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To evaluate the efficacy and safety of patient-tailored 3D printed brace in the treatment of adolescent idiopathic scoliosis (AIS), and to compare the health-related quality of life (HRQoL) of patients treated with 2 different types of brace. From September 2017 to August 2020, 103 AIS patients requiring non-operative management were prospectively recruited in this study. All patients were followed up every 6 months, clinical and radiologic examination were assessed at each follow-up time. Full-length anteroposterior radiographs of the spine in the standing position were obtained. At the last follow-up, each patient completed a standardized HRQoL questionnaire. Compliance is defined as that the patient insists on wearing the brace for ≥23 hours every day (full-time wearing) and follow-up every 6 months until bone maturity. The rate of major curve Cobb progression was defined that maximum Cobb angle of major curve greater than 6° compared with that at the initial diagnosis, or aggravated to more than 45° so that orthopedic surgery was recommended during treatment, which was defined as the rate of conversion to surgery. The effects of these 2 types of braces on the rate of major curve Cobb progression and HRQoL were analyzed by independent sample t test and χ2 test. The thickness was 4 mm for thoracolumbosacral orthosis (TLSO) and 3 mm for 3D-printed brace (3DPB). In addition, compared with the material used in TLSO, the weight (600–800 g) of the 3DPB materials with the same area is reduced by about 25% to 30%. In our sample, 55 patients (49.1%) and 48 patients (33.1%) were respectively included in the 3DPB cohort and the TLSO cohort. The maximum Cobb angle of major curve in the 3DPB cohort was significantly lower than those in the TLSO cohort at 6 months, 12 months, and the last follow-up (P < 0.01). The thoracic kyphosis (TK) and lumbar lordosis (LL) of the 2 cohorts at the last follow-up were lower than those before brace treatment, in addition, there was a significant difference in TK (P = 0.001) and LL (P = 0.004) between the 2 cohorts at the follow-up. The scores of physical function, pain, self-image, mental health, and treatment satisfaction in the Chinese version of the 22-item questionnaire of the Scoliosis Research Society in the 3DPB cohort were higher than those in the TLSO cohort (P < 0.01 and P < 0.05, respectively). The scores of the 3DPB cohort were significantly higher than those of the TLSO group in the 4 dimensions (P = 0.008, 0.013, 0.015, and 0.002, respectively) of the EuroQol-5D health description system except for mobility, and the overall health status of EuroQol-5D was higher for the 3DPB cohort (P < 0.001). At the last follow-up, 1 patient in the 3DPB cohort and 10 patients in the TLSO cohort had major curve Cobb progression of greater than 6°, and the rate of major curve Cobb progression in the 3DPB cohort was significantly lower than that in the TLSO cohort (OR 14.2, 95% CI 1.7∼115.8, P < 0.01). One patient in the 3DPB and 7 patients in the TLSO cohorts received subsequent surgery or were recommended for surgery, and the rate of conversion to surgery was significantly lower than in the 3DPB cohort (OR 9.2, 95% CI 1.1∼77.9, P < 0.05). A patient-tailored 3D-printed brace is lighter, thinner, and more comfortable than conventional braces in the treatment of AIS. It can substantially improve the HRQoL of patients and can significantly reduce the progression of major curve Cobb progression and rate of conversion of surgery. [ABSTRACT FROM AUTHOR]

Respiratory muscle function is compromised in children recovering from chest wall burns, which potentially leads to more impact on exercise capacity and quality of life. This study investigates the effects of an inspiratory muscle training intervention accompanied with a pulmonary rehabilitation program on respiratory muscle strength, lung function, functional capacity, and quality of life in chest burned children. Forty children with burns, aged from 10 to 18 years old and total body surface area of 30% to 50%, were randomly allocated to the inspiratory muscle training group (IMT- G: n = 20) or control group (CG: n = 20). They received IMT plus pulmonary rehabilitation or pulmonary rehabilitation with sham IMT, respectively for eight weeks. The outcomes were the respiratory muscle strength measured by maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP); lung functions (FEV1, FVC and FEV1/FVC ratio); functional capacity as well as Pediatric Quality of Life to measure physical and psychosocial functioning. outcome measures were assessed at before and after intervention (after eight weeks). Based on the pre-intervention assessments, we found no significant difference between both groups (p > 0.05). Significant post-intervention differences were reported between both groups in MIP (P =.003), MEP (P =.017), FVC (P =.001), FEV 1 (P =.007), FEV 1 /FVC ratio (P =.028), functional capacity (P =.003), physical domain of QoL (P =.006) and psychological domain of QoL (P =.002) in favor of the IMT group. Eight weeks of inspiratory muscle training combined with pulmonary rehabilitation program improved children with chest burns' respiratory muscles strength, lung functions, functional capacity, and quality of life. Inspiratory muscle training may be employed in burn rehabilitation programs. It is a safe and effective therapy in chest burned children. • Inspiratory muscle training with pulmonary rehab improved respiratory muscle strength, lung functions. • Quality of life significantly improved with inspiratory muscle training. • Inspiratory muscle training can be used in burn rehab programs as a safe and effective therapy. [ABSTRACT FROM AUTHOR]

In Japan, the mobility functions of principal arterial roads are hindered by lined-up roadside facilities and densely located signalized intersections. As one of the solutions, it is necessary to consider a functional hierarchy of road networks, based on the structure and traffic operations of each road. The purpose of this study was to propose an index to evaluate the degree to which the road network could be used hierarchically according to their mobility function, based on the location of the bases and the location of roads at each level of the hierarchy, and to propose a method to evaluate the road network using this index. To accomplish this, we proposed a four-level method for the evaluation of the functional hierarchy of road networks based on the derived index values. As a case study, we calculated the degree of hierarchy for the road networks in northern Mie and western Shizuoka. The results showed that the current evaluations of the functional hierarchy in these regions were low, and that introducing mid-level roads was necessary to improve the current situation. The evaluation method proposed in this study will enable us to examine the ideal network configuration for each road in the region to exhibit its mobility function as a preliminary step to studying solutions to various road network issues, such as ensuring the smooth movement between bases and safety. © 2023 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0) Peer-review under responsibility of the scientific committee of the World Conference on Transport Research – WCTR 2023. • Proposed a four-level evaluation method for the functional hierarchy of road networks. • Focused on the utilization rate of road hierarchy according to trip length. • Effective for road planning from the viewpoint of hierarchical road use. [ABSTRACT FROM AUTHOR]

Anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) are proven surgical treatment options for both traumatic and degenerative conditions of the shoulder. Our objective is to report both clinical and patient-reported outcomes (PROs) of patients over the age of 75 at the time of arthroplasty. We hypothesize no functional difference in outcomes between patient groups. Patients over the age of 75 at the time of surgery who received primary aTSA or rTSA between 2009 and 2020 with a minimum of two-year follow-up were selected. A retrospective chart review was performed. Patients 60-75 were included as a control group. 2:1 propensity matching using sex, Charlson Comorbidity Index, preoperative forward elevation (FE), and external rotation (ER) was used in selecting a comparison cohort of patients 60-75. Statistical analysis included the t -test, Wilcoxon signed-rank test, and chi-squared test. For aTSA, 25 patients older than 75 years fit the inclusion criteria. The mean follow-up time was 4.2 (2.0-12.0) years. aTSA patients over the age of 75 had significant improvements in FE 111 to 141 degrees (P =.007), ER 28 to 44 degrees (P <.001), and internal rotation (IR) sacrum to L4 (P =.003). There were also improvements in FE strength (FES) 4+/5 to 5/5 (P =.0303) and IR strength (IRS) but not ER strength (ERS) from 4+/5 to 5/5 (P =.098). There was no significant difference in range of motion (ROM), strength, or PROs between age groups (>75 years vs. 60-74 years). For rTSA, 47 patients older than 75 years fit the inclusion criteria. Average clinical follow-up was 3.5 (2.0-10.6) years. Patients demonstrated ROM improvements in ER (31 to 40 degrees, P =.0413), FE (96 to 138 degrees, P <.001) but not IR (L5 to L4, P =.3509). There were significant improvements in postoperative strength in FES (4-/5 to 4+/5, P <.001), ERS (4-/5 to 4+/5, P <.001), and IRS (4/5 to 5/5, P <.001). The only significant difference between propensity-matched age groups was postoperative IR (L4 to L5, P =.013). There were no significant differences in PROs between different age groups. aTSA and rTSA provide significant improvements in ER, FE, ROM, ERS, FES, and IRS in patients over the age of 75 with no significant difference in outcomes compared to a younger cohort. [ABSTRACT FROM AUTHOR]

This study examines the extent to which depressive symptoms mediate the link between childhood friendship (CF) and physical function among middle-aged and older adults in China. China Health and Retirement Longitudinal Study (CHARLS) data were used; specifically, CHARLS life history survey (conducted from June 1–December 31, 2014) and follow-up health survey (conducted from July 1–September 30, 2015) data were used. The Sobel test, Bootstrap test and multivariable logistic regression were performed to examine the mediating role of depressive symptoms (measured by the 10-item Center for Epidemiologic Studies Depression Scale) in the association between CF (measured by a standardized retrospective questionnaire) and physical function, which was measured by basic activities of daily living (BADL) disability, instrumental activities of daily living (IADL) disability, and grip strength. A total of 12,170 participants aged 45 years or older were included in this cross-sectional study. After controlling for covariates, low-quality CF was associated with an increased prevalence of BADL disability (OR = 1.18; 95 % CI = 1.05–1.32), IADL disability (OR = 1.25; 95 % CI = 1.12–1.40), and low grip strength (OR = 1.21; 95 % CI = 1.09–1.34). The proportion of the mediating effect of depressive symptoms was 48 % for CF and BADL, 40 % for CF and IADL, and 11 % for CF and grip strength. Depressive symptoms and worse CF have a joint effect on BADL disability (OR = 3.30; 95 % CI = 2.82–3.85), IADL disability (OR = 3.52; 95 % CI = 3.03–4.09), and low grip strength (OR = 1.65; 95 % CI = 1.43–1.92). Not all potential confounding factors (such as childhood behavioural problems, genetic factors, and memory function) were measured in the analysis, and there may have been recall bias in the retrospective collection of CF data. Individuals with high-quality CF were more likely to have a decreased prevalence of impaired physical function in later life. Depressive symptoms acted as a mediator associated with the development of CF. • High-quality childhood friendship can protect older people from impaired physical function. • Depression mediates the link between childhood friendship and physical function. • Joint effect of depression and childhood friendship on physical function were found. • We found that depression was more strongly associated with physical function. [ABSTRACT FROM AUTHOR]

Patients with schizophrenia suffer from physical health conditions, culminating in reduced physical functioning with enormous costs for patients and society. Although aerobic endurance and skeletal muscle strength, typically reduced in this population, relate to cognition and function, no study has explored their respective contributions to performance of functional skills and everyday tasks. In a cross-sectional study, 48 outpatients (28/20 men/women; 35 ± 11(SD) years) with schizophrenia spectrum disorders (ICD-10; F20–25) were administered the UCSD Performance-based Skills Assessment-Brief (UPSA-B; functional skills), Specific Level of Functioning (SLOF; functional performance) and the Positive and Negative Syndrome (PANSS) scale. Peak oxygen uptake (V̇O 2peak) was assessed along with leg press maximal muscle strength (1RM) and mechanical power. UPSA-B performance was associated with V̇O 2peak (r = 0.28, p < 0.05), accounting for 8 % (p < 0.05) of shared variance, but was unrelated to 1RM and mechanical power. The SLOF physical functioning domain was associated with V̇O 2peak (r = 0.30, p < 0.05) and 1RM (r = 0.24,p < 0.05), while SLOF personal care (r = 0.27,p < 0.05) and activities (r = 0.30,p < 0.05) were related only to V̇O 2peak. Hierarchical regression analyses revealed that while V̇O 2peak and age combined to account for 20 % (p < 0.05) of the variance in physical functioning, the contribution of 1RM was eliminated after adjusting for age. V̇O 2peak and negative symptoms combined predicted 24 % and 35 % of the variance in personal care and activities, respectively. UPSA-B scores did not add to the prediction of SLOF scores. Although V̇O 2peak and 1RM both relate to functional outcomes, the combination of V̇O 2peak , age, and negative symptoms exert the greatest detrimental influence on functional performance beyond skills deficits. [Display omitted] [ABSTRACT FROM AUTHOR]

Sarcopenia is a disease in which a decline in muscle mass with age is associated with a decline in physical performance. In the field of otorhinolaryngology, head and neck surgery, sarcopenia is gaining attention as a cause of swallowing disorders and as a problem in the treatment of head and neck cancer. Head and neck cancer occurs in anatomical sites related to swallowing, so patients with head and neck cancer are prone to swallowing disorders and "nutrition-related sarcopenia." Since it is a cancer, it also becomes a "disease-related sarcopenia," making it easy for patients to develop secondary sarcopenia. Medical intervention against sarcopenia is important in order to decrease the number of adverse events related to treatments for cases with sarcopenia, with reports stating that proactive exercise and nutritional therapy prior to treatment for cases with sarcopenia contributes to a decrease in serious complications as well as improving the survival rate. It is the same for head and neck cancer patients with sarcopenia, so intervention prior to treatment of head and neck cancer is an area that is expected to see reports in the future. However, if the disease is malignant, it is highly likely that sarcopenia cannot be sufficiently improved due to the short period of time from diagnosis to the beginning of treatment. In this case, choosing a treatment that takes sarcopenia into consideration is another way to handle it. Assessing sarcopenia prior to treatment may help avoid post-treatment pneumonia related to sarcopenia, postoperative complications including fistula, radiation-induced toxicity including swallowing disorders, and chemotherapy-related toxicity, and it is believed to greatly contribute to the prognosis of the overall survival (OS), disease-free survival (DFS), and disease-specific survival (DSS). [ABSTRACT FROM AUTHOR]

• Maximal hip and knee extension muscle strength increased by the training program. • Apathy and anxiety decreased after the 12-week training. • Muscle hypertrophy was induced by resistance training. Myotonic dystrophy type 1 (DM1) is a hereditary disease characterized by muscular impairments. Fundamental and clinical positive effects of strength training have been reported in men with DM1, but its impact on women remains unknown. We evaluated the effects of a 12-week supervised strength training on physical and neuropsychiatric health. Women with DM1 performed a twice-weekly supervised resistance training program (3 series of 6–8 repetitions of squat, leg press, plantar flexion, knee extension, and hip abduction). Lower limb muscle strength, physical function, apathy, anxiety and depression, fatigue and excessive somnolence, pain, and patient-reported outcomes were assessed before and after the intervention, as well as three and six months after completion of the training program. Muscle biopsies of the vastus lateralis were also taken before and after the training program to assess muscle fiber growth. Eleven participants completed the program (attendance: 98.5 %). Maximal hip and knee extension strength (p < 0.006), all One-Repetition Maximum strength measures (p < 0.001), apathy (p = 0.0005), depression (p = 0.02), pain interference (p = 0.01) and perception of the lower limb function (p = 0.003) were significantly improved by training. Some of these gains were maintained up to six months after the training program. Strength training is a good therapeutic strategy for women with DM1. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify causes of quadriceps muscle weakness in facioscapulohumeral muscular dystrophy (FSHD). To this aim, we evaluated quadriceps muscle and fat volumes by magnetic resonance imaging and their relationships with muscle strength and oxidative stress markers in adult patients with FSHD (n = 32) and healthy controls (n = 7), and the effect of antioxidant supplementation in 20 of the 32 patients with FSHD (n = 10 supplementation and n = 10 placebo) (NCT01596803). Compared with healthy controls, the dominant quadriceps strength and quality (muscle strength per unit of muscle volume) were decreased in patients with FSHD. In addition, fat volume was increased, without changes in total muscle volume. Moreover, in patients with FSHD, the lower strength of the non-dominant quadriceps was associated with lower muscle quality compared with the dominant muscle. Antioxidant supplementation significantly changed muscle and fat volumes in the non-dominant quadriceps, and muscle quality in the dominant quadriceps. This was associated with improved muscle strength (both quadriceps) and antioxidant response. These findings suggest that quadriceps muscle strength decline may not be simply explained by atrophy and may be influenced also by the muscle intrinsic characteristics. As FSHD is associated with increased oxidative stress, supplementation might reduce oxidative stress and increase antioxidant defenses, promoting changes in muscle function. [Display omitted] • In FSHD, reduced quadriceps muscle quality is associated with oxidative stress. • Muscle quality participates to the reduction of FSHD quadriceps strength. • FSHD quadriceps muscle quality is improved by antioxidant supplementation. • Antioxidant supplementation improves patient quality of life by increasing physical functioning. [ABSTRACT FROM AUTHOR]

Determine if herniation morphology based on the Michigan State University Classification is associated with differences in (1) patient-reported outcome measures (or (2) surgical outcomes after a microdiscectomy. Adult patients undergoing single-level microdiscectomy between 2014 and 2021 were identified. Demographics and surgical characteristics were collected through a query search and manual chart review. The Michigan State University classification, which assesses disc herniation laterality (zone A was central, zone B/C was lateral) and degree of extrusion into the central canal (grade 1 was up to 50% of the distance to the intra-facet line, grade >1 was beyond this line), was identified on preoperative MRIs. patient-reported outcome measures were collected at preoperative, 3-month, and 1-year postoperative time points. Of 233 patients, 84 had zone A versus 149 zone B/C herniations while 76 had grade 1 disc extrusion and 157 had >1 grade. There was no difference in surgical outcomes between groups (P > 0.05). Patients with extrusion grade >1 were found to have lower Physical Component Score at baseline. On bivariate and multivariable logistic regression analysis, extrusion grade >1 was a significant independent predictor of greater improvement in Physical Component Score at three months (estimate = 7.957; CI: 4.443–11.471, P < 0.001), but not at 1 year. Although all patients were found to improve after microdiscectomy, patients with disc herniations extending further posteriorly reported lower preoperative physical function but experienced significantly greater improvement three months after surgery. However, improvement in Visual Analog Scale Leg and back, ODI, and MCS at three and twelve months was unrelated to laterality or depth of disc herniation. [ABSTRACT FROM AUTHOR]

To determine how depression state impacts postoperative Patient-Reported Outcomes Measurement Information System (PROMIS) scores and achievement of minimum clinically important difference (MCID) following lumbar fusion. Depression has been shown to negatively impact outcomes following numerous orthopedic surgeries. Situational and major clinical depression can differentially affect postoperative outcomes. Adult patients undergoing elective 1–3 level lumbar fusion were reviewed. Patients with a formal diagnosis of major depression were classified as "clinically depressed" whereas patients with at least "mild" PROMIS Depression scores in the absence of formal depression diagnosis were deemed "situationally depressed." analysis of variance testing was used to assess differences within and between groups. Multivariate regression was used to identify features associated with the achievement of MCID. Two hundred patients were included. The average age was 65.9 ± 12.2 years. 75 patients (37.5%) were nondepressed, 66 patients (33.0%) were clinically depressed, and 59 patients (29.5%) were situationally depressed. Situationally depressed patients had worse preoperative physical function (PF) and pain interference (PI) scores and were more likely to have severe symptoms (P = 0.001, P = 0.001). All groups improved significantly from preoperative baseline scores. All groups met MCID PF at different rates, with highest proportion of situationally depressed reaching this metric (P = 0.03). Rates of achieving MCID PI were not significantly different between groups (P = 0.47). Situational depression was predictive of achieving MCID PF (P = 0.002) but not MCID PI. Our study investigated the relationship between depression and postoperative PROMIS scores and identified situationally depressed patients as having the worst preoperative impairment. Despite this, the situationally depressed cohort had the highest likelihood of achieving MCID PF, suggestive of a bidirectional relationship between lumbar degenerative disease and subclinical, situational depression. These findings may help guide preoperative counseling on expectations, and patient selection. [ABSTRACT FROM AUTHOR]

Although many studies indicate that individuals who have experienced a traumatic event can experience posttraumatic growth (PTG), some researchers have questioned the significance of PTG in associations with functioning. The role of PTG in functioning following trauma may be better elucidated by accounting for its joint effects with posttraumatic stress disorder (PTSD) symptoms. Data were analyzed from the National Health and Resilience in Veterans Study, which surveyed a nationally representative sample of 3847 trauma-exposed U.S. veterans. Participants completed assessments of potentially traumatic events, PTSD symptoms, and PTG, as well as a broad range of sociodemographic, military, trauma, health, personality, and psychosocial characteristics. PTG was independently and moderately associated with higher mental, cognitive, and psychosocial functioning, but not physical functioning. Results showed a similar pattern of findings when examining relations between subdomains of PTG and these aspects of functioning. Additionally, among veterans who screened positive for PTSD, those who endorsed PTG reported higher levels of mental, cognitive, and/or psychosocial functioning than those who did not endorse PTG. Findings may be limited by the use of a cross-sectional design, retrospective self-reports of PTG, and a predominantly older white male veteran sample. Results provide support for the functional significance of PTG and highlight the importance of considering PTSD symptoms to better understand the role of PTG in functioning. Clinical interventions to foster PTG may help promote post-trauma functioning. • Posttraumatic growth (PTG) was associated with better mental, cognitive, and psychosocial, but not physical, functioning • Certain subdomains of PTG may be more strongly associated with particular indices of functioning • PTG moderated the effects of PTSD symptoms on mental, cognitive, and psychosocial functioning [ABSTRACT FROM AUTHOR]

In people with Parkinson's disease, what is the effect of adding external cueing (ie, visual, auditory or somatosensorial cueing) to walking training compared with walking training alone in terms of walking, mobility, balance, fear of falling and freezing? Are any benefits carried over to participation or maintained beyond the intervention period? Systematic review of randomised trials with meta-analysis. Ambulatory adults with Parkinson's disease. Walking training with external cueing compared with walking training without external cueing. Walking (ie, speed, stride length and cadence), mobility, balance, fear of falling, freezing and participation. Ten trials involving a total of 309 participants were included. The mean PEDro score of the included trials was 5 (range 4 to 8). Walking training with auditory cueing improved walking speed by 0.09 m/s (95% CI 0.02 to 0.15) more than walking training alone. Although the best estimate was that auditory cueing may also improve stride length by 5 cm, this estimate was imprecise (95% CI –2 to 11). The addition of visual cueing to walking training did not improve walking speed or stride length. Results regarding cadence, mobility, balance, fear of falling, and freezing and maintenance of benefits beyond the intervention period remain uncertain. This systematic review provided low-quality evidence that walking training with auditory cueing is more effective than walking training alone for improving walking speed in Parkinson's disease. Cueing is an inexpensive and easy to implement intervention, so the mean estimate might be considered clinically worthwhile, although the confidence interval spans clinically trivial and worthwhile effects. PROSPERO CRD42021255065. [ABSTRACT FROM AUTHOR]

Adult spinal deformity (ASD) significantly impacts the quality of life due to three-dimensional spinal abnormalities. Patient-reported outcome measures, such as the Patient-Reported Outcomes Measurement Information System (PROMIS-29), play a crucial role in assessing postoperative outcomes. This study aims to investigate trends in PROMIS-29 scores over 36 months in patients undergoing long-segment thoracolumbar fusion for ASD and provide insights into its long-term utility. A retrospective study including 163 ASD patients undergoing long-segment thoracolumbar fusion was conducted. PROMIS-29 scores were collected at baseline and at postoperative (0-), 3-, 6-, 12-, 18-, 24-, 30-, and 36-month follow-ups. Statistical analyses was performed to assess significant score changes from baseline and in consecutive recordings. Significant improvements in all PROMIS-29 categories were observed at 36 months, with the greatest changes in pain intensity (−35.19%, P < 0.001), physical function (+29.13%, P < 0.001), and pain interference (−28.8%, P < 0.001). Between the 0 and 3 month mark, the greatest significant changes were recorded in pain intensity (−26.5%, P < 0.001), physical function (+24.3%, P < 0.001), and anxiety (−16.9%, P < 0.018). However, scores plateaued after the 3-month mark, with zero categories showing significant changes with subsequent consecutive recordings. PROMIS-29 scores demonstrated notable improvements in ASD patients particularly in pain intensity, pain interference, and physical function. However, scores plateaued beyond the 3-month mark, suggesting PROMIS-29's limited sensitivity to nuanced changes in long-term patient recovery. Future investigations exploring optimal combinations of patient reported outcome measures for comprehensive short- and long-term outcome assessments in ASD surgery would be beneficial. [ABSTRACT FROM AUTHOR]

The prevalence of neuropathic pain (NP) in burn patients is reported in the literature to be as high as 80% 1 . Given the complexity of NP in burn patients and the wide range of treatments available, a systematic review of the literature is warranted to summarize our current understanding of management and treatment of NP in this population. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. The following databases were queried to identify relevant articles: PubMed, Cochrane, Embase, Scopus, Ovid, and Web of Science. The main outcome measures were incidence and management of NP. Secondary outcomes included risk factors for NP. Included articles presented findings from 11 different countries, capturing outcomes for 4366 patients. Risk factors for neuropathic pain in burn patients were identified, including older age, alcohol and substance abuse, current daily smoking, greater % total body surface area burns (TBSA), and longer hospitalizations. Pharmacologic treatments included gabapentin/pregabalin (n = 7), ascorbic acid (n = 1), and lidocaine (n = 1). Overall, the studies showed varied results regarding the efficacy of pharmacological treatments. While certain studies demonstrated gabapentanoids to be effective in reducing neuropathic symptoms, others found conflicting results. With regards to non-pharmacologic treatments, electroconvulsive therapy (n = 1), electropuncture (n = 1), nerve release/reconstruction (n = 2), and somatosensory feedback rehabilitation (n = 1) were used and demonstrated promise in reducing pain intensity and improving functionality. Despite NP afflicting the majority of burn patients long after their injury, this systematic review demonstrates insufficient evidence on the pathophysiology, outcomes, and risk factors in NP, as well as the efficacy of various therapies. Future prospective and randomized studies evaluating the etiology of these factors can substantially improve our treatment strategies. This can allow for the development of well-delineated and evidence-based protocols in NP management in hopes of improving quality of life and both psychological and physical function in burn patients. • Neuropathic pain (NP) is a common and debilitating condition in burn patients. • Risk factors for NP include age, alcohol/substance use, and burn severity. • Evidence remains insufficient or understanding NP's mechanisms and treatments. [ABSTRACT FROM AUTHOR]

• This is the first study to assess brain rs-FC in older masters athletes (MA). • Higher rs-FC within cognitive regions in MA compared to controls. • Higher rs-FC within motor regions in MA compared to controls. • Less rs-FC between cognitive and motor regions in MA compared to controls. • Aging-related rs-FC segregation patterns are attenuated in top-ranked athletes. Aging is characterized by a decline in physical and cognitive functions, often resulting in decreased quality of life. Physical activity has been suggested to potentially slow down various aspects of the aging process, a theory that has been supported by studies of Masters Athletes (MA). For example, MA usually have better cognitive and physical functions than age-matched sedentary and healthy older adults (OA), making them a valuable model to gain insights into mechanisms that promote physical and cognitive function with aging. The purpose of this study was to identify differences in resting-state functional connectivity (rs-FC) of motor and cognitive regions between MA and OA and determine if these differences in the resting brain are associated with differences in cognitive and physical performance between groups. Fifteen MA (9 males) and 12 age-matched OA (six males) were included. rs-FC images were compared to identify significant between-groups differences in brain connectivity. There was higher connectivity between the cognitive and motor networks for the OA group, whereas the MA group had stronger connectivity between different regions within the same network, both for the cognitive and the motor networks. These results are in line with the literature suggesting that aging reduces the segregation between functional networks and causes regions within the same network to be less strongly connected. High-level physical activity practiced by the MA most likely contributes to attenuating aging-related changes in brain functional connectivity, preserving clearer boundaries between different functional networks, which may ultimately favor maintenance of efficient cognitive and sensorimotor processing. [ABSTRACT FROM AUTHOR]

Traditional methods for assessing lower body strength and balance, particularly in older individuals, lack objective and comprehensive analysis. The Up-Down Hop Test is widely used, yet leveraging mobile device sensors, specifically accelerometers and gyroscopes, can enhance the effectiveness of the Up-Down Hop Test by providing an objective evaluation of lower body strength, balance, and neuromuscular control. This study involved attaching mobile devices to participants during the Up-Down Hop Test. Data from the sensors were analyzed to assess patterns of body imbalance and fatigue, focusing on older participants. Integrating mobile sensor data offered insights into the participants' physical performance, revealing specific patterns of imbalance and fatigue. Although traditional assessment methods can observe these patterns, they lack measurability and auditability when evaluating the physical performance of older adults. The experimental results, obtained from analyzing data from mobile device sensors during the Up-Down Hop Test, revealed patterns of imbalance. These findings can be utilized in health monitoring and targeted intervention scenarios, specifically those aimed at enhancing physical performance and preventing injuries. [ABSTRACT FROM AUTHOR]

Little research has been done to evaluate the prognostic value of short-term postoperative patient-reported outcomes (PROs) on long-term PROs following lumbar decompression (LD). We evaluated the prognostic value of short-term PROs on long-term PROs through 2 years after LD. A single spine surgeon database was retrospectively queried for patients undergoing primary LD with 6-week postoperative PROs reported. The demographics, perioperative traits, and preoperative, 6-month, 1-year, and 2-year PROs were recorded. The PROs included the visual analog scale (VAS) for back pain, VAS for leg pain, PRO measure information system for physical function (PROMIS-PF), and Oswestry disability index. Two-step multivariate linear regression was performed to determine the predictive value of 6-week PROs for the 6-month, 1-year, and 2-year PROs. A total of 277 patients were included. The 6-week Oswestry disability index, VAS for leg pain, and 9-item patient health questionnaire (PHQ-9) are all positive predictors for their respective outcomes at 6 months. Additionally, the 6-week PROMIS-PF was a negative predictor of the 6-month PHQ-9. The 6-week PROMIS-PF positively predicted the PROMIS-PF through 1 year, and the PHQ-9 was a positive predictor of the PHQ-9 at 1 and 2 years postoperatively. The 6-week postoperative PROs are predictive of the same outcomes at 6 months, the PROMIS-PF is predictive through 1 year, and the PHQ-9 is predictive through 2 years. Determining the predictive value of early postoperative PROs can be helpful in understanding the likely postoperative trajectory following LD and informing patient expectations. [ABSTRACT FROM AUTHOR]

Heterotopic ossification (HO), or ectopic bone formation in soft tissue, is a not so rare and poorly understood debilitating sequela of burn injury. Individuals developing HO following burn injuries to their hands often experience reductions in mobility, significant contractures, and joint pain. This study identifies demographic characteristics of individuals who develop HO and compares their physical and psychosocial outcomes to the general burn population. Participant demographics, injury characteristics, and PROMIS-29 scores across three time points (discharge, six- and 12- months after injury) were extracted from the Burn Model System National Longitudinal Database representing participants from 2015–2022. Mixed-effects linear regression models were used to compare PROMIS scores across all three longitudinal measurements. Models were adjusted for age, sex, race/ethnicity, HO status, and burn size. Of the 861 participants with data concerning HO, 33 were diagnosed with HO (3.8% of participants). Most participants with HO were male (n = 24, 73%) and had an average age of 40 + /− 13 years. Participants with HO had significantly larger burn size (49 +/−23% Total Body Surface Area (TBSA)) than those without HO (16 +/−17%). Participants with HO reported significantly worse physical function, depression, pain interference and social integration scores than those without HO. After adjusting for covariables, participants with HO continued to report statistically significantly worse physical function than those without HO. Although physical functioning was consistently lower, the two populations did not differ significantly among psychosocial outcome measures. While HO can result in physical limitations, the translation to psychosocial impairments was not evident. Targeted treatment of HO with the goal of maximizing physical function should be a focus of their rehabilitation. 2b Symptom Prevalence Study • Those with heterotopic ossification (HO) had larger burn sizes than those without. • This study highlights physical limitations that burn patients with HO face. • Those with HO do not report worse psychosocial outcomes than those without. [ABSTRACT FROM AUTHOR]

Topography complicates the illumination distribution over rugged terrains and hinders the applications of surface reflectance data over mountainous areas. Topographic correction is an essential process to remove the topographic effects in surface reflectance data. This study proposed a Physical model and image Simulation-based topographic Correction method (PSC) for atmospherically corrected surface reflectance images. In contrast with traditional methods, the proposed approach explicitly estimates the illumination distribution over rugged terrains based on image information and then corrects the topographic effects following physical laws. The proposed method was validated and compared with existing well-performed topographic correction methods, including path length correction (PLC), sun-canopy-sensor correction with c factor (SCSC), C correction (CC), and statistical empirical correction (SE). Simulated and satellite data obtained at different times and geolocations are used for evaluation and comparison. The results demonstrated that most existing methods face challenges in removing the biases induced by topography in surface reflectance images. The PLC method failed to obtain reasonable results for faint illumination conditions when the sun zenith angle is high. SE showed relatively poor performance in terms of physical consistency and outlier percentage. Besides, all the traditional methods failed in the correction of cast shadow regions. Comparably, our method consistently demonstrated superior performance in physical consistency, cast shadow correction, and outlier percentage across various regions, encompassing different sun zenith angles and illumination conditions. The proposed method offers an effective and physically consistent approach for the topographic correction of surface reflectance images, facilitating multi-temporal applications over mountainous areas. [ABSTRACT FROM AUTHOR]

In recent years, the incidence of spinal epidural abscesses (SEA) has tripled in number and nonoperative management has risen in popularity. While there has been a shift towards reserving surgical intervention for patients with focal neurologic deficits, a third of patients will still fail medical management and require surgical intervention. Failure to understand long-term quality of life and functional outcomes hinders effective decision making and prognostication. To describe patterns and associated factors impacting long-term quality of life following treatment of spinal epidural abscess. Multicenter cohort study at two urban academic tertiary referral centers and two community centers. Adult patients treated for a spinal epidural abscess. EuroQoL 5-Dimension 5L (EQ5D), Neuro-Quality of Life Lower Extremity – Mobility (Short Form; NeuroQoL-LE), Patient-Reported Outcomes Measurement Information System Physical Function (short form 4a; PROMIS PF), and PROMIS Global Mental Health score (PROMIS Mental). Eligible patients were enrolled and administered questionnaires. Multivariable analysis assessed the influence of ambulatory status on HRQL, adjusting for covariates including age, biologic sex, Charlson comorbidity index, intravenous drug use, management approach, and ASIA grade on presentation. Sixty-one patients were enrolled (mean age 60.5 years, 46% male). Thirty-four patients (58%) underwent operative management. Mean standard deviation (SD) results for HRQL measures were: EQ5D 0.51 (0.37), EQ5D visual analogue scale 60.34 (25.11), NeuroQoL Lower extremity 41.47 (10.64), PROMIS physical function 39.49 (10.07), and PROMIS Global Mental Health 44.23 (10.36). Adjusted analysis demonstrated ambulatory status at presentation, and at 1 year, to be important drivers of HRQL, irrespective of other factors including IVDU and ASIA grade. Patients with independent ambulatory function at 1 year had mean EQ5D utility of 0.65 (95% CI 0.55, 0.75), whereas those requiring assistive devices saw a 49% decrease with mean EQ5D utility of 0.32 (0.14, 0.51). Ambulatory status was associated with global and physical function but did not impact overall health self-assessment or mental health scores. We found that ambulatory status was the most important factor associated with long-term HRQL regardless of other factors such as ASIA grade or IVDU. Given prior literature demonstrating the protective effect of operative intervention on ambulatory function, this highlights ambulatory dysfunction as a potential indication for surgery and a marker of poor long-term prognosis, even in the absence of focal neurologic deficits. Our work also highlights the importance of optimized long-term rehabilitation strategies aimed to preserve ambulatory function in this high-risk population. Level III, cohort study [ABSTRACT FROM AUTHOR]

The temporal evolution of HRQoL and the importance of other PROs to patients, following resection for pancreatic and peripancreatic malignancy remains unexplored. Patients undergoing pancreatic resection between 2021 and 2022 were enrolled from 2 UK HPB centres. Patients completed the EORTC QLQ-C30, QLQ-PAN26 tools and rated 56 PROs preoperatively (T1), at discharge (T2), 6-weeks (T3), 3-months (T4) and 6-months (T5) postoperatively. ANOVA followed by post-hoc analysis was used to examine patterns in HRQoL through time. Multivariable ANOVA was used to identify impact of clinical factors on HRQoL. 63 patients were recruited [median age, 72 (IQR 41–85); 39/63 male]. Physical functioning declined from 70.4 (26.2) at T1 to 53.5 (20.9) at T2 (p = 0.016). Global QoL score increased significantly from 41.0 (23.0) at T2 to 60.0 (26.1) at T5 (p = 0.007), as did role functioning [21.1 (27.9) at T2 to 59.4 (32.8) at T5, p < 0.001]. Chemotherapy status and the postoperative complications did not significantly change HRQoL. General QoL and health were the only PROs rated as 'very important' (scores 7–9) by more than 80 % of participants at five time-points. Recuperation of HRQoL measures is seen at 6-months postoperative and was not affected by chemotherapy or postoperative complications. Notably, PROs important to patients varied over time. [ABSTRACT FROM AUTHOR]

Background: Osteoarthritis (OA) can cause disability and reduce quality of life (QoL). Objectives: This study aimed to determine whether GreenShell mussel (GSM) powder (PERNAULTRA) consumption was more effective than placebo at improving physical performance and subjective measures of symptoms and function in adults with early signs of knee OA. Methods: The Researching Osteoarthritis and GSM study was a 6-mo randomized, double-blind, placebo-controlled trial in adults aged 55-80 y, screened for signs of OA (n = 120, 65.9 ± 6.43 y, 63% female). Participants consumed either 3 g of powdered whole GSM or placebo (pea protein) daily. Baseline and end data collection included 30-s chair stand, stair test, 40-m fast-paced walk test, Knee Injury and Osteoarthritis Outcome Score (KOOS) questionnaire categorized into 5 subscales [pain (P), symptoms except pain (S), function in activities of daily living (ADL), function in sports/recreation (SP), and QoL], a measure of Intermittent and Constant Osteoarthritis Pain, and visual analog scale of pain and symptoms. Results: Visual analog scale symptoms showed a significantly greater reduction in percentage change for GSM than that for placebo [-28.1 (-59.2, 43.2) compared with 0.00 (-28.6, 100); P = 0.03]. Further, a trend for improvement in percentage change for GSM compared with placebo was seen in 40m fast-paced walk [2.51 (-3.55, 8.12) compared with 0.20 (-6.58, 4.92); P = 0.09], KOOS-SP [11.4 (-4.48, 27.0) compared with 0.00 (-11.1, 17.7); P = 0.09], and Intermittent and Constant Osteoarthritis Pain intermittent pain scale [-27.7 (-77.3, 0.00) compared with -14.6 (-50.0, 36.4); P = 0.08]. In those with body mass index (BMI; in kg/m²) <25, GSM consumption significantly improved KOOS-S compared with placebo [6.35 (3.49, 12.7) compared with 0.00 (-4.65, 4.49); P = 0.03] and showed a trend for improvement in KOOS-ADL [3.29 (1.01, 8.79) compared with 1.01 (-5.75, 4.30); P = 0.07]. Those with BMI of >25, consuming GSM showed a trend for improvement in KOOS-SP [13.6 (-4.76, 33.3) compared with 0.00 (-12.5, 20.0); P = 0.07]. Conclusions: This research suggests consumption of GSM has potential to alleviate symptoms and improve functionality in OA. [ABSTRACT FROM AUTHOR]

It is unclear about whether the oral health has impact on physical performance. Therefore, this study aimed to examine the association between oral health and physical performance in 300 military adults in Taiwan. Oral health was assessed by the presence of periodontitis and dental caries. The status of cardiorespiratory and muscular endurance capacity was respectively assessed by tertiles of time for a 3000-m run and 2-min push-up numbers. Multivariable logistic and linear regression analyses with adjustments for age, smoking, alcohol drinking, blood pressure, anthropometric variables, lipid profile, fasting glucose and physical activity were used to determine the association. Participants with periodontitis were more likely to have worse 3000-m running performance classified in the lowest tertile [odds ratio (OR) and 95% confidence interval: 1.94 (1.03, 3.66)]. Participants with any dental caries were more likely to have worse push-ups performance classified in the lowest tertile [OR: 2.50 (1.27, 4.92)]. In linear regression analyses, dental caries numbers were inversely correlated with 2-min push-ups numbers [β = −1.04 (−2.07, −0.01)]. This study suggests that oral health is crucial to maintain physical fitness, and dental caries and periodontitis may affect differently on aerobic and muscular endurance capacities. [ABSTRACT FROM AUTHOR]

Up to 50 % of patients surviving a pulmonary embolism (PE) report persisting shortness of breath, reduced physical capacity and psychological distress. As the PE population is heterogeneous compared to other cardiovascular patient groups, outcome measures for assessing physical capacity traditionally used in cardiac populations may not be reliable for the PE population as a whole. This scoping review aims to 1) map performance-based outcome measures (PBOMs) used for assessing physical capacity in PE research, and 2) to report the psychometric properties of the identified PBOMs in a PE population. The review was conducted according to the Joanna Briggs Institute framework for scoping reviews and reported according to the PRISMA-Extension for Scoping Reviews guideline. The systematic search of five databases identified 4585 studies, of which 243 studies met the inclusion criteria. Of these, 185 studies focused on a subgroup of patients with chronic thromboembolic pulmonary hypertension. Ten different PBOMs were identified in the included studies. The 6-minute walk test (6MWT) and cardiopulmonary exercise test (CPET) were the most commonly used, followed by the (Modified) Bruce protocol and Incremental Shuttle Walk test. No studies reported psychometric properties of any of the identified PBOMs in a PE population. Publication of studies measuring physical capacity within PE populations has increased significantly over the past 5–10 years. Still, not one study was identified, reporting the validity, reliability, or responsiveness for any of the identified PBOMs in a PE population. This should be a priority for future research in the field. • Up to 50 % of patients surviving PE experience reduced physical capacity. • 243 studies were identified measuring physical capacity. • Of ten identified physical performance measures, the 6-minute walk test was most common. • No physical performance measure has been validated for use in a PE population. [ABSTRACT FROM AUTHOR]

To identify factors associated with sexual interest and activity among adults with spina bifida and to describe the sexual profile of those who were sexually active. Sexual health of adults with spina bifida is often neglected and current knowledge on the topic is limited. An anonymous web-based survey was advertised and administered between March 2018 and September 2018 and participants 16 years and older with spina bifida were included in this study. Respondents were asked about sexual interest, activity, and function using the validated Patient-Reported Outcomes Measurement Information System Sexual Function Profile. Bivariate and multivariable models with ordinal logistic regression were fitted to evaluate predictors of sexual interest and sexual function. Of the 261 respondents with a self-reported diagnosis of spina bifida (mean age of 38.5 years), 73.2% noted at least a little bit of interest in sexual activity. In multivariate analysis, women were less likely to report higher sexual interest than men (odds ratio (OR) = 0.53, 95% CI 0.31-0.92, P =.03) whereas those with higher physical functioning were more likely to have higher sexual interest (OR = 1.04, confidence interval (CI) 1.01-1.07, P =.03). Just less than half of respondents (46.4%) were sexually active in the past 30 days, and those with a ventriculoperitoneal shunt were less likely to engage in sexual activity compared to those without (OR = 0.36, 95% CI 0.19-0.68; P <.01). The mismatch between sexual interest and sexual activity highlights the importance of exploring issues related to sexual health when counseling adult patients with spina bifida. [ABSTRACT FROM AUTHOR]

Head injury and strangulation are highly prevalent in intimate partner violence (IPV) contexts, but there is little research examining the potential implications of these injuries on physical health and functional status. This pilot study explored the extent to which injury type (head injury, strangulation) and severity (no injury, subconcussive head injury, traumatic brain injury; no strangulation, strangulation, strangulation with loss of consciousness) were associated with biomarkers of cardiometabolic health and self-reported functioning among female survivors of IPV. Participants were 51 individuals assigned female at birth who experienced IPV during their lifetime and screened positive for probable posttraumatic stress disorder (PTSD) on the PTSD Checklist for DSM-5 (average age = 32.6 years, SD = 7.1). Head injury was associated with statistically significant increases in blood glucose levels (p =.01, d = 1.10). Shifts toward more high-risk values with moderate-strong effect sizes were also found in high-density lipoprotein, low-density lipoprotein, and waist-to-hip ratio (p s:.06–.13; d s: 0.51–1.30). Strangulation was associated with increased cholesterol levels, with a moderate effect size (p =.20, d = 0.59). Regression models accounting for age, education, PTSD symptoms, childhood trauma, strangulation, and head injuries predicted functional disability status (R 2 = 0.37, p <.01) and several of its associated domains: cognition (R 2 = 0.34, F(8,42) = 2.73, p =.01), mobility (R 2 = 0.47, F(8,42) = 4.82, p <.001), and participation in society (R 2 = 0.33, F(8,42) = 2.59, p =.02). Findings suggest the need to develop integrated treatments that address physical health comorbidities among female survivors of IPV with a history of head injury to improve daily function and quality of life. [ABSTRACT FROM AUTHOR]

The Patient-Reported Outcomes Measurement Information System (PROMIS) measure, which assesses past week status of seven domains (physical function mobility, anxiety, depressive symptoms, fatigue, peer relationships, pain interference, and pain intensity), represents a new paradigm using patient-reported outcomes. We used a data-driven approach with PROMIS to identify subgroups of youths receiving depression treatment. Youths (n = 721) enrolled in the Texas Youth Depression and Suicide Research Network who completed the PROMIS were analyzed. Latent class analyses (LCAs) identified subgroups and compared their baseline clinical/sociodemographic features. Compared to population norms, our sample had worse than average physical function, anxiety, depression, fatigue, and pain interference. Using LCA, four subgroups were identified: 1) lower symptom severity and higher physical functioning (14.6 %); 2) higher symptom burden, higher pain interference/intensity, and lower physical functioning (52.7 %); 3) higher symptom burden, higher pain interference/intensity, but with higher physical functioning (9.2 %); and 4) higher symptom burden, but lower physical functioning and pain interference/intensity (23.6 %). Group 3 demonstrated higher resilience than Group 2. In contrast, Group 2 had higher anxiety than Group 4. Individuals may have different symptom profiles due to the observational nature of the study. Replication of these subgroups may be difficult, as future samples may differ in these characteristics. Further work may demonstrate the stability of these groups. A data-driven analysis identified a small but significant subgroup with high physical functioning despite high symptom burden and pain, and this group reported higher resilience. Resilience-enhancing interventions may help improve functional outcomes in depressed youth. • Latent class analysis used PROMIS scores from depressed youth to create subgroups. • Subgroups had different profiles of symptom burden, pain, and physical functioning. • Resilience seemed to protect functioning in a group with high symptom burden/pain. [ABSTRACT FROM AUTHOR]

• 47% of Long-COVID autonomic syndrome patients exhibit autonomic-related symptoms and reduced quality of life at 6 months and one-year follow-ups. • Long-COVID autonomic syndrome individuals had symptom spike during acute phase, remission at 3 months, and recurrence at 6 and 12 months post-discharge. • The study's novel findings emphasize the importance of early implementation of rehabilitative and pharmacological interventions after SARS-CoV-2 infection. Long-COVID syndrome is characterized by fatigue, orthostatic intolerance, tachycardia, pain, memory difficulties, and brain fog, which may be associated with autonomic nervous system abnormalities. We aimed to evaluate the short and long-term course of COVID-19 autonomic symptoms and quality of life (QoL) after SARS-CoV-2 infection through a one-year follow-up combined with validated questionnaires. Additionally, we aimed to identify patients with worsening autonomic symptoms at 6 and 12 months by dividing the patient cohort into two sub-groups: the Post-COVID healed Control sub-group (total score<16.4) and the Long-COVID autonomic syndrome sub-group (total score>16.4). This prospective cohort studied 112 SARS-CoV-2 positive patients discharged from Humanitas Research Hospital between January and March 2021. Autonomic symptoms and QoL were assessed using the composite autonomic symptom scale 31 (COMPASS-31) and Short Form Health Survey (SF-36) questionnaires at various time points: before SARS-CoV-2 infection (PRE), at hospital discharge (T0), and at 1 (T1), 3 (T3), 6 (T6), and 12 (T12) months of follow-up. COMPASS-31 total score, Orthostatic Intolerance and Gastrointestinal function indices, QoL, physical functioning, pain, and fatigue scores worsened at T0 compared to PRE but progressively improved at T1 and T3, reflecting the acute phase of COVID-19. Unexpectedly, these indices worsened at T6 and T12 compared to T3. Subgroup analysis revealed that 47% of patients experienced worsening autonomic symptoms at T6 and T12, indicating Long-COVID autonomic syndrome. Early rehabilitative and pharmacological therapy is recommended for patients at the T1 and T3 stages after SARS-CoV-2 infection to minimize the risk of developing long-term autonomic syndrome. [ABSTRACT FROM AUTHOR]

Ankle–foot-complex mobility impairments, which can be assessed by the difference between the sitting and standing positions, are related to an increase in the load on the knee and hip joints during the stance phase of the gait. What is the relationship between the ankle–foot-complex mobility during static weight bearing and the mechanical stresses on the knee and hip joints throughout the stance phase? Ankle–foot-complex mobility and gait data were collected from 26 healthy adults. The complex mobility was established by comparing the foot indices, measured using a three-dimensional foot scanner, in sitting and standing positions. The gait data were acquired using eight cameras (recording at 100 Hz) and three force plates (recording at 1000 Hz). Stance phase data were collected via ground reaction forces. The stance phase was dissected into shock absorption and propulsion phases, during which the external knee and hip adduction moment impulses (KAMi, HAMi) were recorded. The correlation between the ankle–foot-complex mobility during static weight bearing and KAMi and HAMi during the stance phase was examined using Pearson's product–moment correlation coefficients. This study revealed that KAMi correlated with medial malleolus mobility (r = −0.44) throughout the stance phase. Furthermore, in the propulsive phase, KAMi correlated with calcaneus (r = 0.51) and navicular (r = −0.50) mobilities, whereas HAMi correlated with calcaneus mobility (r = −0.40). The study provides insights into the relationship between the static mobility of the ankle–foot complex in healthy individuals and mechanical stress during the stance phase. Calcaneus and navicular mobilities were related to efficient push-off in the propulsive phase. Medial malleolus mobility was related to the control of the lateral tilt of the lower limb and ankle dorsiflexion motion throughout the stance phase. • Hind- and mid-foot mobility contribute to knee and hip mechanical stress during gait. • Medial malleolus mobility linked to lateral tilt of lower limb and ankle dorsiflexion. • Maintaining calcaneus inversion and navicular mobility crucial for push-off propulsion. [ABSTRACT FROM AUTHOR]

Dystrophin, a protein crucial for various brain regions governing higher-order functions like learning and memory is notably absent in individuals with Duchenne muscular dystrophy (DMD). This absence of dystrophin in the brain is believed to underlie cognitive challenges in DMD. Cognitive and motor challenges observed in DMD could potentially hinder the execution of dual tasks. Is there a significant correlation between dual-task performance, functional mobility, and balance in children with DMD? The study included 28 participants (14 DMD, 14 typical development). Timed Up and Go (TUG) test results were recorded for single and dual-task conditions (motor-motor, cognitive-motor). Functional level was assessed using Motor Function Measurement-32 (MFM-32), Brooke Upper Extremity Scale, and Vignos Scale. Balance was evaluated using Balance Master System and Pediatric Functional Reach Test (PFRT). Significant differences in TUG test scores across conditions were observed in both DMD and typical development groups (p < 0.05). Children with DMD exhibited longer completion times compared to typical development children (p < 0.05). Among children with DMD, there was a significant correlation between TUG scores in different task conditions and balance assessment (p < 0.05, r = 0.571 to −0.819). Lower MFM-32 scores in DMD children were correlated with worse TUG performance across conditions (p < 0.05, r = 0.586 to −0.868). This study sheds light on the multifaceted nature of dual-tasking challenges in individuals with DMD, thereby contributing to a deeper understanding of the implications for rehabilitation strategies. [Display omitted] • Dual-task conditions deteriorated functional mobility of children with DMD and typical development. • The cognitive-motor dual-task has the greatest impact on functional mobility. • DMD population shows lower single- and dual-task performance than healthy children. • In DMD, better balance associated with improved single- and dual-task performance. • In DMD, high functional level correlated with improved single- and dual-task performance. [ABSTRACT FROM AUTHOR]

Assessment of gait function in People with Parkinson Disease (PwPD) is an important tool for monitoring disease progression in PD. While comprehensive gait analysis has become increasingly popular, only one study, Hass et al. (2014), has established minimal clinically important differences (MCID) for one spatiotemporal variable (velocity) in PwPD. What are the MCIDs for velocity and additional spatiotemporal variables, including mean, variability, and asymmetry of step length, time, and width? As part of a larger clinic-based initiative, 382 medicated, ambulatory PwPD walked on an instrumented walkway during routine clinical visits. Distribution and anchor-based methods (Unified Parkinson's Disease Rating Scale-III, Modified Hoehn and Yahr, and the mobility subsection of the Parkinson Disease Questionnaire) were used to calculate MCIDs for variables of interest in a cross-sectional approach. Distribution measures for all variables are presented. Of nine gait variables, four were significantly associated with every anchor and pooled to the following values: velocity (8.2 cm/s), step length mean (3.6 cm), step length variability (0.7%), and step time variability (0.67%). The finalized MCID for velocity (8.2 cm/s) was nearly half of the MCID of 15 cm/s reported by Hass et al., potentially due to differences in calculations. These results allow for evaluations of effectiveness of interventions by providing values that are specific to changes in gait for PwPD. Alterations of methodology including different versions of clinical or walking assessments, and/or different calculation and selection of gait variables necessitate careful reasoning when using presented MCIDs. • MCIDs help access effectiveness of interventions specific to populations. • 382 medicated people with Parkinson walked at comfortable speed via GAITRite. • MCIDs for gait measures were calculated using a cross-sectional analysis. • MCIDs include velocity (8.2 cm/s) and step length mean (3.6 cm). • MCIDs was also calculated for step length CV (0.7%) and step time CV (0.67%). [ABSTRACT FROM AUTHOR]

Information on determinants of patient-reported functional mobility is lacking but would inform the planning of healthcare, resources and strategies to promote functional mobility in people with Parkinson's disease (PD). To identify the determinants of patient-reported functional mobility of people with PD. Eligible: Randomized Controlled Trials, cohort, case-control, or cross-sectional analyses in people PD without date or setting restrictions, published in English, German, or French. Excluded: instruments with under 50 % of items measuring mobility. On August 9th 2023 we last searched Medline, CINAHL and PsychInfo. We assessed risk of bias using the mixed-methods appraisal tool. Results were synthesized by tabulating the determinants by outcomes and study designs. Eleven studies published 2012–2023 were included (most in Swedish outpatient settings). Samples ranged from 9 to 255 participants. Follow-up varied from 1.5 to 36 months with attrition of 15–42 %. Heterogenic study designs complicated results synthesis. However, determinants related to environment seem to associate the strongest with patient-reported functional mobility, although determinants related to body structures and functions were most investigated. We identified disease duration, the ability to drive, caregiving, sex, age, cognitive impairment, postural instability and social participation as determinants of patient-reported functional mobility. Methodological quality of the studies was limited. No study reported an a priori power calculation. Three studies controlled for confounders. The included studies lack representativeness of the population of people living with PD. Standardized sets of outcomes could enable more systematic research synthesis. Future research should focus on activities, participation and environmental factors and improve methodological quality. • Systematic review of determinants of patient-reported functional mobility (FM). • Out of 2042 articles eleven studies were identified. • Environmental factors were strongest associated with patient-reported FM. • Determinants related to body structures and functions were most investigated. • Standardized sets of outcomes would benefit research on patient-reported FM. [ABSTRACT FROM AUTHOR]

Although feedback from people with adult-onset spinal cord injury (SCI) has been considered for new rehabilitation programs, little is known about the priorities of the pediatric-onset SCI population. This study describes and compares health and life (H&L) domain research priorities of youth with pediatric-onset SCI and their parents/caregivers. A cross-sectional survey, designed by the Pan-European Paediatric Spinal Cord Injury (PEPSCI) Collaboration, was performed at six European countries. Dyad data from 202 participants, youth with pediatric-onset SCI (n = 101) and their parents/caregivers (n = 101), were analyzed with the PEPSCI H&L domain surveys. The cohort was composed of 8 to 12-year-olds (30.7%), 13 to 17-year-olds (38.6%), and 18 to 25-year-olds (30.7%). The top three H&L domain research priorities reported by parents/caregivers of 8 to 12-year-olds were "walking/ability to move" (91%), "bladder" function (90%), and "general health/feel" (89%), compared with "physical function" (93%), "general health/feel" (90%), and "walking/ability to move" (89%) rated by parents/caregivers of 13 to 25-year-olds. "Bowel" function (85%), "leg/foot movement" (84%), and "bladder" function (84%) were reported as priorities by 13 to 25-year-olds, whereas "physical function" (84%), "experience at school" (83%), and "general mood" were highlighted by 8 to 12-year-olds. The top 10 priorities preferred by 13 to 25-year-olds when compared with the top 10 priorities reported by their parents/caregivers, included problems related to "bowel" and "pain." Health domain research priorities were highlighted by 13 to 25-year-olds, compared with their parents/caregivers who equally identified H&L domains. This survey will aid health care and clinical research organizations to engage stakeholders to implement a comprehensive research strategy for the pediatric SCI population. [ABSTRACT FROM AUTHOR]

Physical symptoms such as pain and cancer-related fatigue limit physical function and activities of daily living among patients with terminal cancer, which can lead to a decline in quality of life. Therefore, comprehensive functional impairments should be evaluated to determine the progression of the disease and the effectiveness of palliative treatment. To validate the psychometric properties of the Japanese version of the Edmonton Functional Assessment Tool 2 (EFAT2-J). We developed a Japanese version of the EFAT-2 in accordance with international guidelines. To verify the reliability and validity of the EFAT2-J, patients were evaluated by a physiotherapist and a nurse separately, and correlations with existing evaluation scales for physical function, physical symptoms, and quality of life were analyzed, respectively. The significance level was set at 5%. Twenty patients participated in the reliability measurement. The average EFAT2-J scores were 7.95 ± 4.12 for physical therapists and 7.20 ± 4.23 for nurses, and the intraclass correlation coefficient was 0.95. The weighted kappa coefficient (κ) for each item was 0.57–1.00. Fifty-five patients participated in the validity measurement. The EFAT2-J showed significant correlations with Eastern Cooperative Oncology Group Performance Status and the Karnofsky Performance Scale, Barthel Index, and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care sub-item "physical function." These results indicate that the EFAT2-J has robust psychometric properties and is useful for evaluating physical function in patients with terminal cancer, and thus may be an acceptable clinical instrument in research and practice. [ABSTRACT FROM AUTHOR]

The use of patient-reported outcomes to improve burn care increases. Little is known on burn patients' views on what outcomes are most important, and about preferences regarding online Patient Reported Outcome Measures (PROMs). Therefore, this study assessed what outcomes matter most to patients, and gained insights into patient preferences towards the use of online PROMs. Adult patients (≥18 years old), 3–36 months after injury completed a survey measuring importance of outcomes, separately for three time periods: during admission, short-term (<6 months) and long-term (6–24 months) after burn injury. Both open and closed-ended questions were used. Furthermore, preferences regarding the use of patient-reported outcome measures in burn care were queried. A total of 140 patients were included (response rate: 27%). 'Not having pain' and 'good wound healing' were identified as very important outcomes. Also, 'physical functioning at pre-injury level', 'being independent' and 'taking care of yourself' were considered very important outcomes. The top-ten of most important outcomes largely overlapped in all three time periods. Most patients (84%) had no problems with online questionnaires, and many (67%) indicated that it should take up to 15 minutes. Patients' opinions differed widely on the preferred frequency of follow-up. Not having pain and good wound healing were considered very important during the whole recovery of burns; in addition, physical functioning at pre-injury level, being independent, and taking care of yourself were deemed very important in the short and long-term. These outcomes are recommended to be used in burn care and research, although careful selection of outcomes remains crucial as patients prefer online questionnaires up to 15 minutes. • This study investigated what outcomes are most important to adult burn patients. • 'Not having pain' is a very important outcome during admission. • And 'good wound healing' and 'taking care of yourself' during the whole recovery. • Identified outcomes are recommended to be used to evaluate burn care. • Online questionnaires of maximum 15 minutes are a good method for most patients. [ABSTRACT FROM AUTHOR]

• A multidimensional construct of safety climate is proposed, considering the most salient factors from the literature, and including psychological capital as a new factor. • This research contributes to the literature by being the first empirical research, that incorporates the psychological capital factor as an element affecting safety climate, especially in the construction sector studies. • Accurate methodological description. Descriptive analyses and Partial least squares structural equation modelling (PLS-SEM) were used to assess the quality of the measurement instrument and the hypotheses of the proposed model. • This study proposes and validates a structural model to explain workers' mental and physical health as a function of safety climate, mediated by job satisfaction. • The sample of Spanish construction workers was composed by all random observations contained in the EWCS of all workers in the Spanish sector, totaling 232 workers. • Workers' mental and physical health are influenced by several factors, including, but not limited to, safety climate, work-life balance, and job rewards and compensations. • This study provides some recommendations for construction company managers providing a ranking of all the factors affecting the safety climate and the workers' health. Introduction: The number of physical and mental problems caused by occupational accidents and diseases increases every year. To control them, the safety climate at work is a recognized critical factor. However, a widely applicable model to capture the safety climate for various industries and organizations is lacking. Method: This study proposes a theoretical model to measure the direct and indirect effects of safety climate on workers' physical and mental health, mediated by job satisfaction, in the construction sector. We propose a multidimensional construct of safety climate, considering the most salient factors from the literature, and including psychological capital as a new factor. Using data from the last wave of the European Working Conditions Survey (2015) in Spain, the proposed model was validated using structural equation modeling. Results: Our findings suggest that to further improve the mental health of construction workers, work-life balance and job rewards and compensation must be prioritized along with safety climate. As for physical health, safety climate and work-life balance are crucial. Finally, we provide some recommendations for construction company managers based on a ranking of all the factors affecting the safety climate and the workers' health. [ABSTRACT FROM AUTHOR]

Various total disc replacement (TDR) designs have been compared to anterior cervical discectomy and fusion (ACDF) with favorable short and long-term outcomes in FDA-approved investigational device exemption (IDE) trials. The unique design of M6-C, with a compressible viscoelastic nuclear core and an annular structure, has previously demonstrated favorable clinical outcomes through 24 months. To evaluate the long-term safety and effectiveness of the M6-C compressible artificial cervical disc and compare to ACDF at 5 years. Prospective, multicenter, concurrently and historically controlled, FDA-approved IDE clinical trial. Subjects with one-level symptomatic degenerative cervical radiculopathy were enrolled and received M6-C (n=160) or ACDF (n=189) treatment as part of the IDE study. Safety outcomes were evaluated at 5 years for all subjects. The primary effectiveness endpoint was available at 5 years for 113 M6-C subjects and 106 ACDF controls. The primary endpoint of this analysis was composite clinical success (CCS) at 60 months. Secondary endpoints were function and pain (neck disability index, VAS), physical quality of life (SF-36, SF-12), safety, neurologic, and radiographic assessments. Propensity score subclassification was used to control for selection bias and match baseline covariates of the control group to the M6-C subjects. Sixty-month CCS rates were estimated for each treatment group using a generalized linear model controlling for propensity score. At 5 years postoperatively, the M6-C treatment resulted in 82.3% CCS while the ACDF group showed 67.0% CCS (superiority p=.013). Secondary endpoints indicated that significantly more M6-C subjects achieved VAS neck and arm pain improvements and showed maintained or improved physical functioning on quality-of-life measures compared to baseline assessments. The M6-C group-maintained flexion-extension motion, with significantly greater increases from baseline disc height and disc angle than observed in the control group. The rates of M6-C subsequent surgical interventions (SSI; 3.1%) and definitely device- or procedure-related serious adverse events (SAE failure; 3.1%) were similar to ACDF rates (SSI=5.3%, SAE failure=4.8%; p>.05 for both). Subjects treated with the M6-C artificial disc demonstrated superior 5-year achievement of clinical success when compared to ACDF controls. In addition, significantly more subjects in the M6-C group showed improved pain and physical functioning scores than observed in ACDF subjects, with no difference in reoperation rates or safety outcomes. [ABSTRACT FROM AUTHOR]

Little information is available about the minimal clinically important differences (MCIDs) for objective physical measurements in people with lumbar spinal stenosis (LSS). To use disorder-specific anchor and, multiple anchor-, and distribution-based approaches to determine the MCIDs for walking capacity and physical activity in patients with LSS receiving nonsurgical treatment. Secondary analysis of a randomized controlled trial. Sixty-nine patients with neurogenic claudication caused by LSS receiving outpatient physical therapy. Zurich claudication questionnaire (ZCQ), self-paced walking test (SPWT), and number of daily steps measured by pedometry. All patients completed the ZCQ, SPWT, and pedometry at the baseline and after 6 weeks. For the anchor-based approach, ZCQ symptom severity, physical function, and satisfaction subscales were used as the external anchors. Using the receiver-operating characteristic (ROC) curve, the MCIDs were determined based on the optimal cutoff points for changes in the SPWT or daily steps. For the distribution-based approach, the MCIDs were estimated from the standard deviations (SDs) of the baseline scores of the SPWT and daily steps. In the anchor-based approach, only the ZCQ satisfaction subscale for the SPWT (0.73), and ZCQ symptom severity subscale for daily steps (0.71) exceeded the area under the ROC curve value of 0.7, which is considered acceptable. When using these subscales as anchors, the ROC curves and optimal cutoff points indicated MCIDs of 151 m for the SPWT and 1,149 steps for daily steps. The distribution-based approach estimated the MCIDs as 280 m for the SPWT and 1,274 steps for daily steps, and had a moderate effect size (0.5 SD). The anchor-based approach had limited external responsiveness when the ZCQ was used as the anchor. However, this information may be helpful for interpreting walking capacity and physical activity in patients with LSS receiving nonsurgical treatment and for estimating power and sample size when planning new trials. [ABSTRACT FROM AUTHOR]

Cross-sectional studies on diffuse idiopathic skeletal hyperostosis have focused on its incidence and related factors. However, the long-term changes caused by the disease remain unclear. This longitudinal cohort study aimed to elucidate the progression of diffuse idiopathic skeletal hyperostosis and its effects on physical function, health-related quality of life, and spinal alignment. We recruited 255 older adults (87 men and 168 women; average age, 71.3 years in 2014) who attended local health checkups in 2014 and 2020. Height, body weight, body mass index, blood pressure, grip strength, functional reach, and bone mineral density were measured. The prevalence, location, number of ossified contiguous vertebrae, and spinopelvic parameters were estimated using whole-spine standing radiographs. For health-related quality of life assessment, the Oswestry disability index and EuroQuol-5D were obtained. We performed a 1:1 case-control study with age and sex-matched patients with and without diffuse idiopathic skeletal hyperostosis and analyzed progression over a 6-year period. In 2014, 39 (15.3%) of 255 patients were diagnosed with diffuse idiopathic skeletal hyperostosis (24 males and 15 females), which occurred more frequently in the elderly and males. In 2020, 12 (4.3%) patients were newly diagnosed with diffuse idiopathic skeletal hyperostosis, and 28 (71.7%) of 39 patients diagnosed in 2014 showed varying degrees of progression. Compared with age- and sex-matched patients without diffuse idiopathic skeletal hyperostosis, patients with the condition had higher body mass index and lumbar bone mineral density, larger sagittal vertical axis, and greater T1-pelvic angle. Changes in physical function and spinal-pelvic parameters during the 6-year period did not differ between the groups. Over a 6-year period, the prevalence of diffuse idiopathic skeletal hyperostosis increased by 4.3%, and it progressed in 71.7% of patients. However, it had little effect on longitudinal physical function, health-related quality of life, and spinopelvic parameters in older adults. [ABSTRACT FROM AUTHOR]

Background: We investigated intramuscular fat (IMF) in quadriceps femoris (QF) and hamstring muscles in the middle-aged women with knee osteoarthritis (KOA). We also examined the relationship between muscular infiltration of QF and hamstring muscles and muscle architecture and physical performance of the women with KOA.Methods: In this cross-sectional study, 72 women were included. Body muscle and fat mass were measured by BIA, isometric muscle strength was evaluated by hand-held dynamometer. IMF and muscle architecture were calculated from rectus femoris (RF), vastus intermedius (VIM), vastus lateralis (VL), vastus medialis (VM), biceps femoris (BF), semitendinosus (ST) and semimembranosus (SM) using B-mode ultrasonography. KOA-related symptoms and functions were assessed with KOOS. The functional performance assessments were evaluated with Stair Climbing Test, 20-Meter Walking Test.Results: Women with KOA had more IMF in RF, VIM, VL, VM and BF, ST, SM muscles compared to the healthy women. Pennation angles decreased as the IMF in the RF, VM, BF and ST decreased. As the IMF of the RF and VM increased isometric knee extensor strength decreased and KOOS symptom score, pain score and ADL score increased in women with KOA. Walking and stair climbing speed deteriorated as the IMF in RF, VIM, VM, BF increased in the middle-aged women. As the IMF in BF increased isometric knee flexor strength decreased and KOOS scores increased. Physical performance scores deteriorated as the IMF in BF increased in middle-aged women with KOA.Conclusion: IMF in QF and hamstring muscles were higher in the middle-aged women with KOA group compared with that in the healthy group. Weakness of the QF and hamstring muscles may due to the changes in architectural properties of muscle depending on muscular infiltration. IMF in knee muscles is an important determining factor in performance and physical function of middle-aged women with KOA. [ABSTRACT FROM AUTHOR]

Chronic pain and non-substance use psychiatric disorders (PD) are common comorbidities, both associated with impaired functioning. However, whether and how the prevalence of pain differs in remitted PD compared to past-year PD has been little studied. In this observational study using data from the National Epidemiologic Survey on Alcohol and Related Conditions III, we compared the prevalence of moderate/severe pain interference (PI) in past-year Vs remitted PD among adults with any lifetime PD. We further studied the association of both PI and PD remission with mental and physical function. In a sample representative of 77.9 million US adults with lifetime PDs, 31.7 % met criteria for PD remission. The prevalence and adjusted odds of PI was substantially lower among those with remitted PD compared to past-year PD (21.97 % Vs 35.02 %; p <.0001; Odds ratio 0.58, 95 % confidence interval = 0.51–0.66). While PI was independently associated with poorer mental functioning (Regression coefficient (RC) = −4.43, standard error (SE) = 0.33; p <.0001), PD remission was associated with higher mental functioning (RC = 4.79, SE = 0.24; p <.0001). Both PI and PD remission were independently associated with lower physical functioning, but the association was substantially stronger with PI (RC = −15.04, SE 0.27; p <.0001) than PD remission (RC = −0.37, SE 0.15; p =.016). The negative association of PD remission with PI and their strong associations with mental functioning, albeit in opposite directions, raises the need to further examine PD as a contributing factor in chronic pain and as a target in its treatment. • Little is known about the association of remission from psychiatric disorder and pain • Pain prevalence was notably lower with remitted (22 %) vs current (35 %) psychiatric diagnoses • Markedly low adjusted odds ratio for pain (0.58) with psychiatric disorder remission • Negative association of pain was more pronounced with physical vs mental function • Psychiatric remission had strong independent association with better mental function [ABSTRACT FROM AUTHOR]

This study aimed to investigate the relationship between daytime sleepiness and mortality risk among older adults. The moderating effects of sex and physical function were examined. This 9-year follow-up study was conducted with community-dwelling individuals aged ≥65 years. Daytime sleepiness was evaluated using the Epworth Sleepiness Scale (ESS). Exploratory factor analysis (EFA) was used to examine the ESS factors. Handgrip strength was measured to assess physical function, and the highest quartile was defined as good muscle power. Cox regression analysis was used to estimate the 9-year all-cause mortality risk. The interaction terms were examined to evaluate their moderating effect. In total, 2588 individuals participated in the study. The EFA explored two factors: the passive factor (PF) and the active factor (AF). After controlling for various covariates, the cutoff-defined daytime sleepiness (ESS≥11), total raw scores, and factor scores of the ESS all failed to predict mortality risk. The 3-way interaction terms showed statistical significance in terms of [sex × PF × muscle power (p = 0.03)] but not for [sex × AF × muscle power (p = 0.11)]. Specifically, PF predicted mortality risk in women with good muscle power (hazard ratio (HR): 1.48; 95 % confidence interval (CI): 1.04–2.10), which is female-specific. In contrast, AF predicted mortality risk only in men with good muscle power (HR: 1.35; 95 % CI: 1.02–1.78). The ESS-measured daytime sleepiness in older adults is multidimensional. The mortality risk for each dimension was determined based on sex and physical function. • The Epworth Sleepiness Scale (ESS) had dual construct in older adults. • Sex- and muscle power modified mortality risk conferred from daytime sleepiness. • Dimensions of the ESS conferred sex-specific mortality risk. [ABSTRACT FROM AUTHOR]

Pediatric stroke is a rare medical condition that often leads to long-lasting motor and cognitive impairments. Although therapies for adults after a stroke are well described, treatments for motor deficits following a pediatric stroke are yet to be investigated. We report a case of pediatric stroke in the chronic phase, in which a combination of novel treatments resulted in a significant improvement in physical function. A seven-year-old girl with a left hemispheric cerebral infarction lost almost all right upper extremity motor function. Following onabotulinumtoxinA treatment, she underwent hand-arm bimanual intensive therapy augmented with a hybrid assistive limb for 90 h over 15 days. Evaluation after the training revealed significant improvements in physical function, daily activities, and occupational performance. This report highlights the importance of innovative combinations of techniques in the treatment of pediatric stroke. [ABSTRACT FROM AUTHOR]

Many older adults are discharged from skilled nursing facilities (SNFs) at functional levels below those needed for safe, independent home and community mobility. There is limited evidence explaining this insufficient recovery. The purpose of this secondary analysis was to determine predictors of physical function change following SNF rehabilitation. Secondary analysis of a prospective observational cohort study. Across 4 SNFs, data were collected from 698 adults admitted for physical rehabilitation following an acute hospitalization. Physical function recovery was evaluated as change from admission to discharge in Short Physical Performance Battery (SPPB) scores (N = 698) and gait speed (n = 444). Demographic and clinical characteristics collected at admission served as potential predictors of physical function change. Following imputation, a standardized model selection estimator was calculated for predictors per physical function outcome. Predictor estimates and 95% CIs were calculated for each outcome model. Higher cognitive scores [standardized β (β STD) = 0.11, 95% CI: 0.0004, 0.20] and higher activities of daily living (ADL) independence at admission (β STD = 0.22, 95% CI: 0.05, 0.34) predicted greater SPPB change; higher SPPB scores at admission (β STD = −0.26, 95% CI: −0.35, −0.14) predicted smaller SPPB change. Higher ADL independence at admission (β STD = 0.17, 95% CI: 0.01, 0.37) predicted greater gait speed change; faster gait speed at admission (β STD = −0.30, 95% CI: −0.44, −0.15) predicted smaller gait speed change. Admission cognition, ADL independence, and physical function predicted physical function change following post-hospitalization rehabilitation. Inverse findings for admission physical function and ADL independence predictors suggest independence with ADL is not necessarily aligned with mobility-related function. Findings highlight that functional recovery is multifactorial and requires comprehensive assessment throughout SNF rehabilitation. [ABSTRACT FROM AUTHOR]

Postsurgical outcome measures are crucial to define the efficacy of perioperative pain management; however, it is unclear which are most appropriate. We conducted a prospective study aiming to assess sensitivity-to-change of patient-reported outcome measures assessing the core outcome set of domains pain intensity (at rest/during activity), physical function , adverse events , and self-efficacy. Patient-reported outcome measures were assessed preoperatively, on day 1 (d1), d3, and d7 after four surgical procedures (total knee replacement, breast surgery, endometriosis-related surgery, and sternotomy). Primary outcomes were sensitivity-to-change of patient-reported outcome measures analysed by correlating their changes (d1–d3) with patients' global impression of change and patients' specific impression of change items as anchor criteria. Secondary outcomes included identification of baseline and patient characteristic variables explaining variance in change for each of the scales and descriptive analysis of various patient-reported outcome measures from different domains and after different surgeries. Of 3322 patients included (18 hospitals, 10 countries), data from 2661 patients were analysed. All patient-reported outcome measures improved on average over time; the median calculated sensitivity-to-change for all patient-reported outcome measures (overall surgeries) was 0.22 (range: 0.07–0.31, scale: 0–10); all changes were independent of baseline data or patient characteristics and similar between different procedures. Pain-related patient-reported outcome measures have low to moderate sensitivity-to-change; those showing higher sensitivity-to-change from the same domain should be considered for inclusion in a core outcome set of patient-reported outcome measures to assess the effectiveness and efficacy of perioperative pain management. [ABSTRACT FROM AUTHOR]

The lateral approach to lumbar fusion surgery provides access to the spine without needing to use a transperitoneal pathway thus reducing the incidence of morbidity compared to the anterior approach. Therefore, the frequency in which this approach has been utilized has grown warranting increased need for evaluating patient reported outcomes for this particular surgical technique. The utilization of patient-reported outcome measures (PROMs) administered as surveys is a standard procedure now in spine surgery. These surveys are used to evaluate from the patient's perspective the success of the surgery in alleviating the preoperative symptoms. More information is needed to correlate PROMs with their legacy counterparts in the context of individual pathologies and surgeries. The goal of this study is to correlate Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS-PF) scores with Short Form-12 Physical Component Score (SF-12 PCS) and Veterans RAND-12 Physical Component Score (VR-12 PCS) to assess physical function in individuals undergoing Lateral Lumbar Interbody Fusion (LLIF). This study is a retrospective review. Electronic medical records of a single spine surgeon were searched for individuals undergoing primary, elective LLIF. Excluded cases were related to cancer, infection, trauma, or individuals missing the PROMs of interest. A total of 86 patients were included in the final study. Outcome measures included perioperative characteristics, minimal clinically important difference (MCID) achievement rate, and PROMs of SF-12 PCS, Oswestry Disability Index (ODI), VR-12 PCS, and PROMIS-PF. Demographics, perioperative characteristics, and PROMs were collected both preoperatively and postoperatively at six weeks, 12 weeks, six-months, one year, and two years. As we look to compare "legacy" PROMs to the newer generation of measurements, we will use SF-12 PCS, VR-12, and ODI to represent the legacy PROMs. The newer generation will be represented by PROMIS-PF. Pearson's Correlation Coefficient was used to establish the relationship between the legacy PROM values and PROMIS-PF. All PROMs other than ODI showed improvements in the mean score at each consecutive follow-up time point. PROMIS-PF showed a statistically significant Pearson's Correlation Coefficient with SF-12 PCS, VR-12 PCS, and ODI at all time points measured (p<0.05, all). The Pearson's correlation coefficient for 12-week SF-12 PCS until 2-years is reported as strongly correlated (0.500<|r|, r=0.765, r=0.824, r=0.772, r=0.757, respectively). The correlation coefficients of SF-12 PCS for the preoperative and six-week timepoints were considered moderately strong positive correlation (0.300<|r|≤0.500; r = 0.467, and 0.373, respectively). The correlation coefficients of VR-12 for the preoperative and six weeks were considered strongly positive (0.500<|r|; r = 0.576 and 0.536, respectively). The 12 weeks through 2-year timepoints for VR-12 were considered strongly positive (0.500<|r|; r = 0.770, 0.835, 0.838, 0.817, respectively). The correlation coefficient for ODI from preoperative through 2-year follow-up were all considered strongly negative (0.500<|r| for all). PROMIS-PF demonstrated a strong positive correlation with VR-12 PCS, and SF-12 PCS, and a strong negative correlation with ODI in our patient sample. These results suggest PROMIS-PF can be used as an accurate measure of physical function in patients undergoing LLIF. Therefore, the use of PROMIS-PF as a singular survey for patients may be an accurate measure of patient-reported outcomes in spine surgery. This abstract does not discuss or include any applicable devices or drugs. [ABSTRACT FROM AUTHOR]

The outcomes of revision minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) and lateral lumbar interbody fusion (LLIF) have not been compared in the literature thus far. The purpose of this study is to compare perioperative and patient-reported outcome (PRO) data of revision MIS-TLIF and LLIF. This study is a retrospective cohort study. Patients undergoing elective revision MIS-TLIF and LLIF were identified from a prospective single surgeon registry and grouped into cohorts based on surgical approach. Only patients undergoing fusions at spinal levels accessible through both MIS-TLIF and LLIF were included. In total, 102 patients were included, with 29 MIS-TLIF patients and 73 LLIF patients. Outcome measures were perioperative data, minimal clinically important difference (MCID) achievement rates), and PROs including Veterans Rand-12 Physical and Mental Composite Score (VR-12 PCS, MCS), Patient-Reported Outcome Measurement Information System-physical function (PROMIS-PF), Patient-Health Questionnaire-9 (PHQ-9), Visual Analog Scale-Back and Leg Pain (VAS-BP, LP), and Oswestry Disability Index (ODI). Demographics, perioperative data, and PROs were obtained from the registry and compared through independent samples t-tests or chi-square tests. Improvements in PROs by six weeks and final follow-up were tabulated. Postoperative PROs and changes in PROs were compared through multivariable linear regression to account for age differences. MCID achievement rates were calculated for each group by comparing changes in PROs to thresholds reported in prior literature. MCID achievement rates were then compared between groups using multivariable logistic regression. Patients undergoing LLIF were significantly older (58.7 years) than patients undergoing MIS-TLIF (54.0 years) (p=0.047), but there were no other demographic differences between groups (p≥0.111, all). LLIF patients consumed more narcotics on postoperative day 0 (p=0.035), while there were no other differences in perioperative data. There were no significant differences in baseline PROMs (p≥0.059, all). When controlling for differences in age, there were no differences in 6-week postoperative and final follow-up PROMs (p≥ 0.061, all). The LLIF group reported greater average improvement in VAS-LP scores by six weeks postoperatively compared to the MIS-TLIF group (p=0.049), while other outcomes were statistically similar (p≥0.098, all). The LLIF group also reported greater average final follow-up improvements in PROMIS-PF scores (p=0.003), and similar final follow-up improvements otherwise (p≥0.086, all). There were no significant differences in MCID achievement of any outcome overall (p≥0.052, all). When controlling for age, revision LLIF patients reported earlier and greater reduction in leg pain by six weeks, with similar magnitudes of improvement by final follow-up and greater improvement in physical function at final follow-up. Overall, there were no differences in patients achieving clinically significant improvements in any outcomes. This abstract does not discuss or include any applicable devices or drugs. [ABSTRACT FROM AUTHOR]

In recent years, mental health has increasingly been recognized as an influential determinant of patient outcomes after surgery across many specialties. Patients with back pain, a common manifestation of spine pathology, experience high concomitant rates of depression. Roughly a quarter of patients undergoing spine surgery are regularly taking antidepressant medication, which has been associated with longer hospitals stays and increased cost. Discharge to rehab facilities can contribute significantly to overall cost of care. Recent research has focused on associations between surgical spine patients and nonhome discharge in an effort to identify potential risk factors. In recent years, mental health has increasingly been recognized as an influential determinant of patient outcomes after surgery across many specialties. Patients with back pain, a common manifestation of spine pathology, experience high concomitant rates of depression. Roughly a quarter of patients undergoing spine surgery are regularly taking antidepressant medication, which has been associated with longer hospitals stays and increased cost. Discharge to rehab facilities can contribute significantly to overall cost of care. Recent research has focused on associations between surgical spine patients and nonhome discharge in an effort to identify potential risk factors. The goal of this study was to investigate the association between antidepressant use and discharge disposition, as well as inpatient physical therapy performance. This was a retrospective cohort study. Our patient sample consisted of 1,775 patients undergoing elective lumbar fusion between 2017 and 2021 at a single, academic, teritary care center. Our primary outcome measure was discharge disposition. Secondary outomces included short-term surgical outcomes such as complications and readmission. We also used inpatient physical therapy performance as a secondary outcome, as it is often plays a role in determining discharge disposition. After approval was obtained by the Institutional Review Board, patients undergoing primary 1-3 level lumbar fusion at a single, tertiary care institution from 2017-2021 were retrospectively identified. Patient characteristics, surgical details, and surgical outcomes were collected via chart review. Medications were collected based on active medication lists at the patient's preoperative and first postoperative appointment. A patient was deemed to be taking antidepressants if they were active medication at both the preoperative and follow-up appointment. Inpatient physical therapy metrics including session distance and AMPAC (Activity Measure for Post Acute Care) scores were collected via chart review. Statistical analysis was performed to identify differences between the "antidepressant" and "no antidepressant" groups. A total of 493 patients (27.7%) were taking antidepressants perioperatively. Patients in the antidepressant group were more likely to be female (p<0.001), current smokers (p=0.012), and have a higher Elixhauser comorbidity index (p<0.001). On regression analysis, the antidepressant group was associated with discharge to rehab after surgery (p=0.026). Age (p<0.001), length of stay (p<0.001), 1st session distance (p<0.001), and improvement in gait distance (p<0.001) were associated with nonhome discharge. Antidepressant use was independently associated with discharge to a rehabilitation facility. These patients were still discharged to these facilities without performing significantly worse in in their inpatient physical therapy sessions. These findings suggest that psychosocial factors may play an important role in disposition discharge after spine surgery and patients with depression/anxiety may require additional resources while in the hospital to be discharged safely home. This abstract does not discuss or include any applicable devices or drugs. [ABSTRACT FROM AUTHOR]