[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1111-1119

Titre :	Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial
Type de document :	Article
Auteurs :	Daniel Wadsworth ; Sally Lark ; Arnt Erik Tjønna
Année de publication :	2020
Article en page(s) :	p. 1111-1119
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.009
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Exercice physique ; Personne âgée fragile ; Réadaptation ; Sarcopenie ; Vibration
Résumé :	Objective To investigate the feasibility and benefits of whole-body vibration (WBV) exercise as a safe and effective training tool for countering sarcopenia and age-related declines in mobility and function in the frail elderly. Design An open, randomized controlled trial. Setting Residential care facilities. Participants Male and female volunteers (N=117; 82.5±7.9y). Interventions After prescreening for contraindications, participants were randomly allocated to a control, simulated WBV (SIM), or WBV exercise group. All participants received regular care, whereas WBV and SIM participants also underwent thrice-weekly exercise sessions for 16 weeks. Delivered by overload principle, WBV training began with 5 × 1-minute bouts at 6 Hz/2 mm (1:1 min exercise:rest), progressing to 10 × 1 minute at up to 26 Hz/4 mm, maintaining knee flexion. Training for SIM participants mimicked WBV exercise stance and duration only. Main Outcome Measures The timed Up and Go, Parallel Walk, and 10-m Timed Walk (10mTW) tests performance were assessed, in addition to the Barthel Index Questionnaire, at baseline, 8, and 16 weeks of exercise, and 3, 6, and 12 months postexercise. Results High levels of compliance were reported in SIM (89%) and WBV training (93%), with ease of use and no adverse effects. In comparison to baseline levels, WBV training elicited clinically important treatment effects in all parameters compared to SIM and control groups. Treatment effects remained apparent up to 12 months postintervention for Parallel Walk Test and 6 months for 10mTW Test. Functional test performance declined during and postintervention in non-WBV groups. Conclusions Findings indicate that 16 weeks of low-level WBV exercise provides easily accessible, adequate stimulus for the frail elderly to attain improved levels of physical functionality.
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[article] Effects of Whole-Body Vibration Training on the Physical Function of the Frail Elderly: An Open, Randomized Controlled Trial [Article] / Daniel Wadsworth ; Sally Lark ; Arnt Erik Tjønna . - 2020 . - p. 1111-1119.
https://doi.org/10.1016/j.apmr.2020.02.009
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1111-1119

Descripteurs :	HE Vinci Exercice physique ; Personne âgée fragile ; Réadaptation ; Sarcopenie ; Vibration
Résumé :	Objective To investigate the feasibility and benefits of whole-body vibration (WBV) exercise as a safe and effective training tool for countering sarcopenia and age-related declines in mobility and function in the frail elderly. Design An open, randomized controlled trial. Setting Residential care facilities. Participants Male and female volunteers (N=117; 82.5±7.9y). Interventions After prescreening for contraindications, participants were randomly allocated to a control, simulated WBV (SIM), or WBV exercise group. All participants received regular care, whereas WBV and SIM participants also underwent thrice-weekly exercise sessions for 16 weeks. Delivered by overload principle, WBV training began with 5 × 1-minute bouts at 6 Hz/2 mm (1:1 min exercise:rest), progressing to 10 × 1 minute at up to 26 Hz/4 mm, maintaining knee flexion. Training for SIM participants mimicked WBV exercise stance and duration only. Main Outcome Measures The timed Up and Go, Parallel Walk, and 10-m Timed Walk (10mTW) tests performance were assessed, in addition to the Barthel Index Questionnaire, at baseline, 8, and 16 weeks of exercise, and 3, 6, and 12 months postexercise. Results High levels of compliance were reported in SIM (89%) and WBV training (93%), with ease of use and no adverse effects. In comparison to baseline levels, WBV training elicited clinically important treatment effects in all parameters compared to SIM and control groups. Treatment effects remained apparent up to 12 months postintervention for Parallel Walk Test and 6 months for 10mTW Test. Functional test performance declined during and postintervention in non-WBV groups. Conclusions Findings indicate that 16 weeks of low-level WBV exercise provides easily accessible, adequate stimulus for the frail elderly to attain improved levels of physical functionality.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1120-1130

Titre :	Bilateral Arm Training vs Unilateral Arm Training for Severely Affected Patients With Stroke: Exploratory Single-Blinded Randomized Controlled Trial
Type de document :	Article
Auteurs :	Caroline I. Renner ; Christiane Brendel ; Horst Hummelsheim
Année de publication :	2020
Article en page(s) :	p. 1120-1130
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.007
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Parésie ; Réadaptation
Résumé :	Abstract Objective To compare the effects of unilateral and bilateral arm training on arm impairment in severely affected patients with stroke. Design Single-blinded, randomized controlled trial. Setting Inpatient rehabilitation center. Participants First-time subacute patients (N=69) with stroke and a nonfunctional hand. Patients were stratified according to lesion location post hoc. Interventions Repetitive bilateral arm training on an arm cycle followed by synchronized bilateral repetitive distal hand training or an identical unilateral arm training performed by the paretic limb only. Both unilateral and bilateral trainings were administered twice daily over 6 weeks. Main Outcome Measures The primary outcome measure was the Fugl-Meyer Assessment (FMA) score for the arm, and secondary measures were biomechanical parameters measuring isometric force and rate of force generation. Outcome measures were assessed before, at the end of, and 2 weeks after intervention. Results Patients were homogeneous at study onset. All patients improved regarding the FMA arm score and most biomechanical parameters after intervention. Yet the post hoc analysis stratifying patients according to lesion location showed that patients with pure subcortical stroke, but not patients with cortical involvement of stroke, showed a significantly greater improvement (P=.022) following the bilateral training in FMA arm score (from 6.8±5.7 to 17.8±15.8) compared with unilateral training (from 6.5±7.8 to 8.7±8.6). Conclusions The benefit of bilateral arm training followed by repetitive bilateral hand training for motor control of the severely paretic upper limb may depend on lesion location. Further studies with larger sample size are required for the validation of these results.
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[article] Bilateral Arm Training vs Unilateral Arm Training for Severely Affected Patients With Stroke: Exploratory Single-Blinded Randomized Controlled Trial [Article] / Caroline I. Renner ; Christiane Brendel ; Horst Hummelsheim . - 2020 . - p. 1120-1130.
https://doi.org/10.1016/j.apmr.2020.02.007
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1120-1130

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Parésie ; Réadaptation
Résumé :	Abstract Objective To compare the effects of unilateral and bilateral arm training on arm impairment in severely affected patients with stroke. Design Single-blinded, randomized controlled trial. Setting Inpatient rehabilitation center. Participants First-time subacute patients (N=69) with stroke and a nonfunctional hand. Patients were stratified according to lesion location post hoc. Interventions Repetitive bilateral arm training on an arm cycle followed by synchronized bilateral repetitive distal hand training or an identical unilateral arm training performed by the paretic limb only. Both unilateral and bilateral trainings were administered twice daily over 6 weeks. Main Outcome Measures The primary outcome measure was the Fugl-Meyer Assessment (FMA) score for the arm, and secondary measures were biomechanical parameters measuring isometric force and rate of force generation. Outcome measures were assessed before, at the end of, and 2 weeks after intervention. Results Patients were homogeneous at study onset. All patients improved regarding the FMA arm score and most biomechanical parameters after intervention. Yet the post hoc analysis stratifying patients according to lesion location showed that patients with pure subcortical stroke, but not patients with cortical involvement of stroke, showed a significantly greater improvement (P=.022) following the bilateral training in FMA arm score (from 6.8±5.7 to 17.8±15.8) compared with unilateral training (from 6.5±7.8 to 8.7±8.6). Conclusions The benefit of bilateral arm training followed by repetitive bilateral hand training for motor control of the severely paretic upper limb may depend on lesion location. Further studies with larger sample size are required for the validation of these results.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1131-1137

Titre :	An Innovative STRoke Interactive Virtual thErapy (STRIVE) Online Platform for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial
Type de document :	Article
Auteurs :	Liam Johnson ; Marie-Louise Bird ; Makii Muthalib
Année de publication :	2020
Article en page(s) :	p. 1131-1137
Note générale :	https://doi.org/10.1016/j.apmr.2020.03.011
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Exercice physique ; Membre supérieur ; Réalité de synthèse ; Technologie
Résumé :	Objective To investigate the STRoke Interactive Virtual thErapy (STRIVE) intervention on upper-extremity clinical outcomes in community-dwelling stroke survivors. Design Assessor-blinded randomized controlled trial. Setting Study screening and testing was conducted in a university clinic. Participants completed the virtual therapy (VT) intervention in a community-based stroke support group setting. Participants Of 124 stroke survivors initially assessed, 60 participants were recruited (time poststroke, 13.4±8.9 y). Participants were allocated to either VT or control group using a block randomization design and were stratified by sex. Interventions Participants were randomized to receive 8 weeks of VT or usual care. The intervention consisted of approximately 45 minutes of twice weekly VT training on the Jintronix Rehabilitation System. Main Outcome Measures Between-group differences in the Fugl-Meyer Upper Extremity scale and Action Research Arm Test score were joint primary outcomes in this study. Results Significant between-group differences for the Fugl-Meyer Upper Extremity scale were seen at the end of the intervention (F1, 1=5.37, P=.02, d=0.41). No significant differences were observed with the Action Research Arm Test. No adverse events were reported. Conclusions We demonstrated clinically meaningful improvements in gross upper extremity motor function and use of the affected arm after a VT intervention delivered via a community-based stroke support group setting. This data adds to the contexts in which VT can be used to improve upper limb function. Use of VT in community-based rehabilitation in chronic stroke recovery is supported.
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[article] An Innovative STRoke Interactive Virtual thErapy (STRIVE) Online Platform for Community-Dwelling Stroke Survivors: A Randomized Controlled Trial [Article] / Liam Johnson ; Marie-Louise Bird ; Makii Muthalib . - 2020 . - p. 1131-1137.
https://doi.org/10.1016/j.apmr.2020.03.011
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1131-1137

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Exercice physique ; Membre supérieur ; Réalité de synthèse ; Technologie
Résumé :	Objective To investigate the STRoke Interactive Virtual thErapy (STRIVE) intervention on upper-extremity clinical outcomes in community-dwelling stroke survivors. Design Assessor-blinded randomized controlled trial. Setting Study screening and testing was conducted in a university clinic. Participants completed the virtual therapy (VT) intervention in a community-based stroke support group setting. Participants Of 124 stroke survivors initially assessed, 60 participants were recruited (time poststroke, 13.4±8.9 y). Participants were allocated to either VT or control group using a block randomization design and were stratified by sex. Interventions Participants were randomized to receive 8 weeks of VT or usual care. The intervention consisted of approximately 45 minutes of twice weekly VT training on the Jintronix Rehabilitation System. Main Outcome Measures Between-group differences in the Fugl-Meyer Upper Extremity scale and Action Research Arm Test score were joint primary outcomes in this study. Results Significant between-group differences for the Fugl-Meyer Upper Extremity scale were seen at the end of the intervention (F1, 1=5.37, P=.02, d=0.41). No significant differences were observed with the Action Research Arm Test. No adverse events were reported. Conclusions We demonstrated clinically meaningful improvements in gross upper extremity motor function and use of the affected arm after a VT intervention delivered via a community-based stroke support group setting. This data adds to the contexts in which VT can be used to improve upper limb function. Use of VT in community-based rehabilitation in chronic stroke recovery is supported.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1138-1143

Titre :	Risk Factors for Suicide in a National Sample of Veterans With Multiple Sclerosis
Type de document :	Article
Auteurs :	Quinn D. Kellerman ; Narineh Hartoonian ; Meghan Beier
Année de publication :	2020
Article en page(s) :	p. 1138-1143
Note générale :	https://doi.org/10.1016/j.apmr.2020.03.013
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Anciens combattants ; Cause de décès ; Dépression ; Réadaptation ; Sclérose en plaques ; Suicide
Résumé :	Objectives To examine risk factors in the year before suicide in a national sample of United States veterans with multiple sclerosis (MS), as well as means of suicide and receipt of mental health services prior to death. Design Case control study. Individuals in the Veterans Affairs MS National Data Repository were linked to the National Death Index Plus to obtain death records, including specific causes of death. Participants were veterans with MS who died by suicide and randomly selected nonsuicide MS controls (5 per participant) who were alive at the time of the index suicide. Mental health disorders and medical comorbidities were identified in the year before death for suicides and during the identical time period for controls. Setting Veterans Health Administration. Participants Veterans (N=426) who received treatment for MS in the United States Veterans Health Administration between 1999 and 2011. There were 71 deaths by suicide and 355 randomly selected controls. Interventions Not applicable. Main Outcome Measure Suicide. Results Results from the adjusted multivariable model suggest that the following factors were associated with an increased risk for suicide: male sex (odds ratio [OR], 3.60; 95% confidence interval [CI], 1.35-9.42), depression (OR, 1.82; 95% CI, 1.03-3.23), and alcohol use disorder (OR, 3.10; 95% CI, 1.38-6.96). Half (50.7%) had a mental health appointment in the year before suicide. The primary means of suicide was by firearm (62.0%). Conclusions Routine assessment of suicide risk in individuals with MS is warranted, particularly for those with recent history of depression or alcohol use disorder.
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[article] Risk Factors for Suicide in a National Sample of Veterans With Multiple Sclerosis [Article] / Quinn D. Kellerman ; Narineh Hartoonian ; Meghan Beier . - 2020 . - p. 1138-1143.
https://doi.org/10.1016/j.apmr.2020.03.013
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1138-1143

Descripteurs :	HE Vinci Anciens combattants ; Cause de décès ; Dépression ; Réadaptation ; Sclérose en plaques ; Suicide
Résumé :	Objectives To examine risk factors in the year before suicide in a national sample of United States veterans with multiple sclerosis (MS), as well as means of suicide and receipt of mental health services prior to death. Design Case control study. Individuals in the Veterans Affairs MS National Data Repository were linked to the National Death Index Plus to obtain death records, including specific causes of death. Participants were veterans with MS who died by suicide and randomly selected nonsuicide MS controls (5 per participant) who were alive at the time of the index suicide. Mental health disorders and medical comorbidities were identified in the year before death for suicides and during the identical time period for controls. Setting Veterans Health Administration. Participants Veterans (N=426) who received treatment for MS in the United States Veterans Health Administration between 1999 and 2011. There were 71 deaths by suicide and 355 randomly selected controls. Interventions Not applicable. Main Outcome Measure Suicide. Results Results from the adjusted multivariable model suggest that the following factors were associated with an increased risk for suicide: male sex (odds ratio [OR], 3.60; 95% confidence interval [CI], 1.35-9.42), depression (OR, 1.82; 95% CI, 1.03-3.23), and alcohol use disorder (OR, 3.10; 95% CI, 1.38-6.96). Half (50.7%) had a mental health appointment in the year before suicide. The primary means of suicide was by firearm (62.0%). Conclusions Routine assessment of suicide risk in individuals with MS is warranted, particularly for those with recent history of depression or alcohol use disorder.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1144-1151

Titre :	Measuring Mobility in Low Functioning Hospital Patients: An AM-PAC Replenishment Project
Type de document :	Article
Auteurs :	Daniel L. Young ; Sowmya Kumble ; Carmen E. Capo-Lugo
Année de publication :	2020
Article en page(s) :	p. 1144-1151
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.020
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Performance fonctionnelle physique ; Prestations des soins de santé ; Recherche sur les services de santé
Résumé :	Objective To expand an existing validated measure of basic mobility (Activity Measure for Post-Acute Care [AM-PAC]) for patients at the lowest levels of function. Design Item replenishment for existing item response theory (IRT) derived measure via (1) idea generation and creation of potential new items, (2) item calibration and field testing, and (3) longitudinal pilot test. Setting Two tertiary acute care hospitals. Participants Consecutive inpatients (N=502) ≥18 years old, with an AM-PAC Inpatient Mobility Short Form (IMSF) raw score ≤15. For the longitudinal pilot test, 8 inpatients were evaluated. Results Fifteen new AM-PAC items were developed, 2 of which improved mobility measurement at the lower levels of functioning. Specifically, with the 2 new items, the floor effect of the AM-PAC IMSF was reduced by 19%, statistical power and measurement breadth were greater, and there was greater measurement sensitivity in longitudinal pilot testing. Conclusion Adding 2 new items to the AM-PAC IMSF lowered the floor and increased statistical power, measurement breadth, and sensitivity.
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[article] Measuring Mobility in Low Functioning Hospital Patients: An AM-PAC Replenishment Project [Article] / Daniel L. Young ; Sowmya Kumble ; Carmen E. Capo-Lugo . - 2020 . - p. 1144-1151.
https://doi.org/10.1016/j.apmr.2020.01.020
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1144-1151

Descripteurs :	HE Vinci Performance fonctionnelle physique ; Prestations des soins de santé ; Recherche sur les services de santé
Résumé :	Objective To expand an existing validated measure of basic mobility (Activity Measure for Post-Acute Care [AM-PAC]) for patients at the lowest levels of function. Design Item replenishment for existing item response theory (IRT) derived measure via (1) idea generation and creation of potential new items, (2) item calibration and field testing, and (3) longitudinal pilot test. Setting Two tertiary acute care hospitals. Participants Consecutive inpatients (N=502) ≥18 years old, with an AM-PAC Inpatient Mobility Short Form (IMSF) raw score ≤15. For the longitudinal pilot test, 8 inpatients were evaluated. Results Fifteen new AM-PAC items were developed, 2 of which improved mobility measurement at the lower levels of functioning. Specifically, with the 2 new items, the floor effect of the AM-PAC IMSF was reduced by 19%, statistical power and measurement breadth were greater, and there was greater measurement sensitivity in longitudinal pilot testing. Conclusion Adding 2 new items to the AM-PAC IMSF lowered the floor and increased statistical power, measurement breadth, and sensitivity.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1152-1161

Titre :	Mediating Role of Resilience on Quality of Life in Individuals With Multiple Sclerosis: A Structural Equation Modeling Approach
Type de document :	Article
Auteurs :	Susan L. Kasser ; Asim Zia
Année de publication :	2020
Article en page(s) :	p. 1152-1161
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.010
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Facteurs de protection ; Facteurs de risque ; Qualité de vie ; Sclérose en plaques
Résumé :	Objective To examine the relationship between disease-related risk factors, protective factors, coping, and resilience on quality of life in adults with multiple sclerosis (MS). Design Quantitative descriptive research employing structural equation modeling. Setting Online survey fielded to community members associated with the Greater New England Chapter of the National Multiple Sclerosis Society. Participants Convenience sample of 271 individuals with MS. Intervention Not applicable. Main Outcome Measures The Leeds Multiple Sclerosis Quality of Life (LMSQoL) scale was the primary outcome. Other measures entered into the model included the Brief Resilience Scale (BRS) and the Coping Orientation to Problems Experienced (COPE) scale modeled as 2 latent variables: emotion-based coping and problem-based coping. Disability level, fatigue, walking impairment, fear of falling, falls, and pain were modeled as a latent variable for risk factors while physical activity, self-efficacy, social support, optimism, and health locus of control were modeled as a latent variable of protective factors. Results BRS had a total effect of –0.44 on LMSQoL, significant at P<.001. protective factors also directly and significantly increased qol effect size p emotion-based coping problem-based had insignificant effects on qol. risk a complex influence mediated by resilience coping. total of quality life at whereas higher decreased both indirectly the likelihood with slightly size. model fit data reasonably well explained variance in people ms.> Conclusions The model suggests that developing interventions that increase protective factors and broaden and build resilience may contribute to improved quality of life in individuals with MS.
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[article] Mediating Role of Resilience on Quality of Life in Individuals With Multiple Sclerosis: A Structural Equation Modeling Approach [Article] / Susan L. Kasser ; Asim Zia . - 2020 . - p. 1152-1161.
https://doi.org/10.1016/j.apmr.2020.02.010
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1152-1161

Descripteurs :	HE Vinci Facteurs de protection ; Facteurs de risque ; Qualité de vie ; Sclérose en plaques
Résumé :	Objective To examine the relationship between disease-related risk factors, protective factors, coping, and resilience on quality of life in adults with multiple sclerosis (MS). Design Quantitative descriptive research employing structural equation modeling. Setting Online survey fielded to community members associated with the Greater New England Chapter of the National Multiple Sclerosis Society. Participants Convenience sample of 271 individuals with MS. Intervention Not applicable. Main Outcome Measures The Leeds Multiple Sclerosis Quality of Life (LMSQoL) scale was the primary outcome. Other measures entered into the model included the Brief Resilience Scale (BRS) and the Coping Orientation to Problems Experienced (COPE) scale modeled as 2 latent variables: emotion-based coping and problem-based coping. Disability level, fatigue, walking impairment, fear of falling, falls, and pain were modeled as a latent variable for risk factors while physical activity, self-efficacy, social support, optimism, and health locus of control were modeled as a latent variable of protective factors. Results BRS had a total effect of –0.44 on LMSQoL, significant at P<.001. protective factors also directly and significantly increased qol effect size p emotion-based coping problem-based had insignificant effects on qol. risk a complex influence mediated by resilience coping. total of quality life at whereas higher decreased both indirectly the likelihood with slightly size. model fit data reasonably well explained variance in people ms.> Conclusions The model suggests that developing interventions that increase protective factors and broaden and build resilience may contribute to improved quality of life in individuals with MS.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1162-1169

Titre :	The Effect of Health Service Use, Unmet Need, and Service Obstacles on Quality of Life and Psychological Well-Being in the First Year After Discharge From Spinal Cord Injury Rehabilitation
Type de document :	Article
Auteurs :	David N. Borg ; Michele M. Foster ; Melissa Legg
Année de publication :	2020
Article en page(s) :	p. 1162-1169
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.008
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Psychologie ; Qualité de vie ; Réadaptation ; Services de santé ; Traumatismes de la moelle épinière
Résumé :	Objective This study examined the effects of health and rehabilitation service use, unmet need for services, and service obstacles on health-related quality of life (HR QoL) and psychological well-being after discharge from spinal cord injury (SCI) rehabilitation. Design Prospective cohort study, with participants followed up at 6 and/or 12 months after discharge from SCI inpatient rehabilitation. Setting Community setting. Participants People with SCI (N=55; mean age 51y; 76.4% men; 61.8% traumatic injury; mean length of stay 137d). Interventions Not applicable. Main Outcome Measures Service Usage Scale, Service Obstacles Scale, the EuroQol-5D, and the Depression Anxiety and Stress Scale short form. Eight predictors of outcome were considered: service use (ie, use of general practitioner, medical specialist, nursing, and allied health, and rehospitalization), unmet need, and service obstacles (ie, finances and transport). Possibly important predictors of each outcome were identified via penalized regression, and a final model was fit using Bayesian hierarchical regression with a Gaussian or zero-inflated Poisson response distribution. Results Financial obstacles were associated with a poorer HR QoL (β [95% credible interval]= −0.095 [−0.166 to −0.027]) and higher anxiety (odds ratio, OR [95% credible interval]=1.63 [1.16-2.23]). Rehospitalization was associated with a lower EuroQol visual analog scale (β= −11.2 [−19.7 to −2.5]) and, interestingly, lower anxiety (OR=1.63 [1.16-2.23]). Use of allied health was associated with higher anxiety (OR=2.48 [1.42-4.44]). Conclusion The varying degrees of financial hardship experienced after injury with complex rehabilitation needs requires investigation, as does the interactive effects of service use, unmet need, and service obstacles on outcomes like QoL and psychological well-being.
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[article] The Effect of Health Service Use, Unmet Need, and Service Obstacles on Quality of Life and Psychological Well-Being in the First Year After Discharge From Spinal Cord Injury Rehabilitation [Article] / David N. Borg ; Michele M. Foster ; Melissa Legg . - 2020 . - p. 1162-1169.
https://doi.org/10.1016/j.apmr.2020.02.008
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1162-1169

Descripteurs :	HE Vinci Psychologie ; Qualité de vie ; Réadaptation ; Services de santé ; Traumatismes de la moelle épinière
Résumé :	Objective This study examined the effects of health and rehabilitation service use, unmet need for services, and service obstacles on health-related quality of life (HR QoL) and psychological well-being after discharge from spinal cord injury (SCI) rehabilitation. Design Prospective cohort study, with participants followed up at 6 and/or 12 months after discharge from SCI inpatient rehabilitation. Setting Community setting. Participants People with SCI (N=55; mean age 51y; 76.4% men; 61.8% traumatic injury; mean length of stay 137d). Interventions Not applicable. Main Outcome Measures Service Usage Scale, Service Obstacles Scale, the EuroQol-5D, and the Depression Anxiety and Stress Scale short form. Eight predictors of outcome were considered: service use (ie, use of general practitioner, medical specialist, nursing, and allied health, and rehospitalization), unmet need, and service obstacles (ie, finances and transport). Possibly important predictors of each outcome were identified via penalized regression, and a final model was fit using Bayesian hierarchical regression with a Gaussian or zero-inflated Poisson response distribution. Results Financial obstacles were associated with a poorer HR QoL (β [95% credible interval]= −0.095 [−0.166 to −0.027]) and higher anxiety (odds ratio, OR [95% credible interval]=1.63 [1.16-2.23]). Rehospitalization was associated with a lower EuroQol visual analog scale (β= −11.2 [−19.7 to −2.5]) and, interestingly, lower anxiety (OR=1.63 [1.16-2.23]). Use of allied health was associated with higher anxiety (OR=2.48 [1.42-4.44]). Conclusion The varying degrees of financial hardship experienced after injury with complex rehabilitation needs requires investigation, as does the interactive effects of service use, unmet need, and service obstacles on outcomes like QoL and psychological well-being.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1170-1175

Titre :	Survivors of Chronic Stroke Experience Continued Impairment of Dexterity But Not Strength in the Nonparetic Upper Limb
Type de document :	Article
Auteurs :	Alexander J. Barry ; Kristen M. Triandafilou ; Mary Ellen Stoykov
Année de publication :	2020
Article en page(s) :	p. 1170-1175
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.018
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Réadaptation ; Récupération fonctionnelle Autres descripteurs Lateralite fonctionnelle
Résumé :	Objective To investigate the performance of the less affected upper limb in people with stroke compared with normative values. To examine less affected upper limb function in those whose prestroke dominant limb became paretic and those whose prestroke nondominant limb became paretic. Design Cohort study of survivors of chronic stroke (7.2±6.7y post incident). Setting The study was performed at a freestanding academic rehabilitation hospital. Participants Survivors of chronic stroke (N=40) with severe hand impairment (Chedoke-McMaster Stroke Assessment rating of 2-3 on Stage of Hand) participated in the study. In 20 participants the prestroke dominant hand (DH) was tested (nondominant hand [NH] affected by stroke), and in 20 participants the prestroke NH was tested (DH affected by stroke). Interventions Not applicable. Main Outcome Measure Jebsen-Taylor Hand Function Test. Data from survivors of stroke were compared with normative age- and sex-matched data from neurologically intact individuals. Results When combined, DH and NH groups performed significantly worse on fine motor tasks with their nonparetic hand relative to normative data (P<.007 for all measures even the participants who continued to use their prestroke dh as primary hand after stroke demonstrated reduced fine motor skills compared with normative data. in contrast grip strength was not significantly affected either group of survivors>.140). Conclusions Survivors of stroke with severe impairment of the paretic limb continue to present significant upper extremity impairment in their nominally nonparetic limb even years after stroke. This phenomenon was observed regardless of whether the DH or NH hand was primarily affected. Because this group of survivors of stroke is especially dependent on the nonparetic limb for performing functional tasks, our results suggest that the nonparetic upper limb should be targeted for rehabilitation.
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[article] Survivors of Chronic Stroke Experience Continued Impairment of Dexterity But Not Strength in the Nonparetic Upper Limb [Article] / Alexander J. Barry ; Kristen M. Triandafilou ; Mary Ellen Stoykov . - 2020 . - p. 1170-1175.
https://doi.org/10.1016/j.apmr.2020.01.018
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1170-1175

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Réadaptation ; Récupération fonctionnelle Autres descripteurs Lateralite fonctionnelle
Résumé :	Objective To investigate the performance of the less affected upper limb in people with stroke compared with normative values. To examine less affected upper limb function in those whose prestroke dominant limb became paretic and those whose prestroke nondominant limb became paretic. Design Cohort study of survivors of chronic stroke (7.2±6.7y post incident). Setting The study was performed at a freestanding academic rehabilitation hospital. Participants Survivors of chronic stroke (N=40) with severe hand impairment (Chedoke-McMaster Stroke Assessment rating of 2-3 on Stage of Hand) participated in the study. In 20 participants the prestroke dominant hand (DH) was tested (nondominant hand [NH] affected by stroke), and in 20 participants the prestroke NH was tested (DH affected by stroke). Interventions Not applicable. Main Outcome Measure Jebsen-Taylor Hand Function Test. Data from survivors of stroke were compared with normative age- and sex-matched data from neurologically intact individuals. Results When combined, DH and NH groups performed significantly worse on fine motor tasks with their nonparetic hand relative to normative data (P<.007 for all measures even the participants who continued to use their prestroke dh as primary hand after stroke demonstrated reduced fine motor skills compared with normative data. in contrast grip strength was not significantly affected either group of survivors>.140). Conclusions Survivors of stroke with severe impairment of the paretic limb continue to present significant upper extremity impairment in their nominally nonparetic limb even years after stroke. This phenomenon was observed regardless of whether the DH or NH hand was primarily affected. Because this group of survivors of stroke is especially dependent on the nonparetic limb for performing functional tasks, our results suggest that the nonparetic upper limb should be targeted for rehabilitation.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1176-1182

Titre :	Brain Functional Specialization Is Enhanced Among Tai Chi Chuan Practitioners
Type de document :	Article
Auteurs :	Li-Zhen Chen ; Xinru Yuan ; Yuanchao Zhang
Année de publication :	2020
Article en page(s) :	p. 1176-1182
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.005
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Cognition ; Imagerie par résonance magnétique ; Lobe frontal ; Réadaptation ; Tai chi
Résumé :	Objective To investigate the effect of long-term Tai Chi Chuan (TCC) practice on practitioners’ brain functional specialization compare with the TCC novices. Design A cross-sectional study. Setting A psychology Institute. Participants TCC practitioners (N=22) (52.4±6.8y; 7 men; educated years: 12.18±3.03y) and 18 healthy adults (54.8±6.8y; 8 men; education years: 11.78±2.90y) matched by age, sex, and education were enrolled. Main Outcome Measures Participants underwent functional magnetic resonance imaging scanning and cognitive test to measure the differences in functional specialization and cognitive function. Functional specialization was evaluated by voxel-mirrored homotopic connectivity (VMHC) method. Results Lower middle frontal gyrus VMHC in TCC practitioners compared to controls. For TCC practitioners, the longer they practice, the lower their VMHC in precentral and precuneus. TCC practitioners showed better cognition performance. Conclusions Changed VMHC indicated that TCC practice could enhance functional specialization in the middle frontal cortex of practitioners, which may be associated with higher-order cognitive ability.
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[article] Brain Functional Specialization Is Enhanced Among Tai Chi Chuan Practitioners [Article] / Li-Zhen Chen ; Xinru Yuan ; Yuanchao Zhang . - 2020 . - p. 1176-1182.
https://doi.org/10.1016/j.apmr.2020.02.005
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1176-1182

Descripteurs :	HE Vinci Cognition ; Imagerie par résonance magnétique ; Lobe frontal ; Réadaptation ; Tai chi
Résumé :	Objective To investigate the effect of long-term Tai Chi Chuan (TCC) practice on practitioners’ brain functional specialization compare with the TCC novices. Design A cross-sectional study. Setting A psychology Institute. Participants TCC practitioners (N=22) (52.4±6.8y; 7 men; educated years: 12.18±3.03y) and 18 healthy adults (54.8±6.8y; 8 men; education years: 11.78±2.90y) matched by age, sex, and education were enrolled. Main Outcome Measures Participants underwent functional magnetic resonance imaging scanning and cognitive test to measure the differences in functional specialization and cognitive function. Functional specialization was evaluated by voxel-mirrored homotopic connectivity (VMHC) method. Results Lower middle frontal gyrus VMHC in TCC practitioners compared to controls. For TCC practitioners, the longer they practice, the lower their VMHC in precentral and precuneus. TCC practitioners showed better cognition performance. Conclusions Changed VMHC indicated that TCC practice could enhance functional specialization in the middle frontal cortex of practitioners, which may be associated with higher-order cognitive ability.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1183-1189

Titre :	The Utility of the 2-Minute Walk Test as a Measure of Mobility in People With Lower Limb Amputation
Type de document :	Article
Auteurs :	Ignacio A. Gaunaurd ; Anat Kristal ; Amber Horn
Année de publication :	2020
Article en page(s) :	p. 1183-1189
Note générale :	https://doi.org/10.1016/j.apmr.2020.03.007
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Amputés ; Démarche ; Évaluation de résultat (soins) ; Membre inférieur
Résumé :	Objectives To establish reference values for the 2-minute walk test (2-MWT) distance and gait speed in people with a lower limb amputation (LLA) who are prosthetic ambulators. Also, to describe the differences in distance and gait speed between sexes, causes of amputation, levels of amputation, health risk classification, functional levels, and age groups. Design Cross-sectional study. Setting National meeting for people with lower limb amputation. Participants A convenience sample of unilateral people (N=101; 47 men, 54 women; mean age ± SD, 50.9±14.3 y) with an LLA; 48 had a transtibial amputation and 53 had a transfemoral amputation. Participants were classified as either limited community ambulators, community ambulators, or those who exceed basic ambulation skills (K2, n=7; K3, n=70; K4, n=24). Intervention Not applicable. Main Outcome Measure 2-MWT performance (ie, distance and gait speed). Results The mean ± SD 2-MWT distance and gait speed for the entire sample was 143.8±37.5 meters (range, 49-259 m) and 72.1±18.8 meters per minute (range, 25-130 m/min), respectively. Men walked farther (distance: men, 154.2±34.2 m; women, 134.4±38.1 m) and faster (gait speed: men, 77.3±17.1 m/min; women, 67.4±19.1 m/min) than women (P<.05 the mean sd distance for k4 k3 and k2 level participants was meters respectively. functional performed better than people with transtibial amputation walked farther those transfemoral m vs speed ambulated by classified in very high health risk group worse categorized as being at an increased no increase performance of older years old inferior to all younger age groups.> Conclusions Reference values for the 2-MWT distance and gait speed were established in people with LLA who are prosthetic ambulators. Significant differences in the 2-MWT performance were found between sexes, causes of amputation, levels of amputation, health risk classification, functional levels, and age groups.
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[article] The Utility of the 2-Minute Walk Test as a Measure of Mobility in People With Lower Limb Amputation [Article] / Ignacio A. Gaunaurd ; Anat Kristal ; Amber Horn . - 2020 . - p. 1183-1189.
https://doi.org/10.1016/j.apmr.2020.03.007
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1183-1189

Descripteurs :	HE Vinci Amputés ; Démarche ; Évaluation de résultat (soins) ; Membre inférieur
Résumé :	Objectives To establish reference values for the 2-minute walk test (2-MWT) distance and gait speed in people with a lower limb amputation (LLA) who are prosthetic ambulators. Also, to describe the differences in distance and gait speed between sexes, causes of amputation, levels of amputation, health risk classification, functional levels, and age groups. Design Cross-sectional study. Setting National meeting for people with lower limb amputation. Participants A convenience sample of unilateral people (N=101; 47 men, 54 women; mean age ± SD, 50.9±14.3 y) with an LLA; 48 had a transtibial amputation and 53 had a transfemoral amputation. Participants were classified as either limited community ambulators, community ambulators, or those who exceed basic ambulation skills (K2, n=7; K3, n=70; K4, n=24). Intervention Not applicable. Main Outcome Measure 2-MWT performance (ie, distance and gait speed). Results The mean ± SD 2-MWT distance and gait speed for the entire sample was 143.8±37.5 meters (range, 49-259 m) and 72.1±18.8 meters per minute (range, 25-130 m/min), respectively. Men walked farther (distance: men, 154.2±34.2 m; women, 134.4±38.1 m) and faster (gait speed: men, 77.3±17.1 m/min; women, 67.4±19.1 m/min) than women (P<.05 the mean sd distance for k4 k3 and k2 level participants was meters respectively. functional performed better than people with transtibial amputation walked farther those transfemoral m vs speed ambulated by classified in very high health risk group worse categorized as being at an increased no increase performance of older years old inferior to all younger age groups.> Conclusions Reference values for the 2-MWT distance and gait speed were established in people with LLA who are prosthetic ambulators. Significant differences in the 2-MWT performance were found between sexes, causes of amputation, levels of amputation, health risk classification, functional levels, and age groups.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1190-1198

Titre :	Are Stroke Survivors Discharged to the Recommended Postacute Setting?
Type de document :	Article
Auteurs :	Joel Stein ; Pamela Borg-Jensen ; Alyse Sicklick
Année de publication :	2020
Article en page(s) :	p. 1190-1198
Note générale :	https://doi.org/10.1016/j.apmr.2020.03.006
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Établissements de soins qualifiés ; Prise de décision ; Réadaptation ; Sortie du patient
Résumé :	To examine the processes and barriers involved in providing postdischarge stroke care. Design Prospective study of discharge planners’ (DP) and physical therapists’ (PT) interpretation of factors contributing to patients’ discharge destination. Setting Twenty-three hospitals in the northeastern United States. Participants After exclusions, data on patients (N=427) hospitalized with a primary diagnosis of stroke between May 2015 and November 2016 were examined. Of the patients, 45% were women, and the median age was 71 years. DPs and PTs caring for these patients were queried regarding the selection of discharge destination. Interventions None. Main Outcome Measures Comparison of actual discharge destination for stroke patients with the destinations recommended by their DPs and PTs. Results In total, 184 patients (43.1%) were discharged home, 146 (34.2%) to an inpatient rehabilitation facility, 94 (22.0%) to a skilled nursing facility, and 3 (0.7%) to a long-term acute care hospital. DPs and PTs agreed on the recommended discharge destination in 355 (83.1%) cases. The actual discharge destination matched the DP and PT recommended discharge destination in 92.5% of these cases. In 23 cases (6.5%), the patient was discharged to a less intensive setting than recommended by both respondents. In 4 cases (1.1%), the patient was discharged to a more intensive level of care. In 2 cases (0.6%), the patient was discharged to a long-term acute care hospital rather than an inpatient rehabilitation facility as recommended. Patient or family preference was cited by at least 1 respondent for the discrepancy in discharge destination for 13 patients (3.1%); insurance barriers were cited for 9 patients (2.3%). Conclusions Most stroke survivors in the northeast United States are discharged to the recommended postacute care destination based on the consensus of DP and PT opinions. Further research is needed to guide postacute care service selection.
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[article] Are Stroke Survivors Discharged to the Recommended Postacute Setting? [Article] / Joel Stein ; Pamela Borg-Jensen ; Alyse Sicklick . - 2020 . - p. 1190-1198.
https://doi.org/10.1016/j.apmr.2020.03.006
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1190-1198

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Établissements de soins qualifiés ; Prise de décision ; Réadaptation ; Sortie du patient
Résumé :	To examine the processes and barriers involved in providing postdischarge stroke care. Design Prospective study of discharge planners’ (DP) and physical therapists’ (PT) interpretation of factors contributing to patients’ discharge destination. Setting Twenty-three hospitals in the northeastern United States. Participants After exclusions, data on patients (N=427) hospitalized with a primary diagnosis of stroke between May 2015 and November 2016 were examined. Of the patients, 45% were women, and the median age was 71 years. DPs and PTs caring for these patients were queried regarding the selection of discharge destination. Interventions None. Main Outcome Measures Comparison of actual discharge destination for stroke patients with the destinations recommended by their DPs and PTs. Results In total, 184 patients (43.1%) were discharged home, 146 (34.2%) to an inpatient rehabilitation facility, 94 (22.0%) to a skilled nursing facility, and 3 (0.7%) to a long-term acute care hospital. DPs and PTs agreed on the recommended discharge destination in 355 (83.1%) cases. The actual discharge destination matched the DP and PT recommended discharge destination in 92.5% of these cases. In 23 cases (6.5%), the patient was discharged to a less intensive setting than recommended by both respondents. In 4 cases (1.1%), the patient was discharged to a more intensive level of care. In 2 cases (0.6%), the patient was discharged to a long-term acute care hospital rather than an inpatient rehabilitation facility as recommended. Patient or family preference was cited by at least 1 respondent for the discrepancy in discharge destination for 13 patients (3.1%); insurance barriers were cited for 9 patients (2.3%). Conclusions Most stroke survivors in the northeast United States are discharged to the recommended postacute care destination based on the consensus of DP and PT opinions. Further research is needed to guide postacute care service selection.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1199-1203

Titre :	The Six-Clicks Mobility Measure: A Useful Tool for Predicting Discharge Disposition
Type de document :	Article
Auteurs :	Elizabeth R. Pfoh ; Aaron Hamilton ; Bo Hu
Année de publication :	2020
Article en page(s) :	p. 1199-1203
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.016
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Planification hospitalière ; Réadaptation ; Sortie du patient
Résumé :	Objective To assess the predictive capabilities of 2 measures of functional mobility, the 6-clicks score and the Braden scale mobility score. We also identified the additional predictive value of adding electronic health record data (demographics, laboratory data, and vital signs) to each model. Design Cohort study. Setting A large integrated health system. Participants Patients ≥18 years of age (N=17,022) admitted to the inpatient medical service of one of 8 hospitals. Interventions None. Main Outcome Measures Predictive measures were patient demographics, laboratory values, vital signs, and functional mobility as measured by the 6-clicks score within the first 48 hours of hospital admission. Our outcome was discharge destination (home vs other). Results Our final sample included 19,963 records. Patients were discharged alive from 19,698 admissions. The majority were women (n=11,729, 59%) with a mean age of 73 (standard deviation, 15.3) years. Patients’ initial 6-clicks score had moderate discrimination for discharge destination (c-statistic of 0.78) and outperformed the Braden score (c-statistic of 0.68). Electronic health record data alone had poor discrimination (c-statistic of 0.66) and added little to the model of 6-clicks alone (adjusted c-statistic increased from 0.78 to 0.80). Conclusion Functional mobility measured via 6-clicks within 48 hours of admission can help identify patients who are likely to go home, facilitating early discharge planning.
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[article] The Six-Clicks Mobility Measure: A Useful Tool for Predicting Discharge Disposition [Article] / Elizabeth R. Pfoh ; Aaron Hamilton ; Bo Hu . - 2020 . - p. 1199-1203.
https://doi.org/10.1016/j.apmr.2020.02.016
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1199-1203

Descripteurs :	HE Vinci Planification hospitalière ; Réadaptation ; Sortie du patient
Résumé :	Objective To assess the predictive capabilities of 2 measures of functional mobility, the 6-clicks score and the Braden scale mobility score. We also identified the additional predictive value of adding electronic health record data (demographics, laboratory data, and vital signs) to each model. Design Cohort study. Setting A large integrated health system. Participants Patients ≥18 years of age (N=17,022) admitted to the inpatient medical service of one of 8 hospitals. Interventions None. Main Outcome Measures Predictive measures were patient demographics, laboratory values, vital signs, and functional mobility as measured by the 6-clicks score within the first 48 hours of hospital admission. Our outcome was discharge destination (home vs other). Results Our final sample included 19,963 records. Patients were discharged alive from 19,698 admissions. The majority were women (n=11,729, 59%) with a mean age of 73 (standard deviation, 15.3) years. Patients’ initial 6-clicks score had moderate discrimination for discharge destination (c-statistic of 0.78) and outperformed the Braden score (c-statistic of 0.68). Electronic health record data alone had poor discrimination (c-statistic of 0.66) and added little to the model of 6-clicks alone (adjusted c-statistic increased from 0.78 to 0.80). Conclusion Functional mobility measured via 6-clicks within 48 hours of admission can help identify patients who are likely to go home, facilitating early discharge planning.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1204-1211

Titre :	Beliefs About the Influence of Rest During Concussion Recovery May Predict Activity and Symptom Progression Within an Active Duty Military Population
Type de document :	Article
Auteurs :	Rosemay A. Remigio-Baker ; Emma Gregory ; Wesley R. Cole
Année de publication :	2020
Article en page(s) :	p. 1204-1211
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.015
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Commotion de l'encéphale ; Culture (sociologie) ; Education ; Personnel militaire ; Rééducation neurologique ; Résultat thérapeutique ; Savoir
Résumé :	Objectives To evaluate relationships between beliefs about the impact of rest and the level of activities and symptoms over time among active duty Service members sustaining concussion, and whether these relationships vary by provision of concussion education. Design Longitudinal study using multilevel modeling to assess the relationship between beliefs about rest within 72 hours of concussion and change in activity and symptom level over time, as well as interaction by concussion education at the initial clinic visit. Setting Three military treatment facilities. Participants Study participants included active duty Service members diagnosed with a concussion (N=111; median age, 24 y). Individuals with previous history of concussion within 12 months of study enrollment were excluded. Intervention Not applicable. Main Outcome Measures Activity questionnaire and the Neurobehavioral Symptom Inventory assessed within 72 hours of concussion; at 1 week; and at 1, 3, and 6 month(s) postinjury. Results Receipt of concussion education from providers was significantly associated with greater belief that rest influences concussion recovery. Greater belief that rest influences symptom recovery at the acute stage of concussion was associated with a greater increase in activities over time, but only among those who received education from their provider. Additionally, greater belief about the influence of rest was related to a more rapid decrease in symptoms over time. Conclusions Concussed Service members who underestimate the influence of rest during acute recovery may be at risk for poorer recovery. Treatment of Service members with postconcussive symptoms should consider patient knowledge and/or beliefs about rest and recovery, which may influence prognosis. Our results support the provider’s use of concussion education to correct potential misconceptions that may negatively impact symptom recovery.
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[article] Beliefs About the Influence of Rest During Concussion Recovery May Predict Activity and Symptom Progression Within an Active Duty Military Population [Article] / Rosemay A. Remigio-Baker ; Emma Gregory ; Wesley R. Cole . - 2020 . - p. 1204-1211.
https://doi.org/10.1016/j.apmr.2020.02.015
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1204-1211

Descripteurs :	HE Vinci Commotion de l'encéphale ; Culture (sociologie) ; Education ; Personnel militaire ; Rééducation neurologique ; Résultat thérapeutique ; Savoir
Résumé :	Objectives To evaluate relationships between beliefs about the impact of rest and the level of activities and symptoms over time among active duty Service members sustaining concussion, and whether these relationships vary by provision of concussion education. Design Longitudinal study using multilevel modeling to assess the relationship between beliefs about rest within 72 hours of concussion and change in activity and symptom level over time, as well as interaction by concussion education at the initial clinic visit. Setting Three military treatment facilities. Participants Study participants included active duty Service members diagnosed with a concussion (N=111; median age, 24 y). Individuals with previous history of concussion within 12 months of study enrollment were excluded. Intervention Not applicable. Main Outcome Measures Activity questionnaire and the Neurobehavioral Symptom Inventory assessed within 72 hours of concussion; at 1 week; and at 1, 3, and 6 month(s) postinjury. Results Receipt of concussion education from providers was significantly associated with greater belief that rest influences concussion recovery. Greater belief that rest influences symptom recovery at the acute stage of concussion was associated with a greater increase in activities over time, but only among those who received education from their provider. Additionally, greater belief about the influence of rest was related to a more rapid decrease in symptoms over time. Conclusions Concussed Service members who underestimate the influence of rest during acute recovery may be at risk for poorer recovery. Treatment of Service members with postconcussive symptoms should consider patient knowledge and/or beliefs about rest and recovery, which may influence prognosis. Our results support the provider’s use of concussion education to correct potential misconceptions that may negatively impact symptom recovery.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1212-1219

Titre :	The Effects of Task Prioritization on Dual-Tasking Postural Control in Patients With Parkinson Disease Who Have Different Postural Impairments
Type de document :	Article
Auteurs :	Yu-Ting Hung ; Liang-Chi Chen ; Ruey-Meei Wu
Année de publication :	2020
Article en page(s) :	p. 1212-1219
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.014
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Attention ; Electromyographie ; Équilibre postural ; Maladie de Parkinson ; Réadaptation
Résumé :	Objective To investigate the effect of task prioritization on dual-task control in Parkinson disease (PD) associated with different postural impairments. Design Cross-sectional study. Participants were instructed to keep 2 interlocking rings apart and maintain balance in a tandem stance. Attention was focused on either stance stability (posture-focus strategy) or the interlocking rings (supraposture-focus strategy). Setting University research laboratory. Participants Fifteen patients with PD and less postural impairment and 15 patients with PD and more postural impairment (N=30). Interventions Not applicable. Main Outcome Measures Postural sway, postural determinism (%DET), ankle co-contraction, and ring-touching time. Results In the less-impairment group, the supraposture-focus strategy provided smaller postural sway and postural %DET compared with the posture-focus strategy. In the more-impairment group, task prioritization showed lower effect on both postural sway and postural %DET. The supraposture-focus strategy led to less ankle co-contraction than the posture-focus strategy in the more-impairment group, but task prioritization did not affect ankle co-contraction in the less-impairment group. In both groups, the supraposture-focus strategy led to less ring-touching time than the posture-focus strategy. Conclusions The supraposture-focus strategy provided better dual-task control than the posture-focus strategy in both PD groups. In the less-impairment group, the supraposture-focus strategy enhanced postural automaticity and postural stability. In the more-impairment group, the supraposture-focus strategy reduced ankle stiffness, owing to reduced muscle co-contraction.
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[article] The Effects of Task Prioritization on Dual-Tasking Postural Control in Patients With Parkinson Disease Who Have Different Postural Impairments [Article] / Yu-Ting Hung ; Liang-Chi Chen ; Ruey-Meei Wu . - 2020 . - p. 1212-1219.
https://doi.org/10.1016/j.apmr.2020.02.014
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1212-1219

Descripteurs :	HE Vinci Attention ; Electromyographie ; Équilibre postural ; Maladie de Parkinson ; Réadaptation
Résumé :	Objective To investigate the effect of task prioritization on dual-task control in Parkinson disease (PD) associated with different postural impairments. Design Cross-sectional study. Participants were instructed to keep 2 interlocking rings apart and maintain balance in a tandem stance. Attention was focused on either stance stability (posture-focus strategy) or the interlocking rings (supraposture-focus strategy). Setting University research laboratory. Participants Fifteen patients with PD and less postural impairment and 15 patients with PD and more postural impairment (N=30). Interventions Not applicable. Main Outcome Measures Postural sway, postural determinism (%DET), ankle co-contraction, and ring-touching time. Results In the less-impairment group, the supraposture-focus strategy provided smaller postural sway and postural %DET compared with the posture-focus strategy. In the more-impairment group, task prioritization showed lower effect on both postural sway and postural %DET. The supraposture-focus strategy led to less ankle co-contraction than the posture-focus strategy in the more-impairment group, but task prioritization did not affect ankle co-contraction in the less-impairment group. In both groups, the supraposture-focus strategy led to less ring-touching time than the posture-focus strategy. Conclusions The supraposture-focus strategy provided better dual-task control than the posture-focus strategy in both PD groups. In the less-impairment group, the supraposture-focus strategy enhanced postural automaticity and postural stability. In the more-impairment group, the supraposture-focus strategy reduced ankle stiffness, owing to reduced muscle co-contraction.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1220-1232

Titre :	Establishing the Factor Structure of a Health-Related Quality of Life Measurement System for Caregivers of Persons Living With Traumatic Brain Injury
Type de document :	Article
Auteurs :	Jason Raad ; David S. Tulsky ; Rael T. Lange
Année de publication :	2020
Article en page(s) :	p. 1220-1232
Note générale :	https://doi.org/10.1016/j.apmr.2020.03.014
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aidants ; Anciens combattants ; Lésions encéphaliques ; Mesures des résultats rapportés par les patients (PROM) ; Qualité de vie ; Réadaptation
Résumé :	Objectives To understand the factor structure of health-related quality of life specific to caregivers of people living with traumatic brain injury (TBI). Design Prospective, cross-sectional data collection. Setting Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. Participants Caregivers (N=558) of people who have sustained a TBI (344 caregivers of civilians and 214 caregivers of service members or veterans; 85% women; 58% spouses; mean age, 46.12±14.07y) who have provided care for an average of 5.82±5.40 years. Interventions Not applicable. Main Outcomes Measures The Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) measurement system including 10 Patient-Reported Outcomes Measurement Information System item banks (anger, anxiety, depression, social isolation, sleep disturbance, fatigue, ability to participate in social roles and activities, satisfaction with social roles and activities, emotional support, informational support) and 5 TBI-CareQOL banks (feelings of loss–self, feelings of loss–person with TBI, feeling trapped, caregiver-specific anxiety, caregiver strain). Results Confirmatory factor analysis model fit indices were compared for 14 empirically derived and 5 theoretically derived models. Confirmatory factor analysis results indicated that the best model fit was for a 6-factor model with dimensions that included mental health, social support, social participation, social isolation, physical health, and caregiver emotion. Conclusions Results indicated that a 6-factor model provided the best model fit for health-related quality of life in caregivers of individuals with TBI. These results have utility for both research and clinical applications. Establishing the TBI-CareQOL’s factor structure provides preliminary evidence of the measurement system’s construct validity, helps inform the selection of measures for specific research or clinical interventions, and informs the development of composite scores.
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[article] Establishing the Factor Structure of a Health-Related Quality of Life Measurement System for Caregivers of Persons Living With Traumatic Brain Injury [Article] / Jason Raad ; David S. Tulsky ; Rael T. Lange . - 2020 . - p. 1220-1232.
https://doi.org/10.1016/j.apmr.2020.03.014
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1220-1232

Descripteurs :	HE Vinci Aidants ; Anciens combattants ; Lésions encéphaliques ; Mesures des résultats rapportés par les patients (PROM) ; Qualité de vie ; Réadaptation
Résumé :	Objectives To understand the factor structure of health-related quality of life specific to caregivers of people living with traumatic brain injury (TBI). Design Prospective, cross-sectional data collection. Setting Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility. Participants Caregivers (N=558) of people who have sustained a TBI (344 caregivers of civilians and 214 caregivers of service members or veterans; 85% women; 58% spouses; mean age, 46.12±14.07y) who have provided care for an average of 5.82±5.40 years. Interventions Not applicable. Main Outcomes Measures The Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) measurement system including 10 Patient-Reported Outcomes Measurement Information System item banks (anger, anxiety, depression, social isolation, sleep disturbance, fatigue, ability to participate in social roles and activities, satisfaction with social roles and activities, emotional support, informational support) and 5 TBI-CareQOL banks (feelings of loss–self, feelings of loss–person with TBI, feeling trapped, caregiver-specific anxiety, caregiver strain). Results Confirmatory factor analysis model fit indices were compared for 14 empirically derived and 5 theoretically derived models. Confirmatory factor analysis results indicated that the best model fit was for a 6-factor model with dimensions that included mental health, social support, social participation, social isolation, physical health, and caregiver emotion. Conclusions Results indicated that a 6-factor model provided the best model fit for health-related quality of life in caregivers of individuals with TBI. These results have utility for both research and clinical applications. Establishing the TBI-CareQOL’s factor structure provides preliminary evidence of the measurement system’s construct validity, helps inform the selection of measures for specific research or clinical interventions, and informs the development of composite scores.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1233-1242

Titre :	Shoulder Rotator Cuff Disorders: A Systematic Review of Clinical Practice Guidelines and Semantic Analyses of Recommendations
Type de document :	Article
Auteurs :	Patrick Doiron-Cadrin ; Simon Lafrance ; Marie Saulnier
Année de publication :	2020
Article en page(s) :	p. 1233-1242
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.017
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Coiffe des rotateurs ; Directives ; Réadaptation ; Reprise du travail ; Revue systématique ; Scapulalgie ; Sémantique ; Syndrome de conflit sous-acromial ; Tendinopathie
Résumé :	Objectives To perform a systematic review of clinical practice guidelines (CPGs) and semantic analysis of specific clinical recommendations for the management of rotator cuff disorders in adults. Data Sources A systematic bibliographic search was conducted up until May 2018 in Medline, Embase, and Physiotherapy Evidence Database, or PEDro, databases, in addition to 12 clinical guidelines search engines listed on the Appraisal of Guidelines for Research and Evaluation (AGREE) website. Study Selection Nine CPGs on the management of rotator cuff disorders in adults or workers, available in English or French, and published from January 2008 onward, were included and screened by 2 independent reviewers. Data Extraction CPG methodology was assessed with the AGREE II checklist. A semantic analysis was performed to compare the strength of similar recommendations based on their formulation. The recommendations were categorized in a standardized manner considering the following 4 levels: “essential,” “recommended,” “may be recommended,” and “not recommended.” Data Synthesis Methodological quality was considered high for 3 CPGs and low for 6. All CPGs recommended active treatment modalities, such as an exercise program in the management of rotator cuff disorders. Acetaminophen or nonsteroidal anti-inflammatory drug prescriptions and corticosteroid injections were presented as modalities that may be recommended to decrease pain. Recommendations related to medical imagery and surgical opinion varied among the guidelines. The most commonly recommended return-to-work strategies included intervening early, use of a multidisciplinary approach, and adaptation of work organization. Conclusions Only 3 CPGs were of high quality. The development of more rigorous CPGs is warranted.
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[article] Shoulder Rotator Cuff Disorders: A Systematic Review of Clinical Practice Guidelines and Semantic Analyses of Recommendations [Article] / Patrick Doiron-Cadrin ; Simon Lafrance ; Marie Saulnier . - 2020 . - p. 1233-1242.
https://doi.org/10.1016/j.apmr.2019.12.017
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1233-1242

Descripteurs :	HE Vinci Coiffe des rotateurs ; Directives ; Réadaptation ; Reprise du travail ; Revue systématique ; Scapulalgie ; Sémantique ; Syndrome de conflit sous-acromial ; Tendinopathie
Résumé :	Objectives To perform a systematic review of clinical practice guidelines (CPGs) and semantic analysis of specific clinical recommendations for the management of rotator cuff disorders in adults. Data Sources A systematic bibliographic search was conducted up until May 2018 in Medline, Embase, and Physiotherapy Evidence Database, or PEDro, databases, in addition to 12 clinical guidelines search engines listed on the Appraisal of Guidelines for Research and Evaluation (AGREE) website. Study Selection Nine CPGs on the management of rotator cuff disorders in adults or workers, available in English or French, and published from January 2008 onward, were included and screened by 2 independent reviewers. Data Extraction CPG methodology was assessed with the AGREE II checklist. A semantic analysis was performed to compare the strength of similar recommendations based on their formulation. The recommendations were categorized in a standardized manner considering the following 4 levels: “essential,” “recommended,” “may be recommended,” and “not recommended.” Data Synthesis Methodological quality was considered high for 3 CPGs and low for 6. All CPGs recommended active treatment modalities, such as an exercise program in the management of rotator cuff disorders. Acetaminophen or nonsteroidal anti-inflammatory drug prescriptions and corticosteroid injections were presented as modalities that may be recommended to decrease pain. Recommendations related to medical imagery and surgical opinion varied among the guidelines. The most commonly recommended return-to-work strategies included intervening early, use of a multidisciplinary approach, and adaptation of work organization. Conclusions Only 3 CPGs were of high quality. The development of more rigorous CPGs is warranted.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1243-1259

Titre :	Inconsistent Classification of Mild Stroke and Implications on Health Services Delivery
Type de document :	Article
Auteurs :	Pamela Roberts ; Shilpa Krishnan ; Suzanne Perea Burns
Année de publication :	2020
Article en page(s) :	p. 1243-1259
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.013
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Réadaptation ; Recherche sur les services de santé
Résumé :	Objective To conduct a scoping review on classifications of mild stroke based on stroke severity assessments and/or clinical signs and symptoms reported in the literature. Data Sources Electronic searches of PubMed, PsycINFO (Ovid), and Cumulative Index to Nursing and Allied Health (CINAHL–EBSCO) databases included keyword combinations of mild stroke, minor stroke, mini stroke, mild cerebrovascular, minor cerebrovascular, transient ischemic attack, or TIA. Study Selection Inclusion criteria were limited to articles published between January 2003 and February 2018. Inclusion criteria included studies (1) with a definition of either mild or minor stroke, (2) written in English, and (3) with participants aged 18 years and older. Animal studies, reviews, dissertations, blogs, editorials, commentaries, case reports, newsletters, drug trials, and presentation abstracts were excluded. Data Extraction Five reviewers independently screened titles and abstracts for inclusion and exclusion criteria. Two reviewers independently screened each full-text article for eligibility. The 5 reviewers checked the quality of the included full-text articles for accuracy. Data were extracted by 2 reviewers and verified by a third reviewer. Data Synthesis Sixty-two studies were included in the final review. Ten unique definitions of mild stroke using stroke severity assessments were discovered, and 10 different cutoff points were used. The National Institutes of Health Stroke Scale was the most widely used measure to classify stroke severity. Synthesis also revealed variations in classification of mild stroke across publication years, time since stroke, settings, and medical factors including imaging, medical indicators, and clinical signs and symptoms. Conclusions Inconsistencies in the classification of mild stroke are evident with varying use of stroke severity assessments, measurement cutoff scores, imaging tools, and clinical or functional outcomes. Continued work is necessary to develop a consensus definition of mild stroke, which directly affects treatment receipt, referral for services, and health service delivery.
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[article] Inconsistent Classification of Mild Stroke and Implications on Health Services Delivery [Article] / Pamela Roberts ; Shilpa Krishnan ; Suzanne Perea Burns . - 2020 . - p. 1243-1259.
https://doi.org/10.1016/j.apmr.2019.12.013
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 7 (2020) . - p. 1243-1259

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Réadaptation ; Recherche sur les services de santé
Résumé :	Objective To conduct a scoping review on classifications of mild stroke based on stroke severity assessments and/or clinical signs and symptoms reported in the literature. Data Sources Electronic searches of PubMed, PsycINFO (Ovid), and Cumulative Index to Nursing and Allied Health (CINAHL–EBSCO) databases included keyword combinations of mild stroke, minor stroke, mini stroke, mild cerebrovascular, minor cerebrovascular, transient ischemic attack, or TIA. Study Selection Inclusion criteria were limited to articles published between January 2003 and February 2018. Inclusion criteria included studies (1) with a definition of either mild or minor stroke, (2) written in English, and (3) with participants aged 18 years and older. Animal studies, reviews, dissertations, blogs, editorials, commentaries, case reports, newsletters, drug trials, and presentation abstracts were excluded. Data Extraction Five reviewers independently screened titles and abstracts for inclusion and exclusion criteria. Two reviewers independently screened each full-text article for eligibility. The 5 reviewers checked the quality of the included full-text articles for accuracy. Data were extracted by 2 reviewers and verified by a third reviewer. Data Synthesis Sixty-two studies were included in the final review. Ten unique definitions of mild stroke using stroke severity assessments were discovered, and 10 different cutoff points were used. The National Institutes of Health Stroke Scale was the most widely used measure to classify stroke severity. Synthesis also revealed variations in classification of mild stroke across publication years, time since stroke, settings, and medical factors including imaging, medical indicators, and clinical signs and symptoms. Conclusions Inconsistencies in the classification of mild stroke are evident with varying use of stroke severity assessments, measurement cutoff scores, imaging tools, and clinical or functional outcomes. Continued work is necessary to develop a consensus definition of mild stroke, which directly affects treatment receipt, referral for services, and health service delivery.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 939-947

Titre :	Effects of High-Intensity Interval Training After Stroke (the HIIT-Stroke Study): A Multicenter Randomized Controlled Trial
Type de document :	Article
Auteurs :	Tor Ivar Gjellesvik ; Frank Becker ; Arnt Erik Tjønna
Année de publication :	2020
Article en page(s) :	p. 939-947
Note générale :	https://doi.org/10.1016/j.apmr.2020.02.006
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Angiopathies intracrâniennes ; Exercice physique ; Réadaptation
Résumé :	Objective To examine if 8 weeks of high-intensity interval training (HIIT) in addition to standard care would increase and maintain peak oxygen uptake (Vo2peak) more than standard care alone in patients with stroke. Design This was a single-blind, multicenter, parallel group, randomized controlled trial. Setting Specialized rehabilitation units at 3 Norwegian hospitals. Participants Participants (N=70), 3 months to 5 years after first-ever stroke, were randomly assigned to the intervention group (n=36) or the control group (n=34); 42% were women, mean age was 57.6±9.3 years, mean time post stroke was 26.4±14.5 months. Intervention The intervention was 8 weeks: 3 times a week with HIIT treadmill training with work periods of 4 × 4 minutes at 85%-95% of peak heart rate interspersed with 3 minutes of active recovery at 50%-70% of peak heart rate. The control group received standard care according to national guidelines. Outcomes The primary outcome, analyzed by intention-to-treat, was Vo2peak measured as liters per minute 12 months after inclusion. Secondary outcome measures were blood pressure and blood profile. Results Mean baseline Vo2peak was 2.63±1.08 L·min−1 vs 2.87±0.71 L·min−1, while at 12 months Vo2peak was 2.70±1.00 L·min−1 vs 2.67±0.76 L·min−1 (P=.068) in the intervention and control groups, respectively. There was a significant and greater improvement in the intervention group compared with the control group at 12 months in 3 of 6 secondary outcomes from the peak test but no significant differences for blood pressure or blood profile. Conclusions The HIIT intervention, which was well-tolerated in this sample of well-functioning survivors of stroke, was not superior to standard care in improving and maintaining Vo2peak at the 12-month follow-up. However, secondary results from the peak test showed a significant improvement from before to immediately after the intervention.
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[article] Effects of High-Intensity Interval Training After Stroke (the HIIT-Stroke Study): A Multicenter Randomized Controlled Trial [Article] / Tor Ivar Gjellesvik ; Frank Becker ; Arnt Erik Tjønna . - 2020 . - p. 939-947.
https://doi.org/10.1016/j.apmr.2020.02.006
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 939-947

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Angiopathies intracrâniennes ; Exercice physique ; Réadaptation
Résumé :	Objective To examine if 8 weeks of high-intensity interval training (HIIT) in addition to standard care would increase and maintain peak oxygen uptake (Vo2peak) more than standard care alone in patients with stroke. Design This was a single-blind, multicenter, parallel group, randomized controlled trial. Setting Specialized rehabilitation units at 3 Norwegian hospitals. Participants Participants (N=70), 3 months to 5 years after first-ever stroke, were randomly assigned to the intervention group (n=36) or the control group (n=34); 42% were women, mean age was 57.6±9.3 years, mean time post stroke was 26.4±14.5 months. Intervention The intervention was 8 weeks: 3 times a week with HIIT treadmill training with work periods of 4 × 4 minutes at 85%-95% of peak heart rate interspersed with 3 minutes of active recovery at 50%-70% of peak heart rate. The control group received standard care according to national guidelines. Outcomes The primary outcome, analyzed by intention-to-treat, was Vo2peak measured as liters per minute 12 months after inclusion. Secondary outcome measures were blood pressure and blood profile. Results Mean baseline Vo2peak was 2.63±1.08 L·min−1 vs 2.87±0.71 L·min−1, while at 12 months Vo2peak was 2.70±1.00 L·min−1 vs 2.67±0.76 L·min−1 (P=.068) in the intervention and control groups, respectively. There was a significant and greater improvement in the intervention group compared with the control group at 12 months in 3 of 6 secondary outcomes from the peak test but no significant differences for blood pressure or blood profile. Conclusions The HIIT intervention, which was well-tolerated in this sample of well-functioning survivors of stroke, was not superior to standard care in improving and maintaining Vo2peak at the 12-month follow-up. However, secondary results from the peak test showed a significant improvement from before to immediately after the intervention.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 948-959

Titre :	Emerging From the Haze: A Multicenter, Controlled Pilot Study of a Multidimensional, Psychoeducation-Based Cognitive Rehabilitation Intervention for Breast Cancer Survivors Delivered With Telehealth Conferencing
Type de document :	Article
Auteurs :	Jamie S. Myers ; Galen Cook-Wiens ; Rachel Baynes
Année de publication :	2020
Article en page(s) :	p. 948-959
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.021
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Cognition ; Réadaptation ; Région mammaire ; Télémédecine ; Tumeurs ; Tumeurs du sein
Résumé :	Objective To quantify the effect of a psychoeducation-based cognitive rehabilitation intervention on breast cancer survivors’ self-report of cognitive function and investigate the feasibility of accrual, adherence, and multisite program delivery using secure telehealth conferencing. Design Prospective, nonblinded, wait-list controlled pilot study. Setting Nonprofit academic medical center and university medical center with associated community practice affiliates. Participants Adult female survivors of stage I-III breast cancer reporting cognitive complaints 2 months to 5 years after chemotherapy (N=61). Ongoing endocrine and/or anti-HER-2 therapy was allowed. Patients were excluded for history of other conditions involving impaired cognitive function. Combination referred and volunteered sample. In total, 107 women were screened, 61 consented, and 52 analyzed. No attrition due to adverse events. Group allocation was based on consent timing and next scheduled cohort to minimize wait time for wait-list controls. Intervention Psychoeducation-based cognitive rehabilitation intervention delivered in a group setting during 6 weekly 2.5-hour classes. Included presentation, class exercises, discussion, and homework exercises. Provided in-person and virtually by Health Insurance Portability and Accountability Act compliant and encrypted telehealth conferencing. Main Outcome Measures Primary: self-report of perceived cognitive function (PCF) was compared between the intervention group (n=27) and wait-list controls (n=28) with the Functional Assessment of Cancer Therapy-Cognition perceived cognitive impairment subscale. Secondary: feasibility for multisite delivery via teleconferencing was measured by total accrual, percent adherence to 4 of the 6 weeks of content, and participant satisfaction ratings. Results The intervention group demonstrated improvement in PCF both at the conclusion of the intervention and 1 month later (P<.01 within-group improvement in pcf was maintained at and months> Conclusion These study results provide further preliminary evidence of the efficacy of psychoeducation-based cognitive rehabilitation as an intervention for decreased PCF in breast cancer survivors with cognitive complaints after chemotherapy. Feasibility for accrual, adherence, and participant satisfaction with secure telehealth conferencing was demonstrated. These positive pilot study results will inform future work.
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[article] Emerging From the Haze: A Multicenter, Controlled Pilot Study of a Multidimensional, Psychoeducation-Based Cognitive Rehabilitation Intervention for Breast Cancer Survivors Delivered With Telehealth Conferencing [Article] / Jamie S. Myers ; Galen Cook-Wiens ; Rachel Baynes . - 2020 . - p. 948-959.
https://doi.org/10.1016/j.apmr.2020.01.021
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 948-959

Descripteurs :	HE Vinci Cognition ; Réadaptation ; Région mammaire ; Télémédecine ; Tumeurs ; Tumeurs du sein
Résumé :	Objective To quantify the effect of a psychoeducation-based cognitive rehabilitation intervention on breast cancer survivors’ self-report of cognitive function and investigate the feasibility of accrual, adherence, and multisite program delivery using secure telehealth conferencing. Design Prospective, nonblinded, wait-list controlled pilot study. Setting Nonprofit academic medical center and university medical center with associated community practice affiliates. Participants Adult female survivors of stage I-III breast cancer reporting cognitive complaints 2 months to 5 years after chemotherapy (N=61). Ongoing endocrine and/or anti-HER-2 therapy was allowed. Patients were excluded for history of other conditions involving impaired cognitive function. Combination referred and volunteered sample. In total, 107 women were screened, 61 consented, and 52 analyzed. No attrition due to adverse events. Group allocation was based on consent timing and next scheduled cohort to minimize wait time for wait-list controls. Intervention Psychoeducation-based cognitive rehabilitation intervention delivered in a group setting during 6 weekly 2.5-hour classes. Included presentation, class exercises, discussion, and homework exercises. Provided in-person and virtually by Health Insurance Portability and Accountability Act compliant and encrypted telehealth conferencing. Main Outcome Measures Primary: self-report of perceived cognitive function (PCF) was compared between the intervention group (n=27) and wait-list controls (n=28) with the Functional Assessment of Cancer Therapy-Cognition perceived cognitive impairment subscale. Secondary: feasibility for multisite delivery via teleconferencing was measured by total accrual, percent adherence to 4 of the 6 weeks of content, and participant satisfaction ratings. Results The intervention group demonstrated improvement in PCF both at the conclusion of the intervention and 1 month later (P<.01 within-group improvement in pcf was maintained at and months> Conclusion These study results provide further preliminary evidence of the efficacy of psychoeducation-based cognitive rehabilitation as an intervention for decreased PCF in breast cancer survivors with cognitive complaints after chemotherapy. Feasibility for accrual, adherence, and participant satisfaction with secure telehealth conferencing was demonstrated. These positive pilot study results will inform future work.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 960-968

Titre :	Physical Rehabilitation Needs Per Condition Type: Results From the Global Burden of Disease Study 2017
Type de document :	Article
Auteurs :	Tiago S. Jesus ; Michel D. Landry ; Dina Brooks
Année de publication :	2020
Article en page(s) :	p. 960-968
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.020
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Charge mondiale de morbidité ; Personnes handicapées ; Réadaptation ; Santé mondiale
Résumé :	Objective To determine how total physical rehabilitation needs have been distributed per relevant condition groups (musculoskeletal and pain, neurologic cardiothoracic, neoplasms, pediatric, human immunodeficiency virus [HIV] related), globally and across countries of varying income level. Design Subgroup, secondary analyses of data from the Global Burden of Disease 2017. Data for the year 2017 are used for determining current needs and data from every year between 1990 and 2017 for determining changing trends. Settings Globally and high-, upper-middle-, lower-middle-, and low-income countries. Participants Not applicable. Interventions Not applicable. Main Outcome Measure Years lived with disability (YLD) rates per 100,000 people for the 6 condition groups. Results In 2017, musculoskeletal and pain conditions accounted for 52.6% of the total physical rehabilitation needs worldwide, :HIV related for 5.7% of the physical rehabilitation needs in low-income nations, but about 1% in all other locations. Worldwide, significant increases in YLD rates were observed since 1990 for the 6 condition groups (P<.01 however across country types we observed significant decreases in yld rates for specific conditions: pediatric high-income countries and neurologic neoplasm conditions low-income upper-middle-income from grew exponentially since with overall increases of respectively.> Conclusion At a global scale, physical rehabilitation needs per capita are growing for all major condition groups, with musculoskeletal and pain conditions currently accounting for over half of those needs. Countries of varying income level have different typologies and evolutionary trends in their rehabilitation needs.
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[article] Physical Rehabilitation Needs Per Condition Type: Results From the Global Burden of Disease Study 2017 [Article] / Tiago S. Jesus ; Michel D. Landry ; Dina Brooks . - 2020 . - p. 960-968.
https://doi.org/10.1016/j.apmr.2019.12.020
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 960-968

Descripteurs :	HE Vinci Charge mondiale de morbidité ; Personnes handicapées ; Réadaptation ; Santé mondiale
Résumé :	Objective To determine how total physical rehabilitation needs have been distributed per relevant condition groups (musculoskeletal and pain, neurologic cardiothoracic, neoplasms, pediatric, human immunodeficiency virus [HIV] related), globally and across countries of varying income level. Design Subgroup, secondary analyses of data from the Global Burden of Disease 2017. Data for the year 2017 are used for determining current needs and data from every year between 1990 and 2017 for determining changing trends. Settings Globally and high-, upper-middle-, lower-middle-, and low-income countries. Participants Not applicable. Interventions Not applicable. Main Outcome Measure Years lived with disability (YLD) rates per 100,000 people for the 6 condition groups. Results In 2017, musculoskeletal and pain conditions accounted for 52.6% of the total physical rehabilitation needs worldwide, :HIV related for 5.7% of the physical rehabilitation needs in low-income nations, but about 1% in all other locations. Worldwide, significant increases in YLD rates were observed since 1990 for the 6 condition groups (P<.01 however across country types we observed significant decreases in yld rates for specific conditions: pediatric high-income countries and neurologic neoplasm conditions low-income upper-middle-income from grew exponentially since with overall increases of respectively.> Conclusion At a global scale, physical rehabilitation needs per capita are growing for all major condition groups, with musculoskeletal and pain conditions currently accounting for over half of those needs. Countries of varying income level have different typologies and evolutionary trends in their rehabilitation needs.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 969-977

Titre :	Open Access Physical Therapy Journals: Do Predatory Journals Publish Lower-Quality Randomized Controlled Trials?
Type de document :	Article
Auteurs :	Claudio Bianchini ; Carola Consentino ; Matteo Paci
Année de publication :	2020
Article en page(s) :	p. 969-977
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.012
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Evaluation par les pairs ; Périodique (presse) ; Réadaptation
Résumé :	Objectives To compare the quality of randomized controlled trials (RCTs) published in predatory and nonpredatory journals in the field of physical therapy. Data Sources From a list of 18 journals included either on Beall’s list (n=9) or in the Directory of Open Access Journals (DOAJ) (n=9), 2 independent assessors extracted all the RCTs published between 2014 and 2017. When journals published more than 40 RCTs, a sample of 40 trials was randomly extracted, preserving the proportions among years. Indexing in PubMed, country of journal publication, and dates of submission or acceptance were also recorded for each journal. Main Outcome Measures The PEDro (Physiotherapy Evidence Database) scale and duration of the peer review. Results Four hundred ten RCTs were included. The mean PEDro score of articles published in non-Beall, DOAJ journals was higher than those published in Beall journals (mean score ± SD, 5.8±1.7 vs 4.5±1.5; P<.001 with the differences increasing when indexing in pubmed was also considered vs p peer review duration significantly longer non-beall than beall journals sd and indexed nonindexed strongest independent variable associated pedro score r2="0.182)," but noninclusion on list explained an additional albeit small portion of variance adjusted> Conclusions Potentially predatory journals publish lower-quality trials and have a shorter peer review process than non-Beall journals included in the DOAJ database.
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[article] Open Access Physical Therapy Journals: Do Predatory Journals Publish Lower-Quality Randomized Controlled Trials? [Article] / Claudio Bianchini ; Carola Consentino ; Matteo Paci . - 2020 . - p. 969-977.
https://doi.org/10.1016/j.apmr.2019.12.012
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 969-977

Descripteurs :	HE Vinci Evaluation par les pairs ; Périodique (presse) ; Réadaptation
Résumé :	Objectives To compare the quality of randomized controlled trials (RCTs) published in predatory and nonpredatory journals in the field of physical therapy. Data Sources From a list of 18 journals included either on Beall’s list (n=9) or in the Directory of Open Access Journals (DOAJ) (n=9), 2 independent assessors extracted all the RCTs published between 2014 and 2017. When journals published more than 40 RCTs, a sample of 40 trials was randomly extracted, preserving the proportions among years. Indexing in PubMed, country of journal publication, and dates of submission or acceptance were also recorded for each journal. Main Outcome Measures The PEDro (Physiotherapy Evidence Database) scale and duration of the peer review. Results Four hundred ten RCTs were included. The mean PEDro score of articles published in non-Beall, DOAJ journals was higher than those published in Beall journals (mean score ± SD, 5.8±1.7 vs 4.5±1.5; P<.001 with the differences increasing when indexing in pubmed was also considered vs p peer review duration significantly longer non-beall than beall journals sd and indexed nonindexed strongest independent variable associated pedro score r2="0.182)," but noninclusion on list explained an additional albeit small portion of variance adjusted> Conclusions Potentially predatory journals publish lower-quality trials and have a shorter peer review process than non-Beall journals included in the DOAJ database.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 978-984

Titre :	Pressure and Traction Technique Improves Postural Control More Than Tactile Stimulation in Foot Plantar Fascia: A Randomized Single-Blind Trial
Type de document :	Article
Auteurs :	Eva María Martínez-Jiménez ; Ricardo Becerro-de-Bengoa-Vallejo ; Marta Elena Losa-Iglesias
Année de publication :	2020
Article en page(s) :	p. 978-984
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.017
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Équilibre postural ; Fascia ; Pied ; Réadaptation ; Thérapeutique
Résumé :	Abstract Objective To check the acute effects of manual pressure and traction technique on balance and plantar footprint variables. Design A single-blind clinical study with 2 groups. Setting Private practice. Participants Healthy participants (N=40; 28 female and 12 male) were recruited to carry out a single-blind study. Interventions Experimental group performed a bilateral plantar fascia manual pressure and traction technique. Control group performed a tactile stimulation. The position of the participant, the therapist, and the time of application of the techniques (5min) were the same for both interventions. Main Outcome Measures We measured stabilometry variables and static footprint. The footprint variables were divided in rear, middle, and front foot areas. Results Significant differences were found in stabilometry variables. There was an improvement in experimental group at X displacement with eyes open (P=.014) and surface eyes closed (P=.046) variables. Conclusions After technique the experimental group improved the stabilometry variables, specifically surface with eyes closed and X displacement with eyes open. The static footprint variables have not shown differences after the technique compared with the control group.
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[article] Pressure and Traction Technique Improves Postural Control More Than Tactile Stimulation in Foot Plantar Fascia: A Randomized Single-Blind Trial [Article] / Eva María Martínez-Jiménez ; Ricardo Becerro-de-Bengoa-Vallejo ; Marta Elena Losa-Iglesias . - 2020 . - p. 978-984.
https://doi.org/10.1016/j.apmr.2020.01.017
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 978-984

Descripteurs :	HE Vinci Équilibre postural ; Fascia ; Pied ; Réadaptation ; Thérapeutique
Résumé :	Abstract Objective To check the acute effects of manual pressure and traction technique on balance and plantar footprint variables. Design A single-blind clinical study with 2 groups. Setting Private practice. Participants Healthy participants (N=40; 28 female and 12 male) were recruited to carry out a single-blind study. Interventions Experimental group performed a bilateral plantar fascia manual pressure and traction technique. Control group performed a tactile stimulation. The position of the participant, the therapist, and the time of application of the techniques (5min) were the same for both interventions. Main Outcome Measures We measured stabilometry variables and static footprint. The footprint variables were divided in rear, middle, and front foot areas. Results Significant differences were found in stabilometry variables. There was an improvement in experimental group at X displacement with eyes open (P=.014) and surface eyes closed (P=.046) variables. Conclusions After technique the experimental group improved the stabilometry variables, specifically surface with eyes closed and X displacement with eyes open. The static footprint variables have not shown differences after the technique compared with the control group.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 985-993

Titre :	Muscle Strength Cutoff Points for Functional Independence and Wheelchair Ability in Men With Spinal Cord Injury
Type de document :	Article
Auteurs :	Frederico Ribeiro Neto ; Rodrigo Rodrigues Gomes Costa ; Ricardo Antônio Tanhoffer
Année de publication :	2020
Article en page(s) :	p. 985-993
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.010
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Compétences pour le passage de test ; Dynamomètre pour la mesure de la force musculaire ; Entraînement en résistance ; Réadaptation ; Valeurs de référence
Résumé :	Objective Determine trunk and shoulder muscle strength cutoff points for functional independence and wheelchair skills, and verify the predictive capacity of relative and absolute peak torque in men with spinal cord injury (SCI). Design Cross-sectional study. Setting Rehabilitation hospital setting. Participants Men (N=54) with SCI were recruited and stratified into high and low paraplegia groups. Interventions All participants performed maximum strength tests for shoulder abduction or adduction (isokinetic) and trunk flexion or extension (isometric) to determine relative and absolute peak torque cutoff points for the Spinal Cord Independence Measure version III (SCIM-III) and Adapted Manual Wheelchair Circuit (AMWC). Main outcome measures The primary outcome measures were SCIM-III, AMWC-Brazil test, and strength variables (peak torques). Demographic characteristics obtained from participants’ electronic medical records were the secondary outcomes used as predictor variables of functional independence. Results The best predictive model for SCIM-III (R=0.78, P≤.05) used the sum of trunk flexion and extension relative peak torque values to determine the cutoff points (1.42 N·m/kg for a score of 70). Relative shoulder abduction peak torque was used in the predictive models for AMWC outcomes: performance score (R=0.77, P≤.05, cutoff points of 0.97 N·m/kg for 300.0m) and 3-minute overground wheeling (R=0.72, P≤.05, cutoff points of 0.96 N·m/kg for 18.5s). Conclusions Relative peak torque showed better predictive capacity compared to absolute peak torque. Cutoff points were established for relative muscle strength and could help health professionals set appropriate goals for individuals with SCI to achieve high functional independence and wheelchair ability.
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[article] Muscle Strength Cutoff Points for Functional Independence and Wheelchair Ability in Men With Spinal Cord Injury [Article] / Frederico Ribeiro Neto ; Rodrigo Rodrigues Gomes Costa ; Ricardo Antônio Tanhoffer . - 2020 . - p. 985-993.
https://doi.org/10.1016/j.apmr.2020.01.010
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 985-993

Descripteurs :	HE Vinci Compétences pour le passage de test ; Dynamomètre pour la mesure de la force musculaire ; Entraînement en résistance ; Réadaptation ; Valeurs de référence
Résumé :	Objective Determine trunk and shoulder muscle strength cutoff points for functional independence and wheelchair skills, and verify the predictive capacity of relative and absolute peak torque in men with spinal cord injury (SCI). Design Cross-sectional study. Setting Rehabilitation hospital setting. Participants Men (N=54) with SCI were recruited and stratified into high and low paraplegia groups. Interventions All participants performed maximum strength tests for shoulder abduction or adduction (isokinetic) and trunk flexion or extension (isometric) to determine relative and absolute peak torque cutoff points for the Spinal Cord Independence Measure version III (SCIM-III) and Adapted Manual Wheelchair Circuit (AMWC). Main outcome measures The primary outcome measures were SCIM-III, AMWC-Brazil test, and strength variables (peak torques). Demographic characteristics obtained from participants’ electronic medical records were the secondary outcomes used as predictor variables of functional independence. Results The best predictive model for SCIM-III (R=0.78, P≤.05) used the sum of trunk flexion and extension relative peak torque values to determine the cutoff points (1.42 N·m/kg for a score of 70). Relative shoulder abduction peak torque was used in the predictive models for AMWC outcomes: performance score (R=0.77, P≤.05, cutoff points of 0.97 N·m/kg for 300.0m) and 3-minute overground wheeling (R=0.72, P≤.05, cutoff points of 0.96 N·m/kg for 18.5s). Conclusions Relative peak torque showed better predictive capacity compared to absolute peak torque. Cutoff points were established for relative muscle strength and could help health professionals set appropriate goals for individuals with SCI to achieve high functional independence and wheelchair ability.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 994-1000

Titre :	Electrophysiological Changes in the Peripheral Nervous System After Subacute Spinal Cord Injury
Type de document :	Article
Auteurs :	Chang-Won Moon ; Il-Young Jung ; Kang Hee
Année de publication :	2020
Article en page(s) :	p. 994-1000
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.019
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Phénomènes électrophysiologiques ; Réadaptation ; Système nerveux périphérique ; Traumatismes de la moelle épinière
Résumé :	Objective To assess factors affecting electrophysiological changes in the peripheral nervous system below the neurologic level of injury (NLI) in patients with subacute spinal cord injury (SCI). Design Retrospective observational study. Setting An inpatient rehabilitation center of a university hospital. Participants Through reviewing the medical records of 151 subjects with SCI, 42 without any other disease inducing peripheral neurologic abnormalities were included. They were classified into 2 groups, with or without denervation potentials in electromyography (EMG) below NLI. Intervention Not applicable. Main Outcome Measures Demographics and clinical characteristics including NLI, American Spinal Injury Association Impairment Scale (AIS), and Lower Extremity Motor Score were compared. Results of electrophysiological study including nerve conduction study, somatosensory-evoked potential (SSEP), and motor-evoked potential (MEP) were compared. Results Denervation potentials in EMG below NLI were observed in 20 subjects, and 10 of them were AIS A or B, but there was none in subjects without denervation potentials (P<.001 the lower extremity motor score was in group with denervation potentials than of opposite analysis electrophysiological study patients showed a higher proportion no response without vs peroneal nerve conduction tibial ssep mep p respectively additionally greater axonal loss based on decrease amplitude delayed latency observed> Conclusion Among subjects with subacute SCI, cases of peripheral nervous dysfunction below the injury site occur, possibly associated with the severity of SCI.
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[article] Electrophysiological Changes in the Peripheral Nervous System After Subacute Spinal Cord Injury [Article] / Chang-Won Moon ; Il-Young Jung ; Kang Hee . - 2020 . - p. 994-1000.
https://doi.org/10.1016/j.apmr.2019.12.019
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 994-1000

Descripteurs :	HE Vinci Phénomènes électrophysiologiques ; Réadaptation ; Système nerveux périphérique ; Traumatismes de la moelle épinière
Résumé :	Objective To assess factors affecting electrophysiological changes in the peripheral nervous system below the neurologic level of injury (NLI) in patients with subacute spinal cord injury (SCI). Design Retrospective observational study. Setting An inpatient rehabilitation center of a university hospital. Participants Through reviewing the medical records of 151 subjects with SCI, 42 without any other disease inducing peripheral neurologic abnormalities were included. They were classified into 2 groups, with or without denervation potentials in electromyography (EMG) below NLI. Intervention Not applicable. Main Outcome Measures Demographics and clinical characteristics including NLI, American Spinal Injury Association Impairment Scale (AIS), and Lower Extremity Motor Score were compared. Results of electrophysiological study including nerve conduction study, somatosensory-evoked potential (SSEP), and motor-evoked potential (MEP) were compared. Results Denervation potentials in EMG below NLI were observed in 20 subjects, and 10 of them were AIS A or B, but there was none in subjects without denervation potentials (P<.001 the lower extremity motor score was in group with denervation potentials than of opposite analysis electrophysiological study patients showed a higher proportion no response without vs peroneal nerve conduction tibial ssep mep p respectively additionally greater axonal loss based on decrease amplitude delayed latency observed> Conclusion Among subjects with subacute SCI, cases of peripheral nervous dysfunction below the injury site occur, possibly associated with the severity of SCI.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1001-1008

Titre :	Poststroke Fatigue and Daily Activity Patterns During Outpatient Rehabilitation: An Experience Sampling Method Study
Type de document :	Article
Auteurs :	Bert Lenaert ; Mathea Neijmeijer ; Nadine van Kampen
Année de publication :	2020
Article en page(s) :	p. 1001-1008
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.014
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Évaluation écologique instantanée ; Fatigue ; Réadaptation
Résumé :	Objective To advance our understanding of poststroke fatigue by investigating its momentary and time-lagged relationship with daily activities. Design Longitudinal observational study using the experience sampling method (ESM). Setting Outpatient rehabilitation care. Participants Thirty individuals with stroke (N=30). Interventions Not applicable. Main Outcome Measures ESM is a structured diary method that allows assessing real-time symptoms, behavior, and environment characteristics in the flow of daily life, thereby capturing moment-to-moment variations in fatigue and related factors. Using a mobile application, individuals with stroke were followed during 6 consecutive days, and were prompted at 10 random moments daily to fill in a digital questionnaire about their momentary fatigue and current activity: type of activity, perceived effort and enjoyment, and physical activity levels. Results Based on all completed digital questionnaires (N=1013), multilevel regression analyses showed that fatigue was significantly associated with type of activity and that fatigue was higher when participants had engaged in physical activity. Fatigue was also higher during activities perceived as more effortful and during less enjoyable activities. Time-lagged analyses showed that fatigue was also predicted by physical activity and perceived effort earlier during the day. Importantly, the relationship between these daily activity characteristics and fatigue differed substantially across individuals. Conclusions This study illustrates the need for ESM to design personalized rehabilitation programs and to capture fatigue and other patient-reported outcomes in daily life.
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[article] Poststroke Fatigue and Daily Activity Patterns During Outpatient Rehabilitation: An Experience Sampling Method Study [Article] / Bert Lenaert ; Mathea Neijmeijer ; Nadine van Kampen . - 2020 . - p. 1001-1008.
https://doi.org/10.1016/j.apmr.2019.12.014
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1001-1008

Descripteurs :	HE Vinci Accident vasculaire cérébral (AVC) ; Évaluation écologique instantanée ; Fatigue ; Réadaptation
Résumé :	Objective To advance our understanding of poststroke fatigue by investigating its momentary and time-lagged relationship with daily activities. Design Longitudinal observational study using the experience sampling method (ESM). Setting Outpatient rehabilitation care. Participants Thirty individuals with stroke (N=30). Interventions Not applicable. Main Outcome Measures ESM is a structured diary method that allows assessing real-time symptoms, behavior, and environment characteristics in the flow of daily life, thereby capturing moment-to-moment variations in fatigue and related factors. Using a mobile application, individuals with stroke were followed during 6 consecutive days, and were prompted at 10 random moments daily to fill in a digital questionnaire about their momentary fatigue and current activity: type of activity, perceived effort and enjoyment, and physical activity levels. Results Based on all completed digital questionnaires (N=1013), multilevel regression analyses showed that fatigue was significantly associated with type of activity and that fatigue was higher when participants had engaged in physical activity. Fatigue was also higher during activities perceived as more effortful and during less enjoyable activities. Time-lagged analyses showed that fatigue was also predicted by physical activity and perceived effort earlier during the day. Importantly, the relationship between these daily activity characteristics and fatigue differed substantially across individuals. Conclusions This study illustrates the need for ESM to design personalized rehabilitation programs and to capture fatigue and other patient-reported outcomes in daily life.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1009-1016

Titre :	Function and Caregiver Support Associated With Readmissions During Home Health for Individuals With Dementia
Type de document :	Article
Auteurs :	Sara Knox ; Brian Downer ; Allen Haas
Année de publication :	2020
Article en page(s) :	p. 1009-1016
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.021
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Aidants ; Démence ; État de santé ; Organismes de prise en charge à domicile ; Réadaptation ; Réadmission du patient
Résumé :	Objective The purpose of this study was to determine the association between mobility, self-care, cognition, and caregiver support and 30-day potentially preventable readmissions (PPR) for individuals with dementia. Design This retrospective study derived data from 100% national Centers for Medicare and Medicaid Services data files from July 1, 2013, through June 1, 2015. Participants Criteria from the Home Health Claims-Based Rehospitalization Measure and the Potentially Preventable 30-Day Post Discharge Readmission Measure for the Home Health Quality Reporting Program were used to identify a cohort of 118,171 Medicare beneficiaries. Main Outcome Measure The 30-day PPR rates with associated 95% CIs were calculated for each patient characteristic. Multilevel logistic regression was used to study the relationship between mobility, self-care, caregiver support, and cognition domains and 30-day PPR during home health, adjusting for patient demographics and clinical characteristics. Results The overall rate of 30-day PPR was 7.6%. In the fully adjusted models, patients who were most dependent in mobility (odds ratio [OR], 1.59; 95% CI, 1.47-1.71) and self-care (OR, 1.73; 95% CI, 1.61-1.87) had higher odds for 30-day PPR. Patients with unmet caregiving needs had 1.11 (95% CI, 1.05-1.17) higher odds for 30-day PPR than patients whose caregiving needs were met. Patients with cognitive impairment had 1.23 (95% CI, 1.16-1.30) higher odds of readmission than those with minimal to no cognitive impairment. Conclusions Decreased independence in mobility and self-care tasks, unmet caregiver needs, and impaired cognitive processing at admission to home health are associated with risk of 30-day PPR during home health for individuals with dementia. Our findings indicate that deficits in mobility and self-care tasks have the greatest effect on the risk for PPR.
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[article] Function and Caregiver Support Associated With Readmissions During Home Health for Individuals With Dementia [Article] / Sara Knox ; Brian Downer ; Allen Haas . - 2020 . - p. 1009-1016.
https://doi.org/10.1016/j.apmr.2019.12.021
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1009-1016

Descripteurs :	HE Vinci Aidants ; Démence ; État de santé ; Organismes de prise en charge à domicile ; Réadaptation ; Réadmission du patient
Résumé :	Objective The purpose of this study was to determine the association between mobility, self-care, cognition, and caregiver support and 30-day potentially preventable readmissions (PPR) for individuals with dementia. Design This retrospective study derived data from 100% national Centers for Medicare and Medicaid Services data files from July 1, 2013, through June 1, 2015. Participants Criteria from the Home Health Claims-Based Rehospitalization Measure and the Potentially Preventable 30-Day Post Discharge Readmission Measure for the Home Health Quality Reporting Program were used to identify a cohort of 118,171 Medicare beneficiaries. Main Outcome Measure The 30-day PPR rates with associated 95% CIs were calculated for each patient characteristic. Multilevel logistic regression was used to study the relationship between mobility, self-care, caregiver support, and cognition domains and 30-day PPR during home health, adjusting for patient demographics and clinical characteristics. Results The overall rate of 30-day PPR was 7.6%. In the fully adjusted models, patients who were most dependent in mobility (odds ratio [OR], 1.59; 95% CI, 1.47-1.71) and self-care (OR, 1.73; 95% CI, 1.61-1.87) had higher odds for 30-day PPR. Patients with unmet caregiving needs had 1.11 (95% CI, 1.05-1.17) higher odds for 30-day PPR than patients whose caregiving needs were met. Patients with cognitive impairment had 1.23 (95% CI, 1.16-1.30) higher odds of readmission than those with minimal to no cognitive impairment. Conclusions Decreased independence in mobility and self-care tasks, unmet caregiver needs, and impaired cognitive processing at admission to home health are associated with risk of 30-day PPR during home health for individuals with dementia. Our findings indicate that deficits in mobility and self-care tasks have the greatest effect on the risk for PPR.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1017-1024

Titre :	Changes in Quality of Life During Training for the HandbikeBattle and Associations With Cardiorespiratory Fitness
Type de document :	Article
Auteurs :	Ingrid Kouwijzer ; Sonja De Groot ; Christel Van Leeuwen
Année de publication :	2020
Article en page(s) :	p. 1017-1024
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.015
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Etudes longitudinales ; Exercice physique ; Qualité de vie ; Réadaptation
Résumé :	Objective To investigate (1) changes in life satisfaction and mental health during 5 months of training for the HandbikeBattle and 4 months of follow-up; (2) associations between changes in handcycling cardiorespiratory fitness and changes in life satisfaction and mental health during the training period. Design This is a multicenter prospective cohort study with the following measurements: the start of the training (T1), after the 5-month training period, before the event (T2), and after 4 months of follow-up (T3). At T1, T2, and T3, questionnaires were filled out. At T1 and T2, a graded exercise test was performed to measure cardiorespiratory fitness (peak oxygen consumption [Vo2peak] and peak power output [POpeak]). Setting Ten Dutch rehabilitation centers training for the HandbikeBattle event. Participants Patients with a rehabilitation history (N=136) and health conditions such as spinal cord injury, amputation, or multiple trauma history. Interventions Not applicable. Main Outcome Measure Life satisfaction as the sum score of 2 questions (range, 2-13) and the Mental Health subscale of the 36-item Short Form Health Survey (range, 0-100). Results Multilevel regression analyses showed that life satisfaction increased during the training period and did not significantly change during follow-up (mean ± SD, T1: 8.2±2.2; T2: 8.6±2.3; T3: 8.5±2.4). Mental health showed no change over time (T1: 77.7±14.5; T2: 77.8±14.5; T3: 75.7±16.5). An improvement in cardiorespiratory fitness was associated with an increase in life satisfaction (POpeak, ß=0.014, P=.046; Vo2peak, ß=1.068, P=.04). There were no associations between improvement in cardiorespiratory fitness and an increase in mental health (POpeak, P=.66; Vo2peak, P=.33). Conclusions This study shows a positive course of life satisfaction during training for the HandbikeBattle. An improvement in cardiorespiratory fitness was longitudinally associated with an increase in life satisfaction. Mental health showed no changes over time.
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[article] Changes in Quality of Life During Training for the HandbikeBattle and Associations With Cardiorespiratory Fitness [Article] / Ingrid Kouwijzer ; Sonja De Groot ; Christel Van Leeuwen . - 2020 . - p. 1017-1024.
https://doi.org/10.1016/j.apmr.2019.12.015
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1017-1024

Descripteurs :	HE Vinci Etudes longitudinales ; Exercice physique ; Qualité de vie ; Réadaptation
Résumé :	Objective To investigate (1) changes in life satisfaction and mental health during 5 months of training for the HandbikeBattle and 4 months of follow-up; (2) associations between changes in handcycling cardiorespiratory fitness and changes in life satisfaction and mental health during the training period. Design This is a multicenter prospective cohort study with the following measurements: the start of the training (T1), after the 5-month training period, before the event (T2), and after 4 months of follow-up (T3). At T1, T2, and T3, questionnaires were filled out. At T1 and T2, a graded exercise test was performed to measure cardiorespiratory fitness (peak oxygen consumption [Vo2peak] and peak power output [POpeak]). Setting Ten Dutch rehabilitation centers training for the HandbikeBattle event. Participants Patients with a rehabilitation history (N=136) and health conditions such as spinal cord injury, amputation, or multiple trauma history. Interventions Not applicable. Main Outcome Measure Life satisfaction as the sum score of 2 questions (range, 2-13) and the Mental Health subscale of the 36-item Short Form Health Survey (range, 0-100). Results Multilevel regression analyses showed that life satisfaction increased during the training period and did not significantly change during follow-up (mean ± SD, T1: 8.2±2.2; T2: 8.6±2.3; T3: 8.5±2.4). Mental health showed no change over time (T1: 77.7±14.5; T2: 77.8±14.5; T3: 75.7±16.5). An improvement in cardiorespiratory fitness was associated with an increase in life satisfaction (POpeak, ß=0.014, P=.046; Vo2peak, ß=1.068, P=.04). There were no associations between improvement in cardiorespiratory fitness and an increase in mental health (POpeak, P=.66; Vo2peak, P=.33). Conclusions This study shows a positive course of life satisfaction during training for the HandbikeBattle. An improvement in cardiorespiratory fitness was longitudinally associated with an increase in life satisfaction. Mental health showed no changes over time.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1025-1040

Titre :	Evaluation Tools for Assistive Technologies: A Scoping Review
Type de document :	Article
Auteurs :	Gordon Tao ; Geoffrey Charm ; Katarzyna Kabacinska
Année de publication :	2020
Article en page(s) :	p. 1025-1040
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.008
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Dispositifs d'assistance au mouvement ; Évaluation de résultat (soins) ; Qualité, accès, évaluation des soins de santé ; Réadaptation
Résumé :	Objective Assistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs; ATETs) across disparate fields in order to improve the process of AT evaluation and development. Data Sources We performed a scoping review of ATETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining. Study Selection Articles explicitly referencing ATETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs. Data Extraction We extracted 5 attributes of ATETs: AT category, construct evaluated, conceptual frameworks, type of end user input used for ATET development, and presence of validity testing. Data Synthesis From screening 23,434 records, we included 159 ATETs. Specificity of tools ranged from single to general ATs across 40 AT categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end user input and 80% showed validation testing. Conclusions We characterized a wide range of AT categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future ATETs may provide more holistic views of AT usefulness. ATET selection may be improved with guidelines for conceptually reconciling results of disparate ATETs. Future ATET development may benefit from more integrated approaches to end user engagement.
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[article] Evaluation Tools for Assistive Technologies: A Scoping Review [Article] / Gordon Tao ; Geoffrey Charm ; Katarzyna Kabacinska . - 2020 . - p. 1025-1040.
https://doi.org/10.1016/j.apmr.2020.01.008
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1025-1040

Descripteurs :	HE Vinci Dispositifs d'assistance au mouvement ; Évaluation de résultat (soins) ; Qualité, accès, évaluation des soins de santé ; Réadaptation
Résumé :	Objective Assistive technologies (ATs) support independence and well-being in people with cognitive, perceptual, and physical limitations. Given the increasing availability and diversity of ATs, evaluating the usefulness of current and emerging ATs is crucial for informed comparison. We aimed to chart the landscape and development of AT evaluation tools (ETs; ATETs) across disparate fields in order to improve the process of AT evaluation and development. Data Sources We performed a scoping review of ATETs through database searching of MEDLINE, Embase, CINAHL, HaPI, PsycINFO, Cochrane Reviews, and Compendex as well as citation mining. Study Selection Articles explicitly referencing ATETs were retained for screening. We included ETs if they were designed to specifically evaluate ATs. Data Extraction We extracted 5 attributes of ATETs: AT category, construct evaluated, conceptual frameworks, type of end user input used for ATET development, and presence of validity testing. Data Synthesis From screening 23,434 records, we included 159 ATETs. Specificity of tools ranged from single to general ATs across 40 AT categories. Satisfaction, functional performance, and usage were the most common constructs of 103 identified. We identified 34 conceptual frameworks across 53 ETs. Finally, 36% incorporated end user input and 80% showed validation testing. Conclusions We characterized a wide range of AT categories with diverse approaches to their evaluation based on varied conceptual frameworks. Combining these frameworks in future ATETs may provide more holistic views of AT usefulness. ATET selection may be improved with guidelines for conceptually reconciling results of disparate ATETs. Future ATET development may benefit from more integrated approaches to end user engagement.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1041-1052

Titre :	Epidemiology of Cerebral Palsy in Adulthood: A Systematic Review and Meta-analysis of the Most Frequently Studied Outcomes
Type de document :	Article
Auteurs :	Marloes van Gorp ; Sander R. Hilberink ; Suzie Noten
Année de publication :	2020
Article en page(s) :	p. 1041-1052
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.009
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Adulte (19-44 ans) ; Épidémiologie ; Méta-analyse ; Paralysie cérébrale ; Réadaptation ; Revue systématique ; Santé
Résumé :	Objective To describe the epidemiology of health status, impairments, activities and participation in adults with cerebral palsy (CP). Data Sources Embase, MEDLINE, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health, Cochrane, and Google Scholar were searched for 3 themes (“cerebral palsy,” “adult,” and “outcome assessment”) in literature published between January 2000 and December 2018. Study Selection Full-article peer-reviewed English journal articles on descriptive, observational, or experimental studies describing the most studied outcomes in adults with CP (n≥25, age≥18y) were included. Studies were included in the analyses if frequently studied outcomes were described in at least 3 studies using similar methods of assessment. Data Extraction Data were extracted independently by 2 authors from 65 articles (total N=28,429) using a standardized score sheet. Data Synthesis Meta-analyses revealed that overall, on average 65.1% (95% confidence interval [CI], 55.1-74.5) of adults with CP experienced pain, 57.9% (95% CI, 51.1-64.6) were ambulant, 65.5% (95% CI, 61.2-69.7) had little or no limitation in manual ability, 18.2% (95% CI, 10.6-27.2) had tertiary education, 39.2% (95% CI, 31.5;47.1) were employed, and 29.3% (95% CI, 9.0-55.3) lived independently. In adults without intellectual disability, proportions of individuals who were ambulant (72.6% [95% CI, 58.8-84.5]) and lived independently (90.0% [95% CI, 83.8-94.9]) were higher (P=.014 and P<.01 respectively the fatigue severity scale score was ci epilepsy and asthma were especially prevalent comorbidities.> Conclusions The present systematic review and meta-analysis on the epidemiology of adults with CP provided state-of-the-art knowledge on the most frequently studied outcomes. On average, adults with CP are fatigued, and a majority experience pain, are ambulant, and have little or no difficulty with manual ability. On average, 40% are employed and 30% live independently. More uniformity in assessment and reports is advised to improve knowledge on epidemiology and gain insight in more outcomes.
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[article] Epidemiology of Cerebral Palsy in Adulthood: A Systematic Review and Meta-analysis of the Most Frequently Studied Outcomes [Article] / Marloes van Gorp ; Sander R. Hilberink ; Suzie Noten . - 2020 . - p. 1041-1052.
https://doi.org/10.1016/j.apmr.2020.01.009
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1041-1052

Descripteurs :	HE Vinci Adulte (19-44 ans) ; Épidémiologie ; Méta-analyse ; Paralysie cérébrale ; Réadaptation ; Revue systématique ; Santé
Résumé :	Objective To describe the epidemiology of health status, impairments, activities and participation in adults with cerebral palsy (CP). Data Sources Embase, MEDLINE, Web of Science, PsycINFO, Cumulative Index to Nursing and Allied Health, Cochrane, and Google Scholar were searched for 3 themes (“cerebral palsy,” “adult,” and “outcome assessment”) in literature published between January 2000 and December 2018. Study Selection Full-article peer-reviewed English journal articles on descriptive, observational, or experimental studies describing the most studied outcomes in adults with CP (n≥25, age≥18y) were included. Studies were included in the analyses if frequently studied outcomes were described in at least 3 studies using similar methods of assessment. Data Extraction Data were extracted independently by 2 authors from 65 articles (total N=28,429) using a standardized score sheet. Data Synthesis Meta-analyses revealed that overall, on average 65.1% (95% confidence interval [CI], 55.1-74.5) of adults with CP experienced pain, 57.9% (95% CI, 51.1-64.6) were ambulant, 65.5% (95% CI, 61.2-69.7) had little or no limitation in manual ability, 18.2% (95% CI, 10.6-27.2) had tertiary education, 39.2% (95% CI, 31.5;47.1) were employed, and 29.3% (95% CI, 9.0-55.3) lived independently. In adults without intellectual disability, proportions of individuals who were ambulant (72.6% [95% CI, 58.8-84.5]) and lived independently (90.0% [95% CI, 83.8-94.9]) were higher (P=.014 and P<.01 respectively the fatigue severity scale score was ci epilepsy and asthma were especially prevalent comorbidities.> Conclusions The present systematic review and meta-analysis on the epidemiology of adults with CP provided state-of-the-art knowledge on the most frequently studied outcomes. On average, adults with CP are fatigued, and a majority experience pain, are ambulant, and have little or no difficulty with manual ability. On average, 40% are employed and 30% live independently. More uniformity in assessment and reports is advised to improve knowledge on epidemiology and gain insight in more outcomes.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1053-1063

Titre :	Psychometric Properties of Performance-Based Functional Tests in Patients With Shoulder Pathologies: A Systematic Review and Meta-analysis
Type de document :	Article
Auteurs :	Goris Nazari ; Steve Lu ; Joy C. MacDermid
Année de publication :	2020
Article en page(s) :	p. 1053-1063
Note générale :	https://doi.org/10.1016/j.apmr.2019.11.011
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Epaule ; Performance fonctionnelle physique ; Psychométrie ; Réadaptation ; Revue systématique
Résumé :	Objectives To identify, critically appraise, and synthesize the reported psychometric properties of shoulder performance-based functional tests in patients with shoulder diseases. Data Sources MEDLINE, Embase, Scopus, and Cumulative Index to Nursing and Allied Health databases from inception until March 2019 were searched. Study Selection Randomized/prospective studies of patients with shoulder diseases that reported on the psychometric properties (reliability, validity, responsiveness) of performance-based functional tests (Standardized Index of Shoulder Function [FI2S], Functional Impairment Test–Hand and Neck/Shoulder/Arm, Closed Kinetic Chain Upper Extremity Stability Test, Timed Functional Arm and Shoulder Test, Shoulder Function Index [SFInX], and hand to neck, scapula, and opposite scapula). Data Extraction We used the Consensus-Based Standards for the Selection of Health Measurement Instruments 2018 guideline for systematic reviews. We performed a qualitative synthesis in which the results were summarized based on reported measurement properties and study quality. Data Synthesis Eight eligible studies were included with 28 measures (16 reliability; 10 validity; 2 responsiveness). Performance-based functional tests reliability (test-retest, intra- and interrater) measures indicated excellent reliability properties. Intraclass correlation coefficient (ICC) was ≥0.83 and standard error of the mean (SEM) ranged from 0.03-13.3 points. Validity (construct/convergent/concurrent) measures displayed correlations of −0.76 to 0.91 between performance-based functional tests and other patient-reported outcomes (Disabilities of the Arm, Shoulder, and Hand, Constant, Shoulder Pain and Disability Index). Two studies assessed the responsiveness measures performance-based functional tests. Effect sizes of 0.44 and 1.50 and minimal clinically important differences of 10.3 using the anchor-based approach were reported. Conclusions The FI2S and the SFInX are reliable, valid, and responsive in patients with shoulder-related diseases.
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[article] Psychometric Properties of Performance-Based Functional Tests in Patients With Shoulder Pathologies: A Systematic Review and Meta-analysis [Article] / Goris Nazari ; Steve Lu ; Joy C. MacDermid . - 2020 . - p. 1053-1063.
https://doi.org/10.1016/j.apmr.2019.11.011
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 6 (2020) . - p. 1053-1063

Descripteurs :	HE Vinci Epaule ; Performance fonctionnelle physique ; Psychométrie ; Réadaptation ; Revue systématique
Résumé :	Objectives To identify, critically appraise, and synthesize the reported psychometric properties of shoulder performance-based functional tests in patients with shoulder diseases. Data Sources MEDLINE, Embase, Scopus, and Cumulative Index to Nursing and Allied Health databases from inception until March 2019 were searched. Study Selection Randomized/prospective studies of patients with shoulder diseases that reported on the psychometric properties (reliability, validity, responsiveness) of performance-based functional tests (Standardized Index of Shoulder Function [FI2S], Functional Impairment Test–Hand and Neck/Shoulder/Arm, Closed Kinetic Chain Upper Extremity Stability Test, Timed Functional Arm and Shoulder Test, Shoulder Function Index [SFInX], and hand to neck, scapula, and opposite scapula). Data Extraction We used the Consensus-Based Standards for the Selection of Health Measurement Instruments 2018 guideline for systematic reviews. We performed a qualitative synthesis in which the results were summarized based on reported measurement properties and study quality. Data Synthesis Eight eligible studies were included with 28 measures (16 reliability; 10 validity; 2 responsiveness). Performance-based functional tests reliability (test-retest, intra- and interrater) measures indicated excellent reliability properties. Intraclass correlation coefficient (ICC) was ≥0.83 and standard error of the mean (SEM) ranged from 0.03-13.3 points. Validity (construct/convergent/concurrent) measures displayed correlations of −0.76 to 0.91 between performance-based functional tests and other patient-reported outcomes (Disabilities of the Arm, Shoulder, and Hand, Constant, Shoulder Pain and Disability Index). Two studies assessed the responsiveness measures performance-based functional tests. Effect sizes of 0.44 and 1.50 and minimal clinically important differences of 10.3 using the anchor-based approach were reported. Conclusions The FI2S and the SFInX are reliable, valid, and responsive in patients with shoulder-related diseases.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 741-749

Titre :	Gender-Based Salary Inequities Among Pediatric Rehabilitation Medicine Physicians in the United States
Type de document :	Article
Auteurs :	Amy J. Houtrow ; David W. Pruitt ; Christina K. Zigler
Année de publication :	2020
Article en page(s) :	p. 741-749
Note générale :	https://doi.org/10.1016/j.apmr.2019.11.007
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Identité de genre ; Réadaptation ; Salaires et prestations accessoires
Résumé :	Objective To assess whether gender inequities exist for pediatric physiatrists and, if affirmative, what factors account for this difference. Design Cohort study. Setting Online REDCap survey administered via e-mail. Participants Pediatric physiatrists practicing in the United States in 2017. Interventions Not applicable. Main Outcome Measures Respondents reported on their gender, training, practice type and location, leadership positions, years in practice and years at their current location, salary, research, and clinical productivity. Results Of the 307 surveys sent, 235 individuals responded, yielding a response rate of 76.5%. Pediatric physiatrists who identified as women were more likely to work part-time but were demographically similar to their colleagues who identified as men. The odds of having no leadership role were higher for women (odds ratio=2.17; P=.02) than men. Pediatric physiatrists who identified as men made on average (in US dollars ± SD) 244,798±52,906 annually compared with those who identified as women 224,497±60,756. The average annual difference in full-time salary was $20,311 in favor of those who identified as men (95% confidence interval, $3135-$37,486). The set of predictors in the multivariable model explained about 40% of the total variability in annual full-time salary (R2=0.389; adjusted R2=0.339; F15,197=7.734; P<.001 gender was not a significant predictor in the model but prediction of salaries pediatric physiatrists who identified as men better than those women.> Conclusions Despite representing a majority of the field, pediatric physiatrists who identified as women were paid less than their counterparts who identified as men. The traditional predictors associated with the salaries of men were not enough to explain salary variation among those who identified as women, thereby providing evidence of the importance of intangible and unmeasured aspects of a women’s career, such as bias and institutional culture.
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[article] Gender-Based Salary Inequities Among Pediatric Rehabilitation Medicine Physicians in the United States [Article] / Amy J. Houtrow ; David W. Pruitt ; Christina K. Zigler . - 2020 . - p. 741-749.
https://doi.org/10.1016/j.apmr.2019.11.007
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 741-749

Descripteurs :	HE Vinci Identité de genre ; Réadaptation ; Salaires et prestations accessoires
Résumé :	Objective To assess whether gender inequities exist for pediatric physiatrists and, if affirmative, what factors account for this difference. Design Cohort study. Setting Online REDCap survey administered via e-mail. Participants Pediatric physiatrists practicing in the United States in 2017. Interventions Not applicable. Main Outcome Measures Respondents reported on their gender, training, practice type and location, leadership positions, years in practice and years at their current location, salary, research, and clinical productivity. Results Of the 307 surveys sent, 235 individuals responded, yielding a response rate of 76.5%. Pediatric physiatrists who identified as women were more likely to work part-time but were demographically similar to their colleagues who identified as men. The odds of having no leadership role were higher for women (odds ratio=2.17; P=.02) than men. Pediatric physiatrists who identified as men made on average (in US dollars ± SD) 244,798±52,906 annually compared with those who identified as women 224,497±60,756. The average annual difference in full-time salary was $20,311 in favor of those who identified as men (95% confidence interval, $3135-$37,486). The set of predictors in the multivariable model explained about 40% of the total variability in annual full-time salary (R2=0.389; adjusted R2=0.339; F15,197=7.734; P<.001 gender was not a significant predictor in the model but prediction of salaries pediatric physiatrists who identified as men better than those women.> Conclusions Despite representing a majority of the field, pediatric physiatrists who identified as women were paid less than their counterparts who identified as men. The traditional predictors associated with the salaries of men were not enough to explain salary variation among those who identified as women, thereby providing evidence of the importance of intangible and unmeasured aspects of a women’s career, such as bias and institutional culture.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 750-761

Titre :	Chronic Pain Self-Management Support With Pain Science Education and Exercise (COMMENCE) for People With Chronic Pain and Multiple Comorbidities: A Randomized Controlled Trial
Type de document :	Article
Auteurs :	Jordan Miller ; Joy C. MacDermid ; David M. Walton
Année de publication :	2020
Article en page(s) :	p. 750-761
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.016
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Douleur chronique ; Éducation du patient comme sujet ; Exercice physique ; Gestion de soi ; Réadaptation
Résumé :	Objective To investigate the effectiveness of chronic pain self-management support with pain science education and exercise (COMMENCE) on improving function, pain interference, work status, pain intensity, fatigue, psychological factors associated with pain, health care visits, satisfaction, and perceived change compared with usual care. Design Parallel group randomized controlled trial with 1- and 12-week follow-ups. Setting Community health center. Participants Adults (N=102) with chronic noncancer pain referred for self-management support. Eighty of 102 participants completed 12-week follow-up assessments. No participants withdrew with adverse events. Interventions Participants were randomized to COMMENCE or usual care. Main Outcome Measures Primary: Function measured using the Short Musculoskeletal Function Assessment–Dysfunction Index. Secondary: Short Musculoskeletal Function Assessment–Bother Index, Patient Reported Outcomes Measurement Information System pain interference, work status, numeric pain, and fatigue rating scales, Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Pain Self-Efficacy Scale, Neurophysiology of Pain Questionnaire, number of health care visits, satisfaction, and global rating of change. Results COMMENCE resulted in greater improvements in function (mean difference [MD] at 12-wk follow-up=−8.0; 95% CI, −14.7 to −1.3), bother with functional difficulties (MD, −12.0; 95% CI, −20.8 to −3.2), pain intensity (MD, −1.0; 95% CI, −2.1 to −0.1), catastrophizing (MD , −8.2; 95% CI, −14.5 to −2.0), self-efficacy (MD, 7.0; 95% CI, 0.8-13.2), knowledge (MD, 2.8; 95% CI, 1.6-3.9), satisfaction (MD, 1.2; 95% CI, 0.7-1.8), and perceived change (MD, 1.4; 95% CI, 0.8-2.1). There were no significant between-group differences in pain interference, work, fatigue, depressive symptoms, or health care visits. Conclusion COMMENCE is more effective than usual care at improving function, pain, catastrophic thinking, self-efficacy, pain knowledge, satisfaction, and perceived change but not pain interference, work status, fatigue, depressive symptoms, or health care visits.
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[article] Chronic Pain Self-Management Support With Pain Science Education and Exercise (COMMENCE) for People With Chronic Pain and Multiple Comorbidities: A Randomized Controlled Trial [Article] / Jordan Miller ; Joy C. MacDermid ; David M. Walton . - 2020 . - p. 750-761.
https://doi.org/10.1016/j.apmr.2019.12.016
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 750-761

Descripteurs :	HE Vinci Douleur chronique ; Éducation du patient comme sujet ; Exercice physique ; Gestion de soi ; Réadaptation
Résumé :	Objective To investigate the effectiveness of chronic pain self-management support with pain science education and exercise (COMMENCE) on improving function, pain interference, work status, pain intensity, fatigue, psychological factors associated with pain, health care visits, satisfaction, and perceived change compared with usual care. Design Parallel group randomized controlled trial with 1- and 12-week follow-ups. Setting Community health center. Participants Adults (N=102) with chronic noncancer pain referred for self-management support. Eighty of 102 participants completed 12-week follow-up assessments. No participants withdrew with adverse events. Interventions Participants were randomized to COMMENCE or usual care. Main Outcome Measures Primary: Function measured using the Short Musculoskeletal Function Assessment–Dysfunction Index. Secondary: Short Musculoskeletal Function Assessment–Bother Index, Patient Reported Outcomes Measurement Information System pain interference, work status, numeric pain, and fatigue rating scales, Tampa Scale of Kinesiophobia, Pain Catastrophizing Scale, Pain Self-Efficacy Scale, Neurophysiology of Pain Questionnaire, number of health care visits, satisfaction, and global rating of change. Results COMMENCE resulted in greater improvements in function (mean difference [MD] at 12-wk follow-up=−8.0; 95% CI, −14.7 to −1.3), bother with functional difficulties (MD, −12.0; 95% CI, −20.8 to −3.2), pain intensity (MD, −1.0; 95% CI, −2.1 to −0.1), catastrophizing (MD , −8.2; 95% CI, −14.5 to −2.0), self-efficacy (MD, 7.0; 95% CI, 0.8-13.2), knowledge (MD, 2.8; 95% CI, 1.6-3.9), satisfaction (MD, 1.2; 95% CI, 0.7-1.8), and perceived change (MD, 1.4; 95% CI, 0.8-2.1). There were no significant between-group differences in pain interference, work, fatigue, depressive symptoms, or health care visits. Conclusion COMMENCE is more effective than usual care at improving function, pain, catastrophic thinking, self-efficacy, pain knowledge, satisfaction, and perceived change but not pain interference, work status, fatigue, depressive symptoms, or health care visits.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 762-769

Titre :	Therapeutic Effects of Exercise Training on Elderly Patients With Dementia: A Randomized Controlled Trial
Type de document :	Article
Auteurs :	I-Ting Liu ; Wei-Ju Lee ; Shih-Yi Lin
Année de publication :	2020
Article en page(s) :	p. 762-769
Note générale :	https://doi.org/10.1016/j.apmr.2020.01.012
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Démence ; Entraînement en résistance ; Exercice physique ; Réadaptation ; Sujet âgé
Résumé :	Objective To investigate whether strength or aerobic training can offer significantly more benefits with regarding the activities of daily living of elderly patients with dementia as well as to determine the effects of exercise on cognition, depression, and biochemical markers. Design Single-blind randomized controlled trial. Setting A nursing home for veterans. Participants A volunteer sample of participants (N=80) whose scores on the Mini-Mental State Examination were between 15 and 26 were included. Because of cardiopulmonary or orthopedic conditions that prohibit exercise training, along with any cognitive problems that may impede answering the contents of our questionnaires, 11 participants were excluded. During the exercise training period, 8 participants voluntarily dropped out of the study. Interventions The participants were randomly assigned to perform either strength or aerobic training for a total of 4 weeks. Main Outcome Measures The main outcome measure was the Barthel Index. Other outcome measures included the Mini-Mental State Examination, Montreal Cognitive Assessment, Geriatric Depression Scale, plasma monocyte chemotactic protein-1 levels, insulin-like growth factor-1 levels, and serum brain-derived neurotrophic factor levels. Results After completion of the program, we discovered a significant improvement in the patients’ Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, and plasma monocyte chemotactic protein-1 levels in the strength-training group. For the patients who had received aerobic training, their serum brain-derived neurotrophic factor also improved significantly. However, the degree of improvement regarding these outcome measures did not achieve significant statistical difference between the 2 groups. Conclusions Through our study, an intensive 4-week exercise program, whether it be strength or aerobic training, is evidenced to bring significant benefits to elderly patients with dementia, while the serum brain-derived neurotrophic factor was additionally improved through aerobic training.
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[article] Therapeutic Effects of Exercise Training on Elderly Patients With Dementia: A Randomized Controlled Trial [Article] / I-Ting Liu ; Wei-Ju Lee ; Shih-Yi Lin . - 2020 . - p. 762-769.
https://doi.org/10.1016/j.apmr.2020.01.012
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 762-769

Descripteurs :	HE Vinci Démence ; Entraînement en résistance ; Exercice physique ; Réadaptation ; Sujet âgé
Résumé :	Objective To investigate whether strength or aerobic training can offer significantly more benefits with regarding the activities of daily living of elderly patients with dementia as well as to determine the effects of exercise on cognition, depression, and biochemical markers. Design Single-blind randomized controlled trial. Setting A nursing home for veterans. Participants A volunteer sample of participants (N=80) whose scores on the Mini-Mental State Examination were between 15 and 26 were included. Because of cardiopulmonary or orthopedic conditions that prohibit exercise training, along with any cognitive problems that may impede answering the contents of our questionnaires, 11 participants were excluded. During the exercise training period, 8 participants voluntarily dropped out of the study. Interventions The participants were randomly assigned to perform either strength or aerobic training for a total of 4 weeks. Main Outcome Measures The main outcome measure was the Barthel Index. Other outcome measures included the Mini-Mental State Examination, Montreal Cognitive Assessment, Geriatric Depression Scale, plasma monocyte chemotactic protein-1 levels, insulin-like growth factor-1 levels, and serum brain-derived neurotrophic factor levels. Results After completion of the program, we discovered a significant improvement in the patients’ Barthel Index, Mini-Mental State Examination, Montreal Cognitive Assessment, and plasma monocyte chemotactic protein-1 levels in the strength-training group. For the patients who had received aerobic training, their serum brain-derived neurotrophic factor also improved significantly. However, the degree of improvement regarding these outcome measures did not achieve significant statistical difference between the 2 groups. Conclusions Through our study, an intensive 4-week exercise program, whether it be strength or aerobic training, is evidenced to bring significant benefits to elderly patients with dementia, while the serum brain-derived neurotrophic factor was additionally improved through aerobic training.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 770-780

Titre :	Relative Effectiveness of Electroacupuncture and Biofeedback in the Treatment of Neck and Upper Back Myofascial Pain: A Randomized Clinical Trial
Type de document :	Article
Auteurs :	Fariba Eslamian ; Fatemeh Jahanjoo ; Neda Dolatkhah
Année de publication :	2020
Article en page(s) :	p. 770-780
Note générale :	https://doi.org/10.1016/j.apmr.2019.12.009
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Électroacupuncture ; Points de déclenchement ; Réadaptation ; Rétroaction biologique (psychologie) ; Syndromes de la douleur myofasciale
Résumé :	Objective To determine the differences between clinical effects of electroacupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical myofascial pain syndrome (MPS). Design Randomized clinical trial. Setting Physical medicine and rehabilitation clinic of a university hospital. Participants Fifty patients (N=50) aged 25-55 years of both sexes with chronic neck pain diagnosed with MPS (characterized by trigger points within taut bands) were randomly assigned to 2 equal groups of 25 individuals. Interventions The patients in electroacupuncture group were treated with standard acupuncture and concomitant electrical stimulation; those in biofeedback group received visual electromyography biofeedback therapy for muscle activity and relaxation. Both groups received the intervention 2 times a week for a total of 6 sessions. Basic exercise training and medicines were administered for all the patients. Main Outcome Measures Pain severity based on the visual analog scale (VAS), functional status using Neck Disability Index (NDI), cervical range of motion (ROM) using and inclinometer, and pressure pain threshold (PPT) using an algometer were evaluated before and at 3 and 12 weeks after the treatment. Primary outcome was defined as 20% reduction in the 3-month neck pain and dysfunction compared to baseline, assessed through the NDI. Results Fifty patients (39 women, 11 men) with a mean age (years) ± SD of 39.0±5.5 and neck pain duration (weeks) of 6.0±2.2 were analyzed. All parameters, except for PPT of the lower trapezius and paravertebral muscles were improved significantly in both groups, while baseline values were controlled. The primary outcome was achieved more significantly in the acupuncture group than in the biofeedback group: 20 (80.0%) vs 10 (40.0%); rate ratio=2 with 95% confidence interval (CI), 1.19-3.36; number needed to treat (NNT)=2.5 with 95% CI, 1.54-6.58. Advantages of acupuncture over biofeedback were observed according to values obtained from the NDI, VAS, extension and left lateral-bending ROM, and PPT on the left upper trapezius after the last session of intervention until 3 months (P<.05> Conclusions Both electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters vs biofeedback. Thus, electroacupuncture seems to be a better complementary modality for treatment of MPS in the neck and upper back area.
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[article] Relative Effectiveness of Electroacupuncture and Biofeedback in the Treatment of Neck and Upper Back Myofascial Pain: A Randomized Clinical Trial [Article] / Fariba Eslamian ; Fatemeh Jahanjoo ; Neda Dolatkhah . - 2020 . - p. 770-780.
https://doi.org/10.1016/j.apmr.2019.12.009
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 770-780

Descripteurs :	HE Vinci Électroacupuncture ; Points de déclenchement ; Réadaptation ; Rétroaction biologique (psychologie) ; Syndromes de la douleur myofasciale
Résumé :	Objective To determine the differences between clinical effects of electroacupuncture and biofeedback therapy in addition to conventional treatment in patients with cervical myofascial pain syndrome (MPS). Design Randomized clinical trial. Setting Physical medicine and rehabilitation clinic of a university hospital. Participants Fifty patients (N=50) aged 25-55 years of both sexes with chronic neck pain diagnosed with MPS (characterized by trigger points within taut bands) were randomly assigned to 2 equal groups of 25 individuals. Interventions The patients in electroacupuncture group were treated with standard acupuncture and concomitant electrical stimulation; those in biofeedback group received visual electromyography biofeedback therapy for muscle activity and relaxation. Both groups received the intervention 2 times a week for a total of 6 sessions. Basic exercise training and medicines were administered for all the patients. Main Outcome Measures Pain severity based on the visual analog scale (VAS), functional status using Neck Disability Index (NDI), cervical range of motion (ROM) using and inclinometer, and pressure pain threshold (PPT) using an algometer were evaluated before and at 3 and 12 weeks after the treatment. Primary outcome was defined as 20% reduction in the 3-month neck pain and dysfunction compared to baseline, assessed through the NDI. Results Fifty patients (39 women, 11 men) with a mean age (years) ± SD of 39.0±5.5 and neck pain duration (weeks) of 6.0±2.2 were analyzed. All parameters, except for PPT of the lower trapezius and paravertebral muscles were improved significantly in both groups, while baseline values were controlled. The primary outcome was achieved more significantly in the acupuncture group than in the biofeedback group: 20 (80.0%) vs 10 (40.0%); rate ratio=2 with 95% confidence interval (CI), 1.19-3.36; number needed to treat (NNT)=2.5 with 95% CI, 1.54-6.58. Advantages of acupuncture over biofeedback were observed according to values obtained from the NDI, VAS, extension and left lateral-bending ROM, and PPT on the left upper trapezius after the last session of intervention until 3 months (P<.05> Conclusions Both electroacupuncture and biofeedback therapies were found to be effective in management of MPS when integrated with conventional treatment. However, intergroup differences showed priority of acupuncture in some parameters vs biofeedback. Thus, electroacupuncture seems to be a better complementary modality for treatment of MPS in the neck and upper back area.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 781-788

Titre :	Pressure Pain Threshold in Subjects With Piriformis Syndrome: Test-Retest, Intrarater, and Interrater Reliability, and Minimal Detectible Changes
Type de document :	Article
Auteurs :	Abbas Tabatabaiee ; Ismail Ebrahimi Takamjani ; Javad Sarrafzadeh
Année de publication :	2020
Article en page(s) :	p. 781-788
Note générale :	https://doi.org/10.1016/j.apmr.2019.10.194
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Douleur ; Fesses ; Lombalgie ; Réadaptation ; Syndrome du muscle piriforme
Résumé :	Objective This study aimed to assess the test-retest, intrarater, and interrater reliability of using the pressure pain threshold (PPT) in healthy and affected piriformis muscles and to estimate its absolute reliability. As a secondary objective, the degree of tenderness of the affected piriformis muscles was compared with healthy piriformis muscles. Study Design This study used a comparative and reliability-based design. Setting Rehabilitation clinic. Participants Patients (N=30) with unilateral piriformis muscle syndrome (30 affected and 30 healthy piriformis muscles) were recruited, and the PPT of both the healthy and affected piriformis muscles was recorded using digital algometry. Measurements of PPT were done by 2 raters (rater 1 and 2), which were selected at random order. Rater 1 repeated the PPT measurements 24-72 hours after initial assessment. Interventions Not applicable. Main Outcome Measure PPT. Results Excellent intrarater intraclass correlation coefficient (ICC) values were observed for the PPT of the affected piriformis (ICC: 0.86-0.96) and the healthy piriformis (ICC: 0.88-0.96) in the same session. The PPT measurements using digital algometry showed good-to-excellent interrater reliability (ICC: 0.64-0.92) and test-retest reliability (ICC: 0.72-0.95) in both the healthy and affected piriformis muscles. The findings revealed a significant decrease in the PPT of the affected piriformis muscle in comparison to the healthy piriformis muscle (mean difference 12.76; 95% confidence interval, 15.69-9.82; P<.001> Conclusions Digital algometry is a reliable tool for measuring piriformis PPT, regardless of the testing session and the rater. Patients with unilateral piriformis muscle syndrome have increased tenderness and decreased PPT in the affected piriformis muscle in comparison to the healthy piriformis muscle.
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[article] Pressure Pain Threshold in Subjects With Piriformis Syndrome: Test-Retest, Intrarater, and Interrater Reliability, and Minimal Detectible Changes [Article] / Abbas Tabatabaiee ; Ismail Ebrahimi Takamjani ; Javad Sarrafzadeh . - 2020 . - p. 781-788.
https://doi.org/10.1016/j.apmr.2019.10.194
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 781-788

Descripteurs :	HE Vinci Douleur ; Fesses ; Lombalgie ; Réadaptation ; Syndrome du muscle piriforme
Résumé :	Objective This study aimed to assess the test-retest, intrarater, and interrater reliability of using the pressure pain threshold (PPT) in healthy and affected piriformis muscles and to estimate its absolute reliability. As a secondary objective, the degree of tenderness of the affected piriformis muscles was compared with healthy piriformis muscles. Study Design This study used a comparative and reliability-based design. Setting Rehabilitation clinic. Participants Patients (N=30) with unilateral piriformis muscle syndrome (30 affected and 30 healthy piriformis muscles) were recruited, and the PPT of both the healthy and affected piriformis muscles was recorded using digital algometry. Measurements of PPT were done by 2 raters (rater 1 and 2), which were selected at random order. Rater 1 repeated the PPT measurements 24-72 hours after initial assessment. Interventions Not applicable. Main Outcome Measure PPT. Results Excellent intrarater intraclass correlation coefficient (ICC) values were observed for the PPT of the affected piriformis (ICC: 0.86-0.96) and the healthy piriformis (ICC: 0.88-0.96) in the same session. The PPT measurements using digital algometry showed good-to-excellent interrater reliability (ICC: 0.64-0.92) and test-retest reliability (ICC: 0.72-0.95) in both the healthy and affected piriformis muscles. The findings revealed a significant decrease in the PPT of the affected piriformis muscle in comparison to the healthy piriformis muscle (mean difference 12.76; 95% confidence interval, 15.69-9.82; P<.001> Conclusions Digital algometry is a reliable tool for measuring piriformis PPT, regardless of the testing session and the rater. Patients with unilateral piriformis muscle syndrome have increased tenderness and decreased PPT in the affected piriformis muscle in comparison to the healthy piriformis muscle.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 789-796

Titre :	Measurement Properties of the MPAI-4 in Veterans With mTBI
Type de document :	Article
Auteurs :	Kay J. Waid-Ebbs ; Pey-Shan Wen ; David P. Graham
Année de publication :	2020
Article en page(s) :	p. 789-796
Note générale :	https://doi.org/10.1016/j.apmr.2019.10.191
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Anciens combattants ; Lésions encéphaliques ; Psychométrie ; Réadaptation
Résumé :	Objectives To determine whether the measurement properties of the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) and its participation index (M2PI), which have been adopted as 2 outcome measures in the Veterans Health Administration (VHA) National Polytrauma Rehabilitation Systems of Care, are adequate in veterans with mild traumatic brain injury (mTBI). Design Cross-sectional. Setting Outpatient rehabilitation. Participants Postdeployment veterans with blast-related mTBI (N=177). Intervention Not applicable. Main Outcome Measures Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) and Community Integration Questionnaire (CIQ). Results The unidimensional factor structure of the MPAI-4 total and 3 index scores (abilities, adjustment, participation) were confirmed. Eight of the 30 items were removed for violating monotonicity (6 items) and exceeding Rasch infit (2 items). The rating scale was collapsed from 5 to 3 ratings because of structure issues. The remaining 22 MPAI-4 items demonstrated excellent item/person reliability (0.98/0.91) and separated person ability into 4 strata. Two of the MPAI-4 index scores (abilities and adjustment) had good measurement properties. The third index, M2PI, retained only 3 items that had adequate person reliability (0.75) but separated person ability into only 2 strata. A significant but fair association with the CIQ was demonstrated with the modified MPAI-4. Conclusions The MPAI-4 has been validated in moderate to severe traumatic brain injury but required modification when used in active military personnel with mTBI. We also identified the need for modification of the MPAI-4 to support adequate psychometrics when measuring outcomes in veterans with mTBI. Additional validation of the M2PI is needed in veterans and active military personnel with mTBI, to determine whether the M2PI should continue to be used as an outcome measure in the VHA polytrauma rehabilitation systems.
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[article] Measurement Properties of the MPAI-4 in Veterans With mTBI [Article] / Kay J. Waid-Ebbs ; Pey-Shan Wen ; David P. Graham . - 2020 . - p. 789-796.
https://doi.org/10.1016/j.apmr.2019.10.191
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 789-796

Descripteurs :	HE Vinci Anciens combattants ; Lésions encéphaliques ; Psychométrie ; Réadaptation
Résumé :	Objectives To determine whether the measurement properties of the Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) and its participation index (M2PI), which have been adopted as 2 outcome measures in the Veterans Health Administration (VHA) National Polytrauma Rehabilitation Systems of Care, are adequate in veterans with mild traumatic brain injury (mTBI). Design Cross-sectional. Setting Outpatient rehabilitation. Participants Postdeployment veterans with blast-related mTBI (N=177). Intervention Not applicable. Main Outcome Measures Mayo-Portland Adaptability Inventory Version 4 (MPAI-4) and Community Integration Questionnaire (CIQ). Results The unidimensional factor structure of the MPAI-4 total and 3 index scores (abilities, adjustment, participation) were confirmed. Eight of the 30 items were removed for violating monotonicity (6 items) and exceeding Rasch infit (2 items). The rating scale was collapsed from 5 to 3 ratings because of structure issues. The remaining 22 MPAI-4 items demonstrated excellent item/person reliability (0.98/0.91) and separated person ability into 4 strata. Two of the MPAI-4 index scores (abilities and adjustment) had good measurement properties. The third index, M2PI, retained only 3 items that had adequate person reliability (0.75) but separated person ability into only 2 strata. A significant but fair association with the CIQ was demonstrated with the modified MPAI-4. Conclusions The MPAI-4 has been validated in moderate to severe traumatic brain injury but required modification when used in active military personnel with mTBI. We also identified the need for modification of the MPAI-4 to support adequate psychometrics when measuring outcomes in veterans with mTBI. Additional validation of the M2PI is needed in veterans and active military personnel with mTBI, to determine whether the M2PI should continue to be used as an outcome measure in the VHA polytrauma rehabilitation systems.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 797-806

Titre :	Interrelationships Between Post-TBI Employment and Substance Abuse: A Cross-lagged Structural Equation Modeling Analysis
Type de document :	Article
Auteurs :	Nabil Awan ; Dominic DiSanto ; Shannon B. Juengst
Année de publication :	2020
Article en page(s) :	p. 797-806
Note générale :	https://doi.org/10.1016/j.apmr.2019.10.189
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Emploi ; Lésions traumatiques de l'encéphale ; Réadaptation ; Troubles liés à une substance
Résumé :	Objective To describe the interrelationship of postinjury employment and substance abuse (SA) among individuals with traumatic brain injury. Design Structural equation model (SEM) and logistic regression analytic approach using a merged database of the National Trauma Data Bank (NTDB) and Traumatic Brain Injury Model Systems (TBIMS) National Database, with acute care and rehabilitation hospitalization data and 1, 2, and 5 year follow-up data. Setting United States Level I/II trauma centers and inpatient rehabilitation centers with telephone follow-up. Participants Individuals in the TBIMS National Database successfully matched to their NTDB data, aged 18-59 years, with trauma severity, age, sex, employment, and SA data at 1, 2, and/or 5 years postinjury (N=2890). Interventions Not applicable. Main Outcome Measure Employment status (employed/unemployed) and SA (present/absent) at year 1, year 2, and year 5 postinjury. Results SEM analysis showed older age at injury predicted lower likelihood of employment at all time points postinjury (βYR1=−0.016; βYR2=−0.006; βYR5=−0.016; all P<.001 while higher injury severity score predicted lower likelihood of employment p=".027)" and sa at year male sex each follow-up all despite associations preinjury unemployment with postinjury during the previous period subsequent respectively.> Conclusions Employment and SA have unique longitudinal interrelationships and are additionally influenced by age, sex, and ISS. The present work suggests the need for more research on causal, confounding, and mediating factors and appropriate screening and intervention tools that minimize SA and facilitate successful employment-related outcomes.
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[article] Interrelationships Between Post-TBI Employment and Substance Abuse: A Cross-lagged Structural Equation Modeling Analysis [Article] / Nabil Awan ; Dominic DiSanto ; Shannon B. Juengst . - 2020 . - p. 797-806.
https://doi.org/10.1016/j.apmr.2019.10.189
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 797-806

Descripteurs :	HE Vinci Emploi ; Lésions traumatiques de l'encéphale ; Réadaptation ; Troubles liés à une substance
Résumé :	Objective To describe the interrelationship of postinjury employment and substance abuse (SA) among individuals with traumatic brain injury. Design Structural equation model (SEM) and logistic regression analytic approach using a merged database of the National Trauma Data Bank (NTDB) and Traumatic Brain Injury Model Systems (TBIMS) National Database, with acute care and rehabilitation hospitalization data and 1, 2, and 5 year follow-up data. Setting United States Level I/II trauma centers and inpatient rehabilitation centers with telephone follow-up. Participants Individuals in the TBIMS National Database successfully matched to their NTDB data, aged 18-59 years, with trauma severity, age, sex, employment, and SA data at 1, 2, and/or 5 years postinjury (N=2890). Interventions Not applicable. Main Outcome Measure Employment status (employed/unemployed) and SA (present/absent) at year 1, year 2, and year 5 postinjury. Results SEM analysis showed older age at injury predicted lower likelihood of employment at all time points postinjury (βYR1=−0.016; βYR2=−0.006; βYR5=−0.016; all P<.001 while higher injury severity score predicted lower likelihood of employment p=".027)" and sa at year male sex each follow-up all despite associations preinjury unemployment with postinjury during the previous period subsequent respectively.> Conclusions Employment and SA have unique longitudinal interrelationships and are additionally influenced by age, sex, and ISS. The present work suggests the need for more research on causal, confounding, and mediating factors and appropriate screening and intervention tools that minimize SA and facilitate successful employment-related outcomes.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 807-814

Titre :	Risk Factors for Suboptimal Medication Adherence in Persons With Multiple Sclerosis: Development of an Electronic Health Record-Based Explanatory Model for Disease-Modifying Therapy Use
Type de document :	Article
Auteurs :	Elizabeth S. Gromisch ; Aaron P. Turner ; Steven L. Leipertz
Année de publication :	2020
Article en page(s) :	p. 807-814
Note générale :	https://doi.org/10.1016/j.apmr.2019.11.005
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Adhésion au traitement médicamenteux ; Dossiers médicaux électroniques ; Facteurs de risque ; Réadaptation ; Rendez-vous et plannings ; Sclérose en plaques
Résumé :	Objective To determine which factors are associated with suboptimal disease-modifying therapy (DMT) adherence and to develop an explanatory model that could be used to identify individuals at risk and potentially inform interventions. Design Cross-sectional cohort study using electronic health records. Setting Veterans Health Administration (VA). Participants Veterans with multiple sclerosis (MS) (N=2939; 79.69% men) who received care through the VA and were included in the VA MS Center of Excellence Data Repository. Interventions Not applicable. Main Outcome Measures Suboptimal DMT adherence ( Results Nearly 31% of participants had suboptimal adherence. Flags for suboptimal adherence included >20% missed appointments (odds ratio [OR], 3.78; 95% CI, 2.45-2.82), traumatic brain injuries (OR, 1.55; 95% CI, 1.12-2.14), age younger than 59 years (OR, 1.47; 95% CI, 1.23-1.74), ≥1 emergency department visits (OR, 1.40; 95% CI, 1.18-1.67), mood disorders (ie, depressive and bipolar disorders) (OR, 1.40; 95% CI, 1.18-1.66), and service connection (OR, 1.22; 95% CI, 1.01-1.47). Hyperlipidemia (OR, 0.77; 95% CI, 0.65-0.92) and being issued a wheelchair (OR, 0.83; 95% CI, 0.70-1.00) were associated with lower risk. Conclusions Suboptimal adherence to DMTs continues to be an issue. Interventions that focus on person-level barriers should be urgently explored to increase adherence and improve self-management abilities.
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[article] Risk Factors for Suboptimal Medication Adherence in Persons With Multiple Sclerosis: Development of an Electronic Health Record-Based Explanatory Model for Disease-Modifying Therapy Use [Article] / Elizabeth S. Gromisch ; Aaron P. Turner ; Steven L. Leipertz . - 2020 . - p. 807-814.
https://doi.org/10.1016/j.apmr.2019.11.005
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 807-814

Descripteurs :	HE Vinci Adhésion au traitement médicamenteux ; Dossiers médicaux électroniques ; Facteurs de risque ; Réadaptation ; Rendez-vous et plannings ; Sclérose en plaques
Résumé :	Objective To determine which factors are associated with suboptimal disease-modifying therapy (DMT) adherence and to develop an explanatory model that could be used to identify individuals at risk and potentially inform interventions. Design Cross-sectional cohort study using electronic health records. Setting Veterans Health Administration (VA). Participants Veterans with multiple sclerosis (MS) (N=2939; 79.69% men) who received care through the VA and were included in the VA MS Center of Excellence Data Repository. Interventions Not applicable. Main Outcome Measures Suboptimal DMT adherence ( Results Nearly 31% of participants had suboptimal adherence. Flags for suboptimal adherence included >20% missed appointments (odds ratio [OR], 3.78; 95% CI, 2.45-2.82), traumatic brain injuries (OR, 1.55; 95% CI, 1.12-2.14), age younger than 59 years (OR, 1.47; 95% CI, 1.23-1.74), ≥1 emergency department visits (OR, 1.40; 95% CI, 1.18-1.67), mood disorders (ie, depressive and bipolar disorders) (OR, 1.40; 95% CI, 1.18-1.66), and service connection (OR, 1.22; 95% CI, 1.01-1.47). Hyperlipidemia (OR, 0.77; 95% CI, 0.65-0.92) and being issued a wheelchair (OR, 0.83; 95% CI, 0.70-1.00) were associated with lower risk. Conclusions Suboptimal adherence to DMTs continues to be an issue. Interventions that focus on person-level barriers should be urgently explored to increase adherence and improve self-management abilities.
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[article] 
inArchives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 815-821

Titre :	Early Intervention Service Intensity and Change in Children’s Functional Capabilities
Type de document :	Article
Auteurs :	Zachary S. Richardson ; Elizabeth A. Scully ; Jodi K. Dooling-Litfin
Année de publication :	2020
Article en page(s) :	p. 815-821
Note générale :	https://doi.org/10.1016/j.apmr.2019.10.188
Langues :	Anglais (eng)
Descripteurs :	HE Vinci Activités de la vie quotidienne ; Cognition ; Compétences sociales ; Réadaptation
Résumé :	Objective To estimate correlates of early intervention (EI) service dosage and gains in children’s functional capabilities from EI entry and discharge. Design Retrospective cohort study. Setting Secondary analyses of a subset of data (N=1005) collected from an EI administrative database on children discharged from a large, urban EI program between October 1, 2014 and September 30, 2016. Participants Children who were EI eligible due to developmental delay, had received an EI care plan and at least 1 billable EI service, and had outcomes data at EI entry and exit (N=1005). Measured child characteristics included age (49.0% 12-24mo; n=492), sex (36.0% female; n=362), number of developmental delays (76.1% had 1 developmental delay; n=765), and number of EI services received (78.5% received multiple; n=789). Intervention Not applicable. Main Outcome Measures Outcomes were EI service intensity (hours per month) and change in functional capabilities as measured via the state-mandated Child Outcomes Summary (COS). Adjusted quantile median regression estimated EI intensity. Adjusted linear regression estimated change in function for social-emotional, cognitive, and adaptive domains of the COS. Measures of children’s developmental delay severity, age at EI entry, race and ethnicity, sex, and language. Results Children older than 24 months old experienced significantly higher EI service intensity (b=0.40; 95% confidence interval, 0.18-0.63). Child age and EI service intensity were significantly linked to gains in social and cognitive COS score changes from EI entry to exit. Conclusions Older children receive a higher intensity of EI services. EI service intensity and age were linked with positive changes in functional gains.
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[article] Early Intervention Service Intensity and Change in Children’s Functional Capabilities [Article] / Zachary S. Richardson ; Elizabeth A. Scully ; Jodi K. Dooling-Litfin . - 2020 . - p. 815-821.
https://doi.org/10.1016/j.apmr.2019.10.188
Langues : Anglais (eng)
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 5 (2020) . - p. 815-821

Descripteurs :	HE Vinci Activités de la vie quotidienne ; Cognition ; Compétences sociales ; Réadaptation
Résumé :	Objective To estimate correlates of early intervention (EI) service dosage and gains in children’s functional capabilities from EI entry and discharge. Design Retrospective cohort study. Setting Secondary analyses of a subset of data (N=1005) collected from an EI administrative database on children discharged from a large, urban EI program between October 1, 2014 and September 30, 2016. Participants Children who were EI eligible due to developmental delay, had received an EI care plan and at least 1 billable EI service, and had outcomes data at EI entry and exit (N=1005). Measured child characteristics included age (49.0% 12-24mo; n=492), sex (36.0% female; n=362), number of developmental delays (76.1% had 1 developmental delay; n=765), and number of EI services received (78.5% received multiple; n=789). Intervention Not applicable. Main Outcome Measures Outcomes were EI service intensity (hours per month) and change in functional capabilities as measured via the state-mandated Child Outcomes Summary (COS). Adjusted quantile median regression estimated EI intensity. Adjusted linear regression estimated change in function for social-emotional, cognitive, and adaptive domains of the COS. Measures of children’s developmental delay severity, age at EI entry, race and ethnicity, sex, and language. Results Children older than 24 months old experienced significantly higher EI service intensity (b=0.40; 95% confidence interval, 0.18-0.63). Child age and EI service intensity were significantly linked to gains in social and cognitive COS score changes from EI entry to exit. Conclusions Older children receive a higher intensity of EI services. EI service intensity and age were linked with positive changes in functional gains.
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En ligne :	https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...]