[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2225-2232

Titre :	Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial
Type de document :	Article
Auteurs :	Chung-shan Hung ; Keh-Chung Lin ; Wan-ying Chang
Année de publication :	2019
Article en page(s) :	p. 2225-2232
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.021
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Essai contrôlé randomisé ; Réadaptation ; Robotique
Résumé :	Objective To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. Design A single-blind, randomized controlled trial. Setting Four hospitals. Participants Outpatients with chronic stroke and mild to moderate motor impairment (N=44). Intervention UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks. Main Outcome Measures Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment. Results The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01> Conclusions BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.
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[article] Unilateral vs Bilateral Hybrid Approaches for Upper Limb Rehabilitation in Chronic Stroke: A Randomized Controlled Trial [Article] / Chung-shan Hung ; Keh-Chung Lin ; Wan-ying Chang . - 2019 . - p. 2225-2232.
https://doi.org/10.1016/j.apmr.2019.06.021
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2225-2232

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Essai contrôlé randomisé ; Réadaptation ; Robotique
Résumé :	Objective To investigate the effects of unilateral hybrid therapy (UHT) and bilateral hybrid therapy (BHT) compared with robot-assisted therapy (RT) alone in patients with chronic stroke. Design A single-blind, randomized controlled trial. Setting Four hospitals. Participants Outpatients with chronic stroke and mild to moderate motor impairment (N=44). Intervention UHT combined unilateral RT (URT) and modified constraint-induced therapy. BHT combined bilateral RT (BRT) and bilateral arm training. The RT group received URT and BRT. The intervention frequency for the 3 groups was 90 min/d 3 d/wk for 6 weeks. Main Outcome Measures Fugl-Meyer Assessment (FMA, divided into the proximal and distal subscale) and Stroke Impact Scale (SIS) version 3.0 scores before, immediately after, and 3 months after treatment and Wolf Motor Function Test (WMFT) and Nottingham Extended Activities of Daily Living (NEADL) scale scores before and immediately after treatment. Results The results favored BHT over UHT on the FMA total score and distal score at the posttest (P=.03 and .04) and follow-up (P=.01 and .047) assessment and BHT over RT on the follow-up FMA distal scores (P=.03). At the posttest assessment, the WMFT and SIS scores of the 3 groups improved significantly without between-group differences, and the RT group showed significantly greater improvement in the mobility domain of NEADL compared with the BHT group (P<.01> Conclusions BHT was more effective for improving upper extremity motor function, particularly distal motor function at follow-up, and individuals in the RT group demonstrated improved functional ambulation post intervention.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2233-2243

Titre :	A Cross-Sectional Study to Investigate the Effects of Perceived Discrimination in the Health Care Setting on Pain and Depressive Symptoms in Wheelchair Users With Spinal Cord Injury
Type de document :	Article
Auteurs :	Nathan Hogaboom ; Denise C. Fyffe ; Amanda L. Botticello
Année de publication :	2019
Article en page(s) :	p. 2233-2243
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.016
Langues :	Américain (ame)
Descripteurs :	HE Vinci Dépression ; Discrimination sociale ; Douleur ; Fauteuils roulants ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objectives In a sample of wheelchair users with spinal cord injury (SCI), the objectives were to investigate which participant characteristics are associated with greater perceived discrimination in the health care setting, and how such discrimination relates to health outcomes of pain and depressive symptoms. Design Survey, cross-sectional. Setting Spinal Cord Injury Model Systems (SCIMS) Center. Participants Full-time wheelchair users with SCI from 9 SCIMS centers (N=410), with data collected between 2011 and 2016. Interventions N/A. Main Outcomes A 7-item questionnaire inquiring about perceived discrimination by hospital staff, self-reported pain severity over the past month using a 0-10 Numeric Rating Scale, and depressive symptoms using the 2-question Patient Health Questionnaire screener. Results Participants who were black or from the lowest income group were more likely to report experiencing more discrimination than those who were white or from the highest income group, respectively (incidence rate ratio=2.2-2.6, P<.01 those who reported more perceived discrimination had greater risk of severe pain compared to no confidence interval ci p mild depressive symptoms and symptoms.> Conclusions Wheelchair users with SCI who were from more disadvantaged groups (black, lower income levels) reported experiencing more discrimination in their health care setting. Furthermore, those who reported more discrimination were more likely to report worse mental and physical health outcomes. Attempts to reduce discrimination in health care settings may lead to better outcomes for people with SCI. These observations were correlational and not causal; a prospective analysis is necessary to prove causation. Future investigations should further explore the effect of discrimination on the many facets of living with an SCI.
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[article] A Cross-Sectional Study to Investigate the Effects of Perceived Discrimination in the Health Care Setting on Pain and Depressive Symptoms in Wheelchair Users With Spinal Cord Injury [Article] / Nathan Hogaboom ; Denise C. Fyffe ; Amanda L. Botticello . - 2019 . - p. 2233-2243.
https://doi.org/10.1016/j.apmr.2019.06.016
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2233-2243

Descripteurs :	HE Vinci Dépression ; Discrimination sociale ; Douleur ; Fauteuils roulants ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objectives In a sample of wheelchair users with spinal cord injury (SCI), the objectives were to investigate which participant characteristics are associated with greater perceived discrimination in the health care setting, and how such discrimination relates to health outcomes of pain and depressive symptoms. Design Survey, cross-sectional. Setting Spinal Cord Injury Model Systems (SCIMS) Center. Participants Full-time wheelchair users with SCI from 9 SCIMS centers (N=410), with data collected between 2011 and 2016. Interventions N/A. Main Outcomes A 7-item questionnaire inquiring about perceived discrimination by hospital staff, self-reported pain severity over the past month using a 0-10 Numeric Rating Scale, and depressive symptoms using the 2-question Patient Health Questionnaire screener. Results Participants who were black or from the lowest income group were more likely to report experiencing more discrimination than those who were white or from the highest income group, respectively (incidence rate ratio=2.2-2.6, P<.01 those who reported more perceived discrimination had greater risk of severe pain compared to no confidence interval ci p mild depressive symptoms and symptoms.> Conclusions Wheelchair users with SCI who were from more disadvantaged groups (black, lower income levels) reported experiencing more discrimination in their health care setting. Furthermore, those who reported more discrimination were more likely to report worse mental and physical health outcomes. Attempts to reduce discrimination in health care settings may lead to better outcomes for people with SCI. These observations were correlational and not causal; a prospective analysis is necessary to prove causation. Future investigations should further explore the effect of discrimination on the many facets of living with an SCI.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2244-2250

Titre :	Utilization of Rehabilitation Services in Stroke: A Study Utilizing the Health and Retirement Study With Linked Medicare Claims Data
Type de document :	Article
Auteurs :	Karen M. Keptner ; Kathleen Smyth ; Siran Koroukian
Année de publication :	2019
Article en page(s) :	p. 2244-2250
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.017
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Ergothérapeutes ; Kinésithérapeutes ; Réadaptation ; Services de santé
Résumé :	Objectives To describe Medicare fee-for-service beneficiaries who used poststroke rehabilitation services and identified the strongest predictors of utilization after the initial stroke care episode. Design Pooled, cross-sectional design using data from 1998 to 2010 from the Health and Retirement Study (HRS) with linked Medicare claims data. Setting NA. Participants Stroke survivors who were Medicare fee-for-service beneficiaries and participated in the HRS were included (N=515). Main Outcome Measure Utilization of rehabilitation services up to 10 years poststroke was the primary outcome with logistic regression used to predict utilization. Covariates included demographic factors, baseline functional status, health conditions, personal lifestyle factors, and social support. Results Rehabilitation service utilization was 21.6%, 6.8%, 15.8%, 16.5%, and Conclusion A small number of Medicare fee-for-service beneficiaries who are stroke survivors utilize rehabilitation services in the first 10 years poststroke. Of those who do, age is the primary driver of utilization. We analyzed a multitude of factors that might influence utilization, but other factors not available in these data also need to be explored.
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[article] Utilization of Rehabilitation Services in Stroke: A Study Utilizing the Health and Retirement Study With Linked Medicare Claims Data [Article] / Karen M. Keptner ; Kathleen Smyth ; Siran Koroukian . - 2019 . - p. 2244-2250.
https://doi.org/10.1016/j.apmr.2019.06.017
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2244-2250

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Ergothérapeutes ; Kinésithérapeutes ; Réadaptation ; Services de santé
Résumé :	Objectives To describe Medicare fee-for-service beneficiaries who used poststroke rehabilitation services and identified the strongest predictors of utilization after the initial stroke care episode. Design Pooled, cross-sectional design using data from 1998 to 2010 from the Health and Retirement Study (HRS) with linked Medicare claims data. Setting NA. Participants Stroke survivors who were Medicare fee-for-service beneficiaries and participated in the HRS were included (N=515). Main Outcome Measure Utilization of rehabilitation services up to 10 years poststroke was the primary outcome with logistic regression used to predict utilization. Covariates included demographic factors, baseline functional status, health conditions, personal lifestyle factors, and social support. Results Rehabilitation service utilization was 21.6%, 6.8%, 15.8%, 16.5%, and Conclusion A small number of Medicare fee-for-service beneficiaries who are stroke survivors utilize rehabilitation services in the first 10 years poststroke. Of those who do, age is the primary driver of utilization. We analyzed a multitude of factors that might influence utilization, but other factors not available in these data also need to be explored.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2251-2259

Titre :	Associations Between Adherence to the Physical Activity and Exercise Program Applied in the LAST Study and Functional Recovery After Stroke
Type de document :	Article
Auteurs :	Mari Gunnes ; Bent Indredavik ; Birgitta Langhammer
Année de publication :	2019
Article en page(s) :	p. 2251-2259
Note générale :	https://doi.org/10.1016/j.apmr.2019.04.023
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Exercice physique ; Observance par le patient ; Réadaptation
Résumé :	Objective To investigate the associations between participants’ adherence to a physical activity and exercise program after stroke and functional recovery 18 months after inclusion. Design Secondary analyses of the intervention arm in the multisite randomized controlled trial Life After Stroke (LAST). Setting Primary health care services in 3 Norwegian municipalities. Participants Of the participants enrolled (N=380), 186 (48.9%) were randomized to the intervention. The study sample comprised community dwelling individuals included 3 months after stroke, with mean age of 71.7 ± 11.9 years and 82 (44.1%) women. According to the National Institutes of Health Stroke Scale, 97.3% were diagnosed as having mild (National Institutes of Health Stroke Scale Intervention Monthly coaching by physiotherapists encouraging participants to adhere to 30 minutes of daily physical activity and 45-60 minutes of weekly exercise. Main Outcome Measures The primary outcome was Motor Assessment Scale (MAS). Secondary outcome measures were 6-minute walk test, Timed Up and Go (TUG), Berg Balance Scale (BBS), and the physical domains of the Stroke Impact Scale (SIS). Adherence was assessed by combining participants’ training diaries and physiotherapists’ reports. Results The relationship between adherence and functional recovery was analyzed with simple and multiple linear regression models. Adjusted for age, sex, dependency, and cognition, results showed statistically significant associations between adherence and functional outcomes after 18 months, as measured by MAS, TUG, BBS, and SIS (P≤.026). Conclusions Increased adherence to physical activity and exercise was associated with improved functional recovery after mild to moderate stroke. This emphasizes the importance of developing adherence-enhancing interventions. Dose-response studies are recommended for future research.
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[article] Associations Between Adherence to the Physical Activity and Exercise Program Applied in the LAST Study and Functional Recovery After Stroke [Article] / Mari Gunnes ; Bent Indredavik ; Birgitta Langhammer . - 2019 . - p. 2251-2259.
https://doi.org/10.1016/j.apmr.2019.04.023
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2251-2259

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Exercice physique ; Observance par le patient ; Réadaptation
Résumé :	Objective To investigate the associations between participants’ adherence to a physical activity and exercise program after stroke and functional recovery 18 months after inclusion. Design Secondary analyses of the intervention arm in the multisite randomized controlled trial Life After Stroke (LAST). Setting Primary health care services in 3 Norwegian municipalities. Participants Of the participants enrolled (N=380), 186 (48.9%) were randomized to the intervention. The study sample comprised community dwelling individuals included 3 months after stroke, with mean age of 71.7 ± 11.9 years and 82 (44.1%) women. According to the National Institutes of Health Stroke Scale, 97.3% were diagnosed as having mild (National Institutes of Health Stroke Scale Intervention Monthly coaching by physiotherapists encouraging participants to adhere to 30 minutes of daily physical activity and 45-60 minutes of weekly exercise. Main Outcome Measures The primary outcome was Motor Assessment Scale (MAS). Secondary outcome measures were 6-minute walk test, Timed Up and Go (TUG), Berg Balance Scale (BBS), and the physical domains of the Stroke Impact Scale (SIS). Adherence was assessed by combining participants’ training diaries and physiotherapists’ reports. Results The relationship between adherence and functional recovery was analyzed with simple and multiple linear regression models. Adjusted for age, sex, dependency, and cognition, results showed statistically significant associations between adherence and functional outcomes after 18 months, as measured by MAS, TUG, BBS, and SIS (P≤.026). Conclusions Increased adherence to physical activity and exercise was associated with improved functional recovery after mild to moderate stroke. This emphasizes the importance of developing adherence-enhancing interventions. Dose-response studies are recommended for future research.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2260-2266

Titre :	Associations Between Insurance Provider and Assistive Technology Use for Computer and Electronic Devices 1 Year After Tetraplegia: Findings From the Spinal Cord Injury Model Systems National Database
Type de document :	Article
Auteurs :	Kimberley R. Monden ; Mitch Sevigny ; Jessica M. Ketchum
Année de publication :	2019
Article en page(s) :	p. 2260-2266
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.013
Langues :	Américain (ame)
Descripteurs :	HE Vinci Assurance ; Dispositifs d'assistance au mouvement ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To investigate the association between insurance provider and reported assistive technology (AT) use to access computers and electronic devices 1 year after sustaining tetraplegia. Design Multicenter cross-sectional study. Setting Participants enrolled in the Spinal Cord Injury Model Systems (SCIMS) National Database. Interventions Not applicable. Participants Men and women with tetraplegia (N=498) enrolled in the SCIMS National Database were included in the analysis. Main Outcome Measures The primary study outcome was the use of AT when operating a computer or other mobile electronic device. The primary predictor was the subject’s principal health insurance provider, which was grouped into the 3 categories: government (Medicare, Medicaid, and other government), private (private insurance, private funds, and other), and workers’ compensation. Results Overall, 34.7% of participants reported using AT to access computers and electronic devices. Results of logistic regression analysis revealed sex, injury level, injury completeness, self-perceived health status, and 12-month history of pressure ulcer were all significantly associated with AT use. After adjusting for these factors, participants with workers’ compensation were more likely to report AT use than individuals with either government or private insurance. Conclusions Despite significant technological advances, AT is not readily available to the people who might benefit most from its use. Findings from the present study are the first to shed light on AT funding sources and reveal that individuals with workers’ compensation are more likely use AT than individuals with either government or private insurance. Additional work focused on AT use and functional outcomes is needed to assess the effect of barriers to use. Collectively, this work may inform insurers of the importance of having AT available for this unique population to potentially improve quality of life and participation.
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[article] Associations Between Insurance Provider and Assistive Technology Use for Computer and Electronic Devices 1 Year After Tetraplegia: Findings From the Spinal Cord Injury Model Systems National Database [Article] / Kimberley R. Monden ; Mitch Sevigny ; Jessica M. Ketchum . - 2019 . - p. 2260-2266.
https://doi.org/10.1016/j.apmr.2019.06.013
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2260-2266

Descripteurs :	HE Vinci Assurance ; Dispositifs d'assistance au mouvement ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To investigate the association between insurance provider and reported assistive technology (AT) use to access computers and electronic devices 1 year after sustaining tetraplegia. Design Multicenter cross-sectional study. Setting Participants enrolled in the Spinal Cord Injury Model Systems (SCIMS) National Database. Interventions Not applicable. Participants Men and women with tetraplegia (N=498) enrolled in the SCIMS National Database were included in the analysis. Main Outcome Measures The primary study outcome was the use of AT when operating a computer or other mobile electronic device. The primary predictor was the subject’s principal health insurance provider, which was grouped into the 3 categories: government (Medicare, Medicaid, and other government), private (private insurance, private funds, and other), and workers’ compensation. Results Overall, 34.7% of participants reported using AT to access computers and electronic devices. Results of logistic regression analysis revealed sex, injury level, injury completeness, self-perceived health status, and 12-month history of pressure ulcer were all significantly associated with AT use. After adjusting for these factors, participants with workers’ compensation were more likely to report AT use than individuals with either government or private insurance. Conclusions Despite significant technological advances, AT is not readily available to the people who might benefit most from its use. Findings from the present study are the first to shed light on AT funding sources and reveal that individuals with workers’ compensation are more likely use AT than individuals with either government or private insurance. Additional work focused on AT use and functional outcomes is needed to assess the effect of barriers to use. Collectively, this work may inform insurers of the importance of having AT available for this unique population to potentially improve quality of life and participation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2267-2275

Titre :	Comparison of Rest to Aerobic Exercise and Placebo-like Treatment of Acute Sport-Related Concussion in Male and Female Adolescents
Type de document :	Article
Auteurs :	Barry S. Willer ; Mohammad N. Haider ; Itai Bezherano
Année de publication :	2019
Article en page(s) :	p. 2267-2275
Note générale :	https://doi.org/10.1016/j.apmr.2019.07.003
Langues :	Américain (ame)
Descripteurs :	HE Vinci Adolescent ; Commotion de l'encéphale ; Epreuve d'effort ; Exercice physique ; Réadaptation ; Syndrome post-commotionnel
Résumé :	Objective To compare a sample of adolescents with sport-related concussion (SRC) who were prescribed rest with 2 arms of a randomized controlled trial comparing aerobic exercise with placebo-like stretching. We also compared sex differences across the 3 approaches to treatment. Design Quasi-experimental trial. Setting University concussion management clinics. Participants Adolescent athletes (aged 13-18 years) presenting within 10 days of SRC (mean, 5 days after injury) received a recommendation for rest (rest group [RG], n=48, 15.4±1y, 25% female). Their outcomes were compared with matched samples of adolescents assigned to aerobic exercise (exercise group [EG], n=52, 15.3±2y, 46% female) or placebo-like stretching (placebo group [PG], n=51, 15.4±2y, 47% female) (N=151). Main Outcome Measures The primary outcome was median days from injury to recovery. The secondary outcome was proportion classified as normal recovery ( Results The RG recovered in 16 days (interquartile range, 9.25-23.25d), which was significantly delayed (P=.020) compared with EG (13d; interquartile range, 10-18.5d). The PG recovered in 17 days (interquartile range, 13-23d). Four percent of the EG, 14% of the PG, and 13% of the RG had delayed recovery (P=.190). There was no difference in recovery time or delayed recovery between male participants and female participants across groups. Female participants prescribed rest experienced an increase in symptoms vs the other groups (P=.013). Conclusion Relative rest and a placebo-like stretching program were very similar in days to recovery and symptom improvement pattern after SRC. Both conditions were less effective than subsymptom threshold aerobic exercise. Female adolescents appear to be susceptible to symptom increase when prescribed rest.
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[article] Comparison of Rest to Aerobic Exercise and Placebo-like Treatment of Acute Sport-Related Concussion in Male and Female Adolescents [Article] / Barry S. Willer ; Mohammad N. Haider ; Itai Bezherano . - 2019 . - p. 2267-2275.
https://doi.org/10.1016/j.apmr.2019.07.003
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2267-2275

Descripteurs :	HE Vinci Adolescent ; Commotion de l'encéphale ; Epreuve d'effort ; Exercice physique ; Réadaptation ; Syndrome post-commotionnel
Résumé :	Objective To compare a sample of adolescents with sport-related concussion (SRC) who were prescribed rest with 2 arms of a randomized controlled trial comparing aerobic exercise with placebo-like stretching. We also compared sex differences across the 3 approaches to treatment. Design Quasi-experimental trial. Setting University concussion management clinics. Participants Adolescent athletes (aged 13-18 years) presenting within 10 days of SRC (mean, 5 days after injury) received a recommendation for rest (rest group [RG], n=48, 15.4±1y, 25% female). Their outcomes were compared with matched samples of adolescents assigned to aerobic exercise (exercise group [EG], n=52, 15.3±2y, 46% female) or placebo-like stretching (placebo group [PG], n=51, 15.4±2y, 47% female) (N=151). Main Outcome Measures The primary outcome was median days from injury to recovery. The secondary outcome was proportion classified as normal recovery ( Results The RG recovered in 16 days (interquartile range, 9.25-23.25d), which was significantly delayed (P=.020) compared with EG (13d; interquartile range, 10-18.5d). The PG recovered in 17 days (interquartile range, 13-23d). Four percent of the EG, 14% of the PG, and 13% of the RG had delayed recovery (P=.190). There was no difference in recovery time or delayed recovery between male participants and female participants across groups. Female participants prescribed rest experienced an increase in symptoms vs the other groups (P=.013). Conclusion Relative rest and a placebo-like stretching program were very similar in days to recovery and symptom improvement pattern after SRC. Both conditions were less effective than subsymptom threshold aerobic exercise. Female adolescents appear to be susceptible to symptom increase when prescribed rest.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2276-2282

Titre :	Continuous Positive Airway Pressure Use for Obstructive Sleep Apnea in Acute, Traumatic Tetraplegia
Type de document :	Article
Auteurs :	Marnie Graco ; Rachel Schembri ; Jacqueline Ross
Année de publication :	2019
Article en page(s) :	p. 2276-2282
Note générale :	https://doi.org/10.1016/j.apmr.2019.07.005
Langues :	Américain (ame)
Descripteurs :	HE Vinci Observance par le patient ; Réadaptation ; Syndromes d'apnées du sommeil ; Traumatismes de la moelle épinière ; Ventilation en pression positive continue
Résumé :	Objective To describe continuous positive airway pressure (CPAP) use for treatment of obstructive sleep apnea (OSA) in acute tetraplegia, including adherence rates and associated factors. Design Secondary analysis of CPAP data from a multinational randomized controlled trial. Setting Inpatient rehabilitation units of 11 spinal cord injury centers. Participants : People with acute, traumatic tetraplegia and OSA (N=79). Interventions Autotitrating CPAP for OSA for 3 months. Main Outcome Measures Adherence measured as mean daily hours of use. Adherent (yes/no) was defined as an average of at least 4 hours a night throughout the study. Regression analyses determined associations between baseline factors and adherence. CPAP device pressure and leak data were analyzed descriptively. Results A total of 79 participants from 10 spinal units (91% men; mean age ± SD, 46±16; 78±64d postinjury) completed the study in the treatment arm and 33% were adherent. Mean daily CPAP use ± SD was 2.9±2.3 hours. Better adherence was associated with more severe OSA (P=.04) and greater CPAP use in the first week (P<.01 average percentile pressure was low cmh2o and leak high l> Conclusion Adherence to CPAP after acute, traumatic tetraplegia is low. Early acceptance of therapy and more severe OSA predict CPAP use over 3 months. People with acute tetraplegia require less pressure to treat their OSA than the nondisabled; however, air leak is high. These findings highlight the need for further investigation of OSA treatment in acute tetraplegia.
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[article] Continuous Positive Airway Pressure Use for Obstructive Sleep Apnea in Acute, Traumatic Tetraplegia [Article] / Marnie Graco ; Rachel Schembri ; Jacqueline Ross . - 2019 . - p. 2276-2282.
https://doi.org/10.1016/j.apmr.2019.07.005
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2276-2282

Descripteurs :	HE Vinci Observance par le patient ; Réadaptation ; Syndromes d'apnées du sommeil ; Traumatismes de la moelle épinière ; Ventilation en pression positive continue
Résumé :	Objective To describe continuous positive airway pressure (CPAP) use for treatment of obstructive sleep apnea (OSA) in acute tetraplegia, including adherence rates and associated factors. Design Secondary analysis of CPAP data from a multinational randomized controlled trial. Setting Inpatient rehabilitation units of 11 spinal cord injury centers. Participants : People with acute, traumatic tetraplegia and OSA (N=79). Interventions Autotitrating CPAP for OSA for 3 months. Main Outcome Measures Adherence measured as mean daily hours of use. Adherent (yes/no) was defined as an average of at least 4 hours a night throughout the study. Regression analyses determined associations between baseline factors and adherence. CPAP device pressure and leak data were analyzed descriptively. Results A total of 79 participants from 10 spinal units (91% men; mean age ± SD, 46±16; 78±64d postinjury) completed the study in the treatment arm and 33% were adherent. Mean daily CPAP use ± SD was 2.9±2.3 hours. Better adherence was associated with more severe OSA (P=.04) and greater CPAP use in the first week (P<.01 average percentile pressure was low cmh2o and leak high l> Conclusion Adherence to CPAP after acute, traumatic tetraplegia is low. Early acceptance of therapy and more severe OSA predict CPAP use over 3 months. People with acute tetraplegia require less pressure to treat their OSA than the nondisabled; however, air leak is high. These findings highlight the need for further investigation of OSA treatment in acute tetraplegia.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2283-2292

Titre :	Responsiveness and Predictive Validity of the Participation Measure–3 Domains, 4 Dimensions in Survivors of Stroke
Type de document :	Article
Auteurs :	Feng-Hang Chang ; Pengsheng Ni
Année de publication :	2019
Article en page(s) :	p. 2283-2292
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.018
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Participation sociale ; Patients en consultation externe ; Psychométrie ; Réadaptation
Résumé :	To examine the responsiveness and predictive validity of the Participation Measure–3 Domains, 4 Dimensions (PM-3D4D) in people receiving outpatient rehabilitation following stroke. Design Prospective cohort observational study. Setting Outpatient rehabilitation settings. Participants Volunteer patients (N=269) with stroke (mean age ± SD [y], 55.36±12.46; 70.26% male). Interventions Not applicable. Main Outcome Measures The PM-3D4D was designed to measure 3 domains (Productivity, Social, and Community) and 4 dimensions (Diversity, Frequency, Desire for change, and Difficulty) of participation in individuals with rehabilitation needs. All participants completed the PM-3D4D, the Participation Assessment with Recombined Tools-Objective (PART-O), the Participation Measure for Post-Acute Care (PM-PAC), and the EuroQol-5-Dimension (EQ-5D) at the baseline assessment and again following 3 months of outpatient rehabilitation. Results Significant mean changes in scores were observed for most of the PM-3D4D subscales, with the largest score change observed in the Difficulty subscale (standardized response mean=0.57∼0.88). The minimal detectable change and meaningful clinically important differences were calculated for each subscale. The Frequency and Difficulty dimensions of the PM-3D4D demonstrated significantly greater responsiveness than the PART-O and PM-PAC, respectively. The baseline PM-3D4D scores, except for Desire for change subscales, were significantly correlated with the PART-O, PM-PAC, and EQ-5D scores after 3 months of rehabilitation. Conclusions This study provides evidence supporting the responsiveness and predictive validity of the PM-3D4D in survivors of stroke. Among all subscales of the PM-3D4D, the Difficulty dimensional scale demonstrated the greatest responsiveness. The Desire for change dimension of the PM-3D4D showed less responsiveness, and we recommend that it be used as a goal-setting tool rather than an outcome measure. The PM-3D4D can potentially be used to predict participation outcomes and the health-related quality of life following rehabilitation interventions.
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[article] Responsiveness and Predictive Validity of the Participation Measure–3 Domains, 4 Dimensions in Survivors of Stroke [Article] / Feng-Hang Chang ; Pengsheng Ni . - 2019 . - p. 2283-2292.
https://doi.org/10.1016/j.apmr.2019.06.018
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2283-2292

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Participation sociale ; Patients en consultation externe ; Psychométrie ; Réadaptation
Résumé :	To examine the responsiveness and predictive validity of the Participation Measure–3 Domains, 4 Dimensions (PM-3D4D) in people receiving outpatient rehabilitation following stroke. Design Prospective cohort observational study. Setting Outpatient rehabilitation settings. Participants Volunteer patients (N=269) with stroke (mean age ± SD [y], 55.36±12.46; 70.26% male). Interventions Not applicable. Main Outcome Measures The PM-3D4D was designed to measure 3 domains (Productivity, Social, and Community) and 4 dimensions (Diversity, Frequency, Desire for change, and Difficulty) of participation in individuals with rehabilitation needs. All participants completed the PM-3D4D, the Participation Assessment with Recombined Tools-Objective (PART-O), the Participation Measure for Post-Acute Care (PM-PAC), and the EuroQol-5-Dimension (EQ-5D) at the baseline assessment and again following 3 months of outpatient rehabilitation. Results Significant mean changes in scores were observed for most of the PM-3D4D subscales, with the largest score change observed in the Difficulty subscale (standardized response mean=0.57∼0.88). The minimal detectable change and meaningful clinically important differences were calculated for each subscale. The Frequency and Difficulty dimensions of the PM-3D4D demonstrated significantly greater responsiveness than the PART-O and PM-PAC, respectively. The baseline PM-3D4D scores, except for Desire for change subscales, were significantly correlated with the PART-O, PM-PAC, and EQ-5D scores after 3 months of rehabilitation. Conclusions This study provides evidence supporting the responsiveness and predictive validity of the PM-3D4D in survivors of stroke. Among all subscales of the PM-3D4D, the Difficulty dimensional scale demonstrated the greatest responsiveness. The Desire for change dimension of the PM-3D4D showed less responsiveness, and we recommend that it be used as a goal-setting tool rather than an outcome measure. The PM-3D4D can potentially be used to predict participation outcomes and the health-related quality of life following rehabilitation interventions.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2293-2300

Titre :	Transforming a Traumatic Brain Injury Measure of Participation Into a Psychometrically Sound Spinal Cord Injury Participation Measure
Type de document :	Article
Auteurs :	Gale G. Whiteneck ; Julie Gassaway ; Jessica M. Ketchum
Année de publication :	2019
Article en page(s) :	p. 2293-2300
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.020
Langues :	Américain (ame)
Descripteurs :	HE Vinci Évaluation des résultats des patients ; Lésions traumatiques de l'encéphale ; Mesures des résultats rapportés par les patients ; Participation communautaire ; Participation sociale ; Psychométrie ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To evaluate the use of Participation Assessment with Recombined Tools–Objective (PART-O) in spinal cord injury (SCI) and compare it with the Craig Handicap Assessment and Reporting Technique–Short Form (CHART-SF). Design Follow-up survey of inception cohort. Setting Community. Participants Individuals with SCI, rehabilitated at 2 large SCI Model Systems and enrolled in the SCI Model Systems National Database, who were due for routine follow-up (N=468; median age at injury, 29; median time post injury, 5 years). Interventions Not applicable. Main Outcome Measures PART-O and CHART-SF. Results Use of Rasch analysis identified an SCI-specific scoring of PART-O that demonstrated unidimensionality (first contrast eigenvalue of 1.76) with no misfitting items or disordered steps in any response categories. Person separation and reliability were 2.00 and .80, respectively. Unlike CHART-SF, PART-O had a relatively normal distribution with no floor or ceiling effects. Test-retest reliability PART-O administered 2-4 weeks apart was 0.97, with a reliable change index of 3.1 points on a 100-point scale. PART-O correlated 0.79 with the sum of 3 CHART-SF domains with similar content. The PART-O scoring was initially validated on a second data set. Conclusions PART-O can be used successfully to measure participation in a population of people with SCI. A new method of scoring PART-O in SCI provides an initially validated, univariate interval measure of participation with good psychometric properties that has advantages over the CHART-SF legacy measure of participation.
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[article] Transforming a Traumatic Brain Injury Measure of Participation Into a Psychometrically Sound Spinal Cord Injury Participation Measure [Article] / Gale G. Whiteneck ; Julie Gassaway ; Jessica M. Ketchum . - 2019 . - p. 2293-2300.
https://doi.org/10.1016/j.apmr.2019.06.020
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2293-2300

Descripteurs :	HE Vinci Évaluation des résultats des patients ; Lésions traumatiques de l'encéphale ; Mesures des résultats rapportés par les patients ; Participation communautaire ; Participation sociale ; Psychométrie ; Réadaptation ; Traumatismes de la moelle épinière
Résumé :	Objective To evaluate the use of Participation Assessment with Recombined Tools–Objective (PART-O) in spinal cord injury (SCI) and compare it with the Craig Handicap Assessment and Reporting Technique–Short Form (CHART-SF). Design Follow-up survey of inception cohort. Setting Community. Participants Individuals with SCI, rehabilitated at 2 large SCI Model Systems and enrolled in the SCI Model Systems National Database, who were due for routine follow-up (N=468; median age at injury, 29; median time post injury, 5 years). Interventions Not applicable. Main Outcome Measures PART-O and CHART-SF. Results Use of Rasch analysis identified an SCI-specific scoring of PART-O that demonstrated unidimensionality (first contrast eigenvalue of 1.76) with no misfitting items or disordered steps in any response categories. Person separation and reliability were 2.00 and .80, respectively. Unlike CHART-SF, PART-O had a relatively normal distribution with no floor or ceiling effects. Test-retest reliability PART-O administered 2-4 weeks apart was 0.97, with a reliable change index of 3.1 points on a 100-point scale. PART-O correlated 0.79 with the sum of 3 CHART-SF domains with similar content. The PART-O scoring was initially validated on a second data set. Conclusions PART-O can be used successfully to measure participation in a population of people with SCI. A new method of scoring PART-O in SCI provides an initially validated, univariate interval measure of participation with good psychometric properties that has advantages over the CHART-SF legacy measure of participation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2301-2307

Titre :	Intensive In-Hospital Rehabilitation After Hip Fracture Surgery and Activities of Daily Living in Patients With Dementia: Retrospective Analysis of a Nationwide Inpatient Database
Type de document :	Article
Auteurs :	Kazuaki Uda ; Hiroki Matsui ; Kiyohide Fushimi
Année de publication :	2019
Article en page(s) :	p. 2301-2307
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.019
Langues :	Américain (ame)
Descripteurs :	HE Vinci Activités de la vie quotidienne ; Démence ; Fractures de la hanche ; Réadaptation
Résumé :	Objectives To examine the effects of earlier, more frequent, and larger daily amounts of postoperative rehabilitation on activities of daily living (ADL) after hip fracture surgery in patients with dementia. Design Retrospective cohort study. Setting A total of 1053 acute-care hospitals. Participants Patients aged ≥65 years with dementia at admission underwent hip fracture surgery and received postoperative rehabilitation from April 1, 2014 to March 31, 2016 (N=43,206). Interventions Three rehabilitation variables as key independent variables: (1) the interval from surgery to starting rehabilitation (days); (2) the frequency of postoperative rehabilitation (days per week); and (3) the average daily units of postoperative rehabilitation (minutes per daily rehabilitation). Main Outcome Measure ADLs based on the Barthel Index (BI) at discharge from acute-care hospitals. Results In the multivariable linear regression analysis, delayed rehabilitation was significantly associated with a lower BI at discharge (for each day of the interval increase, BI at discharge was 0.38 lower; 95% confidence interval [CI], 0.21-0.54), and a significant increase in the BI at discharge was observed in patients who underwent more frequent rehabilitation (BI [95% CI] was 2.62 [0.99-4.25], 5.83 [4.28-7.38], 7.56 [5.95-9.16], and 9.16 [7.34-10.97] higher for frequencies of 3.1-4.0, 4.1-5.0, 5.1-6.0, and >6.0 days per week, respectively) and larger daily amounts of rehabilitation (4.37 [3.69-5.06] and 6.60 [5.63-7.57] higher for 40-59 and ≥60 minutes per day, respectively). Conclusions These results suggest that earlier, more frequent, and larger daily amounts of postoperative rehabilitation in acute-care hospitals are independently associated with better recovery in ADL at discharge from acute-care hospitals after hip fracture surgery in patients with dementia.
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[article] Intensive In-Hospital Rehabilitation After Hip Fracture Surgery and Activities of Daily Living in Patients With Dementia: Retrospective Analysis of a Nationwide Inpatient Database [Article] / Kazuaki Uda ; Hiroki Matsui ; Kiyohide Fushimi . - 2019 . - p. 2301-2307.
https://doi.org/10.1016/j.apmr.2019.06.019
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2301-2307

Descripteurs :	HE Vinci Activités de la vie quotidienne ; Démence ; Fractures de la hanche ; Réadaptation
Résumé :	Objectives To examine the effects of earlier, more frequent, and larger daily amounts of postoperative rehabilitation on activities of daily living (ADL) after hip fracture surgery in patients with dementia. Design Retrospective cohort study. Setting A total of 1053 acute-care hospitals. Participants Patients aged ≥65 years with dementia at admission underwent hip fracture surgery and received postoperative rehabilitation from April 1, 2014 to March 31, 2016 (N=43,206). Interventions Three rehabilitation variables as key independent variables: (1) the interval from surgery to starting rehabilitation (days); (2) the frequency of postoperative rehabilitation (days per week); and (3) the average daily units of postoperative rehabilitation (minutes per daily rehabilitation). Main Outcome Measure ADLs based on the Barthel Index (BI) at discharge from acute-care hospitals. Results In the multivariable linear regression analysis, delayed rehabilitation was significantly associated with a lower BI at discharge (for each day of the interval increase, BI at discharge was 0.38 lower; 95% confidence interval [CI], 0.21-0.54), and a significant increase in the BI at discharge was observed in patients who underwent more frequent rehabilitation (BI [95% CI] was 2.62 [0.99-4.25], 5.83 [4.28-7.38], 7.56 [5.95-9.16], and 9.16 [7.34-10.97] higher for frequencies of 3.1-4.0, 4.1-5.0, 5.1-6.0, and >6.0 days per week, respectively) and larger daily amounts of rehabilitation (4.37 [3.69-5.06] and 6.60 [5.63-7.57] higher for 40-59 and ≥60 minutes per day, respectively). Conclusions These results suggest that earlier, more frequent, and larger daily amounts of postoperative rehabilitation in acute-care hospitals are independently associated with better recovery in ADL at discharge from acute-care hospitals after hip fracture surgery in patients with dementia.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2308-2313

Titre :	Item Reduction of the Boston Carpal Tunnel Questionnaire Using Decision Tree Modeling
Type de document :	Article
Auteurs :	Miguel C. Jansen ; Mark J. van der Oest ; Harm P. Slijper
Année de publication :	2019
Article en page(s) :	p. 2308-2313
Note générale :	https://doi.org/10.1016/j.apmr.2019.04.021
Langues :	Américain (ame)
Descripteurs :	HE Vinci Arbres de décision ; Enquêtes et questionnaires ; Réadaptation ; Syndrome du canal carpien
Résumé :	Objective To produce an electronic decision tree version of the Boston Carpal Tunnel Questionnaire (DT-BCTQ) using the chi-squared automatic interaction detection (CHAID) algorithm to reduce questionnaire length of the Boston Carpal Tunnel Questionnaire (BCTQ) while minimizing the loss of measurement properties. Design Criterion standard study. All BCTQs completed between January 2012 and September 2016 by patients who were treated for carpal tunnel syndrome (CTS) were randomly divided into a development and a validation dataset at a 3-to-1 ratio. Optimization of the CHAID algorithm was performed in the development dataset to determine the most optimal DT-BCTQ. Setting Private hand clinic providing both surgical and nonsurgical (orthosis and exercise therapy) treatment for hand and wrist disorders. Participants Patients with CTS (N=4470) completed a total of 10,055 BCTQs. Interventions Not applicable. Main Outcome Measures The intraclass correlation coefficient (ICC) was calculated between the original BCTQ scores and the scores predicted by the DT-BCTQ in the validation dataset. Bland-Altman plots visualized the agreement between the BCTQ and the DT-BCTQ. Results The DT-BCTQ reduced the number of questions needed to ask a patient from 11 to a maximum of 3 for the symptom severity scale domain and from 8 to maximum of 3 for the functional status scale domain. The ICC between the original BCTQ and DT-BCTQ was 0.94. The mean difference between the BCTQ and DT-BCTQ was 0.05 on the 0-5 scale (95% confidence interval [CI], -0.48 to 0.57) for the symptom severity scale; 0.02 (95% CI, -0.45 to 0.49) for the functional status scale; and 0.04 (95% CI, -0.31 to 0.39) for the total BCTQ score. Conclusion By creating the DT-BCTQ, we diminished the number of questions needed to ask a patient from 18 to a maximum of 6 questions (3 for each subscore) when administering the BCTQ while maintaining an ICC of 0.94 with the original BCTQ.
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[article] Item Reduction of the Boston Carpal Tunnel Questionnaire Using Decision Tree Modeling [Article] / Miguel C. Jansen ; Mark J. van der Oest ; Harm P. Slijper . - 2019 . - p. 2308-2313.
https://doi.org/10.1016/j.apmr.2019.04.021
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2308-2313

Descripteurs :	HE Vinci Arbres de décision ; Enquêtes et questionnaires ; Réadaptation ; Syndrome du canal carpien
Résumé :	Objective To produce an electronic decision tree version of the Boston Carpal Tunnel Questionnaire (DT-BCTQ) using the chi-squared automatic interaction detection (CHAID) algorithm to reduce questionnaire length of the Boston Carpal Tunnel Questionnaire (BCTQ) while minimizing the loss of measurement properties. Design Criterion standard study. All BCTQs completed between January 2012 and September 2016 by patients who were treated for carpal tunnel syndrome (CTS) were randomly divided into a development and a validation dataset at a 3-to-1 ratio. Optimization of the CHAID algorithm was performed in the development dataset to determine the most optimal DT-BCTQ. Setting Private hand clinic providing both surgical and nonsurgical (orthosis and exercise therapy) treatment for hand and wrist disorders. Participants Patients with CTS (N=4470) completed a total of 10,055 BCTQs. Interventions Not applicable. Main Outcome Measures The intraclass correlation coefficient (ICC) was calculated between the original BCTQ scores and the scores predicted by the DT-BCTQ in the validation dataset. Bland-Altman plots visualized the agreement between the BCTQ and the DT-BCTQ. Results The DT-BCTQ reduced the number of questions needed to ask a patient from 11 to a maximum of 3 for the symptom severity scale domain and from 8 to maximum of 3 for the functional status scale domain. The ICC between the original BCTQ and DT-BCTQ was 0.94. The mean difference between the BCTQ and DT-BCTQ was 0.05 on the 0-5 scale (95% confidence interval [CI], -0.48 to 0.57) for the symptom severity scale; 0.02 (95% CI, -0.45 to 0.49) for the functional status scale; and 0.04 (95% CI, -0.31 to 0.39) for the total BCTQ score. Conclusion By creating the DT-BCTQ, we diminished the number of questions needed to ask a patient from 18 to a maximum of 6 questions (3 for each subscore) when administering the BCTQ while maintaining an ICC of 0.94 with the original BCTQ.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2314-2323

Titre :	Comprehensive ADL Outcome Measurement after Stroke: Rasch Validation of the Lucerne ICF-Based Multidisciplinary Observation Scale (LIMOS)
Type de document :	Article
Auteurs :	Ann Van de Winckel ; Beatrice Ottiger ; Stephan Bohlhalter
Année de publication :	2019
Article en page(s) :	p. 2314-2323
Note générale :	https://doi.org/10.1016/j.apmr.2019.02.012
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Activités de la vie quotidienne ; Mesures des résultats rapportés par les patients ; Réadaptation
Résumé :	Objective To establish Rasch validation of the Lucerne International Classification of Functioning, Disability and Health (ICF)-based Multidisciplinary Observation Scale (LIMOS) in stroke. LIMOS measures the level of assistance in daily life activities related to motor function, communication, cognition, and domestic life. Rasch Measurement Theory (RMT) transforms an ordinal scale into an interval scale and thus the Rasch-based LIMOS scale captures a more accurate improvement of functional outcomes via Rasch-transformed scores. Design Cross-sectional study design. Setting Neurorehabilitation center, Luzerne, Switzerland. Participants We recruited participants with stroke (N=407; age=63.2±16.0y; n=157 women) through consecutive sampling. Interventions Not applicable. Main Outcome Measures Participants were assessed with LIMOS at admission and discharge of rehabilitation. We used RMT to evaluate overall model fit, response dependency, floor and ceiling effect, reliability, and differential item functioning (DIF) for sex, age, type, and time of stroke on the 4 LIMOS subscales using the Rasch Unidimensional Measurement Model (RUMM) 2030 program. Results The Rasch-based LIMOS subscales fit the Rasch model after reducing and rescoring items: motor (from 20 to 18 items), communication (5 items), cognition (from 15 to 13 items), and domestic life (5 items). There was no floor or ceiling effect. Some artificial DIF was identified. Scoring at discharge was dependent on the scoring responses at admission, which means that without applying a correction factor to the discharge scores, there was an underestimation of change in scores between admission and discharge, ranging from 0.24 to 0.97 logits (10.79%-49.24%) on the different subscales. Conclusions The Rasch-based LIMOS scale is recommended to measure functional outcome in people with acute or chronic stages of ischemic or hemorrhagic stroke.
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[article] Comprehensive ADL Outcome Measurement after Stroke: Rasch Validation of the Lucerne ICF-Based Multidisciplinary Observation Scale (LIMOS) [Article] / Ann Van de Winckel ; Beatrice Ottiger ; Stephan Bohlhalter . - 2019 . - p. 2314-2323.
https://doi.org/10.1016/j.apmr.2019.02.012
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2314-2323

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Activités de la vie quotidienne ; Mesures des résultats rapportés par les patients ; Réadaptation
Résumé :	Objective To establish Rasch validation of the Lucerne International Classification of Functioning, Disability and Health (ICF)-based Multidisciplinary Observation Scale (LIMOS) in stroke. LIMOS measures the level of assistance in daily life activities related to motor function, communication, cognition, and domestic life. Rasch Measurement Theory (RMT) transforms an ordinal scale into an interval scale and thus the Rasch-based LIMOS scale captures a more accurate improvement of functional outcomes via Rasch-transformed scores. Design Cross-sectional study design. Setting Neurorehabilitation center, Luzerne, Switzerland. Participants We recruited participants with stroke (N=407; age=63.2±16.0y; n=157 women) through consecutive sampling. Interventions Not applicable. Main Outcome Measures Participants were assessed with LIMOS at admission and discharge of rehabilitation. We used RMT to evaluate overall model fit, response dependency, floor and ceiling effect, reliability, and differential item functioning (DIF) for sex, age, type, and time of stroke on the 4 LIMOS subscales using the Rasch Unidimensional Measurement Model (RUMM) 2030 program. Results The Rasch-based LIMOS subscales fit the Rasch model after reducing and rescoring items: motor (from 20 to 18 items), communication (5 items), cognition (from 15 to 13 items), and domestic life (5 items). There was no floor or ceiling effect. Some artificial DIF was identified. Scoring at discharge was dependent on the scoring responses at admission, which means that without applying a correction factor to the discharge scores, there was an underestimation of change in scores between admission and discharge, ranging from 0.24 to 0.97 logits (10.79%-49.24%) on the different subscales. Conclusions The Rasch-based LIMOS scale is recommended to measure functional outcome in people with acute or chronic stages of ischemic or hemorrhagic stroke.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2324-2333

Titre :	Using the ICF to Identify Contextual Factors That Influence Participation of Persons With Deafblindness
Type de document :	Article
Auteurs :	Atul Jaiswal ; Heather M. Aldersey ; Walter Wittich
Année de publication :	2019
Article en page(s) :	p. 2324-2333
Note générale :	https://doi.org/10.1016/j.apmr.2019.03.010
Langues :	Américain (ame)
Descripteurs :	HE Vinci Classification internationale du fonctionnement, du handicap et de la santé ; Environnement ; Inde ; Réadaptation ; Surdité-cécité
Résumé :	Objective To identify and describe the contextual factors that influence the participation of people with deafblindness in India. Design Qualitative study, using directed content analysis approach and the International Classification of Functioning, Disability and Health (ICF) as a framework to analyze the data. Setting Community and social participation settings. Participants Community-dwelling individuals with deafblindness (N=16). Age ranges from 18-45 years. Interventions Not applicable. Main Outcome Measures Personal and environmental factors that influence the participation of individuals with deafblindness using the ICF framework. Results Results indicate that the age of onset and nature of impairment (deafblindness) and willingness to explain the condition (functional consequences of deafblindness) emerged as important personal factors. Access to resources such as assistive technology, social support, and deafblind-specific services were found to be enablers of participation. Lack of services, systems, and policies specific to deafblindness along with negative societal attitude toward disability were highly perceived environmental barriers that influence participation of people with deafblindness in India. Conclusions Professionals must acknowledge aspects of the environment in conducting assessments and delivering interventions and understand the dynamic interactions between environment of the individual and his/her concurrent vision and hearing impairments. Approaches to enable participation require rehabilitation professionals to work with those with deafblindness to advocate for removal of environmental barriers and ensure provision of appropriate resources from the government to facilitate their participation. Social policy and government must ensure emphasis on awareness about deafblindness, access to deafblind-specific services, positive societal attitude, and opportunities for full participation for people with deafblindness in society.
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[article] Using the ICF to Identify Contextual Factors That Influence Participation of Persons With Deafblindness [Article] / Atul Jaiswal ; Heather M. Aldersey ; Walter Wittich . - 2019 . - p. 2324-2333.
https://doi.org/10.1016/j.apmr.2019.03.010
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2324-2333

Descripteurs :	HE Vinci Classification internationale du fonctionnement, du handicap et de la santé ; Environnement ; Inde ; Réadaptation ; Surdité-cécité
Résumé :	Objective To identify and describe the contextual factors that influence the participation of people with deafblindness in India. Design Qualitative study, using directed content analysis approach and the International Classification of Functioning, Disability and Health (ICF) as a framework to analyze the data. Setting Community and social participation settings. Participants Community-dwelling individuals with deafblindness (N=16). Age ranges from 18-45 years. Interventions Not applicable. Main Outcome Measures Personal and environmental factors that influence the participation of individuals with deafblindness using the ICF framework. Results Results indicate that the age of onset and nature of impairment (deafblindness) and willingness to explain the condition (functional consequences of deafblindness) emerged as important personal factors. Access to resources such as assistive technology, social support, and deafblind-specific services were found to be enablers of participation. Lack of services, systems, and policies specific to deafblindness along with negative societal attitude toward disability were highly perceived environmental barriers that influence participation of people with deafblindness in India. Conclusions Professionals must acknowledge aspects of the environment in conducting assessments and delivering interventions and understand the dynamic interactions between environment of the individual and his/her concurrent vision and hearing impairments. Approaches to enable participation require rehabilitation professionals to work with those with deafblindness to advocate for removal of environmental barriers and ensure provision of appropriate resources from the government to facilitate their participation. Social policy and government must ensure emphasis on awareness about deafblindness, access to deafblind-specific services, positive societal attitude, and opportunities for full participation for people with deafblindness in society.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2334-2345

Titre :	Health-Related Problems and Changes After 1 Year as Assessed With the Geriatric ICF Core Set (GeriatrICS) in Community-Living Older Adults Who Are Frail Receiving Person-Centered and Integrated Care From Embrace
Type de document :	Article
Auteurs :	Sophie L. Spoorenberg ; Sijmen A. Reijneveld ; Ronald J. Uittenbroek
Année de publication :	2019
Article en page(s) :	p. 2334-2345
Note générale :	https://doi.org/10.1016/j.apmr.2019.02.014
Langues :	Américain (ame)
Descripteurs :	HE Vinci prise en charge personnalisée du patient ; Qualité des soins de santé ; Réadaptation ; Santé ; Sujet âgé ; Vie autonome ; Vieillissement
Résumé :	Objective To assess the prevalence, severity, and change in health-related problems in a sample of older adults who received individual care and support from Embrace, for the whole sample, per subgroup based on complexity of care needs and frailty, and for those who had at baseline a health-related problem. Design A pretest-posttest study with assessments at baseline and after 12 months. Setting Community. Participants Older adults aged 75 years and older (N=136) who are frail (n=56) or who have complex care needs (n=80). Intervention Participants received care and support by Embrace, a person-centered and integrated care service for community-living older adults supporting them to age in place. A multidisciplinary team provided care and support, with intensity depending on the older adults' risk profile. Main Outcome Measure Health-related problems as perceived by older adults and measured with the Geriatric International Classification of Functioning, Disability and Health Core Set. Results Health-related problems were related to 6 coherent clusters: (1) Mental Functions; (2) Physical Health; (3) Mobility; (4) Personal Care; (5) Nutrition; and (6) Support. The most prevalent and most severe problems at baseline were related to Mental Functions and Mobility. Changes in the prevalence of problems after 12 months varied. Severity scores decreased or remained stable, except for Mobility items which showed a varying changing pattern in participants with complex care needs. Prevalence and severity of problems for those with a problem at baseline decreased after 12 months. Frail participants with a problem had higher baseline severity scores than those with complex care needs experiencing a problem, but differences in changes between individuals who are frail and those with complex care needs were small. Conclusions The results are encouraging and may indicate that individual, person-centered and integrated care and support from Embrace offers a route to counteracting the decline in physical, cognitive and social functioning associated with aging.
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[article] Health-Related Problems and Changes After 1 Year as Assessed With the Geriatric ICF Core Set (GeriatrICS) in Community-Living Older Adults Who Are Frail Receiving Person-Centered and Integrated Care From Embrace [Article] / Sophie L. Spoorenberg ; Sijmen A. Reijneveld ; Ronald J. Uittenbroek . - 2019 . - p. 2334-2345.
https://doi.org/10.1016/j.apmr.2019.02.014
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2334-2345

Descripteurs :	HE Vinci prise en charge personnalisée du patient ; Qualité des soins de santé ; Réadaptation ; Santé ; Sujet âgé ; Vie autonome ; Vieillissement
Résumé :	Objective To assess the prevalence, severity, and change in health-related problems in a sample of older adults who received individual care and support from Embrace, for the whole sample, per subgroup based on complexity of care needs and frailty, and for those who had at baseline a health-related problem. Design A pretest-posttest study with assessments at baseline and after 12 months. Setting Community. Participants Older adults aged 75 years and older (N=136) who are frail (n=56) or who have complex care needs (n=80). Intervention Participants received care and support by Embrace, a person-centered and integrated care service for community-living older adults supporting them to age in place. A multidisciplinary team provided care and support, with intensity depending on the older adults' risk profile. Main Outcome Measure Health-related problems as perceived by older adults and measured with the Geriatric International Classification of Functioning, Disability and Health Core Set. Results Health-related problems were related to 6 coherent clusters: (1) Mental Functions; (2) Physical Health; (3) Mobility; (4) Personal Care; (5) Nutrition; and (6) Support. The most prevalent and most severe problems at baseline were related to Mental Functions and Mobility. Changes in the prevalence of problems after 12 months varied. Severity scores decreased or remained stable, except for Mobility items which showed a varying changing pattern in participants with complex care needs. Prevalence and severity of problems for those with a problem at baseline decreased after 12 months. Frail participants with a problem had higher baseline severity scores than those with complex care needs experiencing a problem, but differences in changes between individuals who are frail and those with complex care needs were small. Conclusions The results are encouraging and may indicate that individual, person-centered and integrated care and support from Embrace offers a route to counteracting the decline in physical, cognitive and social functioning associated with aging.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2346-2353

Titre :	Peak Cough Flow Fails to Detect Upper Airway Collapse During Negative Pressure Titration for Cough-Assist
Type de document :	Article
Auteurs :	Matthieu Lacombe ; Aurélien Boré ; Lorena Del Amo Castrillo
Année de publication :	2019
Article en page(s) :	p. 2346-2353
Note générale :	https://doi.org/10.1016/j.apmr.2019.06.012
Langues :	Américain (ame)
Descripteurs :	HE Vinci Insufflation ; Maladies neuromusculaires ; Réadaptation ; Toux
Résumé :	Objective To study the ability of peak cough flow (PCF) and effective cough volume, defined as the volume exsufflated >3 L/s, to detect upper airway collapse during mechanical insufflation-exsufflation (MI-E) titration in neuromuscular patients. Design Prospective observational study. Setting Rehabilitation hospital. Participants Patients (N=27) with neuromuscular disease causing significant impairment of chest wall and/or diaphragmatic movement. Interventions The lowest insufflation pressure producing the highest inspiratory capacity was used. Exsufflation pressure was decreased from −20 cm H2O to −60/−70 cm H2O, in 10-cm H2O decrements, until upper airway collapse was detected using the reference standard of flow-volume curve analysis (after PCF, abrupt flattening or flow decrease vs previous less negative exsufflation pressure). Main Outcome Measures PCF and effective cough volume profiles during expiration with MI-E. Results Upper airway collapse occurred in 10 patients during titration. Effective cough volume increased with decreasing expiratory pressure then decreased upon upper airway collapse occurrence. PCF continued to increase after upper airway collapse occurrence. In 5 other patients, upper airway collapse occurred at the initial −20 cm H2O exsufflation pressure, and during titration, PCF increased and effective cough volume remained unchanged at Conclusion Of 27 patients, 15 experienced upper airway collapse during MI-E titration. Upper airway collapse was associated with an effective cough volume decrease or plateau and with increasing PCF. Accordingly, effective cough volume, but not PCF, can detect upper airway collapse.
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[article] Peak Cough Flow Fails to Detect Upper Airway Collapse During Negative Pressure Titration for Cough-Assist [Article] / Matthieu Lacombe ; Aurélien Boré ; Lorena Del Amo Castrillo . - 2019 . - p. 2346-2353.
https://doi.org/10.1016/j.apmr.2019.06.012
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2346-2353

Descripteurs :	HE Vinci Insufflation ; Maladies neuromusculaires ; Réadaptation ; Toux
Résumé :	Objective To study the ability of peak cough flow (PCF) and effective cough volume, defined as the volume exsufflated >3 L/s, to detect upper airway collapse during mechanical insufflation-exsufflation (MI-E) titration in neuromuscular patients. Design Prospective observational study. Setting Rehabilitation hospital. Participants Patients (N=27) with neuromuscular disease causing significant impairment of chest wall and/or diaphragmatic movement. Interventions The lowest insufflation pressure producing the highest inspiratory capacity was used. Exsufflation pressure was decreased from −20 cm H2O to −60/−70 cm H2O, in 10-cm H2O decrements, until upper airway collapse was detected using the reference standard of flow-volume curve analysis (after PCF, abrupt flattening or flow decrease vs previous less negative exsufflation pressure). Main Outcome Measures PCF and effective cough volume profiles during expiration with MI-E. Results Upper airway collapse occurred in 10 patients during titration. Effective cough volume increased with decreasing expiratory pressure then decreased upon upper airway collapse occurrence. PCF continued to increase after upper airway collapse occurrence. In 5 other patients, upper airway collapse occurred at the initial −20 cm H2O exsufflation pressure, and during titration, PCF increased and effective cough volume remained unchanged at Conclusion Of 27 patients, 15 experienced upper airway collapse during MI-E titration. Upper airway collapse was associated with an effective cough volume decrease or plateau and with increasing PCF. Accordingly, effective cough volume, but not PCF, can detect upper airway collapse.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2354-2370

Titre :	Psychometric Properties of Functional, Ambulatory, and Quality of Life Instruments in Lower Limb Amputees: A Systematic Review
Type de document :	Article
Auteurs :	Ethan M. Balk ; Abhilash Gazula ; Georgios Markozannes
Année de publication :	2019
Article en page(s) :	p. 2354-2370
Note générale :	https://doi.org/10.1016/j.apmr.2019.02.015
Langues :	Américain (ame)
Descripteurs :	HE Vinci Amputation chirurgicale ; Etudes de validation ; Évaluation de l'invalidité ; Membre inférieur ; Membres artificiels ; Psychométrie ; Réadaptation ; Reproductibilité des résultats ; Revue systématique
Résumé :	Objective Summarize the psychometric properties of functional, ambulatory, and quality of life instruments among adult lower limb amputees, highlighting evidence deemed generalizable to the United States Medicare population. Data Sources Six databases and existing systematic reviews through October 30, 2017. Searches included terms for lower limb amputation or prostheses and outcome measures in humans, without language restriction. Study Selection We included peer-reviewed studies of at least 20 adults (≥18 years) with lower limb amputation. Eligible studies reported on psychometric properties of functional, ambulatory, or quality of life instruments. Fifty-three of 425 retrieved articles (12%) met criteria. Data Extraction Study characteristics and psychometric property data (validity, reliability, responsiveness, minimum detectable change, minimal important difference, or floor or ceiling effect) were extracted into a customized form based on standardized criteria. All extracted data were confirmed by 2 experts in systematic review and rehabilitation outcome measurement. Instruments were categorized regarding having been validated and found reliable. Other reported psychometric properties were recorded. Studies were also assessed for applicability to the Medicare population based on age and amputation etiology (dysvascular). Data Synthesis Fifty-six studies (in 53 articles) reported psychometric properties of 50 instruments. There is evidence for both validity and reliability for 30 instruments, 17 of which have evidence that was deemed generalizable to the Medicare population. Most of the remaining instruments have evidence of either validity or reliability, but not both. Twelve instruments have been assessed specifically among lower limb amputees prior to prosthesis prescription. Thirteen instruments have been assessed regarding their predictive properties for future outcomes. Conclusions Numerous instruments assessing ambulation, function, quality of life, and other patient-centered outcomes have evidence of validity and reliability for adults with lower limb amputations. Researchers and clinicians should use validated, reliable instruments when feasible. Many existing and new instruments require validation for use with lower limb amputees.
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[article] Psychometric Properties of Functional, Ambulatory, and Quality of Life Instruments in Lower Limb Amputees: A Systematic Review [Article] / Ethan M. Balk ; Abhilash Gazula ; Georgios Markozannes . - 2019 . - p. 2354-2370.
https://doi.org/10.1016/j.apmr.2019.02.015
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2354-2370

Descripteurs :	HE Vinci Amputation chirurgicale ; Etudes de validation ; Évaluation de l'invalidité ; Membre inférieur ; Membres artificiels ; Psychométrie ; Réadaptation ; Reproductibilité des résultats ; Revue systématique
Résumé :	Objective Summarize the psychometric properties of functional, ambulatory, and quality of life instruments among adult lower limb amputees, highlighting evidence deemed generalizable to the United States Medicare population. Data Sources Six databases and existing systematic reviews through October 30, 2017. Searches included terms for lower limb amputation or prostheses and outcome measures in humans, without language restriction. Study Selection We included peer-reviewed studies of at least 20 adults (≥18 years) with lower limb amputation. Eligible studies reported on psychometric properties of functional, ambulatory, or quality of life instruments. Fifty-three of 425 retrieved articles (12%) met criteria. Data Extraction Study characteristics and psychometric property data (validity, reliability, responsiveness, minimum detectable change, minimal important difference, or floor or ceiling effect) were extracted into a customized form based on standardized criteria. All extracted data were confirmed by 2 experts in systematic review and rehabilitation outcome measurement. Instruments were categorized regarding having been validated and found reliable. Other reported psychometric properties were recorded. Studies were also assessed for applicability to the Medicare population based on age and amputation etiology (dysvascular). Data Synthesis Fifty-six studies (in 53 articles) reported psychometric properties of 50 instruments. There is evidence for both validity and reliability for 30 instruments, 17 of which have evidence that was deemed generalizable to the Medicare population. Most of the remaining instruments have evidence of either validity or reliability, but not both. Twelve instruments have been assessed specifically among lower limb amputees prior to prosthesis prescription. Thirteen instruments have been assessed regarding their predictive properties for future outcomes. Conclusions Numerous instruments assessing ambulation, function, quality of life, and other patient-centered outcomes have evidence of validity and reliability for adults with lower limb amputations. Researchers and clinicians should use validated, reliable instruments when feasible. Many existing and new instruments require validation for use with lower limb amputees.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2371-2380

Titre :	Does Intradialytic Exercise Improve Removal of Solutes by Hemodialysis? A Systematic Review and Meta-analysis
Type de document :	Article
Auteurs :	Gustavo D. Ferreira ; Maristela Bohlke ; Christiano M. Correa
Année de publication :	2019
Article en page(s) :	p. 2371-2380
Note générale :	https://doi.org/10.1016/j.apmr.2019.02.009
Langues :	Américain (ame)
Descripteurs :	HE Vinci Dialyse rénale ; Exercice physique ; Réadaptation
Résumé :	Objective To describe a systematic review and meta-analysis to identify if intradialytic exercise improves the removal of solutes and the hemodialysis adequacy. Data Sources A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed. The sources were MEDLINE (via PubMed), Web of Science, LILACS, and SciELO, from inception until July 2018. Study Selection Clinical trials including patients on chronic hemodialysis submitted to the intervention of aerobic intradialytic exercise. Data Extraction Evaluating as outcomes the removal of solutes (creatinine, phosphate, potassium) and/or adequacy parameters (Kt/V-urea). Data Synthesis The systematic review included 23 studies (7 evaluating the effect of 1 exercise session and 16 evaluating the effect of training, lasting from 6 to 25 weeks). Eleven RCT were included in the meta-analyses. It was observed that the aerobic intradialytic exercise increased the Kt/V-urea (0.15; 95% confidence interval [95% CI], 0.08-0.21) and decreased creatinine (–1.82 mg/dL; 95% CI, –2.50 to –1.13), despite the high heterogeneity of the analysis. No differences were found in phosphorus and potassium removal. Conclusion The aerobic intradialytic exercise may be suggested to improve the Kt/V-urea and the creatinine removal during the dialysis.
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[article] Does Intradialytic Exercise Improve Removal of Solutes by Hemodialysis? A Systematic Review and Meta-analysis [Article] / Gustavo D. Ferreira ; Maristela Bohlke ; Christiano M. Correa . - 2019 . - p. 2371-2380.
https://doi.org/10.1016/j.apmr.2019.02.009
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2371-2380

Descripteurs :	HE Vinci Dialyse rénale ; Exercice physique ; Réadaptation
Résumé :	Objective To describe a systematic review and meta-analysis to identify if intradialytic exercise improves the removal of solutes and the hemodialysis adequacy. Data Sources A systematic review and meta-analysis of randomized controlled trials (RCTs) were performed. The sources were MEDLINE (via PubMed), Web of Science, LILACS, and SciELO, from inception until July 2018. Study Selection Clinical trials including patients on chronic hemodialysis submitted to the intervention of aerobic intradialytic exercise. Data Extraction Evaluating as outcomes the removal of solutes (creatinine, phosphate, potassium) and/or adequacy parameters (Kt/V-urea). Data Synthesis The systematic review included 23 studies (7 evaluating the effect of 1 exercise session and 16 evaluating the effect of training, lasting from 6 to 25 weeks). Eleven RCT were included in the meta-analyses. It was observed that the aerobic intradialytic exercise increased the Kt/V-urea (0.15; 95% confidence interval [95% CI], 0.08-0.21) and decreased creatinine (–1.82 mg/dL; 95% CI, –2.50 to –1.13), despite the high heterogeneity of the analysis. No differences were found in phosphorus and potassium removal. Conclusion The aerobic intradialytic exercise may be suggested to improve the Kt/V-urea and the creatinine removal during the dialysis.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2381-2388

Titre :	Identifying Gaps in Research on Rehabilitation for Patients With Head and Neck Cancer: A Scoping Review
Type de document :	Article
Auteurs :	Sara C. Parke ; Sonal Oza ; Sam Shahpar
Année de publication :	2019
Article en page(s) :	p. 2381-2388
Note générale :	https://doi.org/10.1016/j.apmr.2019.03.022
Langues :	Américain (ame)
Descripteurs :	HE Vinci Réadaptation ; Tumeurs de la tête et du cou
Résumé :	Objectives Examine the amount and nature of research activity in head and neck cancer (HNC) rehabilitation; highlight publication trends, including information about the authors, settings, and study designs; and identify gaps in the existing literature. Data Sources Eligible studies were identified using PubMed, Embase, and CINAHL databases. Study Selection Inclusion criteria included human subjects, English language, publication between 1/1/1990 and 4/30/2017, HNC patients at any timepoint in disease, and evaluation of rehabilitation outcomes as described by the International Classification of Functioning, Disability and Health (ICF) framework. Exclusion criteria included intervention or outcome not specific to rehabilitation or the HNC population, and protocols or abstracts without corresponding full manuscripts. Data Extraction An established 6-step scoping review framework was utilized to develop the review protocol. A 3-level review was then performed. Data on eligible studies were collected using a Research Electronic Data Capture (REDCap) tool. Data Synthesis Among 2201 publications, 258 met inclusion criteria. Publication rate increased by 390% over the study timeframe. Most studies were observational (n=150). Few were interventional (n=35). The most common interventions focused on chewing or swallowing (n=14), followed by exercise (n=10). Most primary outcome measures fit the ICF definition of impairment; fewer fit the definitions of activity limitation or participation restriction. Conclusions Although research volume in HNC rehabilitation is increasing, the literature is dominated by small (≤100 patients), outpatient-based observational studies involving chewing or swallowing-related impairments. More prospective studies in multidisciplinary domains across the cancer care continuum are needed. There is particular need for interventional studies and prospective observational studies. Future studies should evaluate clinically-relevant activity limitations and participation restrictions. Rehabilitation professionals have an important role in the design of future HNC rehabilitation research.
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[article] Identifying Gaps in Research on Rehabilitation for Patients With Head and Neck Cancer: A Scoping Review [Article] / Sara C. Parke ; Sonal Oza ; Sam Shahpar . - 2019 . - p. 2381-2388.
https://doi.org/10.1016/j.apmr.2019.03.022
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2381-2388

Descripteurs :	HE Vinci Réadaptation ; Tumeurs de la tête et du cou
Résumé :	Objectives Examine the amount and nature of research activity in head and neck cancer (HNC) rehabilitation; highlight publication trends, including information about the authors, settings, and study designs; and identify gaps in the existing literature. Data Sources Eligible studies were identified using PubMed, Embase, and CINAHL databases. Study Selection Inclusion criteria included human subjects, English language, publication between 1/1/1990 and 4/30/2017, HNC patients at any timepoint in disease, and evaluation of rehabilitation outcomes as described by the International Classification of Functioning, Disability and Health (ICF) framework. Exclusion criteria included intervention or outcome not specific to rehabilitation or the HNC population, and protocols or abstracts without corresponding full manuscripts. Data Extraction An established 6-step scoping review framework was utilized to develop the review protocol. A 3-level review was then performed. Data on eligible studies were collected using a Research Electronic Data Capture (REDCap) tool. Data Synthesis Among 2201 publications, 258 met inclusion criteria. Publication rate increased by 390% over the study timeframe. Most studies were observational (n=150). Few were interventional (n=35). The most common interventions focused on chewing or swallowing (n=14), followed by exercise (n=10). Most primary outcome measures fit the ICF definition of impairment; fewer fit the definitions of activity limitation or participation restriction. Conclusions Although research volume in HNC rehabilitation is increasing, the literature is dominated by small (≤100 patients), outpatient-based observational studies involving chewing or swallowing-related impairments. More prospective studies in multidisciplinary domains across the cancer care continuum are needed. There is particular need for interventional studies and prospective observational studies. Future studies should evaluate clinically-relevant activity limitations and participation restrictions. Rehabilitation professionals have an important role in the design of future HNC rehabilitation research.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2389-2398

Titre :	Focus on Risk Factors for Cardiometabolic Disease in Cerebral Palsy: Toward a Core Set of Outcome Measurement Instruments
Type de document :	Article
Auteurs :	Joyce L. Benner ; Patrick G. McPhee ; Jan Willem Gorter
Année de publication :	2019
Article en page(s) :	p. 2389-2398
Note générale :	https://doi.org/10.1016/j.apmr.2019.04.012
Langues :	Américain (ame)
Descripteurs :	HE Vinci Facteurs de risque ; Paralysie cérébrale ; Réadaptation ; Revue systématique
Résumé :	Objective To identify existing outcome measurement instruments (OMIs) assessing risk factors for cardiometabolic disease in adolescents and adults with cerebral palsy (CP) reported on in the literature or used in the field. Data Sources The COnsensus-based Standards for the selection of health Measurement Instruments database of systematic reviews and 4 electronic databases (Embase, MEDLINE/Ovid, MEDLINE/Pubmed, PsychINFO) were searched up to June 19, 2017, that yielded 2594 articles. Experts in the field were consulted to identify any additional OMIs. Study Selection Two reviewers independently applied inclusion criteria to select eligible studies using or evaluating measurement properties of OMIs assessing 1 of 8 outcomes: cardiorespiratory endurance, body size, body composition, physical behavior, sleep, nutrition, blood pressure, and blood lipids and glucose. Studies with an experimental or observational design including ≥10 adolescents or adults with CP were included. Data Extraction One reviewer extracted data that were summarized for study and sample characteristics, outcomes, OMIs used, and if applicable data on measurement properties. Two reviewers rated the methodological quality and the quality of the OMIs. Feasibility for clinical practice and research was rated by experts in the field. Data Synthesis Ninety OMIs were identified from 56 included articles and by the experts. Seventy OMIs pertained to cardiorespiratory endurance, body size, body composition, and physical behavior, whereas only 5 were identified for sleep and nutrition. Overall synthesis revealed that there is moderate to poor evidence for good quality of OMIs in this population. Based on feasibility for clinical practice, experts agreed on a single OMI per outcome (and 2 for cardiorespiratory endurance) to be included in a core set. Conclusion Despite the range of available OMIs to assess risk factors for cardiometabolic disease in adolescents and adults with CP, evidence of good quality is often lacking. Nonetheless, a preliminary core set of 9 OMIs was systematically developed.
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[article] Focus on Risk Factors for Cardiometabolic Disease in Cerebral Palsy: Toward a Core Set of Outcome Measurement Instruments [Article] / Joyce L. Benner ; Patrick G. McPhee ; Jan Willem Gorter . - 2019 . - p. 2389-2398.
https://doi.org/10.1016/j.apmr.2019.04.012
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 12 (2019) . - p. 2389-2398

Descripteurs :	HE Vinci Facteurs de risque ; Paralysie cérébrale ; Réadaptation ; Revue systématique
Résumé :	Objective To identify existing outcome measurement instruments (OMIs) assessing risk factors for cardiometabolic disease in adolescents and adults with cerebral palsy (CP) reported on in the literature or used in the field. Data Sources The COnsensus-based Standards for the selection of health Measurement Instruments database of systematic reviews and 4 electronic databases (Embase, MEDLINE/Ovid, MEDLINE/Pubmed, PsychINFO) were searched up to June 19, 2017, that yielded 2594 articles. Experts in the field were consulted to identify any additional OMIs. Study Selection Two reviewers independently applied inclusion criteria to select eligible studies using or evaluating measurement properties of OMIs assessing 1 of 8 outcomes: cardiorespiratory endurance, body size, body composition, physical behavior, sleep, nutrition, blood pressure, and blood lipids and glucose. Studies with an experimental or observational design including ≥10 adolescents or adults with CP were included. Data Extraction One reviewer extracted data that were summarized for study and sample characteristics, outcomes, OMIs used, and if applicable data on measurement properties. Two reviewers rated the methodological quality and the quality of the OMIs. Feasibility for clinical practice and research was rated by experts in the field. Data Synthesis Ninety OMIs were identified from 56 included articles and by the experts. Seventy OMIs pertained to cardiorespiratory endurance, body size, body composition, and physical behavior, whereas only 5 were identified for sleep and nutrition. Overall synthesis revealed that there is moderate to poor evidence for good quality of OMIs in this population. Based on feasibility for clinical practice, experts agreed on a single OMI per outcome (and 2 for cardiorespiratory endurance) to be included in a core set. Conclusion Despite the range of available OMIs to assess risk factors for cardiometabolic disease in adolescents and adults with CP, evidence of good quality is often lacking. Nonetheless, a preliminary core set of 9 OMIs was systematically developed.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 1999-2005

Titre :	The Rehabilitation Enhancing Aging Through Connected Health Prehabilitation Trial
Type de document :	Article
Auteurs :	Jonathan F. Bean ; Lorna Brown ; Tamara R. DeAngelis
Année de publication :	2019
Article en page(s) :	p. 1999-2005
Langues :	Américain (ame)
Descripteurs :	HE Vinci Mobilité réduite ; Prestations des soins de santé ; Réadaptation ; Sujet âgé ; Télémédecine
Résumé :	Objective To evaluate the proof of concept of an innovative model of physical therapy Rehabilitation Enhancing Aging through Connected Health (REACH) and evaluated its feasibility and effect on physical function and health care utilization. Design Quasi-experimental 12-month clinical trial. Setting Two outpatient rehabilitation centers. Participants Community-dwelling older primary care patients with a treatment arm undergoing the intervention (n=75; mean age=77±5.9y; 54% women) and propensity matched controls derived from a longitudinal cohort study (n=430; mean age=71±7.0y; 68% women) using identical recruitment criteria (N=505). Intervention Combined outpatient and home PT augmented with a commercially available app and computer tablet. Measurements Primary outcomes included a feasibility questionnaire, exercise adherence, self-reported function, and the Short Physical Performance Battery (SPPB). Secondary outcomes included the rates of emergency department (ED) visits and hospitalizations. Results Among REACH participants, we observed a 9% dropout rate. After accounting for dropouts, with propensity matching, n=68 treatments and n=100 controls were analyzed. Over the 12-month study duration, 85% of participants adhered to the exercise program an average of 2 times a week and evaluated the treatment experience favorably. In comparison to controls, after 1 year of treatment and within multivariable regression models, REACH participants did not manifest a significant difference in patient reported function (group x time effect 1.67 units, P=.10) but did manifest significant differences in SPPB (group x time effect 0.69 units, P=.03) and gait speed (group x time effect .08m/s, P=.02). In comparison to controls, after 1 year, the rate of ED visits (group x time treatment rate=0.27, P<.004 were significantly reduced but a significant reduction in hospitalizations was not observed.> Conclusion The REACH intervention is feasible and has proof of concept in preventing functional decline and favorably affecting health care utilization. Evaluation on a larger scale is warranted.
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[article] The Rehabilitation Enhancing Aging Through Connected Health Prehabilitation Trial [Article] / Jonathan F. Bean ; Lorna Brown ; Tamara R. DeAngelis . - 2019 . - p. 1999-2005.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 1999-2005

Descripteurs :	HE Vinci Mobilité réduite ; Prestations des soins de santé ; Réadaptation ; Sujet âgé ; Télémédecine
Résumé :	Objective To evaluate the proof of concept of an innovative model of physical therapy Rehabilitation Enhancing Aging through Connected Health (REACH) and evaluated its feasibility and effect on physical function and health care utilization. Design Quasi-experimental 12-month clinical trial. Setting Two outpatient rehabilitation centers. Participants Community-dwelling older primary care patients with a treatment arm undergoing the intervention (n=75; mean age=77±5.9y; 54% women) and propensity matched controls derived from a longitudinal cohort study (n=430; mean age=71±7.0y; 68% women) using identical recruitment criteria (N=505). Intervention Combined outpatient and home PT augmented with a commercially available app and computer tablet. Measurements Primary outcomes included a feasibility questionnaire, exercise adherence, self-reported function, and the Short Physical Performance Battery (SPPB). Secondary outcomes included the rates of emergency department (ED) visits and hospitalizations. Results Among REACH participants, we observed a 9% dropout rate. After accounting for dropouts, with propensity matching, n=68 treatments and n=100 controls were analyzed. Over the 12-month study duration, 85% of participants adhered to the exercise program an average of 2 times a week and evaluated the treatment experience favorably. In comparison to controls, after 1 year of treatment and within multivariable regression models, REACH participants did not manifest a significant difference in patient reported function (group x time effect 1.67 units, P=.10) but did manifest significant differences in SPPB (group x time effect 0.69 units, P=.03) and gait speed (group x time effect .08m/s, P=.02). In comparison to controls, after 1 year, the rate of ED visits (group x time treatment rate=0.27, P<.004 were significantly reduced but a significant reduction in hospitalizations was not observed.> Conclusion The REACH intervention is feasible and has proof of concept in preventing functional decline and favorably affecting health care utilization. Evaluation on a larger scale is warranted.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2006-2014

Titre :	Randomized Controlled Trial of a Telephone-Delivered Physical Activity and Fatigue Self-management Interventions in Adults With Multiple Sclerosis
Type de document :	Article
Auteurs :	Matthew Plow ; Marcia Finlayson ; Jintao Liu
Année de publication :	2019
Article en page(s) :	p. 2006-2014
Langues :	Américain (ame)
Descripteurs :	HE Vinci Comportement ; Exercice physique ; Fatigue ; Gestion de soi ; Réadaptation ; Recherche comparative sur l'efficacité ; Sclerose en plaques
Résumé :	Objective To compare the effectiveness of telephone-delivered interventions on fatigue, physical activity, and quality of life outcomes in adults with multiple sclerosis (MS). Design A single-blinded, randomized controlled trial. Participants were randomized to contact-control intervention (CC), physical activity–only intervention (PA-only), and physical activity plus fatigue self-management intervention (FM+). Outcomes were measured at baseline (2wk prerandomization), posttest (14wk postrandomization), and follow-up (26wk postrandomization). Setting Telephone-delivered in Midwest and Northeast regions of the United States. Participants Inactive adults with MS (N=208) and moderate-to-severe fatigue. Interventions Three or 6 group teleconferences followed by 4 individually tailored phone calls delivered during 12 weeks. An occupational therapist and research assistant delivered the teleconferences and tailored phone calls, respectively. Main Outcome Measures Primary outcomes were self-report fatigue and physical activity measured with the Fatigue Impact Scale and Godin Leisure-Time Exercise Questionnaire, respectively. Secondary outcomes included quality of life measured with the Multiple Sclerosis Impact Scale and moderate-to-vigorous exercise and step count measured with an accelerometer. Results Linear mixed effects models showed FM+ significantly improved self-reported fatigue (β=−11.08; P=.03) and physical activity (β=0.54; P=.01) compared with CC at posttest. However, FM+ had nonsignificant differences compared with PA-only on self-report fatigue (β=−1.08, P=.84) and physical activity (β=0.09; P=.68) at posttest. PA–only had significant improvements compared with CC on moderate-to-vigorous exercise (β=0.38; P=.02) at posttest and step count at posttest (β=1.30; P<.01 and follow-up p=".01)" measured with an accelerometer. fm pa-only had nonsignificant differences compared cc on quality of life.> Conclusions Group teleconferences followed by tailored phone calls have a small yet statistically significant effect in promoting physical activity and reducing fatigue impact in people with MS.
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[article] Randomized Controlled Trial of a Telephone-Delivered Physical Activity and Fatigue Self-management Interventions in Adults With Multiple Sclerosis [Article] / Matthew Plow ; Marcia Finlayson ; Jintao Liu . - 2019 . - p. 2006-2014.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2006-2014

Descripteurs :	HE Vinci Comportement ; Exercice physique ; Fatigue ; Gestion de soi ; Réadaptation ; Recherche comparative sur l'efficacité ; Sclerose en plaques
Résumé :	Objective To compare the effectiveness of telephone-delivered interventions on fatigue, physical activity, and quality of life outcomes in adults with multiple sclerosis (MS). Design A single-blinded, randomized controlled trial. Participants were randomized to contact-control intervention (CC), physical activity–only intervention (PA-only), and physical activity plus fatigue self-management intervention (FM+). Outcomes were measured at baseline (2wk prerandomization), posttest (14wk postrandomization), and follow-up (26wk postrandomization). Setting Telephone-delivered in Midwest and Northeast regions of the United States. Participants Inactive adults with MS (N=208) and moderate-to-severe fatigue. Interventions Three or 6 group teleconferences followed by 4 individually tailored phone calls delivered during 12 weeks. An occupational therapist and research assistant delivered the teleconferences and tailored phone calls, respectively. Main Outcome Measures Primary outcomes were self-report fatigue and physical activity measured with the Fatigue Impact Scale and Godin Leisure-Time Exercise Questionnaire, respectively. Secondary outcomes included quality of life measured with the Multiple Sclerosis Impact Scale and moderate-to-vigorous exercise and step count measured with an accelerometer. Results Linear mixed effects models showed FM+ significantly improved self-reported fatigue (β=−11.08; P=.03) and physical activity (β=0.54; P=.01) compared with CC at posttest. However, FM+ had nonsignificant differences compared with PA-only on self-report fatigue (β=−1.08, P=.84) and physical activity (β=0.09; P=.68) at posttest. PA–only had significant improvements compared with CC on moderate-to-vigorous exercise (β=0.38; P=.02) at posttest and step count at posttest (β=1.30; P<.01 and follow-up p=".01)" measured with an accelerometer. fm pa-only had nonsignificant differences compared cc on quality of life.> Conclusions Group teleconferences followed by tailored phone calls have a small yet statistically significant effect in promoting physical activity and reducing fatigue impact in people with MS.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2015-2021

Titre :	Postacute Care Setting Is Associated With Employment After Burn Injury
Type de document :	Article
Auteurs :	Leda F. Espinoza ; Laura C. Simko ; Richard Goldstein
Année de publication :	2019
Article en page(s) :	p. 2015-2021
Langues :	Américain (ame)
Descripteurs :	HE Vinci Emploi ; Établissements de soins qualifiés ; Réadaptation ; Soins de suite
Résumé :	Objective To examine differences in long-term employment outcomes in the postacute care setting. Design Retrospective review of the prospectively collected Burn Model System National Database. Setting and Participants A total of 695 adult survivors of burn injury enrolled between May 1994 and June 2016 who required postacute care at a Burn Model System center following acute care discharge were included. Participants were divided into 2 groups based on acute care discharge disposition. Those who received postacute care at an inpatient rehabilitation facility (IRF) following acute care were included in the IRF group (N=447), and those who were treated at a skilled nursing facility, long-term care hospital, or other extended-care facility following acute care were included in the Other Rehab group (N=248). Interventions Not applicable. Main Outcome Measures Employment status at 12 months postinjury. Propensity score matching and logistic regression were utilized to determine the effect of postacute care setting on employment status. Results Individuals in the IRF group had larger burns and were more likely to have an inhalation injury and to undergo amputation. At 12 months postinjury, the IRF group had over 9 times increased odds of being employed compared to the Other Rehab group, using propensity score matching (P=.046). Conclusions While admitting patients with more severe injuries, IRFs provided a long-term benefit for survivors of burn injury in terms of regaining employment. Given the current lack of evidence-based guidelines on postacute care decisions, the results of this study shed light on the potential benefits of the intensive services provided at IRFs in this population.
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[article] Postacute Care Setting Is Associated With Employment After Burn Injury [Article] / Leda F. Espinoza ; Laura C. Simko ; Richard Goldstein . - 2019 . - p. 2015-2021.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2015-2021

Descripteurs :	HE Vinci Emploi ; Établissements de soins qualifiés ; Réadaptation ; Soins de suite
Résumé :	Objective To examine differences in long-term employment outcomes in the postacute care setting. Design Retrospective review of the prospectively collected Burn Model System National Database. Setting and Participants A total of 695 adult survivors of burn injury enrolled between May 1994 and June 2016 who required postacute care at a Burn Model System center following acute care discharge were included. Participants were divided into 2 groups based on acute care discharge disposition. Those who received postacute care at an inpatient rehabilitation facility (IRF) following acute care were included in the IRF group (N=447), and those who were treated at a skilled nursing facility, long-term care hospital, or other extended-care facility following acute care were included in the Other Rehab group (N=248). Interventions Not applicable. Main Outcome Measures Employment status at 12 months postinjury. Propensity score matching and logistic regression were utilized to determine the effect of postacute care setting on employment status. Results Individuals in the IRF group had larger burns and were more likely to have an inhalation injury and to undergo amputation. At 12 months postinjury, the IRF group had over 9 times increased odds of being employed compared to the Other Rehab group, using propensity score matching (P=.046). Conclusions While admitting patients with more severe injuries, IRFs provided a long-term benefit for survivors of burn injury in terms of regaining employment. Given the current lack of evidence-based guidelines on postacute care decisions, the results of this study shed light on the potential benefits of the intensive services provided at IRFs in this population.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2022-2031

Titre :	Shorter vs Longer Immobilization After Surgery for Thumb Carpometacarpal Osteoarthritis: A Propensity Score-Matched Study
Type de document :	Article
Auteurs :	Jonathan Tsehaie ; Robbert M. Wouters ; Reinier Feitz
Année de publication :	2019
Article en page(s) :	p. 2022-2031
Langues :	Américain (ame)
Descripteurs :	HE Vinci Arthroplastie ; Arthrose ; Articulations carpométacarpiennes ; Essais d'équivalence comme sujet ; Pouce ; Réadaptation
Résumé :	Objective To investigate if shorter immobilization is noninferior to longer immobilization after Weilby procedure for thumb carpometacarpal osteoarthritis Design Prospective cohort study with propensity score matching. Setting Data collection took place in 16 outpatient clinics for hand surgery and hand therapy. Participants A total of 131 participants with shorter immobilization and 131 participants with longer immobilization (N=262). Intervention Shorter immobilization (3-5 days plaster cast followed by a thumb spica orthosis including wrist until 4 weeks postoperatively) was compared with longer immobilization (10-14 days plaster cast followed by a thumb spica orthosis including wrist until 6 weeks postoperatively) after Weilby procedure for first carpometacarpal joint osteoarthritis. Propensity score matching was used to control for confounders. Main Outcome Measures Outcomes were pain measured with a visual analog scale and hand function measured with the Michigan Hand Outcomes Questionnaire at 3 and 12 months. Secondary outcomes were complications, range of motion, grip and pinch strength, satisfaction with treatment, and return to work. Results No significant differences were found in visual analog scale pain (effect size, 0.03; 95% confidence interval [CI], −0.21 to 0.27) or the Michigan Hand Outcomes Questionnaire (effect size, 0.01; 95% CI, −0.23 to 0.25) between the groups at 3 months or at 12 months. Furthermore, no differences were found in complication rate or in other secondary outcomes. Conclusions In conclusion, shorter immobilization of 3-5 days of a plaster cast after Weilby procedure is equal to longer immobilization for outcomes on pain, hand function, and our secondary outcomes. These results indicate that shorter immobilization is safe and can be recommended, since discomfort of longer immobilization may be prevented and patients may be able to recover sooner, which may lead to reduced loss of productivity. Future studies need to investigate effectiveness of early active and more progressive hand therapy following first carpometacarpal joint arthroplasty.
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[article] Shorter vs Longer Immobilization After Surgery for Thumb Carpometacarpal Osteoarthritis: A Propensity Score-Matched Study [Article] / Jonathan Tsehaie ; Robbert M. Wouters ; Reinier Feitz . - 2019 . - p. 2022-2031.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2022-2031

Descripteurs :	HE Vinci Arthroplastie ; Arthrose ; Articulations carpométacarpiennes ; Essais d'équivalence comme sujet ; Pouce ; Réadaptation
Résumé :	Objective To investigate if shorter immobilization is noninferior to longer immobilization after Weilby procedure for thumb carpometacarpal osteoarthritis Design Prospective cohort study with propensity score matching. Setting Data collection took place in 16 outpatient clinics for hand surgery and hand therapy. Participants A total of 131 participants with shorter immobilization and 131 participants with longer immobilization (N=262). Intervention Shorter immobilization (3-5 days plaster cast followed by a thumb spica orthosis including wrist until 4 weeks postoperatively) was compared with longer immobilization (10-14 days plaster cast followed by a thumb spica orthosis including wrist until 6 weeks postoperatively) after Weilby procedure for first carpometacarpal joint osteoarthritis. Propensity score matching was used to control for confounders. Main Outcome Measures Outcomes were pain measured with a visual analog scale and hand function measured with the Michigan Hand Outcomes Questionnaire at 3 and 12 months. Secondary outcomes were complications, range of motion, grip and pinch strength, satisfaction with treatment, and return to work. Results No significant differences were found in visual analog scale pain (effect size, 0.03; 95% confidence interval [CI], −0.21 to 0.27) or the Michigan Hand Outcomes Questionnaire (effect size, 0.01; 95% CI, −0.23 to 0.25) between the groups at 3 months or at 12 months. Furthermore, no differences were found in complication rate or in other secondary outcomes. Conclusions In conclusion, shorter immobilization of 3-5 days of a plaster cast after Weilby procedure is equal to longer immobilization for outcomes on pain, hand function, and our secondary outcomes. These results indicate that shorter immobilization is safe and can be recommended, since discomfort of longer immobilization may be prevented and patients may be able to recover sooner, which may lead to reduced loss of productivity. Future studies need to investigate effectiveness of early active and more progressive hand therapy following first carpometacarpal joint arthroplasty.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2032-2038

Titre :	Accessibility of Medical Diagnostic Equipment for Patients With Disability: Observations From Physicians
Type de document :	Article
Auteurs :	Nicole Agaronnik ; Eric G. Campbell ; Julie Ressalam
Année de publication :	2019
Article en page(s) :	p. 2032-2038
Langues :	Américain (ame)
Descripteurs :	HE Vinci Matériel de diagnostic ; Personnel médical hospitalier ; Personnes handicapées ; Réadaptation ; Tables d'examen
Résumé :	Objective To explore attitudes and practices of physicians relating to accessible medical diagnostic equipment in serving patients with mobility disability. Design Open-ended individual telephone interviews, which reached data saturation. Interview recordings were transcribed verbatim for qualitative conventional content analysis. Setting Massachusetts, the United States, October 2017-January 2018. Participants Practicing physicians from 5 clinical specialties (N=20). Interventions Not applicable. Main Outcome Measures Common themes concerning physical accessibility. Results Mean ± SD time in practice was 27.5±12.5 years; 14 practices had height-adjustable examination tables; and 7 had wheelchair-accessible weight scales. The analysis identified 6 broad themes: height-adjustable examination tables have advantages; height-adjustable examination tables have drawbacks; transferring patients onto examination tables is challenging; rationale for examining patients in their wheelchairs; perceptions of wheelchair-accessible weight scales; and barriers and facilitators to improving physical accessibility. Major barriers identified by participants included costs of equipment, limited space, and inadequate payment for extra time required to care for persons with disability. Even physicians with accessible examination tables sometimes examined patients seated in their wheelchairs. Conclusions Even if physicians have accessible equipment, they do not always use it in examining patients with disability. Future efforts will need to consider ways to eliminate these access barriers in clinical practice. Given small sample size, results are not generalizable to physicians nationwide and globally.
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[article] Accessibility of Medical Diagnostic Equipment for Patients With Disability: Observations From Physicians [Article] / Nicole Agaronnik ; Eric G. Campbell ; Julie Ressalam . - 2019 . - p. 2032-2038.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2032-2038

Descripteurs :	HE Vinci Matériel de diagnostic ; Personnel médical hospitalier ; Personnes handicapées ; Réadaptation ; Tables d'examen
Résumé :	Objective To explore attitudes and practices of physicians relating to accessible medical diagnostic equipment in serving patients with mobility disability. Design Open-ended individual telephone interviews, which reached data saturation. Interview recordings were transcribed verbatim for qualitative conventional content analysis. Setting Massachusetts, the United States, October 2017-January 2018. Participants Practicing physicians from 5 clinical specialties (N=20). Interventions Not applicable. Main Outcome Measures Common themes concerning physical accessibility. Results Mean ± SD time in practice was 27.5±12.5 years; 14 practices had height-adjustable examination tables; and 7 had wheelchair-accessible weight scales. The analysis identified 6 broad themes: height-adjustable examination tables have advantages; height-adjustable examination tables have drawbacks; transferring patients onto examination tables is challenging; rationale for examining patients in their wheelchairs; perceptions of wheelchair-accessible weight scales; and barriers and facilitators to improving physical accessibility. Major barriers identified by participants included costs of equipment, limited space, and inadequate payment for extra time required to care for persons with disability. Even physicians with accessible examination tables sometimes examined patients seated in their wheelchairs. Conclusions Even if physicians have accessible equipment, they do not always use it in examining patients with disability. Future efforts will need to consider ways to eliminate these access barriers in clinical practice. Given small sample size, results are not generalizable to physicians nationwide and globally.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2039-2045

Titre :	Similarities and Differences of Gait Patterns in Women and Men With Parkinson Disease With Mild Disability
Type de document :	Article
Auteurs :	Micaela Porta ; Giuseppina Pilloni ; Federico Arippa
Année de publication :	2019
Article en page(s) :	p. 2039-2045
Langues :	Américain (ame)
Descripteurs :	HE Vinci Démarche ; Maladie de Parkinson ; Phénomènes biomécaniques ; Réadaptation ; Sexe
Résumé :	Objective This study aimed to quantitatively investigate the existence of differences in spatiotemporal and kinematic parameters of gait in men and women with Parkinson disease (PD) using computerized 3-dimensional gait analysis. Design Retrospective cohort study. Setting Laboratory of Biomechanics. Participants Individuals with PD (N=35; 17 female, 18 male) of mean age 70.7 years characterized by mild disability (Hoehn and Yahr ≤2.5) who were tested in On medication state approximately 60 to 90 minutes after intake of the usual morning Levodopa dose. Intervention Not applicable. Main Outcome Measures Spatiotemporal parameters of gait (speed, stride length, cadence, step width, duration of stance, swing, double support phases) and kinematics of hip, knee, and ankle joints in the sagittal plane. Results Men and women exhibit similar spatiotemporal parameters, except for step width (wider in men). In contrast, relevant differences were found in terms of ankle kinematics. In particular, women presented increased ankle dorsiflexion through all the stance phase and mid to late swing phase, and reduced plantarflexion at the stance-swing phase transition. Conclusions Gait patterns of men and women with PD with mild disability are similar in terms of spatiotemporal parameters but characterized by marked differences regarding the ankle kinematics on the sagittal plane. The findings of the present study support the concept that investigations seeking to clarify the complex pathophysiology of PD-related gait disturbances should consider the role played by an individual's sex, thereby achieving more effective designing of physical and rehabilitative treatments.
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[article] Similarities and Differences of Gait Patterns in Women and Men With Parkinson Disease With Mild Disability [Article] / Micaela Porta ; Giuseppina Pilloni ; Federico Arippa . - 2019 . - p. 2039-2045.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2039-2045

Descripteurs :	HE Vinci Démarche ; Maladie de Parkinson ; Phénomènes biomécaniques ; Réadaptation ; Sexe
Résumé :	Objective This study aimed to quantitatively investigate the existence of differences in spatiotemporal and kinematic parameters of gait in men and women with Parkinson disease (PD) using computerized 3-dimensional gait analysis. Design Retrospective cohort study. Setting Laboratory of Biomechanics. Participants Individuals with PD (N=35; 17 female, 18 male) of mean age 70.7 years characterized by mild disability (Hoehn and Yahr ≤2.5) who were tested in On medication state approximately 60 to 90 minutes after intake of the usual morning Levodopa dose. Intervention Not applicable. Main Outcome Measures Spatiotemporal parameters of gait (speed, stride length, cadence, step width, duration of stance, swing, double support phases) and kinematics of hip, knee, and ankle joints in the sagittal plane. Results Men and women exhibit similar spatiotemporal parameters, except for step width (wider in men). In contrast, relevant differences were found in terms of ankle kinematics. In particular, women presented increased ankle dorsiflexion through all the stance phase and mid to late swing phase, and reduced plantarflexion at the stance-swing phase transition. Conclusions Gait patterns of men and women with PD with mild disability are similar in terms of spatiotemporal parameters but characterized by marked differences regarding the ankle kinematics on the sagittal plane. The findings of the present study support the concept that investigations seeking to clarify the complex pathophysiology of PD-related gait disturbances should consider the role played by an individual's sex, thereby achieving more effective designing of physical and rehabilitative treatments.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2046-2052

Titre :	Acute and Long-Term Effects of Mechanotherapy on the Outcome After an Achilles Repair: A Prospective Cohort Study With Historical Controls
Type de document :	Article
Auteurs :	Pei-Yun Wang ; Kao-Shang Shih ; Hsiao-Li Ma
Année de publication :	2019
Article en page(s) :	p. 2046-2052
Langues :	Américain (ame)
Descripteurs :	HE Vinci Microcirculation ; Réadaptation ; Tendon calcanéen ; Vibration
Résumé :	Abstract Objectives To evaluate the effects of vibration on Achilles’ tendon microcirculation and characteristics following surgical repair of Achilles’ tendon rupture. Design Cohort study with historical controls. Setting A university institute. Participants Participants (N=32), including 19 (16 men, 3 women; median [range] age: 43.0 [25.0-57.0] years) and 13 (10 men, 3 women; 44.00 [29.0-60.0] years) in the vibration (application to the ball of the foot, 30Hz, 2mm amplitude, 4kg pressure, and self-administration) and control groups, respectively, who underwent unilateral Achilles’ tendon repairs were recruited. Intervention A 4-week vibration intervention in the vibration group. Main Outcome Measurements The tendon microcirculation was measured after the first session of vibration. The participants were evaluated repeatedly with bilateral follow-up measurements of tendon stiffness, 3 functional outcome tests, and a questionnaire survey. Results Acute effects of the vibration were observed immediately after the 5-minute vibration (P≤.001). Lower total hemoglobin and oxygen saturation were respectively observed (P=.043) in the repaired legs 3 and 6 months postsurgery in the vibration group as compared with the control group. The vibration group also showed greater tendon stiffness, heel raising height and hopping distance 3 or 6 months postoperation in both the repaired and noninjured legs (all P<.05 the microcirculatory characteristics months postoperation were correlated with outcomes at postoperation.> Conclusions Differences in microcirculatory characteristics and better rehabilitation outcomes were observed in the legs with an Achilles repair that underwent the early vibration intervention.
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[article] Acute and Long-Term Effects of Mechanotherapy on the Outcome After an Achilles Repair: A Prospective Cohort Study With Historical Controls [Article] / Pei-Yun Wang ; Kao-Shang Shih ; Hsiao-Li Ma . - 2019 . - p. 2046-2052.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2046-2052

Descripteurs :	HE Vinci Microcirculation ; Réadaptation ; Tendon calcanéen ; Vibration
Résumé :	Abstract Objectives To evaluate the effects of vibration on Achilles’ tendon microcirculation and characteristics following surgical repair of Achilles’ tendon rupture. Design Cohort study with historical controls. Setting A university institute. Participants Participants (N=32), including 19 (16 men, 3 women; median [range] age: 43.0 [25.0-57.0] years) and 13 (10 men, 3 women; 44.00 [29.0-60.0] years) in the vibration (application to the ball of the foot, 30Hz, 2mm amplitude, 4kg pressure, and self-administration) and control groups, respectively, who underwent unilateral Achilles’ tendon repairs were recruited. Intervention A 4-week vibration intervention in the vibration group. Main Outcome Measurements The tendon microcirculation was measured after the first session of vibration. The participants were evaluated repeatedly with bilateral follow-up measurements of tendon stiffness, 3 functional outcome tests, and a questionnaire survey. Results Acute effects of the vibration were observed immediately after the 5-minute vibration (P≤.001). Lower total hemoglobin and oxygen saturation were respectively observed (P=.043) in the repaired legs 3 and 6 months postsurgery in the vibration group as compared with the control group. The vibration group also showed greater tendon stiffness, heel raising height and hopping distance 3 or 6 months postoperation in both the repaired and noninjured legs (all P<.05 the microcirculatory characteristics months postoperation were correlated with outcomes at postoperation.> Conclusions Differences in microcirculatory characteristics and better rehabilitation outcomes were observed in the legs with an Achilles repair that underwent the early vibration intervention.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2053-2062

Titre :	Gait- and Posture-Related Factors Associated With Changes in Hip Pain and Physical Function in Patients With Secondary Hip Osteoarthritis: A Prospective Cohort Study
Type de document :	Article
Auteurs :	Hiroshige Tateuchi ; Haruhiko Akiyama ; Koji Goto
Année de publication :	2019
Article en page(s) :	p. 2053-2062
Langues :	Américain (ame)
Descripteurs :	HE Vinci Arthrite ; Démarche ; Posture ; Pronostic ; Réadaptation
Résumé :	Objective To identify gait- and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA). Design Prospective cohort study. Setting Clinical biomechanics laboratory of a university. Participants Consecutive sampling of female patients with mild-to-moderate secondary hip OA (N=30). Main Outcome Measures Hip pain (visual analog scale) and physical function (physical component summary of the Medical Outcomes Study 36-Item Short-Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait- and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angles of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were walking speed, steps per day, joint angles, external hip joint moment impulses, and daily cumulative hip moments. Results Multiple linear regression analyses showed that limited hip extension (adjusted standardized B coefficient [95% confidence interval]: −0.52 [−0.88 to −0.17]) and limited external rotation angles (−0.51 [−0.85 to −0.18]) during walking were associated with the worsening of hip pain. An increased thoracic kyphosis (−0.54 [−0.99 to −0.09]), less sacral anterior tilt (0.40 [0.01-0.79]), reduced thoracic spine mobility (0.59 [0.23-0.94]), less steps per day (0.53 [0.13-0.92]), and a slower walking speed (0.45 [0.04-0.86]) were associated with deterioration in physical function. Conclusions Gait- and posture-related factors should be considered when assessing risk and designing preventive interventions for the clinical progression of secondary hip OA.
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[article] Gait- and Posture-Related Factors Associated With Changes in Hip Pain and Physical Function in Patients With Secondary Hip Osteoarthritis: A Prospective Cohort Study [Article] / Hiroshige Tateuchi ; Haruhiko Akiyama ; Koji Goto . - 2019 . - p. 2053-2062.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2053-2062

Descripteurs :	HE Vinci Arthrite ; Démarche ; Posture ; Pronostic ; Réadaptation
Résumé :	Objective To identify gait- and posture-related factors associated with changes in hip pain and physical function in patients with hip osteoarthritis (OA). Design Prospective cohort study. Setting Clinical biomechanics laboratory of a university. Participants Consecutive sampling of female patients with mild-to-moderate secondary hip OA (N=30). Main Outcome Measures Hip pain (visual analog scale) and physical function (physical component summary of the Medical Outcomes Study 36-Item Short-Form Health Survey) were measured at baseline and 12 months later. With changes in hip pain and physical function as dependent variables, linear regression analyses were performed with gait- and posture-related factors as independent variables with and without adjustment for age, joint space width, and hip pain or physical function at baseline. Posture-related factors included angles of thoracic kyphosis, lumbar lordosis, sacral inclination, spinal inclination, and spinal mobility. Gait-related factors were walking speed, steps per day, joint angles, external hip joint moment impulses, and daily cumulative hip moments. Results Multiple linear regression analyses showed that limited hip extension (adjusted standardized B coefficient [95% confidence interval]: −0.52 [−0.88 to −0.17]) and limited external rotation angles (−0.51 [−0.85 to −0.18]) during walking were associated with the worsening of hip pain. An increased thoracic kyphosis (−0.54 [−0.99 to −0.09]), less sacral anterior tilt (0.40 [0.01-0.79]), reduced thoracic spine mobility (0.59 [0.23-0.94]), less steps per day (0.53 [0.13-0.92]), and a slower walking speed (0.45 [0.04-0.86]) were associated with deterioration in physical function. Conclusions Gait- and posture-related factors should be considered when assessing risk and designing preventive interventions for the clinical progression of secondary hip OA.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2063-2070

Titre :	Comorbidities in Patients With End-Stage Knee OA: Prevalence and Effect on Physical Function
Type de document :	Article
Auteurs :	Won Bin Kim ; Bo Ryun Kim ; Sang Rim Kim
Année de publication :	2019
Article en page(s) :	p. 2063-2070
Langues :	Américain (ame)
Descripteurs :	HE Vinci Arthrose ; Comorbidité ; Genou ; Qualité de vie ; Réadaptation
Résumé :	Objective To investigate the prevalence of comorbidities and their effect on physical function, quality of life (QOL), and pain, in patients with end-stage knee osteoarthritis (OA). Design A cross-sectional study. Setting A rehabilitation facility at university hospital. Participants Patients (N=577; 503 women and 74 men) diagnosed with end-stage knee OA between October 2013 and June 2018. Intervention Not applicable. Main Outcome Measures Comorbidities were as follows: osteoporosis, presarcopenia, degenerative spine disease, diabetes, and hypertension. All patients completed the following performance-based physical function tests: stair-climbing test (SCT), 6-minute walk test (6MWT), timed Up and Go (TUG) test, and gait analysis. Self-reported physical function and pain were measured using Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and a visual analog scale (VAS), respectively, and self-reported QOL was measured using EuroQoL 5 dimensions (EQ-5D) questionnaire. Results Univariate analyses revealed that patients with osteoporosis had significantly higher scores in SCT ascent, SCT descent, TUG, WOMAC pain tests, and lower scores in 6MWT, gait speed, and cadence tests than those without osteoporosis. Patients with presarcopenia recorded higher scores in SCT ascent, TUG, EQ-5D, and lower scores in 6MWT and gait speed tests than those without presarcopenia. Patients with degenerative spine disease showed higher scores in WOMAC pain and lower scores in gait speeds than those without degenerative spine disease. Patients with diabetes showed higher scores in SCT ascent than those without diabetes, and patients with hypertension showed lower scores in 6MWT than those without hypertension. After adjusting age, sex, and body mass index, SCT descent retained significant association with osteoporosis, SCT ascent showed independent association with presarcopenia and diabetes, and WOMAC pain revealed significant association with degenerative spine disease. Conclusion The results confirm associations between comorbidities, performance-based and self-reported physical functions, and QOL in patients with end-stage knee OA.
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[article] Comorbidities in Patients With End-Stage Knee OA: Prevalence and Effect on Physical Function [Article] / Won Bin Kim ; Bo Ryun Kim ; Sang Rim Kim . - 2019 . - p. 2063-2070.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2063-2070

Descripteurs :	HE Vinci Arthrose ; Comorbidité ; Genou ; Qualité de vie ; Réadaptation
Résumé :	Objective To investigate the prevalence of comorbidities and their effect on physical function, quality of life (QOL), and pain, in patients with end-stage knee osteoarthritis (OA). Design A cross-sectional study. Setting A rehabilitation facility at university hospital. Participants Patients (N=577; 503 women and 74 men) diagnosed with end-stage knee OA between October 2013 and June 2018. Intervention Not applicable. Main Outcome Measures Comorbidities were as follows: osteoporosis, presarcopenia, degenerative spine disease, diabetes, and hypertension. All patients completed the following performance-based physical function tests: stair-climbing test (SCT), 6-minute walk test (6MWT), timed Up and Go (TUG) test, and gait analysis. Self-reported physical function and pain were measured using Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and a visual analog scale (VAS), respectively, and self-reported QOL was measured using EuroQoL 5 dimensions (EQ-5D) questionnaire. Results Univariate analyses revealed that patients with osteoporosis had significantly higher scores in SCT ascent, SCT descent, TUG, WOMAC pain tests, and lower scores in 6MWT, gait speed, and cadence tests than those without osteoporosis. Patients with presarcopenia recorded higher scores in SCT ascent, TUG, EQ-5D, and lower scores in 6MWT and gait speed tests than those without presarcopenia. Patients with degenerative spine disease showed higher scores in WOMAC pain and lower scores in gait speeds than those without degenerative spine disease. Patients with diabetes showed higher scores in SCT ascent than those without diabetes, and patients with hypertension showed lower scores in 6MWT than those without hypertension. After adjusting age, sex, and body mass index, SCT descent retained significant association with osteoporosis, SCT ascent showed independent association with presarcopenia and diabetes, and WOMAC pain revealed significant association with degenerative spine disease. Conclusion The results confirm associations between comorbidities, performance-based and self-reported physical functions, and QOL in patients with end-stage knee OA.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2071-2078

Titre :	Determinants of Social Participation at 1, 3, and 6 Months Poststroke in Benin
Type de document :	Article
Auteurs :	Oyéné Kossi ; Félix Nindorera ; Thierry Adoukonou
Année de publication :	2019
Article en page(s) :	p. 2071-2078
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Réadaptation
Résumé :	Objective To build a model of prediction of social participation of community-dwelling stroke survivors in Benin at 1 month, 3 months, and 6 months. Design An observational study with evaluations at 1 month, 3 months, and 6 months poststroke. Correlational analyses and multivariate linear regressions were performed. Setting Outpatient rehabilitation centers in Benin. Participants A volunteer sample of 91 stroke patients was enrolled at baseline; 64 (70%) patients completed all the study (N=64): 70% male and 52% right hemiparesis. Intervention Not applicable. Main Outcome Measures Participants were evaluated with the Participation Measurement Scale, ACTIVLIM-Stroke (activities of daily living [ADL]), Stroke Impairment Assessment Set, 6-minute walk test, Hospital Anxiety and Depression Scale, and the modified Rankin Scale. Results The significant predictors of social participation after controlling the confounders were the following: at 1 month ADL (0.4 [0.3, 0.6]) and depression (‒0.6 [‒0.8, ‒0.2]) with total model R2=0.44; at 3 months ADL (0.58 [0.4, 0.7]) and depression (‒0.58 [‒0.5, ‒0.7]) with total model R2=0.65; and at 6 months ADL (0.31 [0.2, 0.5]), impairments (‒0.82 [‒0.5, ‒0.7]), and depression (‒0.94 [‒0.8, ‒0.2]) with total model R2=0.78. Conclusions Using socioculturally tailored tools, the present study identified ADL performance (ACTIVLIM-Stroke), depression (Hospital Anxiety Depression Scale), and overall impairments (Stroke Impairment Assessment Set) as the significant determinants of social participation (Participation Measurement Scale) poststroke in Benin. These findings will be a valuable resource for rehabilitation stakeholders in evaluating interventions, programs, and policies designed to encourage social participation for stroke patients.
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[article] Determinants of Social Participation at 1, 3, and 6 Months Poststroke in Benin [Article] / Oyéné Kossi ; Félix Nindorera ; Thierry Adoukonou . - 2019 . - p. 2071-2078.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2071-2078

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Réadaptation
Résumé :	Objective To build a model of prediction of social participation of community-dwelling stroke survivors in Benin at 1 month, 3 months, and 6 months. Design An observational study with evaluations at 1 month, 3 months, and 6 months poststroke. Correlational analyses and multivariate linear regressions were performed. Setting Outpatient rehabilitation centers in Benin. Participants A volunteer sample of 91 stroke patients was enrolled at baseline; 64 (70%) patients completed all the study (N=64): 70% male and 52% right hemiparesis. Intervention Not applicable. Main Outcome Measures Participants were evaluated with the Participation Measurement Scale, ACTIVLIM-Stroke (activities of daily living [ADL]), Stroke Impairment Assessment Set, 6-minute walk test, Hospital Anxiety and Depression Scale, and the modified Rankin Scale. Results The significant predictors of social participation after controlling the confounders were the following: at 1 month ADL (0.4 [0.3, 0.6]) and depression (‒0.6 [‒0.8, ‒0.2]) with total model R2=0.44; at 3 months ADL (0.58 [0.4, 0.7]) and depression (‒0.58 [‒0.5, ‒0.7]) with total model R2=0.65; and at 6 months ADL (0.31 [0.2, 0.5]), impairments (‒0.82 [‒0.5, ‒0.7]), and depression (‒0.94 [‒0.8, ‒0.2]) with total model R2=0.78. Conclusions Using socioculturally tailored tools, the present study identified ADL performance (ACTIVLIM-Stroke), depression (Hospital Anxiety Depression Scale), and overall impairments (Stroke Impairment Assessment Set) as the significant determinants of social participation (Participation Measurement Scale) poststroke in Benin. These findings will be a valuable resource for rehabilitation stakeholders in evaluating interventions, programs, and policies designed to encourage social participation for stroke patients.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2079-2088

Titre :	Oxygen Cost During Mobility Tasks and Its Relationship to Fatigue in Progressive Multiple Sclerosis
Type de document :	Article
Auteurs :	Augustine J. Devasahayam ; Liam P. Kelly ; Elizabeth M. Wallack
Année de publication :	2019
Article en page(s) :	p. 2079-2088
Langues :	Américain (ame)
Descripteurs :	HE Vinci Activités de la vie quotidienne ; Consommation d'oxygène ; Déconditionnement cardiovasculaire ; Fatigue ; Réadaptation ; Sclerose en plaques
Résumé :	Objective To compare the oxygen costs of mobility tasks between individuals with progressive multiple sclerosis (MS) using walking aids and matched controls and to determine whether oxygen cost predicted fatigue. Design Cross-sectional descriptive. Setting A rehabilitation research laboratory. Participants A total of 14 adults with progressive MS (mean age ± SD [y], 54.07±8.46) using walking aids and 8 age- and sex-matched controls without MS (N=22). Interventions Participants performed 5 mobility tasks (rolling in bed, lying to sitting, sitting to standing, walking, climbing steps) wearing a portable metabolic cart. Main Outcome Measures Oxygen consumption ( o2) during mobility tasks, maximal o2 during graded maximal exercise test, perceived exertion, and task-induced fatigue were measured on a visual analog scale before and after mobility tasks. Results People with progressive MS had significantly higher oxygen cost in all tasks compared to controls (P<.05 climbing steps times more in ms rolling bed walking lying to sitting and standing there was a strong positive correlation between task-induced fatigue oxygen cost of p=".022).<br"> Conclusions People with progressive MS used 2.81 times more energy on average for mobility tasks compared to controls. People with progressive MS experienced accumulation of oxygen cost, fatigue, and exertion when repeating tasks and higher oxygen cost during walking was related to greater perception of fatigue. Our findings suggest that rehabilitation interventions that increase endurance during functional tasks could help reduce fatigue in people with progressive MS who use walking aids.
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[article] Oxygen Cost During Mobility Tasks and Its Relationship to Fatigue in Progressive Multiple Sclerosis [Article] / Augustine J. Devasahayam ; Liam P. Kelly ; Elizabeth M. Wallack . - 2019 . - p. 2079-2088.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2079-2088

Descripteurs :	HE Vinci Activités de la vie quotidienne ; Consommation d'oxygène ; Déconditionnement cardiovasculaire ; Fatigue ; Réadaptation ; Sclerose en plaques
Résumé :	Objective To compare the oxygen costs of mobility tasks between individuals with progressive multiple sclerosis (MS) using walking aids and matched controls and to determine whether oxygen cost predicted fatigue. Design Cross-sectional descriptive. Setting A rehabilitation research laboratory. Participants A total of 14 adults with progressive MS (mean age ± SD [y], 54.07±8.46) using walking aids and 8 age- and sex-matched controls without MS (N=22). Interventions Participants performed 5 mobility tasks (rolling in bed, lying to sitting, sitting to standing, walking, climbing steps) wearing a portable metabolic cart. Main Outcome Measures Oxygen consumption ( o2) during mobility tasks, maximal o2 during graded maximal exercise test, perceived exertion, and task-induced fatigue were measured on a visual analog scale before and after mobility tasks. Results People with progressive MS had significantly higher oxygen cost in all tasks compared to controls (P<.05 climbing steps times more in ms rolling bed walking lying to sitting and standing there was a strong positive correlation between task-induced fatigue oxygen cost of p=".022).<br"> Conclusions People with progressive MS used 2.81 times more energy on average for mobility tasks compared to controls. People with progressive MS experienced accumulation of oxygen cost, fatigue, and exertion when repeating tasks and higher oxygen cost during walking was related to greater perception of fatigue. Our findings suggest that rehabilitation interventions that increase endurance during functional tasks could help reduce fatigue in people with progressive MS who use walking aids.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2089-2095

Titre :	Association Between Performance on an Interdisciplinary Stroke Assessment Battery and Falls in Patients With Acute Stroke in an Inpatient Rehabilitation Facility: A Retrospective Cohort Study
Type de document :	Article
Auteurs :	Megan Eikenberry ; Kathleen J. Ganley ; Nan Zhang
Année de publication :	2019
Article en page(s) :	p. 2089-2095
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Chutes accidentelles ; Réadaptation
Résumé :	Objective To explore the association between demographic factors and functional performance measures of patients with acute stroke in an inpatient rehabilitation facility (IRF) and falls during the IRF stay and to quantify the diagnostic accuracy of functional outcome measures in identifying fallers. Design Retrospective cohort study. Setting Inpatient rehabilitation facility. Participants Individuals with acute stroke admitted to hospital-based IRF (N=139). Interventions Not applicable. Main Outcome Measures Odds ratios were used to examine the relationship between fall frequency and functional outcome measures (National Institute of Stroke Scale, neglect [Item #11], Berg Balance Scale, Stroke Rehabilitation Assessment of Movement mobility and Stroke Rehabilitation Assessment of Movement lower extremity subscales [STREAM-LE], Montreal Cognitive Assessment, Dynamic Gait Index, and Stroke Impact Scale). Receiver operator characteristic analysis with area under the curve, sensitivity, specificity, and diagnostic odds ratio were used to assess the diagnostic accuracy of each functional outcome measure to distinguish patients who fell vs those who did not fall in the IRF. Results A total of 23 patients (16.2%) fell during the IRF hospitalization. Patients who did and did not fall did not differ in terms of age, sex, stroke type, or stroke location. Only the STREAM-LE was associated with falls (odds ratio, 0.93; 95% CI, 0.86-0.99). Area under the curve was 0.67 (95% CI, 0.51-0.82). With a positivity cutoff point of 12, sensitivity and specificity were 73.3% (95% CI, 54.6%-92.2%) and 50.0% (95% CI, 39.9%-59.2%), respectively. The diagnostic odds ratio was 3.4. Conclusions The STREAM-LE score at admission to IRF may identify patients with acute stroke who are more likely to fall during their stay. However, the search for measures with greater diagnostic accuracy should continue.
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[article] Association Between Performance on an Interdisciplinary Stroke Assessment Battery and Falls in Patients With Acute Stroke in an Inpatient Rehabilitation Facility: A Retrospective Cohort Study [Article] / Megan Eikenberry ; Kathleen J. Ganley ; Nan Zhang . - 2019 . - p. 2089-2095.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2089-2095

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Chutes accidentelles ; Réadaptation
Résumé :	Objective To explore the association between demographic factors and functional performance measures of patients with acute stroke in an inpatient rehabilitation facility (IRF) and falls during the IRF stay and to quantify the diagnostic accuracy of functional outcome measures in identifying fallers. Design Retrospective cohort study. Setting Inpatient rehabilitation facility. Participants Individuals with acute stroke admitted to hospital-based IRF (N=139). Interventions Not applicable. Main Outcome Measures Odds ratios were used to examine the relationship between fall frequency and functional outcome measures (National Institute of Stroke Scale, neglect [Item #11], Berg Balance Scale, Stroke Rehabilitation Assessment of Movement mobility and Stroke Rehabilitation Assessment of Movement lower extremity subscales [STREAM-LE], Montreal Cognitive Assessment, Dynamic Gait Index, and Stroke Impact Scale). Receiver operator characteristic analysis with area under the curve, sensitivity, specificity, and diagnostic odds ratio were used to assess the diagnostic accuracy of each functional outcome measure to distinguish patients who fell vs those who did not fall in the IRF. Results A total of 23 patients (16.2%) fell during the IRF hospitalization. Patients who did and did not fall did not differ in terms of age, sex, stroke type, or stroke location. Only the STREAM-LE was associated with falls (odds ratio, 0.93; 95% CI, 0.86-0.99). Area under the curve was 0.67 (95% CI, 0.51-0.82). With a positivity cutoff point of 12, sensitivity and specificity were 73.3% (95% CI, 54.6%-92.2%) and 50.0% (95% CI, 39.9%-59.2%), respectively. The diagnostic odds ratio was 3.4. Conclusions The STREAM-LE score at admission to IRF may identify patients with acute stroke who are more likely to fall during their stay. However, the search for measures with greater diagnostic accuracy should continue.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2096-2105

Titre :	Comparing Participation Outcome Over Time Across International Stroke Cohorts: Outcomes and Methods
Type de document :	Article
Auteurs :	Daan Verberne ; Tamara Tse ; Thomas Matyas
Année de publication :	2019
Article en page(s) :	p. 2096-2105
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Comparaison interculturelle ; Etude comparative ; Etudes de faisabilité ; Participation sociale ; Réadaptation
Résumé :	Objective To enable a direct comparison of participation levels in the first year post-stroke, assessed by different outcome measures internationally. Design Two prospective stroke cohort studies following persons from stroke onset to 12 months post-stroke. Setting Community. Participants Persons with stroke (N=495), not living at a nursing home, from Australia STroke imAging pRevention and Treatment-Prediction and Prevention to Achieve optimal Recovery Endpoints after stroke (START-PrePARE; n=100) and the Netherlands (Restore4stroke; n=395). Interventions Not applicable. Main Outcome Measures Activity Card Sort-Australia and Utrecht Scale for Evaluation of Rehabilitation-Participation. Activity domains were matched across measures to find common denominators and original scoring methods were recoded, hereby enabling a direct comparison of retained activities. Results Ninety-one (START-PrePARE) and 218 (Restore4stroke) persons with stroke were included for analyses. No major differences in background characteristics were observed between the cohorts; the Dutch cohort suffered from slightly more severe stroke. A higher level of participation was observed (radar charts) in the first months post-stroke for the Australian cohort than in the Dutch cohort, especially for unpaid work (P<.003 at months post-stroke participation levels were similar without significant differences in retained activities using the defined common denominators>.003). Conclusions An international comparison of actual activities that persons re-engage in in the first year post-stroke was achieved using a new method and recoding of data. High levels of participation were observed in both cohorts. Unpaid work showed different frequencies at 2-3 months, contributing to different trajectories over time across cultures. Important insights were gained. Although valuable information is inevitably lost with recoding, the approach may assist future studies on the harmonization of data across cohorts, particularly for 1 of the key outcomes of stroke: participation.
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[article] Comparing Participation Outcome Over Time Across International Stroke Cohorts: Outcomes and Methods [Article] / Daan Verberne ; Tamara Tse ; Thomas Matyas . - 2019 . - p. 2096-2105.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2096-2105

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Comparaison interculturelle ; Etude comparative ; Etudes de faisabilité ; Participation sociale ; Réadaptation
Résumé :	Objective To enable a direct comparison of participation levels in the first year post-stroke, assessed by different outcome measures internationally. Design Two prospective stroke cohort studies following persons from stroke onset to 12 months post-stroke. Setting Community. Participants Persons with stroke (N=495), not living at a nursing home, from Australia STroke imAging pRevention and Treatment-Prediction and Prevention to Achieve optimal Recovery Endpoints after stroke (START-PrePARE; n=100) and the Netherlands (Restore4stroke; n=395). Interventions Not applicable. Main Outcome Measures Activity Card Sort-Australia and Utrecht Scale for Evaluation of Rehabilitation-Participation. Activity domains were matched across measures to find common denominators and original scoring methods were recoded, hereby enabling a direct comparison of retained activities. Results Ninety-one (START-PrePARE) and 218 (Restore4stroke) persons with stroke were included for analyses. No major differences in background characteristics were observed between the cohorts; the Dutch cohort suffered from slightly more severe stroke. A higher level of participation was observed (radar charts) in the first months post-stroke for the Australian cohort than in the Dutch cohort, especially for unpaid work (P<.003 at months post-stroke participation levels were similar without significant differences in retained activities using the defined common denominators>.003). Conclusions An international comparison of actual activities that persons re-engage in in the first year post-stroke was achieved using a new method and recoding of data. High levels of participation were observed in both cohorts. Unpaid work showed different frequencies at 2-3 months, contributing to different trajectories over time across cultures. Important insights were gained. Although valuable information is inevitably lost with recoding, the approach may assist future studies on the harmonization of data across cohorts, particularly for 1 of the key outcomes of stroke: participation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2106-2112

Titre :	Predicting Mobility Limitations in Patients With Total Knee Arthroplasty in the Inpatient Setting
Type de document :	Article
Auteurs :	Eleanor Shu-Xian Chew ; Seng-Jin Yeo ; Terry Haines
Année de publication :	2019
Article en page(s) :	p. 2106-2112
Langues :	Américain (ame)
Descripteurs :	HE Vinci Arthroplastie prothétique de genou ; Genou ; Modèles statistiques ; Pronostic ; Réadaptation ; Risque
Résumé :	Objective To develop a prediction model for postoperative day 3 mobility limitations in patients undergoing total knee arthroplasty (TKA). Design Prospective cohort study. Setting Inpatients in a tertiary care hospital. Participants A sample of patients (N=2300) who underwent primary TKA in 2016-2017. Interventions Not applicable. Main Outcome Measure Candidate predictors included demographic variables and preoperative clinical and psychosocial measures. The outcome of interest was mobility limitations on post-TKA day 3, and this was determined a priori by an ordinal mobility outcome hierarchy based on the type of the gait aids prescribed and the level of physiotherapist assistance provided. To develop the model, we fitted a multivariable proportional odds regression model with bootstrap internal validation. We used a model approximation approach to create a simplified model that approximated predictions from the full model with 95% accuracy. Results On post-TKA day 3, 11% of patients required both walkers and therapist assistance to ambulate safely. Our prediction model had a concordance index of 0.72 (95% confidence interval, 0.68-0.75) when evaluating these patients. In the simplified model, predictors of greater mobility limitations included older age, greater walking aid support required preoperatively, less preoperative knee flexion range of movement, low-volume surgeon, contralateral knee pain, higher body mass index, non-Chinese race, and greater self-reported walking limitations preoperatively. Conclusion We have developed a prediction model to identify patients who are at risk for mobility limitations in the inpatient setting. When used preoperatively as part of a shared-decision making process, it can potentially influence rehabilitation strategies and facilitate discharge planning.
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[article] Predicting Mobility Limitations in Patients With Total Knee Arthroplasty in the Inpatient Setting [Article] / Eleanor Shu-Xian Chew ; Seng-Jin Yeo ; Terry Haines . - 2019 . - p. 2106-2112.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2106-2112

Descripteurs :	HE Vinci Arthroplastie prothétique de genou ; Genou ; Modèles statistiques ; Pronostic ; Réadaptation ; Risque
Résumé :	Objective To develop a prediction model for postoperative day 3 mobility limitations in patients undergoing total knee arthroplasty (TKA). Design Prospective cohort study. Setting Inpatients in a tertiary care hospital. Participants A sample of patients (N=2300) who underwent primary TKA in 2016-2017. Interventions Not applicable. Main Outcome Measure Candidate predictors included demographic variables and preoperative clinical and psychosocial measures. The outcome of interest was mobility limitations on post-TKA day 3, and this was determined a priori by an ordinal mobility outcome hierarchy based on the type of the gait aids prescribed and the level of physiotherapist assistance provided. To develop the model, we fitted a multivariable proportional odds regression model with bootstrap internal validation. We used a model approximation approach to create a simplified model that approximated predictions from the full model with 95% accuracy. Results On post-TKA day 3, 11% of patients required both walkers and therapist assistance to ambulate safely. Our prediction model had a concordance index of 0.72 (95% confidence interval, 0.68-0.75) when evaluating these patients. In the simplified model, predictors of greater mobility limitations included older age, greater walking aid support required preoperatively, less preoperative knee flexion range of movement, low-volume surgeon, contralateral knee pain, higher body mass index, non-Chinese race, and greater self-reported walking limitations preoperatively. Conclusion We have developed a prediction model to identify patients who are at risk for mobility limitations in the inpatient setting. When used preoperatively as part of a shared-decision making process, it can potentially influence rehabilitation strategies and facilitate discharge planning.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2113-2118

Titre :	Prospectively Classifying Community Walkers After Stroke: Who Are They?
Type de document :	Article
Auteurs :	Marijn Mulder ; Rinske H. Nijland ; Ingrid G. van de Port
Année de publication :	2019
Article en page(s) :	p. 2113-2118
Langues :	Américain (ame)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Classification ; Démarche ; Enquêtes et questionnaires ; Marche à pied ; Mobilité
Résumé :	Objective To classify patients with stroke into subgroups based on their characteristics at the moment of discharge from inpatient rehabilitation in order to predict community ambulation outcome 6 months later. Design Prospective cohort study with a baseline measurement at discharge from inpatient care and final outcome determined after 6 months. Setting Community. Participants A cohort of patients (N=243) with stroke, referred for outpatient physical therapy, after completing inpatient rehabilitation in The Netherlands. Interventions Not applicable. Main Outcome Measures A classification model was developed using Classification And Regression Tree (CART) analysis. Final outcome was determined using the community ambulation questionnaire. Potential baseline predictors included patient demographics, stroke characteristics, use of assistive devices, comfortable gait speed, balance, strength, motivation, falls efficacy, anxiety, and depression. Results The CART model accurately predicted independent community ambulation in 181 of 193 patients with stroke, based on a comfortable gait speed at discharge of 0.5 meters per second or faster. In contrast, 27 of 50 patients with gait speeds below 0.5 meters per second were correctly predicted to become noncommunity walkers. Conclusions We show that comfortable gait speed is a key factor in the prognosis of community ambulation outcome. The CART model may support clinicians in organizing community services at the moment of discharge from inpatient care.
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[article] Prospectively Classifying Community Walkers After Stroke: Who Are They? [Article] / Marijn Mulder ; Rinske H. Nijland ; Ingrid G. van de Port . - 2019 . - p. 2113-2118.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2113-2118

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Classification ; Démarche ; Enquêtes et questionnaires ; Marche à pied ; Mobilité
Résumé :	Objective To classify patients with stroke into subgroups based on their characteristics at the moment of discharge from inpatient rehabilitation in order to predict community ambulation outcome 6 months later. Design Prospective cohort study with a baseline measurement at discharge from inpatient care and final outcome determined after 6 months. Setting Community. Participants A cohort of patients (N=243) with stroke, referred for outpatient physical therapy, after completing inpatient rehabilitation in The Netherlands. Interventions Not applicable. Main Outcome Measures A classification model was developed using Classification And Regression Tree (CART) analysis. Final outcome was determined using the community ambulation questionnaire. Potential baseline predictors included patient demographics, stroke characteristics, use of assistive devices, comfortable gait speed, balance, strength, motivation, falls efficacy, anxiety, and depression. Results The CART model accurately predicted independent community ambulation in 181 of 193 patients with stroke, based on a comfortable gait speed at discharge of 0.5 meters per second or faster. In contrast, 27 of 50 patients with gait speeds below 0.5 meters per second were correctly predicted to become noncommunity walkers. Conclusions We show that comfortable gait speed is a key factor in the prognosis of community ambulation outcome. The CART model may support clinicians in organizing community services at the moment of discharge from inpatient care.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2119-2128

Titre :	Ultrasound-Guided Standard vs Dual-Target Subacromial Corticosteroid Injections for Shoulder Impingement Syndrome: A Randomized Controlled Trial
Type de document :	Article
Auteurs :	Jia-Chi Wang ; Ke-Vin Chang ; Wei-Ting Wu
Année de publication :	2019
Article en page(s) :	p. 2119-2128
Langues :	Américain (ame)
Descripteurs :	HE Vinci Douleur ; Echographie ; Epaule ; Réadaptation
Résumé :	Objective To compare dual-target injection with standard ultrasound (US)-guided subacromial injection in patients with subacromial impingement syndrome (SIS) and possible disorders of the biceps long-head tendons. Design Double-blind, randomized controlled trial. Setting Rehabilitation outpatient clinic. Participants Patients with SIS (N=60). Intervention (1) US-guided standard subacromial bursa; (2) dual-target (subacromial bursa plus proximal biceps long-head tendon) injection, with 40-mg triamcinolone acetonide administered to patients in each group. Main Outcome Measures Clinical assessments were performed at baseline. The outcomes, including results from a self-administered questionnaire, the Shoulder Pain and Disability Index (SPADI), and a self-pain report, the visual analog scale (VAS) scores for pain at rest, at night, and during overhead activities, were evaluated at baseline and at the first and third months postintervention. Results No significant difference was observed in baseline evaluations between groups (n=30 in each treatment arm) prior to injections. Both groups exhibited significant SPADI and VAS-score improvements after the first month. The dual-target injection group had less rebounding pain at the 3-month follow-up. The standard injection group had more patients reporting worsening pain within 1 day postinjection. Conclusion US-guided dual-target corticosteroid injection showed similar short-term efficacy to standard subacromial injections, but with an extended duration of symptom relief. Therefore, dual-target corticosteroid injections may be useful for shoulder pain treatment in patients with SIS.
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[article] Ultrasound-Guided Standard vs Dual-Target Subacromial Corticosteroid Injections for Shoulder Impingement Syndrome: A Randomized Controlled Trial [Article] / Jia-Chi Wang ; Ke-Vin Chang ; Wei-Ting Wu . - 2019 . - p. 2119-2128.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2119-2128

Descripteurs :	HE Vinci Douleur ; Echographie ; Epaule ; Réadaptation
Résumé :	Objective To compare dual-target injection with standard ultrasound (US)-guided subacromial injection in patients with subacromial impingement syndrome (SIS) and possible disorders of the biceps long-head tendons. Design Double-blind, randomized controlled trial. Setting Rehabilitation outpatient clinic. Participants Patients with SIS (N=60). Intervention (1) US-guided standard subacromial bursa; (2) dual-target (subacromial bursa plus proximal biceps long-head tendon) injection, with 40-mg triamcinolone acetonide administered to patients in each group. Main Outcome Measures Clinical assessments were performed at baseline. The outcomes, including results from a self-administered questionnaire, the Shoulder Pain and Disability Index (SPADI), and a self-pain report, the visual analog scale (VAS) scores for pain at rest, at night, and during overhead activities, were evaluated at baseline and at the first and third months postintervention. Results No significant difference was observed in baseline evaluations between groups (n=30 in each treatment arm) prior to injections. Both groups exhibited significant SPADI and VAS-score improvements after the first month. The dual-target injection group had less rebounding pain at the 3-month follow-up. The standard injection group had more patients reporting worsening pain within 1 day postinjection. Conclusion US-guided dual-target corticosteroid injection showed similar short-term efficacy to standard subacromial injections, but with an extended duration of symptom relief. Therefore, dual-target corticosteroid injections may be useful for shoulder pain treatment in patients with SIS.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2129-2135

Titre :	Cognition Predicts Mobility Change in Lower Extremity Amputees Between Discharge From Rehabilitation and 4-Month Follow-up: A Prospective Cohort Study
Type de document :	Article
Auteurs :	Susan W. Hunter ; Pavlos Bobos ; Courtney Frengopoulos
Année de publication :	2019
Article en page(s) :	p. 2129-2135
Langues :	Américain (ame)
Descripteurs :	HE Vinci Amputation chirurgicale ; Cognition ; Évaluation de résultat (soins) ; Réadaptation
Résumé :	Objectives To assess (1) the effect of task (single and dual task), time (discharge and 4mo), and their interaction for mobility; (2) task prioritization during dual-task testing; and (3) the association between cognition on change in mobility between discharge from rehabilitation and 4 months’ follow-up. Design Prospective cohort study. Setting Rehabilitation hospital. Participants People with lower extremity amputations (N=22) were consecutively recruited at discharge from an inpatient prosthetic rehabilitation program. Interventions Not applicable. Main Outcome Measures Gait velocity and the L Test of Functional Mobility, single and dual task (serial subtractions by 3), were the primary outcomes. Montreal Cognitive Assessment and Trail Making Test quantified cognition as secondary outcomes. Repeated measures analysis of variance evaluated the effects of task (single task and dual task) and time (at discharge and 4 months’ follow-up) and their interaction on each outcome. A performance-resource operating characteristic graph evaluated gait and cognitive task prioritization. Multivariable linear regression evaluated the association between cognition and change in mobility over time. Results No significant interactions between task and time were found (all P>.121) for L Test and gait velocity. The L Test single task (P=.001) and dual task (P=.004) improved over time. Gait velocity improved over time for both single task and dual task (P<.001 dual-task performance was slower than single-task performances at each time point. the trail making test b independently associated with change in l and gait velocity follow-up.> Conclusions Gait velocity and L Test single and dual task improved over time. No significant interactions indicated that cognitive task did not differentially affect performance over time. Lower executive function scores at discharge were independently associated with lower gains in all gait velocity and dual-task L Test outcomes at follow-up.
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[article] Cognition Predicts Mobility Change in Lower Extremity Amputees Between Discharge From Rehabilitation and 4-Month Follow-up: A Prospective Cohort Study [Article] / Susan W. Hunter ; Pavlos Bobos ; Courtney Frengopoulos . - 2019 . - p. 2129-2135.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2129-2135

Descripteurs :	HE Vinci Amputation chirurgicale ; Cognition ; Évaluation de résultat (soins) ; Réadaptation
Résumé :	Objectives To assess (1) the effect of task (single and dual task), time (discharge and 4mo), and their interaction for mobility; (2) task prioritization during dual-task testing; and (3) the association between cognition on change in mobility between discharge from rehabilitation and 4 months’ follow-up. Design Prospective cohort study. Setting Rehabilitation hospital. Participants People with lower extremity amputations (N=22) were consecutively recruited at discharge from an inpatient prosthetic rehabilitation program. Interventions Not applicable. Main Outcome Measures Gait velocity and the L Test of Functional Mobility, single and dual task (serial subtractions by 3), were the primary outcomes. Montreal Cognitive Assessment and Trail Making Test quantified cognition as secondary outcomes. Repeated measures analysis of variance evaluated the effects of task (single task and dual task) and time (at discharge and 4 months’ follow-up) and their interaction on each outcome. A performance-resource operating characteristic graph evaluated gait and cognitive task prioritization. Multivariable linear regression evaluated the association between cognition and change in mobility over time. Results No significant interactions between task and time were found (all P>.121) for L Test and gait velocity. The L Test single task (P=.001) and dual task (P=.004) improved over time. Gait velocity improved over time for both single task and dual task (P<.001 dual-task performance was slower than single-task performances at each time point. the trail making test b independently associated with change in l and gait velocity follow-up.> Conclusions Gait velocity and L Test single and dual task improved over time. No significant interactions indicated that cognitive task did not differentially affect performance over time. Lower executive function scores at discharge were independently associated with lower gains in all gait velocity and dual-task L Test outcomes at follow-up.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2136-2143

Titre :	Effect of Psychomotricity in Combination With 3 Months of Active Shoulder Exercises in Individuals With Chronic Shoulder Pain: Primary Results From an Investigator-Blinded, Randomized, Controlled Trial
Type de document :	Article
Auteurs :	Ingwersen Kim Gordon ; Jette Wessel Vobbe ; Pedersen Lise Lang
Année de publication :	2019
Article en page(s) :	p. 2136-2143
Langues :	Américain (ame)
Descripteurs :	HE Vinci Douleur ; Epaule ; Exercice physique ; Réadaptation
Résumé :	Objective To evaluate whether psychomotor therapy (PMT) in combination with usual care active exercise (AE) rehabilitation for the shoulder is superior to merely AE. Design The trial was a single-center, stratified (by corticosteroid injection [yes or no]), randomized, and controlled superiority trial. Setting Shoulder unit of the orthopedic department at Hospital Lillebaelt, Vejle Hospital. Participants Eligible participants (N=87) were adults aged 18-75 years with shoulder complaints lasting for at least 3 months, in addition to a score equal to or below 3 on the Multidimensional Assessment of Interoceptive Awareness score. Furthermore, patients had at least a visual analog scale pain score of 2 at rest, 3 at night, and 5 in activity (range: 0-10). Interventions Patients were randomized to 12 weeks of AE (control group) or in combination with 5 PMT sessions (intervention group). Main Outcome Measure The primary outcome was the patient-reported outcome score Disability of the Arm, Shoulder and Hand questionnaire. The primary endpoint was 12 weeks after baseline. Results There was no between-group difference in function between the intervention group and control group. Conclusions Our results showed no additional benefit on patient-reported function and pain from PMT over usual care in patients with long-lasting shoulder pain and low body awareness. This finding suggests that PMT adds no additional benefit to patients’ recovery in relation to pain and active function in comparison to standard care.
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[article] Effect of Psychomotricity in Combination With 3 Months of Active Shoulder Exercises in Individuals With Chronic Shoulder Pain: Primary Results From an Investigator-Blinded, Randomized, Controlled Trial [Article] / Ingwersen Kim Gordon ; Jette Wessel Vobbe ; Pedersen Lise Lang . - 2019 . - p. 2136-2143.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2136-2143

Descripteurs :	HE Vinci Douleur ; Epaule ; Exercice physique ; Réadaptation
Résumé :	Objective To evaluate whether psychomotor therapy (PMT) in combination with usual care active exercise (AE) rehabilitation for the shoulder is superior to merely AE. Design The trial was a single-center, stratified (by corticosteroid injection [yes or no]), randomized, and controlled superiority trial. Setting Shoulder unit of the orthopedic department at Hospital Lillebaelt, Vejle Hospital. Participants Eligible participants (N=87) were adults aged 18-75 years with shoulder complaints lasting for at least 3 months, in addition to a score equal to or below 3 on the Multidimensional Assessment of Interoceptive Awareness score. Furthermore, patients had at least a visual analog scale pain score of 2 at rest, 3 at night, and 5 in activity (range: 0-10). Interventions Patients were randomized to 12 weeks of AE (control group) or in combination with 5 PMT sessions (intervention group). Main Outcome Measure The primary outcome was the patient-reported outcome score Disability of the Arm, Shoulder and Hand questionnaire. The primary endpoint was 12 weeks after baseline. Results There was no between-group difference in function between the intervention group and control group. Conclusions Our results showed no additional benefit on patient-reported function and pain from PMT over usual care in patients with long-lasting shoulder pain and low body awareness. This finding suggests that PMT adds no additional benefit to patients’ recovery in relation to pain and active function in comparison to standard care.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2144-2150

Titre :	Caregiver Strategy Use to Promote Children's Home Participation After Pediatric Critical Illness
Type de document :	Article
Auteurs :	Jessica M. Jarvis ; Andrea R. Gurga ; Heather Lim
Année de publication :	2019
Article en page(s) :	p. 2144-2150
Langues :	Américain (ame)
Descripteurs :	HE Vinci Aidants ; Participation des patients ; Pédiatrie ; Réadaptation ; Soins de réanimation
Résumé :	Objectives The primary objectives are to assess the most common type of caregiver strategy (remedial vs compensatory) reported for supporting their child’s home participation after critical illness and identify themes in compensatory strategies described, with a secondary objective to describe themes in strategy use as reported by caregivers of children who did and did not receive pediatric intensive care unit (PICU) rehabilitation services. Design Qualitative substudy of the Wee-Cover prospective cohort study. Setting Two PICU sites. Participants Wee-Cover enrolled caregivers (N=180) of children 1-17 years of age, who were admitted to a PICU for ≥48 hours. This study excluded participants missing relevant data (n=12). Intervention Not applicable. Main Outcome Measures Qualitative data were gathered from open-ended questions on strategies within the Participation and Environment Measure at PICU discharge and 3 and 6 months post-PICU discharge. Strategies were classified as remedial or compensatory pending their content fit with 1 of 5 environmental chapters in the International Classification of Functioning, Disability, and Health–Children and Youth Version. Data on PICU-based rehabilitation services were obtained prospectively from electronic medical records and dichotomized (yes or no). Results Most caregiver strategies were compensatory, with more than half (60%) of the strategies pertaining to fostering supportive relationships. In contrast, strategies addressing the child’s natural environment (12%), services (3%), and attitudes of others in the home (1%) were least commonly described. Similar themes were identified for caregivers whose children did and did not receive PICU rehabilitation services. Conclusions Caregivers identify a range of strategies to facilitate their child’s participation in home activities post-PICU discharge, but primarily report on strategies for addressing supports and relationships in the child’s home environment. Results highlight areas warranting caregiver education to support the child’s participation after critical illness.
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[article] Caregiver Strategy Use to Promote Children's Home Participation After Pediatric Critical Illness [Article] / Jessica M. Jarvis ; Andrea R. Gurga ; Heather Lim . - 2019 . - p. 2144-2150.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2144-2150

Descripteurs :	HE Vinci Aidants ; Participation des patients ; Pédiatrie ; Réadaptation ; Soins de réanimation
Résumé :	Objectives The primary objectives are to assess the most common type of caregiver strategy (remedial vs compensatory) reported for supporting their child’s home participation after critical illness and identify themes in compensatory strategies described, with a secondary objective to describe themes in strategy use as reported by caregivers of children who did and did not receive pediatric intensive care unit (PICU) rehabilitation services. Design Qualitative substudy of the Wee-Cover prospective cohort study. Setting Two PICU sites. Participants Wee-Cover enrolled caregivers (N=180) of children 1-17 years of age, who were admitted to a PICU for ≥48 hours. This study excluded participants missing relevant data (n=12). Intervention Not applicable. Main Outcome Measures Qualitative data were gathered from open-ended questions on strategies within the Participation and Environment Measure at PICU discharge and 3 and 6 months post-PICU discharge. Strategies were classified as remedial or compensatory pending their content fit with 1 of 5 environmental chapters in the International Classification of Functioning, Disability, and Health–Children and Youth Version. Data on PICU-based rehabilitation services were obtained prospectively from electronic medical records and dichotomized (yes or no). Results Most caregiver strategies were compensatory, with more than half (60%) of the strategies pertaining to fostering supportive relationships. In contrast, strategies addressing the child’s natural environment (12%), services (3%), and attitudes of others in the home (1%) were least commonly described. Similar themes were identified for caregivers whose children did and did not receive PICU rehabilitation services. Conclusions Caregivers identify a range of strategies to facilitate their child’s participation in home activities post-PICU discharge, but primarily report on strategies for addressing supports and relationships in the child’s home environment. Results highlight areas warranting caregiver education to support the child’s participation after critical illness.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2151-2158

Titre :	Intradialytic Resistance Training Improves Functional Capacity and Lean Mass Gain in Individuals on Hemodialysis: A Randomized Pilot Trial
Type de document :	Article
Auteurs :	Lorena Cristina Curado Lopes ; João Felipe Mota ; Jonato Prestes
Année de publication :	2019
Article en page(s) :	p. 2151-2158
Langues :	Américain (ame)
Descripteurs :	HE Vinci Dialyse rénale ; Entraînement en résistance ; Qualité de vie ; Réadaptation ; Sarcopenie
Résumé :	Objective To compare the effects of high vs moderate loads of intradialytic resistance training (RT) on body composition, sarcopenia prevalence, functional capacity, inflammatory markers, and quality of life (QoL) in individuals on hemodialysis. Design A pilot randomized clinical trial. Setting Two hemodialysis centers. Participants Individuals on hemodialysis (N=80; 51% men, aged 30-75y) in treatment for at least 3 months, adequately dialyzed (Kt/V≥1.2, where K is dialyzer clearance in mL/min, t is time, and V is volume of water) with vascular access via arteriovenous fistula. Interventions The 12 weeks of intradialytic RT was performed 3 times per week. The training groups were: high-load intradialytic group (HLG, 8-10 repetitions), moderate-load intradialytic group (MLG, 16-18 repetitions), and control group (CG, stretching exercise). The total training volume was equalized among training groups. Main Outcome Measures Lean leg mass was assessed by a dual-energy x-ray absorptiometry; functional capacity was assessed by Short Physical Performance Battery and Timed Up and Go test; and QoL was assessed by Kidney Disease QoL Instrument, inflammatory markers, and sarcopenia. Results After the training period, the HLG increased lean leg mass compared with the CG. The HLG also displayed improvements in the pain and physical function domains. The skeletal muscle index and functional capacity increased in both RT protocols. The prevalence of sarcopenia was reduced 14.3% and 25% in the MLG and HLG, respectively, while there was an increase of 10% in the CG. No differences were observed in cytokines after intervention. Conclusions High-load intradialytic RT was associated with gains in lean leg mass and QoL while functional capacity, appendicular muscle mass, and sarcopenia status were improved regardless of the RT load.
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[article] Intradialytic Resistance Training Improves Functional Capacity and Lean Mass Gain in Individuals on Hemodialysis: A Randomized Pilot Trial [Article] / Lorena Cristina Curado Lopes ; João Felipe Mota ; Jonato Prestes . - 2019 . - p. 2151-2158.
Langues : Américain (ame)
in Archives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2151-2158

Descripteurs :	HE Vinci Dialyse rénale ; Entraînement en résistance ; Qualité de vie ; Réadaptation ; Sarcopenie
Résumé :	Objective To compare the effects of high vs moderate loads of intradialytic resistance training (RT) on body composition, sarcopenia prevalence, functional capacity, inflammatory markers, and quality of life (QoL) in individuals on hemodialysis. Design A pilot randomized clinical trial. Setting Two hemodialysis centers. Participants Individuals on hemodialysis (N=80; 51% men, aged 30-75y) in treatment for at least 3 months, adequately dialyzed (Kt/V≥1.2, where K is dialyzer clearance in mL/min, t is time, and V is volume of water) with vascular access via arteriovenous fistula. Interventions The 12 weeks of intradialytic RT was performed 3 times per week. The training groups were: high-load intradialytic group (HLG, 8-10 repetitions), moderate-load intradialytic group (MLG, 16-18 repetitions), and control group (CG, stretching exercise). The total training volume was equalized among training groups. Main Outcome Measures Lean leg mass was assessed by a dual-energy x-ray absorptiometry; functional capacity was assessed by Short Physical Performance Battery and Timed Up and Go test; and QoL was assessed by Kidney Disease QoL Instrument, inflammatory markers, and sarcopenia. Results After the training period, the HLG increased lean leg mass compared with the CG. The HLG also displayed improvements in the pain and physical function domains. The skeletal muscle index and functional capacity increased in both RT protocols. The prevalence of sarcopenia was reduced 14.3% and 25% in the MLG and HLG, respectively, while there was an increase of 10% in the CG. No differences were observed in cytokines after intervention. Conclusions High-load intradialytic RT was associated with gains in lean leg mass and QoL while functional capacity, appendicular muscle mass, and sarcopenia status were improved regardless of the RT load.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 100, n° 11 (2019) . - p. 2159-2166

Titre :	Effect of an mHealth Wheelchair Skills Training Program for Older Adults: A Feasibility Randomized Controlled Trial
Type de document :	Article
Auteurs :	Edward M. Giesbrecht ; William C. Miller
Année de publication :	2019
Article en page(s) :	p. 2159-2166
Langues :	Américain (ame)
Descripteurs :	HE Vinci Fauteuils roulants ; Réadaptation ; Sujet âgé ; Télémédecine ; Téléréadaptation
Résumé :	Objective To evaluate the effect of an mHealth wheelchair skills training program on clinical outcomes among older adult manual wheelchair users. Design 2×2 factorial randomized controlled trial. Setting Community setting in 2 Canadian cities. Participants Convenience sample of manual wheelchair users 50 years and older living in the community who were able to self-propel with both hands and communicate in English. Participants (N=18) were randomized into either a mHealth treatment (n=10) or tablet gaming control (n=8) group. Interventions All participants received 2 in-person sessions with their trainer and engaged in a 4-week monitored home training program with a computer tablet. The Enhancing Participation In the Community by improving Wheelchair Skills program provided wheelchair skills training; the control program included 9 dexterity and cognitive training games. Main Outcome Measures The primary outcome was wheelchair skill capacity. Secondary outcomes included safety, self-efficacy, activity participation, mobility, divided-attention, and health-related quality of life. Results Data collection was blinded to group allocation. Capacity improved by 2 skills but with no statistically significant between-group difference. The mHealth training program had a significant effect on participation (P=.03) and self-efficacy (P=.06) with large effect sizes (ηp2=0.22-0.29). Mobility, safety with skill performance, and divided attention measures demonstrated medium effect size changes, but only safety with skill performance was statistically significant. The program was more beneficial for participants with Conclusion Enhancing Participation In the Community by improving Wheelchair Skills participants demonstrated good program adherence and clinical benefits were evident in community participation and wheelchair self-efficacy. Wheelchair safety and mobility were positively affected, while skill capacity showed a small, nonsignificant improvement. Future study should investigate benefit retention over time.
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