Archives of Physical Medicine and Rehabilitation

No abstract text is available yet for this article.

OBJECTIVE: To examine parent/family outcomes of a randomized controlled trial (RCT) comparing Teen Online Problem-Solving with Family (TOPS-F), Teen Online Problem-Solving- Teen Only (TOPS-TO), or access to internet resources alone (IRC). DESIGN: Three-arm randomized controlled trial. SETTING: Four children's hospitals and one general medical center in Ohio and Colorado. PARTICIPANTS: 152 children/adolescents, 11-18 years old, hospitalized for complicated mild to severe traumatic brain injury (TBI) in the previous 18-months...

OBJECTIVE: To expand the scope of prior spontaneous swallowing frequency analysis (SFA) studies, by evaluating the role of SFA in dysphagia-and stroke-related outcomes at acute stroke discharge. DESIGN: Period prevalence study SETTING: Tertiary care university hospital PARTICIPANTS: 96 patients with acute stroke. INTERVENTIONS: Subjects were screened for dysphagia using SFA. Mode of screening was 24 hours from identified stroke onset. All patients completed dysphagia- and stroke-related assessments...

Older adults are the fastest growing segment of our population and contribute greatly to the high costs of healthcare. The primary concern among older adults seeking healthcare is maintaining or improving functional independence. This concern is the focus of both Rehabilitative Care and Geriatric Medicine; however, collaboration between these fields can be hampered by a lack of mutual understanding of the fundamental principles of the other field. We describe three steps that can be implemented at an organizational or individual level to bridge the fields of Geriatric Medicine and Rehabilitation, allowing them to better serve older patients...

OBJECTIVES: To investigate which clinical assessments are suitable for differentiating fallers from non-fallers in patients with idiopathic normal pressure hydrocephalus (iNPH). DESIGN: Prospective observational study. SETTING: Medical College Hospital. PARTICIPANTS: Sixty-eight patients with a cerebrospinal fluid tap test (TT) result meeting the diagnosis criteria for iNPH. INTERVENTIONS: Not applicable...

OBJECTIVE: To evaluate the effect of providing a greater percentage of therapy as contextualized treatment on acute traumatic brain injury (TBI) rehabilitation outcomes. DESIGN: Propensity score methods are applied to the TBI-Practice-Based Evidence (TBI-PBE) database, a database consisting of multi-site, prospective, longitudinal observational data. SETTING: Acute inpatient rehabilitation. PARTICIPANTS: Patients enrolled in the TBI-PBE study (n=1843), aged 14 years or older, who sustained a severe, moderate, or complicated mild TBI, receiving their first IRF admission in the US, and consented to follow-up 3 and 9 months post discharge from inpatient rehabilitation...

No abstract text is available yet for this article.

OBJECTIVE: To evaluate if allocation concealment and intention-to-treat (ITT) analysis influence the treatment effects of physical therapy interventions in low back pain trials. DATA SOURCES: We searched on PubMed, Embase, Cochrane Database of Systematic Reviews, PEDro and CINAHL up to February 2017. STUDY SELECTION: We included low back pain trials that compared physical therapy interventions to placebo or no intervention or minimal intervention with pain or disability outcomes...

Knowledge of upper limb activity in the natural environment is critical for evaluating the effectiveness of rehabilitation services. Wearable sensors allow efficient collection of these data, and have the potential to be less burdensome than self-report measures of activity. Sensors can capture many different variables of activity and daily performance, many of which could be useful in identifying deviation from typical movement behavior and/or measuring outcomes from rehabilitation interventions. While it has potential, sensor measurement is just emerging and there is a lack of consensus on which variables of daily performance are valid, sensitive, specific, and useful...

OBJECTIVE: To examine the effectiveness of epidural steroid injection (ESI) and back education with and without physical therapy (PT) in patients with lumbar spinal stenosis (LSS). DESIGN: Randomized clinical trial. SETTING: Orthopaedic spine clinics. PARTICIPANTS: 390 patients were screened with 60 eligible and randomly selected to receive ESI and education with or without PT. INTERVENTIONS: 54 patients received 1-3 injections and education in a 10 week intervention period with 31 receiving injections and education only (ESI) and 23 additionally receiving 8-10 sessions of multi-modal PT (ESI+PT)...

The purpose of this paper is to discuss how knowledge of the biomechanics of walking can be used to inform the prescription of resistance exercises for people with mobility limitations. Muscle weakness is a key physical impairment that limits walking in commonly occurring neurological conditions such as cerebral palsy, traumatic brain injury and stroke. Few randomised trials to date have shown conclusively that strength training improves walking in people living with these conditions. This appears to be because 1) the most important muscle groups for forward propulsion when walking have not been targeted for strengthening, and 2) strength training protocols have focused on slow and heavy resistance exercises, which do not improve the fast muscle contractions required for walking...

OBJECTIVE: To compare results of the observational Wisconsin Gait Scale (WGS) and global gait indexes such as GDI/GVI, constituting an objective method of assessing gait, and taking into account parameters identified during 3-dimensional gait analysis. DESIGN: A validation study. SETTING: Rehabilitation Clinic. PARTICIPANTS: 50 individuals after a stroke and 50 healthy individuals without gait disorders INTERVENTIONS: Not applicable...

OBJECTIVES: To describe development and testing of a physical therapy treatment code documentation taxonomy. DESIGN: Clinician survey within a practice-based evidence (PBE) study framework for patients with lymphedema. SETTING: Outpatient physical therapy clinics within a large public healthcare service using a central electronic medical record. PARTICIPANTS: Forty-three certified lymphedema therapists (CLTs). INTERVENTION: Treatment coding of 10 treatment vignettes representing real-life clinical scenarios...

Many studies to date have conducted a meta-analysis on a mix of effectiveness and superiority studies. This methodological flaw will lead to difficulties in interpreting the results. We addressed this issue in this article, illustrated our point with a simulated experiment, and re-analyzed a recent meta-analysis study based on the effectiveness-superiority dichotomy to provide a real-world correlate of our point of view. The number of meta-analyses has increased astonishingly over the past few decades. (Figure 1) In 2016 alone, approximately 13 thousand new meta-analysis studies were indexed in PubMed, more than 200 of which are rehabilitation-related...

OBJECTIVE: To critically appraise the evidence for the clinical determinants of fitness to drive in adults with Multiple Sclerosis (MS). DATA SOURCES: The research librarian and lead author searched seven databases for driving simulator and on-road studies for adults with MS published in the English language from 1991 to 2018. STUDY SELECTION: Three reviewers independently screened titles/abstracts and full-texts for studies with: cohort, case-control, or cross-sectional designs; participants, 18 years or older, with relapsing or progressive MS; visual, cognitive, or motor clinical assessments as predictors; and driving performance through simulator or fitness to drive through on-road assessment as outcomes...

OBJECTIVE: To estimate differences in the length of stay and costs for comparable hospitalizations of patients with spina bifida (SB) with and without pressure injuries. DESIGN: Retrospective, cross-sectional, observational study. SETTING: Nationwide Inpatient Sample from years 2010 to 2014. PARTICIPANTS: Hospitalized patients with SB. Hospitalizations among patients with SB and pressure injuries (n=3888) were matched to hospitalizations among patients with SB but without pressure injuries (n=3888)...

OBJECTIVE: To synthesize literature about the impact of early physical therapy (PT) for acute low back pain (LBP) on subsequent health services utilization (HSU), compared to delayed PT or usual care. DATA SOURCES: Electronic databases (MEDLINE, CINAHL, and EMBASE) were searched from their inception to May 2018. STUDY SELECTION: Study selection included randomized control trials and prospective and retrospective cohort studies that investigated the association between early PT and HSU compared to delayed PT or usual care...

OBJECTIVE: The goal was to examine the outcomes of an existing swallow screen protocol in comparison to results from a formal videofluoroscopic protocol. DESIGN: Prospective cohort study. SETTING: Acute hospital. PARTICIPANTS: 48 patients after acute stroke. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The Johns Hopkins Hospital Brain Rescue Unit 3 oz. Swallow Screen was implemented by nursing staff upon admission...

OBJECTIVE: To examine the relationships between caregiver resilience and a comprehensive set of sociodemographic and health-related quality of life (HRQOL) predictors among both caregivers and injured service members. DESIGN: Cross-sectional analysis of an observational cohort. SETTING: Community dwelling. PARTICIPANTS: Caregivers (N = 87) who provide instrumental or emotional support to injured service members (N = 73)...

OBJECTIVE: To develop and validate a self-reported questionnaire assessing the barriers to physical activity (PA) among stroke survivors. DESIGN: Psychometric study. SETTING: Ambulatory stroke care. PARTICIPANTS: In stage 1, community-living stroke survivors (N=37; 13 women) with low-moderate disability (modified Rankin score 0-3, stroke >3 mo) were included. In stage 2, participants (N=109; 40 women) with same characteristics were included...