[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 11 (2020) . - p. 1849-1856

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Titre :	Longitudinal Monitoring of Pain Associated Distress With the Optimal Screening for Prediction of Referral and Outcome Yellow Flag Tool: Predicting Reduction in Pain Intensity and Disability
Type de document :	Article
Auteurs :	Steven Z George ; Cai Li ; Sheng Luo ; Maggie E. Horn ; Trevor A. Lentz
Année de publication :	2020
Article en page(s) :	p. 1763-1770
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.025
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Douleur chronique ; Pronostic ; Réadaptation
Résumé :	Objective To investigate the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool for longitudinal monitoring of pain associated distress with the goal of improving prediction of 50% reduction in pain intensity and disability outcomes. Design Cohort study with 12-month follow-up after initial care episode. Setting Ambulatory care, participants seeking care from outpatient physical therapy clinics. Participants Participants (N=440) were seeking care for primary complaint of neck, low back, knee, or shoulder pain. This secondary analysis included 440 subjects (62.5% female; mean age, 45.1±17y) at baseline with n=279 (63.4%) providing follow-up data at 12 months. Interventions Not applicable. Main Outcome Measures A 50% reduction (baseline to 12-mo follow-up) in pain intensity and self-reported disability. Results Trends for prediction accuracy were similar for all versions of the OSPRO-YF. For predicting 50% reduction in pain intensity, model fit met the statistical criterion for improvement (P<.05 with each additional time point added from baseline. model discrimination improved statistically when the to change was under curve="0.849," p=".003)." for predicting reduction in disability there no evidence of improvement fit or baseline addition changes>.05). Conclusions These results suggested that longitudinal monitoring improved prediction accuracy for reduction in pain intensity but not for disability reduction. Differences in OSPRO-YF item sets (10 vs 17 items) or scoring methods (simple summary score vs yellow flag count) did not affect predictive accuracy for pain intensity, providing flexibility for implementing this tool in practice settings.
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[article] Longitudinal Monitoring of Pain Associated Distress With the Optimal Screening for Prediction of Referral and Outcome Yellow Flag Tool: Predicting Reduction in Pain Intensity and Disability [Article] / Steven Z George ; Cai Li ; Sheng Luo ; Maggie E. Horn ; Trevor A. Lentz . - 2020 . - p. 1763-1770.
https://doi.org/10.1016/j.apmr.2020.05.025
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1763-1770

Descripteurs :	HE Vinci Douleur chronique ; Pronostic ; Réadaptation
Résumé :	Objective To investigate the Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO-YF) tool for longitudinal monitoring of pain associated distress with the goal of improving prediction of 50% reduction in pain intensity and disability outcomes. Design Cohort study with 12-month follow-up after initial care episode. Setting Ambulatory care, participants seeking care from outpatient physical therapy clinics. Participants Participants (N=440) were seeking care for primary complaint of neck, low back, knee, or shoulder pain. This secondary analysis included 440 subjects (62.5% female; mean age, 45.1±17y) at baseline with n=279 (63.4%) providing follow-up data at 12 months. Interventions Not applicable. Main Outcome Measures A 50% reduction (baseline to 12-mo follow-up) in pain intensity and self-reported disability. Results Trends for prediction accuracy were similar for all versions of the OSPRO-YF. For predicting 50% reduction in pain intensity, model fit met the statistical criterion for improvement (P<.05 with each additional time point added from baseline. model discrimination improved statistically when the to change was under curve="0.849," p=".003)." for predicting reduction in disability there no evidence of improvement fit or baseline addition changes>.05). Conclusions These results suggested that longitudinal monitoring improved prediction accuracy for reduction in pain intensity but not for disability reduction. Differences in OSPRO-YF item sets (10 vs 17 items) or scoring methods (simple summary score vs yellow flag count) did not affect predictive accuracy for pain intensity, providing flexibility for implementing this tool in practice settings.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1771-1779

Titre :	Psychometric Properties of the Multidimensional Impression of Change in a Cohort of Pediatric Patients With Pain
Type de document :	Article
Auteurs :	Christine M. Gagnon ; Paul Scholten ; Diane Amstutz ; Lauren Henderson ; Gadi Revivo
Année de publication :	2020
Article en page(s) :	p. 1771-1779
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.015
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Douleur chronique ; Évaluation des résultats des patients ; Gestion de la douleur ; Pédiatrie ; Réadaptation
Résumé :	Objectives This study assessed the utility of the Multidimensional Patient Impression of Change (MPIC) questionnaire in a pediatric pain population after interdisciplinary treatment. Design Observational study with retrospective chart review. The observed treatment program included psychological counseling, relaxation training, physical therapy, occupational therapy, and physician management. Setting Outpatient pain management center affiliated with an academic rehabilitation hospital. Participants A heterogeneous group of pediatric patients with chronic pain (N=202) who completed an interdisciplinary pain management program. Interventions Not applicable. Main Outcome Measures Measures assessing pain, mood, development, social functioning, physical functioning, and family functioning were administered pre- and posttreatment, and the MPIC was administered posttreatment. Results Statistically significant improvements were observed in all outcomes (P<.05 the majority of patients perceived themselves to be improved very much in all clinical domains mpic ranging from efficacy with pain ratings were significantly correlated improvements most outcome measures. accounted for more than half unique variance predictive models when added patient global impression change and first.> Conclusions The MPIC was found to be an effective screening tool for assessing patient perceived progress in a pediatric chronic pain population.
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[article] Psychometric Properties of the Multidimensional Impression of Change in a Cohort of Pediatric Patients With Pain [Article] / Christine M. Gagnon ; Paul Scholten ; Diane Amstutz ; Lauren Henderson ; Gadi Revivo . - 2020 . - p. 1771-1779.
https://doi.org/10.1016/j.apmr.2020.06.015
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1771-1779

Descripteurs :	HE Vinci Douleur chronique ; Évaluation des résultats des patients ; Gestion de la douleur ; Pédiatrie ; Réadaptation
Résumé :	Objectives This study assessed the utility of the Multidimensional Patient Impression of Change (MPIC) questionnaire in a pediatric pain population after interdisciplinary treatment. Design Observational study with retrospective chart review. The observed treatment program included psychological counseling, relaxation training, physical therapy, occupational therapy, and physician management. Setting Outpatient pain management center affiliated with an academic rehabilitation hospital. Participants A heterogeneous group of pediatric patients with chronic pain (N=202) who completed an interdisciplinary pain management program. Interventions Not applicable. Main Outcome Measures Measures assessing pain, mood, development, social functioning, physical functioning, and family functioning were administered pre- and posttreatment, and the MPIC was administered posttreatment. Results Statistically significant improvements were observed in all outcomes (P<.05 the majority of patients perceived themselves to be improved very much in all clinical domains mpic ranging from efficacy with pain ratings were significantly correlated improvements most outcome measures. accounted for more than half unique variance predictive models when added patient global impression change and first.> Conclusions The MPIC was found to be an effective screening tool for assessing patient perceived progress in a pediatric chronic pain population.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1780-1788

Titre :	The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial
Type de document :	Article
Auteurs :	Luis Espejo-Antúnez ; José Manuel Pérez-Marmol ; Ma de Los Angeles Cardero-Durán ; José Vincente Toledo-Marhuenda ; Manuel Albornoz-Cabello
Année de publication :	2020
Article en page(s) :	p. 1780-1788
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.010
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Essai contrôlé randomisé ; Exercice physique ; Performance fonctionnelle physique ; Proprioception ; Réadaptation ; Sujet âgé
Résumé :	Objectives To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. Design Randomized, single-blind, controlled trial. Setting A Spanish nursing home in the autonomous community of Extremadura, Spain. Participants An initial sample was created by recruiting 148 older adult volunteers. The final sample (N=42) was randomly divided into 2 groups. Interventions Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), with each session lasting 55 minutes. Main Outcome Measures Timed Up and Go (TUG), Cooper, Tinetti, 1-leg stance, and the Morse Fall Scale (MFS). Results Analysis of variance showed a time × group interaction in TUG score (F=10.41, P=.002), Cooper test (F=5.94, P=.019), Tinetti score (F=6.41, P=.015), and MFS scores (F=5.24, P=.028). Differences between groups were achieved for TUG scores (d=0.76), Tinetti scores (d=1.12), 1-leg stance test scores (d=0.77), and MFS scale scores (d=0.85). In the experimental group, within-group analyses showed pre- to post-treatment differences for TUG scores (d=0.72), Cooper test scores in meters (d=0.18), Tinetti scores (d=0.60), 1-leg stance scores (d=0.55), and MFS scores (d=0.42). Conclusions A proprioceptive exercise program demonstrated significant improvements compared with the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program.
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[article] The Effect of Proprioceptive Exercises on Balance and Physical Function in Institutionalized Older Adults: A Randomized Controlled Trial [Article] / Luis Espejo-Antúnez ; José Manuel Pérez-Marmol ; Ma de Los Angeles Cardero-Durán ; José Vincente Toledo-Marhuenda ; Manuel Albornoz-Cabello . - 2020 . - p. 1780-1788.
https://doi.org/10.1016/j.apmr.2020.06.010
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1780-1788

Descripteurs :	HE Vinci Essai contrôlé randomisé ; Exercice physique ; Performance fonctionnelle physique ; Proprioception ; Réadaptation ; Sujet âgé
Résumé :	Objectives To evaluate the efficacy of a proprioceptive exercise program on functional mobility, musculoskeletal endurance, dynamic and static balance, gait, and risk of falls in institutionalized older adults. Design Randomized, single-blind, controlled trial. Setting A Spanish nursing home in the autonomous community of Extremadura, Spain. Participants An initial sample was created by recruiting 148 older adult volunteers. The final sample (N=42) was randomly divided into 2 groups. Interventions Both the control and experimental group received physical therapy treatment based on a combination of adapted exercises and other physical therapy techniques (physical therapy intervention program) for a period of 12 weeks. This program consisted of 45 minutes (group intervention) plus 100 minutes (individual intervention) a week, for a total of 36 sessions (29 hours). The experimental group received a proprioceptive training program during the same intervention period, which was conducted twice weekly (24 sessions), with each session lasting 55 minutes. Main Outcome Measures Timed Up and Go (TUG), Cooper, Tinetti, 1-leg stance, and the Morse Fall Scale (MFS). Results Analysis of variance showed a time × group interaction in TUG score (F=10.41, P=.002), Cooper test (F=5.94, P=.019), Tinetti score (F=6.41, P=.015), and MFS scores (F=5.24, P=.028). Differences between groups were achieved for TUG scores (d=0.76), Tinetti scores (d=1.12), 1-leg stance test scores (d=0.77), and MFS scale scores (d=0.85). In the experimental group, within-group analyses showed pre- to post-treatment differences for TUG scores (d=0.72), Cooper test scores in meters (d=0.18), Tinetti scores (d=0.60), 1-leg stance scores (d=0.55), and MFS scores (d=0.42). Conclusions A proprioceptive exercise program demonstrated significant improvements compared with the control group in areas such as functional mobility, musculoskeletal endurance, balance, gait, and risk of falls in institutionalized older adults. This study may help to enhance our understanding of the impact of a specific protocol for a proprioceptive rehabilitation program.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1789-1795

Titre :	Analysis of the Microbiota of the Physiotherapist's Environment
Type de document :	Article
Auteurs :	Tomás Pérez-Fernández ; Francisco Llinares-Pinel ; Mayte Troya-Franco ; Luis Fernández-Rosa
Année de publication :	2020
Article en page(s) :	p. 1789-1795
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.006
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Environnement de travail ; Infection croisée ; Kinésithérapeutes ; Prévention des infections ; Réadaptation
Résumé :	Objectives To analyze the microbiota of the physiotherapist’s work environment to understand the existing potential risks and to adopt appropriate preventive measures. Design Cross-sectional descriptive observational study. Setting Physiotherapist’s working environment. Participants Physiotherapy and rehabilitation centers (N=19). Interventions A microbiological sampling was carried out in the physiotherapy centers. The samples were studied using the usual culture and analysis methodology for characterization and isolation of a range of bacteria. Main Outcome Measures Absolute and relative frequency of microorganism isolation. Results In the analysis, pathogens normally responsible for nosocomial infections were detected, especially on instruments and equipment used by the physiotherapist such as sponge electrodes, and were significantly more contaminated than the rest of the places studied (P<.01> Conclusion This situation confirms the absence of measures and protocols for the prevention and control of such infections in the physiotherapist's environment, which is why they must be considered to protect both physiotherapy professionals and patients.
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[article] Analysis of the Microbiota of the Physiotherapist's Environment [Article] / Tomás Pérez-Fernández ; Francisco Llinares-Pinel ; Mayte Troya-Franco ; Luis Fernández-Rosa . - 2020 . - p. 1789-1795.
https://doi.org/10.1016/j.apmr.2020.06.006
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1789-1795

Descripteurs :	HE Vinci Environnement de travail ; Infection croisée ; Kinésithérapeutes ; Prévention des infections ; Réadaptation
Résumé :	Objectives To analyze the microbiota of the physiotherapist’s work environment to understand the existing potential risks and to adopt appropriate preventive measures. Design Cross-sectional descriptive observational study. Setting Physiotherapist’s working environment. Participants Physiotherapy and rehabilitation centers (N=19). Interventions A microbiological sampling was carried out in the physiotherapy centers. The samples were studied using the usual culture and analysis methodology for characterization and isolation of a range of bacteria. Main Outcome Measures Absolute and relative frequency of microorganism isolation. Results In the analysis, pathogens normally responsible for nosocomial infections were detected, especially on instruments and equipment used by the physiotherapist such as sponge electrodes, and were significantly more contaminated than the rest of the places studied (P<.01> Conclusion This situation confirms the absence of measures and protocols for the prevention and control of such infections in the physiotherapist's environment, which is why they must be considered to protect both physiotherapy professionals and patients.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1796-1812

Titre :	Implementing Patient-Reported Outcome Measures in Outpatient Rehabilitation Settings: A Systematic Review of Facilitators and Barriers Using the Consolidated Framework for Implementation Research
Type de document :	Article
Auteurs :	Matthew S. Briggs ; Katherine Kozak Rethman ; Justin Crookes ; Fern Cheek ; Kristy Pottkotter ; Shana McGrath ; John DeWitt ; Lindsay E. Harmon-Matthews ; Catherine Quatman-Yates
Année de publication :	2020
Article en page(s) :	p. 1796-1812
Note générale :	https://doi.org/10.1016/j.apmr.2020.04.007
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Ergotherapie ; Kinésithérapie (spécialité) ; Pathologie de la parole et du langage (spécialité) ; Réadaptation ; Science de la mise en oeuvre
Résumé :	Objective This systematic review examines the facilitators and barriers to the use of patient-reported outcome measures (PROMs) in outpatient rehabilitation settings and provides strategies to improve care to maximize patient outcomes. Data Sources Eleven databases were systematically searched from November 2018 to May 2019. Study Selection Two reviewers independently assessed articles based on the following inclusion criteria: English text, evaluate barriers and facilitators, include PROMs, and occur in an outpatient rehabilitation setting (physical therapy, occupational therapy, speech language pathology, or athletic training). Of the 10,164 articles initially screened, 15 articles were included in this study. Data Extraction Data were extracted from the selected articles by 2 independent reviewers and put into an extraction template and into the Consolidated Framework for Implementation Research (CFIR) model. The Appraisal Tool for Cross-Sectional Studies (AXIS) was conducted on each study to assess study design, risk of bias, and reporting quality of the eligible studies. Data Synthesis Ten studies were identified as high quality, according to the AXIS. Based on the CFIR model, the top barriers identified focused on clinician training and time in the implementation process, lack of recognized value and knowledge at the individual level, lack of access and support in the inner setting, and inability of patients to complete PROMs in the intervention process. Facilitators were identified as education in the implementation process, support and availability of PROMs in the inner setting, and recognized value at the individual level. Conclusions More barriers than facilitators have been identified, which is consistent with PROM underuse. Clinicians and administrators should find opportunities to overcome the barriers identified and leverage the facilitators to improve routine PROM use and maximize patient outcomes.
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[article] Implementing Patient-Reported Outcome Measures in Outpatient Rehabilitation Settings: A Systematic Review of Facilitators and Barriers Using the Consolidated Framework for Implementation Research [Article] / Matthew S. Briggs ; Katherine Kozak Rethman ; Justin Crookes ; Fern Cheek ; Kristy Pottkotter ; Shana McGrath ; John DeWitt ; Lindsay E. Harmon-Matthews ; Catherine Quatman-Yates . - 2020 . - p. 1796-1812.
https://doi.org/10.1016/j.apmr.2020.04.007
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1796-1812

Descripteurs :	HE Vinci Ergotherapie ; Kinésithérapie (spécialité) ; Pathologie de la parole et du langage (spécialité) ; Réadaptation ; Science de la mise en oeuvre
Résumé :	Objective This systematic review examines the facilitators and barriers to the use of patient-reported outcome measures (PROMs) in outpatient rehabilitation settings and provides strategies to improve care to maximize patient outcomes. Data Sources Eleven databases were systematically searched from November 2018 to May 2019. Study Selection Two reviewers independently assessed articles based on the following inclusion criteria: English text, evaluate barriers and facilitators, include PROMs, and occur in an outpatient rehabilitation setting (physical therapy, occupational therapy, speech language pathology, or athletic training). Of the 10,164 articles initially screened, 15 articles were included in this study. Data Extraction Data were extracted from the selected articles by 2 independent reviewers and put into an extraction template and into the Consolidated Framework for Implementation Research (CFIR) model. The Appraisal Tool for Cross-Sectional Studies (AXIS) was conducted on each study to assess study design, risk of bias, and reporting quality of the eligible studies. Data Synthesis Ten studies were identified as high quality, according to the AXIS. Based on the CFIR model, the top barriers identified focused on clinician training and time in the implementation process, lack of recognized value and knowledge at the individual level, lack of access and support in the inner setting, and inability of patients to complete PROMs in the intervention process. Facilitators were identified as education in the implementation process, support and availability of PROMs in the inner setting, and recognized value at the individual level. Conclusions More barriers than facilitators have been identified, which is consistent with PROM underuse. Clinicians and administrators should find opportunities to overcome the barriers identified and leverage the facilitators to improve routine PROM use and maximize patient outcomes.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1813-1821

Titre :	Gait Change in Dual Task as a Behavioral Marker to Detect Mild Cognitive Impairment in Elderly Persons: A Systematic Review and Meta-analysis
Type de document :	Article
Auteurs :	Qing Yang ; Chong Tian ; Benjamin Tseng ; Beibei Zhang ; Sha Huang ; Jin Si ; Jing Mao
Année de publication :	2020
Article en page(s) :	p. 1813-1821
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.020
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Démarche ; Dysfonctionnement cognitif ; Endophénotypes ; Sujet âgé
Résumé :	Objectives To systematically summarize the evidence of gait tests as screening tools for mild cognitive impairment (MCI). Data Sources Electronic database searches were conducted in PubMed, EBSCO, Cochrane, Web of Science, Ovid, China National Knowledge Infrastructure, WanFang, and SinoMed, and studies published before November 30, 2018, were included. Study Selection Synonyms of MCI, gait, and cognitive-motor interference (CMI) were searched. Studies that analyzed gait change of people with MCI in single- or dual-task gait tests were included. Data Extraction The quality of the included studies was assessed with Downs and Black methodological quality appraisal tools. Study characteristics, participants’ characteristics, test descriptions, and results were extracted from the included studies. Data Synthesis Twenty-two studies involving 1928 participants were included. Meta-analysis showed that gait velocity difference in dual task (effect size [ES]=−0.89) were more obvious than in single task (ES=−0.74) between older adults with and without MCI, and the ES increased with the complexity of cognitive load (countdown by 1s, ES=−0.83; verbal fluency, ES=−0.96; serial reduction by 7s, ES=−1.26). The dual-task cost of gait velocity showed high sensitivity (ES=0.90) in detecting MCI. Meta-regression analysis demonstrated strong criterion-related validity between the CMI of gait velocity and the Montreal Cognitive Assessment score. Conclusions In comparison with the single-task gait test, gait change under cognitive load is more pronounced in older adults with MCI. CMI of gait velocity can be a potential screening tool for MCI in elderly persons.
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[article] Gait Change in Dual Task as a Behavioral Marker to Detect Mild Cognitive Impairment in Elderly Persons: A Systematic Review and Meta-analysis [Article] / Qing Yang ; Chong Tian ; Benjamin Tseng ; Beibei Zhang ; Sha Huang ; Jin Si ; Jing Mao . - 2020 . - p. 1813-1821.
https://doi.org/10.1016/j.apmr.2020.05.020
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1813-1821

Descripteurs :	HE Vinci Démarche ; Dysfonctionnement cognitif ; Endophénotypes ; Sujet âgé
Résumé :	Objectives To systematically summarize the evidence of gait tests as screening tools for mild cognitive impairment (MCI). Data Sources Electronic database searches were conducted in PubMed, EBSCO, Cochrane, Web of Science, Ovid, China National Knowledge Infrastructure, WanFang, and SinoMed, and studies published before November 30, 2018, were included. Study Selection Synonyms of MCI, gait, and cognitive-motor interference (CMI) were searched. Studies that analyzed gait change of people with MCI in single- or dual-task gait tests were included. Data Extraction The quality of the included studies was assessed with Downs and Black methodological quality appraisal tools. Study characteristics, participants’ characteristics, test descriptions, and results were extracted from the included studies. Data Synthesis Twenty-two studies involving 1928 participants were included. Meta-analysis showed that gait velocity difference in dual task (effect size [ES]=−0.89) were more obvious than in single task (ES=−0.74) between older adults with and without MCI, and the ES increased with the complexity of cognitive load (countdown by 1s, ES=−0.83; verbal fluency, ES=−0.96; serial reduction by 7s, ES=−1.26). The dual-task cost of gait velocity showed high sensitivity (ES=0.90) in detecting MCI. Meta-regression analysis demonstrated strong criterion-related validity between the CMI of gait velocity and the Montreal Cognitive Assessment score. Conclusions In comparison with the single-task gait test, gait change under cognitive load is more pronounced in older adults with MCI. CMI of gait velocity can be a potential screening tool for MCI in elderly persons.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1822-1834

Titre :	The Efficacy of Higher Versus Lower Dose Exercise in Rotator Cuff Tendinopathy: A Systematic Review of Randomized Controlled Trials
Type de document :	Article
Auteurs :	Peter Malliaras ; Renea Johnston ; Gabriele Street ; Chris Littlewood ; Kim Bennell ; Terry Haines ; Rachelle Buchbinder
Année de publication :	2020
Article en page(s) :	p. 1822-1834
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.013
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Epaule ; Exercice physique ; Réadaptation ; Tendinopathie
Résumé :	Highlights • There is low-certainty evidence that higher load and volume exercise may improve function but not activity or night pain in people with rotator cuff tendinopathy compared with lower load and lower volume exercise at 6 weeks to 3 months. • There is very low-certainty evidence that higher load exercise does not improve function more than lower load exercise up to 6 weeks, and no data are available for pain outcomes. • There is very low-certainty evidence that higher volume exercise may improve function compared with lower volume exercise at 6 weeks to 3 months, but no data are available for pain outcomes.
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[article] The Efficacy of Higher Versus Lower Dose Exercise in Rotator Cuff Tendinopathy: A Systematic Review of Randomized Controlled Trials [Article] / Peter Malliaras ; Renea Johnston ; Gabriele Street ; Chris Littlewood ; Kim Bennell ; Terry Haines ; Rachelle Buchbinder . - 2020 . - p. 1822-1834.
https://doi.org/10.1016/j.apmr.2020.06.013
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1822-1834

Descripteurs :	HE Vinci Epaule ; Exercice physique ; Réadaptation ; Tendinopathie
Résumé :	Highlights • There is low-certainty evidence that higher load and volume exercise may improve function but not activity or night pain in people with rotator cuff tendinopathy compared with lower load and lower volume exercise at 6 weeks to 3 months. • There is very low-certainty evidence that higher load exercise does not improve function more than lower load exercise up to 6 weeks, and no data are available for pain outcomes. • There is very low-certainty evidence that higher volume exercise may improve function compared with lower volume exercise at 6 weeks to 3 months, but no data are available for pain outcomes.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1835-1838

Titre :	Cardiac Rehabilitation During Quarantine in COVID-19 Pandemic: Challenges for Center-Based Programs
Type de document :	Article
Auteurs :	Florent Besnier ; Mathieu Gayda ; Anil Nigam ; Martin Juneau ; Louis Bherer
Année de publication :	2020
Article en page(s) :	p. 1835-1838
Note générale :	https://doi.org/10.1016/j.apmr.2020.06.004
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Coronavirus ; COVID-19 ; Exercice physique ; Réadaptation cardiaque
Résumé :	Because of the coronavirus disease 2019 (COVID-19) epidemic, many cardiac rehabilitation (CR) services and programs are stopped. Because CR is a class I level A recommendation with clinical benefits that are now well documented, the cessation of CR programs can lead to dramatic consequences in terms of public health. We propose here a viewpoint of significant interest about the sudden need to develop remote home-based CR programs both in clinical research and in clinical care routine. This last decade, the literature on remote home-based CR programs has been increasing, but to date only clinical research experiences have been implemented. Benefits are numerous and the relevance of this approach has obviously increased with the actual health emergency. The COVID-19 crisis, the important prevalence of smartphones, and high-speed Internet during confinement should be viewed as an opportunity to promote a major shift in CR programs with the use of telemedicine to advance the health of a larger number of individuals with cardiac disease.
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[article] Cardiac Rehabilitation During Quarantine in COVID-19 Pandemic: Challenges for Center-Based Programs [Article] / Florent Besnier ; Mathieu Gayda ; Anil Nigam ; Martin Juneau ; Louis Bherer . - 2020 . - p. 1835-1838.
https://doi.org/10.1016/j.apmr.2020.06.004
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n°10 (2020) . - p. 1835-1838

Descripteurs :	HE Vinci Coronavirus ; COVID-19 ; Exercice physique ; Réadaptation cardiaque
Résumé :	Because of the coronavirus disease 2019 (COVID-19) epidemic, many cardiac rehabilitation (CR) services and programs are stopped. Because CR is a class I level A recommendation with clinical benefits that are now well documented, the cessation of CR programs can lead to dramatic consequences in terms of public health. We propose here a viewpoint of significant interest about the sudden need to develop remote home-based CR programs both in clinical research and in clinical care routine. This last decade, the literature on remote home-based CR programs has been increasing, but to date only clinical research experiences have been implemented. Benefits are numerous and the relevance of this approach has obviously increased with the actual health emergency. The COVID-19 crisis, the important prevalence of smartphones, and high-speed Internet during confinement should be viewed as an opportunity to promote a major shift in CR programs with the use of telemedicine to advance the health of a larger number of individuals with cardiac disease.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1485-1496

Titre :	Efficacy and Safety of MT10107 (Coretox) in Poststroke Upper Limb Spasticity Treatment: A Randomized, Double-Blind, Active Drug-Controlled, Multicenter, Phase III Clinical Trial
Type de document :	Périodique
Auteurs :	Junekyung Lee, Auteur ; Min Ho Chun, Auteur ; Young-Jin Ko, Auteur ; Deog Young Kim, Auteur ; Nam-Jong Paik, Auteur ; Bum Sun Kwon, Auteur ; Y.G. Park, Auteur
Année de publication :	2020
Article en page(s) :	p. 1485-1496
Note générale :	https://doi.org/10.1016/j.apmr.2020.03.025
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Membre supérieur ; Réadaptation ; Securité ; Spasticité musculaire ; Toxines botuliniques
Résumé :	Objective To compare the efficacy and safety of MT10107 (Coretox) with those of onabotulinum toxin A (Botox) in patients with poststroke upper limb spasticity Design Prospective, randomized, double-blind, active drug-controlled, multicenter, phase III clinical trial. Setting Seven university hospitals in the Republic of Korea. Participants Patients (N=220) with poststroke upper limb spasticity. Interventions All participants received a single injection of either MT10107 (Coretox group) or onabotulinum toxin A (Botox group). Main Outcome Measures The primary outcome was change in wrist flexor spasticity from baseline to week 4, which was assessed using the modified Ashworth scale (MAS). The secondary outcomes were MAS scores for wrist, elbow, and finger flexors; percentage of treatment responders (response rate); Disability Assessment Scale (DAS) score, and global assessment of treatment. Safety was evaluated based on adverse events, vital signs, physical examination findings, and laboratory test results. The efficacy and safety were evaluated at 4, 8, and 12 weeks postintervention. Results The primary outcome was found to be −1.32±0.69 and −1.40±0.69 for the Coretox and Botox groups, respectively. MT10107 showed a non-inferior efficacy compared with onabotulinum toxin A, as the 95% confidence interval for between-group differences was −0.10 to 0.27 and the upper limit was less than the non-inferiority margin of 0.45. Regarding the secondary outcomes, MAS scores for all muscles and DAS scores showed a significant improvement at all time points in both groups, with no significant between-group difference. No significant between-group differences were observed regarding response rate, global assessment of treatment, and safety measures. Conclusions MT10107 showed no significant difference in efficacy and safety compared with onabotulinum toxin A in poststroke upper limb spasticity treatment.
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[article] Efficacy and Safety of MT10107 (Coretox) in Poststroke Upper Limb Spasticity Treatment: A Randomized, Double-Blind, Active Drug-Controlled, Multicenter, Phase III Clinical Trial [Périodique] / Junekyung Lee, Auteur ; Min Ho Chun, Auteur ; Young-Jin Ko, Auteur ; Deog Young Kim, Auteur ; Nam-Jong Paik, Auteur ; Bum Sun Kwon, Auteur ; Y.G. Park, Auteur . - 2020 . - p. 1485-1496.
https://doi.org/10.1016/j.apmr.2020.03.025
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1485-1496

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Membre supérieur ; Réadaptation ; Securité ; Spasticité musculaire ; Toxines botuliniques
Résumé :	Objective To compare the efficacy and safety of MT10107 (Coretox) with those of onabotulinum toxin A (Botox) in patients with poststroke upper limb spasticity Design Prospective, randomized, double-blind, active drug-controlled, multicenter, phase III clinical trial. Setting Seven university hospitals in the Republic of Korea. Participants Patients (N=220) with poststroke upper limb spasticity. Interventions All participants received a single injection of either MT10107 (Coretox group) or onabotulinum toxin A (Botox group). Main Outcome Measures The primary outcome was change in wrist flexor spasticity from baseline to week 4, which was assessed using the modified Ashworth scale (MAS). The secondary outcomes were MAS scores for wrist, elbow, and finger flexors; percentage of treatment responders (response rate); Disability Assessment Scale (DAS) score, and global assessment of treatment. Safety was evaluated based on adverse events, vital signs, physical examination findings, and laboratory test results. The efficacy and safety were evaluated at 4, 8, and 12 weeks postintervention. Results The primary outcome was found to be −1.32±0.69 and −1.40±0.69 for the Coretox and Botox groups, respectively. MT10107 showed a non-inferior efficacy compared with onabotulinum toxin A, as the 95% confidence interval for between-group differences was −0.10 to 0.27 and the upper limit was less than the non-inferiority margin of 0.45. Regarding the secondary outcomes, MAS scores for all muscles and DAS scores showed a significant improvement at all time points in both groups, with no significant between-group difference. No significant between-group differences were observed regarding response rate, global assessment of treatment, and safety measures. Conclusions MT10107 showed no significant difference in efficacy and safety compared with onabotulinum toxin A in poststroke upper limb spasticity treatment.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1497-1508

Titre :	Cost-Benefit Analysis From the Payor’s Perspective for Screening and Diagnosing Obstructive Sleep Apnea During Inpatient Rehabilitation for Moderate to Severe TBI
Type de document :	Périodique
Auteurs :	Risa Nakase-Richardson ; Jeanne M. Hoffman ; Ulysses J. Magalang ; Emily Almeida ; Daniel J. Schwartz ; Leah Drasher-Phillips ; Jessica M. Ketchum ; John Whyte ; Jennifer A. Bogner ; Clara E. Dismuke-Greer
Année de publication :	2020
Article en page(s) :	p. 1497-1508
Note générale :	https://doi.org/10.1016/j.apmr.2020.03.020
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Analyse coût-bénéfice ; Encephale ; Plaies et blessures ; Polysomnographie ; Réadaptation ; Syndromes d'apnées du sommeil
Résumé :	Objective To describe the cost benefit of 4 different approaches to screening for sleep apnea in a cohort of participants with moderate to severe traumatic brain injury (TBI) receiving inpatient rehabilitation from the payor’s perspective. Design A cost-benefit analysis of phased approaches to sleep apnea diagnosis. Setting Six TBI Model System Inpatient Rehabilitation Centers. Participants Trial data from participants (N=214) were used in analyses (mean age 44±18y, 82% male, 75% white, with primarily motor vehicle–related injury [44%] and falls [33%] with a sample mean emergency department Glasgow Coma Scale of 8±5). Intervention Not applicable. Main Outcome Cost benefit. Results At apnea-hypopnea index (AHI) ≥15 (34%), phased modeling approaches using screening measures (Snoring, Tired, Observed, Blood Pressure, Body Mass Index, Age, Neck Circumference, and Gender [STOPBANG] [–$5291], Multivariable Apnea Prediction Index MAPI [–$5262]) resulted in greater cost savings and benefit relative to the portable diagnostic approach (–$5210) and initial use of laboratory-quality polysomnography (–$5,011). Analyses at AHI≥5 (70%) revealed the initial use of portable testing (–$6323) relative to the screening models (MAPI [–$6250], STOPBANG [–$6237) and initial assessment with polysomnography (–$5977) resulted in greater savings and cost-effectiveness. Conclusions The high rates of sleep apnea after TBI highlight the importance of accurate diagnosis and treatment of this comorbid disorder. However, financial and practical barriers exist to obtaining an earlier diagnosis during inpatient rehabilitation hospitalization. Diagnostic cost savings are demonstrated across all phased approaches and OSA severity levels with the most cost-beneficial approach varying by incidence of OSA.
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[article] Cost-Benefit Analysis From the Payor’s Perspective for Screening and Diagnosing Obstructive Sleep Apnea During Inpatient Rehabilitation for Moderate to Severe TBI [Périodique] / Risa Nakase-Richardson ; Jeanne M. Hoffman ; Ulysses J. Magalang ; Emily Almeida ; Daniel J. Schwartz ; Leah Drasher-Phillips ; Jessica M. Ketchum ; John Whyte ; Jennifer A. Bogner ; Clara E. Dismuke-Greer . - 2020 . - p. 1497-1508.
https://doi.org/10.1016/j.apmr.2020.03.020
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1497-1508

Descripteurs :	HE Vinci Analyse coût-bénéfice ; Encephale ; Plaies et blessures ; Polysomnographie ; Réadaptation ; Syndromes d'apnées du sommeil
Résumé :	Objective To describe the cost benefit of 4 different approaches to screening for sleep apnea in a cohort of participants with moderate to severe traumatic brain injury (TBI) receiving inpatient rehabilitation from the payor’s perspective. Design A cost-benefit analysis of phased approaches to sleep apnea diagnosis. Setting Six TBI Model System Inpatient Rehabilitation Centers. Participants Trial data from participants (N=214) were used in analyses (mean age 44±18y, 82% male, 75% white, with primarily motor vehicle–related injury [44%] and falls [33%] with a sample mean emergency department Glasgow Coma Scale of 8±5). Intervention Not applicable. Main Outcome Cost benefit. Results At apnea-hypopnea index (AHI) ≥15 (34%), phased modeling approaches using screening measures (Snoring, Tired, Observed, Blood Pressure, Body Mass Index, Age, Neck Circumference, and Gender [STOPBANG] [–$5291], Multivariable Apnea Prediction Index MAPI [–$5262]) resulted in greater cost savings and benefit relative to the portable diagnostic approach (–$5210) and initial use of laboratory-quality polysomnography (–$5,011). Analyses at AHI≥5 (70%) revealed the initial use of portable testing (–$6323) relative to the screening models (MAPI [–$6250], STOPBANG [–$6237) and initial assessment with polysomnography (–$5977) resulted in greater savings and cost-effectiveness. Conclusions The high rates of sleep apnea after TBI highlight the importance of accurate diagnosis and treatment of this comorbid disorder. However, financial and practical barriers exist to obtaining an earlier diagnosis during inpatient rehabilitation hospitalization. Diagnostic cost savings are demonstrated across all phased approaches and OSA severity levels with the most cost-beneficial approach varying by incidence of OSA.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1509-1514

Titre :	Predictors of Discharge Settings After Total Knee Arthroplasty in Medicare Patients
Type de document :	Périodique
Auteurs :	Rodney Laine Welsh ; Dana L. Wild ; Amol M. Karmarkar ; N.E. Leland ; Jacques G. Baillargeon ; Kenneth J. Ottenbacher ; James E. Graham
Année de publication :	2020
Article en page(s) :	p. 1509-1514
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.019
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Arthroplastie ; Arthroplastie prothétique de genou ; Réadaptation ; Soins de suite ; Sortie du patient
Résumé :	Abstract Objectives To determine the factors associated with acute hospital discharge to the 3 most common postacute settings following total knee arthroplasty (TKA): inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and directly back to the community. Design Retrospective cohort study. Setting Acute care hospitals submitting claims to Medicare. Participants National cohort (N=1,189,286) of 100% Medicare Part A data files from 2009-2011. Interventions Not applicable. Main Outcome Measures Observed rates and adjusted odds of discharge to the 3 main postacute settings based on the clinical and facility level variables: amount of comorbidity, bilateral procedures, and facility TKA volume. Results Using IRF discharge as the reference, patients who received a bilateral procedure had lower odds of both SNF and community discharge, patients with more comorbidity had lower odds for community discharge and higher odds for SNF discharge, and patients who received their TKA from hospitals with lower TKA volumes had lower odds of SNF and community discharge. Conclusions Clinical populations within Medicare beneficiaries may systematically vary across the 3 most common discharge settings following TKA. This information may be helpful for a better understanding on which patient or clinical factors influence postacute care settings following TKA. Additional research including functional status, living situation, and social support systems would be beneficial.
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[article] Predictors of Discharge Settings After Total Knee Arthroplasty in Medicare Patients [Périodique] / Rodney Laine Welsh ; Dana L. Wild ; Amol M. Karmarkar ; N.E. Leland ; Jacques G. Baillargeon ; Kenneth J. Ottenbacher ; James E. Graham . - 2020 . - p. 1509-1514.
https://doi.org/10.1016/j.apmr.2020.05.019
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1509-1514

Descripteurs :	HE Vinci Arthroplastie ; Arthroplastie prothétique de genou ; Réadaptation ; Soins de suite ; Sortie du patient
Résumé :	Abstract Objectives To determine the factors associated with acute hospital discharge to the 3 most common postacute settings following total knee arthroplasty (TKA): inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), and directly back to the community. Design Retrospective cohort study. Setting Acute care hospitals submitting claims to Medicare. Participants National cohort (N=1,189,286) of 100% Medicare Part A data files from 2009-2011. Interventions Not applicable. Main Outcome Measures Observed rates and adjusted odds of discharge to the 3 main postacute settings based on the clinical and facility level variables: amount of comorbidity, bilateral procedures, and facility TKA volume. Results Using IRF discharge as the reference, patients who received a bilateral procedure had lower odds of both SNF and community discharge, patients with more comorbidity had lower odds for community discharge and higher odds for SNF discharge, and patients who received their TKA from hospitals with lower TKA volumes had lower odds of SNF and community discharge. Conclusions Clinical populations within Medicare beneficiaries may systematically vary across the 3 most common discharge settings following TKA. This information may be helpful for a better understanding on which patient or clinical factors influence postacute care settings following TKA. Additional research including functional status, living situation, and social support systems would be beneficial.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1515-1522

Titre :	Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke
Type de document :	Périodique
Auteurs :	Robert L. Askew ; Carmen E. Capo-Lugo ; Andrew Naidech ; Shyam K. Prabhakaran
Année de publication :	2020
Article en page(s) :	p. 1515-1522
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.005
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Abdomen aigu ; Accident vasculaire cérébral (AVC) ; Évaluation des résultats et des processus en soins de santé ; Mesures des résultats rapportés par les patients (PROM) ; Qualité des soins de santé ; Réadaptation ; Rééducation neurologique ; Services de santé
Résumé :	Objective To assess the effect of time to acute therapy on health-related quality of life (HRQoL) and disability after ischemic stroke. Design Prospective cohort study. Setting Comprehensive stroke care center in a large metropolitan city. Participants Patients (N=553; mean age, 67 y; 51.9% male; 64.4% white; 88.8% ischemic stroke) with ischemic stroke or transient ischemic attack (TIA) enrolled in a longitudinal observational study between August 2012 to January 2014 who received rehabilitation services. Intervention Not applicable. Main Outcome Measures Disability status was assessed with the modified Rankin Scale (mRS) and Barthel Index (BI). HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity, and lower extremity mobility. Time to therapy consult and treatment were defined as the number of days from hospital admission to initial consult by a therapist and number of days from hospital admission to initial treatment, respectively. Results Among the participants, the median number of days from hospital admission to acute therapy consult was 2 days (interquartile range, 1-3d). Multivariable linear and logistic regression models indicated that for those with the National Institutes of Health Stroke Scale (NIHSS) score Conclusions Longer time to initiation of acute therapy has differential effects on poststroke disability and HRQoL up to 1-month after ischemic stroke and TIA. The effect of acute therapy consult is more notable for those with mild deficits, while the effect of acute therapy treatment is more notable for those with moderate to severe deficits. Minimizing time to therapy consults and treatments in the acute hospital period might improve outcomes after ischemic stroke and TIA.
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[article] Differential Effects of Time to Initiation of Therapy on Disability and Quality of Life in Patients With Mild and Moderate to Severe Ischemic Stroke [Périodique] / Robert L. Askew ; Carmen E. Capo-Lugo ; Andrew Naidech ; Shyam K. Prabhakaran . - 2020 . - p. 1515-1522.
https://doi.org/10.1016/j.apmr.2020.05.005
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1515-1522

Descripteurs :	HE Vinci Abdomen aigu ; Accident vasculaire cérébral (AVC) ; Évaluation des résultats et des processus en soins de santé ; Mesures des résultats rapportés par les patients (PROM) ; Qualité des soins de santé ; Réadaptation ; Rééducation neurologique ; Services de santé
Résumé :	Objective To assess the effect of time to acute therapy on health-related quality of life (HRQoL) and disability after ischemic stroke. Design Prospective cohort study. Setting Comprehensive stroke care center in a large metropolitan city. Participants Patients (N=553; mean age, 67 y; 51.9% male; 64.4% white; 88.8% ischemic stroke) with ischemic stroke or transient ischemic attack (TIA) enrolled in a longitudinal observational study between August 2012 to January 2014 who received rehabilitation services. Intervention Not applicable. Main Outcome Measures Disability status was assessed with the modified Rankin Scale (mRS) and Barthel Index (BI). HRQoL was assessed using the Quality of Life in Neurological Disorders measures of executive function, general cognitive concerns, upper extremity dexterity, and lower extremity mobility. Time to therapy consult and treatment were defined as the number of days from hospital admission to initial consult by a therapist and number of days from hospital admission to initial treatment, respectively. Results Among the participants, the median number of days from hospital admission to acute therapy consult was 2 days (interquartile range, 1-3d). Multivariable linear and logistic regression models indicated that for those with the National Institutes of Health Stroke Scale (NIHSS) score Conclusions Longer time to initiation of acute therapy has differential effects on poststroke disability and HRQoL up to 1-month after ischemic stroke and TIA. The effect of acute therapy consult is more notable for those with mild deficits, while the effect of acute therapy treatment is more notable for those with moderate to severe deficits. Minimizing time to therapy consults and treatments in the acute hospital period might improve outcomes after ischemic stroke and TIA.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1523-1531

Titre :	Data Mining to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome: A Population-Based Sex-Stratified Study
Type de document :	Périodique
Auteurs :	Vincy Chan ; Mitchell Sutton ; Tatyana Mollayeva ; Michael Escobar ; Mackenzie Hurst ; Angela Colantonio ; Angela Colantonio
Année de publication :	2020
Article en page(s) :	p. 1523-1531
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.017
Langues :	Anglais (eng)
Descripteurs :	HE Vinci CLASSIFICATION INTERNATIONALE DES MALADIES (CIM-10) ; Comorbidité ; Lésions encéphaliques ; Réadaptation
Résumé :	Objectives To understand how health status preceding traumatic brain injury (TBI) affects relative functional gain after inpatient rehabilitation using a data mining approach. Design Population-based, sex-stratified, retrospective cohort study using health administrative data from Ontario, Canada (39% of the Canadian population). Setting Inpatient rehabilitation. Participants Patients 14 years or older (N=5802; 63.4% male) admitted to inpatient rehabilitation within 1 year of a TBI-related acute care discharge between April 1, 2008, and March 31, 2015. Interventions Not applicable. Main Outcome Measures Relative functional gain (RFG) in percentage, calculated as ([discharge FIM−admission FIM]/[126−admission FIM]×100). Health status prior to TBI was identified and internally validated using a data mining approach that categorized all International Classification of Diseases, 10th revision, codes for each patient. Results The average RFG was 52.8%±27.6% among male patients and 51.6%±27.1% among female patients. Sex-specific Bonferroni adjusted multivariable linear regressions identified 10 factors of preinjury health status related to neurology, emergency medicine, cardiology, psychiatry, geriatrics, and gastroenterology that were significantly associated with reduced RFG in FIM for male patients. Only 1 preinjury health status category, geriatrics, was significantly associated with RFG in female patients. Conclusions Comorbid health conditions present up to 5 years preceding the TBI event were significantly associated with RFG. These findings should be considered when planning and executing interventions to maximize functional gain and to support an interdisciplinary approach. Best practices guidelines and clinical interventions for older male and female patients with TBI should be developed given the increasingly aging population with TBI.
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[article] Data Mining to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome: A Population-Based Sex-Stratified Study [Périodique] / Vincy Chan ; Mitchell Sutton ; Tatyana Mollayeva ; Michael Escobar ; Mackenzie Hurst ; Angela Colantonio ; Angela Colantonio . - 2020 . - p. 1523-1531.
https://doi.org/10.1016/j.apmr.2020.05.017
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1523-1531

Descripteurs :	HE Vinci CLASSIFICATION INTERNATIONALE DES MALADIES (CIM-10) ; Comorbidité ; Lésions encéphaliques ; Réadaptation
Résumé :	Objectives To understand how health status preceding traumatic brain injury (TBI) affects relative functional gain after inpatient rehabilitation using a data mining approach. Design Population-based, sex-stratified, retrospective cohort study using health administrative data from Ontario, Canada (39% of the Canadian population). Setting Inpatient rehabilitation. Participants Patients 14 years or older (N=5802; 63.4% male) admitted to inpatient rehabilitation within 1 year of a TBI-related acute care discharge between April 1, 2008, and March 31, 2015. Interventions Not applicable. Main Outcome Measures Relative functional gain (RFG) in percentage, calculated as ([discharge FIM−admission FIM]/[126−admission FIM]×100). Health status prior to TBI was identified and internally validated using a data mining approach that categorized all International Classification of Diseases, 10th revision, codes for each patient. Results The average RFG was 52.8%±27.6% among male patients and 51.6%±27.1% among female patients. Sex-specific Bonferroni adjusted multivariable linear regressions identified 10 factors of preinjury health status related to neurology, emergency medicine, cardiology, psychiatry, geriatrics, and gastroenterology that were significantly associated with reduced RFG in FIM for male patients. Only 1 preinjury health status category, geriatrics, was significantly associated with RFG in female patients. Conclusions Comorbid health conditions present up to 5 years preceding the TBI event were significantly associated with RFG. These findings should be considered when planning and executing interventions to maximize functional gain and to support an interdisciplinary approach. Best practices guidelines and clinical interventions for older male and female patients with TBI should be developed given the increasingly aging population with TBI.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1532-1540

Titre :	What Is the Impact of Engaging With Natural Environments Delivered Via Virtual Reality on the Psycho-emotional Health of People With Spinal Cord Injury Receiving Rehabilitation in Hospital? Findings From a Pilot Randomized Controlled Trial
Type de document :	Périodique
Auteurs :	Ali Lakhani ; Kate Martin ; Gray Lyndal ; Jessica Mallison ; Peter Grimbeek ; Izak Hollins ; Col Mackareth
Année de publication :	2020
Article en page(s) :	p. 1532-1540
Note générale :	https://doi.org/10.1016/j.apmr.2020.05.013
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Réadaptation ; Réalité de synthèse ; Traumatismes de la moelle épinière
Résumé :	Objectives This study investigated (1) the effect of engaging with 20-minute simulated natural environments delivered via virtual reality (VR) on current mood state and (2) the effect of engaging with multiple VR sessions over a period of a week on the depressive symptoms of people with a spinal cord injury (SCI). Design Randomized controlled trial design. Setting Spinal Cord Injury Rehabilitation Unit in Australia. Participants Participants (N=24) were assigned to a group engaging in VR sessions during week 1 (group 1, n=10) or week 2 (group 2, n=14). Interventions The intervention week involved participation in up to three 20-minute VR sessions over 3 consecutive days. The control condition involved regular rehabilitation practice over a week. Main Outcome Measures The Patient Health Questionnaire-8 (PHQ-8) was completed prior to the first week (T1), after the first week and prior to the second week (T2), and after the second week (T3). Current feeling states, including depressed/happy, anxious/relaxed, and not feeling good/feeling good, were rated immediately prior and after each VR session. Results Levels of happiness, relaxation, and feeling good were significantly higher subsequent to engaging with each VR session. Between-group differences in PHQ-8 scores were significantly greater for participants who experienced the intervention during the first week compared to participants within the control group: intervention participants had significant improvements in psycho-emotional health. Within-group PHQ-8 scores were reduced for each group subsequent to experiencing the intervention; however, differences were not significant. Conclusions Engaging with simulated natural environments delivered via VR can favorably affect the psycho-emotional health of people with SCI receiving rehabilitation in hospital. Future research including larger samples and investigating the effect over a longer time period is required to confirm the findings presented.
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