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991.
Positive aspects of self-compassion (i.e., self-kindness and nonjudgmental acceptance of personal experiences) as well as negative aspects (i.e., high self-criticism and self-coldness) are strong predictors of anxiety, depression, worry, and quality of life. To date, however, relatively little is known about (a) how both aspects of self-compassion change during naturalistic treatment, (b) whether and how such changes relate to symptom improvement, and (c) which processes might explain the potential benefits of self-compassion. To address these gaps, the present study examined whether relations between changes in both aspects of self-compassion and treatment outcomes in a brief partial hospital setting for acute psychology could be explained by associated changes in repetitive negative thinking (RNT), an established maladaptive cognitive process involved in anxiety and depressive disorders. In a sample of 582 people receiving cognitive-behavioral (CBT) and dialectical behavior therapy over the course of 1–2 weeks, increases in positive aspects of self-compassion and decreases in negative aspects related to improvements in depression and anxiety. RNT mediated the relationship between decreases in negative aspects of self-compassion and improvements in anxiety and depression. However, a reverse model also showed that decreases in negative aspects of self-compassion could also explain relations between RNT and depressive symptom improvement only. These findings suggest that negative aspects of self-compassion and RNT may constitute important targets for treatment in acute settings. Future studies should investigate the impact of greater focus on self-compassion on RNT and symptom improvement using longitudinal experimental designs with multiple assessment points, examining causality and directionality.  相似文献   
992.
We report the sonographic appearance of a rare case of neuritis ossificans of the median nerve at the wrist, which appeared as a hyperechoic lesion around the nerve. Diagnosis was confirmed with magnetic resonance imaging (MRI).  相似文献   
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994.

Objective

To examine the feasibility and preliminary effectiveness of an individualized yoga program.

Design

Pilot randomized controlled trial.

Setting

Military medical center.

Participants

Patients (N=68) with chronic low back pain.

Interventions

Restorative Exercise and Strength Training for Operational Resilience and Excellence (RESTORE) program (9–12 individual yoga sessions) or treatment as usual (control) for an 8-week period.

Main Outcome Measures

The primary outcome was past 24-hour pain (Defense & Veterans Pain Rating Scale 2.0). Secondary outcomes included disability (Roland-Morris Disability Questionnaire) and physical functioning and symptom burden (Patient-Reported Outcomes Measurement Information System-29 subscales). Assessment occurred at baseline, week 4, week 8, 3-month follow-up, and 6-month follow-up. Exploratory outcomes included the proportion of participants in each group reporting clinically meaningful changes at 3- and 6-month follow-ups.

Results

Generalized linear mixed models with sequential Bonferroni-adjusted pairwise significance tests and chi-square analyses examined longitudinal outcomes. Secondary outcome significance tests were Bonferroni adjusted for multiple outcomes. The RESTORE group reported improved pain compared with the control group. Secondary outcomes did not retain significance after Bonferroni adjustments for multiple outcomes, although a higher proportion of RESTORE participants reported clinically meaningfully changes in all outcomes at 3-month follow-up and in symptom burden at 6-month follow-up.

Conclusions

RESTORE may be a viable nonpharmacological treatment for low back pain with minimal side effects, and research efforts are needed to compare the effectiveness of RESTORE delivery formats (eg, group vs individual) with that of other treatment modalities.  相似文献   
995.

Objective

To determine the impact of long-term, body weight–supported locomotor training after chronic, incomplete spinal cord injury (SCI), and to estimate the health care costs related to lost recovery potential and preventable secondary complications that may have occurred because of visit limits imposed by insurers.

Design

Prospective observational cohort with longitudinal follow-up.

Setting

Eight outpatient rehabilitation centers that participate in the Christopher & Dana Reeve Foundation NeuroRecovery Network (NRN).

Participants

Individuals with motor incomplete chronic SCI (American Spinal Injury Association Impairment Scale C or D; N=69; 0.1–45y after SCI) who completed at least 120 NRN physical therapy sessions.

Interventions

Manually assisted locomotor training (LT) in a body weight–supported treadmill environment, overground standing and stepping activities, and community integration tasks.

Main Outcome Measures

International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores, orthostatic hypotension, bowel/bladder/sexual function, Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI), Berg Balance Scale, Modified Functional Reach, 10-m walk test, and 6-minute walk test. Longitudinal outcome measure collection occurred every 20 treatments and at 6- to 12-month follow-up after discharge from therapy.

Results

Significant improvement occurred for upper and lower motor strength, functional activities, psychological arousal, sensation of bowel movement, and SCI-FAI community ambulation. Extended training enabled minimal detectable changes at 60, 80, 100, and 120 sessions. After detectable change occurred, it was sustained through 120 sessions and continued 6 to 12 months after treatment.

Conclusions

Delivering at least 120 sessions of LT improves recovery from incomplete chronic SCI. Because walking reduces rehospitalization, LT delivered beyond the average 20-session insurance limit can reduce rehospitalizations and long-term health costs.  相似文献   
996.
997.

Objective

To identify predictors for back pain, leg pain, and activity limitation in patients with early persistent low back disorders (LBDs).

Design

Prospective inception cohort study.

Setting

Primary care private physiotherapy clinics in Melbourne, Australia.

Participants

Individuals (N=300) aged 18-65 years with low back and/or referred leg pain of ≥6 weeks and ≤6 months duration.

Interventions

Not applicable.

Main Outcome Measures

Numeric rating scales for back pain and leg pain as well as the Oswestry Disability Scale.

Results

Prognostic factors included sociodemographics, treatment related factors, subjective/physical examination, subgrouping factors, and standardized questionnaires. Univariate analysis followed by generalized estimating equations were used to develop a multivariate prognostic model for back pain, leg pain, and activity limitation. Fifty-eight prognostic factors progressed to the multivariate stage where 15 showed significant (P<.05) associations with at least 1 of the 3 outcomes. There were 5 indicators of positive outcome (2 types of LBD subgroups, paresthesia below waist, walking as an easing factor, and low transversus abdominis tone) and 10 indicators of negative outcome (both parents born overseas, deep leg symptoms, longer sick leave duration, high multifidus tone, clinically determined inflammation, higher back and leg pain severity, lower lifting capacity, lower work capacity, and higher pain drawing percentage coverage). The preliminary model identifying predictors of LBDs explained up to 37% of the variance in outcome.

Conclusions

This study evaluated a comprehensive range of prognostic factors reflective of both the biomedical and psychosocial domains of LBDs. The preliminary multivariate model requires further validation before being considered for clinical use.  相似文献   
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