Category Archives: Arch Phys Med Rehabil

Association between shoulder problems in persons with spinal cord injury at discharge from inpatient rehabilitation with activities and participation at 5 years later.

Association between shoulder problems in persons with spinal cord injury at discharge from inpatient rehabilitation with activities and participation at 5 years later.
Arch Phys Med Rehabil. 2015 Sep 13;
Authors: Eri… Continue reading

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How do Fugl-Meyer arm motor scores relate to dexterity according to the Action Research Arm test at 6 months post stroke?

How do Fugl-Meyer arm motor scores relate to dexterity according to the Action Research Arm test at 6 months post stroke?

Arch Phys Med Rehabil. 2015 Jul 1;

Authors: Hoonhorst MH, Nijland RH, van den Berg JS, Emmelot CH, Kollen BJ, Kwakkel G

Abstract
OBJECTIVE: The Action Research Arm Test (ARAT) and the Fugl-Meyer assessment of the upper extremity (FM-UE) are frequently used outcome measures for arm-hand capacity and motor impairments of the upper paretic limb after stroke. The aim of the present study was to determine the optimal cut-off scores for the FM-UE with regard to predicting no, poor, limited, notable or full upper limb capacity according to frequently used cut-off points for the ARAT at 6 months post stroke.
DESIGN: Prospective.
SETTING: Rehabilitation centre.
PARTICIPANTS: 460 stroke patients with a first-ever ischemic stroke at 6 months post-stroke.
INTERVENTION: Not applicable MAIN OUTCOME MEASURES: Based on the ARAT classification of poor to full upper limb capacity, receiver operating characteristic curves (ROCs) were used to calculate the area under the curve (AUC), optimal cut-off points for the FM-UE were determined and a weighted Kappa (Кw) was used to assess the agreement.
RESULTS: FM-UE scores of 0-22 represent no upper limb capacity (ARAT 0-10); scores of 23-31 represent poor capacity (ARAT 11-21); scores of 32-47 represent limited capacity (ARAT 22-42); scores of 48-52 represent notable capacity (ARAT 43-54) and scores 53-66-represent full upper limb capacity (ARAT 55-57). Overall, AUCs ranged from 0.916 (95%CI 0.890-0.943) to 0.988 (95%CI 0.978-0.998; p <0.001).
CONCLUSIONS: There is considerable overlap in AUC between the ARAT and the FM-UE. FM-UE scores below 31 points correspond to no to poor arm-hand capacity (i.e., ≤ 21 points) on the ARAT, whereas FM-UE scores higher than 31 correspond to limited to full arm-hand capacity (i.e., ≥ 22 points) on the ARAT.

PMID: 26143054 [PubMed – as supplied by publisher]

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Associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke.

Associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke.

Arch Phys Med Rehabil. 2015 Apr 25;

Authors: Tielemans NS, Schepers VP, Visser-Meily JM, Post MW, van Heugten CM

Abstract
OBJECTIVE: To examine the associations of proactive coping and self-efficacy with psychosocial outcomes in individuals after stroke.
DESIGN: Cross-sectional study. Regression analyses were performed.
SETTING: Outpatient settings of hospitals and rehabilitation centers in the Netherlands.
PARTICIPANTS: Individuals after stroke (n=112; mean age 57.1±8.9 y; mean months since stroke 18.9±28.5).
MAIN OUTCOME MEASURES: Proactive coping was measured using the Utrecht Proactive Coping Competence scale (UPCC), and self-efficacy was measured using the General Self-Efficacy Scale (GSES). Psychosocial outcomes were measured as participation using the restriction and satisfaction subscales of the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation), emotional problems with the Hospital Anxiety and Depression Scale (HADS), life satisfaction with two questions (2LS), and health-related quality of life with the Short Stroke-Specific Quality of Life scale (SSQOL12).
RESULTS: Higher UPCC scores were associated with lower HADS scores (β=-.55; p<.001) and with higher USER-Participation satisfaction (β=.31; p=.001), 2LS (β=.34; p<.001), and SSQOL12 scores (β=.44; p<.001). The influence of UPCC scores on HRQOL was indirect through self-efficacy. Higher GSES scores were associated with higher UPCC scores (β=.65; p<.001), which in turn were associated with lower HADS scores (β=-.51; p<.001). GSES scores were directly associated with higher SSQOL12 scores (β=.32; p=.002). GSES scores did not influence the association between UPCC scores and any of the psychosocial outcomes (all p>.05).
CONCLUSIONS: Proactive coping and self-efficacy have different associations with each of the psychosocial outcomes. Therefore, outcome-specific models appear to be necessary to describe these associations.

PMID: 25921978 [PubMed – as supplied by publisher]

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Epidural steroids for lumbosacral radicular syndrome compared to usual care: quality of life and cost utility in general practice.

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Epidural steroids for lumbosacral radicular syndrome compared to usual care: quality of life and cost utility in general practice.
Arch Phys Med Rehabil. 2015 Mar;96(3):381-7
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Psychological factors determine depressive symptomatology after stroke.

Psychological factors determine depressive symptomatology after stroke.

Arch Phys Med Rehabil. 2015 Feb 11;

Authors: van Mierlo ML, van Heugten CM, Post MW, de Kort PL,…

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Participation in society in patients with coronary artery disease before and after cardiac rehabilitation.

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Participation in society in patients with coronary artery disease before and after cardiac rehabilitation.
Arch Phys Med Rehabil. 2015 Feb 5;
Authors: Hoeve NT, van Geffen ME, Post MW, Stam HJ, Sunamu… Continue reading

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Improved gait performance in a patient with hereditary spastic paraplegia after a continuous intrathecal baclofen test-infusion and subsequent pump-implantation; a case report.

Improved gait performance in a patient with hereditary spastic paraplegia after a continuous intrathecal baclofen test-infusion and subsequent pump-implantation; a case report.

Arch Phys Med Rehabil. 2015 Jan 24;

Authors: Heetla HW, Halbertsma JP, Dekker R, Staal MJ, van Laar T

Abstract
OBJECTIVE: To show the benefits of a continuous ITB test-infusion in a patient with HSP with an improved gait performance after ITB pump-implantation DESIGN: Case report SETTING: Clinical setting PARTICIPANT: A 49-year old male, with hereditary spastic paraplegia (HSP), experiencing progressive walking difficulties due to spasticity of the lower extremities, which did not respond to oral spasmolytics.
INTERVENTIONS: Prolonged continuous ITB test-infusion, which started low and was increased gradually, to provide a stable dose of ITB over a prolonged period of time, providing the patient enough time to experience the effects of ITB, because he feared functional loss due to the ITB-therapy.
MAIN OUTCOME MEASURES: Modified Ashworth Scale (MAS), EMG, muscle strength, Timed Up and Go tests and a Patient Global Impression of Change were performed as outcome measures. Gait performance before and after ITB pump-implantation was assessed in a motion lab.
RESULTS: During the test-infusion ITB dose was gradually increased to a continuous dose of 108 μg/day. This dose caused a decreased spasticity, with maintenance of the muscle strength. After pump-implantation gait performance was improved resulting in an increased knee flexion during the loading response and a doubled walking speed as compared to baseline.
CONCLUSION: HSP patients suffering from mild spasticity, not responding to oral spasmolytics should receive a continuous ITB test-infusion, to provide the patient with enough time to experience the delicate balance between spasmolysis and muscle strength. ITB-therapy has shown to be a suitable therapy to improve gait performance in HSP patients.

PMID: 25626112 [PubMed – as supplied by publisher]

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Outcomes of neurogenic bowel management in individuals living with a spinal cord injury for at least ten years.

Outcomes of neurogenic bowel management in individuals living with a spinal cord injury for at least ten years.
Arch Phys Med Rehabil. 2015 Jan 22;
Authors: Adriaansen JJ, van Asbeck FW, van Kuppevelt D, Snoek GJ, Po… Continue reading

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The Dutch Multifactor Fatigue Scale (DMFS): a new scale to measure the different aspects of fatigue after acquired brain injury.

The Dutch Multifactor Fatigue Scale (DMFS): a new scale to measure the different aspects of fatigue after acquired brain injury.
Arch Phys Med Rehabil. 2015 Jan 2;
Authors: Visser-Keizer AC, Hogenkamp A, Westerhof-Ev… Continue reading

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Does the frequency of participation change after stroke and is this change associated with the subjective experience of participation?

Does the frequency of participation change after stroke and is this change associated with the subjective experience of participation?

Arch Phys Med Rehabil. 2014 Sep 25;

Authors: Blömer AM, van Mierlo ML, Visser-Meily JM, van Heugten CM, Post MW

Abstract
OBJECTIVE: To investigate changes in the frequency of participation six months post stroke compared to the prestroke situation and establish whether such a change is associated with participation restrictions and satisfaction with participation six months post stroke.
DESIGN: Inception cohort study. Prestroke frequency of participation was measured retrospectively in the first week post stroke. Frequency, participation restrictions and satisfaction with participation were assessed six months post stroke.
SETTING: General hospitals and home residences in the Netherlands PARTICIPANTS: Patients with stroke (N = 325; 65.5% male; mean age 66.9 (SD 12.2) years) admitted to one of six participating general hospitals.
INTERVENTION: Not applicable.
MAIN OUTCOME MEASURE: Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation) [0-100], consisting of three scales: frequency, restrictions and satisfaction. The frequency scale consists of two parts: vocational activities (work, volunteer work, education and household activities) and leisure and social activities.
RESULTS: Vocational activities showed a large decrease (effect size: 0.6) and leisure and social activities a small decrease (effect size: 0.13) post stroke. In multiple regression analyses, both the frequency of participation in vocational activities six months post stroke and the decrease in vocational activities compared to before the stroke were significantly associated with the participation restrictions experienced and satisfaction with participation after controlling for age, gender, level of education, dependency in activities of daily living, cognitive functioning, and presence of depressive symptoms. The presence of depressive symptoms showed the strongest association with the subjective experience of participation.
CONCLUSIONS: The frequency of participation decreased after a stroke and this decrease was associated with the participation restrictions experienced and satisfaction with participation. Resuming vocational activities and screening and, if applicable, treatment of depressive symptoms should be priorities in stroke rehabilitation.

PMID: 25264108 [PubMed – as supplied by publisher]

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Can functional capacity tests predict future work capacity in patients with whiplash-associated disorders?

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Can functional capacity tests predict future work capacity in patients with whiplash-associated disorders?

Arch Phys Med Rehabil. 2014 Aug 12;

Authors: Trippolini MA, Dijkstra PU, Côté P, Scholz-Odermatt SM, Geertzen JH, Reneman MF

Abstract
OBJECTIVE: To determine whether Functional Capacity Evaluation (FCE) tests predict future work capacity of patients with whiplash-associated disorders (WAD) grades I and II who did not regain full work capacity 6-12 weeks after injury.
DESIGN: Prospective cohort study.
SETTING: Rehabilitation center.
PARTICIPANTS: Workers listed as sick with WAD 6 to 12 weeks after injury.
INTERVENTIONS: Patients performed 8 work-related FCE tests.
MAIN OUTCOME MEASURES: Work capacity (WC; 0-100%) measured at baseline and 1, 3, 6, and 12 months after testing. Correlation coefficients between FCE tests and WC were calculated. A linear mixed model analysis was used to assess the association between FCE and future WC.
RESULTS: In total, 267 patients with grade I or II WAD participated in the study. Mean WC increased over time from 20.8 (SD 27.6) at baseline to 32.3 (SD 38.4), 51.3 (SD 42.8), 65.6 (SD 42.2), and 83.2 (SD 35.0) at the 1, 3, 6, and 12-month follow-up respectively. Correlation coefficients between FCE tests and WC ranged from r=0.06 (lifting low at 12-month follow-up) to r=0.39 (walking speed at 3 months). Strength of the correlations decreased over time. FCE tests did not predict WC at follow-up. The predictors of WC were ln (time) (β = 23.74), mother language (β=5.49), work capacity at baseline (β=1.01), and self-reported disability (β=-0.20). Two interaction terms ln (time) x workcapacity (β=-0.19), and ln (time) x self-reported disability (β=-0.21) were significant predictors of WC.
CONCLUSION: FCE tests performed within 6-12 weeks after WAD injury grades I and II are associated with WC at baseline, but do not predict future WC, whereas time course, mother language, WC at baseline, and self-reported disability do predict future WC. Additionally, the interaction between time course WC at baseline and self-reported disability predicted future WC.

PMID: 25127998 [PubMed – as supplied by publisher]

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Trajectories in the course of body mass index after spinal cord injury.

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Trajectories in the course of body mass index after spinal cord injury.

Arch Phys Med Rehabil. 2014 Jun;95(6):1083-92

Authors: de Groot S, Post MW, Hoekstra T, Valent LJ, Faber WX, van der Woude LH

Abstract
OBJECTIVE: To identify different trajectories of the course of body mass index (BMI) after spinal cord injury (SCI) and to study whether other cardiovascular risk factors (blood pressure, lipid profile) follow the same trajectories.
DESIGN: Multicenter prospective cohort study with measurements at the start of active rehabilitation, after 3 months, at discharge, and 1 and 5 years after discharge.
SETTING: Rehabilitation centers.
PARTICIPANTS: Persons with a recent SCI (N=204).
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURE: BMI trajectories.
RESULTS: Three BMI trajectories were identified: (1) a favorable stable BMI during and after rehabilitation (± 22-23 kg/m(2)) (54%); (2) a higher but stable BMI during inpatient rehabilitation (± 24 kg/m(2)) and an increase after discharge (up to 29 kg/m(2)) (38%); and (3) an increase in BMI during inpatient rehabilitation (from ± 23 up to 28 kg/m(2)) and leveling off after discharge (8%). Profile analyses showed that an unfavorable change in BMI was not accompanied by clear unfavorable changes in blood pressure or lipid levels.
CONCLUSIONS: BMI in people with SCI follows distinct trajectories. Monitoring body mass, food intake, and daily physical activity during and especially after inpatient SCI rehabilitation is important to prevent obesity and related cardiovascular risk factors.

PMID: 24534297 [PubMed – indexed for MEDLINE]

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Long-term trajectories of health-related quality of life in individuals with cerebral palsy: a multi-center longitudinal study.

Long-term trajectories of health-related quality of life in individuals with cerebral palsy: a multi-center longitudinal study.
Arch Phys Med Rehabil. 2014 Jun 11;
Authors: Tan SS, van Meeteren J, Ketelaar M, Schueng… Continue reading

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Clinical relevance of pharmacological and physiological data in intrathecal baclofen therapy.

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Clinical relevance of pharmacological and physiological data in intrathecal baclofen therapy.

Arch Phys Med Rehabil. 2014 May 31;

Authors: …

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Employment trajectories after spinal cord injury: results from a 5-year prospective cohort study.

Employment trajectories after spinal cord injury: results from a 5-year prospective cohort study.

Arch Phys Med Rehabil. 2014 May 12;

Authors: Ferdiana A, Post MW, Hoekstra T, van der Woude L, van der Klink JJ, Bültmann U

Abstract
OBJECTIVE: To identify different employment trajectories in individuals with spinal cord injury (SCI) after discharge from initial rehabilitation and to determine predictors of different trajectories from demographic, injury, functional and psychological characteristics.
DESIGN: Prospective cohort study with baseline measurement at the start of active rehabilitation, a measurement at discharge and follow-up measurements at 1, 2 and 5 years after discharge.
SETTING: Eight rehabilitation centres with SCI units in the Netherlands.
PARTICIPANTS: A total of 176 people with acute SCI, aged between 18 and 60 years at baseline, who completed at least two follow-up measurements.
INTERVENTIONS: Not applicable MAIN OUTCOME MEASURE: Employment was defined as having paid work for ≥12 hours/week.
RESULTS: Using latent class growth mixture modeling, three distinct employment trajectories were identified: 1) no employment group (22.2%), i.e., participants without employment pre-SCI and during 5-year follow-up; 2) low employment group (56.3%), i.e., participants with pre-SCI employment and a low, slightly increasing probability of employment during 5-year follow-up; and 3) steady employment group (21.6%), i.e., participants with continuous employment pre-SCI and within 5-year follow-up. Predictors of steady employment versus low employment were having secondary education (OR=4.32, 95% CI 1.69-11.02) and a higher Functional Independence Measure motor-score (OR=1.04, 95% CI 1.01-1.06) at discharge.
CONCLUSION: Distinct employment trajectories following SCI were identified. More than half of individuals with SCI had a low employment trajectory, and only one-fifth of individuals with SCI had a steady employment trajectory. Secondary education and higher functional independence level predicted steady employment.

PMID: 24832572 [PubMed – as supplied by publisher]

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Upper extremity kinematics and muscle activation patterns in subjects with facioscapulohumeral dystrophy.

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Upper extremity kinematics and muscle activation patterns in subjects with facioscapulohumeral dystrophy.

Arch Phys Med Rehabil. 2014 Apr 26;

Authors: Bergsma A, Murgia A, Cup EH, Verstegen PP, Meijer K, de Groot IJ

Abstract
OBJECTIVE: To compare the kinematics and muscle activity of facioscapulohumeral dystrophy (FSHD) subjects with healthy controls during the performance of standardized upper extremity tasks. . DESIGN: Exploratory case-control study.
SETTING: The study was performed in the movement laboratory of the University of Maastricht, The Netherlands.
PARTICIPANTS: 11 subjects with FSHD and 8 healthy controls were measured.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Kinematic data were recorded using a VICON MX system. Muscle activities, recorded using electromyography (EMG) were obtained from six superficial muscles around the glenohumeral joint. Shoulder elevation and elbow flexion angles, and maximum EMG activity during the movements, as a percentage of maximum voluntary contraction (%MVC), were calculated.
RESULTS: Kinematic differences between the FSHD group and the healthy control group were found in the shoulder elevation angle during single shoulder movements and both reaching tasks. In general, FSHD subjects presented higher percentages of muscle activation. The median activity of the trapezius was close to the MVC activity during the single shoulder movements. Moreover, deltoid and pectoralis muscles were also highly active.
CONCLUSIONS: Higher activation of the trapezius in FSHD subjects indicates a mechanism that could help relieve impaired shoulder muscles during arm elevation around 90°. Compared to healthy subjects, persons with FSHD activated their shoulder muscles to a greater extent during movements that required arm elevation.

PMID: 24780289 [PubMed – as supplied by publisher]

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Physical and psychosocial factors associated with physical activity in patients with chronic obstructive pulmonary disease.

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Physical and psychosocial factors associated with physical activity in patients with chronic obstructive pulmonary disease.
Arch Phys Med Rehabil. 2013 Dec;94(12):2396-2402.e7
Authors: Hartman JE, Boezen HM, d… Continue reading

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Sensibility of the stump in adults with an acquired major upper extremity amputation.

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Sensibility of the stump in adults with an acquired major upper extremity amputation.

Arch Phys Med Rehabil. 2013 Nov;94(11):2179-85

Authors: van Gils W,…

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Postconcussive complaints, anxiety, and depression related to vocational outcome in minor to severe traumatic brain injury.

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Postconcussive complaints, anxiety, and depression related to vocational outcome in minor to severe traumatic brain injury.
Arch Phys Med Rehabil. 2013 May;94(5):867-74
Authors: van der Horn HJ, Spikman JM, Ja… Continue reading

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Climbing stairs after outpatient rehabilitation for a lower-limb amputation.

Climbing stairs after outpatient rehabilitation for a lower-limb amputation.

Arch Phys Med Rehabil. 2013 Feb 2;

Authors: de Laat FA, Rommers GM, Dijkstra PU, Geertzen JH, Roorda…

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