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1.
Danilo de Oliveira Silva Fernando Henrique Magalhães Nathálie Clara Faria Deisi Ferrari Marcella Ferraz Pazzinatto Evangelos Pappas Fábio Mícolis de Azevedo 《Archives of physical medicine and rehabilitation》2017,98(1):114-119
Objective
To determine the association between the amplitude of vastus medialis (VM) Hoffmann reflex (H-reflex) and pain level, self-reported physical function, and chronicity of pain in women with patellofemoral pain (PFP).Design
Cross-sectional study.Setting
Laboratory of biomechanics and motor control.Participants
Women diagnosed with PFP (N=15) aged 18 to 35 years.Interventions
Not applicable.Main Outcome Measures
Data on worst pain level during the previous month, self-reported physical function, and symptom duration (chronicity) were collected from the participants. Maximum evoked responses were obtained by electrical stimulation applied to the femoral nerve and peak-to-peak amplitudes of normalized maximal H-reflexes (maximal Hoffmann reflex/maximal motor wave ratios) of the VM were calculated. A Pearson product-moment correlation matrix (r) was used to explore the relations between the amplitude of VM H-reflex and worst pain during the previous month, self-reported function, and chronicity of pain.Results
Strong negative correlations were found between the amplitude of VM H-reflex and worst pain in the previous month (r=?.71; P=.003) and chronicity (r=?.74; P=.001). A strong positive correlation was found between the amplitude of VM H-reflex and self-reported physical function (r=.62; P=.012).Conclusions
The strong and significant relations reported in this study suggest that women with PFP showing greater VM H-reflex excitability tend to have lower pain, better physical function, and more recent symptoms. Therefore, rehabilitation strategies designed to increase the excitability of the monosynaptic stretch reflex should be considered in the treatment of women with PFP if their effectiveness is demonstrated in future studies. 相似文献2.
Peter C. Coyle Jenifer M. Pugliese J. Megan Sions Mark S. Eskander Jennifer A. Schrack Gregory E. Hicks 《Archives of physical medicine and rehabilitation》2018,99(11):2251-2256
Objectives
To investigate the impact that the presence of chronic low back pain with radiculopathy (CLBPR) may have on (1) energy efficiency and (2) energy capacity among community-dwelling older adults.Design
Matched case-control study.Setting
Clinical research laboratory.Participants
Included in the analysis were community-dwelling older adults (N=38, 60-85 years) with and without CLBPR. Participants were matched between-groups on age (±5 years), sex, and diabetic status.Interventions
Not applicable.Main Outcome Measures
Energy cost of walking at self-selected speed (ie, energy efficiency) and peak volume of oxygen consumed (ie, energy capacity).Results
Older adults with CLBPR had a higher energy cost of walking at self-selected speed (P=.009) and lower peak volume of oxygen consumed while walking (P=.050), compared to those without pain.Conclusions
Older adults with CLBPR may benefit from specific rehabilitative interventions that target these potentially modifiable energetic outcomes, thereby reducing the risk of mobility decline. Future studies should identify which mechanisms specifically contribute to diminished energy efficiency and capacity among older adults with CLBPR. 相似文献3.
Minyoung Lee Sang Heon Lee TaeYeong Kim Hyun-Joon Yoo Sung Hoon Kim Dong-Won Suh Jaebum Son BumChul Yoon 《Archives of physical medicine and rehabilitation》2017,98(1):80-87
Objective
To explore the feasibility of a newly developed smartphone-based exercise program with an embedded self-classification algorithm for office workers with neck pain, by examining its effect on the pain intensity, functional disability, quality of life, fear avoidance, and cervical range of motion (ROM).Design
Single-group, repeated-measures design.Setting
The laboratory and participants' home and work environments.Participants
Offices workers with neck pain (N=23; mean age ± SD, 28.13±2.97y; 13 men).Intervention
Participants were classified as having 1 of 4 types of neck pain through a self-classification algorithm implemented as a smartphone application, and conducted corresponding exercise programs for 10 to 12min/d, 3d/wk, for 8 weeks.Main Outcome Measures
The visual analog scale (VAS), Neck Disability Index (NDI), Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36), Fear-Avoidance Beliefs Questionnaire (FABQ), and cervical ROM were measured at baseline and postintervention.Results
The VAS (P<.001) and NDI score (P<.001) indicated significant improvements in pain intensity and functional disability. Quality of life showed significant improvements in the physical functioning (P=.007), bodily pain (P=.018), general health (P=.022), vitality (P=.046), and physical component scores (P=.002) of the SF-36. The FABQ, cervical ROM, and mental component score of the SF-36 showed no significant improvements.Conclusions
The smartphone-based exercise program with an embedded self-classification algorithm improves the pain intensity and perceived physical health of office workers with neck pain, although not enough to affect their mental and emotional states. 相似文献4.
Louise M. Fuller Doa El-Ansary Brenda M. Button Monique Corbett Greg Snell Silvana Marasco Anne E. Holland 《Archives of physical medicine and rehabilitation》2018,99(7):1257-1264.e2
Objective
To investigate the effect of a supervised upper limb (UL) program (SULP) compared to no supervised UL program (NULP) after lung transplantation (LTx).Design
Randomized controlled trial.Setting
Physiotherapy gym.Participants
Participants (N=80; mean age, 56±11y; 37 [46%] men) were recruited after LTx.Interventions
All participants underwent lower limb strength thrice weekly and endurance training. Participants randomized to SULP completed progressive UL strength training program using handheld weights and adjustable pulley equipment.Main Outcome Measures
Overall bodily pain was rated on the visual analog scale. Shoulder flexion and abduction muscle strength were measured on a hand held dynamometer. Health related quality of life was measured with Medical Outcomes Study 36-item Short Form health Survey and the Quick Dash. Measurements were made at baseline, 6 weeks, 12 weeks, and 6 months by blinded assessors.Results
After 6 weeks of training, participants in the SULP (n=41) had less overall bodily pain on the visual analog scale than did participants in the NULP (n=36) (mean VAS bodily pain score, 2.1±1.3cm vs 3.8±1.7cm; P<.001) as well as greater UL strength than did participants in the NULP (mean peak force, 8.4±4.0Nm vs 6.7±2.8Nm; P=.037). At 12 weeks, participants in the SULP better quality of life related to bodily pain (76±17 vs 66±26; P=.05), but at 6 months there were no differences between the groups in any outcome measures. No serious adverse events were reported.Conclusions
UL rehabilitation results in short-term improvements in pain and muscle strength after LTx, but no longer-term effects were evident. 相似文献5.
Luciana de Araujo Cazotti Anamaria Jones Diego Roger-Silva Luiza Helena Coutinho Ribeiro Jamil Natour 《Archives of physical medicine and rehabilitation》2018,99(9):1740-1746
Objective
To assess the effectiveness of the Pilates method on pain, function, quality of life, and consumption of pain medication in patients with mechanical neck pain.Design
The design was a randomized controlled trial, with a blinded assessor and intention-to-treat analysis.Setting
The study took place in the outpatient clinic of the rheumatology department, referral center.Participants
Patients (N=64) with chronic mechanical neck pain were randomly allocated to 2 groups: the Pilates group (PG) and a control group (CG).Interventions
The PG attended 2 sessions of Pilates per week, for 12 weeks. The protocol included Pilates exercises performed on a mat and on equipment and was adapted depending on the physical fitness of each participant; the repetitions varied from 6 to 12, respecting patient reports of fatigue and pain, using a single series for each exercise. The CG received only the standard pharmacological treatment. Both groups were instructed to use acetaminophen 750 mg if necessary. Patients were evaluated at baseline after 45, 90, and 180 days.Main Outcome Measures
We used the Numerical Pain Scale for pain, the Neck Disability Index for function, and the SF-36 questionnaire for quality of life.Results
The groups were homogeneous at baseline, the only exception being body mass index (BMI), with the PG showing higher BMI. Regarding the assessment between groups over time, statistical differences were identified for pain (P<.001), function (P<.001) and the SF-36 (functional capacity, P=.019; pain, P<.001; general health, P=.022; vitality, P<.001; mental health, P=.012) with the PG consistently achieving better results. Drug consumption was lower in PG patients (P=.037).Conclusions
This trial demonstrated the effectiveness of the Pilates method for the treatment of chronic mechanical neck pain, resulting in improvement of pain, function, quality of life, and reduction of the use of analgesics. 相似文献6.
Dawn B. Simpson Monique Breslin Toby Cumming Sam de Zoete Seana L. Gall Matthew Schmidt Coralie English Michele L. Callisaya 《Archives of physical medicine and rehabilitation》2018,99(11):2216-2221.e1
Objective
To examine whether change in rehabilitation environment (hospital or home) and other factors influence time spent sitting upright and walking after stroke.Design
Observational study.Setting
Two inpatient rehabilitation units and community residences following discharge.Participants
Participants (N=34) with stroke were recruited.Main Outcome Measure
An activity monitor was worn continuously for 7 days during the final week in the hospital and the first week at home. Other covariates included mood, fatigue, physical function, pain, and cognition. Linear mixed models were performed to examine the associations between the environment (exposure) and physical activity levels (outcome) in the hospital and at home. Interaction terms between the exposure and other covariates were added to the model to determine whether they modified activity with change in environment.Results
The mean age of participants was 68±13 years and 53% were male. At home, participants spent 45 fewer minutes sitting (95% CI -84.8, -6.1; P=.02), 45 more minutes upright (95% CI 6.1, 84.8; P=.02), and 12 more minutes walking (95% CI 5, 19; P=.001), and completed 724 additional steps (95% CI 199, 1250; P=.01) each day compared to in the hospital. Depression at discharge predicted greater sitting time and less upright time (P=.03 respectively) at home.Conclusions
Environmental change from hospital to home was associated with reduced sitting time and increased the time spent physically active, though depression modified this change. The rehabilitation environment may be a target to reduce sitting and promote physical activity. 相似文献7.
Marcalee Alexander Khurram Bashir Craig Alexander Lesley Marson Raymond Rosen 《Archives of physical medicine and rehabilitation》2018,99(2):299-305
Objective
To examine the safety and efficacy of using a clitoral vacuum suction device (CVSD) versus vibratory stimulation (V) to treat orgasmic dysfunction in women with multiple sclerosis (MS) or spinal cord injury (SCI).Design
Randomized clinical trial.Setting
Two academic medical centers.Participants
Women (N=31) including 20 with MS and 11 with SCI.Intervention
A 12-week trial of the use of a CVSD versus V.Main Outcome Measures
Female Sexual Function Inventory (FSFI) and Female Sexual Distress Scale (FSDS).Results
Twenty-three women (18 MS, 5 SCI) completed the study including 13 of 16 randomized to CVSD and 10 of 15 randomized to V. There was a statistically significant increase in total FSFI score (P=.011), desire (P=.009), arousal (P=.009), lubrication (P=.008), orgasm (P=.012), and satisfaction (P=.049), and a significant decrease in distress as measured by FSDS (P=.020) in subjects using the CVSD. In subjects who used V, there was a statistically significant increase in the orgasm subscale of the FSFI (P=.028). Subjects using the CVSD maintained improvements 4 weeks after treatment.Conclusions
CVSD is safe and overall efficacious to treat female neurogenic sexual dysfunction related to MS and SCI. V is also safe and efficacious for female neurogenic orgasmic dysfunction; however, results were limited to the active treatment period. Because of ease of access and cost, clinicians can consider use of V for women with MS or SCI with orgasmic dysfunction. CVSD is recommended for women with multiple sexual dysfunctions or for whom V is ineffective. 相似文献8.
Sara J. Francois Vanessa M. Lanier Andrej V. Marich Michael Wallendorf Linda R. Van Dillen 《Archives of physical medicine and rehabilitation》2018,99(12):2496-2503
Objective
To assess treatment preference and attributes of 2 exercise-based treatments for people with chronic low back pain (LBP).Design
Cross-sectional study.Setting
Academic research setting.Participants
Individuals (N=154) with chronic LBP.Interventions
Not applicable.Main Outcome Measures
Participants completed a treatment preference assessment (TPA) measure that described 2 treatments for chronic LBP (strength and flexibility [SF] and motor skill training [MST]). Participants rated each treatment on 4 attributes: effectiveness, acceptability/logicality, suitability/appropriateness, and convenience. An overall score for each treatment was calculated as the mean of the 4 attribute ratings. The participants indicated either (1) no treatment preference or (2) preference for SF or MST.Results
One hundred four participants (67.5%) had a treatment preference; of those, 95 (91.3%) preferred SF and 9 (8.7%) preferred MST. The SF preference group rated SF higher than MST overall and on all attributes (all Ps <.01, ds ranged from .48-1.07). The MST preference group did not rate the treatments differently overall or on any of the attributes (all Ps >.05, ds ranged from .43-.66). Convenience of SF (P=.05, d=.79) and effectiveness (d=1.20), acceptability/logicality (d=1.27), and suitability/appropriateness (d=1.52) of MST (all Ps <.01) were rated differently between the 2 preference groups.Conclusions
When presented with 2 treatment options, a majority of patients preferred SF over MST. Convenience was a particularly important attribute affecting preference. Assessing treatment preference and attributes prior to treatment initiation allows the clinician to identify factors that may need to be addressed to enhance adherence to, and outcomes of, treatment. 相似文献9.
Katie L. Cederberg Julia M. Balto Robert W. Motl 《Archives of physical medicine and rehabilitation》2018,99(5):920-926
Objective
To examine self-regulation strategies as correlates of physical activity in persons with multiple sclerosis (MS).Design
Cross-sectional, or survey, study.Setting
University-based research laboratory.Participants
Convenience sample of persons with MS (N=68).Interventions
Not applicable.Main Outcome Measures
Exercise Self-Efficacy Scale (EXSE), 12-item Physical Activity Self-Regulation Scale (PASR-12), and Godin Leisure-Time Exercise Questionnaire (GLTEQ).Results
Correlation analyses indicated that GLTEQ scores were positively and significantly associated with overall self-regulation (r=.43), self-monitoring (r=.45), goal-setting (r=.27), reinforcement (r=.30), time management (r=.41), and relapse prevention (r=.53) PASR-12 scores. Regression analyses indicated that relapse prevention (B=5.01; SE B=1.74; β=.51) and self-monitoring (B=3.65; SE B=1.71; β=.33) were unique predictors of physical activity behavior, and relapse prevention demonstrated a significant association with physical activity behavior that was accounted for by EXSE.Conclusions
Our results indicate that self-regulatory strategies, particularly relapse prevention, may be important correlates of physical activity behavior that can inform the design of future behavioral interventions in MS. 相似文献10.
Mia Forslin Katharina Fink Ulf Hammar Lena von Koch Sverker Johansson 《Archives of physical medicine and rehabilitation》2018,99(8):1483-1490
Objective
To identify predictors for employment status after 10 years in a cohort of people with multiple sclerosis (MS), with the aim to increase knowledge concerning factors present at an early stage that are important for working life and work-life balance.Design
A 10-year longitudinal observational cohort study.Setting
University hospital.Participants
A consecutive sample of people with MS (N=154) of working age were included at baseline, of which a total of 116 people participated in the 10-year follow-up; 27 people declined participation and 11 were deceased.Interventions
Not applicable.Main Outcome Measures
Baseline data on personal factors and functioning were used as independent variables. Employment status 10 years after baseline, categorized as full-time work, part-time work, and no work, was used as the dependent variable. A generalized ordinal logistic regression was used to analyze the predictive value of the independent variables.Results
Predictors for full- or part-time work after 10 years were young age (P=.002), low perceived physical impact of MS (P=.02), fatigue (P=.03), full-time work (P=.001), and high frequency of social/lifestyle activities (P=.001) at baseline. Low perceived physical impact of MS (P=.02) at baseline also predicted full-time work after 10 years.Conclusions
This study underlines the complexity of working life for people with MS, and indicates that it may be valuable to give more attention to the balance between working and private life, both in clinical practice and future research, to achieve a sustainable working life over time. 相似文献11.
Colin M. Bosma Nashwa Mansoor Chiara S. Haller 《Archives of physical medicine and rehabilitation》2018,99(8):1576-1583
Objective
To investigate the relation between posttraumatic stress (PTS) symptom severity and health-related quality of life (HRQoL) after severe traumatic brain injury (TBI).Design
Longitudinal prospective multicenter, cohort study on severe TBI in Switzerland (2007–2011).Setting
Hospital, rehabilitation unit, and/or patient’s living facility.Participants
Patients with severe TBI (N=109) were included in the analyses. Injury severity was determined using the Abbreviated Injury Score of the head region after clinical assessment and initial computed tomography scan.Interventions
Not applicable.Main Outcome Measures
HRQoL (Medical Outcomes Study 12-Item Short-Form Health Survey Physical and Mental Component Summaries) and self-reported emotional, cognitive, and interpersonal functioning (Patient Competency Rating Scale for Neurorehabilitation).Results
Multilevel models for patients >50 and ≤50 years of age revealed significant negative associations between PTS symptom severity and interpersonal functioning (P<.001 and P=.002), respectively. Among patients ≤50 years of age, PTS symptom severity was significantly associated with total functioning (P=.001) and emotional functioning (P<.001). Among all patients, PTS symptom severity was significantly associated with cognitive functioning (P<.001) and mental HRQoL (P=.01).Conclusions
Findings indicate that PTS symptoms after severe TBI are negatively associated with HRQoL and emotional, cognitive, and interpersonal functioning. 相似文献12.
Yu-wei Hsieh Ku-chou Chang Jen-wen Hung Ching-yi Wu Mu-hui Fu Chih-chi Chen 《Archives of physical medicine and rehabilitation》2018,99(12):2399-2407
Objective
We investigated the treatment effects of a home-based rehabilitation program compared with clinic-based rehabilitation in patients with stroke.Design
A single-blinded, 2-sequence, 2-period, crossover-designed study.Setting
Rehabilitation clinics and participant’s home environment.Participants
Individuals with disabilities poststroke.Interventions
During each intervention period, each participant received 12 training sessions, with a 4-week washout phase between the 2 periods. Participants were randomly allocated to home-based rehabilitation first or clinic-based rehabilitation first. Intervention protocols included mirror therapy and task-specific training.Main Outcome Measures
Outcome measures were selected based on the International Classification of Functioning, Disability and Health. Outcomes of impairment level were the Fugl-Meyer Assessment, Box and Block Test, and Revised Nottingham Sensory Assessment. Outcomes of activity and participation levels included the Motor Activity Log, 10-meter walk test, sit-to-stand test, Canadian Occupational Performance Measure, and EuroQoL-5D Questionnaire.Results
Pretest analyses showed no significant evidence of carryover effect. Home-based rehabilitation resulted in significantly greater improvements on the Motor Activity Log amount of use subscale (P=.01) and the sit-to-stand test (P=.03) than clinic-based rehabilitation. The clinic-based rehabilitation group had better benefits on the health index measured by the EuroQoL-5D Questionnaire (P=.02) than the home-based rehabilitation group. Differences between the 2 groups on the other outcomes were not statistically significant.Conclusions
The home-based and clinic-based rehabilitation groups had comparable benefits in the outcomes of impairment level but showed differential effects in the outcomes of activity and participation levels. 相似文献13.
Daniel Dominguez Ferraz Karen Valadares Trippo Gabriel Pereira Duarte Mansueto Gomes Neto Kionna Oliveira Bernardes Santos Jamary Oliveira Filho 《Archives of physical medicine and rehabilitation》2018,99(5):826-833
Objectives
To compare the effects of functional training, bicycle exercise, and exergaming on walking capacity of elderly with Parkinson disease (PD).Design
A pilot randomized, controlled, single-blinded trial.Setting
A state reference health care center for elderly, a public reference outpatient clinic for the elderly.Participants
Elderly individuals (≥60 years of age; N=62) with idiopathic PD (stage 2 to 3 of modified Hoehn and Yahr staging scale) according to the London Brain Bank.Intervention
The participants were randomly assigned to three groups. Group 1 (G1) participated in functional training (n=22); group 2 (G2) performed bicycle exercise (n=20), and group 3 (G3) trained with Kinect Adventures (Microsoft, Redmond, WA) exergames (n=20).Main Outcome Measures
The primary outcome measure was the 6-minute walk test (6MWT); secondary outcome measures were the 10-m walk test (10MWT), sitting-rising test (SRT), body mass index, Parkinson Disease Questionnaire-39, World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), and 15-item Geriatric Depression Scale.Results
All groups showed significant improvements in 6MWT (G1 P=.008; G2 P=.001; G3 P=.005), SRT (G1 P<.001; G2 P=.001; G3 P=.003), and WHODAS 2.0 (G1 P=.018; G2 P=.019; G3 P=.041). Only G3 improved gait speed in 10MWT (P=.11). G1 (P=.014) and G3 (P=.004) improved quality of life. No difference was found between groups.Conclusions
Eight weeks of exergaming can improve the walking capacity of elderly patients with PD. Exergame training had similar outcomes compared with functional training and bicycle exercise. The three physical exercise modalities presented significant improvements on walking capacity, ability to stand up and sit, and functionality of the participants. 相似文献14.
Stephanie Rigot Lynn Worobey Michael L. Boninger 《Archives of physical medicine and rehabilitation》2018,99(8):1591-1598
Objectives
To investigate the relation of gait training (GT) during inpatient rehabilitation (IPR) to outcomes of people with traumatic spinal cord injury (SCI).Design
Prospective observational study using the SCIRehab database.Setting
Six IPR facilities.Participants
Patients with new SCI (N=1376) receiving initial rehabilitation.Interventions
Patients were divided into groups consisting of those who did and did not receive GT. Patients were further subdivided based on their primary mode of mobility as measured by the FIM.Main Outcome Measures
Pain rating scales, Patient Health Questionnaire Mood Subscale, Satisfaction With Life Scale, and Craig Handicap Assessment and Reporting Technique (CHART).Results
Nearly 58% of all patients received GT, including 33.3% of patients who were primarily using a wheelchair 1 year after discharge from IPR. Those who used a wheelchair and received GT, received significantly less transfer and wheeled mobility training (P<.001). CHART physical independence (P=.002), mobility (P=.024), and occupation (P=.003) scores were significantly worse in patients who used a wheelchair at 1 year and received GT, compared with those who used a wheelchair and did not receive GT in IPR. Older age was also a significant predictor of worse participation as measured by the CHART.Conclusions
A significant percentage of individuals who are not likely to become functional ambulators are spending portions of their IPR stays performing GT, which is associated with less time allotted for other functional interventions. GT in IPR was also associated with participation deficits at 1 year for those who used a wheelchair, implying the potential consequences of opportunity costs, pain, and psychological difficulties of receiving unsuccessful GT. Clinicians should consider these data when deciding to implement GT during initial IPR. 相似文献15.
Stephanie Hyeyoung Lee Ji-Yeong Lee Mi-Young Kim Yu-Jin Jeon Suyoung Kim Joon-Ho Shin 《Archives of physical medicine and rehabilitation》2018,99(8):1447-1453.e1
Objective
To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke.Design
A pilot, randomized, single-blind, controlled trial.Setting
Stroke rehabilitation inpatient unit.Participants
Participants (N=48) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3.Interventions
FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity–based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period.Main Outcome Measures
Primary outcome measures were changes in Fugl-Meyer Assessment–Upper Extremity and Wolf Motor Function Test scores. Secondary outcome measures were changes in Box and Block Test, Jebsen-Taylor Hand Function Test, and Stroke Impact Scale scores. Assessments were performed at baseline (t0) and at 2 weeks (t1), 4 weeks (t4), and 8 weeks (t8). Between-group comparisons were evaluated using a repeated-measures analysis of variance.Results
Forty-one participants were included in the analysis. Compared with FES alone, VR-FES produced a substantial increase in Fugl-Meyer Assessment–distal score (P=.011) and marginal improvement in Jebsen-Taylor Hand Function Test–gross score (P=.057). VR-FES produced greater, although nonsignificant, improvements in all other outcome measures, except in the Stroke Impact Scale–activities of daily living/instrumental activities of daily living score.Conclusions
FES with VR-based rehabilitation may be more effective than cyclic FES in improving distal upper extremity gross motor performance poststroke. 相似文献16.
Cory L. Christiansen Matthew J. Miller Amanda M. Murray Ryan O. Stephenson Jennifer E. Stevens-Lapsley William R. Hiatt Margaret L. Schenkman 《Archives of physical medicine and rehabilitation》2018,99(11):2160-2167
Objective
To determine preliminary efficacy of a home-based behavior-change intervention designed to promote exercise, walking activity, and disease self-management.Design
A single-blind, randomized controlled pilot trial.Setting
One Veterans Administration and 2 regional medical centers.Participants
A total of 38 participants randomized to behavior-change intervention (n=19) or attention control (CTL; n=19) group.Interventions
Weekly 30-minute telephone sessions for 12 weeks with intervention group sessions focused on health behavior change and CTL group sessions focused on health status monitoring.Main Outcome Measures
Physical function, walking activity (steps/d averaged over 10d), and disability were measured at baseline, 12 weeks (intervention end), and 24 weeks after baseline with the Timed Up and Go (TUG) test as the primary outcome measure.Results
The TUG test was not changed from baseline in either group and was not different between groups after 12 or 24 weeks. Several exploratory outcomes were assessed, including daily step count, which increased 1135 steps per day in the intervention group compared to 144 steps per day in the CTL group after 12 weeks (P=.03). Only the intervention group had within-group increase in steps per day from baseline to 12 (P<.001) and 24 (P=.03) weeks and spent significantly less time in sedentary activity (4.8% decrease) than the CTL group (0.2% decrease) at 24 weeks (P=.04). There were no other between-group differences in physical function or disability change over time.Conclusion
The behavior-change intervention demonstrates promise for increasing walking activity for people with dysvascular transtibial amputation (TTA). The efficacy of implementing such intervention in the scope of conventional TTA rehabilitation should be further studied. 相似文献17.
Gema Bodes Pardo Enrique Lluch Girbés Nathalie A. Roussel Tomás Gallego Izquierdo Virginia Jiménez Penick Daniel Pecos Martín 《Archives of physical medicine and rehabilitation》2018,99(2):338-347
Objective
To assess the effect of a pain neurophysiology education (PNE) program plus therapeutic exercise (TE) for patients with chronic low back pain (CLBP).Design
Single-blind randomized controlled trial.Setting
Private clinic and university.Participants
Patients with CLBP for ≥6 months (N=56).Interventions
Participants were randomized to receive either a TE program consisting of motor control, stretching, and aerobic exercises (n=28) or the same TE program in addition to a PNE program (n=28), conducted in two 30- to 50-minute sessions in groups of 4 to 6 participants.Main Outcomes Measures
The primary outcome was pain intensity rated on the numerical pain rating scale which was completed immediately after treatment and at 1- and 3-month follow-up. Secondary outcome measures were pressure pain threshold, finger-to-floor distance, Roland-Morris Disability Questionnaire, Pain Catastrophizing Scale, Tampa Scale for Kinesiophobia, and Patient Global Impression of Change.Results
At 3-month follow-up, a large change in pain intensity (numerical pain rating scale: ?2.2; ?2.93 to ?1.28; P<.001; d=1.37) was observed for the PNE plus TE group, and a moderate effect size was observed for the secondary outcome measures.Conclusions
Combining PNE with TE resulted in significantly better results for participants with CLBP, with a large effect size, compared with TE alone. 相似文献18.
Ishanka Weerasekara Peter Osmotherly Suzanne Snodgrass Jodie Marquez Rutger de Zoete Darren A. Rivett 《Archives of physical medicine and rehabilitation》2018,99(7):1395-1412.e5
Objective
To assess the clinical benefits of joint mobilization for ankle sprains.Data Sources
MEDLINE, MEDLINE In-Process, Embase, AMED, PsycINFO, CINAHL, Cochrane Library, PEDro, Scopus, SPORTDiscus, and Dissertations and Theses were searched from inception to June 2017.Study Selection
Studies investigating humans with grade I or II lateral or medial sprains of the ankle in any pathologic state from acute to chronic, who had been treated with joint mobilization were considered for inclusion. Any conservative intervention was considered as a comparator. Commonly reported clinical outcomes were considered such as ankle range of movement, pain, and function. After screening of 1530 abstracts, 56 studies were selected for full-text screening, and 23 were eligible for inclusion. Eleven studies on chronic sprains reported sufficient data for meta-analysis.Data Extraction
Data were extracted using the participants, interventions, comparison, outcomes, and study design approach. Clinically relevant outcomes (dorsiflexion range, proprioception, balance, function, pain threshold, pain intensity) were assessed at immediate, short-term, and long-term follow-up points.Data Synthesis
Methodological quality was assessed independently by 2 reviewers, and most studies were found to be of moderate quality, with no studies rated as poor. Meta-analysis revealed significant immediate benefits of joint mobilization compared with comparators on improving posteromedial dynamic balance (P=.0004), but not for improving dorsiflexion range (P=.16), static balance (P=.96), or pain intensity (P=.45). Joint mobilization was beneficial in the short-term for improving weight-bearing dorsiflexion range (P=.003) compared with a control.Conclusions
Joint mobilization appears to be beneficial for improving dynamic balance immediately after application, and dorsiflexion range in the short-term. Long-term benefits have not been adequately investigated. 相似文献19.
Donna L. Murdaugh Kim E. Ono Andrew Reisner Thomas G. Burns 《Archives of physical medicine and rehabilitation》2018,99(5):960-966