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Summary Background Objectives Study design Methods Results Main limitations Conclusions Impinging dorsal spinous processes (IDSP) are a common cause of pain and loss of performance in sports horses, with a range of surgical and conservative treatments available.Identify relationships between treatment choice and the likelihood of returning to previous level of performance for horses diagnosed with IDSP.Cross‐sectional survey of owners with horses diagnosed with IDSP.A 14‐question online survey was circulated via social media. Data were collected for 260 horses and analysed for associations between treatment choice and return to pre‐diagnosis level of performance.Just under 50% of horses in the sample returned to their previous level of performance post‐treatment. Horses that were treated surgically had twice the odds of returning to their previous level than those that were not, and horses that underwent an exercise rehabilitation programme had 10 times the odds of returning to level.As this was an owner survey, self‐selection bias and recall bias could have influenced the findings.If the aim is for the horse to return to a competitive career post‐treatment, the most appropriate surgical intervention appears to be the best approach, and an exercise rehabilitation plan may have benefit. [ABSTRACT FROM AUTHOR]

Neuralgic amyotrophy (NA) is an underrecognized peripheral nerve disorder distinguished by severe pain followed by weakness in the distribution of one or more nerves, most commonly in the upper extremity. While classically felt to carry a favorable prognosis, updates in research have demonstrated that patients frequently endure delay in diagnosis and continue to experience long term pain, paresis, and fatigue even years after the diagnosis is made. A transition in therapeutic approach is recommended and described by this review, which emphasizes the necessity to target compensatory abnormal motor control and fatigue by focusing on motor coordination, energy conservation strategies, and behavioral change, rather than strength training which may worsen the symptoms. The development of structural hourglass‐like constrictions (HGCs) on imaging can help confirm the suspected clinical diagnosis, and in association with persistent weakness and limited recovery on electrodiagnostic testing may be considered for surgical consultation. Given the complex nature of management, a multidisciplinary approach is described, which can provide an optimal level of care and support for patients with persistent symptoms from NA and allow more unified guidance of rehabilitation and surgical referrals. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Methods Results Conclusions Emerging evidence suggests a link between salivary metabolite changes and neurodegenerative dementia, with antimicrobial peptides (AMPs) implicated in its pathogenesis.We investigated the effects of a clinical oral rehabilitation programme tailored for dementia patients on salivary flow rate, AMP levels and oral health‐related quality of life (OHRQoL).Eligible patients were randomly assigned to either the experimental group (EG; n = 28) or the control group (CG; n = 27). Both groups received a leaflet on oral health. In addition, the EG received an oral care intervention that included individual lessons on oral muscle exercises and oral self‐care practices. Saliva samples and OHRQoL data were collected at baseline and follow‐up visits. Generalised estimating equation models were used to analyse the changes over time.At the 3‐month follow‐up, EG showed significantly lower histatin 5 (HTN‐5) levels (β = −0.08; effect size [ES] = 0.72) than CG. At 6 months, EG exhibited improved salivary flow rate (β = 0.89; ES = 0.89) and OHRQoL (β = 6.99; ES = 1.31) compared to CG. Changes in salivary flow rate (β = 4.03), HTN‐5 level (β = −0.78) and beta‐defensin 2 level (BD‐2) (β = −0.91) at 3 months predicted improved OHRQoL at 6 months (all p < 0.05).Our clinical oral rehabilitation programme reduced the level of salivary HTN‐5, increased salivary flow rate and enhanced OHRQoL in dementia patients. Furthermore, changes in salivary flow rate, HTN‐5 level and BD‐2 level were associated with improvements in patients' OHRQoL. [ABSTRACT FROM AUTHOR]

Background Objectives Method Results Conclusions When re‐learning a motor skill, practicing a variety of treatment targets promotes error processing and the exploration of motor control strategies, which initially disrupts accuracy during training (motor performance), but ultimately enhances generalization, retention, and transfer (motor learning). Cough skill training (CST) is feasible and efficacious to improve cough strength; however, previous studies have used the same practice target during training.Our goal was to examine the impact of CST with variable practice on motor performance, motor learning, and respiratory system adaptations.The study was a prospective three‐visit single group design. Twenty individuals with Parkinson's disease (PD) and concomitant dysphagia and dystussia completed two sessions of CST involving three randomized practice targets. Cough, lung volume, and airway clearance outcomes were assessed before and after treatment sessions with long‐term retention evaluated after 1 month.Peak expiratory flow rate improved after CST with variable practice for voluntary single (β = 0.35 L/s) and sequential (β = 0.22 L/s) cough, which were maintained after 1 month without treatment. The ability to expel material from the upper airway demonstrated a small magnitude of improvement (β = −1.87%). During CST, participants altered lung volume based on the treatment target and lung volume decreased during reflex cough after completing CST.Individuals with PD demonstrated improvements in several aspects of motor learning after two sessions of CST with variable practice. Increasing lung volume may not be an implicit strategy to upregulate voluntary cough strength in this treatment paradigm. The findings support the need for larger investigations exploring the potential benefits of this CST approach. [ABSTRACT FROM AUTHOR]

Flatfoot, a foot deformity characterized by the collapse of the arch, significantly impacts an individual's balance and stability. This study explored postural adjustments and sway excursions in individuals with and without flatfoot using the Time‐in‐Boundary method. This method assessed relative stability by exploring various center of pressure radius thresholds during three trials of single‐leg stance. We observed significant interactions in threshold levels (F = 4.37, p = 0.04) and normalized relative stable times (F = 7.64, p = 0.01), particularly in the initial trials. Initially, the flatfoot group showed marked decreases in stable times at 10 mm, 15 mm, and 20 mm thresholds, which expanded to 25 mm and 30 mm in subsequent trials. Despite a significant decrease in stability at the 30 mm threshold in early trials, participants exhibited improved stability control as trials progressed. This enhancement likely reflects a combination of a learning effect and an increased understanding of the task requirements, underscoring the adaptability of postural control systems to the biomechanical challenges posed by flatfoot. The Time‐in‐Boundary method has proven to be an effective tool for clinicians to assess postural control, playing a vital role in developing customized rehabilitation strategies for individuals with flatfoot. [ABSTRACT FROM AUTHOR]

This study compared cardiovascular and metabolic responses during concentric and eccentric stepping. Eight participants (5 m, 3f; 22 ± 2 years) performed maximal concentric and eccentric ramp incremental tests on a modified stepping ergometer. Subsequently, three randomized 15‐min constant‐power tests were performed (1) concentric stepping at 90% of the concentric lactate threshold (LT), (2) eccentric stepping at the same power, and (3) eccentric stepping at the same oxygen uptake (V̇O2). At equivalent power (36 ± 6 W, p = 0.62), eccentric stepping resulted in 46 ± 8% lower V̇O2, 16 ± 6% lower heart rate (HR), and 11 ± 5% lower mean arterial blood pressure compared to concentric (p < 0.01). Matching V̇O2 required 65 ± 19% more power during eccentric stepping (p < 0.01). During this test, eccentric V̇O2 and HR continued to increase, resulting in a 22 ± 29% higher V̇O2 and 19 ± 16% higher HR in the final minute (p < 0.001). Reduced cardiorespiratory demand during eccentric stepping at the same power as concentric demonstrates a higher eccentric power is required to produce the same V̇O2. However, despite being below the concentric LT, eccentric V̇O2 and HR continued to increase past the predicted steady state, indicating a higher exercise intensity. [ABSTRACT FROM AUTHOR]

In persons with a spinal cord injury (SCI), resistance training using neuromuscular electrical stimulation (NMES‐RT) increases lean mass in the lower limbs. However, whether protein supplementation in conjunction with NMES‐RT further enhances this training effect is unknown. In this randomized controlled pilot trial, 15 individuals with chronic SCI engaged in 3 times/week NMES‐RT, with (NMES+PRO, n = 8) or without protein supplementation (NMES, n = 7), for 12 weeks. Before and after the intervention, whole body and regional body composition (DXA) and fasting glucose and insulin concentrations were assessed in plasma. Adherence to the intervention components was ≥96%. Thigh lean mass was increased to a greater extent after NMES+PRO compared to NMES (0.3 (0.2, 0.4) kg; p < 0.001). Furthermore, fasting insulin concentration and Homeostatic Model Assessment for Insulin Resistance (HOMA‐IR) were decreased similarly in both groups (fasting insulin: 1 [−9, 11] pmol∙L−1; HOMA‐IR: 0.1 [−0.3, 0.5] AU; both p ≥ 0.617). Twelve weeks of home‐based NMES‐RT increased thigh lean mass, an effect that was potentiated by protein supplementation. In combination with the excellent adherence and apparent improvement in cardiometabolic health outcomes, these findings support further investigation through a full‐scale randomized controlled trial. [ABSTRACT FROM AUTHOR]

Evaluation and strengthening of existing bridges – historical outlines and findings regarding the Hessian road bridge inventory Two short histographical sketches introduce the concepts of refurbishment, condition and load‐bearing capacity assessment between 1700 and 2010 and take a look at the development of the recalculation of existing bridges. Based on project sketches, the hidden safety features of existing road bridges are worked out and procedures for achieving efficient structural bridge strengthening are presented. The focus is on the determination of real object‐specific traffic load models, calibrated structural analyses and additive and non‐destructive strengthening methods. Some critical comments on planning acceleration and the current approval system, together with the demand that bridge construction should be reflected in the common objective of "traffic", broaden the definition of strengthening holistically. This offers the opportunity to stimulate a discussion about the sensible handling of existing bridges as part of our road infrastructure. [ABSTRACT FROM AUTHOR]

Objectives: One stage functional jaw reconstruction is defined as the resection and reconstruction of segmental defects in conjunction with the placement of dental implants in an ideal prosthetic position and loaded with a provisional restoration, during one surgical procedure. The aim of the study is to describe clinical outcomes of patients who underwent one stage functional jaw reconstruction. Methods: Patients who underwent one‐stage functional jaw reconstruction, from January 2013 to March 2016 were recalled in 2022 and 2023. Planning and execution for the reconstruction utilized either analogue or digital techniques. Outcome parameters recorded were treatment‐related outcomes at patient level, implant‐related outcomes and patient‐reported outcome measures. Results: Eighteen patients underwent one‐stage jaw reconstruction with a total of 57 implants. Four patients had maxillary and 14 had mandibular reconstructions. Ten patients underwent postoperative radiotherapy. Ten patients were planned using analogue and eight by digital planning. Three patients had partial flap necrosis, three patients had plate fractures, implant loss was seen in one patient and four patients died during the period. A functional prosthesis was provided in 16 out of the 18 patients. Conclusion: One‐stage functional jaw reconstruction is a predictable method for providing rehabilitation with successful outcomes at 7–11 years. However, caution should be exercised when the treatment modality is carried out in patients with malignant pathologies who have undergone radiotherapy. [ABSTRACT FROM AUTHOR]

Introduction: Forensic mental health services balance recovery‐focussed therapy with risk management, which may limit opportunities for participation in meaningful occupation. Previous research describes forensic patients in secure settings participating mainly in passive leisure and sleep. This study aimed to use quantitative and qualitative evidence to investigate how patients in the sub‐acute and rehabilitation units of an Australian forensic hospital perceive and use their time and to discuss how the findings compare with the previous study within the organisation, published in 2004. Method: An explanatory sequential mixed methods design was used with convenience sampling of patients and purposive sampling of staff. Patients completed time use diaries followed by semi‐structured interviews. Staff perceptions were obtained via survey. Results: Seven male patients with a diagnosis of schizophrenia and five staff members (three occupational therapists and two nurses) participated. Time use diaries indicated patients spent most time in personal care, passive recreation, and leisure activities. Qualitative data illustrated patient time use was influenced by the individualised meaningfulness of activities. Patients drew meaning from past roles, personal interests/needs, and their goals for recovery. While patients had some choice over how time is spent and with whom they chose to engage, external factors such as staff/program availability prevented their having full control. Staff provided additional perspectives on the links between time use and recovery, identifying enablers and barriers to meaningful time use. Conclusion: Patient time use has not changed significantly when compared to past research, although perceptions of time use are more future and recovery‐focussed. The amount of time recorded in activities typically associated with recovery does not necessarily capture the quality and benefit of that time use. Patient participation continues to be influenced by broader systems. PLAIN LANGUAGE SUMMARY: Forensic mental health services provide recovery‐focussed therapy while also managing risks, which can limit the activities patients can do. Past research has described forensic patients spending a lot of time sleeping and doing passive leisure activities. This study explored how patients in the sub‐acute and rehabilitation units of an Australian forensic hospital used their time, and how they felt about it. These findings were compared with findings of a past study within the same service. Patients completed time‐use diaries then shared more information in interviews. Staff views about patient time use were shared in a survey. Seven male patients with a diagnosis of schizophrenia and five staff members (three occupational therapists and two nurses) participated. Patients spent most of their time in personal care, passive recreation, and leisure activities. They spoke about the meaning of their activities, including their roles, interests, needs, and recovery goals. Sometimes they had control over how they spent their time, and other times they had to wait for staff or programs to be available. Staff talked about how patient time use was linked to their recovery, and noted things that can help or prevent patients using their time meaningfully. Compared with previous research, the way patients use their time has not changed. There is a change in the way patients think about their time use, with them now reflecting more on recovery and the future. The structures of the forensic system continue to influence patients' participation in activities and how they use their time. [ABSTRACT FROM AUTHOR]

Introduction: Occupation‐based interventions use engagement in a person's daily activities to achieve change. There is growing research into the use of occupation‐based group interventions in the inpatient rehabilitation setting. It remains unclear whether occupation‐based groups offer comparable outcomes to occupation‐based interventions delivered individually; this research will precede a clinical trial aimed at comparing these two approaches for improving occupational performance outcomes. This study details the process of co‐designing the intervention. Partnering with clinicians and patients in the design of healthcare interventions can promote patient‐centred care, enhance uptake, and improve applicability and sustainability of the intervention to that setting. Methods: A modified nominal group technique (NGT) design was applied to facilitate two meetings and an electronic survey with an expert panel of clinicians and patients. Twelve participants (n = 4 occupational therapists, n = 1 registered nurse, n = 1 physiotherapist, n = 1 occupational therapy assistant, n = 1 occupational therapy manager, and n = 4 patients) were purposively recruited. A modified approach to the technique's four stages was used: silent generation, round robin, clarification, and voting. Consensus was set at >50%. Qualitative data from group discussions were analysed thematically. Findings: All participants agreed the intervention should include patient‐centred, goal‐directed, practice of daily activities, including breakfast and lunch preparation, domestic tasks, and laundry. Other components that were agreed included where the groups could run, group size, eligibility criteria, and frequency. Key themes from clinicians included needing a goal‐directed intervention, focused on progressing towards hospital discharge; time and resource requirements were also discussed. Patients emphasised the importance of building social connections, opportunity to engage in meaningful activity, and the importance of linking participation to patient goals. Conclusion: Through collaboration with clinicians and patients, an occupation‐based group intervention considering the available evidence, alongside clinical, experiential, and contextual sources of knowledge was developed; this resulted in an evidence‐based, patient‐centred, and contextually relevant intervention. [ABSTRACT FROM AUTHOR]

Background and aims: Young people accessing alcohol and other drug (AOD) treatment experience high rates of treatment disengagement, contributing to poorer outcomes. To improve outcomes, it is important to identify factors associated with treatment retention. This study measured the relationships between client characteristics, treatment characteristics, clinical severity measures and completion of treatment among young people. Design, setting and participants: This study was a retrospective analysis of routinely collected data set in residential‐ and community‐based AOD services in New South Wales, Australia. Routinely collected data from the Network of Alcohol and Other Drug Agencies' (NADA) database were used. Included individuals were aged 10–24 years and accessed treatment between 2012 and 2023 (n = 17 474). Measurements: Variables included client‐related characteristics, service characteristics and baseline measures of clinical severity [Kessler‐10 (K10), EUROHIS–QoL, severity of dependence scale (SDS)]. Multivariable binary logistic regression models assessed the relationships between these characteristics and treatment completion. Findings Rates of treatment completion were highest among adolescents in community‐based treatment (57%) and lowest among young adults in residential treatment (35%). Polysubstance use was negatively associated with treatment completion among adolescents [adjusted odds ratio (adjOR) = 0.71, P < 0.001] and adults (adjOR = 0.70, P < 0.001) in community‐based treatment, and adolescents in residential treatment (adjOR = 0.62, P = 0.006), as was housing insecurity (adolescents in community treatment, adjOR = 0.61, P = 0.001; adults in community treatment, adjOR = 0.77, P = 0.002; adolescents in residential treatment, adjOR = 0.42, P = 0.005). Attending youth‐specific services was associated with higher treatment completion rates among adults in community‐based (adjOR = 1.81, P < 0.001) and residential treatment (adjOR = 1.72, P < 0.001). Varying correlates of treatment completion were identified throughout treatment groups, reflecting the differences in population and/or needs across contexts. Conclusions: In New South Wales, Australia, fewer than half of young people accessing alcohol and other drug treatment between 2012 and 2023 completed treatment, and completion rates were lower among those facing barriers such as polysubstance use and housing insecurity. [ABSTRACT FROM AUTHOR]

Rationale: Cervical radiculopathy is initially typically managed conservatively. Surgery is indicated when conservative management fails or with severe/progressive neurological signs. Personalised multimodal physiotherapy could be a promising conservative strategy. However, aggregated evidence on the (cost‐)effectiveness of personalised multimodal physiotherapy compared to surgery with/without post‐operative physiotherapy is lacking. Aim/Objectives: To systematically summarise the literature on the (cost‐)effectiveness of personalised multimodal physiotherapy compared to surgery with or without post‐operative physiotherapy in patients with cervical radiculopathy. Methods: PubMed, Embase, CINAHL, PsycINFO and Web of Science were searched from inception to 1st of March 2023. Primary outcomes were effectiveness regarding costs, arm pain intensity and disability. Neck pain intensity, perceived recovery, quality of life, neurological symptoms, range‐of‐motion, return‐to‐work, medication use, (re)surgeries and adverse events were considered secondary outcomes. Randomised clinical trials comparing personalised multimodal physiotherapy versus surgical approaches with/without post‐operative physiotherapy were included. Two independent reviewers performed study selection, data‐extraction, and risk of bias assessment using the Cochrane RoB 2 and Consolidated Health Economic Evaluation Reporting Standards statement. Certainty of the evidence was determined using Grading of Recommendations, Assessment, Development and Evaluations. Results: From 2109 records, eight papers from two original trials, with 117 participants in total were included. Low certainty evidence showed there were no significant differences on arm pain intensity and disability, except for the subscale 'heavy work' related disability (12 months) and disability at 5–8 years. Cost‐effectiveness was not assessed. There was low certainty evidence that physiotherapy improved significantly less on neck pain intensity, sensory loss and perceived recovery compared to surgery with/without physiotherapy. Low certainty evidence showed there were no significant differences on numbness, range of motion, medication use, and quality of life. No adverse events were reported. Conclusion: Considering the clinical importance of accurate management recommendations and the current low level of certainty, high‐quality cost‐effectiveness studies are needed. [ABSTRACT FROM AUTHOR]

Rationale: Despite the widespread recommendation to engage in therapeutic exercise for the treatment of low back pain (LBP), there is conflicting evidence regarding clinical outcomes and effectiveness. Poor methodological quality may be to blame for reducing the overall strength of evidence for this intervention, yet little is known about the difficulties researchers encounter when designing and implementing their study methods. Aims and Objectives: The aim of this study was to characterize the extent and type of self‐acknowledged limitations (SALs) in exercise therapy trials for LBP to gain a better understanding of challenges encountered when conducting this research. Methods: This is a methodological review of clinical trials in which SALs were extracted, categorized by theme and subcategorized within each theme. Counts and prevalence rates were tabulated for the number of SALs in each category and subcategory. Results: There were 914 SALs among the 312 included trials, with a mean of 2.93 (95% confidence interval [CI], 2.77–3.09) per trial. Analysis of the data resulted in the development of 13 distinct categories of limitations, among which were 37 subcategories. The top three categories pertained to statistical power (14.3% of total SALs), study length and/or follow‐up (14.3%) and inclusion criteria (14.2%). The top three subcategories were lack of long‐term follow‐up (13.8% of total SALs), inadequate sample size (13.3%) and inclusion of specific populations (12.3%). Conclusion: Statistical power, study length and/or follow‐up, and inclusion criteria were the three most commonly reported categories of SALs in exercise trials for LBP. Lack of long‐term follow‐up, inadequate sample size and inclusion of specific populations were the most common subcategories. Research protocols recognizing and avoiding these limitations will enhance the overall quality of evidence of exercise therapy trials for LBP. [ABSTRACT FROM AUTHOR]

ABSTRACT Background Objective Methods Results Conclusion Onychocryptosis is characterized by the nail plate penetrating the lateral nail fold, resulting in varying degrees of infection and deformity. Standardized treatment protocols for onychocryptosis, particularly in Stages IIb, III, and IV, have not been universally established, highlighting the urgent need for the development of effective interventions.To evaluate the effectiveness and safety of wedge resection and nail groove reconstruction using the hanging thread knot for the treatment of onychocryptosis.At our hospital, a total of 155 patients with onychocryptosis in Stages IIb, III, and IV underwent treatment. Wedge resection and nail groove reconstruction with the hanging thread knot were applied based on the severity of deformity and infection for treating onychocryptosis. All patients received perioperative systematic and topical anti‐infective treatments. Follow‐ups conducted over a period of 2–6 months assessed postoperative rehabilitation and complications.The cure rate reached 95%, with a low recurrence rate of 5%. Recurrence, observed in eight patients, was attributed to various causes: three due to improper trimming, three related to trauma, one associated with obesity, and one due to incomplete matrix resection. All eight patients achieved complete recovery through health guidance and secondary surgery. Satisfaction results were reported during the 2–6 months follow‐up period. Although 10 patients experienced secondary local infections, all achieved complete recovery following active treatment.Wedge resection and nail groove reconstruction with the hanging thread knot prove to be an effective and safe method for treating onychocryptosis. [ABSTRACT FROM AUTHOR]

The aim of this study is to assess the effectiveness of various therapy methods in elderly individuals with traumatic brain injury (TBI), taking into account the degree of memory loss and the severity of the injury. The study was conducted in 2022 in Moscow, Russia, and Sofia, Bulgaria, involving six clinics. A total of 200 elderly patients with TBI participated in the study, with a mean age of 72 years. Patients were categorized into groups based on the degree of memory loss and severity of the injury. Standardized tests, including the Mini‐Mental State Examination (MMSE), Clock Drawing Test, Digit Symbol Substitution Test, and Free, and Cued Selective Reminding Test, were used to assess cognitive functions. The Progressive Learning Test evaluated patients' ability to memorize and reproduce information over time. Groups receiving physical therapy and cognitive rehabilitation showed statistically significant improvement in cognitive functions compared to other therapy methods. Specifically, the mean score of the MMSE in these groups increased by 7 points (p < .001). Patients with more severe memory loss demonstrated more pronounced improvement in cognitive functions following the integrated therapy approach. The mean MMSE score increased by 10 points (p < .001), whereas in patients with milder memory loss, the growth was less significant (mean increase of 5 points, p < .05). Groups receiving physical therapy and cognitive rehabilitation consistently demonstrated significantly better results compared to speech therapy and psychological support throughout the study period. [ABSTRACT FROM AUTHOR]

Evidence suggests that chronic ankle instability (CAI) is not merely a peripheral musculoskeletal injury but should be recognized as a neurophysiological dysfunction. This reflects a paradigm shift from focusing on peripheral structural changes to emphasizing the central nervous system. However, changes in cortical activity during functional activities remain poorly understood. Thus, this study aimed to compare preparatory brain activity during gait initiation (GI) through movement‐related cortical potentials (MRCPs) in individuals with CAI and healthy subjects. The proactive components of MRCPs, including contingent negative variation (CNV) and event‐related desynchronization (ERD), were measured using electroencephalography. The primary outcomes were late CNV amplitude, CNV peak amplitude, CNV peak time, and alpha/beta ERD. The results indicated that the late CNV amplitude was significantly lower in the CAI group compared to the healthy group at the Fz and Cz electrodes (P < 0.001). The CAI group also demonstrated lower CNV peak amplitude at the Fz, Cz, and Pz electrodes (P < 0.0025). Additionally, in the CAI group, signals peaked earlier at the Cz electrode (P = 0.002). Furthermore, alpha ERD at Pz was significantly lower in the CAI group than in the healthy group (P = 0.003), suggesting diminished preparatory brain activity during GI in CAI subjects. Recognizing CAI as a condition involving both peripheral and central dysfunctions highlights the importance of a multidisciplinary approach in treatment and rehabilitation. This approach should target brain activity in addition to peripheral structures, potentially leading to improved long‐term outcomes for patients. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Appropriate pain management can facilitate rehabilitation after a hip fracture as patients transition back to the community setting. Differences in opioid prescribing by race may exist during this critical transition period.We conducted a retrospective cohort study of older adult U.S. Medicare beneficiaries with a hip fracture to examine whether the receipt and dose of opioids differs between Black and White patients as they transitioned back to the community setting. We stratified beneficiaries by whether they received institutional post‐acute care (PAC). Outcomes were (1) receipt of an opioid and (2) opioid doses in the first 90 days in the community in milligram morphine equivalents (MMEs; also presented in mg oxycodone). We estimated relative rates and risk differences of opioid receipt and dose differences using Poisson and linear regression models, respectively, using the parametric g‐formula to standardize for age and sex.We identified 164,170 older adults with hip fracture (mean age = 82.7 years; 75% female; 72% with PAC; 46% with opioid use after fracture). Overall use of opioids in the community was similar between Black and white beneficiaries. Black beneficiaries had lower average doses in their first 90 days in both total cumulative doses (PAC group: 165 [95% CI −264 to −69] fewer MMEs [−248 mg oxycodone]; no PAC: 167 [95% CI −274 to −62] fewer MMEs [−251 mg oxycodone]) and average MME per days' supply of medication (PAC: −3.0 [−4.6 to −1.4] fewer MMEs per day [−4.5 mg oxycodone]; no PAC: −4.7 [−4.6 to −1.4] fewer MMEs per day [−7.1 mg oxycodone]). In secondary analyses, Asian beneficiaries experienced the greatest differences (e.g., 617–653 fewer cumulative mg oxycodone).Racial differences exist in pain management for Medicare beneficiaries after a hip fracture. Future work should examine whether these differences result in disparities in short‐ and long‐term health outcomes. [ABSTRACT FROM AUTHOR]

In patients previously hospitalised for COVID‐19, a 12‐week high‐intensity interval training (HIIT) intervention has previously been shown to increase left ventricular mass (LVM) immediately after the intervention. In the present study, we examined the effects of the same HIIT scheme on LVM, pulmonary diffusing capacity, symptom severity and functional capacity at 12‐month follow‐up. In this investigator‐blinded, randomised controlled trial, 12 weeks of a supervised HIIT scheme (4 × 4 min, three times a week) was compared to standard care (control) in patients recently discharged from hospital due to COVID‐19. At inclusion and at 12‐month follow‐up, LVM was assessed by cardiac magnetic resonance imaging (cMRI, primary outcome), while pulmonary diffusing capacity for carbon monoxide (DLCOc, secondary outcome) was examined by the single‐breath method. Symptom severity and functional status were examined by the Post‐COVID‐19 Functional Scale (PCFS) and King's Brief Interstitial Lung Disease (KBILD) questionnaire score. Of the 28 patients assessed at baseline, 22 completed cMRI at 12‐month follow‐up (12.4 ± 0.6 months after inclusion). LVM was maintained in the HIIT but not the standard care group, with a mean between‐group difference of 9.68 [95% CI: 1.72, 17.64] g (P = 0.0182). There was no differences in change from baseline to 12‐month follow‐up between groups in DLCOc % predicted (−2.45 [−11.25, 6.34]%; P = 0.578). PCFS and KBILD improved similarly in the two groups. In individuals previously hospitalised for COVID‐19, a 12‐week supervised HIIT scheme resulted in a preserved LVM at 12‐month follow‐up but did not affect pulmonary diffusing capacity or symptom severity. [ABSTRACT FROM AUTHOR]

Background Objective(s) Methods Results Conclusion Swallowing is a complex function that requires precise coordination between different muscles. Weakness in submental muscles can lead to complications such as pharyngeal residue and aspiration. Therefore, exercise interventions targeting these muscles, such as the Head‐Lift Exercise (HLE), are clinically important but pose challenges.This study aimed to compare the myoelectric activity of submental muscles during traditional Head‐Lift Exercise (HLE), Tongue‐Press Exercise (TPE) and Head Extension Tongue‐Press Exercise (HETPE), providing potential alternatives to HLE.Thirty healthy volunteers (22 females and 8 males, mean age 25.63 ± 5.27 years) participated in this cross‐sectional study. Surface electromyography (sEMG) recorded activity of the submental muscles bilaterally during HLE, TPE and HETPE. Participants performed each manoeuvre for 14 s, repeated three times in a counterbalanced order. Statistical analyses assessed differences in mean, maximum and median frequency of the sEMG signals among manoeuvres using repeated‐measures analysis of variance (RM‐ANOVA). The experienced irritation levels by participants during manoeuvres were also compared by the Friedman test.HETPE exhibited significantly higher maximum sEMG activity compared to HLE and TPE (p < .05). Mean sEMG activity was significantly increased during HETPE compared to TPE. Median frequency was significantly lower during HETPE compared to the two other exercises, indicating greater muscle fatigue. Participants reported similar levels of irritation for HLE and HETPE, and significantly lower levels during TPE.These results indicate that HETPE is effective in activating and strengthening submental muscles, potentially serving as a viable alternative to HLE without added difficulty. Further research is recommended to assess the long‐term impacts on swallowing physiology in patients with dysphagia. [ABSTRACT FROM AUTHOR]

Paired vagus nerve stimulation (VNS) has emerged as a promising strategy to potentiate recovery after neurological injury. This approach, which combines short bursts of electrical stimulation of the vagus nerve with rehabilitation exercises, received approval from the US Food and Drug Aministration in 2021 as the first neuromodulation‐based therapy for chronic stroke. Because this treatment is increasingly implemented in clinical practice, there is a need to take stock of what we know about this approach and what we have yet to learn. Here, we provide a survey on the foundational basis of VNS therapy for stroke and offer insight into the mechanisms that underlie potentiated recovery, focusing on the principles of neuromodulatory reinforcement. We discuss the current state of observations regarding synaptic reorganization in motor networks that are enhanced by VNS, and we propose other prospective loci of neuromodulation that should be evaluated in the future. Finally, we highlight the future opportunities and challenges to be faced as this approach is increasingly translated to clinical use. Collectively, a clearer understanding of the mechanistic basis of VNS therapy may reveal ways to maximize its benefits. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion Childhood stroke has an estimated incidence of 2–13 per 100 000 children. Limited consensus exists regarding best practice recommendations for childhood stroke rehabilitation. A retrospective study completed at a tertiary institution identified potential associations between factors including type of stroke, functional presentation, muscle strength and length of stay (LOS).A retrospective study of children post‐stroke admitted 2014–2019 evaluated factors influencing outcome within inpatient rehabilitation. Exploratory analyses were completed to investigate relationships between variables including LOS, functional change, premorbid comorbidities and muscle strength.Data on 42 episodes of care (42 children: 18 males) following stroke were sourced from 2014 to 2019. Descriptive statistics were calculated for patient demographics, stroke characteristics, surgical treatment, premorbid comorbidities and muscle strength. Differences in WeeFIM scores between admission and discharge from the inpatient rehabilitation unit were tested using paired t tests. A higher number of children sustained ischaemic stroke (AIS, n = 24) when compared with haemorrhagic stroke (HS, n = 16). The average proportion of rehabilitation LOS to total hospital stay across all stroke types was 54.5%. Assessment of function demonstrated significant improvement between admission and discharge scores across all WeeFIM domains. Presence of comorbidities across stroke survivors was correlated with lower functional levels at discharge despite similar rehabilitation LOS.Limited consensus exists guiding paediatric rehabilitation post‐childhood stroke. This paper provides preliminary data on a cohort post‐childhood stroke at a tertiary‐level inpatient service. Paediatric stroke survivors showed significant functional improvements after inpatient rehabilitation, with the self‐care domain showing greater improvements than mobility and cognition domains, respectively. [ABSTRACT FROM AUTHOR]

This study identified evidence and considerations for allied health clinicians in providing group interventions for people with cognitive impairment. A scoping review was conducted by searching the MEDLINE (Ovid), CINHAL (EBSCOhost), Scopus (Elsevier), Embase (Ovid) and TROVE databases from 2016. Articles of any study design in which group interventions were performed by an allied health professional with participants with cognitive impairment were included. Data on physical, cognitive, psychological, and quality of life measures were extracted from the selected articles. Standardised mean changes (SMC) were calculated. Ten articles were included in the study. No article directly compared group interventions versus one‐to‐one interventions. The results of the meta‐analysis showed significant improvements after the intervention in the physical (SMC = 0.42, P = 0.013), cognitive (SMC = 0.43, P = 0.005), psychological (SMC = 0.14, P = 0.005), and quality of life domains (SMC = 0.28, P = 0.002). This review identified considerations for clinicians when developing group interventions for people with cognitive impairments, including specific participant criteria, increasing support, modifications to intervention difficulty, and environmental considerations. Group intervention for people with cognitive impairments demonstrated moderate effectiveness in improving physical and cognitive domains and a small effect in improving psychological and quality of life domains. Specific considerations are recommended when clinicians provide group interventions for people with cognitive impairments. [ABSTRACT FROM AUTHOR]

Background: Persistent high levels of knee pain after a total knee replacement have been estimated to affect 5%–10% of people and this is related to dissatisfaction with surgery, reduced function and reduced quality of life. This systematic review aims to evaluate the effectiveness of rehabilitation programs or strategies to reduce persistent pain and improve function and quality of life in people following a total knee replacement. Methods: The systematic review was conducted following PRISMA guidelines with a search of relevant online databases up to 17 July 2024. The search criteria included English language randomised controlled trials of rehabilitation programs or strategies in any setting to treat people with persistent knee pain more than 3 months after a total knee replacement. Rehabilitation could include exercise, education, cognitive strategies and self‐management programs and excluded medication trials, procedural techniques and complementary therapies. Results: After removal of duplicates, there were 468 abstracts screened for eligibility with 23 remaining for full‐text screening and finally, one study meeting the eligibility criteria. This study's interventions were pain neuroscience education alone and pain neuroscience education plus neuromuscular exercise. There were no statistically significant between‐group differences for pain reduction or functional improvement. Conclusion: The evidence examining the value of rehabilitation programs or strategies for pain reduction and functional improvement in people with persistent pain following total knee replacement is deficient. Given the high number of people affected annually, further research concerning both prevention and management of persistent pain after knee replacement is warranted. [ABSTRACT FROM AUTHOR]

Background: This study aimed to explore the awareness, experiences, and beliefs of individuals with osteoarthritis (OA) regarding their healthcare management, along with assessing their overall satisfaction levels. Methods: A cross‐sectional online survey was conducted in Italy, Sweden, and Russia, rigorously developed based on OA international guidelines in collaboration with healthcare professionals and individuals with OA. Participants over 40 years of age with self‐reported hip and/or knee OA were eligible. The analytical framework included descriptive analysis (assessment of awareness levels for 'recommended', 'optional', and 'not recommended' treatments), analysis of suggested treatments and taken treatments, exploration of beliefs, barriers and satisfaction analysis (0–100 scale). Results: A total of 401 participants (mean age: 59.7, 78.3% female, 28% Italian, 49% Swedish, 23% Russian) contributed to the study. In Sweden, 57%–72% accurately identified recommended treatments, while in Russia, the range was 34%–91%, and in Italy, it was 35%–73%. The predominant suggested and taken treatments were oral anti‐inflammatory drugs in Italy (87/81%) and Russia (97/97%) and specific exercise in Sweden (84/79%). Notably, only Sweden reached a consensus on the effectiveness of exercise for everyone, while Russia and Italy insisted on radiographic findings as a prerequisite for exercise. Mean satisfaction levels were 59.7 (Italy), 47.4 (Sweden), and 35.2 (Russia). Conclusions: This study uncovered variations in awareness, treatment preferences, and beliefs among the three countries, underscoring the necessity for tailored education on OA management that accounts for regional differences across Europe. [ABSTRACT FROM AUTHOR]

Purpose: Although hip or knee arthroplasty is generally a successful intervention, it is documented that 15%–30% of patients undergoing arthroplasty report suboptimal outcomes. This narrative review aims to provide an overview of the key findings concerning the management of poorer outcomes after hip or knee arthroplasty. Method: A comprehensive search of articles was conducted up to November 2023 across three electronic databases. Only studies written in English were included, with no limitations applied regarding study design and time. Result: Efficiently addressing poorer outcomes after arthroplasty necessitates a thorough exploration of appropriate methods for assessing recovery following hip or knee arthroplasty, ensuring accurate identification of patients at risk or experiencing poorer recovery. When selecting appropriate outcome measure tools, various factors should be taken into consideration, including understanding patients' priorities throughout the recovery process, assessing psychometric properties of outcome measure tools at different time points after arthroplasty, understanding how to combine/reconcile provider‐assessed and patient‐reported outcome measures, and determining the appropriate methods to interpret outcome measure scores. However, further research in these areas is warranted. In addition, the identification of key modifiable factors affecting outcomes and the development of interventions to manage these factors are needed. Conclusion: There is growing attention paid to delivering interventions for patients at risk or not optimally recovering following hip or knee arthroplasty. To achieve this, it is essential to identify the most appropriate outcome measure tools, factors associated with poorer recovery and management of these factors. [ABSTRACT FROM AUTHOR]

Animal‐assisted interventions (AAIs) have the potential to enhance people's well‐being and function and are increasingly being implemented across a range of settings. This scoping review explored how AAIs have been used in adult hospital rehabilitative care. Using JBI and PRISMA‐ScR guidelines, a systematic search of four databases was undertaken. Inclusion criteria involved adults, aged >18 years, who had received AAIs in the hospital rehabilitation setting. Twenty‐two articles met the inclusion criteria. Results identified two intervention types: visitation activities (n = 8 studies) and structured therapeutic interventions (n = 14 studies). Dogs were the most common animal species. Improvements in social and emotional well‐being were reported across both types of interventions, with improvements in ambulation, motor skills, and verbal communication reported by those engaged in structured therapeutic interventions. Implementation challenges included a dependency on volunteer dog‐handlers; the need for better recording of interventions in medical records to enable evaluation; and cost, safety, infection control, and animal welfare considerations. Strengthening the planning of AAIs is fundamental for the realization of potential outcomes from human–animal interactions in hospital rehabilitative care. [ABSTRACT FROM AUTHOR]

Background: Functional tests such as the 6‐minute walk test (6MWT) are used in many areas of medicine to monitor disease progression and outcomes of treatment. They are particularly helpful in Orthopaedic surgery as the outcomes have been shown to be responsive to recovery over time. The 6MWT is typically performed in a controlled supervised environment which may limit its widespread use (Terwee et al., Rheumatology (Oxford), 2006, 45, 890–902). The primary aim is to investigate if a patient measured 6MWT is comparable to a 6MWT performed under formal testing conditions (Täger et al., Int. J. Cardiol. 2014, 176, 94–98). Methods: A total of 55 patients undergoing elective primary hip or knee replacement were instructed to use a smart watch to record a 6MWT in their home community environment (C‐6MWT). These measurements were compared to a formally tested 6MWT (F‐6MWT) at 2 separate time periods—6 and 12 weeks post‐surgery. Results: At 6 weeks post operation the Intraclass Correlation Coefficient between a formally tested and a patient self‐administered 6MWT was 0.928 (95% CI 0.832–0.970) and at 12 weeks it was 0.831 (0594–0.935). Conclusion: A patient recorded 6 minute walk test shows high agreement with a formally recorded one under research conditions. This makes this test a suitable way to monitor rehabilitation progression and research outcomes at multiple time periods and in remote situations. [ABSTRACT FROM AUTHOR]

Introduction: Controlled ankle motion (CAM) boots are a below‐knee orthotic device prescribed for the management of foot and ankle injuries to reduce ankle range of motion (RoM) and offload the foot and ankle whilst allowing continued ambulation during recovery. There is a lack of clarity within the current literature surrounding the biomechanical understanding and effectiveness of CAM boots. Aims: To summarise the biomechanical effects of CAM boot wear as an orthotic for restricting ankle RoM and offloading the foot. Methods: A systematic literature review was conducted in accordance with the PRISMA 2020 guidelines. All papers were independently screened by two authors for inclusion. Methodological quality was appraised using Joanna Briggs Critical Appraisal checklists. A narrative synthesis of all eligible papers was produced. Results: Thirteen studies involving 197 participants (113 male and 84 female) were included. All studies were quasi‐randomised and employed a within‐study design, of which 12 studies included a control group and a range of CAM boots were investigated. CAM boots can be seen to restrict ankle RoM, however, neighboring joints such as the knee and hip do have kinetic and kinematic compensatory alterations. Plantar pressure of the forefoot is effectively redistributed to the hindfoot by CAM boots. Conclusion: The compensatory mechanisms at the hip and knee joint during CAM boot wear could explain the secondary site pain often reported in patients, specifically at the ipsilateral knee and contralateral hip. Although CAM boots can be used to restrict ankle motion, this review has highlighted a lack of in‐boot kinematic analyses during CAM boot use, where tracking markers are placed on the anatomical structure rather than on the boot, or through video fluoroscopy, urging the need for a more robust methodological approach to achieve this. There is a need for studies to assess the biomechanical alterations caused by CAM boots in populations living with foot and ankle pathologies. Future research, adopting a longitudinal study design, is required to fully understand the effectiveness of CAM boots for rehabilitation. [ABSTRACT FROM AUTHOR]

Background: The field of medical grade footwear is dynamic. Originally, a field where individual knowledge, expertise and skills determined the footwear and its outcomes, now becoming a more evidence‐based and data‐driven field with protocols and systems in place to create appropriate footwear. However, scientific evidence concerning medical grade footwear is still limited. Evidently, all stakeholders, from patients to pedorthists to rehabilitation physicians, will profit from a larger evidence‐base in this field. A widely supported research agenda is an essential first step to advance and facilitate new knowledge. Methods: We formed a multidisciplinary team and followed the methodology from Dutch medical societies for the development of a research agenda on medical grade footwear. This consisted of seven steps: (1) inventory of relevant questions with users and professionals; (2) analyses of responses; (3) analyses of existing knowledge and evidence; (4) formulating research questions; (5) prioritising research questions by users and professionals; (6) finalising the research agenda and (7) implementing the research agenda. Results: In phase 1, 109 participants completed a survey, including 50% pedorthists, 6% rehabilitation physicians and 3% users. Participants provided 228 potential research questions. In phases 2–4, these were condensed to 65 research questions. In phase 5, 152 participants prioritised these 65 research questions, including 50% pedorthists, 13% rehabilitation physicians and 9% users. In phase 6, the final research agenda was created, with 26 research questions, categorised based on the International Classification of Functioning Disability and Health 'process description assistive devices'. In phase 7, an implementation meeting was held with over 50 stakeholders (including users and professionals), resulting in seven applications for research projects based on one or more research questions from the research agenda. Conclusions: This research agenda structures and guides knowledge development within the field of medical grade footwear in the Netherlands and elsewhere. We expect that this will help to stimulate the field to tackle the research questions prioritised and with that to advance scientific knowledge in this field. [ABSTRACT FROM AUTHOR]

We aimed to report the trajectory of self‐reported outcomes up to 11 years post‐ACLR. We also explored the relationship between hop performance at 1 year and: (i) future self‐reported knee outcomes; and (ii) risk of subsequent knee events. 124 participants (43 women, mean age 31 ± 8 years) were recruited at 1 year following hamstring‐autograft ACLR. Hop performance was assessed with single‐forward and side‐hop tests. Follow‐up was completed at 3 (n = 114), 5 (n = 89) and 11 years (n = 72) post‐ACLR. Self‐reported outcomes were assessed at each follow‐up with the Knee injury Osteoarthritis Outcome Score (KOOS) pain and quality of life (QOL) subscales. Generalized linear mixed models estimated the relationship between hop performance and self‐reported outcomes. Subsequent knee events (new injury/surgery) to either knee were recorded, with the relationship between hop performance and risk of subsequent knee events analyzed with Cox proportional hazards. Self‐reported knee outcomes were stable (mean change < 10 points) across all timepoints but with major within‐sample variability. There was a modest relationship between greater hop performance at 1 year and better future KOOS‐pain (average marginal effect [AME] % improvement with + 1 cm single forward hop = 0.06% [95% CI 0.02–0.10]). A nonlinear spline relationship showed better single‐forward hop performance was associated with better KOOS‐QOL for scores < 108 cm, not present for higher hop scores > 108 cm. There were 21 index and 11 contralateral subsequent knee events. Hop performance was not related to risk of a subsequent knee event (hazard ratio index knee 0.99 [95% CI 0.98–1.02]). In conclusion, self‐reported knee pain and quality of life were generally stable across the 11‐year follow‐up period. Greater hop performance at 1‐year post‐ACLR was related to better self‐reported knee outcomes up to 11‐year follow‐up (of questionable clinical importance), but not associated with the risk of subsequent knee injury/surgery. [ABSTRACT FROM AUTHOR]

Low‐load blood‐flow‐restriction resistance training (LL‐BFR‐RT) is gaining popularity, but its physiological effects remain unclear. This study aimed to compare LL‐BFR‐RT with low‐load resistance exercise (LL‐RT) and high‐load resistance exercise (HL‐RT) on metabolism, electrolytes, and ions in the lower extremities by invasive catheter measurements, which are crucial for risk assessment. Ten healthy men (27.6 ± 6.4 years) completed three trials of knee‐extensor exercises with LL‐RT (30% 1RM), LL‐BFR‐RT (30% 1RM, 50% limb occlusion pressure), and HL‐RT (75% 1RM). The exercise protocol consisted of four sets to voluntary muscle failure with 1 min of rest between sets. Blood gas analysis was collected before, during, and after each trial through intravenous catheters at the exercising leg. LL‐BFR‐RT had lower total workload (1274 ± 237 kg, mean ± SD) compared to LL‐RT (1745 ± 604 kg), and HL‐RT (1847 ± 367 kg, p < 0.01), with no difference between LL‐RT and HL‐RT. Pain perception did not differ significantly. Exercise‐induced drop in oxygen partial pressure, lactate accumulation and electrolyte shifts (with increased [K+]) occurred during under all conditions (p < 0.001). Creatine kinase and lactate dehydrogenase increased significantly 24‐ and 48‐h postexercise under all three conditions (p < 0.001). This study, using invasive catheter measurements, found no significant differences in metabolic, ionic, and electrolyte responses among LL‐BFR‐RT, LL‐RT, and HL‐RT when exercised to voluntary muscular failure. LL‐BFR‐RT reduced time to failure without specific physiological responses. [ABSTRACT FROM AUTHOR]

Background: Functional electrical stimulation (FES) is an evidence‐based intervention that is rarely used by Canadian physical therapists (PTs) and occupational therapists (OTs). A common barrier to FES implementation is a lack of knowledge and training. FES learning resources that meet therapists' learning needs and preferences may address this barrier. Objective: To explore OTs' and PTs' perspectives on the utility of FES e‐learning resources, including whether the resources met their learning needs and preferences. Methods: Through this qualitative descriptive study, feedback on FES e‐learning resources was solicited from 5 PTs and 18 OTs who work clinically, but do not use FES. Participants reviewed ≥3 prerecorded lectures on FES topics and then completed a semi‐structured interview. Participants were asked about the lectures' content, delivery, ease of use and comprehensibility, and were asked to suggest modifications to facilitate self‐directed learning about FES. Interviews were analyzed using conventional content analysis. Results: Three themes were identified. (1) Feedback on FES e‐learning: the content and delivery of the prerecorded lectures facilitated participants' learning, although opportunities to improve content and delivery were identified. (2) Factors influencing FES learning needs and preferences: Participants identified internal (i.e., baseline knowledge, learning style) and external (i.e., learning with colleagues, practice setting) factors that affected learning. Themes 1 and 2 impacted (3) the effects of FES e‐learning: Participants described the outcomes of their FES e‐learning, including increases in FES knowledge, confidence, and use in clinical practice. Conclusion: Therapists' perceived the FES e‐learning resources to be useful and to address their learning needs and preferences. [ABSTRACT FROM AUTHOR]

This paper applies key insights from constitutive penology to advance the practice framework literature in correctional rehabilitation. First, I provide some brief commentary on the origins and subsequent development of constitutive thought in studies of governance, crime and justice. Second, I outline the central ontological convictions and epistemological commitments of constitutive penology. Third, I explain where and how the ontic and epistemic 'lessons' of constitutive penology contribute to the conversation about practice framework theory and therapeutic practice in correctional rehabilitation. These comments especially emphasize the importance of (a) rethinking the responsibility of theory in therapeutic practice; (b) reframing the method of study in the practice of therapy and (c) repurposing the practice guidelines for undertaking therapeutic work. [ABSTRACT FROM AUTHOR]

Introduction: Anorexia nervosa (AN) is characterised by limited remission rates and emotional dimensions are often neglected. Cognitive remediation and emotional skills training (CREST) protocol aims to address cognitive and emotional factors. This study evaluates the feasibility and effectiveness of a modified rolling‐group CREST protocol in an inpatient setting. Methods: Quasi‐experimental design evaluated CREST protocol in a rehabilitation programme. A total of 116 females diagnosed with AN were included, of whom 63 were included in the CREST protocol and 53 in the standard rehabilitation treatment. Various standardized measures were employed to assess psychopathology. Data collection occurred longitudinally, before and after CREST implementation. Results: No significant differences emerged between groups regarding changes in specific eating psychopathology. CREST group exhibited significant improvements in emotion regulation (p = 0.002) and social skills (p = 0.014), besides a reduction in alexithymia (p < 0.001) and cognitive rigidity (p = 0.013). Empathic features remained stable. Participants reported positive perceptions of the CREST intervention. Discussion: The study highlights the potential benefits of integrating emotional training within multidisciplinary intensive treatment for AN. Results emphasise the importance of treatment protocol with more affective and hot‐cognition‐related interventions, beyond weight‐related psychopathology. Implementing a rolling‐group CREST protocol in an inpatient setting showed promise in enhancing the emotional abilities of AN patients. Highlights: The Cognitive remediation and emotional skills training (CREST) group exhibited exceptional adherence, with no dropouts observed, indicating strong engagement and acceptability of the programme among participants.Participants in the CREST group experienced significant reductions in Difficulties in Emotion Regulation Scale (DERS) scores, suggesting enhanced emotional regulation skills compared to the treatment as usual ,TAU group.The CREST intervention led to a notable decrease in alexithymia scores, indicating improved emotional awareness and expression among participants. [ABSTRACT FROM AUTHOR]

Background: Older people often have multiple health conditions and therefore extended care needs. The transition from the hospital back to their home requires careful planning. The fragmented healthcare system and rapid discharge from the hospital can result in limited involvement of the older patient in the discharge planning process. We aimed to explore how older hospitalised patients experienced the transition from hospital to home and how possibilities and constraints in interactions with relevant parties in the transition affected their everyday lives. Method: An ethnographic participant observation study including interviews was conducted with 10 older hospitalised patients. The theoretical perspective in the study is critical psychology and data were analysed using the condition‐, meaning‐ and reasoning analysis. Results: Three themes were identified: (1) Lost in transition – the person's ability to act is limited, (2) In transition – the relatives become important, (3) At home – the home transforms into a workplace. Conclusion: Lack of involvement becomes a condition for older patients as some struggle to create meaning in their transition, affecting their everyday lives. The patients experienced their relatives as important as they ensured that the HCPs got to know their values and wishes. This knowledge is important for HCPs working closely with older people both at the hospital and at home ensuring active involvement of the older person with respect and acknowledgement of the older person's wishes, needs, resources and vulnerability. [ABSTRACT FROM AUTHOR]

Rationale: Rehabilitation has the potential to significantly improve the lives of people and, most importantly, for persons with Parkinson's disease (PD). Although numerous studies have reported the benefits of rehabilitation for persons with PD (PwPD), these services are still limited and underutilized even when patients exhibit problems that require rehabilitation. Aims and Objectives: This review aims to describe the (a) indication for referral for rehabilitation services, (b) patterns of referral for rehabilitation and (c) factors that facilitate or hinder the utilization and delivery of rehabilitation services among PwPD. Methods: A comprehensive literature search was conducted across selected databases, African Journals Online, EBSCOhost (CINAHL, Africa‐wide), PubMed, SCOPUS and Web of Science. Studies published in English from January 2002 until December 2022 were applied as limiters. Reference and grey data sources tracking were also conducted. Two reviewers conducted the study selection, screening of titles, abstracts and full text and data charting. A descriptive analysis was performed. Findings were narratively presented and illustrated with tables, diagrams and descriptive formats as appropriate. Results: Twelve studies were included in the review; however, none were from Africa. Impairments and activity limitations were the key functioning problems indicated for rehabilitation. Age, gender, income, race, disease stage, specific functioning problems, quality of life and care by a neurologist were the main predictors for referral to rehabilitation. Physiotherapy, occupational therapy and speech and language therapy were the most utilized rehabilitation services and were sometimes utilized together. The rate of rehabilitation service utilization among PwPD ranged from 0.9% to 62.5%. Lack of referrals and limited rehabilitation units/professionals were the common barriers to rehabilitation service utilization. Conclusion: Per the studies reviewed, utilization of rehabilitation services is generally low among PwPD. Lack of referral and nonavailability of professionals are cited as barriers to access. Adequate measures are needed to improve rehabilitation services for all PwPD. Plain Language Summary: This review explored the reasons for the use and non‐use of rehabilitation services among persons with Parkinson's disease (PwPD) by searching existing literature. It aimed to describe the reasons for referral, types and rates of rehabilitation services utilize and factors that affect rehabilitation service use. A comprehensive literature search was conducted across selected databases, unpublished data sources and reference lists. Studies published in English from January 2002 until December 2022 were selected. Two reviewers selected, screened and extracted the data. A descriptive analysis was performed. Twelve studies were included in the review and found that impairments and activity limitations were the key reasons for referrals to rehabilitation. Age, gender, income, race, disease stage, specific functioning problems, quality of life and care by a neurologist were the main predictors for rehabilitation. Also, physiotherapy, occupational therapy and speech and language therapy/pathology were the most utilized rehabilitation services. The rate of rehabilitation service utilization among the PwPD ranged from 0.9% to 62.5%. Lack of referrals and limited rehabilitation units/professionals were the common barriers to rehabilitation service utilization. In conclusion, PwPD present with numerous functioning problems which require rehabilitation. Adequate measures are needed to improve access to rehabilitation for all PwPD. [ABSTRACT FROM AUTHOR]

Objectives: To examine patient, surgical and hospital factors associated with Day‐1 postoperative mobility after hip fracture surgery in older adults. Methods: A cohort study using Australia and New Zealand Hip Fracture Registry was conducted. Participants were aged older than 50 years and underwent hip fracture surgery between 1 January 2020 and 31 December 2020 inclusive. The outcome was standing and step transferring out of bed onto a chair and/or walking Day‐1 after hip fracture surgery. Results: Mean age was 82 years and 68% were women. Of 12,318 patients with hip fracture, 5981 (49%) actually mobilised Day‐1. Odds of actual first‐day mobilisation were lower for individuals usually walking with either stick or crutch (OR = 0.71, 95% CI 0.62–0.82) or two aids or frame (OR = 0.57, 95% CI 0.52–0.64) or wheelchair/bed bound (OR = 0.24, 95% CI 0.17–0.33); who had impaired cognition preadmission (OR = 0.57, 95% CI 0.51–0.64); from aged care facilities (OR = 0.59, 95% CI 0.52–0.67); had an American Society of Anaesthesiologists grade 2 (OR = 0.63, 95% CI 0.41–0.97), 3 (OR = 0.31, 95% CI 0.20–0.47) or 4 or 5 (OR = 0.21, 95% CI 0.14–0.32); surgery delay >48 h (OR = 0.81, 95% CI 0.71–0.91); and restricted/non‐weight‐bearing status immediately postoperatively (OR = 0.53, 95% CI 0.42–0.67). Conclusions: Both non‐modifiable and modifiable patient and surgical factors influence first‐day mobilisation after hip fracture surgery. Reducing time to surgery might assist future quality improvement efforts to increase Day‐1 postoperative mobility. [ABSTRACT FROM AUTHOR]

Objective: This paper describes the study protocol in an ongoing clinical trial evaluating oral screen training as part of a post‐stroke rehabilitation programme. Baseline data were related to four domains: dysphagia, lip function, masticatory performance and patient‐related outcome measures (PROM). Background: Stroke is one of the most common causes of disability‐adjusted life years, and dysphagia is a common remaining problem after stroke. Rehabilitation using oral screen training has been suggested to improve swallowing, but evidence is still insufficient. Materials and Methods: Patients diagnosed with stroke with persisting objective and/or subjective swallowing dysfunction after primary rehabilitation were assessed for eligibility. In total, 25 patients were included. Objective function was assessed by swallowing capacity test (SCT), lip force and masticatory performance, subjective function by EAT‐10 and NOT‐S and PROM by LiSat‐11 and ESAS. Results: Baseline data presented a heterogeneous pattern with no significant association between objective and subjective dysfunction. Most of the participants (20/25) showed impaired swallowing capacity in SCT, and 23/24 revealed orofacial dysfunction according to NOT‐S. The most common subjective item reported was chewing and swallowing problems (19/24). Conclusion: The heterogenous findings in the included tests and the lack of correlations emphasise the importance of multidisciplinary approaches to identify objective and subjective orofacial post‐stroke dysfunction in clinical practice to be able to offer evidence‐based individualised care. The included participants were representative of stroke patients with dysphagia, which supports proceeding with the planned intervention. [ABSTRACT FROM AUTHOR]

Aim: To investigate the factors that influence readiness for hospital discharge in Chinese patients after total knee arthroplasty and to identify priorities for nursing interventions. Design: A cross‐sectional study. Methods: From January to August 2022, data were collected from 339 patients at two tertiary A‐level hospitals in Jinan, Shandong Province. SPSS 26.0 and Mplus 8.3 software were used for statistical analysis. Results: Results from multiple linear regression showed that patients' age, residence status, education level, knee pain during sleep, quality of discharge teaching, self‐efficacy for rehabilitation, pain control knowledge, and social support were factors influencing their readiness for hospital discharge. The results of the structural equation model had shown that there were also indirect effects of the education level, knee pain during sleep, quality of discharge teaching, and pain control knowledge. Conclusion: Patients' readiness for hospital discharge needs further improvement, hence physicians and nurses should judiciously allocate medical resources and concentrate their efforts on high‐risk groups characterized by low readiness for hospital discharge. Implications for the Profession and Patient Care: This study underscores the importance of physicians and nurses prioritizing key factors such as age, residency status, education level, and social support in total knee arthroplasty patients to enhance their readiness for hospital discharge. By implementing targeted discharge planning, effective pain management, and comprehensive rehabilitation education, healthcare providers can improve patient outcomes. Impact: This study identified key factors influencing readiness for hospital discharge in total knee arthroplasty patients, guiding targeted nursing interventions to improve post‐operative care. Reporting Method: STROBE. Patient or Public Contribution: The participants recruited for this study were actively engaged in the data collection process. [ABSTRACT FROM AUTHOR]

The active/passive distinction, once a hallmark of classical metaphysics, has largely been discarded from contemporary thought. The revival of powers theory has not seen an equally vigorous rehabilitation of the real distinction between active and passive powers. I begin an analysis and vindication with a critique of E.J. Lowe's discussion. I then argue that the active/passive problem is a metaphysical one, not a logical or logico‐linguistic one, and so logic is impotent to solve it. Following this is a discussion of the rights and wrongs of Aristotle's and Aquinas's (identical) defence of the distinction. We will see that one main part of their analysis is a bright red herring while the other part contains the solution to the problem. I then state and clarify the key Scholastic principle concerning action and passion, which I call the Fundamental Thesis – one that will appear scandalous to contemporary ears, yet from which we can derive the tools needed to understand action and passion in the right way. I end with a definition of what I call the Minimal Metaphysical Agent, where the formulation is to be understood as an epistemic criterion for identifying agent and patient in a given causal interaction. [ABSTRACT FROM AUTHOR]

Background Aims Methods Results Conclusion WHAT THIS PAPER ADDS What is already known on the subject What this study adds What are the clinical implications of this work? People with communication disability after stroke experience low rates of return to vocational roles. Vocational rehabilitation is recommended; however, there are no clear guidelines informing vocational rehabilitation for people with communication disability. Understanding the needs and experiences of this population is critical to improving vocational stroke rehabilitation outcomes.This study aimed to: (1) investigate the experience of vocational rehabilitation for people with communication disability after stroke, (2) identify gaps and, (3) provide preliminary recommendations for tailored service delivery.Seven participants with an identified communication impairment following stroke were recruited from a larger clinical trial of early vocational rehabilitation (20% of total sample, n = 34). To address the study aims, a qualitative design was employed. Semi‐structured, in‐depth interviews were conducted and analysed using thematic analysis. Data were integrated with demographic and intervention audit data to contextualise participant experiences, identify vocational rehabilitation gaps and inform preliminary recommendations.Participants were five men and two women aged 24–69 years whose communication profiles included difficulties with auditory comprehension and information processing, reading comprehension, thinking, executive function and self‐regulation, as well as difficulties with verbal and written expression. Vocational rehabilitation was perceived as beneficial but participants identified gaps including limited access to psychological and peer‐based support during early rehabilitation, limitations to accessing specialist vocational rehabilitation programs, barriers to accessing ongoing rehabilitation after resumption of vocational activity, and limited preparedness for the degree of impact that their communication changes had on execution of vocational roles and responsibilities.Vocational environments are communicatively demanding and people living with acquired communication difficulties face a range of vocation‐related participation barriers even when communication difficulties are mild. Greater emphasis on evaluating the vocational communication environment and targeted communication training and preparation for colleagues within the workplace is recommended to reduce barriers faced. Interdisciplinary rehabilitation, inclusive of psychological care, may support working‐age stroke survivors to recognise and acknowledge changes in their communication function, lead to improved engagement in the rehabilitation process, and ensure early identification of factors likely to influence successful return‐to‐vocational activity. Stroke is common amongst people of working age yet fewer than half of stroke survivors will return to pre‐stroke vocational roles. Communication difficulties affect anywhere between 24% and 45% of people after stroke and include changes to language abilities, motor speech, vision, hearing and cognition. This group experiences much lower rates of return to vocational roles when compared to people with stroke who do not have a concomitant communication difficulty. Vocational rehabilitation is recommended. However, currently there is limited evidence to inform vocational rehabilitation guidelines for people with stroke and communication difficulties. Achieving a successful return to vocational activity is associated with improved life satisfaction for people with communication difficulties after stroke and is a key research priority for this population. This study investigated the experiences of people with communication difficulty after stroke who reported a goal of returning to pre‐stroke vocational activity. Data associated with types of interventions received, the experiences and perceptions of vocational rehabilitation, and experiences of returning to vocational activity were analysed to identify core rehabilitation needs and develop preliminary recommendations to inform future vocational rehabilitation guidelines for this population. The present study provides preliminary evidence that people experiencing communication difficulties after stroke require a more integrated rehabilitation pathway. During early stages of vocational rehabilitation psychological and peer‐based support is indicated to support adjustment to changed communication function and to enable productive goal setting and engagement in rehabilitation. Clinicians need to complete a detailed analysis of the vocational communication environment and consider the communication activities involved in the individual's future vocational duties in order to plan meaningful rehabilitation. A multidisciplinary approach is required and additional training for clinicians is indicated to support clinicians to work collaboratively within the vocational setting. [ABSTRACT FROM AUTHOR]

Aim Method Results Interpretation To map the ingredients of non‐invasive interventions provided to young ambulant children with cerebral palsy.Articles were screened and each study's characteristics extracted. The intervention ingredients were described in terms of the Rehabilitation Treatment Specification System and linked to the ‘F‐words’. Results were interpreted and validated by a patient and public involvement group.Sixty‐one papers were included, of which 55.5% were classified as randomized controlled trial design studies. The selected studies included a total of 2187 children (mean age range 3 months to 5 years 11 months), most from high‐income countries. The included studies investigated a total of 27 interventions, which together presented ingredients representing all F‐words, in the following order of frequency: ‘fitness’ (e.g. strength and endurance training), ‘functioning’ (e.g. active and repetitive practice of a task), ‘family’ (e.g. context‐focused therapy), ‘fun’ (e.g. inclusion of child‐friendly activities), ‘friends’ (e.g. group activities), and ‘future’ (e.g. didactic information sharing). Thus, ingredients related to the F‐word ‘future’ were the most infrequently reported.Therapists and families need to be aware of the most appropriate match between the F‐word goals, ingredients, and targets. Finally, ‘fun’, ‘friends’, and ‘future’ should be addressed as potential outcomes in future studies. [ABSTRACT FROM AUTHOR]

The wide range of pressure detection and the exceptional linearity are essential performance parameters for flexible pressure sensors, enabling them to adapt to diverse scenarios and acquire information accurately. However, currently available "ultra‐wide range" piezoresistive sensors lack an optimal solution that effectively balances sensing properties, device thickness, and process cost. This study proposes a distinctive approach by introducing a Janus conductive structure assembled with dual resistive sensitive layers. The design allows for a pressure‐induced staged transformation of the current transport path, effectively mitigating variations and saturation in sensor resistance over a wide pressure range. The resulting piezoresistive sensor demonstrates an unprecedented detection range of 0–3800 kPa, showcasing remarkable sensitivity of 4.11 kPa−1 and outstanding linearity of 99.9% within the range of 0–1000 kPa. Additionally, the sensor boasts a thickness of only ≈200 µm, made possible through the utilization of a cellulose nanofibers material matrix. These performance achievements stand at the forefront when compared to existing reports. This research explores the potential applications of these sensors and extended arrays in the domains of human health and motion monitoring. It investigates their utility in gait analysis for assisted posture correction, as well as in the assessment and rehabilitation of gait instability. [ABSTRACT FROM AUTHOR]

Purpose: To examine complications, visual outcomes, photic patient‐reported symptoms, corneal morphology, IOL tilt, and intraocular pressure after implantation of an intraocular lens (IOL) and iris prosthesis (IP) following iridocyclectomy. Methods: Patients with previous iridocyclectomy treated with an IOL and IP at the Copenhagen University Hospital Rigshospitalet between 2007 and 2018 were included in this national retrospective non‐comparative case series. The assessment encompassed BCVA, PRO questionnaire, corneal topography, and anterior segment OCT. Results: 45 patients were included. Eight of 45 patients were previously treated with ruthenium‐106 brachytherapy in conjunction with iridocyclectomy. Six of 45 patients developed endothelial dysfunction four of whom had received ruthenium‐106 brachytherapy. Five of 45 patients had subluxation of the IOL/IP complex due to incomplete zonula apparatus. BCVA improved for all patients after lens surgery. 26 patients participated in the invited follow‐up examination. 19 of 26 (73%) reported none or mild photic symptoms after IP instalment. Five (19%) reported ongoing severe photic symptoms. The corneal astigmatism significantly increased after iridocyclectomy but did not change after lens surgery. Conclusions: Implantation of an IOL and IP is a safe procedure, alleviating photic symptoms in most patients. It comes with higher risk of complications due to a more demanding procedure and larger surgical traumas from previous treatments. Ruthenium‐106 brachytherapy increases the complication risk. Corneal astigmatism is induced by iridocyclectomy but does not change after lens surgery. [ABSTRACT FROM AUTHOR]

Background: Nutritional prehabilitation may improve haematopoietic cell transplantation (HCT) outcomes, although little evidence exists. The present study aimed to understand healthcare professional (HCP) perceptions of prehabilitation and nutritional care pre‐HCT in UK centres. Methods: An anonymous online survey (developed and refined via content experts and piloting) was administered via email to multidisciplinary HCPs in 39 UK adult centres, between July 2021 and June 2022. Data are presented as proportions of responses. Routine provision denotes that care was provided >70% of time. Results: Seventy‐seven percent (n = 66) of HCPs, representing 61.5% (n = 24) of UK adult HCT centres, responded. All HCPs supported prehabilitation, proposing feasible implementation between induction chemotherapy (60.4%; n = 40) and first HCT clinic (83.3%; n = 55). Only 12.5% (n = 3) of centres had a dedicated prehabilitation service. Nutrition (87.9%; n = 58), emotional wellbeing (92.4%; n = 61) and exercise (81.8%; n = 54) were considered very important constituents. HCPs within half of the HCT centres (n = 12 centres) reported routine use of nutrition screening pre‐HCT with a validated tool; 66.7% of HCPs (n = 36) reported using the malnutrition universal screening tool (MUST). Sixty‐two percent (n = 41) of HCPs reported those at risk, received nutritional assessments, predominantly by dietitians (91.6%; n = 22) using the dietetic care process (58.3%; n = 14). Body mass index (BMI) was the most frequently reported body composition measure used by HCPs (70.2%, n = 33). Of 59 respondents, non‐dietitians most routinely provided dietary advice pre‐HCT (82.4%; n = 28 vs. 68%; n = 17, p = 0.2); including high‐energy/protein/fat and neutropenic diet advice. Prophylactic enteral feeding pre‐HCT was rare, indicated by low BMI and significant unintentional weight loss. Just under half (n = 25 of 59, 42.4%) HCPs reported exercise advice was given routinely pre‐HCT. Conclusions: Nutrition and prehabilitation pre‐HCT are considered important and deliverable by HCPs, but current provision in UK centres is limited and inconsistent. Key Points: Prehabilitation was considered important in the context of haematopoietic stem cell transplantation care by all health care professionals (HCPs), although only 12.5% of centres had a dedicated prehabilitation service.There are inequities in nutritional care provision prior to haematopoietic cell transplantation (HCT) between transplantation centres.Lack of nutrition screening and systematic approaches to body composition assessments may limit the potential to identify and optimise nutritional and functional health prior to HCT.Non‐dietitians most frequently provided dietary advice pre‐HCT. Dietary advice focused on total energy intake (71.1%, n = 32) over protein (46.7%, n = 21), fat (44.4%, n = 20) and fibre (24.4%, n = 11). [ABSTRACT FROM AUTHOR]

Introduction: Individuals with acetabular dysplasia often report hip joint instability, pain, and poor hip‐related function. Periacetabular osteotomy (PAO) is a surgical procedure that aims to reposition the acetabulum to improve joint congruency and improve pain and function. We aimed to examine the influence of presurgery clinical measures on functional recovery following PAO and the associations among clinical outcomes after PAO. Methods: We screened 49 potential participants, 28 were enrolled, and 23 completed both study visits (pre‐PAO and 6 months post‐PAO). We evaluated dynamometer‐measured hip and thigh strength, loading patterns during a squat and countermovement jump (CMJ), pain intensity, and device‐measured physical activity (PA) levels (light, moderate‐to‐vigorous PA [MVPA], and daily steps). We used linear regression models to examine the influence of muscle strength (peak torque; limb symmetry index [LSI]) and loading patterns before PAO on pain intensity and PA levels in individuals 6 months following PAO. Additionally, we used Pearson correlation coefficient to examine cross‐sectional associations among all variables 6 months following PAO. Results: Lower extremity muscle strength and loading patterns during the squat and CMJ before PAO did not predict pain intensity or device‐measured PA levels in individuals 6 months following PAO (p > 0.05). Six months following PAO, higher knee extensor LSI was associated with higher time spent in MVPA (r = 0.56; p = 0.016), higher hip abductor LSI was associated with both lower pain (r = 0.50; p = 0.036) and higher involved limb loading during the squat task (r = 0.59; p = 0.010). Lastly, higher hip flexor LSI was associated with higher CMJ takeoff involved limb loading (r = 0.52; p = 0.021) and higher involved hip extensor strength was associated with higher CMJ landing involved limb loading (r = 0.56; p = 0.012). Conclusion: Six months after PAO, higher hip and thigh muscle strength and strength symmetry were associated with lower pain, higher PA levels, and greater normalized limb loading during dynamic movement tasks. [ABSTRACT FROM AUTHOR]

Background: Older breast cancer survivors (BCS, age ≥ 65) are vulnerable to experiencing persistent symptoms and associated declines in health‐related quality of life (HRQOL). In research trials, cancer rehabilitation interventions (physical or occupational therapy, PT/OT) have been shown to enhance HRQOL, but the impact of community‐based PT/OT services for older BCS is unknown. We performed a retrospective, observational study to better understand the impact of PT/OT services on the HRQOL of older BCS. Methods: Outcomes and covariates were extracted from the outpatient rehabilitation medical record. HRQOL outcomes included: PROMIS® global physical health (GPH), global mental health (GMH), physical function (PF), and ability to participate in social roles and activities (SRA). Linear mixed‐effect models were used to examine change in HRQOL outcomes and explore the influence of patient age and service type (PT/OT). ICD‐10 codes were examined and compared between service types to describe the impairments treated. Results: PT/OT cases (N = 694) were 71.79 ± 5.44 years old and participated in a median of 11 visits (IQR: 7.0–17.25) over 9.71 weeks (IQR: 6.29–15.29). Most (84.4%) attended PT (n = 579; 84%) versus OT (n = 115; 16%). Overall, significant improvement was observed in each HRQOL outcome (GPH: +3.00, p < 0.001; GMH: +1.80, p < 0.001; PF: +1.97, p < 0.001; SRA: +2.34, p < 0.001). Service type influenced only GPH (p = 0.041); mean improvement was +3.24 (SE: 0.290, p < 0.001) for PT cases and + 1.78 for OT cases (SE: 0.651, p = 0.007). PT cases commonly received treatment for weakness/atrophy, pain, walking, and posture; OT cases commonly received treatment for lymphedema and scarring/fibrosis. No age effects were observed. Conclusions: In this large study of older BCS who participated in community‐based PT/OT services across the United States, we observed significant improvements in HRQOL outcomes that are important to older BCS and their providers. Although more research is needed, these findings suggest that improved access to PT/OT could help address unmet HRQOL needs among this population. [ABSTRACT FROM AUTHOR]

Background and Objective: Both bronchoscopic lung volume reduction with endobronchial valves (BLVR‐EBV) and pulmonary rehabilitation (PR) are effective treatments for improving exercise capacity and patient‐reported outcomes in patients with severe Chronic Obstructive Pulmonary Disease (COPD). According to current recommendations, all BLVR‐EBV patients should have undergone PR first. Our aim was to study the effects of PR both before and after BLVR‐EBV compared to BLVR‐EBV alone. Methods: We included patients with severe COPD who were eligible for BLVR‐EBV and PR. Participants were randomized into three groups: PR before BLVR‐EBV, PR after BLVR‐EBV or BLVR‐EBV without PR. The primary outcome was change in constant work rate cycle test (CWRT) endurance time at 6‐month follow‐up of the PR groups compared to BLVR‐EBV alone. Secondary endpoints included changes in 6‐minute walking test, daily step count, dyspnoea and health‐related quality of life. Results: Ninety‐seven participants were included. At 6‐month follow‐up, there was no difference in change in CWRT endurance time between the PR before BLVR‐EBV and BLVR‐EBV alone groups (median: 421 [IQR: 44; 1304] vs. 787 [123; 1024] seconds, p = 0.82) or in any of the secondary endpoints, but the PR after BLVR‐EBV group exhibited a smaller improvement in CWRT endurance time (median: 107 [IQR: 2; 573], p = 0.04) and health‐related quality of life compared to BLVR‐EBV alone. Conclusion: The addition of PR to BLVR‐EBV did not result in increased exercise capacity, daily step count or improved patient‐reported outcomes compared to BLVR‐EBV alone, neither when PR was administered before BLVR‐EBV nor when PR was administered after BLVR‐EBV. Our findings suggest that a combination of pulmonary rehabilitation and bronchoscopic lung volume reduction with endobronchial valves (BLVR‐EBV) may not provide additional benefits compared to BLVR‐EBV alone at a group‐level. Future challenges lie in selecting patients for whom a combined rehabilitation trajectory would be beneficial. See relatededitorial [ABSTRACT FROM AUTHOR]

Background: Functional dystonia (FD) is a common subtype of functional movement disorder. FD can be readily diagnosed based on positive signs and is potentially treatable with rehabilitation. Despite this, clinical outcomes remain variable and a gold standard approach to treatment is lacking. Cases: Here we present four cases of axial and limb functional dystonia who were treated with integrated rehabilitation and improved. The therapy approach and clinical outcomes are described, including videos. Literature review: A literature review evaluated the published treatment strategies for the treatment of functional dystonia. Out of 338 articles, 25 were eligible for review and included mainly case reports and case series. Most patients received more than one treatment modality. Non‐invasive therapies, commonly physiotherapy and psychological approaches were mostly associated with positive outcomes. Multiple treatments commonly used in dystonia were used, including botulinum toxin injections, pharmacotherapy and surgery, leading to variable outcomes. Conclusion: Therapy should be personalized to the clinical presentation. In challenging cases, initiation of a multidisciplinary approach may provide benefit regardless of etiology. Pharmacotherapy should be used judiciously, and surgical therapy should be avoided. [ABSTRACT FROM AUTHOR]