[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2061-2070

Titre :	Physical Activity and Sedentary Behavior From Discharge to 1 Year After Inpatient Rehabilitation in Ambulatory People With Spinal Cord Injury: A Longitudinal Cohort Study
Type de document :	Article
Auteurs :	Karin Postma ; Johannes B.J. Bussmann ; Tijn van Diemen ; Marcel W.M. Post ; Jos Dekkers ; Ilse J.W. van Nes ; Rutger Osterthun ; Rita J.G. van den Berg-Emons
Année de publication :	2020
Article en page(s) :	p. 2061-2070
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.027
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Exercice physique ; Marche à pied ; Mode de vie sédentaire ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To evaluate changes in duration of physical activity (PA) and sedentary behavior (SB) from discharge to 1 year after inpatient rehabilitation in ambulatory people with spinal cord injury (SCI). Design Longitudinal cohort study with objective measurements of physical behavior at discharge and at 6 and 12 months post discharge. Setting Three rehabilitation centers and the participant’s home environment. Participants Participants (N=47) with ambulatory function were consecutively recruited from the self-management and self-efficacy in patients with SCI cohort (age 18 years or older, recent SCI, expected inpatient stay ≥4wk). Mean age was 54.5±12.9 years, all had incomplete lesions, 53% were men, 49% had tetraplegia, and 51% were community ambulators at discharge. Interventions Not applicable. Main Outcome Measures Duration (min) of PA (summed duration of walking, cycling, running, and wheeling) and SB (sitting/lying). Results Mean duration of PA increased by 21 min/d (95% confidence interval, 7-35) and SB decreased by 64 min/d (95% confidence interval, −94 to −35) from discharge to 6 months after inpatient rehabilitation. No changes were found in the second half-year. One year after discharge mean PA was 116±59 min/d and mean SB was 665±121 min/d. The increase in PA was the result of an almost doubling of time spent walking. Variability in physical behavior and its change was large. Older age and lower ambulation level were associated with lower PA, lower ambulation level with higher SB, and tetraplegia was associated with a reduced increase in PA. Conclusions At group level, duration of PA and SB improved following inpatient rehabilitation in ambulatory people with SCI. However, there were large differences between individuals. Levels 1 year after discharge were still unfavorable, particularly regarding SB.
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[article] Physical Activity and Sedentary Behavior From Discharge to 1 Year After Inpatient Rehabilitation in Ambulatory People With Spinal Cord Injury: A Longitudinal Cohort Study [Article] / Karin Postma ; Johannes B.J. Bussmann ; Tijn van Diemen ; Marcel W.M. Post ; Jos Dekkers ; Ilse J.W. van Nes ; Rutger Osterthun ; Rita J.G. van den Berg-Emons . - 2020 . - p. 2061-2070.
https://doi.org/10.1016/j.apmr.2020.06.027
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2061-2070

Descripteurs :	HE Vinci Exercice physique ; Marche à pied ; Mode de vie sédentaire ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To evaluate changes in duration of physical activity (PA) and sedentary behavior (SB) from discharge to 1 year after inpatient rehabilitation in ambulatory people with spinal cord injury (SCI). Design Longitudinal cohort study with objective measurements of physical behavior at discharge and at 6 and 12 months post discharge. Setting Three rehabilitation centers and the participant’s home environment. Participants Participants (N=47) with ambulatory function were consecutively recruited from the self-management and self-efficacy in patients with SCI cohort (age 18 years or older, recent SCI, expected inpatient stay ≥4wk). Mean age was 54.5±12.9 years, all had incomplete lesions, 53% were men, 49% had tetraplegia, and 51% were community ambulators at discharge. Interventions Not applicable. Main Outcome Measures Duration (min) of PA (summed duration of walking, cycling, running, and wheeling) and SB (sitting/lying). Results Mean duration of PA increased by 21 min/d (95% confidence interval, 7-35) and SB decreased by 64 min/d (95% confidence interval, −94 to −35) from discharge to 6 months after inpatient rehabilitation. No changes were found in the second half-year. One year after discharge mean PA was 116±59 min/d and mean SB was 665±121 min/d. The increase in PA was the result of an almost doubling of time spent walking. Variability in physical behavior and its change was large. Older age and lower ambulation level were associated with lower PA, lower ambulation level with higher SB, and tetraplegia was associated with a reduced increase in PA. Conclusions At group level, duration of PA and SB improved following inpatient rehabilitation in ambulatory people with SCI. However, there were large differences between individuals. Levels 1 year after discharge were still unfavorable, particularly regarding SB.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2071-2079

Titre :	Self-reported Participation Restrictions Among Male and Female Veterans With Traumatic Brain Injury in Veterans Health Administration Outpatient Polytrauma Programs
Type de document :	Article
Auteurs :	Alison M. Cogan ; Bridget Smith ; Theresa L. Bender Pape ; Trudy Mallinson ; Blessen C. Eapen
Année de publication :	2020
Article en page(s) :	p. 2071-2079
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.030
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Anciens combattants ; Identité de genre ; Lésions traumatiques de l'encéphale ; Participation communautaire ; Polytraumatisme ; Réadaptation
Résumé :	Objectives To identify areas of most restricted self-reported participation among veterans with traumatic brain injury (TBI), explore associations among participation restriction and clinical characteristics, and examine differences in participation restrictions by sex. Design Retrospective cross-sectional design. Setting National VA Polytrauma System of Care outpatient settings. Participants Veterans with a confirmed TBI event (N=6065). Interventions Not applicable. Main Outcome Measure(s) Mayo-Portland Participation Index (M2PI), a 5-point Likert-type scale with 8 items. Total score was converted to standardized T score for analysis. Results The sample consisted of 5679 male and 386 female veterans with ≥1 clinically confirmed TBI events (69% white; 74% with blast exposure). The M2PI items with greatest perceived restrictions were social contact, leisure, and initiation. There were no significant differences between men and women on M2PI standardized T scores. Wilcoxon rank-sum analyses showed significant differences by sex on 4 items: leisure, residence, employment, and financial management (all P<.01 in multinomial logistic regression on each item controlling for demographics injury characteristics and comorbidities female veterans had significantly greater relative risk part-time work unemployment the employment less impairment residence financial management item.> Conclusions There was no significant difference between men and women. Veterans on M2PI standardized T scores, which masks differences in response patterns to individual items. Clinical teams should be encouraged to discuss perceived restrictions with patients and target these areas in treatment planning. Future work is needed to investigate the psychometric properties of the M2PI by biological sex.
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[article] Self-reported Participation Restrictions Among Male and Female Veterans With Traumatic Brain Injury in Veterans Health Administration Outpatient Polytrauma Programs [Article] / Alison M. Cogan ; Bridget Smith ; Theresa L. Bender Pape ; Trudy Mallinson ; Blessen C. Eapen . - 2020 . - p. 2071-2079.
https://doi.org/10.1016/j.apmr.2020.06.030
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2071-2079

Descripteurs :	HE Vinci Anciens combattants ; Identité de genre ; Lésions traumatiques de l'encéphale ; Participation communautaire ; Polytraumatisme ; Réadaptation
Résumé :	Objectives To identify areas of most restricted self-reported participation among veterans with traumatic brain injury (TBI), explore associations among participation restriction and clinical characteristics, and examine differences in participation restrictions by sex. Design Retrospective cross-sectional design. Setting National VA Polytrauma System of Care outpatient settings. Participants Veterans with a confirmed TBI event (N=6065). Interventions Not applicable. Main Outcome Measure(s) Mayo-Portland Participation Index (M2PI), a 5-point Likert-type scale with 8 items. Total score was converted to standardized T score for analysis. Results The sample consisted of 5679 male and 386 female veterans with ≥1 clinically confirmed TBI events (69% white; 74% with blast exposure). The M2PI items with greatest perceived restrictions were social contact, leisure, and initiation. There were no significant differences between men and women on M2PI standardized T scores. Wilcoxon rank-sum analyses showed significant differences by sex on 4 items: leisure, residence, employment, and financial management (all P<.01 in multinomial logistic regression on each item controlling for demographics injury characteristics and comorbidities female veterans had significantly greater relative risk part-time work unemployment the employment less impairment residence financial management item.> Conclusions There was no significant difference between men and women. Veterans on M2PI standardized T scores, which masks differences in response patterns to individual items. Clinical teams should be encouraged to discuss perceived restrictions with patients and target these areas in treatment planning. Future work is needed to investigate the psychometric properties of the M2PI by biological sex.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2080-2086

Titre :	Understanding the Multidimensional Nature of Sexuality After Traumatic Brain Injury
Type de document :	Article
Auteurs :	Elinor E. Fraser ; Marina G. Downing ; Jennie L. Ponsford
Année de publication :	2020
Article en page(s) :	p. 2080-2086
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.028
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Dépression ; Lésions encéphaliques ; Réadaptation ; Sexualité
Résumé :	Objective To investigate the association of sexuality with sociodemographic (age, sex, education), medical (injury severity, time since injury), physical (fatigue, pain, independence), neuropsychological (memory, attention, executive function), psychological (depression, anxiety, self-esteem), and social participation factors after traumatic brain injury (TBI). Design Survey. Individuals with TBI completed measures at a mean average of 2.78 years post injury (range, 1-10.3y). Setting All participants were community based at the time of data collection. Participants Eighty-four individuals with TBI consecutively recruited after discharge from rehabilitation and 88 age-, sex-, and education-matched controls with TBI recruited from the general community. Interventions Not applicable. Main Outcome Measure Brain Injury Questionnaire of Sexuality. Results Individuals with TBI performed significantly worse on sexuality, mood, and self-esteem measures than the control group without TBI, supporting previous findings. Research findings highlighted a range of significant correlations between sociodemographic, physical, neuropsychological, psychological, and social participation factors and sexuality outcomes after TBI. In the multiple regression model, older age, greater depression, and lower self-esteem were significant predictors of poorer sexuality post injury. Further analyses indicated that depression mediated the independent relationships between lower social participation and greater fatigue with a decline in sexuality after TBI. Conclusions These findings support sexuality changes after TBI as a multidimensional construct, highlighting depression as a key mechanism through which other factors may affect sexual functioning. Further research is needed to target assessment and intervention services for sexuality problems after TBI.
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[article] Understanding the Multidimensional Nature of Sexuality After Traumatic Brain Injury [Article] / Elinor E. Fraser ; Marina G. Downing ; Jennie L. Ponsford . - 2020 . - p. 2080-2086.
https://doi.org/10.1016/j.apmr.2020.06.028
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2080-2086

Descripteurs :	HE Vinci Dépression ; Lésions encéphaliques ; Réadaptation ; Sexualité
Résumé :	Objective To investigate the association of sexuality with sociodemographic (age, sex, education), medical (injury severity, time since injury), physical (fatigue, pain, independence), neuropsychological (memory, attention, executive function), psychological (depression, anxiety, self-esteem), and social participation factors after traumatic brain injury (TBI). Design Survey. Individuals with TBI completed measures at a mean average of 2.78 years post injury (range, 1-10.3y). Setting All participants were community based at the time of data collection. Participants Eighty-four individuals with TBI consecutively recruited after discharge from rehabilitation and 88 age-, sex-, and education-matched controls with TBI recruited from the general community. Interventions Not applicable. Main Outcome Measure Brain Injury Questionnaire of Sexuality. Results Individuals with TBI performed significantly worse on sexuality, mood, and self-esteem measures than the control group without TBI, supporting previous findings. Research findings highlighted a range of significant correlations between sociodemographic, physical, neuropsychological, psychological, and social participation factors and sexuality outcomes after TBI. In the multiple regression model, older age, greater depression, and lower self-esteem were significant predictors of poorer sexuality post injury. Further analyses indicated that depression mediated the independent relationships between lower social participation and greater fatigue with a decline in sexuality after TBI. Conclusions These findings support sexuality changes after TBI as a multidimensional construct, highlighting depression as a key mechanism through which other factors may affect sexual functioning. Further research is needed to target assessment and intervention services for sexuality problems after TBI.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2087-2092

Titre :	Suitability of YouTube Videos for Learning Knee Stability Tests: A Cross-sectional Review
Type de document :	Article
Auteurs :	Myungeun Yoo ; Juntaek Hong ; Chan Woong Jang
Année de publication :	2020
Article en page(s) :	p. 2087-2092
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.024
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Articulation du genou ; Education ; Examen clinique ; Genou ; Ligaments ; Réadaptation
Résumé :	Objective To verify the suitability and reliability of YouTube videos pertaining to the 5 most commonly used knee stability tests for educational purposes. Design Cross-sectional observational study. Setting YouTube videos were categorized into 2 groups according to their sources: professional and nonprofessional groups. Only videos that satisfied the purpose and procedure parts among comprehensiveness scores were defined as suitable for educational purposes. For evaluating the reliability, the modified DISCERN was used. One-way analysis of variance and Kruskal-Wallis test were used to compare continuous and categorical variables, respectively. Participants Research on YouTube videos (N=218) from November 13, 2019, to November 17, 2019, was done using the following keywords: “anterior drawer test knee,” “Lachman test knee,” “posterior drawer test,” “valgus knee test,” and “varus knee test.” Interventions Not applicable. Main Outcome Measures Comprehensiveness score that focused on the purpose, procedure, interpretation, and limitations or precautions of the test were developed by the authors, and modified DISCERN score. Results In terms of the suitability for educational purposes, 126 videos (58%) were classified into the suitable group, and 92 (42%) were classified into the unsuitable group. Neither group had significantly more views, views per posting days, likes, dislikes, or posting days. When comparing the comprehensiveness and reliability scores of each group, significant differences between groups were identified. Only 47 videos met the limitations/precautions category. A total of 155 videos (71%) were from the professional group and 63 videos (29%) were from the nonprofessional group. Significant differences were found in views, views per posting days, likes, and dislikes between the professional group and nonprofessional group. Conclusions YouTube should not be used for learning about knee stability tests. Professionals, especially those in rehabilitation medicine, should pay more attention to uploading high-quality videos with reliable content.
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[article] Suitability of YouTube Videos for Learning Knee Stability Tests: A Cross-sectional Review [Article] / Myungeun Yoo ; Juntaek Hong ; Chan Woong Jang . - 2020 . - p. 2087-2092.
https://doi.org/10.1016/j.apmr.2020.05.024
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2087-2092

Descripteurs :	HE Vinci Articulation du genou ; Education ; Examen clinique ; Genou ; Ligaments ; Réadaptation
Résumé :	Objective To verify the suitability and reliability of YouTube videos pertaining to the 5 most commonly used knee stability tests for educational purposes. Design Cross-sectional observational study. Setting YouTube videos were categorized into 2 groups according to their sources: professional and nonprofessional groups. Only videos that satisfied the purpose and procedure parts among comprehensiveness scores were defined as suitable for educational purposes. For evaluating the reliability, the modified DISCERN was used. One-way analysis of variance and Kruskal-Wallis test were used to compare continuous and categorical variables, respectively. Participants Research on YouTube videos (N=218) from November 13, 2019, to November 17, 2019, was done using the following keywords: “anterior drawer test knee,” “Lachman test knee,” “posterior drawer test,” “valgus knee test,” and “varus knee test.” Interventions Not applicable. Main Outcome Measures Comprehensiveness score that focused on the purpose, procedure, interpretation, and limitations or precautions of the test were developed by the authors, and modified DISCERN score. Results In terms of the suitability for educational purposes, 126 videos (58%) were classified into the suitable group, and 92 (42%) were classified into the unsuitable group. Neither group had significantly more views, views per posting days, likes, dislikes, or posting days. When comparing the comprehensiveness and reliability scores of each group, significant differences between groups were identified. Only 47 videos met the limitations/precautions category. A total of 155 videos (71%) were from the professional group and 63 videos (29%) were from the nonprofessional group. Significant differences were found in views, views per posting days, likes, and dislikes between the professional group and nonprofessional group. Conclusions YouTube should not be used for learning about knee stability tests. Professionals, especially those in rehabilitation medicine, should pay more attention to uploading high-quality videos with reliable content.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2093-2102

Titre :	Prediction of Psychological Distress Among Persons With Spinal Cord Injury or Acquired Brain Injury and Their Significant Others
Type de document :	Article
Auteurs :	Eline W.M. Scholten ; Marjolijn Ketelaar ; Johanna M. Visser-Meily ; Ellen H. Roels ; Mirjam Kouwenhoven ; Marcel W.M. Post
Année de publication :	2020
Article en page(s) :	p. 2093-2102
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.023
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aidants ; Lésions encéphaliques ; Réadaptation ; Santé mentale ; Traumatismes de la moelle épinière
Résumé :	Objectives To identify intra- and interpersonal sociodemographic, injury-related, and psychological variables measured at admission of inpatient rehabilitation that predict psychological distress among dyads of individuals with spinal cord injury (SCI) or acquired brain injury (ABI) and their significant others (ie, individuals close to the individual with a disability, mostly family members) 6 months after discharge. Differences in predictors were investigated for persons with SCI or ABI and their significant others and were compared between diagnoses. Design Prospective longitudinal study. Setting Twelve Dutch rehabilitation centers. Participants Dyads (N=157) consisting of adults with SCI or ABI who were admitted to inpatient rehabilitation and their adult significant others. Interventions Not applicable. Main Outcome Measures Psychological distress (Hospital Anxiety and Depression Scale). Results Sociodemographic and injury-related variables were not or were only weakly associated with psychological distress among individuals with SCI or ABI and their significant others 6 months after discharge. Bivariately, higher baseline psychological distress, lower scores on adaptive psychological characteristics (combination of self-efficacy, proactive coping, purpose in life, resilience), and higher scores on maladaptive psychological characteristics (combination of passive coping, neuroticism, appraisals of threat and loss) were related to higher psychological distress, as well as crosswise between individuals with SCI or ABI and their significant others, although less strongly. Combined prediction models showed that psychological distress among persons with SCI or ABI was predicted by education level of their significant other, their own baseline psychological distress, and their own maladaptive psychological characteristics (explained variance, 41.9%). Among significant others, only their own baseline psychological distress predicted psychological distress (explained variance, 40.4%). Results were comparable across diagnoses. Conclusions Although a dyadic connection was shown, primarily one's own baseline psychological distress and psychological characteristics were important in the prediction of later psychological distress among both individuals with SCI or ABI and their significant others. Screening based on these variables could help to identify persons at risk for psychological distress.
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[article] Prediction of Psychological Distress Among Persons With Spinal Cord Injury or Acquired Brain Injury and Their Significant Others [Article] / Eline W.M. Scholten ; Marjolijn Ketelaar ; Johanna M. Visser-Meily ; Ellen H. Roels ; Mirjam Kouwenhoven ; Marcel W.M. Post . - 2020 . - p. 2093-2102.
https://doi.org/10.1016/j.apmr.2020.05.023
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2093-2102

Descripteurs :	HE Vinci Aidants ; Lésions encéphaliques ; Réadaptation ; Santé mentale ; Traumatismes de la moelle épinière
Résumé :	Objectives To identify intra- and interpersonal sociodemographic, injury-related, and psychological variables measured at admission of inpatient rehabilitation that predict psychological distress among dyads of individuals with spinal cord injury (SCI) or acquired brain injury (ABI) and their significant others (ie, individuals close to the individual with a disability, mostly family members) 6 months after discharge. Differences in predictors were investigated for persons with SCI or ABI and their significant others and were compared between diagnoses. Design Prospective longitudinal study. Setting Twelve Dutch rehabilitation centers. Participants Dyads (N=157) consisting of adults with SCI or ABI who were admitted to inpatient rehabilitation and their adult significant others. Interventions Not applicable. Main Outcome Measures Psychological distress (Hospital Anxiety and Depression Scale). Results Sociodemographic and injury-related variables were not or were only weakly associated with psychological distress among individuals with SCI or ABI and their significant others 6 months after discharge. Bivariately, higher baseline psychological distress, lower scores on adaptive psychological characteristics (combination of self-efficacy, proactive coping, purpose in life, resilience), and higher scores on maladaptive psychological characteristics (combination of passive coping, neuroticism, appraisals of threat and loss) were related to higher psychological distress, as well as crosswise between individuals with SCI or ABI and their significant others, although less strongly. Combined prediction models showed that psychological distress among persons with SCI or ABI was predicted by education level of their significant other, their own baseline psychological distress, and their own maladaptive psychological characteristics (explained variance, 41.9%). Among significant others, only their own baseline psychological distress predicted psychological distress (explained variance, 40.4%). Results were comparable across diagnoses. Conclusions Although a dyadic connection was shown, primarily one's own baseline psychological distress and psychological characteristics were important in the prediction of later psychological distress among both individuals with SCI or ABI and their significant others. Screening based on these variables could help to identify persons at risk for psychological distress.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2103-2111

Titre :	Cohort Profile of the International Spinal Cord Injury Community Survey Implemented in 22 Countries
Type de document :	Article
Auteurs :	Christine Fekete ; Mirjam Brach ; Cristina Ehrmann ; Marcel W.M. Post
Année de publication :	2020
Article en page(s) :	p. 2103-2111
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.022
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Enquêtes et questionnaires ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objectives To detail the methodological features of the first International Spinal Cord Injury (InSCI) Community Survey by describing recruitment and data collection procedures, and to report on the recruitment results and basic characteristics of participants by country and income setting. Design Cross-sectional survey. Setting Community setting in 22 countries representing all 6 World Health Organization regions. Participants Individuals (N=12,591) with traumatic or non-traumatic spinal cord injury (SCI) aged over 18 years. Interventions Not applicable. Main Outcome Measures Recruitment and data collection procedures, recruitment results, and basic sociodemographic and lesion characteristics of participants. Results Eight countries used predefined sampling frames and 14 countries applied convenience sampling for recruitment. Most countries recruited participants through specialized rehabilitation facilities, patient organizations, or acute and general hospitals. Modes of approaching potential participants depended on the sampling strategy and multiple response modes were offered to maximize participation. Contact rates ranged from 33% to 98%, cooperation rates ranged from 29% to 90%, and response rates ranged from 23% to 54%. The majority of participants were men (73%), the median age was 52 years (interquartile range, 40-63y), 60% had a partner, 8% reported that they were born in another country than where they were currently residing, and the median length of education was 12 years (interquartile range, 9-15y). Paraplegia was the main diagnosis (63%), traumatic etiologies were the major cause of injury (81%), and the median time since injury (TSI) was 9 years (interquartile range, 4-19y). Compared with participants from lower income settings, participants from higher income settings were over-represented and, in general, were older, more often diagnosed with tetraplegia, had a longer TSI, higher education, and were more often born in a country different than their current residence country. Conclusions The successful implementation of the InSCI survey enables the comparison of the situation of individuals with SCI around the world and constitutes a crucial starting point for an international learning experience.
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[article] Cohort Profile of the International Spinal Cord Injury Community Survey Implemented in 22 Countries [Article] / Christine Fekete ; Mirjam Brach ; Cristina Ehrmann ; Marcel W.M. Post . - 2020 . - p. 2103-2111.
https://doi.org/10.1016/j.apmr.2020.01.022
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2103-2111

Descripteurs :	HE Vinci Enquêtes et questionnaires ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objectives To detail the methodological features of the first International Spinal Cord Injury (InSCI) Community Survey by describing recruitment and data collection procedures, and to report on the recruitment results and basic characteristics of participants by country and income setting. Design Cross-sectional survey. Setting Community setting in 22 countries representing all 6 World Health Organization regions. Participants Individuals (N=12,591) with traumatic or non-traumatic spinal cord injury (SCI) aged over 18 years. Interventions Not applicable. Main Outcome Measures Recruitment and data collection procedures, recruitment results, and basic sociodemographic and lesion characteristics of participants. Results Eight countries used predefined sampling frames and 14 countries applied convenience sampling for recruitment. Most countries recruited participants through specialized rehabilitation facilities, patient organizations, or acute and general hospitals. Modes of approaching potential participants depended on the sampling strategy and multiple response modes were offered to maximize participation. Contact rates ranged from 33% to 98%, cooperation rates ranged from 29% to 90%, and response rates ranged from 23% to 54%. The majority of participants were men (73%), the median age was 52 years (interquartile range, 40-63y), 60% had a partner, 8% reported that they were born in another country than where they were currently residing, and the median length of education was 12 years (interquartile range, 9-15y). Paraplegia was the main diagnosis (63%), traumatic etiologies were the major cause of injury (81%), and the median time since injury (TSI) was 9 years (interquartile range, 4-19y). Compared with participants from lower income settings, participants from higher income settings were over-represented and, in general, were older, more often diagnosed with tetraplegia, had a longer TSI, higher education, and were more often born in a country different than their current residence country. Conclusions The successful implementation of the InSCI survey enables the comparison of the situation of individuals with SCI around the world and constitutes a crucial starting point for an international learning experience.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2112-2143

Titre :	Describing Functioning in People Living With Spinal Cord Injury Across 22 Countries: A Graphical Modeling Approach
Type de document :	Article
Auteurs :	Cristina Ehrmann ; Jan D. Reinhardt ; Conran Joseph ; Nazirah Hasnan ; Brigitte Perrouin-Verbe ; Piotr Tederko ; Mauro Zampolini
Année de publication :	2020
Article en page(s) :	p. 2112-2143
Note générale :	https://doi.org/10.1016/j.apmr.2020.09.374
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Classification internationale du fonctionnement, du handicap et de la santé (ICF) ; Prévalence ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To provide prevalence estimates for problems in functioning of community-dwelling persons with spinal cord injury (SCI) and to examine associations between various areas of functioning with the purpose of supporting countries in identifying targets for interventions. Design Cross-sectional survey. Setting Community, 22 countries including all World Health Organization regions. Participants Persons (N=12,591) with traumatic or nontraumatic SCI aged 18 years or older. Interventions Not applicable. Main Outcome Measures We estimated the prevalence of problems in 53 areas of functioning from the Brief International Classification of Functioning, Disability and Health (ICF) core set for SCI, long-term context, or ICF rehabilitation set covering 4 domains: impairments in body functions, impairments in mental functions, independence in performing activities, and restrictions in participation. Associations between areas of functioning were identified and visualized using conditional independence graphs. Results Participants had a median age of 52 years, 73% were male, and 63% had paraplegia. Feeling tired, bowel dysfunction, sexual functions, spasticity, pain, carrying out daily routine, doing housework, getting up off the floor from lying on the back, pushing open a heavy door, and standing unsupported had the highest prevalence of problems (>70%). Clustering of associations within the 4 functioning domains was found, with the highest numbers of associations within impairments in mental functions. For the whole International Spinal Cord Injury sample, areas with the highest numbers of associations were circulatory problems, transferring bed-wheelchair, and toileting, while for the World Health Organization European and Western Pacific regions, these were dressing upper body, transferring bed-wheelchair, handling stress, feeling downhearted and depressed, and feeling happy. Conclusions In each domain of functioning, high prevalence of problems and high connectivity of areas of functioning were identified. The understanding of problems and the identification of potential targets for intervention can inform decision makers at all levels of the health system aiming to improve the situation of people living with SCI.
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[article] Describing Functioning in People Living With Spinal Cord Injury Across 22 Countries: A Graphical Modeling Approach [Article] / Cristina Ehrmann ; Jan D. Reinhardt ; Conran Joseph ; Nazirah Hasnan ; Brigitte Perrouin-Verbe ; Piotr Tederko ; Mauro Zampolini . - 2020 . - p. 2112-2143.
https://doi.org/10.1016/j.apmr.2020.09.374
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2112-2143

Descripteurs :	HE Vinci Classification internationale du fonctionnement, du handicap et de la santé (ICF) ; Prévalence ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To provide prevalence estimates for problems in functioning of community-dwelling persons with spinal cord injury (SCI) and to examine associations between various areas of functioning with the purpose of supporting countries in identifying targets for interventions. Design Cross-sectional survey. Setting Community, 22 countries including all World Health Organization regions. Participants Persons (N=12,591) with traumatic or nontraumatic SCI aged 18 years or older. Interventions Not applicable. Main Outcome Measures We estimated the prevalence of problems in 53 areas of functioning from the Brief International Classification of Functioning, Disability and Health (ICF) core set for SCI, long-term context, or ICF rehabilitation set covering 4 domains: impairments in body functions, impairments in mental functions, independence in performing activities, and restrictions in participation. Associations between areas of functioning were identified and visualized using conditional independence graphs. Results Participants had a median age of 52 years, 73% were male, and 63% had paraplegia. Feeling tired, bowel dysfunction, sexual functions, spasticity, pain, carrying out daily routine, doing housework, getting up off the floor from lying on the back, pushing open a heavy door, and standing unsupported had the highest prevalence of problems (>70%). Clustering of associations within the 4 functioning domains was found, with the highest numbers of associations within impairments in mental functions. For the whole International Spinal Cord Injury sample, areas with the highest numbers of associations were circulatory problems, transferring bed-wheelchair, and toileting, while for the World Health Organization European and Western Pacific regions, these were dressing upper body, transferring bed-wheelchair, handling stress, feeling downhearted and depressed, and feeling happy. Conclusions In each domain of functioning, high prevalence of problems and high connectivity of areas of functioning were identified. The understanding of problems and the identification of potential targets for intervention can inform decision makers at all levels of the health system aiming to improve the situation of people living with SCI.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2144-2156

Titre :	Environmental Barriers Experienced by People With Spinal Cord Injury Across 22 Countries: Results From a Cross-Sectional Survey
Type de document :	Article
Auteurs :	Jan D. Reinhardt ; James Middleton ; Andrea Bökel ; Apichana Kovindha ; Athanasios Kyriakides ; Abderrazak Athanasios ; Ken Kouda ; Jolanta Kujawa
Année de publication :	2020
Article en page(s) :	p. 2144-2156
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.027
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Comorbidité ; Enquêtes et questionnaires ; Environnement ; Facteurs socioéconomiques ; Réadaptation ; Revenu ; Santé mentale ; Traumatismes de la moelle épinière
Résumé :	Objectives To investigate the experience of environmental barriers by people with spinal cord injury (SCI) across 22 countries. Specific aims were to describe and compare the prevalence of environmental barriers experienced across countries, and to analyze determinants of environmental barriers at individual and country level. Design Cross-sectional community survey. Participants Individuals (N=12,591) living with SCI in the community. Interventions Not applicable. Main Outcome Measure Nottwil Environmental Factors Inventory–Short Form. Results Most barriers were experienced in relation to accessibility, climate, transportation, finances, and state services. More severe barriers were experienced in settings with lower gross domestic product (GDP), which especially refers to medical supplies (gamma=–0.38; P<.001 and finances p in this study. however a multivariable negative binomial regression using within-between estimation of the number barriers experienced on selected predictors effect gdp was reversed when it adjusted for covariates. individual level decreased with better mental health greater self-care ability. people low income paraplegia complete lesions more problems reported barriers. country fewer were countries higher average age ability as well those percentage traumatic sci lesions. married individuals lower household time since injury mean vitality scores inequality.> Conclusions Study participants reported a significant number of environmental barriers, many of which are modifiable. Complementary interventions are recommended. Within and between country effects of covariates sometimes pointed in different directions, suggesting that countries with a different composition of SCI population also differed in environmental contexts.
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[article] Environmental Barriers Experienced by People With Spinal Cord Injury Across 22 Countries: Results From a Cross-Sectional Survey [Article] / Jan D. Reinhardt ; James Middleton ; Andrea Bökel ; Apichana Kovindha ; Athanasios Kyriakides ; Abderrazak Athanasios ; Ken Kouda ; Jolanta Kujawa . - 2020 . - p. 2144-2156.
https://doi.org/10.1016/j.apmr.2020.04.027
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2144-2156

Descripteurs :	HE Vinci Comorbidité ; Enquêtes et questionnaires ; Environnement ; Facteurs socioéconomiques ; Réadaptation ; Revenu ; Santé mentale ; Traumatismes de la moelle épinière
Résumé :	Objectives To investigate the experience of environmental barriers by people with spinal cord injury (SCI) across 22 countries. Specific aims were to describe and compare the prevalence of environmental barriers experienced across countries, and to analyze determinants of environmental barriers at individual and country level. Design Cross-sectional community survey. Participants Individuals (N=12,591) living with SCI in the community. Interventions Not applicable. Main Outcome Measure Nottwil Environmental Factors Inventory–Short Form. Results Most barriers were experienced in relation to accessibility, climate, transportation, finances, and state services. More severe barriers were experienced in settings with lower gross domestic product (GDP), which especially refers to medical supplies (gamma=–0.38; P<.001 and finances p in this study. however a multivariable negative binomial regression using within-between estimation of the number barriers experienced on selected predictors effect gdp was reversed when it adjusted for covariates. individual level decreased with better mental health greater self-care ability. people low income paraplegia complete lesions more problems reported barriers. country fewer were countries higher average age ability as well those percentage traumatic sci lesions. married individuals lower household time since injury mean vitality scores inequality.> Conclusions Study participants reported a significant number of environmental barriers, many of which are modifiable. Complementary interventions are recommended. Within and between country effects of covariates sometimes pointed in different directions, suggesting that countries with a different composition of SCI population also differed in environmental contexts.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2157-2166

Titre :	Employment Among People With Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey
Type de document :	Article
Auteurs :	Marcel W. Post ; Jan D. Reinhardt ; Mercè Avellanet ; Reuben Escorpizo ; Julia P. Engkasan
Année de publication :	2020
Article en page(s) :	p. 2157-2166
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.027
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Emploi ; Maladies de la moelle épinière ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objectives To describe the employment situation of individuals with spinal cord injury (SCI) in 22 countries participating in the International Spinal Cord Injury community survey, to compare observed and predicted employment rates, to estimate gaps in employment rates among people with SCI compared with the general population, and to study differences in employment between men and women. Design Cross-sectional survey. Setting Community. Participants People of employable age (N=9875; 18-64 y) with traumatic or non-traumatic SCI (including cauda equina syndrome) who were at least 18 years of age at the time of the survey, living in the community, and able to respond to one of the available language versions of the questionnaire. Interventions Not applicable Main Outcome Measures The observed employment rate was defined as performing paid work for at least 1 hour a week, and predicted employment rate was adjusted for sample composition from mixed logistic regression analysis. Results A total of 9875 participants were included (165-1174 per country). Considerable differences in sample composition were found. The observed worldwide employment rate was 38%. A wide variation was found across countries, ranging from 10.3% to 61.4%. Some countries showed substantially higher or lower employment rates than predicted based on the composition of their sample. Gaps between the observed employment rates among participants with SCI and the general population ranged from 14.8% to 54.8%. On average, employment rates were slightly higher among men compared with women, but with large variation across countries. Employment gaps, however, were smaller among women for most countries. Conclusions This first worldwide survey among people with SCI shows an average employment rate of 38%. Differences between observed and predicted employment rates across countries point at country-specific factors that warrant further investigation. Gaps with employment rates in the general population were considerable and call for actions for more inclusive labor market policies in most of the countries investigated.
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[article] Employment Among People With Spinal Cord Injury in 22 Countries Across the World: Results From the International Spinal Cord Injury Community Survey [Article] / Marcel W. Post ; Jan D. Reinhardt ; Mercè Avellanet ; Reuben Escorpizo ; Julia P. Engkasan . - 2020 . - p. 2157-2166.
https://doi.org/10.1016/j.apmr.2020.05.027
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2157-2166

Descripteurs :	HE Vinci Emploi ; Maladies de la moelle épinière ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objectives To describe the employment situation of individuals with spinal cord injury (SCI) in 22 countries participating in the International Spinal Cord Injury community survey, to compare observed and predicted employment rates, to estimate gaps in employment rates among people with SCI compared with the general population, and to study differences in employment between men and women. Design Cross-sectional survey. Setting Community. Participants People of employable age (N=9875; 18-64 y) with traumatic or non-traumatic SCI (including cauda equina syndrome) who were at least 18 years of age at the time of the survey, living in the community, and able to respond to one of the available language versions of the questionnaire. Interventions Not applicable Main Outcome Measures The observed employment rate was defined as performing paid work for at least 1 hour a week, and predicted employment rate was adjusted for sample composition from mixed logistic regression analysis. Results A total of 9875 participants were included (165-1174 per country). Considerable differences in sample composition were found. The observed worldwide employment rate was 38%. A wide variation was found across countries, ranging from 10.3% to 61.4%. Some countries showed substantially higher or lower employment rates than predicted based on the composition of their sample. Gaps between the observed employment rates among participants with SCI and the general population ranged from 14.8% to 54.8%. On average, employment rates were slightly higher among men compared with women, but with large variation across countries. Employment gaps, however, were smaller among women for most countries. Conclusions This first worldwide survey among people with SCI shows an average employment rate of 38%. Differences between observed and predicted employment rates across countries point at country-specific factors that warrant further investigation. Gaps with employment rates in the general population were considerable and call for actions for more inclusive labor market policies in most of the countries investigated.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2167-2176

Titre :	Quality of Life and the Health System: A 22-Country Comparison of the Situation of People With Spinal Cord Injury
Type de document :	Article
Auteurs :	Diana Pacheco Barzallo ; Mirja Gross-Hemmi ; Jerome Bickenbach ; Alvydas Juocevicius ; Daiana Popa ; Luh Karunia Wahyuni ; Vegard Strøm
Année de publication :	2020
Article en page(s) :	p. 2167-2176
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.030
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accessibilité des services de santé ; Politique de santé ; Prestations des soins de santé ; Qualité de vie ; Réadaptation
Résumé :	Objective To analyze and compare how performance of the health system are linked to the self-reported quality of life (QOL) of people with spinal cord injury (SCI) in 22 countries participating in the International Spinal Cord (InSCI) community survey. Design Cross-sectional survey. Setting Twenty-two countries representing all 6 World Health Organization regions, community setting. Participants Persons (N=12,591) with traumatic or nontraumatic SCI aged ≥18 years. Interventions Not applicable. Main outcomes Self-reported satisfaction on several indicators that include: health, ability to perform daily activities, oneself, personal relationships, and living conditions. A total score of QOL was calculated using these 5 definitions. Results The most important indicators for self-reported QOL of persons with SCI were social attitudes and access to health care services, followed by nursing care, access to public spaces, the provision of vocational rehabilitation, transportation, medication, and assistive devices. In general, persons with SCI living in higher-income countries reported a higher QOL than people in lower-income countries, with some exceptions. The top performing country was The Netherlands with an estimated median QOL of 66% (on a 0%-100% scale). Conclusions The living situation of people with SCI is highly influenced by the performance of the health system. Measuring and comparing health systems give accountability to a country’s citizens, but it also helps to determine areas for improvement.
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[article] Quality of Life and the Health System: A 22-Country Comparison of the Situation of People With Spinal Cord Injury [Article] / Diana Pacheco Barzallo ; Mirja Gross-Hemmi ; Jerome Bickenbach ; Alvydas Juocevicius ; Daiana Popa ; Luh Karunia Wahyuni ; Vegard Strøm . - 2020 . - p. 2167-2176.
https://doi.org/10.1016/j.apmr.2020.04.030
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2167-2176

Descripteurs :	HE Vinci Accessibilité des services de santé ; Politique de santé ; Prestations des soins de santé ; Qualité de vie ; Réadaptation
Résumé :	Objective To analyze and compare how performance of the health system are linked to the self-reported quality of life (QOL) of people with spinal cord injury (SCI) in 22 countries participating in the International Spinal Cord (InSCI) community survey. Design Cross-sectional survey. Setting Twenty-two countries representing all 6 World Health Organization regions, community setting. Participants Persons (N=12,591) with traumatic or nontraumatic SCI aged ≥18 years. Interventions Not applicable. Main outcomes Self-reported satisfaction on several indicators that include: health, ability to perform daily activities, oneself, personal relationships, and living conditions. A total score of QOL was calculated using these 5 definitions. Results The most important indicators for self-reported QOL of persons with SCI were social attitudes and access to health care services, followed by nursing care, access to public spaces, the provision of vocational rehabilitation, transportation, medication, and assistive devices. In general, persons with SCI living in higher-income countries reported a higher QOL than people in lower-income countries, with some exceptions. The top performing country was The Netherlands with an estimated median QOL of 66% (on a 0%-100% scale). Conclusions The living situation of people with SCI is highly influenced by the performance of the health system. Measuring and comparing health systems give accountability to a country’s citizens, but it also helps to determine areas for improvement.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2177-2205

Titre :	Effect of Exercise on Cardiometabolic Risk Factors in Adults With Chronic Spinal Cord Injury: A Systematic Review
Type de document :	Article
Auteurs :	Matthew Farrow ; Thomas E. Nightingale ; Jennifer Maher ; Carly D. McKay ; Dylan Thompson ; James L.J. Bilzon
Année de publication :	2020
Article en page(s) :	p. 2177-2205
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.020
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Maladies métaboliques ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To determine the effects of exercise on individual cardiometabolic syndrome (CMS) risk factors in adults with chronic spinal cord injury (SCI). Data Sources English language searches of PubMed, Web of Science, EMBASE, and Scopus (January 1, 1970, to July 31, 2019). Study Selection Articles were included if they met the following criteria: (1) original articles with statistical analysis, (2) participants were adults with a SCI sustained ≥1 year ago, (3) exercise intervention duration ≥2 weeks, and (4) included any CMS risk factor as an outcome. Data Extraction The methodological quality of articles was assessed using the Downs and Black score. Data Synthesis Sixty-five studies were included for the final analysis, including 9 studies classified as high quality (≥66.7%), 35 studies classified as fair quality (50%-66.6%), and 21 studies classified as low quality ( Conclusions Upper body aerobic exercise training (>75% maximum heart rate) appears to improve waist circumference and hepatic insulin sensitivity but appears insufficient for improving fasting glucose, lipid profile, or resting blood pressure. The addition of RT to upper body aerobic exercise may elicit favorable changes in the lipid profile. More high-quality studies are needed to confirm if FES cycling is effective at improving peripheral insulin sensitivity.
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[article] Effect of Exercise on Cardiometabolic Risk Factors in Adults With Chronic Spinal Cord Injury: A Systematic Review [Article] / Matthew Farrow ; Thomas E. Nightingale ; Jennifer Maher ; Carly D. McKay ; Dylan Thompson ; James L.J. Bilzon . - 2020 . - p. 2177-2205.
https://doi.org/10.1016/j.apmr.2020.04.020
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2177-2205

Descripteurs :	HE Vinci Maladies métaboliques ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To determine the effects of exercise on individual cardiometabolic syndrome (CMS) risk factors in adults with chronic spinal cord injury (SCI). Data Sources English language searches of PubMed, Web of Science, EMBASE, and Scopus (January 1, 1970, to July 31, 2019). Study Selection Articles were included if they met the following criteria: (1) original articles with statistical analysis, (2) participants were adults with a SCI sustained ≥1 year ago, (3) exercise intervention duration ≥2 weeks, and (4) included any CMS risk factor as an outcome. Data Extraction The methodological quality of articles was assessed using the Downs and Black score. Data Synthesis Sixty-five studies were included for the final analysis, including 9 studies classified as high quality (≥66.7%), 35 studies classified as fair quality (50%-66.6%), and 21 studies classified as low quality ( Conclusions Upper body aerobic exercise training (>75% maximum heart rate) appears to improve waist circumference and hepatic insulin sensitivity but appears insufficient for improving fasting glucose, lipid profile, or resting blood pressure. The addition of RT to upper body aerobic exercise may elicit favorable changes in the lipid profile. More high-quality studies are needed to confirm if FES cycling is effective at improving peripheral insulin sensitivity.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2206-2218

Titre :	Intervention Treatment for Myocardial Infarction With Tai Chi: A Systematic Review and Meta-analysis
Type de document :	Article
Auteurs :	Bingxin Wu ; Yining Ding ; Biying Zhong ; Xiao Jin ; Yongtao Cao ; Danping Xu
Année de publication :	2020
Article en page(s) :	p. 2206-2218
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.012
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Infarctus du myocarde ; Prévention et contrôle ; Réadaptation ; Tai chi ; Traitement par les exercices physiques
Résumé :	Objective To assess the efficacy of Tai Chi (TC) in patients with myocardial infarction and provide up-to-date evidence for its application. Data Sources Three English databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) and 3 Chinese databases (China Knowledge Resource Integrated, Wanfang, Weipu) were screened for the time period between January 1, 1976 and May 31, 2019. Study Selection Seven randomized and controlled experiments were included. Data Extraction Two independent researchers under 2 independent advisors extracted and classified the data from all relevant studies based on the prespecified inclusion criteria and rules for data extraction. Data Synthesis A total of 615 patients were included in this study. The TC group was comprised of 294 patients, and the control group included 261 patients. The results revealed that TC has significant effects on the outcomes of the 6-minute walk (standardized mean difference, 1.30; 95% confidence interval, 0.50-2.11) and left ventricular ejection fraction (standardized mean difference, 1; 95% confidence interval, 0.43-1.57) compared with no or low-density exercise. Also, TC positively affected the quality of life, pro-B type natriuretic peptide, and short form-36. However, TC did not significantly affect activities of daily living (P=.060), sense of coherence-13 (P=.057) and N-terminal-pro-brain natriuretic peptide (P=.081). A moderate to high heterogeneity was observed across all comparisons. Conclusions Compared with no exercise or other types of low-intensity physical activities, TC improved the outcome of the 6-minute walk, left ventricular ejection fraction, quality of life, and short form-36 scores, but reduced the outcome of pro-B type natriuretic peptide in patients with myocardial infarction. Therefore, TC could be an effective exercise option for cardiac rehabilitation. More research should be done to identify the effects of TC on academic functioning and to determine ways of motivating patients to use preventive TC interventions.
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[article] Intervention Treatment for Myocardial Infarction With Tai Chi: A Systematic Review and Meta-analysis [Article] / Bingxin Wu ; Yining Ding ; Biying Zhong ; Xiao Jin ; Yongtao Cao ; Danping Xu . - 2020 . - p. 2206-2218.
https://doi.org/10.1016/j.apmr.2020.02.012
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2206-2218

Descripteurs :	HE Vinci Infarctus du myocarde ; Prévention et contrôle ; Réadaptation ; Tai chi ; Traitement par les exercices physiques
Résumé :	Objective To assess the efficacy of Tai Chi (TC) in patients with myocardial infarction and provide up-to-date evidence for its application. Data Sources Three English databases (PubMed, Embase, and Cochrane Central Register of Controlled Trials) and 3 Chinese databases (China Knowledge Resource Integrated, Wanfang, Weipu) were screened for the time period between January 1, 1976 and May 31, 2019. Study Selection Seven randomized and controlled experiments were included. Data Extraction Two independent researchers under 2 independent advisors extracted and classified the data from all relevant studies based on the prespecified inclusion criteria and rules for data extraction. Data Synthesis A total of 615 patients were included in this study. The TC group was comprised of 294 patients, and the control group included 261 patients. The results revealed that TC has significant effects on the outcomes of the 6-minute walk (standardized mean difference, 1.30; 95% confidence interval, 0.50-2.11) and left ventricular ejection fraction (standardized mean difference, 1; 95% confidence interval, 0.43-1.57) compared with no or low-density exercise. Also, TC positively affected the quality of life, pro-B type natriuretic peptide, and short form-36. However, TC did not significantly affect activities of daily living (P=.060), sense of coherence-13 (P=.057) and N-terminal-pro-brain natriuretic peptide (P=.081). A moderate to high heterogeneity was observed across all comparisons. Conclusions Compared with no exercise or other types of low-intensity physical activities, TC improved the outcome of the 6-minute walk, left ventricular ejection fraction, quality of life, and short form-36 scores, but reduced the outcome of pro-B type natriuretic peptide in patients with myocardial infarction. Therefore, TC could be an effective exercise option for cardiac rehabilitation. More research should be done to identify the effects of TC on academic functioning and to determine ways of motivating patients to use preventive TC interventions.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2219-2226

Titre :	Novel Effect Size Interpretation Guidelines and an Evaluation of Statistical Power in Rehabilitation Research
Type de document :	Article
Auteurs :	Adam R. Kinney ; Aaron M. Eakman ; James E. Graham
Année de publication :	2020
Article en page(s) :	p. 2219-2226
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.017
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Méta-analyse ; Méthodes ; Réadaptation ; Recherche en réadaptation ; Statistiques ; Taille de l'échantillon
Résumé :	Objective First, to establish empirically-based effect size interpretation guidelines for rehabilitation treatment effects. Second, to evaluate statistical power in rehabilitation research. Data Sources The Cochrane Database of Systematic Reviews was searched through June 2019. Study Selection Meta-analyses included in the Cochrane Database of Systematic Reviews with “rehabilitation” as a keyword and clearly evaluated a rehabilitation intervention. Data Extraction We extracted Cohen’s d effect sizes and associated sample sizes for treatment and comparison groups. Two independent investigators classified the interventions into 4 categories using the Rehabilitation Treatment Specification System. The 25th, 50th, and 75th percentile values within the effect size distribution were used to establish interpretation guidelines for small, medium, and large effects, respectively. A priori power analyses established sample sizes needed to detect the empirically-based values for small, medium, and large effects. Post-hoc power analyses using median sample sizes revealed whether the “typical” rehabilitation study was sufficiently powered to detect the empirically-based values. Post hoc power analyses established the statistical power of each test based on the sample size and reported effect size. Data Synthesis We analyzed 3381 effect sizes extracted from 99 meta-analyses. Interpretation guidelines for small effects ranged from 0.08 to 0.15; medium effects ranged from 0.19 to 0.36; and large effects ranged from 0.41 to 0.67. We present sample sizes needed to detect these values based on a priori power analyses. Post hoc power analyses revealed that a “typical” rehabilitation study lacks sufficient power to detect the empirically-based values. Post hoc power analyses using reported sample sizes and effects indicated the studies were underpowered, with median power ranging from 0.14 to 0.23. Conclusions This study presented novel and empirically-based interpretation guidelines for small, medium, and large rehabilitation treatment effects. The observed effect size distributions differed across intervention categories, indicating that researchers should use category-specific guidelines. Furthermore, many published rehabilitation studies are underpowered.
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[article] Novel Effect Size Interpretation Guidelines and an Evaluation of Statistical Power in Rehabilitation Research [Article] / Adam R. Kinney ; Aaron M. Eakman ; James E. Graham . - 2020 . - p. 2219-2226.
https://doi.org/10.1016/j.apmr.2020.02.017
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 12 (2020) . - p. 2219-2226

Descripteurs :	HE Vinci Méta-analyse ; Méthodes ; Réadaptation ; Recherche en réadaptation ; Statistiques ; Taille de l'échantillon
Résumé :	Objective First, to establish empirically-based effect size interpretation guidelines for rehabilitation treatment effects. Second, to evaluate statistical power in rehabilitation research. Data Sources The Cochrane Database of Systematic Reviews was searched through June 2019. Study Selection Meta-analyses included in the Cochrane Database of Systematic Reviews with “rehabilitation” as a keyword and clearly evaluated a rehabilitation intervention. Data Extraction We extracted Cohen’s d effect sizes and associated sample sizes for treatment and comparison groups. Two independent investigators classified the interventions into 4 categories using the Rehabilitation Treatment Specification System. The 25th, 50th, and 75th percentile values within the effect size distribution were used to establish interpretation guidelines for small, medium, and large effects, respectively. A priori power analyses established sample sizes needed to detect the empirically-based values for small, medium, and large effects. Post-hoc power analyses using median sample sizes revealed whether the “typical” rehabilitation study was sufficiently powered to detect the empirically-based values. Post hoc power analyses established the statistical power of each test based on the sample size and reported effect size. Data Synthesis We analyzed 3381 effect sizes extracted from 99 meta-analyses. Interpretation guidelines for small effects ranged from 0.08 to 0.15; medium effects ranged from 0.19 to 0.36; and large effects ranged from 0.41 to 0.67. We present sample sizes needed to detect these values based on a priori power analyses. Post hoc power analyses revealed that a “typical” rehabilitation study lacks sufficient power to detect the empirically-based values. Post hoc power analyses using reported sample sizes and effects indicated the studies were underpowered, with median power ranging from 0.14 to 0.23. Conclusions This study presented novel and empirically-based interpretation guidelines for small, medium, and large rehabilitation treatment effects. The observed effect size distributions differed across intervention categories, indicating that researchers should use category-specific guidelines. Furthermore, many published rehabilitation studies are underpowered.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1849-1856

Titre :	Effects of Dual-Task Group Training on Gait, Cognitive Executive Function, and Quality of Life in People With Parkinson Disease: Results of Randomized Controlled DUALGAIT Trial
Type de document :	Article
Auteurs :	Constanza San Martín Valenzuela ; Lirios Dueñas Moscardó ; Juan López-Pascual ; Pilar Serra-Añó ; José M. Tomás
Année de publication :	2020
Article en page(s) :	p. 1849-1856
Note générale :	https://doi.org/10.1016/j.apmr.2020.07.008
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Cognition ; Maladie de Parkinson ; Marche à pied ; Qualité de vie ; Réadaptation
Résumé :	Objectives The aims of this study were to analyze the effects of a dual-task group program, to compare it with the effects of a single-task group program, and to analyze the effects of functional secondary tasks. Design Single-blind randomized controlled trial. Setting University laboratory and a rehabilitation gym at a health center. Participants Patients (N=40) with a diagnosis of Parkinson disease (mean age, 66.72y; age range, 44-79y) with Hoehn and Yahr stage I to III who were on medication were randomized to either a group with dual-task training or a group with single-task training (only gait). Intervention Both interventions involved 20 sessions lasting 1 hour each and conducted twice a week. Dual-task training included walking exercises and cognitive or motor tasks carried out separately, then later performed together as a dual-task according to a progressive protocol in the same training session. Main Outcome Measures Velocity and spatiotemporal parameters of gait were measured without a secondary task and during dual-task gait combined with a visual, verbal, auditory, and motor task. In addition, executive cognitive function and quality of life were measured. Assessments were conducted at baseline, postrehabilitation, and at the 8-week follow-up. Results The dual-task group demonstrated improved velocity and stride length time in all assessment conditions after training (P<.05 as well perceived quality of life the single-task group experienced improvements in same outcomes for only motor condition after training but failed to improve>.05). Likewise, the dual-task group showed higher velocity and stride length after treatment than the single-task group across conditions. No significant changes were observed in cognitive performance (P>.05), although the dual-task group tended to improve performance during the executive function test. Conclusions Dual-task training in functional contexts is associated with greater improvements in velocity and stride length in patients with PD compared with regular physiotherapy without secondary tasks. Dual-task training also improves perceived quality of life.
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[article] Effects of Dual-Task Group Training on Gait, Cognitive Executive Function, and Quality of Life in People With Parkinson Disease: Results of Randomized Controlled DUALGAIT Trial [Article] / Constanza San Martín Valenzuela ; Lirios Dueñas Moscardó ; Juan López-Pascual ; Pilar Serra-Añó ; José M. Tomás . - 2020 . - p. 1849-1856.
https://doi.org/10.1016/j.apmr.2020.07.008
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1849-1856

Descripteurs :	HE Vinci Cognition ; Maladie de Parkinson ; Marche à pied ; Qualité de vie ; Réadaptation
Résumé :	Objectives The aims of this study were to analyze the effects of a dual-task group program, to compare it with the effects of a single-task group program, and to analyze the effects of functional secondary tasks. Design Single-blind randomized controlled trial. Setting University laboratory and a rehabilitation gym at a health center. Participants Patients (N=40) with a diagnosis of Parkinson disease (mean age, 66.72y; age range, 44-79y) with Hoehn and Yahr stage I to III who were on medication were randomized to either a group with dual-task training or a group with single-task training (only gait). Intervention Both interventions involved 20 sessions lasting 1 hour each and conducted twice a week. Dual-task training included walking exercises and cognitive or motor tasks carried out separately, then later performed together as a dual-task according to a progressive protocol in the same training session. Main Outcome Measures Velocity and spatiotemporal parameters of gait were measured without a secondary task and during dual-task gait combined with a visual, verbal, auditory, and motor task. In addition, executive cognitive function and quality of life were measured. Assessments were conducted at baseline, postrehabilitation, and at the 8-week follow-up. Results The dual-task group demonstrated improved velocity and stride length time in all assessment conditions after training (P<.05 as well perceived quality of life the single-task group experienced improvements in same outcomes for only motor condition after training but failed to improve>.05). Likewise, the dual-task group showed higher velocity and stride length after treatment than the single-task group across conditions. No significant changes were observed in cognitive performance (P>.05), although the dual-task group tended to improve performance during the executive function test. Conclusions Dual-task training in functional contexts is associated with greater improvements in velocity and stride length in patients with PD compared with regular physiotherapy without secondary tasks. Dual-task training also improves perceived quality of life.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1857-1864

Titre :	Comparison of Corticosteroid Injection Dosages in Mild to Moderate Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial
Type de document :	Article
Auteurs :	Po-Cheng Hsu ; Kwong-Kum Liao ; Kon-Ping Lin ; Jan-Wei Chiu ; Pin-Yi Wu ; Cheng-Liang Chou ; Nin-Yi Wang ; Jia-Chi Wang
Année de publication :	2020
Article en page(s) :	p. 1857-1864
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.018
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Essai contrôlé randomisé ; Réadaptation ; Syndrome du canal carpien ; Triamcinolone acétonide
Résumé :	Objectives To evaluate whether the therapeutic effect of ultrasound-guided injections with 10 mg or 40 mg triamcinolone acetonide (TA) was dose-dependent in patients with idiopathic mild to moderate carpal tunnel syndrome (CTS). Design Prospective, double-blind, randomized controlled study with 12 weeks of follow-up. Setting Rehabilitation outpatient clinic of a single medical center. Participants Patients with CTS (N=56). Intervention Participants were randomly assigned to 2 treatment groups for injection: (A) 40 mg TA+2% lidocaine hydrochloride or (B) 10 mg TA+2% lidocaine hydrochloride. Main Outcome Measures Participants were evaluated using visual analog scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ, including Symptom Severity Scale [SSS] and Functional Status Scale [FSS]) at baseline and 6 and 12 weeks after injection). Nerve conduction studies, including parameters of distal motor latency, amplitude of compound motor action potential, amplitude of sensory nerve action potential and sensory nerve conduction velocity of median nerve, and the patient’s subjective impression of improvement, were recorded before injection and 6 and 12 weeks after injection. Results No significant differences were observed in baseline demographic characteristics and clinical evaluations. The parameters in group A and B at baseline, 6 weeks, and 12 weeks were (1) SSS: 2.17±0.14, 1.19±0.04, and 1.34±0.09 and 1.87±0.11, 1.21±0.07, and 1.26±0.04; (2) FSS: 1.63±0.07, 1.27±0.06, and 1.33±0.08 and 1.50±0.10, 1.18±0.05, and 1.26±0.05; (3) VAS: 6.4±0.3, 2.2±0.3, and 3.0±0.1 and 6.7±0.3, 2.0±0.3, and 3.1±0.3, respectively, and significantly decreased after 6 and 12 weeks in both treatment groups (P<.05 all parameters of nerve conduction studies improved in both groups after weeks vas bctq and did not show significant intergroup differences weeks.> Conclusion In patients with idiopathic mild to moderate CTS, ultrasound-guided injection with 10 and 40 mg TA yield similar improvements in BCTQ, VAS, and nerve conduction studies at the 12-week follow-up.
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[article] Comparison of Corticosteroid Injection Dosages in Mild to Moderate Idiopathic Carpal Tunnel Syndrome: A Randomized Controlled Trial [Article] / Po-Cheng Hsu ; Kwong-Kum Liao ; Kon-Ping Lin ; Jan-Wei Chiu ; Pin-Yi Wu ; Cheng-Liang Chou ; Nin-Yi Wang ; Jia-Chi Wang . - 2020 . - p. 1857-1864.
https://doi.org/10.1016/j.apmr.2020.06.018
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1857-1864

Descripteurs :	HE Vinci Essai contrôlé randomisé ; Réadaptation ; Syndrome du canal carpien ; Triamcinolone acétonide
Résumé :	Objectives To evaluate whether the therapeutic effect of ultrasound-guided injections with 10 mg or 40 mg triamcinolone acetonide (TA) was dose-dependent in patients with idiopathic mild to moderate carpal tunnel syndrome (CTS). Design Prospective, double-blind, randomized controlled study with 12 weeks of follow-up. Setting Rehabilitation outpatient clinic of a single medical center. Participants Patients with CTS (N=56). Intervention Participants were randomly assigned to 2 treatment groups for injection: (A) 40 mg TA+2% lidocaine hydrochloride or (B) 10 mg TA+2% lidocaine hydrochloride. Main Outcome Measures Participants were evaluated using visual analog scale (VAS) and Boston Carpal Tunnel Questionnaire (BCTQ, including Symptom Severity Scale [SSS] and Functional Status Scale [FSS]) at baseline and 6 and 12 weeks after injection). Nerve conduction studies, including parameters of distal motor latency, amplitude of compound motor action potential, amplitude of sensory nerve action potential and sensory nerve conduction velocity of median nerve, and the patient’s subjective impression of improvement, were recorded before injection and 6 and 12 weeks after injection. Results No significant differences were observed in baseline demographic characteristics and clinical evaluations. The parameters in group A and B at baseline, 6 weeks, and 12 weeks were (1) SSS: 2.17±0.14, 1.19±0.04, and 1.34±0.09 and 1.87±0.11, 1.21±0.07, and 1.26±0.04; (2) FSS: 1.63±0.07, 1.27±0.06, and 1.33±0.08 and 1.50±0.10, 1.18±0.05, and 1.26±0.05; (3) VAS: 6.4±0.3, 2.2±0.3, and 3.0±0.1 and 6.7±0.3, 2.0±0.3, and 3.1±0.3, respectively, and significantly decreased after 6 and 12 weeks in both treatment groups (P<.05 all parameters of nerve conduction studies improved in both groups after weeks vas bctq and did not show significant intergroup differences weeks.> Conclusion In patients with idiopathic mild to moderate CTS, ultrasound-guided injection with 10 and 40 mg TA yield similar improvements in BCTQ, VAS, and nerve conduction studies at the 12-week follow-up.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1865-1876

Titre :	Effectiveness of High-Intensity Interval Training vs Moderate-Intensity Continuous Training in Patients With Fibromyalgia: A Pilot Randomized Controlled Trial
Type de document :	Article
Auteurs :	Tugba Atan ; Yusuf Karavelioglu
Année de publication :	2020
Article en page(s) :	p. 1865-1876
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.022
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Capacité cardiorespiratoire ; Consommation d'oxygène ; Entrainement fractionné de haute intensité ; Exercice physique ; Réadaptation
Résumé :	Objective To compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) combined with strengthening and stretching exercises in patients with fibromyalgia. Design Interventional, single-blind, randomized controlled trial. Setting Outpatient rehabilitation center. Participants Women with fibromyalgia (N=60) were randomized to HIIT, MICT, and control groups. Interventions HIIT included a 5-minute warm-up at 50% of peak heart rate and 4 cycles of 4 minutes at 80%-95% of peak heart rate followed by 3-minute recovery intervals at 70% of peak heart rate. MICT consisted of 45 minutes at 65%-70% of peak heart rate. Each aerobic training session was followed by standardized strengthening and stretching exercises. The programs performed using cycle ergometers for 5 sessions per week for 6 weeks. The control group did not participate in any supervised exercise sessions. Main Outcome Measures The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). The secondary outcome measures were visual analog scale for pain, Short Form-36 Health Survey (SF-36), cardiopulmonary exercise test (CPET), and body composition parameters. Results Fifty-five participants completed the study. There was no significant difference in FIQ between HIIT vs MICT (1.03; 95% CI, −9.67 to 11.75) after treatment. Group-time interactions were significant for the FIQ between interventions and control (HIIT vs control, −16.20; 95% CI, −27.23 to −5.13 and MICT vs control, −17.24; 95% CI, −28.27 to −6.22) (all P<.001 there were significant group-time interactions for the pain sf-36 and cpet parameters between treatments control p body weight fat percentage mass index improved significantly only in mict group after treatment.> Conclusions The HIIT plus strengthening and stretching exercises and MICT plus strengthening and stretching exercises interventions showed significant improvements for the effect of fibromyalgia, pain degree, functional capacity, and quality of life compared with the control group. HIIT was not superior to MICT. Furthermore, body composition parameters were improved significantly only for the MICT group.
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[article] Effectiveness of High-Intensity Interval Training vs Moderate-Intensity Continuous Training in Patients With Fibromyalgia: A Pilot Randomized Controlled Trial [Article] / Tugba Atan ; Yusuf Karavelioglu . - 2020 . - p. 1865-1876.
https://doi.org/10.1016/j.apmr.2020.05.022
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1865-1876

Descripteurs :	HE Vinci Capacité cardiorespiratoire ; Consommation d'oxygène ; Entrainement fractionné de haute intensité ; Exercice physique ; Réadaptation
Résumé :	Objective To compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) combined with strengthening and stretching exercises in patients with fibromyalgia. Design Interventional, single-blind, randomized controlled trial. Setting Outpatient rehabilitation center. Participants Women with fibromyalgia (N=60) were randomized to HIIT, MICT, and control groups. Interventions HIIT included a 5-minute warm-up at 50% of peak heart rate and 4 cycles of 4 minutes at 80%-95% of peak heart rate followed by 3-minute recovery intervals at 70% of peak heart rate. MICT consisted of 45 minutes at 65%-70% of peak heart rate. Each aerobic training session was followed by standardized strengthening and stretching exercises. The programs performed using cycle ergometers for 5 sessions per week for 6 weeks. The control group did not participate in any supervised exercise sessions. Main Outcome Measures The primary outcome measure was the Fibromyalgia Impact Questionnaire (FIQ). The secondary outcome measures were visual analog scale for pain, Short Form-36 Health Survey (SF-36), cardiopulmonary exercise test (CPET), and body composition parameters. Results Fifty-five participants completed the study. There was no significant difference in FIQ between HIIT vs MICT (1.03; 95% CI, −9.67 to 11.75) after treatment. Group-time interactions were significant for the FIQ between interventions and control (HIIT vs control, −16.20; 95% CI, −27.23 to −5.13 and MICT vs control, −17.24; 95% CI, −28.27 to −6.22) (all P<.001 there were significant group-time interactions for the pain sf-36 and cpet parameters between treatments control p body weight fat percentage mass index improved significantly only in mict group after treatment.> Conclusions The HIIT plus strengthening and stretching exercises and MICT plus strengthening and stretching exercises interventions showed significant improvements for the effect of fibromyalgia, pain degree, functional capacity, and quality of life compared with the control group. HIIT was not superior to MICT. Furthermore, body composition parameters were improved significantly only for the MICT group.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1877-1886

Titre :	Cardiac Rehabilitation for Patients Treated for Atrial Fibrillation With Ablation Has Long-Term Effects: 12-and 24-Month Follow-up Results From the Randomized CopenHeartRFA Trial
Type de document :	Article
Auteurs :	Signe Stelling Risom ; Ann-Dorthe Zwisler ; Kirstine Lærum Sibilitz ; Trine Bernholdt Rasmussen ; Rod Stephen Taylor ; Lau Caspar Thygesen ; Trine Stougaard Madsen ; Jesper Hastrup Svendsen ; Selina Kikkenborg Berg
Année de publication :	2020
Article en page(s) :	p. 1877-1886
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.026
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Fibrillation auriculaire ; Mesures des résultats rapportés par les patients (PROM) ; Qualité de vie ; Réadaptation ; Réadaptation cardiaque ; Réadmission du patient
Résumé :	Objective To assess outcomes at 12 and 24 months after participation in a multidisciplinary cardiac rehabilitation program plus usual care compared with usual care alone for patients treated for atrial fibrillation with catheter ablation. Design Long-term follow-up on the randomized CopenHeartRFA trial. Setting Patients were enrolled and outcome assessed at the hospital and the intervention were carried out at the hospital or at local rehabilitation centers. Participants Patients (N=210) treated for atrial fibrillation with catheter ablation included in the CopenHeartRFA trial. Interventions A 6-month cardiac rehabilitation program consisting of physical exercise and psychoeducational consultations plus usual care or usual care alone. Main Outcome Measures Physical capacity was measured by peak oxygen uptake (Vo2peak) at 12 months, and patient-reported outcomes on perceived health, anxiety, and depression were collected by validated questionnaires at 12 and 24 months. Information on hospital admissions and mortality was collected through national registers up to 24 months. Results Mean Vo2peak was higher at 12 months in the cardiac rehabilitation group (cardiac rehabilitation group: 25.82 mL/kg/min vs usual care group, 22.43 mL/kg/min, P=.003). A lower proportion of patients had high levels of anxiety at 24 months in the cardiac rehabilitation group compared to usual care (12% vs 24%, P=.004). There was no difference in mortality or hospital admissions at 24 months between groups. Conclusions This long-term follow-up of a comprehensive multidisciplinary cardiac rehabilitation program for patients treated for atrial fibrillation with catheter ablation found sustained improvements with respect to physical capacity and anxiety compared to usual care but no difference on mortality or hospital admission.
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[article] Cardiac Rehabilitation for Patients Treated for Atrial Fibrillation With Ablation Has Long-Term Effects: 12-and 24-Month Follow-up Results From the Randomized CopenHeartRFA Trial [Article] / Signe Stelling Risom ; Ann-Dorthe Zwisler ; Kirstine Lærum Sibilitz ; Trine Bernholdt Rasmussen ; Rod Stephen Taylor ; Lau Caspar Thygesen ; Trine Stougaard Madsen ; Jesper Hastrup Svendsen ; Selina Kikkenborg Berg . - 2020 . - p. 1877-1886.
https://doi.org/10.1016/j.apmr.2020.06.026
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1877-1886

Descripteurs :	HE Vinci Fibrillation auriculaire ; Mesures des résultats rapportés par les patients (PROM) ; Qualité de vie ; Réadaptation ; Réadaptation cardiaque ; Réadmission du patient
Résumé :	Objective To assess outcomes at 12 and 24 months after participation in a multidisciplinary cardiac rehabilitation program plus usual care compared with usual care alone for patients treated for atrial fibrillation with catheter ablation. Design Long-term follow-up on the randomized CopenHeartRFA trial. Setting Patients were enrolled and outcome assessed at the hospital and the intervention were carried out at the hospital or at local rehabilitation centers. Participants Patients (N=210) treated for atrial fibrillation with catheter ablation included in the CopenHeartRFA trial. Interventions A 6-month cardiac rehabilitation program consisting of physical exercise and psychoeducational consultations plus usual care or usual care alone. Main Outcome Measures Physical capacity was measured by peak oxygen uptake (Vo2peak) at 12 months, and patient-reported outcomes on perceived health, anxiety, and depression were collected by validated questionnaires at 12 and 24 months. Information on hospital admissions and mortality was collected through national registers up to 24 months. Results Mean Vo2peak was higher at 12 months in the cardiac rehabilitation group (cardiac rehabilitation group: 25.82 mL/kg/min vs usual care group, 22.43 mL/kg/min, P=.003). A lower proportion of patients had high levels of anxiety at 24 months in the cardiac rehabilitation group compared to usual care (12% vs 24%, P=.004). There was no difference in mortality or hospital admissions at 24 months between groups. Conclusions This long-term follow-up of a comprehensive multidisciplinary cardiac rehabilitation program for patients treated for atrial fibrillation with catheter ablation found sustained improvements with respect to physical capacity and anxiety compared to usual care but no difference on mortality or hospital admission.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1887-1897

Titre :	Phenotypic Characteristics of Patients With Chronic Obstructive Pulmonary Disease After Stratification for the Short Physical Performance Battery Summary Score
Type de document :	Article
Auteurs :	Anouk A.F. Stoffels ; Jana De Brandt ; Roy Meys ; Hieronymus W.H. van Hees ; Anouk W. Vaes ; Peter Klijn ; Chris Burtin ; Frits M.E. Franssen ; Bram van den Borst ; Maurice J.H. Sillen ; Emiel Wouters ; Daisy J. A. Janssen ; Martijn A. Spruit
Année de publication :	2020
Article en page(s) :	p. 1887-1897
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.011
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Anxiété ; Aptitude physique ; Broncho-pneumopathie chronique obstructive ; Dépression ; Équilibre postural ; Performance fonctionnelle physique ; Thérapie respiratoire
Résumé :	Objective To assess the phenotypic characteristics of patients with chronic obstructive pulmonary disease (COPD) after stratification for Short Physical Performance Battery (SPPB) summary scores and to determine phenotypic characteristics of the SPPB summary score at the start of pulmonary rehabilitation (PR). Design Retrospective, cross-sectional. Setting Baseline assessment for PR program. Participants Patients with COPD (n=900; age 65±8y, 52% male, forced expiratory volume in the first second of expiration, 43% [interquartile range, 31%-62%] predicted). Interventions Not applicable. Main Outcome Measures Patients were stratified according to their SPPB summary scores into low-performance (LP), moderate-performance (MP), or high-performance (HP) groups. Furthermore, lung function, arterial blood gases, body composition, physical capacity, lower limb muscle strength and endurance, and symptoms of anxiety and depression were assessed. Results Generally, physical capacity and muscle function were lower and scores for symptoms of anxiety and depression were higher in LP patients than MP and HP patients (all values, P<.01 however of hp patients with copd scored high on symptoms anxiety and depression points still had average an impaired physical capacity walk test distance predicted furthermore age were the only independent predictors in a multivariate regression model explaining variance sppb summary score.> Conclusions In COPD, LP patients have the worst physical and emotional functioning. However, HP patients can still exhibit physical and emotional impairments. Because the explained variance in SPPB summary score is low, SPPB should not be considered as a test to discriminate between patients with COPD with a low or preserved physical capacity and emotional status.
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[article] Phenotypic Characteristics of Patients With Chronic Obstructive Pulmonary Disease After Stratification for the Short Physical Performance Battery Summary Score [Article] / Anouk A.F. Stoffels ; Jana De Brandt ; Roy Meys ; Hieronymus W.H. van Hees ; Anouk W. Vaes ; Peter Klijn ; Chris Burtin ; Frits M.E. Franssen ; Bram van den Borst ; Maurice J.H. Sillen ; Emiel Wouters ; Daisy J. A. Janssen ; Martijn A. Spruit . - 2020 . - p. 1887-1897.
https://doi.org/10.1016/j.apmr.2020.05.011
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1887-1897

Descripteurs :	HE Vinci Anxiété ; Aptitude physique ; Broncho-pneumopathie chronique obstructive ; Dépression ; Équilibre postural ; Performance fonctionnelle physique ; Thérapie respiratoire
Résumé :	Objective To assess the phenotypic characteristics of patients with chronic obstructive pulmonary disease (COPD) after stratification for Short Physical Performance Battery (SPPB) summary scores and to determine phenotypic characteristics of the SPPB summary score at the start of pulmonary rehabilitation (PR). Design Retrospective, cross-sectional. Setting Baseline assessment for PR program. Participants Patients with COPD (n=900; age 65±8y, 52% male, forced expiratory volume in the first second of expiration, 43% [interquartile range, 31%-62%] predicted). Interventions Not applicable. Main Outcome Measures Patients were stratified according to their SPPB summary scores into low-performance (LP), moderate-performance (MP), or high-performance (HP) groups. Furthermore, lung function, arterial blood gases, body composition, physical capacity, lower limb muscle strength and endurance, and symptoms of anxiety and depression were assessed. Results Generally, physical capacity and muscle function were lower and scores for symptoms of anxiety and depression were higher in LP patients than MP and HP patients (all values, P<.01 however of hp patients with copd scored high on symptoms anxiety and depression points still had average an impaired physical capacity walk test distance predicted furthermore age were the only independent predictors in a multivariate regression model explaining variance sppb summary score.> Conclusions In COPD, LP patients have the worst physical and emotional functioning. However, HP patients can still exhibit physical and emotional impairments. Because the explained variance in SPPB summary score is low, SPPB should not be considered as a test to discriminate between patients with COPD with a low or preserved physical capacity and emotional status.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1898-1905

Titre :	Case-Control Study of Ultrasound Evaluation of Acute Median Nerve Response to Upper Extremity Circuit Training in Spinal Cord Injury
Type de document :	Article
Auteurs :	Luisa Betancourt ; Rachel E. Cowan ; Andrew Chang ; Robert Irwin
Année de publication :	2020
Article en page(s) :	p. 1898-1905
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.008
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Exercice physique ; Fauteuils roulants ; Nerf médian ; Paraplégie ; Réadaptation
Résumé :	Objective Individuals with spinal cord injury (SCI) often present signs and symptoms of median nerve (MN) pathology. Preclinical signs identification of MN pathology might facilitate early intervention to prevent or delay carpal tunnel syndrome in SCI. We assessed if ultrasound parameters changed in response to upper extremity (UE) circuit training exercise in individuals with paraplegia and able-bodied individuals. Design Case-control study. Participants Adults (N=32) with paraplegia (n=16) and age- and sex-matched able-bodied controls (n=16). Intervention Circuit training exercise. Main Outcome Measures MN ultrasound evaluation at the pisiform and radius before and after UE exercise. Ultrasound parameters included cross-sectional area (CSA), and gray scale (GS). Data presented as mean ± SD. Results Pre-exercise CSAs were larger in SCI at the radius (12.0±2.9 vs 9.0±2.1; P=.003), but not the pisiform (9.8±3.1 vs 9.1±1.7; P=.431). There were no statistical differences in MN response to exercise between groups (all P≥.293). Across participants, CSA changes were inversely associated with their pre-exercise values at the pisiform (r=–0.648; P<.001 and the radius p=".043)." participants with pre-exercise csa values mm2 at pisiform responded to exercise decreases in change sd gs no increased> Conclusions CSA exercise response was more strongly related to pre-exercise MN values than presence or absence of SCI.
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[article] Case-Control Study of Ultrasound Evaluation of Acute Median Nerve Response to Upper Extremity Circuit Training in Spinal Cord Injury [Article] / Luisa Betancourt ; Rachel E. Cowan ; Andrew Chang ; Robert Irwin . - 2020 . - p. 1898-1905.
https://doi.org/10.1016/j.apmr.2020.05.008
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1898-1905

Descripteurs :	HE Vinci Exercice physique ; Fauteuils roulants ; Nerf médian ; Paraplégie ; Réadaptation
Résumé :	Objective Individuals with spinal cord injury (SCI) often present signs and symptoms of median nerve (MN) pathology. Preclinical signs identification of MN pathology might facilitate early intervention to prevent or delay carpal tunnel syndrome in SCI. We assessed if ultrasound parameters changed in response to upper extremity (UE) circuit training exercise in individuals with paraplegia and able-bodied individuals. Design Case-control study. Participants Adults (N=32) with paraplegia (n=16) and age- and sex-matched able-bodied controls (n=16). Intervention Circuit training exercise. Main Outcome Measures MN ultrasound evaluation at the pisiform and radius before and after UE exercise. Ultrasound parameters included cross-sectional area (CSA), and gray scale (GS). Data presented as mean ± SD. Results Pre-exercise CSAs were larger in SCI at the radius (12.0±2.9 vs 9.0±2.1; P=.003), but not the pisiform (9.8±3.1 vs 9.1±1.7; P=.431). There were no statistical differences in MN response to exercise between groups (all P≥.293). Across participants, CSA changes were inversely associated with their pre-exercise values at the pisiform (r=–0.648; P<.001 and the radius p=".043)." participants with pre-exercise csa values mm2 at pisiform responded to exercise decreases in change sd gs no increased> Conclusions CSA exercise response was more strongly related to pre-exercise MN values than presence or absence of SCI.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1906-1913

Titre :	Decannulation After a Severe Acquired Brain Injury
Type de document :	Article
Auteurs :	Bahia Hakiki ; Francesca Draghi ; Silvia Pancani ; Emilio Portaccio ; Antonello Grippo ; Barbara Binazzi ; Ariela Tofani ; Maenia Scarpino ; Claudio Macchi ; Francesca Cecchi
Année de publication :	2020
Article en page(s) :	p. 1906-1913
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.004
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Bronchoscopie ; Lésions encéphaliques ; Réadaptation ; Trachéostomie ; Troubles de la conscience
Résumé :	Objective To identify the effect of some clinical characteristics of severe acquired brain injury (sABI) patients on decannulation success during their intensive rehabilitation unit (IRU) stay. Design Nonconcurrent cohort study. Setting Don Gnocchi Foundation Institute. Participants Patients (N=351) with sABI and tracheostomy were retrospectively selected from the database of the IRU of the Don Gnocchi Foundation Institute. Main Outcome Measures Potential predictors of decannulation were screened from variables collected at admission during clinical examination, conducted by trained and experienced examiners. The association between clinical characteristics and decannulation status was investigated through a Cox regression model. Kaplan-Meier curves were then created for time-event analysis. Results Among the patients (mean age, 64.1±15.5y), 54.1% were decannulated during their IRU stay. Absence of pulmonary infections (P<.001 sepsis tracheal alteration at the fibrobronchoscopy examination and a higher coma recovery scale-revised score or better state of consciousness admission were associated with probability decannulation.> Conclusions Fibrobronchoscopy assessment of patency of airways and accurate evaluation of the state of consciousness using the CRS-R are relevant in this setting of care to better identify patients who are more likely to have the tracheostomy tube removed. These results may help clinicians choose the appropriate timing and intensity of rehabilitation interventions and plan for discharge.
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[article] Decannulation After a Severe Acquired Brain Injury [Article] / Bahia Hakiki ; Francesca Draghi ; Silvia Pancani ; Emilio Portaccio ; Antonello Grippo ; Barbara Binazzi ; Ariela Tofani ; Maenia Scarpino ; Claudio Macchi ; Francesca Cecchi . - 2020 . - p. 1906-1913.
https://doi.org/10.1016/j.apmr.2020.05.004
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1906-1913

Descripteurs :	HE Vinci Bronchoscopie ; Lésions encéphaliques ; Réadaptation ; Trachéostomie ; Troubles de la conscience
Résumé :	Objective To identify the effect of some clinical characteristics of severe acquired brain injury (sABI) patients on decannulation success during their intensive rehabilitation unit (IRU) stay. Design Nonconcurrent cohort study. Setting Don Gnocchi Foundation Institute. Participants Patients (N=351) with sABI and tracheostomy were retrospectively selected from the database of the IRU of the Don Gnocchi Foundation Institute. Main Outcome Measures Potential predictors of decannulation were screened from variables collected at admission during clinical examination, conducted by trained and experienced examiners. The association between clinical characteristics and decannulation status was investigated through a Cox regression model. Kaplan-Meier curves were then created for time-event analysis. Results Among the patients (mean age, 64.1±15.5y), 54.1% were decannulated during their IRU stay. Absence of pulmonary infections (P<.001 sepsis tracheal alteration at the fibrobronchoscopy examination and a higher coma recovery scale-revised score or better state of consciousness admission were associated with probability decannulation.> Conclusions Fibrobronchoscopy assessment of patency of airways and accurate evaluation of the state of consciousness using the CRS-R are relevant in this setting of care to better identify patients who are more likely to have the tracheostomy tube removed. These results may help clinicians choose the appropriate timing and intensity of rehabilitation interventions and plan for discharge.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1914-1921

Titre :	Construct Validity of the Chilean-Spanish Version of the Functional Status Score for the Intensive Care Unit: A Prospective Observational Study Using Actigraphy in Mechanically Ventilated Patients
Type de document :	Article
Auteurs :	Agustin Camus-Molina ; Felipe González-Seguel ; Ana Cristina Castro-Ávila ; Jaime Leppe
Année de publication :	2020
Article en page(s) :	p. 1914-1921
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.019
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Actigraphie ; Etudes de validation ; Évaluation de résultat (soins) ; Réadaptation ; Unités de soins intensifs
Résumé :	Objective To evaluate the construct validity (hypotheses testing) of the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU) using continuous actigraphy from intensive care unit (ICU) admission to ICU discharge. Design The Chilean-Spanish version of the FSS-ICU was used in a prospective observational study to mainly evaluate its correlation with actigraphy variables. The FSS-ICU was assessed on awakening and at ICU discharge, while actigraphy variables were recorded from ICU admission to ICU discharge. Setting A 12-bed academic medical-surgical ICU. Participants Mechanically ventilated patients (N=30), of 92 patients screened. Interventions Not applicable. Main Outcome Measures Construct validity of the FSS-ICU Chilean-Spanish version was assessed by testing 12 hypotheses, including the correlation with activity counts, activity time (>99 counts/min), inactivity time (0-99 counts/min), muscle strength, ICU length of stay, and duration of mechanical ventilation. Results The median FSS-ICU was 19 points (interquartile range [IQR], 10-26 points) on awakening and 28.5 points (IQR, 22-32 points) at ICU discharge. There was no floor/ceiling effect of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that was acceptable (0%/10%). Less activity time was associated with better mobility on the FSS-ICU at both awakening (ρ=−0.62, P<.001 and icu discharge p activity counts time were not correlated as expected with the fss-icu.> Conclusions The Chilean-Spanish FSS-ICU had a strong correlation with inactivity time during the ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.
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[article] Construct Validity of the Chilean-Spanish Version of the Functional Status Score for the Intensive Care Unit: A Prospective Observational Study Using Actigraphy in Mechanically Ventilated Patients [Article] / Agustin Camus-Molina ; Felipe González-Seguel ; Ana Cristina Castro-Ávila ; Jaime Leppe . - 2020 . - p. 1914-1921.
https://doi.org/10.1016/j.apmr.2020.04.019
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1914-1921

Descripteurs :	HE Vinci Actigraphie ; Etudes de validation ; Évaluation de résultat (soins) ; Réadaptation ; Unités de soins intensifs
Résumé :	Objective To evaluate the construct validity (hypotheses testing) of the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU) using continuous actigraphy from intensive care unit (ICU) admission to ICU discharge. Design The Chilean-Spanish version of the FSS-ICU was used in a prospective observational study to mainly evaluate its correlation with actigraphy variables. The FSS-ICU was assessed on awakening and at ICU discharge, while actigraphy variables were recorded from ICU admission to ICU discharge. Setting A 12-bed academic medical-surgical ICU. Participants Mechanically ventilated patients (N=30), of 92 patients screened. Interventions Not applicable. Main Outcome Measures Construct validity of the FSS-ICU Chilean-Spanish version was assessed by testing 12 hypotheses, including the correlation with activity counts, activity time (>99 counts/min), inactivity time (0-99 counts/min), muscle strength, ICU length of stay, and duration of mechanical ventilation. Results The median FSS-ICU was 19 points (interquartile range [IQR], 10-26 points) on awakening and 28.5 points (IQR, 22-32 points) at ICU discharge. There was no floor/ceiling effect of the FSS-ICU at awakening (0%/0%) and only a ceiling effect at ICU discharge that was acceptable (0%/10%). Less activity time was associated with better mobility on the FSS-ICU at both awakening (ρ=−0.62, P<.001 and icu discharge p activity counts time were not correlated as expected with the fss-icu.> Conclusions The Chilean-Spanish FSS-ICU had a strong correlation with inactivity time during the ICU stay. These findings enhance the available clinimetric properties of the FSS-ICU.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1922-1928

Titre :	Sex Differences in Emotional Insight After Traumatic Brain Injury
Type de document :	Article
Auteurs :	Dawn Neumann ; Barbra Zupan
Année de publication :	2020
Article en page(s) :	p. 1922-1928
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.018
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Émotions ; Empathie ; Lésions encéphaliques ; Réadaptation ; Symptômes affectifs
Résumé :	Objective To compare sex differences in alexithymia (poor emotional processing) in males and females with traumatic brain injury (TBI) and uninjured controls. Design Cross-sectional study. Setting TBI rehabilitation facility in the United States and a university in Canada. Participants Sixty adults with moderate to severe TBI (62% men) and 60 uninjured controls (63% men) (N=120). Interventions Not applicable. Main Outcome Measures Toronto Alexithymia Scale-20 (TAS-20). Results Uninjured men had significantly higher (worse) alexithymia scores than uninjured female participants on the TAS-20 (P=.007), whereas, no sex differences were found in the TBI group (P=.698). Men and women with TBI had significantly higher alexithymia compared with uninjured same-sex controls (both P<.001 the prevalence of participants with scores exceeding alexithymia sex-based norms for men and women tbi was respectively compared without tbi.> Conclusions Contrary to most findings in the general population, men with TBI were not more alexithymic than their female counterparts with TBI. Both men and women with TBI have more severe alexithymia than their uninjured same-sex peers. Moreover, both are equally at risk for elevated alexithymia compared with the norms. Alexithymia should be evaluated and treated after TBI regardless of patient sex.
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[article] Sex Differences in Emotional Insight After Traumatic Brain Injury [Article] / Dawn Neumann ; Barbra Zupan . - 2020 . - p. 1922-1928.
https://doi.org/10.1016/j.apmr.2020.04.018
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1922-1928

Descripteurs :	HE Vinci Émotions ; Empathie ; Lésions encéphaliques ; Réadaptation ; Symptômes affectifs
Résumé :	Objective To compare sex differences in alexithymia (poor emotional processing) in males and females with traumatic brain injury (TBI) and uninjured controls. Design Cross-sectional study. Setting TBI rehabilitation facility in the United States and a university in Canada. Participants Sixty adults with moderate to severe TBI (62% men) and 60 uninjured controls (63% men) (N=120). Interventions Not applicable. Main Outcome Measures Toronto Alexithymia Scale-20 (TAS-20). Results Uninjured men had significantly higher (worse) alexithymia scores than uninjured female participants on the TAS-20 (P=.007), whereas, no sex differences were found in the TBI group (P=.698). Men and women with TBI had significantly higher alexithymia compared with uninjured same-sex controls (both P<.001 the prevalence of participants with scores exceeding alexithymia sex-based norms for men and women tbi was respectively compared without tbi.> Conclusions Contrary to most findings in the general population, men with TBI were not more alexithymic than their female counterparts with TBI. Both men and women with TBI have more severe alexithymia than their uninjured same-sex peers. Moreover, both are equally at risk for elevated alexithymia compared with the norms. Alexithymia should be evaluated and treated after TBI regardless of patient sex.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1929-1936

Titre :	Motivational Strategies for Stroke Rehabilitation: A Delphi Study
Type de document :	Article
Auteurs :	Kazuaki Oyake ; Makoto Suzuki ; Yohei Otaka ; Kimito Momose ; Satoshi Tanaka
Année de publication :	2020
Article en page(s) :	p. 1929-1936
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.007
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Angiopathies intracrâniennes ; Consensus ; Motivation ; Réadaptation
Résumé :	Objectives The primary objective was to provide a list of effective motivational strategies based on consensus among rehabilitation experts, generated using the Delphi technique. The secondary objective was to identify the types of information that are important when selecting motivational strategies. Design Delphi study. Setting On-site survey at academic conferences and web-based survey. Participants Rehabilitation experts (N=198) including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists who had worked in stroke rehabilitation for at least 5 years. Intervention Not applicable. Main Outcome Measures Panelists were asked to rate the effectiveness of motivational strategies and to rate the importance of different types of information using a 5-point Likert scale. Consensus was defined as having been reached for items with an interquartile range of 1 or less. Results A total of 116 experts (58.6%) completed the third round of the Delphi survey. Consensus was reached on all of the 26 presented strategies. Seven strategies, such as control of task difficulty and goal setting, were considered to be very effective in increasing patient motivation. In addition, all 11 of the presented types of information regarding patient health status, environmental factors, and personal factors were deemed very important or important in determining which motivational strategies to use. Conclusions We generated a list of effective motivational strategies for stroke rehabilitation based on expert consensus. Our results suggest that experts consider a comprehensive range of patient information when choosing motivational strategies. These findings represent a group of consensus-based recommendations for increasing patient adherence to stroke rehabilitation programs, which may be beneficial to many medical professionals working in stroke rehabilitation.
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[article] Motivational Strategies for Stroke Rehabilitation: A Delphi Study [Article] / Kazuaki Oyake ; Makoto Suzuki ; Yohei Otaka ; Kimito Momose ; Satoshi Tanaka . - 2020 . - p. 1929-1936.
https://doi.org/10.1016/j.apmr.2020.06.007
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1929-1936

Descripteurs :	HE Vinci Angiopathies intracrâniennes ; Consensus ; Motivation ; Réadaptation
Résumé :	Objectives The primary objective was to provide a list of effective motivational strategies based on consensus among rehabilitation experts, generated using the Delphi technique. The secondary objective was to identify the types of information that are important when selecting motivational strategies. Design Delphi study. Setting On-site survey at academic conferences and web-based survey. Participants Rehabilitation experts (N=198) including physicians, physical therapists, occupational therapists, and speech-language-hearing therapists who had worked in stroke rehabilitation for at least 5 years. Intervention Not applicable. Main Outcome Measures Panelists were asked to rate the effectiveness of motivational strategies and to rate the importance of different types of information using a 5-point Likert scale. Consensus was defined as having been reached for items with an interquartile range of 1 or less. Results A total of 116 experts (58.6%) completed the third round of the Delphi survey. Consensus was reached on all of the 26 presented strategies. Seven strategies, such as control of task difficulty and goal setting, were considered to be very effective in increasing patient motivation. In addition, all 11 of the presented types of information regarding patient health status, environmental factors, and personal factors were deemed very important or important in determining which motivational strategies to use. Conclusions We generated a list of effective motivational strategies for stroke rehabilitation based on expert consensus. Our results suggest that experts consider a comprehensive range of patient information when choosing motivational strategies. These findings represent a group of consensus-based recommendations for increasing patient adherence to stroke rehabilitation programs, which may be beneficial to many medical professionals working in stroke rehabilitation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1937-1945

Titre :	Self-Efficacy Predicts Personal and Family Adjustment Among Persons With Spinal Cord Injury or Acquired Brain Injury and Their Significant Others: A Dyadic Approach
Type de document :	Article
Auteurs :	Eline W.M. Scholten ; Marjolijn Ketelaar ; Johanna M. Visser-Meily ; Janneke Stolwijk-Swüste ; Ilse J.W. van Nes ; David Gobets
Année de publication :	2020
Article en page(s) :	p. 1937-1945
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.003
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Auto-efficacité ; Lésions encéphaliques ; Réadaptation ; Santé mentale ; Traumatismes de la moelle épinière
Résumé :	Objectives To investigate whether the combination of self-efficacy levels of individuals with spinal cord injury (SCI) or acquired brain injury (ABI) and their significant others, measured shortly after the start of inpatient rehabilitation, predict their personal and family adjustment 6 months after inpatient discharge. Design Prospective longitudinal study. Setting Twelve Dutch rehabilitation centers. Participants Volunteer sample consisting of dyads (N=157) of adults with SCI or ABI who were admitted to inpatient rehabilitation and their adult significant others. Interventions Not applicable. Main Outcome Measures Self-efficacy (General Competence Scale) and personal and family adjustment (Hospital Anxiety and Depression Scale and McMaster Family Assessment Device General Functioning). Results In 20 dyads, both individuals with SCI or ABI and their significant others showed low self-efficacy at baseline. In 67 dyads, both showed high self-efficacy. In the low-self-efficacy dyads, 61% of the individuals with SCI or ABI and 50% of the significant others showed symptoms of anxiety 6 months after discharge, vs 23% and 30%, respectively, in the high-self-efficacy dyads. In the low-self-efficacy dyads, 56% of individuals with SCI or ABI and 50% of the significant others reported symptoms of depression, vs 20% and 27%, respectively, in the high-self-efficacy dyads. Problematic family functioning was reported by 53% of the individuals with SCI or ABI and 42% of the significant others in the low-self-efficacy dyads, vs 4% and 12%, respectively, in the high-self-efficacy dyads. Multivariate analysis of variance analyses showed that the combination of levels of self-efficacy of individuals with SCI or ABI and their significant others at the start of inpatient rehabilitation predict personal (V=0.12; F6,302=2.8; P=.010) and family adjustment (V=0.19; F6,252=4.3; P<.001 months after discharge.> Conclusions Low-self-efficacy dyads appear to be more at risk for personal and family adjustment problems after discharge. Screening for self-efficacy may help healthcare professionals to identify and support families at risk for long-term adjustment problems.
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[article] Self-Efficacy Predicts Personal and Family Adjustment Among Persons With Spinal Cord Injury or Acquired Brain Injury and Their Significant Others: A Dyadic Approach [Article] / Eline W.M. Scholten ; Marjolijn Ketelaar ; Johanna M. Visser-Meily ; Janneke Stolwijk-Swüste ; Ilse J.W. van Nes ; David Gobets . - 2020 . - p. 1937-1945.
https://doi.org/10.1016/j.apmr.2020.06.003
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1937-1945

Descripteurs :	HE Vinci Auto-efficacité ; Lésions encéphaliques ; Réadaptation ; Santé mentale ; Traumatismes de la moelle épinière
Résumé :	Objectives To investigate whether the combination of self-efficacy levels of individuals with spinal cord injury (SCI) or acquired brain injury (ABI) and their significant others, measured shortly after the start of inpatient rehabilitation, predict their personal and family adjustment 6 months after inpatient discharge. Design Prospective longitudinal study. Setting Twelve Dutch rehabilitation centers. Participants Volunteer sample consisting of dyads (N=157) of adults with SCI or ABI who were admitted to inpatient rehabilitation and their adult significant others. Interventions Not applicable. Main Outcome Measures Self-efficacy (General Competence Scale) and personal and family adjustment (Hospital Anxiety and Depression Scale and McMaster Family Assessment Device General Functioning). Results In 20 dyads, both individuals with SCI or ABI and their significant others showed low self-efficacy at baseline. In 67 dyads, both showed high self-efficacy. In the low-self-efficacy dyads, 61% of the individuals with SCI or ABI and 50% of the significant others showed symptoms of anxiety 6 months after discharge, vs 23% and 30%, respectively, in the high-self-efficacy dyads. In the low-self-efficacy dyads, 56% of individuals with SCI or ABI and 50% of the significant others reported symptoms of depression, vs 20% and 27%, respectively, in the high-self-efficacy dyads. Problematic family functioning was reported by 53% of the individuals with SCI or ABI and 42% of the significant others in the low-self-efficacy dyads, vs 4% and 12%, respectively, in the high-self-efficacy dyads. Multivariate analysis of variance analyses showed that the combination of levels of self-efficacy of individuals with SCI or ABI and their significant others at the start of inpatient rehabilitation predict personal (V=0.12; F6,302=2.8; P=.010) and family adjustment (V=0.19; F6,252=4.3; P<.001 months after discharge.> Conclusions Low-self-efficacy dyads appear to be more at risk for personal and family adjustment problems after discharge. Screening for self-efficacy may help healthcare professionals to identify and support families at risk for long-term adjustment problems.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1678-1682

Titre :	Investigation of the Effects of Dual-Task Balance Training on Gait and Balance in Transfemoral Amputees: A Randomized Controlled Trial
Type de document :	Périodique
Auteurs :	Senem Demirdel ; Fatih Erbahçeci
Année de publication :	2020
Article en page(s) :	p. 1678-1682
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.009
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Amputés ; Démarche ; Réadaptation
Résumé :	Objectives To investigate the effects of dual-task balance training on static and dynamic balance, functional mobility, cognitive level, and sleep quality in individuals with transfemoral amputation. Design Randomized controlled clinical trial. Participants Transfemoral amputees (N=20). Interventions Participants were randomly assigned to the single-task gait and balance training group (n=10) or the dual-task gait and balance training group (n=10). Training was given in sessions of 60 min/d, 3 d/wk for 4 weeks. The single-task training group performed traditional gait and balance exercises, and the dual-task training group practiced cognitive and motor tasks while performing gait and balance exercises. Main Outcome Measures The 1-leg stance test and the Four Square Step Test were used for balance assessment. The timed Up and Go test and 10-m walk test were used for gait assessment. Three test conditions to evaluate the training effects were single walking, walking while performing a cognitive task (serial subtraction), and walking while performing a motor task (tray carrying). The Montreal Cognitive Assessment scale was used for cognitive assessment and the Pittsburgh Sleep Quality Index for sleep quality assessment. Results Balance and mobility improved in both groups. Dual-task balance performance, functional mobility, and gait speed improved more in the dual-task training group after training (P<.05 cognitive status and sleep quality improved significantly in the dual-task group> Conclusions Dual-task training was more effective than single-task training in the improvement of dual-task performance and cognitive status. The inclusion of dual-task exercises in the rehabilitation program of transfemoral amputees will provide a different perspective because of increased task automation.
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[article] Investigation of the Effects of Dual-Task Balance Training on Gait and Balance in Transfemoral Amputees: A Randomized Controlled Trial [Périodique] / Senem Demirdel ; Fatih Erbahçeci . - 2020 . - p. 1678-1682.
https://doi.org/10.1016/j.apmr.2020.06.009
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1678-1682

Descripteurs :	HE Vinci Amputés ; Démarche ; Réadaptation
Résumé :	Objectives To investigate the effects of dual-task balance training on static and dynamic balance, functional mobility, cognitive level, and sleep quality in individuals with transfemoral amputation. Design Randomized controlled clinical trial. Participants Transfemoral amputees (N=20). Interventions Participants were randomly assigned to the single-task gait and balance training group (n=10) or the dual-task gait and balance training group (n=10). Training was given in sessions of 60 min/d, 3 d/wk for 4 weeks. The single-task training group performed traditional gait and balance exercises, and the dual-task training group practiced cognitive and motor tasks while performing gait and balance exercises. Main Outcome Measures The 1-leg stance test and the Four Square Step Test were used for balance assessment. The timed Up and Go test and 10-m walk test were used for gait assessment. Three test conditions to evaluate the training effects were single walking, walking while performing a cognitive task (serial subtraction), and walking while performing a motor task (tray carrying). The Montreal Cognitive Assessment scale was used for cognitive assessment and the Pittsburgh Sleep Quality Index for sleep quality assessment. Results Balance and mobility improved in both groups. Dual-task balance performance, functional mobility, and gait speed improved more in the dual-task training group after training (P<.05 cognitive status and sleep quality improved significantly in the dual-task group> Conclusions Dual-task training was more effective than single-task training in the improvement of dual-task performance and cognitive status. The inclusion of dual-task exercises in the rehabilitation program of transfemoral amputees will provide a different perspective because of increased task automation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1683-1688

Titre :	Comparison of Removable Rigid Dressing and Elastic Bandage for Residual Limb Maturation in Transtibial Amputees: A Randomized Controlled Trial
Type de document :	Périodique
Auteurs :	Nantawan Koonalinthip ; Aungsumalin Sukthongsa
Année de publication :	2020
Article en page(s) :	p. 1683-1688
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.009
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Amputés ; Bandages ; Réadaptation
Résumé :	Objective To determine the effect of a removable rigid dressing (RRD) on the time to residual limb maturation compared with elastic bandage (EB) in transtibial amputees. Design Experimental single-blinded (assessor-blinded) randomized controlled trial. Setting Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital. Participants Transtibial amputees (N=25) with immature residual limb. Intervention Participants were allocated to use RRD or EB to achieve residual limb maturation, and all participants in both groups were trained with the same preprosthetic program. Main Outcome Measures The time to residual limb maturation, patient satisfaction, and complications were compared between the 2 groups. Results Median time to residual limb maturation was significantly lower in the RRD group (median, 28d [interquartile range, 17-51d]) than in the EB group (median, 54d [interquartile range, 30-77d]; P=.020). After accounting for time since amputation, maturation time remained significantly lower in the RRD group (adjusted hazard ratio, 3.32; 95% CI, 1.08-10.20; P=.036). There was no significant difference in complications or patient satisfaction. Conclusion In postoperative management of transtibial amputation, the use of RRD had a significantly shorter period to residual limb maturation when compared with the EB group.
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[article] Comparison of Removable Rigid Dressing and Elastic Bandage for Residual Limb Maturation in Transtibial Amputees: A Randomized Controlled Trial [Périodique] / Nantawan Koonalinthip ; Aungsumalin Sukthongsa . - 2020 . - p. 1683-1688.
https://doi.org/10.1016/j.apmr.2020.05.009
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1683-1688

Descripteurs :	HE Vinci Amputés ; Bandages ; Réadaptation
Résumé :	Objective To determine the effect of a removable rigid dressing (RRD) on the time to residual limb maturation compared with elastic bandage (EB) in transtibial amputees. Design Experimental single-blinded (assessor-blinded) randomized controlled trial. Setting Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital. Participants Transtibial amputees (N=25) with immature residual limb. Intervention Participants were allocated to use RRD or EB to achieve residual limb maturation, and all participants in both groups were trained with the same preprosthetic program. Main Outcome Measures The time to residual limb maturation, patient satisfaction, and complications were compared between the 2 groups. Results Median time to residual limb maturation was significantly lower in the RRD group (median, 28d [interquartile range, 17-51d]) than in the EB group (median, 54d [interquartile range, 30-77d]; P=.020). After accounting for time since amputation, maturation time remained significantly lower in the RRD group (adjusted hazard ratio, 3.32; 95% CI, 1.08-10.20; P=.036). There was no significant difference in complications or patient satisfaction. Conclusion In postoperative management of transtibial amputation, the use of RRD had a significantly shorter period to residual limb maturation when compared with the EB group.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1689-1695

Titre :	Comparison of the Effects of Vapocoolant Spray and Topical Anesthetic Cream on Pain During Intraarticular Injection of the Shoulder: A Randomized Double-Blind Controlled Trial
Type de document :	Périodique
Auteurs :	Young-Eun Moon ; Sang-Hyun Kim ; Hyun Seok ; Lee, SeungYeol
Année de publication :	2020
Article en page(s) :	p. 1689-1695
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.021
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Anesthesique local ; Anesthesiques ; Injections articulaires ; Perception de la douleur ; Réadaptation
Résumé :	Objective This study was performed to compare the effects of a vapocoolant spray and a eutectic mixture of local anesthetics (EMLA) cream on reducing pain during intra-articular (IA) injection of the shoulder. Design Double-blind randomized placebo-controlled clinical trial. Setting University hospital. Participants Patients (N=63) who underwent IA injection of the shoulder joint were randomized into the spray group, EMLA group, or placebo group. Intervention Placebo cream+vapocoolant spray (spray group), EMLA cream+placebo spray (EMLA group), or placebo cream+placebo spray (placebo group) before IA injection. Main Outcome Measures A 100-mm visual analog scale (VAS) for injection pain and 5-point Likert scales for participant satisfaction and preference for repeated use were administered immediately after IA injection. Results The VAS scores for pain during IA injection were 30.0 (95% CI, 19.7-41.2) in the spray group, 50.0 (95% CI, 37.7-63.0) in the EMLA group, and 53.8 (95% CI, 41.6-65.0) in the placebo group (F=6.403, P<.01 the spray group showed significantly better likert scale scores than placebo for participant satisfaction and preference repeated use> Conclusions Vapocoolant spray was effective in reducing pain during IA injection of the shoulder.
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[article] Comparison of the Effects of Vapocoolant Spray and Topical Anesthetic Cream on Pain During Intraarticular Injection of the Shoulder: A Randomized Double-Blind Controlled Trial [Périodique] / Young-Eun Moon ; Sang-Hyun Kim ; Hyun Seok ; Lee, SeungYeol . - 2020 . - p. 1689-1695.
https://doi.org/10.1016/j.apmr.2020.04.021
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1689-1695

Descripteurs :	HE Vinci Anesthesique local ; Anesthesiques ; Injections articulaires ; Perception de la douleur ; Réadaptation
Résumé :	Objective This study was performed to compare the effects of a vapocoolant spray and a eutectic mixture of local anesthetics (EMLA) cream on reducing pain during intra-articular (IA) injection of the shoulder. Design Double-blind randomized placebo-controlled clinical trial. Setting University hospital. Participants Patients (N=63) who underwent IA injection of the shoulder joint were randomized into the spray group, EMLA group, or placebo group. Intervention Placebo cream+vapocoolant spray (spray group), EMLA cream+placebo spray (EMLA group), or placebo cream+placebo spray (placebo group) before IA injection. Main Outcome Measures A 100-mm visual analog scale (VAS) for injection pain and 5-point Likert scales for participant satisfaction and preference for repeated use were administered immediately after IA injection. Results The VAS scores for pain during IA injection were 30.0 (95% CI, 19.7-41.2) in the spray group, 50.0 (95% CI, 37.7-63.0) in the EMLA group, and 53.8 (95% CI, 41.6-65.0) in the placebo group (F=6.403, P<.01 the spray group showed significantly better likert scale scores than placebo for participant satisfaction and preference repeated use> Conclusions Vapocoolant spray was effective in reducing pain during IA injection of the shoulder.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1696-1703

Titre :	Can the Positional Release Technique Affect Central Sensitization in Patients With Chronic Tension-Type Headache? A Randomized Clinical Trial
Type de document :	Périodique
Auteurs :	Marzieh Mohamadi ; Zahra Rojhani Shirazi ; Reza Assadsangabi ; Abbas Rahimi
Année de publication :	2020
Article en page(s) :	p. 1696-1703
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.028
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Douleur chronique ; Encephale ; Hyperalgésie ; Réadaptation ; Sensibilisation du système nerveux central
Résumé :	Objectives To investigate whether the positional release technique (PRT) affects central sensitization in patients with chronic tension-type headache (TTH). Design Randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Setting Two university neurology clinics. Participants Patients (N=32) with TTH and myofascial trigger points (MTrP) in their cervical muscles. Interventions Patients in the PRT group received 10 treatment sessions for each of their MTrPs over the course of 5 weeks. All participants could use ibuprofen 200 mg for their headaches during the study. Main Outcome Measures The primary outcome measure was brain metabolite profile. The secondary outcome measures were headache frequency and intensity, McGill score, and pressure pain threshold (PPT), which were evaluated in each participant during 5 weeks with proton magnetic resonance spectroscopy, patients’ self-reports, the McGill Pain Questionnaire, and a pressure algometer. Results Analysis of the data from 26 patients showed that headache frequency (P=.001), headache intensity (P=.002), McGill score (P=.003), and local PPT (P=.003) changed significantly after PRT. The myo-inositol/creatine concentration ratio in the somatosensory cortex (P=.041) decreased significantly in the control group. Furthermore, there were significant differences between groups in headache frequency (P<.001 headache intensity mcgill score local ppt distal and glutamate concentration ratio in the thalamus> Conclusions These findings indicate that PRT did not affect central sensitization in patients with TTH despite the improvement in clinical symptoms.
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[article] Can the Positional Release Technique Affect Central Sensitization in Patients With Chronic Tension-Type Headache? A Randomized Clinical Trial [Périodique] / Marzieh Mohamadi ; Zahra Rojhani Shirazi ; Reza Assadsangabi ; Abbas Rahimi . - 2020 . - p. 1696-1703.
https://doi.org/10.1016/j.apmr.2020.05.028
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1696-1703

Descripteurs :	HE Vinci Douleur chronique ; Encephale ; Hyperalgésie ; Réadaptation ; Sensibilisation du système nerveux central
Résumé :	Objectives To investigate whether the positional release technique (PRT) affects central sensitization in patients with chronic tension-type headache (TTH). Design Randomized controlled trial with concealed allocation, assessor blinding, and intention-to-treat analysis. Setting Two university neurology clinics. Participants Patients (N=32) with TTH and myofascial trigger points (MTrP) in their cervical muscles. Interventions Patients in the PRT group received 10 treatment sessions for each of their MTrPs over the course of 5 weeks. All participants could use ibuprofen 200 mg for their headaches during the study. Main Outcome Measures The primary outcome measure was brain metabolite profile. The secondary outcome measures were headache frequency and intensity, McGill score, and pressure pain threshold (PPT), which were evaluated in each participant during 5 weeks with proton magnetic resonance spectroscopy, patients’ self-reports, the McGill Pain Questionnaire, and a pressure algometer. Results Analysis of the data from 26 patients showed that headache frequency (P=.001), headache intensity (P=.002), McGill score (P=.003), and local PPT (P=.003) changed significantly after PRT. The myo-inositol/creatine concentration ratio in the somatosensory cortex (P=.041) decreased significantly in the control group. Furthermore, there were significant differences between groups in headache frequency (P<.001 headache intensity mcgill score local ppt distal and glutamate concentration ratio in the thalamus> Conclusions These findings indicate that PRT did not affect central sensitization in patients with TTH despite the improvement in clinical symptoms.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1704-1710

Titre :	The Influence of Tobacco Use, Alcohol Consumption, and Weight Gain on Development of Secondary Musculoskeletal Injury After Lower Limb Amputation
Type de document :	Périodique
Auteurs :	Haylee Yepson ; Brittney Mazzone ; Susan Eskridge ; Kaeley Shannon ; Elizabeth Awodele ; Shawn Farrokhi
Année de publication :	2020
Article en page(s) :	p. 1704-1710
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.022
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Amputation ; Consommation d'alcool ; Douleur ; Prise de poids ; Réadaptation ; Tabagisme
Résumé :	Objectives To evaluate whether tobacco use, alcohol consumption, and weight gain are associated with the diagnosis of overuse musculoskeletal injuries within the first 12 months after lower limb amputation. Design Retrospective cohort study. Setting Military treatment facilities. Participants Service members (N=681) with a deployment-related lower limb amputation. Interventions Not applicable. Main Outcome Measures Clinical diagnosis codes associated with musculoskeletal overuse injuries of the lower limb, upper limb, and low back regions. Results In the first three months after amputation, tobacco use and alcohol consumption were reported in 55.7% and 72.0%, respectively, of the retrospective sample. The overall mean weight change was 22.9±23.6 pounds. The prevalence of reporting at least 1 overuse injury within 4 to 12 months after amputation was 57.0% in the sample, with prevalence rates of lower limb, upper limb and low back pain diagnoses at 28.3%, 21.7%, and 21.1%, respectively. Service members reporting tobacco use in the first 3 months after amputation were nearly twice as likely to be diagnosed with a lower limb musculoskeletal injury 4 to 12 months after amputation. Similarly, service members reporting alcohol consumption within the first 3 months after amputation were more than twice as likely to be diagnosed with at least 1 overuse musculoskeletal injury 4 to 12 months after amputation. However, weight change or maximum weight after amputation were not associated with the diagnosis of an overuse musculoskeletal injury. Conclusions Development of secondary overuse musculoskeletal injury appears to be related to tobacco use and alcohol consumption, but not to weight gain. These findings warrant focused research efforts toward developing preventive interventions.
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[article] The Influence of Tobacco Use, Alcohol Consumption, and Weight Gain on Development of Secondary Musculoskeletal Injury After Lower Limb Amputation [Périodique] / Haylee Yepson ; Brittney Mazzone ; Susan Eskridge ; Kaeley Shannon ; Elizabeth Awodele ; Shawn Farrokhi . - 2020 . - p. 1704-1710.
https://doi.org/10.1016/j.apmr.2020.04.022
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1704-1710

Descripteurs :	HE Vinci Amputation ; Consommation d'alcool ; Douleur ; Prise de poids ; Réadaptation ; Tabagisme
Résumé :	Objectives To evaluate whether tobacco use, alcohol consumption, and weight gain are associated with the diagnosis of overuse musculoskeletal injuries within the first 12 months after lower limb amputation. Design Retrospective cohort study. Setting Military treatment facilities. Participants Service members (N=681) with a deployment-related lower limb amputation. Interventions Not applicable. Main Outcome Measures Clinical diagnosis codes associated with musculoskeletal overuse injuries of the lower limb, upper limb, and low back regions. Results In the first three months after amputation, tobacco use and alcohol consumption were reported in 55.7% and 72.0%, respectively, of the retrospective sample. The overall mean weight change was 22.9±23.6 pounds. The prevalence of reporting at least 1 overuse injury within 4 to 12 months after amputation was 57.0% in the sample, with prevalence rates of lower limb, upper limb and low back pain diagnoses at 28.3%, 21.7%, and 21.1%, respectively. Service members reporting tobacco use in the first 3 months after amputation were nearly twice as likely to be diagnosed with a lower limb musculoskeletal injury 4 to 12 months after amputation. Similarly, service members reporting alcohol consumption within the first 3 months after amputation were more than twice as likely to be diagnosed with at least 1 overuse musculoskeletal injury 4 to 12 months after amputation. However, weight change or maximum weight after amputation were not associated with the diagnosis of an overuse musculoskeletal injury. Conclusions Development of secondary overuse musculoskeletal injury appears to be related to tobacco use and alcohol consumption, but not to weight gain. These findings warrant focused research efforts toward developing preventive interventions.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1711-1719

Titre :	Factors Associated With Health-Related Quality of Life in People Living With Partial Foot or Transtibial Amputation
Type de document :	Périodique
Auteurs :	Michael Dillon ; Matthew Quigley ; Phil Stevens ; Yuri Balasanov ; Sarah P. Anderson
Année de publication :	2020
Article en page(s) :	p. 1711-1719
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.026
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Amputation ; Pied ; Qualité de vie ; Réadaptation
Résumé :	Objectives To determine which demographic, amputation, and health-related factors were associated with health-related quality of life (HR-QoL) in people living with partial foot amputation (PFA) or transtibial amputation (TTA). Design Cross-sectional survey. Setting Community. Participants Adults (N=123) with unilateral PFA (n=42) or TTA (n=81). Intervention Not applicable. Main Outcome Measure Medical Outcome Short Form (SF-36) version 2. Results Variation in the SF-36 Physical or Mental Component Summary scores were associated with complex interactions between factors, including: time since amputation, fatigue, anxiety, depression, pain interference, and physical function. Level of amputation (ie, PFA or TTA) did not explain a significant part of the variation in either the SF-36 Physical or Mental Component Summary scores. Conclusions Given the complex interactions between factors associated with the physical and mental health components of HR-QoL, there are opportunities to consider the long-term holistic care required by people living in the community with PFA or TTA.
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[article] Factors Associated With Health-Related Quality of Life in People Living With Partial Foot or Transtibial Amputation [Périodique] / Michael Dillon ; Matthew Quigley ; Phil Stevens ; Yuri Balasanov ; Sarah P. Anderson . - 2020 . - p. 1711-1719.
https://doi.org/10.1016/j.apmr.2020.04.026
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1711-1719

Descripteurs :	HE Vinci Amputation ; Pied ; Qualité de vie ; Réadaptation
Résumé :	Objectives To determine which demographic, amputation, and health-related factors were associated with health-related quality of life (HR-QoL) in people living with partial foot amputation (PFA) or transtibial amputation (TTA). Design Cross-sectional survey. Setting Community. Participants Adults (N=123) with unilateral PFA (n=42) or TTA (n=81). Intervention Not applicable. Main Outcome Measure Medical Outcome Short Form (SF-36) version 2. Results Variation in the SF-36 Physical or Mental Component Summary scores were associated with complex interactions between factors, including: time since amputation, fatigue, anxiety, depression, pain interference, and physical function. Level of amputation (ie, PFA or TTA) did not explain a significant part of the variation in either the SF-36 Physical or Mental Component Summary scores. Conclusions Given the complex interactions between factors associated with the physical and mental health components of HR-QoL, there are opportunities to consider the long-term holistic care required by people living in the community with PFA or TTA.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1720-1730

Titre :	Health Services Utilization, Health Care Costs, and Diagnoses by Mild Traumatic Brain Injury Exposure: A Chronic Effects of Neurotrauma Consortium Study
Type de document :	Périodique
Auteurs :	Clara E. Dismuke-Greer ; Shawn Hirsch ; Kathleen F. Carlson ; Terri K. Pogoda ; Risa Nakase-Richardson ; Subhash C. Bhatnagar ; Blessen Eapen ; Maya Troyanskaya ; Shannon R. Miles ; Tracy Nolen ; William C. Walker
Année de publication :	2020
Article en page(s) :	p. 1720-1730
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.008
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Anciens combattants ; Coûts et analyse des coûts ; Lésions encéphaliques ; Réadaptation ; Traumatisme
Résumé :	Objective To compare Veterans Health Administration (VHA) diagnoses, health services utilization, and costs by mild traumatic brain injury (mTBI) group (blast-related [BR] mTBI vs non–blast-related [NBR] mTBI vs no mTBI) among Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans in the Chronic Effects of Neurotrauma Consortium multicenter observational study. Design Prospective cohort study. Setting Four Veterans Affairs Medical Centers. Participants OEF/OIF/OND veterans (N=472) who used Veterans Affairs Medical Centers services between 2002-2017. Interventions Not applicable. Lifetime mTBI history was assessed via semistructured interviews. Main Outcome Measures VHA diagnoses, health services utilization, and costs. Results Relative to NBR mTBI and no mTBI, veterans with BR mTBI were more likely to be male, have greater combat, and have controlled and uncontrolled detonations exposures (median BR, 15.0 vs NBR, 3.0 vs no mTBI, 3.0). They also had higher prevalence of headache, posttraumatic stress disorder, and anxiety diagnoses. Veterans with BR had the highest site-adjusted mean annual VHA utilization (26.31 visits; 95% confidence interval [CI], 26.01-26.61) relative to NBR (20.43 visits; 95% CI, 20.15-20.71) and no mTBI (16.62 visits; 95% CI, 16.21-17.04) and highest site adjusted mean annual VHA outpatient costs ($6480; 95% CI, $5842-$7187) relative to NBR ($4901; 95% CI, $4392-$5468) and no mTBI ($4069; 95% CI, $3404-$4864). Conclusions Veterans with BR mTBI had higher exposure to combat and detonation. BR was associated with greater prevalence of select diagnoses and higher health services utilization and costs relative to NBR and no mTBI. The role of health care needs from mTBI polytrauma, other deployment-related exposures, and VHA access warrants future research.
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[article] Health Services Utilization, Health Care Costs, and Diagnoses by Mild Traumatic Brain Injury Exposure: A Chronic Effects of Neurotrauma Consortium Study [Périodique] / Clara E. Dismuke-Greer ; Shawn Hirsch ; Kathleen F. Carlson ; Terri K. Pogoda ; Risa Nakase-Richardson ; Subhash C. Bhatnagar ; Blessen Eapen ; Maya Troyanskaya ; Shannon R. Miles ; Tracy Nolen ; William C. Walker . - 2020 . - p. 1720-1730.
https://doi.org/10.1016/j.apmr.2020.06.008
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1720-1730

Descripteurs :	HE Vinci Anciens combattants ; Coûts et analyse des coûts ; Lésions encéphaliques ; Réadaptation ; Traumatisme
Résumé :	Objective To compare Veterans Health Administration (VHA) diagnoses, health services utilization, and costs by mild traumatic brain injury (mTBI) group (blast-related [BR] mTBI vs non–blast-related [NBR] mTBI vs no mTBI) among Operation Enduring Freedom (OEF)/Operation Iraqi Freedom (OIF)/Operation New Dawn (OND) veterans in the Chronic Effects of Neurotrauma Consortium multicenter observational study. Design Prospective cohort study. Setting Four Veterans Affairs Medical Centers. Participants OEF/OIF/OND veterans (N=472) who used Veterans Affairs Medical Centers services between 2002-2017. Interventions Not applicable. Lifetime mTBI history was assessed via semistructured interviews. Main Outcome Measures VHA diagnoses, health services utilization, and costs. Results Relative to NBR mTBI and no mTBI, veterans with BR mTBI were more likely to be male, have greater combat, and have controlled and uncontrolled detonations exposures (median BR, 15.0 vs NBR, 3.0 vs no mTBI, 3.0). They also had higher prevalence of headache, posttraumatic stress disorder, and anxiety diagnoses. Veterans with BR had the highest site-adjusted mean annual VHA utilization (26.31 visits; 95% confidence interval [CI], 26.01-26.61) relative to NBR (20.43 visits; 95% CI, 20.15-20.71) and no mTBI (16.62 visits; 95% CI, 16.21-17.04) and highest site adjusted mean annual VHA outpatient costs ($6480; 95% CI, $5842-$7187) relative to NBR ($4901; 95% CI, $4392-$5468) and no mTBI ($4069; 95% CI, $3404-$4864). Conclusions Veterans with BR mTBI had higher exposure to combat and detonation. BR was associated with greater prevalence of select diagnoses and higher health services utilization and costs relative to NBR and no mTBI. The role of health care needs from mTBI polytrauma, other deployment-related exposures, and VHA access warrants future research.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1731-1738

Titre :	Assessing the Ability of Comorbidity Indexes to Capture Comorbid Disease in the Inpatient Rehabilitation Spinal Cord Injury Population
Type de document :	Article
Auteurs :	Donna Huang ; Sameer Siddiqui ; Chloé S. Sclocum ; Richard Goldstein ; Ross Zafonte ; Jeffrey C. Schneider
Année de publication :	2020
Article en page(s) :	p. 1731-1738
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.025
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Comorbidité ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, the Centers for Medicare and Medicaid Services [CMS] comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population. Design Retrospective cross-sectional study. Participants Data were obtained from the Uniform Data System for Medical Rehabilitation from October 1, 2015 to December 31, 2017 for adults with spinal cord injury (SCI) (Medicare-established Impairment Group Codes 04.110-04.230, 14.1, 14.3). This study included SCI discharges (N=66,235) from 833 inpatient rehabilitation facilities. Main Outcome Measures International Classification of Diseases–10th Revision–Clinical Modifications (ICD-10-CM) codes were used to assess 3 comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, CMS comorbidity tiers). The comorbidity codes that occurred with >1% frequency were reported. The percentages of discharges for which no comorbidities were captured by each comorbidity index were calculated. Results Of the total study population, 39,285 (59.3%) were men and 11,476 (17.3%) were tetraplegic. The mean number of comorbidities was 14.7. There were 13,939 distinct ICD-10-CM comorbidity codes. There were 237 comorbidities that occurred with >1% frequency. The Deyo-Charlson comorbidity index, Elixhauser comorbidity index, and the CMS tiers did not capture comorbidities of 58.4% (95% confidence interval, 58.08%-58.84%), 29.4% (29.07%-29.76%), and 66.1% (65.73%-66.46%) of the discharges in our study, respectively, and 28.8% (28.42%-29.11%) of the discharges did not have any comorbidities captured by any of the comorbidity indexes. Conclusion Commonly used comorbidity indexes do not reflect the extent of comorbid disease in the SCI rehabilitation population. This work suggests that alternative measures may be needed to capture the complexity of this population.
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[article] Assessing the Ability of Comorbidity Indexes to Capture Comorbid Disease in the Inpatient Rehabilitation Spinal Cord Injury Population [Article] / Donna Huang ; Sameer Siddiqui ; Chloé S. Sclocum ; Richard Goldstein ; Ross Zafonte ; Jeffrey C. Schneider . - 2020 . - p. 1731-1738.
https://doi.org/10.1016/j.apmr.2020.04.025
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1731-1738

Descripteurs :	HE Vinci Comorbidité ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To examine whether commonly used comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, the Centers for Medicare and Medicaid Services [CMS] comorbidity tiers) capture comorbidities in the acute traumatic and nontraumatic SCI inpatient rehabilitation population. Design Retrospective cross-sectional study. Participants Data were obtained from the Uniform Data System for Medical Rehabilitation from October 1, 2015 to December 31, 2017 for adults with spinal cord injury (SCI) (Medicare-established Impairment Group Codes 04.110-04.230, 14.1, 14.3). This study included SCI discharges (N=66,235) from 833 inpatient rehabilitation facilities. Main Outcome Measures International Classification of Diseases–10th Revision–Clinical Modifications (ICD-10-CM) codes were used to assess 3 comorbidity indexes (Deyo-Charlson comorbidity index, Elixhauser comorbidity index, CMS comorbidity tiers). The comorbidity codes that occurred with >1% frequency were reported. The percentages of discharges for which no comorbidities were captured by each comorbidity index were calculated. Results Of the total study population, 39,285 (59.3%) were men and 11,476 (17.3%) were tetraplegic. The mean number of comorbidities was 14.7. There were 13,939 distinct ICD-10-CM comorbidity codes. There were 237 comorbidities that occurred with >1% frequency. The Deyo-Charlson comorbidity index, Elixhauser comorbidity index, and the CMS tiers did not capture comorbidities of 58.4% (95% confidence interval, 58.08%-58.84%), 29.4% (29.07%-29.76%), and 66.1% (65.73%-66.46%) of the discharges in our study, respectively, and 28.8% (28.42%-29.11%) of the discharges did not have any comorbidities captured by any of the comorbidity indexes. Conclusion Commonly used comorbidity indexes do not reflect the extent of comorbid disease in the SCI rehabilitation population. This work suggests that alternative measures may be needed to capture the complexity of this population.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1739-1746

Titre :	Challenges of Developing a Natural Language Processing Method With Electronic Health Records to Identify Persons With Chronic Mobility Disability
Type de document :	Article
Auteurs :	Nicole Agaronnik ; Charlotta Lindvall ; Areej El-Jawahri ; Wei He ; Lisa I. Iezonni
Année de publication :	2020
Article en page(s) :	p. 1739-1746
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.024
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Apprentissage machine ; Dossiers médicaux électroniques ; Réadaptation ; Traitement du langage naturel
Résumé :	Objective To assess the utility of applying natural language processing (NLP) to electronic health records (EHRs) to identify individuals with chronic mobility disability. Design We used EHRs from the Research Patient Data Repository, which contains EHRs from a large Massachusetts health care delivery system. This analysis was part of a larger study assessing the effects of disability on diagnosis of colorectal cancer. We applied NLP text extraction software to longitudinal EHRs of colorectal cancer patients to identify persons who use a wheelchair (our indicator of mobility disability for this analysis). We manually reviewed the clinical notes identified by NLP using directed content analysis to identify true cases using wheelchairs, duration or chronicity of use, and documentation quality. Setting EHRs from large health care delivery system Participants Patients (N=14,877) 21-75 years old who were newly diagnosed with colorectal cancer between 2005 and 2017. Interventions Not applicable. Main Outcome Measures Confirmation of patients’ chronic wheelchair use in NLP-flagged notes; quality of disability documentation. Results We identified 14,877 patients with colorectal cancer with 303,182 associated clinical notes. NLP screening identified 1482 (0.5%) notes that contained 1+ wheelchair-associated keyword. These notes were associated with 420 patients (2.8% of colorectal cancer population). Of the 1482 notes, 286 (19.3%, representing 105 patients, 0.7% of the total) contained documentation of reason for wheelchair use and duration. Directed content analysis identified 3 themes concerning disability documentation: (1) wheelchair keywords used in specific EHR contexts; (2) reason for wheelchair not clearly stated; and (3) duration of wheelchair use not consistently documented. Conclusions NLP offers an option to screen for patients with chronic mobility disability in much less time than required by manual chart review. Nonetheless, manual chart review must confirm that flagged patients have chronic mobility disability (are not false positives). Notes, however, often have inadequate disability documentation.
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[article] Challenges of Developing a Natural Language Processing Method With Electronic Health Records to Identify Persons With Chronic Mobility Disability [Article] / Nicole Agaronnik ; Charlotta Lindvall ; Areej El-Jawahri ; Wei He ; Lisa I. Iezonni . - 2020 . - p. 1739-1746.
https://doi.org/10.1016/j.apmr.2020.04.024
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1739-1746

Descripteurs :	HE Vinci Apprentissage machine ; Dossiers médicaux électroniques ; Réadaptation ; Traitement du langage naturel
Résumé :	Objective To assess the utility of applying natural language processing (NLP) to electronic health records (EHRs) to identify individuals with chronic mobility disability. Design We used EHRs from the Research Patient Data Repository, which contains EHRs from a large Massachusetts health care delivery system. This analysis was part of a larger study assessing the effects of disability on diagnosis of colorectal cancer. We applied NLP text extraction software to longitudinal EHRs of colorectal cancer patients to identify persons who use a wheelchair (our indicator of mobility disability for this analysis). We manually reviewed the clinical notes identified by NLP using directed content analysis to identify true cases using wheelchairs, duration or chronicity of use, and documentation quality. Setting EHRs from large health care delivery system Participants Patients (N=14,877) 21-75 years old who were newly diagnosed with colorectal cancer between 2005 and 2017. Interventions Not applicable. Main Outcome Measures Confirmation of patients’ chronic wheelchair use in NLP-flagged notes; quality of disability documentation. Results We identified 14,877 patients with colorectal cancer with 303,182 associated clinical notes. NLP screening identified 1482 (0.5%) notes that contained 1+ wheelchair-associated keyword. These notes were associated with 420 patients (2.8% of colorectal cancer population). Of the 1482 notes, 286 (19.3%, representing 105 patients, 0.7% of the total) contained documentation of reason for wheelchair use and duration. Directed content analysis identified 3 themes concerning disability documentation: (1) wheelchair keywords used in specific EHR contexts; (2) reason for wheelchair not clearly stated; and (3) duration of wheelchair use not consistently documented. Conclusions NLP offers an option to screen for patients with chronic mobility disability in much less time than required by manual chart review. Nonetheless, manual chart review must confirm that flagged patients have chronic mobility disability (are not false positives). Notes, however, often have inadequate disability documentation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1747-1753

Titre :	Predictors of Physical Therapy Referral Among Persons With Peripheral Vestibular Disorders in the United States
Type de document :	Article
Auteurs :	Pamela M. Dunlap ; Samannaaz S. Khoja ; Susan Whitney ; Janet K. Fredburger
Année de publication :	2020
Article en page(s) :	p. 1747-1753
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.016
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Orientation vers un spécialiste ; Réadaptation ; Sensation vertigineuse ; Vertige
Résumé :	Objective To determine the rate of physical therapy (PT) referral and patient and physician characteristics associated with PT referral for benign paroxysmal positional vertigo (BPPV) and other peripheral vestibular disorders (PVD) in ambulatory care clinics in the United States. Design Cross-sectional analysis of the National Ambulatory Medical Care Survey 2004-2015 Setting Ambulatory care clinics in the United States. Participants We identified 5.6 million weighted adult visits for BPPV (International Classification of Diseases–9th Revision–Clinical Modifications (ICD-9-CM): 386.11) and 6.6 million weighted visits for other PVDs (ICD-9-CM: 386.1-386.9, excluding 386.11 and 386.2) made by patients 18 years and older from 2004 through 2015. Interventions Not applicable. Main Outcome Measures Patient, clinical, and physician characteristics were extracted, and descriptive statistics were stratified by referral to PT. Two multivariable logistic regression models were estimated for each diagnostic group (BPPV and other PVDs) to identify predictors of PT referral. Results PT referrals for BPPV increased from 6.2% in the period from 2004 to 2006 to 12.9% in the period from 2013 to 2015, whereas PT referrals for other PVDs decreased from 3.8% in the period from 2004 to 2006 to 0.5% in the period from 2013 to 2015. Other insurance coverage (versus private) and neurologists and other specialists (versus otolaryngologists) were associated with a greater odds of PT referral for BPPV. Visits made in the Midwest and West (versus the Northeast) and in rural versus metropolitan areas had greater odds of PT referral for BPPV. Relative to otolaryngologists, primary care physicians were less likely to refer to PT for other PVDs. Visits made in metropolitan versus rural areas and visits with 1 or more comorbidities (versus none) had greater odds of PT referral for other PVDs. Conclusions PT referrals remain low for ambulatory care visits for BPPV and other PVDs in the United States. Referral to PT for BPPV and other PVDs varied by insurance type, physician specialty, and office location.
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[article] Predictors of Physical Therapy Referral Among Persons With Peripheral Vestibular Disorders in the United States [Article] / Pamela M. Dunlap ; Samannaaz S. Khoja ; Susan Whitney ; Janet K. Fredburger . - 2020 . - p. 1747-1753.
https://doi.org/10.1016/j.apmr.2020.04.016
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1747-1753

Descripteurs :	HE Vinci Orientation vers un spécialiste ; Réadaptation ; Sensation vertigineuse ; Vertige
Résumé :	Objective To determine the rate of physical therapy (PT) referral and patient and physician characteristics associated with PT referral for benign paroxysmal positional vertigo (BPPV) and other peripheral vestibular disorders (PVD) in ambulatory care clinics in the United States. Design Cross-sectional analysis of the National Ambulatory Medical Care Survey 2004-2015 Setting Ambulatory care clinics in the United States. Participants We identified 5.6 million weighted adult visits for BPPV (International Classification of Diseases–9th Revision–Clinical Modifications (ICD-9-CM): 386.11) and 6.6 million weighted visits for other PVDs (ICD-9-CM: 386.1-386.9, excluding 386.11 and 386.2) made by patients 18 years and older from 2004 through 2015. Interventions Not applicable. Main Outcome Measures Patient, clinical, and physician characteristics were extracted, and descriptive statistics were stratified by referral to PT. Two multivariable logistic regression models were estimated for each diagnostic group (BPPV and other PVDs) to identify predictors of PT referral. Results PT referrals for BPPV increased from 6.2% in the period from 2004 to 2006 to 12.9% in the period from 2013 to 2015, whereas PT referrals for other PVDs decreased from 3.8% in the period from 2004 to 2006 to 0.5% in the period from 2013 to 2015. Other insurance coverage (versus private) and neurologists and other specialists (versus otolaryngologists) were associated with a greater odds of PT referral for BPPV. Visits made in the Midwest and West (versus the Northeast) and in rural versus metropolitan areas had greater odds of PT referral for BPPV. Relative to otolaryngologists, primary care physicians were less likely to refer to PT for other PVDs. Visits made in metropolitan versus rural areas and visits with 1 or more comorbidities (versus none) had greater odds of PT referral for other PVDs. Conclusions PT referrals remain low for ambulatory care visits for BPPV and other PVDs in the United States. Referral to PT for BPPV and other PVDs varied by insurance type, physician specialty, and office location.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1754-1762

Titre :	Discrete and Dynamic Postoperative Pain Catastrophizing Trajectories Across 6 Months: A Prospective Observational Study
Type de document :	Article
Auteurs :	Nicholas A. Giordano ; Alexandra Kane ; Kalyn C. Jannace ; Winifred Rojas ; Mary Jo Lindl ; Eugenio Lujan ; Harold Gelfand ; Michael L. Kent ; Krista Beth Highland
Année de publication :	2020
Article en page(s) :	p. 1754-1762
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.023
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Catastrophisation ; Chirurgie générale ; Douleur ; Douleur postopératoire ; Mesures des résultats rapportés par les patients (PROM) ; Militaire ; Réadaptation ; Santé
Résumé :	Objectives To investigate pain catastrophizing presentations up to 6 months postoperatively and subsequent changes in pain intensity and physical function. Design Prospective observational multisite study. Setting Two tertiary care facilities between 2016 and 2019. Participants : Adult patients (N=348) undergoing a mastectomy, thoracic surgery, total knee or hip arthroplasty, spinal fusion, or major abdominal surgery. Interventions Not applicable. Main Outcome Measures Pain Catastrophizing Scale scores, Defense and Veterans Pain Rating Scale, average pain intensity, and Patient Reported Outcomes Measurement Information System (PROMIS) physical function. Results Four pain catastrophizing trajectories were identified in 348 surgical patients during the 6 months of postoperative recovery: stable, remitting, worsening, and unremitting. Linear mixed-effects models found that the unremitting trajectory was associated with higher pain intensity over time. The average pain intensity of participants in the remitting trajectory was estimated to decrease at a faster rate over the 6 months after surgery than pain of other trajectories, despite participants reporting high preoperative Pain Catastrophizing Scale and pain scores. Worsening and unremitting trajectories were associated with reduced physical function. Preoperative average pain intensity scores were not associated with postoperative physical function scores, nor were participants’ preoperative physical function scores associated with average pain intensity scores postoperatively. Prolonged hospitalization, smoking, and preoperative opioid prescriptions were associated with the unremitting trajectory. Conclusions Findings suggest that preoperative pain catastrophizing scores alone may not be adequate for estimating long-term patient-reported outcomes during postoperative rehabilitation. Pain catastrophizing has a dynamic presentation and is associated with changes in pain intensity and physical function up to 6 months postoperatively. Routine assessments can inform the delivery of early interventions to surgical patients at risk of experiencing a pain catastrophizing trajectory associated with suboptimal outcomes during rehabilitation.
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[article] Discrete and Dynamic Postoperative Pain Catastrophizing Trajectories Across 6 Months: A Prospective Observational Study [Article] / Nicholas A. Giordano ; Alexandra Kane ; Kalyn C. Jannace ; Winifred Rojas ; Mary Jo Lindl ; Eugenio Lujan ; Harold Gelfand ; Michael L. Kent ; Krista Beth Highland . - 2020 . - p. 1754-1762.
https://doi.org/10.1016/j.apmr.2020.04.023
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1754-1762

Descripteurs :	HE Vinci Catastrophisation ; Chirurgie générale ; Douleur ; Douleur postopératoire ; Mesures des résultats rapportés par les patients (PROM) ; Militaire ; Réadaptation ; Santé
Résumé :	Objectives To investigate pain catastrophizing presentations up to 6 months postoperatively and subsequent changes in pain intensity and physical function. Design Prospective observational multisite study. Setting Two tertiary care facilities between 2016 and 2019. Participants : Adult patients (N=348) undergoing a mastectomy, thoracic surgery, total knee or hip arthroplasty, spinal fusion, or major abdominal surgery. Interventions Not applicable. Main Outcome Measures Pain Catastrophizing Scale scores, Defense and Veterans Pain Rating Scale, average pain intensity, and Patient Reported Outcomes Measurement Information System (PROMIS) physical function. Results Four pain catastrophizing trajectories were identified in 348 surgical patients during the 6 months of postoperative recovery: stable, remitting, worsening, and unremitting. Linear mixed-effects models found that the unremitting trajectory was associated with higher pain intensity over time. The average pain intensity of participants in the remitting trajectory was estimated to decrease at a faster rate over the 6 months after surgery than pain of other trajectories, despite participants reporting high preoperative Pain Catastrophizing Scale and pain scores. Worsening and unremitting trajectories were associated with reduced physical function. Preoperative average pain intensity scores were not associated with postoperative physical function scores, nor were participants’ preoperative physical function scores associated with average pain intensity scores postoperatively. Prolonged hospitalization, smoking, and preoperative opioid prescriptions were associated with the unremitting trajectory. Conclusions Findings suggest that preoperative pain catastrophizing scores alone may not be adequate for estimating long-term patient-reported outcomes during postoperative rehabilitation. Pain catastrophizing has a dynamic presentation and is associated with changes in pain intensity and physical function up to 6 months postoperatively. Routine assessments can inform the delivery of early interventions to surgical patients at risk of experiencing a pain catastrophizing trajectory associated with suboptimal outcomes during rehabilitation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1763-1770

Titre :	Longitudinal Monitoring of Pain Associated Distress With the Optimal Screening for Prediction of Referral and Outcome Yellow Flag Tool: Predicting Reduction in Pain Intensity and Disability
Type de document :	Article
Auteurs :	Steven Z George ; Cai Li ; Sheng Luo ; Maggie E. Horn ; Trevor A. Lentz
Année de publication :	2020
Article en page(s) :	p. 1763-1770
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.025
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Douleur chronique ; Pronostic ; Réadaptation
Résumé :	Objective To investigate the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool for longitudinal monitoring of pain associated distress with the goal of improving prediction of 50% reduction in pain intensity and disability outcomes. Design Cohort study with 12-month follow-up after initial care episode. Setting Ambulatory care, participants seeking care from outpatient physical therapy clinics. Participants Participants (N=440) were seeking care for primary complaint of neck, low back, knee, or shoulder pain. This secondary analysis included 440 subjects (62.5% female; mean age, 45.1±17y) at baseline with n=279 (63.4%) providing follow-up data at 12 months. Interventions Not applicable. Main Outcome Measures A 50% reduction (baseline to 12-mo follow-up) in pain intensity and self-reported disability. Results Trends for prediction accuracy were similar for all versions of the OSPRO-YF. For predicting 50% reduction in pain intensity, model fit met the statistical criterion for improvement (P<.05 with each additional time point added from baseline. model discrimination improved statistically when the to change was under curve="0.849," p=".003)." for predicting reduction in disability there no evidence of improvement fit or baseline addition changes>.05). Conclusions These results suggested that longitudinal monitoring improved prediction accuracy for reduction in pain intensity but not for disability reduction. Differences in OSPRO-YF item sets (10 vs 17 items) or scoring methods (simple summary score vs yellow flag count) did not affect predictive accuracy for pain intensity, providing flexibility for implementing this tool in practice settings.
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