCTs, optimal treatment parameters could not be identified. Conclusions Moderate evidence was found for several physical therapy and electrophysical modalities for CTS in the short term and midterm. Future studies should concentrate on long-term effects and which treatment parameters of physical therapy and electrophysical modalities are most effective for CTS. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Effectiveness of Conservative, Surgical, and Postsurgical Interventions for Trigger Finger, Dupuytren Disease, and De Quervain Disease: A Systematic Review / Bionka M. Huisstede in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1635-1649 Titre : Effectiveness of Conservative, Surgical, and Postsurgical Interventions for Trigger Finger, Dupuytren Disease, and De Quervain Disease: A Systematic Review Type de document : Article Auteurs : Bionka M. Huisstede ; Saskia Gladdines ; Manon S. Randsdorp Article en page(s) : p. 1635-1649 Langues : Anglais (eng) Descripteurs : HE Vinci Maladie de Dupuytren ; Rééducation et réadaptation ; Revue de la littérature Mots-clés : Dupuytren contracture  Review  Tenosynovitis  Ténosynovite  Treatment outcome  Résultat thérapeutique  Trigger finger disorder  Doigt à ressaut Résumé : Objectives To provide an evidence-based overview of the effectiveness of conservative and (post)surgical interventions for trigger finger, Dupuytren disease, and De Quervain disease. Data Sources Cochrane Library, Physiotherapy Evidence Database, PubMed, Embase, and CINAHL were searched to identify relevant systematic reviews and randomized controlled trials (RCTs). Data Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results. Two reviews (trigger finger and De Quervain disease) and 37 randomized controlled trials (RCTs) (trigger finger: n=8; Dupuytren disease: n=14, and De Quervain disease: n=15) were included. The trials reported on oral medication (Dupuytren disease), physiotherapy (De Quervain disease), injections and surgical treatment (trigger finger, Dupuytren disease, and De Quervain disease), and other conservative (De Qervain disease) and postsurgical treatment (Dupuytren disease). Moderate evidence was found for the effect of corticosteroid injection on the very short term for trigger finger, De Quervain disease, and for injections with collagenase (30d) when looking at all joints, and no evidence was found when looking at the PIP joint for Dupuytren disease. A thumb splint as additive to a corticosteroid injection seems to be effective (moderate evidence) for De Quervain disease (short term and midterm). For Dupuytren disease, use of a corticosteroid injection within a percutaneous needle aponeurotomy in the midterm and tamoxifen versus a placebo before or after a fasciectomy seems to promising (moderate evidence). We also found moderate evidence for splinting after Dupuytren surgery in the short term. Conclusions In recent years, more and more RCTs have been conducted to study treatment of the aforementioned hand disorders. However, more high-quality RCTs are still needed to further stimulate evidence-based practice for patients with trigger finger, Dupuytren disease, and De Quervain disease. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Effectiveness of Conservative, Surgical, and Postsurgical Interventions for Trigger Finger, Dupuytren Disease, and De Quervain Disease: A Systematic Review [Article] / Bionka M. Huisstede ; Saskia Gladdines ; Manon S. Randsdorp . - p. 1635-1649. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1635-1649 Descripteurs : HE Vinci Maladie de Dupuytren ; Rééducation et réadaptation ; Revue de la littérature Mots-clés : Dupuytren contracture  Review  Tenosynovitis  Ténosynovite  Treatment outcome  Résultat thérapeutique  Trigger finger disorder  Doigt à ressaut Résumé : Objectives To provide an evidence-based overview of the effectiveness of conservative and (post)surgical interventions for trigger finger, Dupuytren disease, and De Quervain disease. Data Sources Cochrane Library, Physiotherapy Evidence Database, PubMed, Embase, and CINAHL were searched to identify relevant systematic reviews and randomized controlled trials (RCTs). Data Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results. Two reviews (trigger finger and De Quervain disease) and 37 randomized controlled trials (RCTs) (trigger finger: n=8; Dupuytren disease: n=14, and De Quervain disease: n=15) were included. The trials reported on oral medication (Dupuytren disease), physiotherapy (De Quervain disease), injections and surgical treatment (trigger finger, Dupuytren disease, and De Quervain disease), and other conservative (De Qervain disease) and postsurgical treatment (Dupuytren disease). Moderate evidence was found for the effect of corticosteroid injection on the very short term for trigger finger, De Quervain disease, and for injections with collagenase (30d) when looking at all joints, and no evidence was found when looking at the PIP joint for Dupuytren disease. A thumb splint as additive to a corticosteroid injection seems to be effective (moderate evidence) for De Quervain disease (short term and midterm). For Dupuytren disease, use of a corticosteroid injection within a percutaneous needle aponeurotomy in the midterm and tamoxifen versus a placebo before or after a fasciectomy seems to promising (moderate evidence). We also found moderate evidence for splinting after Dupuytren surgery in the short term. Conclusions In recent years, more and more RCTs have been conducted to study treatment of the aforementioned hand disorders. However, more high-quality RCTs are still needed to further stimulate evidence-based practice for patients with trigger finger, Dupuytren disease, and De Quervain disease. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Do Patients With Carpal Tunnel Syndrome Benefit From Low-Level Laser Therapy? A Systematic Review of Randomized Controlled Trials / Thierry P. Franke in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1650-1659 Titre : Do Patients With Carpal Tunnel Syndrome Benefit From Low-Level Laser Therapy? A Systematic Review of Randomized Controlled Trials Type de document : Article Auteurs : Thierry P. Franke ; Bart W. Koes ; Sven J. Geelen Article en page(s) : p. 1650-1659 Langues : Anglais (eng) Descripteurs : HE Vinci Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Lasers  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To systematically review the literature on the effectiveness of low-level laser therapy for patients with carpal tunnel syndrome. Data Sources The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database were searched for relevant systematic reviews and randomized controlled trials (RCTs) up to April 8, 2016. Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the 2 systematic reviews and 17 RCTs that were included. Strong evidence was found for the effectiveness of low-level laser therapy compared with placebo treatment in the very short term (0 to ≤5wk). After 5 weeks, the positive effects of low-level laser therapy on pain, function, or recovery diminished over time (moderate and conflicting evidence were found at 7- and 12-wk follow-up, respectively). Conclusions In the very short term, low-level laser therapy is more effective as a single intervention than placebo low-level laser therapy in patients with carpal tunnel syndrome, after which the positive effects of low-level laser therapy tend to subside. Evidence in the midterm and long term is sparse. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Do Patients With Carpal Tunnel Syndrome Benefit From Low-Level Laser Therapy? A Systematic Review of Randomized Controlled Trials [Article] / Thierry P. Franke ; Bart W. Koes ; Sven J. Geelen . - p. 1650-1659. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1650-1659 Descripteurs : HE Vinci Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Lasers  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To systematically review the literature on the effectiveness of low-level laser therapy for patients with carpal tunnel syndrome. Data Sources The Cochrane Library, PubMed, Embase, CINAHL, and Physiotherapy Evidence Database were searched for relevant systematic reviews and randomized controlled trials (RCTs) up to April 8, 2016. Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results of the 2 systematic reviews and 17 RCTs that were included. Strong evidence was found for the effectiveness of low-level laser therapy compared with placebo treatment in the very short term (0 to ≤5wk). After 5 weeks, the positive effects of low-level laser therapy on pain, function, or recovery diminished over time (moderate and conflicting evidence were found at 7- and 12-wk follow-up, respectively). Conclusions In the very short term, low-level laser therapy is more effective as a single intervention than placebo low-level laser therapy in patients with carpal tunnel syndrome, after which the positive effects of low-level laser therapy tend to subside. Evidence in the midterm and long term is sparse. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Effectiveness of Surgical and Postsurgical Interventions for Carpal Tunnel Syndrome—A Systematic Review / Bionka M. Huisstede in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1660-1680 Titre : Effectiveness of Surgical and Postsurgical Interventions for Carpal Tunnel Syndrome—A Systematic Review Type de document : Article Auteurs : Bionka M. Huisstede ; Janneke van den Brink ; Manon S. Randsdorp Article en page(s) : p. 1660-1680 Langues : Anglais (eng) Descripteurs : HE Vinci Chirurgie plastique ; Orthopedie ; Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Orthopedics  Surgery  Plastic  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To present an evidence-based overview of the effectiveness of surgical and postsurgical interventions for carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs) up to April 8, 2016. Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results. Four systematic reviews and 33 RCTs were included. Surgery versus nonsurgical interventions, timing of surgery, and various surgical techniques and postoperative interventions were studied. Corticosteroid injection was more effective than surgery (strong evidence, short-term). Surgery was more effective than splinting or anti-inflammatory drugs plus hand therapy (moderate evidence, midterm and long-term). Manual therapy was more effective than surgical treatment (moderate evidence, short-term and midterm). Within surgery, corticosteroid irrigation of the median nerve before skin closure as additive to CTS release or the direct vision plus tunneling technique was more effective than standard open CTS release (moderate evidence, short-term). Furthermore, short was more effective than long bulky dressings, and a sensory retraining program was more effective than no program after surgery (moderate evidence, short-term). For all other interventions only conflicting, limited, or no evidence was found. Conclusions Surgical treatment seems to be more effective than splinting or anti-inflammatory drugs plus hand therapy in the short-term, midterm, and/or long-term to treat CTS. However there is strong evidence that a local corticosteroid injection is more effective than surgery in the short-term, and moderate evidence that manual therapy is more effective than surgery in the short-term and midterm. There is no unequivocal evidence that suggests one surgical treatment is more effective than the other. Postsurgical, a short- (2-3 days) favored a long-duration (9-14 days) bulky dressing and a sensory retraining program seems to be more effective than no program in short-term. More research regarding the optimal timing of surgery for CTS is needed. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Effectiveness of Surgical and Postsurgical Interventions for Carpal Tunnel Syndrome—A Systematic Review [Article] / Bionka M. Huisstede ; Janneke van den Brink ; Manon S. Randsdorp . - p. 1660-1680. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1660-1680 Descripteurs : HE Vinci Chirurgie plastique ; Orthopedie ; Rééducation et réadaptation ; Revue de la littérature ; Syndrome du canal carpien Mots-clés : Carpal tunnel syndrome  Orthopedics  Surgery  Plastic  Review  Treatment outcome  Résultat thérapeutique Résumé : Objective To present an evidence-based overview of the effectiveness of surgical and postsurgical interventions for carpal tunnel syndrome (CTS). Data Sources The Cochrane Library, PubMed, EMBASE, CINAHL, and PEDro were searched for relevant systematic reviews and randomized controlled trials (RCTs) up to April 8, 2016. Study Selection Two reviewers independently applied the inclusion criteria to select potential studies. Data Extraction Two reviewers independently extracted the data and assessed the methodologic quality. Data Synthesis A best-evidence synthesis was performed to summarize the results. Four systematic reviews and 33 RCTs were included. Surgery versus nonsurgical interventions, timing of surgery, and various surgical techniques and postoperative interventions were studied. Corticosteroid injection was more effective than surgery (strong evidence, short-term). Surgery was more effective than splinting or anti-inflammatory drugs plus hand therapy (moderate evidence, midterm and long-term). Manual therapy was more effective than surgical treatment (moderate evidence, short-term and midterm). Within surgery, corticosteroid irrigation of the median nerve before skin closure as additive to CTS release or the direct vision plus tunneling technique was more effective than standard open CTS release (moderate evidence, short-term). Furthermore, short was more effective than long bulky dressings, and a sensory retraining program was more effective than no program after surgery (moderate evidence, short-term). For all other interventions only conflicting, limited, or no evidence was found. Conclusions Surgical treatment seems to be more effective than splinting or anti-inflammatory drugs plus hand therapy in the short-term, midterm, and/or long-term to treat CTS. However there is strong evidence that a local corticosteroid injection is more effective than surgery in the short-term, and moderate evidence that manual therapy is more effective than surgery in the short-term and midterm. There is no unequivocal evidence that suggests one surgical treatment is more effective than the other. Postsurgical, a short- (2-3 days) favored a long-duration (9-14 days) bulky dressing and a sensory retraining program seems to be more effective than no program in short-term. More research regarding the optimal timing of surgery for CTS is needed. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]

Optimizing the Management of Spasticity in People With Spinal Cord Damage: A Clinical Care Pathway for Assessment and Treatment Decision Making From the Ability Network, an International Initiative / Indira S. Lanig in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 8 (2018)  

Public ISBD [article]  inArchives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1681-1687 Titre : Optimizing the Management of Spasticity in People With Spinal Cord Damage: A Clinical Care Pathway for Assessment and Treatment Decision Making From the Ability Network, an International Initiative Type de document : Article Auteurs : Indira S. Lanig ; Peter W. New ; Anthony S. Burns Article en page(s) : p. 1681-1687 Langues : Anglais (eng) Descripteurs : HE Vinci Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Muscle spasticity  Spasticité musculaire  Spinal cord diseases  Maladies de la moelle épinière  Spinal cord injuries Résumé : The recognition, evaluation, and management of disabling spasticity in persons with spinal cord damage (SCD) is a challenge for health care professionals, institutions, health systems, and patients. To guide the assessment and management of disabling spasticity in individuals with SCD, the Ability Network, an international panel of clinical experts, developed a clinical care pathway. The aim of this pathway is to facilitate treatment decisions that take into account the effect of disabling spasticity on health status, individual preferences and treatment goals, tolerance for adverse events, and burden on caregivers. The pathway emphasizes a patient-centered, individualized approach and the need for interdisciplinary coordination of care, patient involvement in goal setting, and the use of assessment and outcome measures that lend themselves to practical application in the clinic. The clinical care pathway is intended for use by health care professionals who provide care for persons with SCD and disabling spasticity in various settings. Barriers to optimal spasticity management in these people are also discussed. There is an urgent need for the clinical community to clarify and overcome barriers (knowledge-based, organizational, health system) to optimizing the management of spasticity in people with SCD. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] [article] Optimizing the Management of Spasticity in People With Spinal Cord Damage: A Clinical Care Pathway for Assessment and Treatment Decision Making From the Ability Network, an International Initiative [Article] / Indira S. Lanig ; Peter W. New ; Anthony S. Burns . - p. 1681-1687. Langues : Anglais (eng) in Archives of Physical Medicine and Rehabilitation > Vol. 99, n° 8 (2018) . - p. 1681-1687 Descripteurs : HE Vinci Rééducation et réadaptation ; Traumatismes de la moelle épinière Mots-clés : Muscle spasticity  Spasticité musculaire  Spinal cord diseases  Maladies de la moelle épinière  Spinal cord injuries Résumé : The recognition, evaluation, and management of disabling spasticity in persons with spinal cord damage (SCD) is a challenge for health care professionals, institutions, health systems, and patients. To guide the assessment and management of disabling spasticity in individuals with SCD, the Ability Network, an international panel of clinical experts, developed a clinical care pathway. The aim of this pathway is to facilitate treatment decisions that take into account the effect of disabling spasticity on health status, individual preferences and treatment goals, tolerance for adverse events, and burden on caregivers. The pathway emphasizes a patient-centered, individualized approach and the need for interdisciplinary coordination of care, patient involvement in goal setting, and the use of assessment and outcome measures that lend themselves to practical application in the clinic. The clinical care pathway is intended for use by health care professionals who provide care for persons with SCD and disabling spasticity in various settings. Barriers to optimal spasticity management in these people are also discussed. There is an urgent need for the clinical community to clarify and overcome barriers (knowledge-based, organizational, health system) to optimizing the management of spasticity in people with SCD. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]