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Tracheostomy and dysphagia are independently associated with increased complications and poorer functional outcome after acquired brain injury (ABI). The aim of this study was to identify and evaluate rehabilitation to restore functional swallowing ability and respiratory capacity during tracheal tube weaning. The review was conducted according to PRISMA guidelines. Any study design with adult patients with ABI and tracheostomy was eligible. The primary outcome was decannulation. A total of 2647 records were identified and eight papers included. Four studies investigated pharyngeal electrical stimulation (PES), two explored Facial Oral Tract Therapy (F.O.T.T.), one respiratory physiotherapy (RPT), and one study investigated external subglottic air flow (ESAF). Two RCTs found a significant difference between intervention and control on successful decannulation and readiness for decannulation in favour of PES. Time from rehabilitation admission and tracheostomy to decannulation was significantly reduced after implementing an F.O.T.T.-based protocol. Four interventions were identified, PES, F.O.T.T., RPT, and ESAF, all aimed at increasing oropharyngeal sensory input through stimulation. Due to heterogeneity of interventions, designs and outcome measures, effect could not be estimated. This review highlights the limited research on rehabilitative interventions and thus the limited evidence to guide clinical rehabilitation. Rehabilitation for early decannulation after brain injury Dysphagia and tracheostomy often coexist in neurocritical care and early rehabilitation. Four rehabilitative interventions were identified—pharyngeal electrical stimulation, external subglottic airflow, respiratory physiotherapy and facial-oral tract therapy. Interventions points to a consensus that sensory stimulation of the oropharynx can increase excitability of the swallowing network and support pharyngeal sensorimotor cortex reorganisation. This review highlights the limited research on therapeutic rehabilitative interventions and thus the limited evidence to guide clinical rehabilitation. [ABSTRACT FROM AUTHOR]

A library of Virtual Reality (VR) tasks has been developed for targeted post-stroke rehabilitation of distal upper extremities. The objective of this pilot study was to evaluate the clinical potential of the targeted VR-based therapeutic intervention in a small cohort of patients specifically with chronic stroke. Furthermore, our aim was to explore the possible neuronal reorganizations in corticospinal pathways in response to the distal upper limb targeted VR-intervention. Five patients with chronic stroke were enrolled in this study and were given VR-intervention of 20 sessions of 45 min each. Clinical Scales, cortical-excitability measures (using Transcranial Magnetic Stimulation): Resting Motor Threshold (RMT), and Motor Evoked Potential (MEP) amplitude, task-specific performance metrics i.e., Time taken to complete the task (TCT), smoothness of trajectory, relative % error were evaluated pre- and post-intervention to evaluate the intervention-induced improvements. Pre-to post-intervention improvements were observed in Fugl-Meyer Assessment (both total and wrist/hand component), Modified Barthel Index, Stroke Impact Scale, Motor Assessment Scale, active range of motion at wrist, and task-specific outcome metrics. Pre-to post-intervention ipsilesional RMT reduced (mean ∼9%) and MEP amplitude increased (mean ∼29µV), indicating increased cortical excitability at post-intervention. VR-training exhibited improved motor outcomes and cortical-excitability in patients with stroke. Neurophysiological changes observed in terms of improved cortical-excitability might be a consequence of plastic reorganization induced by VR-intervention. Post-stroke rehabilitation of distal upper extremities is crucial and needs targeted intervention to rehabilitate in the chronic phase of recovery. Virtual reality (VR) has emerged as a supplemental approach in post-stroke rehabilitation. However, its customization as per clinical need is still under research. This pilot study provides preliminary evidence of the clinical utility of the developed VR tasks targeted for distal upper extremities. [ABSTRACT FROM AUTHOR]

After a total knee arthroplasty (TKA), ensuring rehabilitation is continued at home is essential for a successful recovery. The aim of this randomized clinical trial (NCT04155957) was to demonstrate the safety and efficacy of an interactive telerehabilitation system (ReHub®) to guide and provide feedback during exercise in the postoperative period of a fast-track TKA program. Fifty-two patients who underwent TKA were randomized to intervention (N = 26) or control (N = 26). Upon discharge, they followed a 4-week plan of 5 daily exercises and up to 10 physiotherapy home visits. The intervention group performed exercises with ReHub® autonomously, control did not use any auxiliary device. Data were collected 1) on the day of discharge, 2) after 2 weeks and 3) after 4 weeks. Telerehabilitation patients showed higher adherence to exercise (p = 0.002) and greater quadriceps strength (p = 0.028). No significant differences between groups were found in other outcomes. Only 1 adverse event was linked to ReHub®. Patients gave the platform high System Usability Scale scores (83/100). Interactive telerehabilitation with ReHub® during a post-TKA exercise program is effective, safe, and well-received by patients. It provides real-time performance feedback and ensures communication. Quadriceps strength and adherence to the exercise plan are improved with ReHub®. Telerehabilitation platforms can be introduced into fast-track total knee arthroplasty protocols to monitor home-based exercise programmes without compromising efficacy and safety. Telerehabilitation and remote patient monitoring contribute to obtaining high levels of adherence to exercise plans, which is a current challenge faced by rehabilitation professionals. Real-time biofeedback on exercise performance facilitates correct exercise performance and motivates the patient. This technology allows professionals to monitor and adjust the patient's therapy remotely and avoid unnecessary travel. [ABSTRACT FROM AUTHOR]

To assess professional reintegration, the perceived impact of stroke on work, and the main determinants of return to work (RTW) among stroke survivors. A cross-sectional study was performed, based on a cohort of stroke survivors. A structured questionnaire was administered to previously working stroke survivors, 18–24 months post-stroke. Data on sociodemographic characteristics, stroke features and their impact on work, access to rehabilitation services during hospital admission and after discharge, social support, and professional reintegration were reported by 553 stroke survivors. On average, 56.6% (95% CI 52.4–60.8) of stroke survivors resumed professional activity, 20 months after stroke. Approximately 90% of survivors who RTW, returned to the same job and same function they performed before stroke. The majority did not receive reintegration support. The main determinants of RTW were lower age, higher socioeconomic status, and better functional status. Professional reintegration and vocational support after stroke, remained below the international goals for community reintegration of stroke survivors. Future studies should explore the impact of professional and social reintegration on the psychological health and quality of life of stroke survivors and the barriers, challenges, and strategies used to overcome them, to allow for effective professional reintegration policies. The amount of professionally active people affected by stroke events is rising worldwide, with increasing numbers of survivors with restricted occupational participation. Higher age and lower socioeconomic status appear to be main determinants for no return to work and so, a special attention should be given to this particular group of stroke survivors. Vocational and social support after stroke is highly needed to help in the reintegration of a professionally active life. Social and community support after stroke should be offered as soon as possible after stroke to promote a successful professional reintegration. [ABSTRACT FROM AUTHOR]

Physical activity (PA) can provide multiple benefits for children with visual impairments (VI). To date, little research has explored the retention effects of PA interventions for children with VI. Thus, the purpose of this study was to explore the PA experiences of parents of children with VI three months after completing a PA intervention. This descriptive-qualitative study was situated in the Theory of Planned Behavior. Five parents completed semi-structured interviews that were transcribed and analyzed using a thematic line-by-line analysis. Four themes characterizing how parents created PA opportunities for their children with VI were constructed: (a) Teaching from Awareness (b) Advocating for Needs, (c) Engaging Family through Community, and (d) Seeking More PA Opportunities. Parent's awareness of their child's abilities, parents' advocacy, and parents' teaching skills all helped to expose their children to new types of PA in the community. Parents reflected about a lack of consistently offered community-based PA for their children. Researchers must consider the importance of educating parents on how to teach skills, increase awareness, and advocate for more community-based PA programs. Three months after a physical activity intervention for children with visual impairments, parents' awareness of their child's abilities, advocacy, and competence teaching motor skills helped to expose their children to new types of physical activities in the community and at home. The lack of consistently offered community-based physical activities for children with visual impairments calls for rehabilitation professionals to create or promote existing physical activity programs for children with visual impairments. Rehabilitation professionals should explore how physical activity programs can address barriers faced by participants (e.g., lack of knowledge, lack of physical activity equipment), and offer a continuum of activities and programming for these families in the home and community setting. Rehabilitation professionals should educate parents on the importance of physical activity, how to teach motor skills, and advocate for more community-based physical activity programs for their children with visual impairments. [ABSTRACT FROM AUTHOR]

Because people living with environmental sensitivities are poorly acknowledged in our society, we still know very little about their experiences navigating in the health care system, especially with respect to dental services. Our objective, therefore, was to describe their dental care pathway and better understand their experiences accessing oral health services. A qualitative descriptive study was conducted in partnership with organizations supporting people with environmental sensitivities. Through a criterion sampling technique, 12 people living with environmental sensitivities in Quebec (Canada) were invited to participate in individual semi-structured interviews. These interviews lasted around 90 min and were transcribed to be thematically analysed. Participants faced major barriers accessing dental services and thus lived for long periods of time with unmet dental needs. Their dental care pathways were often delayed or even interrupted for several reasons. First because they were exposed to pollutants upon leaving their house, which rendered their trip to the dentist perilous. Second because dentists lacked knowledge about environmental sensitivities and seemed reluctant to accommodate them. We invite governments, dental professionals, and researchers to develop policies and clinical approaches for improving people living with environmental sensitivities' quality of life and access to dental services. Although environmental sensitivities are recognized as disability in several countries such as Sweden and Germany, people with these conditions face major barriers to access healthcare services. Dental professionals, for instance, are reluctant to acknowledge environmental sensitivities as a disability and seldom accommodate sufferers' special needs. We invite dentists to foster holistic and person-centered approaches and be receptive to the health conditions and needs of people with environmental sensitivities. Dentists could address oral health needs of people with environmental sensitivities by doing home-visits with portable dental equipment as this removes barriers related to their exposure to pollutants. [ABSTRACT FROM AUTHOR]

To investigate satisfaction with and perceived benefits of a model of needs-assessment related to rehabilitation (NARR) in women with early breast cancer after (neo)adjuvant chemotherapy. Mixed methods were applied using survey (N = 200) along with interviews (N = 20). The survey included measurement of distress and self-assessed need of and satisfaction with the NARR. Type of experienced side/late effects were registered along with numbers of and reasons for referrals to rehabilitation. Individual semi-structured interviews were conducted. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed with thematic analysis. Overall, 217 patients participated in a NARR and 200 (92%) accepted participation in the survey. Furthermore, 20/37 (54%) invited patients were interviewed. After the NARR, 39 patients (20%) were referred to rehabilitation. While satisfaction was high, findings regarding distress and need of the NARR were equivocal and indicated a need for talking about experiences throughout the cancer trajectory. While only 20% had rehabilitation needs, satisfaction with the NARR was high and patients benefitted from being confirmed in normality of their experiences. It is recommended to address patients' side/late effects after chemotherapy for early breast cancer to identify rehabilitation needs, reduce distress, and improve quality of life. One fifth of patients with early breast cancer were referred to rehabilitation after needs-assessments conducted 2 months after chemotherapy termination. Higher distress and higher self-reported need were significantly associated with not working and experiencing a higher number of side effects/late effects. It is recommended to address patients' side effects/late effects, including psychological distress, after termination of chemotherapy for early breast cancer to identify rehabilitation needs, reduce distress, and ultimately improve quality of life. [ABSTRACT FROM AUTHOR]

Characterizations of offenders as ‘evil’ appear in popular entertainment, political rhetoric, and scholarship and may be rooted in widely endorsed cultural narratives. Integrating psychological and criminological literatures, we argue that endorsement of good-and-evil myths may be associated with criminal justice policy support via stigmatizing attitudes about those who engage in crime. We partially tested these hypotheses in a preliminary study using an online convenience sample (recruited using Amazon MTurk in 2015), then tested the full theoretical model using more comprehensive measures in a survey of American adults conducted via Qualtrics Panel in 2021 (N = 1,162). We found that both belief in evil (i.e. belief in evil forces) and belief in redemptive violence (i.e. belief in a clash between good and evil) were positively associated with punitive policy support, and stigmatizing attitudes partially mediated the effects of both. While belief in redemptive violence was negatively associated with rehabilitative policy support and stigmatizing attitudes mediated that relationship, belief in evil was not associated with support for rehabilitation. We consider the implications of our findings for mitigating the harms of public stigma and punitive criminal justice policy. [ABSTRACT FROM AUTHOR]

Narrative methods have been shown to help people with cancer to create meaning, find hope and restore a sense of coherence in life. Likewise, the combination of rehabilitation and palliative care for people with life-threatening illness is receiving increasing interest and is generally perceived as beneficial for patients. Four narrative courses combining rehabilitation and palliative care approaches for people who have or have had cancer were carried out in Denmark between 2021 and 2022. An ethnographic field study revealed that some of the course participants experienced harm during the courses and therefore chose to withdraw. Findings show that a rehabilitation approach dominated in the courses and that the participants’ experiences of harm occurred in a complex interplay between the participants, the professionals and the specific narrative exercises. While some participants’ stories were recognised as legitimate and meaningful and were continuously supported and encouraged, other participants’ stories of suffering were suppressed. [ABSTRACT FROM AUTHOR]

ObjectivesMethodsResultsConclusionTo examine the safety of cardiorespiratory fitness (CRF) assessment and training in the early sub-acute phase of recovery (≤3 months) following moderate-to-extremely severe traumatic brain injury (TBI).A systematic review was completed in accordance with the PRISMA guidelines. Studies investigating adults and adolescents ≥15 years with moderate-to-extremely severe TBI were considered for inclusion. The methodological quality of the included studies was evaluated according to the McMaster Guidelines for Critical Review Form – Quantitative Studies.Eleven studies with a total of 380 participants were included in the review. Adverse events (AEs) and symptom monitoring were poorly reported. Only four studies reported on the occurrence of AEs, with a total of eight AEs reported. Three of the reported AEs were concussion-like symptoms with no further exercise-induced symptom exacerbation reported. No serious AEs were reported.There is no evidence to suggest that CRF assessment and training is unsafe in the early sub-acute phase of recovery following moderate-to-extremely severe TBI. However, despite the low AE and symptom exacerbation rates identified, a timeframe for safe commencement was unable to be established due to poor reporting and/or monitoring of exercise-induced symptoms and AEs in the current literature. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONTo propose a standardized method for the use of the International Classification of Functioning, Disability and Health (ICF) to describe the health status in Post-Acute COVID-19 Syndrome (PACS) and investigate interrater agreement in the linking process in instruments and clinical exams using the ICF categories.Cross-sectional and interrater agreement study that followed the Guidelines for Reporting Reliability and Agreement Studies. Two raters performed the linking coding process in instruments of quality of life, anxiety and depression, fatigue and pulmonary function, inspiratory muscle strength and cardiopulmonary exercise testing. The codes were qualified by standards defined to each instrument and exams.The instrument with the lowest Cohen’s Kappa coefficient was anxiety and depression (k = 0.57). Forty ICF codes were linked to clinical instruments and exams. The fatigue instrument presented a higher degree of disability by the qualification process, from severe to complete, in the linked codes.The study presents a standardized method for the assessment of the health status of patients with PACS through ICF. Restriction in work performance, socialization and family relationships as well as disabilities in physical endurance, fatigue and exercise tolerance were found in the sample. The agreement between the raters was moderate to perfect, demonstrating that the method can be reproducible.The body structures and functions, environmental factors, activities and participation in a person’s environment are determinant aspects of his health.Ways to measure these aspects are key to assessing health not only as absence of disease, so the International Classification of Disability and Functional Health demonstrates the ability to fully describe health.This study proposes a standardization in the use of the tool to facilitate usability in clinical practice.The body structures and functions, environmental factors, activities and participation in a person’s environment are determinant aspects of his health.Ways to measure these aspects are key to assessing health not only as absence of disease, so the International Classification of Disability and Functional Health demonstrates the ability to fully describe health.This study proposes a standardization in the use of the tool to facilitate usability in clinical practice. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONTo describe disparities in community participation during the COVID-19 pandemic among people with disabilities.Respondents to Phase 3.3 of the COVID Household Pulse Survey (US Census Bureau) were classified by disability status. Risk ratios and risk differences were computed to compare the risk of poor outcomes on economic participation, community service use, and community activities by disability status - both overall (compared to the nondisabled reference) and by race/ethnicity (each subgroup compared to the White nondisabled reference).At least one type of disability was reported by 59.6% of respondents. People with disabilities were more likely to report in-person medical appointments but were at greater risk of poor outcomes across all other outcomes [risk ratio range = 1.01(1.01–1.02) to 1.91(1.80–2.01), risk difference range = 1.0(0.5–1.5) to 13.4(12.6–14.2)]. The disabled Black and disabled Hispanic/Latino groups experienced disproportionately high risk of poor outcomes across all indicators [risk ratio range = 1.0 (1.0–1.1) to 6.1 (5.0–7.1), risk difference range = 3.2 (1.9–4.4) to 33.1 (30.1–35.4)].The high number of people reporting disability, along with the notable disparities in community participation outcomes among those reporting disability, suggest the need for expanded rehabilitation services and community supports to enhance participation.People with disabilities experienced disparities in community participation outcomes during the pandemic, particularly in indicators of economic participation (paid employment, income, and education).Disabled people from racial and ethnic minority groups experienced the most severe disparities in outcomes.Stronger rehabilitation services are critical to address new disability or pandemic-related changes in the experience or severity of existing disability.Stronger community and social supports (employment supports, accessible assistive technology, and safe transportation options) may also reduce the disparities in community participation experienced by people with disabilities.People with disabilities experienced disparities in community participation outcomes during the pandemic, particularly in indicators of economic participation (paid employment, income, and education).Disabled people from racial and ethnic minority groups experienced the most severe disparities in outcomes.Stronger rehabilitation services are critical to address new disability or pandemic-related changes in the experience or severity of existing disability.Stronger community and social supports (employment supports, accessible assistive technology, and safe transportation options) may also reduce the disparities in community participation experienced by people with disabilities. [ABSTRACT FROM AUTHOR]

Pain management constitutes a pivotal aspect of palliative care. Certain instances of distressing pain are significantly relieved through interventional pain methodologies, demanding the expertise of pain specialists. Our perspective revolves around the integration of these 2 facets, envisaging a symbiotic relationship that could enhance patient outcomes. A prospective assessment was carried out within a collaborative clinic, uniting the realms of pain management and palliative medicine. Anonymized patient information was scrutinized to grasp the advantages of this amalgamation and identify strategies to address any inherent deficiencies. Furthermore, an illustrative case study was delineated, spotlighting the collaborative dynamics at a systemic level. During the period spanning from November 2020 to June 2021, a total of 43 patients received consultations at this collaborative clinic. Each patient was exposed to a comprehensive pain management regimen, with the most frequently conducted procedure being an intercostal nerve block, which was administered in 9.30% of cases. For the provision of effective pain relief within the palliative care context, the confluence of joint consultations from cancer pain specialists emerges as a requisite measure. This approach carries the promise of optimizing pain control and augmenting the quality of palliative care. [ABSTRACT FROM AUTHOR]

Aim: Best-practice in audiological rehabilitation takes a holistic client- and family-centred approach and considers hearing care in the context of personal well-being. Hearing loss not only impairs the ability to hear, but can also compromise the ability to communicate, thus negatively impacting both social and emotional well-being. Hearing care professionals play a key role in fostering their client's well-being. This paper aims to provide evidence-based recommendations to ensure inclusion of social-emotional well-being in audiologic rehabilitation clinical practice. Methods: A review of current research and expert opinion. Results: This guide proposes a 5-step plan which includes: identifying the client's social-emotional well-being; including family members in audiological rehabilitation; incorporating social-emotional needs and goals in an individualized management plan; relating identified hearing needs and goals to rehabilitation recommendations; and using counselling skills and techniques to explore and monitor social-emotional well-being. Each component of the 5-step plan is discussed and clinical considerations are presented. Conclusion: These comprehensive recommendations provide guidance to hearing care professionals looking to ensure clients' social-emotional well-being are considered throughout the rehabilitation journey. [ABSTRACT FROM AUTHOR]

The objective of the study was to evaluate the effect of including synchronous remote fine-tuning and follow-up as a part of the aural rehabilitation process. A randomised controlled trial (RCT). Experienced hearing aid users who were due for renewed aural rehabilitation were randomised to either an intervention group (n = 46) or a control group (n = 49). Both groups underwent all stages of the conventional renewed aural rehabilitation process within our clinics, but the intervention group was also offered remote follow-up visits, including an opportunity for synchronous remote fine-tuning of hearing aids. The Hearing Handicap Inventory for the Elderly/Adults (HHIE/A), the Abbreviated Profile of Hearing Aid Benefit (APHAB), and the International Outcome Intervention for Hearing Aid Users (IOI-HA) were used as outcome measures. Both groups improved in self-rated hearing difficulties and hearing aid benefits measured with HHIE/A and APHAB. No significant differences were found between the intervention and the control group. Including synchronous remote follow-up and fine-tuning as a part of an aural rehabilitation process may effectively complement clinical visits. Additionally, the synchronous remote follow-up has the potential to further develop person-centred care by enabling hearing aid users to identify individual needs directly in an everyday environment. [ABSTRACT FROM AUTHOR]

Background: Speech and language therapy can reduce the level of impairment and disability caused by aphasia (Brady et al., 2016). Selecting a therapy can be challenging for clinicians who may struggle to stay abreast of the best evidence to support therapy selection (Rose et al., 2014). Once a therapy is selected, accessing relevant resources is a significant barrier to implementation (Shrubsole et al., 2019). The Aphasia Therapy Finder (ATF) is proposed to be an online repository of therapy resources designed to aid selection of evidence-based aphasia therapies and to bridge the evidence-practice gap in aphasia rehabilitation. Aims: In this study, we aimed to explore speech pathologists’ selection and use of aphasia therapy approaches, and access to aphasia therapy resources in clinical practice. We further aimed to explore speech pathologists’ perspectives on the proposed ATF. Methods & Procedures: A cross-sectional, mixed-methods, survey design was employed. A 22-item web-based survey was developed and disseminated to speech pathologists via professional networks internationally. Data analyses included descriptive statistics and conventional content analysis. Outcomes & Results: Eligible responses from 176 speech pathologists across 19 countries were included in the analyses (86.3% completion rate). Speech pathologists reported using a range of therapy approaches (n = 43) in aphasia rehabilitation, consistent with previous findings (Rose et al., 2014). Information regarding new therapy approaches was predominantly obtained from academic sources including conferences, research literature, and professional development workshops. Speech pathologists placed high importance on research evidence when selecting therapy approaches. Resource limitations, including time and budget constraints, were identified as key barriers to implementing evidencebased aphasia therapy approaches in clinical practice. There was strong support for development of the ATF; 91.7% of respondents indicated they would use it in clinical practice. Recency of research, equity of access with the inclusion of linguistically and culturally diverse resources, and usability of resources were identified as priorities when developing the ATF. Conclusions: While speech pathologists report using a range of aphasia therapy approaches in clinical practice and consider research evidence when selecting therapy approaches, resource limitations continue to present a barrier to the implementation of evidence-based practice. The development of the ATF may support the translation of research evidence into clinical practice. [ABSTRACT FROM AUTHOR]

To examine whether extended compared to standard level of physiotherapy is feasible and has beneficial effects on physical function in ICU survivors. This prospective pilot study with a before and after design included patients discharged from ICU to a surgical ward. The comparison group were recruited between January and April 2019 and received standard level of physiotherapy. The intervention group were recruited between May and December 2019 and received extended physiotherapy, corresponding to 50% additional physiotherapist, working 4 hours per weekday. The intervention participants received an individual rehabilitation plan developed in collaboration with a ward-based physiotherapist, and an extended number of sessions provided by the extra resource included practicing individualized exercises, for example walking and stair climbing. Physical function was measured with the Chelsea Critical Care Physical Assessment tool (CPAx) at ICU discharge, during hospital stay and discharge. Group differences were analyzed using the Mann–Whitney U-test and Chi2 test. Out of 46 eligible patients, 39 (85%) fulfilled the study (comparison n = 12, intervention n = 27) and were included in the final analyses. No adverse events occurred, and the attendance rate was high (98.5%). There were no statistically significant differences between the groups regarding physical function, hospital stay, and readmissions, but there were tendencies to better outcomes in all these parameters in favor of the intervention group. Additionally, patients in the intervention group had statistically significantly higher scores in the CPAx items "transferring from bed to chair" (median 5 vs 4, p =.039) and "stepping" (median 5 vs 4, p =.005) at hospital discharge. This pilot study indicates that extended physiotherapy after ICU discharge is feasible and does not entail patient safety risks. However, determining the potential beneficial effects for the patients remains to be evaluated in a larger trial. [ABSTRACT FROM AUTHOR]

Active patient participation is an important factor in optimizing post-stroke recovery, yet it is often low, regardless of stroke severity. The reasons behind this trend are unclear. To explore how people who have suffered a stroke, perceive the transition from independence to dependence and whether their role in post-stroke rehabilitation influences active participation. In-depth interviews with 17 people who have had a stroke. Data were analyzed using systematic text condensation informed by the concept of autonomy from enactive theory. Two categories emerged. The first captures how the stroke and the resultant hospital admission produces a shift from being an autonomous subject to "an object on an assembly line." Protocol-based investigations, inactivity, and a lack of patient involvement predominantly determine the hospital context. The second category illuminates how people who have survived a stroke passively adapt to the hospital system, a behavior that stands in contrast to the participatory enablement facilitated by community. Patients feel more prepared for the transition home after in-patient rehabilitation rather than following direct discharge from hospital. Bodily changes, the traditional patient role, and the hospital context collectively exacerbate a reduction of individual autonomy. Thus, an interactive partnership between people who survived a stroke and multidisciplinary professionals may strengthen autonomy and promote participation after a stroke. [ABSTRACT FROM AUTHOR]

Although inspiratory muscle training reduces dyspnea in patients with chronic respiratory diseases, it was not yet evaluated in a sample composed exclusively of patients with interstitial lung diseases. To discuss the perception of patients with interstitial lung diseases about inspiratory muscle training intervention. This is a qualitative study. Data were collected using semi-structured interviews, transcribed, and analyzed by thematic analysis. Fourteen patients (64 ± 7 years) with interstitial lung disease were interviewed. Average participation in the inspiratory muscle training program was 90% (range, 66–100%). Three themes were elaborated: 1) dyspnea and other symptoms in daily life (e.g. "I could not carry out a bag; I was very uncomfortable"); 2) less symptom and greater performance (e.g. "I wash and change my clothes, house cleaning, do everything without feeling anything"); and 3) IMT: a time dedicated to my health (e.g. "For me it was great because I saw my evolution every day"). Patients noticed improvements in symptoms and performance related to daily activities. Despite initial difficulties, patients continued training as planned. [ABSTRACT FROM AUTHOR]

Enhancing the therapeutic alliance has been associated with improved outcomes for patients with chronic low back pain (CLBP). Qualitatively trust has been described to be part of the therapeutic alliance, but it has not been measured quantitatively within the physical therapy literature. Examine the relationship between trust and outcomes during physical therapy for CLBP. Observational study of patients with CLBP being seen for physical therapy were assessed through self-report measures. The Primary Care Assessment Survey (PCAS) trust measurement scale was completed by patients at initial, post-initial, and discharge visit. These measurements were compared for correlations with patient reported outcome measures for pain and function recorded at initial visit and discharge. A convenience sample of 29 patients (49.3 ± 15 years old) with CLBP were measured. The PCAS showed correlations for changes in trust throughout treatment for improvements in pain and discharge pain rating. Average discharge pain rating correlated to changes in the PCAS (rs = −0.692, p <.001), with lower pain ratings relating to higher changes in trust over time. Average change in pain (rs = 0.745, p <.001) throughout treatment also correlated with higher changes in trust. Higher trust scores at discharge also correlated with improved Global Rating of Change and Oswestry Disability Index scores at discharge. The linear regression model showed adjusted R2 values for the trust scores and outcomes varied between 0.247 and 0.642. Both increases in trust throughout the treatment and end trust scores during physical therapy were related to improved outcomes for patients with CLBP. [ABSTRACT FROM AUTHOR]

1) Characterize the delivery of programs that support acceptance and resiliency for people with brain injury in the healthcare sector; 2) Understand the barriers and facilitators in implementation of programs to support self-acceptance and resiliency for people with brain injury Participatory focus groups were used to explore experiences of conducting brain injury programs and knowledge of the barriers and facilitators to their implementation. Focus group data were analyzed with manifest content analysis to minimally deviate from broad and structural information provided by participants. Four focus group sessions were conducted online through a video calling platform. 22 individuals from community associations conducting programs for people with brain injury. Participants were recruited from a public brain injury organization database. Systemic challenges such as access to and allocation of funding require navigation support. Resource consistency and availability, including stable program leaders and a welcoming atmosphere, are important for program implementation and sustainability. Shared experiences promote connection with the community and personal development. This study informs individual- and community-level approaches to promote meaningful life after brain injury. Findings highlight existing resources and support future programming for people with brain injury. [ABSTRACT FROM AUTHOR]

Persistent symptoms experienced by adults following mild traumatic brain injury (mTBI) can significantly impact their daily activities. It is often difficult for them to access specialized rehabilitation services. The aim of this study is to explore this population's experience surrounding access to specialized rehabilitation services, including waiting time. This study used a qualitative phenomenological approach and was conducted using semi-structured interviews. Twelve adults with mTBI who had received specialized interdisciplinary rehabilitation services were recruited. The interviews focused on participants' recollection of their patient journey after injury, their perception of waiting, barriers and facilitators to access, and the impacts of these experiences on their condition. Participants reported experiencing symptoms such as anxiety, depression, worry, sadness, and discouragement before accessing specialized services. They all agreed that they did not receive clear information about their recovery process or the health services available to them, which exacerbated their mental health symptoms. The findings show that participants experienced uncertainty because they lacked information regarding recovery and access to health services after their injury. Education about symptoms and recovery, as well as emotional support for people with mTBI should be made available during the waiting period. Adults with persistent post-mild traumatic brain injury (mTBI) symptoms experienced many challenges in accessing health services such as long wait times, which they perceived as impacting their recovery. According to those concerned, more support from qualified health professionals is needed in the first weeks or months following the injury. Participants unanimously support free and timely access to specialized mTBI rehabilitation services. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of exercises by mechanical hippotherapy devices on postural control, balance, mobility, and Quality of Life in patients with stroke. This was a randomized controlled clinical trial with a total of 30 which were randomly divided into two groups. The participants in the mechanical hippotherapy group (MHG) (n = 15) were given exercises with a mechanical hippotherapy device for 15 min in addition to intensive conventional treatments (45 min), while the control group (CG) (n = 15) received additional 15 min of postural control and balance exercises for five days per week for four consecutive weeks. The primary outcome was The Berg Balance Scale (BBS). Secondary outcomes were the Fugl–Meyer (FM) Rating Scale, Biodex Balance Measurement (BBM), Trunk Impairment Scale (TIS), the Timed Up and Go Test (TUG) and quality of Life Short Form (SF-36). In the MHG, FM-Lower extremity score (−6.4, p = 0.024), FM-Upper extremity score (−12.87, p = 0.013), TIS (−5.87, p = 0.04) and TUG (5.73, p = 0.027) improved statistically significant compared to CG. Exercises using mechanical hippotherapy devices could improve postural control, functional mobility and balance in patients with stroke. It may also improve the quality of life. NCT03528993 NCT03528993 It was concluded from our results that mechanical hippotherapy could be included in the treatment programs of stroke patients. [ABSTRACT FROM AUTHOR]

We aimed to investigate health care needs, health service utilization, and their socio-economic and health-related determinants in people with spinal cord injury (SCI) living in Jiangsu and Sichuan Provinces of China. A total of 1355 participants with SCI living in the community were recruited using a multi-stage stratified random sample and surveyed by telephone or online. Outcomes evaluated included the presence of health care needs, mode of health service utilization, and specific provider types seen within 12 months preceding the survey. The prevalence of healthcare needs was 92%. Needs were higher in Sichuan (98%) as compared to Jiangsu (80%). Of those in need of health care, 38% reported not having utilized care, more in Sichuan (39%) than in Jiangsu (37%). In Jiangsu, inpatient care was more often used than in Sichuan (46% vs. 27%), while in Sichuan outpatient services were utilized more often (33% vs. 17%). On average, 1.6 provider types were seen, with Sichuan reporting fewer different provider types. Considerable differences in the prevalence of health care needs and service utilization patterns were found between provinces, mostly in favour of the economically more developed Jiangsu Province. People with low income, particularly those below the World Bank poverty line for middle-income countries, had increased health care needs but utilized health care less often. Moreover, environmental barriers contributed significantly to unmet health care needs. This implies the necessity to provide better accessible and more affordable rehabilitation services for people with spinal cord injury (SCI) in China such as community-based rehabilitation programming. Policies for alleviation of poverty in the case of SCI including insurance for catastrophic health expenditure should also be reviewed and adapted where applicable. [ABSTRACT FROM AUTHOR]

Brain injuries (traumatic-/nontraumatic, TBI/nTBI) in young patients may lead to problems e.g., decreased health-related quality of life (HRQoL), and causes family impact. Knowledge regarding the family impact and the relationship with patients' HRQoL over time is scarce. This follow-up study describes family impact/HRQoL and their mutual relationship in young patients (5–24 years) after TBI/nTBI. Parents of patients that were referred to outpatient rehabilitation completed the PedsQL™Family-Impact-Module questionnaire to assess the family impact and the parent-reported PedsQL™Generic-core-set-4.0 to assess patients' HRQoL (lower scores: more family impact/worse HRQoL). Questionnaires were completed at the time of referral to rehabilitation (baseline) and one/two years later (T1/T2). Linear-mixed models were used to examine family impact/HRQoL change scores, and repeated-measure correlations (r) to determine longitudinal relationships. Two-hundred-forty-six parents participated at baseline, 72 (at T2), median patient's age at baseline was 14 years (IQR:11–16), and 181 (74%) had TBI. Mean (SD) PedsQL™Family-Impact-Module score at baseline was 71.7 (SD:16.4) and PedsQL™Generic-core-set-4.0: 61.4 (SD:17.0). Over time, PedsQL™Family-Impact-Module scores remained stable, while PedsQL™Generic-core-set-4.0 scores improved significantly(p < 0.05). A moderately strong longitudinal correlation was found between family impact&HRQoL (r = 0.51). Family impact does not tend to decrease over time but remained a considerable problem, although patients' HRQoL improved. Next to focusing on patients' HRQoL, it remains important to consider family impact and offer family support throughout rehabilitation. This longitudinal study found that in young patients with traumatic brain injury (TBI) or non-traumatic brain injury (nTBI) referred for rehabilitation there is a considerable impact on the family until two years after referral, whereas the patients' health-related quality of life (HRQoL) improved significantly. Improvements in patients' quality of life status may not automatically lead to a decrease of family impact. Rehabilitation clinicians should monitor the impact on the family over time and provide long-term family support with special attention to parental worrying when needed. Clinicians should be aware that, despite significant differences between the clinical characteristics of patients with TBI and nTBI, the courses of family impact are very similar. [ABSTRACT FROM AUTHOR]

To verify the effectiveness of experimental occupational therapy plus intensive standard rehabilitation compared to intensive standard rehabilitation alone on the reintegration to social activities of complex patients three months after hospital discharge. Patients with a score ≥ 9 on the Rehabilitation Complexity Scale at admission to an intensive rehabilitation ward were randomized to the control or experimental group. Both groups received intensive multidisciplinary rehabilitation aimed at recovering independence in the basic activities of daily life (ADL). The experimental group also received experimental occupational therapy services to address goals identified through the administration of the Canadian Occupational Performance Measure (COPM). Experimental occupational therapy began during the in-hospital phase and continued in the home-based setting. It consisted of teaching strategies, recommending aids, and providing personalized information regarding available community support. Ninety-two individuals with a mean age of 65 years (female 44.6%) were enrolled. The experimental group significantly improved participation measured by the Reintegration to Normal Living Index (mean changes 8.61, 95% CI: 1–16.23, p = 0.027). The performance and satisfaction scores of the COPM, both during hospitalization and after discharge, and independence in ADL also improved. No differences in mood disturbances were found. Early post-discharge occupational therapy integrated with multidisciplinary rehabilitation improves the social participation of complex patients. Future research should investigate the concrete feasibility of implementing this complex intervention cost-effectively and in different contexts. ClinicalTrials.gov Identifier NCT03668938 (first posted date 13/09/2018) Early post-discharge rehabilitation assists patients' transition from hospital to home by improving the management of problems they encounter. In complex patients, occupational therapy initiated during hospitalization and extended to the early post-discharge phase improves social participation, independence in basic and instrumental daily activities, and performance and satisfaction when carrying out relevant occupational activities. The strong partnership between the Occupational Therapist and the patient improves compliance to treatment, enhancing the chances of success of rehabilitation interventions. [ABSTRACT FROM AUTHOR]

Eccentric quasi-isometric (EQI) contractions (maintaining a yielding contraction for as long as possible, beyond task failure) have gained interest in research and applied settings. However, little is known regarding the biomechanical profile of EQIs. Fourteen well-trained males performed four maximal effort knee-extensor EQIs, separated by 180 seconds. Angular impulse, velocity, and time-under-tension through the 30–100º range of motion (ROM), and in eight ROM brackets were quantified. Statistical parametric mapping, analyses of variance, and standardised effects (Hedges' g (ES), %Δ) detected between-contraction joint-angle-specific differences in time-normalised and absolute variables. Mean velocity was 1.34º·s−1 with most (62.5 ± 4.9%) of the angular impulse imparted between 40–70º. Most between-contraction changes occurred between 30–50º (p≤ 0.067, ES = 0.53 ± 0.31, 60 ± 52%), while measures remained constant between 50–100º (= 0.069–0.83, ES = 0.10 ± 0.26, 14.3 ± 24.6%). EQIs are a time-efficient means to impart high cumulative mechanical tension, especially at short to medium muscle lengths. However, angular impulse distribution shifts towards medium to long muscle lengths with repeat contractions. Practitioners may utilise EQIs to emphasize the initial portion of the ROM, and limit ROM, or apply EQIs in a fatigued state to emphasize longer muscle lengths. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONPediatric constraint-induced movement therapy (CIMT) is an evidence-based treatment that has a long history of demonstrating efficacy for children with hemiparesis. The purpose of this study is to determine the effectiveness of a culturally responsive CIMT program for children with hemiplegic cerebral palsy (CP) developed for the Vietnam healthcare system.Thirty children with hemiplegic CP (mean age = 2.88 years, age range: 1 to 8 yrs, 60% male) were recruited to a CIMT program (7.5 h/week, 4 weeks) developed for the cultural context of Vietnam. Motor abilities of the affected arm and participation in daily activities were evaluated at 3 time points (one-week prior to CIMT (baseline), one-week before (pre) and after (post) CIMT) using the Quality of Upper Extremity Skill Test (QUEST) and Pediatric Motor Activity Log-Revised (PMAL-R). Individual goals were measured using the Goal Attainment Scale (GAS).There were significant increases in the “How often scale” and “How Well” scales of the PMAL-R (0.75 and 0.75, p < 0.00)). Score of Grasp and Dissociated Movement items on the QUEST increased significantly (6.47 and 7.63, p < 0.001). Group GAS T-Scores were 52.19 indicating that children met individual goals.A model of CIMT was successfully developed and delivered within the Vietnamese healthcare system. Future studies should explore the optimal model for CIMT in various regions of world where the delivery of rehabilitation services may vary.This is the first study to investigate the effectiveness of a pediatric constraint-induced movement therapy (PCIMT), which was specially designed to be contextually and culturally relevant for Vietnam.The program was delivered by trained therapists and parents educated about the essential elements of PCIMT.The results provide important guidance on how to adapt current evidence-based components of PCIMT models to meet the needs of children globally in settings where culture, values, and models of healthcare may differ.Future global studies on PCIMT should continue to explore the optimal implementation model for CIMT to support all children with unilateral motor weakness in various regions of the world where the delivery of rehabilitation services may vary.This is the first study to investigate the effectiveness of a pediatric constraint-induced movement therapy (PCIMT), which was specially designed to be contextually and culturally relevant for Vietnam.The program was delivered by trained therapists and parents educated about the essential elements of PCIMT.The results provide important guidance on how to adapt current evidence-based components of PCIMT models to meet the needs of children globally in settings where culture, values, and models of healthcare may differ.Future global studies on PCIMT should continue to explore the optimal implementation model for CIMT to support all children with unilateral motor weakness in various regions of the world where the delivery of rehabilitation services may vary. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONRehabilitation plays a critical role in minimising disability after stroke, with the concept of “challenge” proposed to be essential to rehabilitation efficacy and outcomes. This review unpacks how challenge is conceptualised in stroke rehabilitation literature from the perspectives of physiotherapy, occupational therapy, speech-language therapy and people with stroke. A secondary purpose was to provide a definition of challenge that is applicable to stroke rehabilitation.Principle-based concept analysis was utilised to examine challenge within the stroke rehabilitation literature. Forty-two papers were included. Data analysis involved immersion, analytical questioning, coding and synthesis to elicit the conceptual components of challenge.Challenge was understood as a multidimensional and dynamic concept with three facets: nominal, functional and perceived challenge. Functional and perceived challenge were integral to optimal challenge. Optimal challenge was central to enhancing the outcomes and experiences of people with stroke, in rehabilitation and everyday life.Challenge is a key concept which, when carefully optimised to the person’s ability and experience, may positively influence their learning, recovery and engagement after stroke. This review lays a conceptual foundation for better understanding, operationalisation and advancement of challenge, offering important implications for addressing the growing burden of stroke disability, through rehabilitation.Challenge involves a multifaceted, multidimensional and dynamic interaction between the task, the person’s ability and their subjective experience.The therapist and the person’s perspective should collectively shape the process of co-creating a challenge that is truly optimal for the person.Therapists should consider both functional and perceived approaches to operationalising challenge with the person.Challenge involves a multifaceted, multidimensional and dynamic interaction between the task, the person’s ability and their subjective experience.The therapist and the person’s perspective should collectively shape the process of co-creating a challenge that is truly optimal for the person.Therapists should consider both functional and perceived approaches to operationalising challenge with the person. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusions\nIMPLICATIONS FOR REHABILITATIONIn this study, we sought to examine how lower limb prosthesis users define success, what constructs they associate with success, and what barriers and facilitators contribute to achieving success.Purposively sampled lower limb prosthesis users were recruited to participate in a focus group study. Verbatim transcripts from focus groups were analyzed using inductive thematic analysis. Identified constructs were mapped to existing outcome measures, and a conceptual framework for success with a lower limb prosthesis was proposed.Thirty-one lower limb prosthesis users participated in one of five focus groups. Five themes were developed: keep moving forward, despite ups and downs; being able to live MY normal life and do the things I want to do with ease; learning what works for me and how to manage my prosthesis; only I can define my success; and what about my mental health? Several constructs that do not align with existing measures were identified, including prosthetic attention, grief/loss after amputation, and trust in prosthesis. Facilitators for success described by participants included peer connection, finding the right prosthetist, and mental health support.According to lower limb prosthesis users, success must be patient-driven, individually defined, and continually reassessed.According to prosthesis users, success with a lower limb prosthesis should be patient-driven, individually defined, and continually reassessed.Lower limb prosthesis users described facilitators for success to include peer connection, finding the right prosthetist, mental health support, and access to appropriate prosthetic technology.Constructs described by lower limb prosthesis users as relating to success that are currently difficult to measure include prosthetic attention, grief/loss after amputation, prosthesis management, ability to blend in, and trust in the prosthesis.According to prosthesis users, success with a lower limb prosthesis should be patient-driven, individually defined, and continually reassessed.Lower limb prosthesis users described facilitators for success to include peer connection, finding the right prosthetist, mental health support, and access to appropriate prosthetic technology.Constructs described by lower limb prosthesis users as relating to success that are currently difficult to measure include prosthetic attention, grief/loss after amputation, prosthesis management, ability to blend in, and trust in the prosthesis. [ABSTRACT FROM AUTHOR]

Rehabilitation services play an important role in the lives of persons who experience vision loss. These services provide necessary practical techniques for adjustment to visual impairment. However, there is insufficient research exploring the ways in which these services act at the level of meaning and identity. This paper summarises the findings from a study that investigated the operation of blindness discourses in rehabilitation services for adults with visual impairments in South Africa. The study posed questions concerning the meanings about blindness which are produced and reinforced in rehabilitation practice. It also considered the implications of exposure to these meanings for persons with visual impairments. Foucauldian discourse analytic reviews were conducted on digital documentary sources, as well as on data gathered through semi-structured interviews with rehabilitation service providers and service users. This paper discusses two overarching discursive practices in visual impairment rehabilitation, namely, ‘Journey discourse’ and ‘charitable discourse’. We conclude that, rather than an abstract exercise, considering the ideological assumptions embedded in rehabilitation practice is essential to uncover and address discursive systems that support the continued marginalisation of people with visual impairment. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONThis pilot study aimed to (a) investigate opportunities for immersive Virtual Reality (VR) technology in communication, physical, and visual rehabilitation by examining the interaction of people without disabilities in a range of structured virtual environments; and (b) validate research protocols that might be used to evaluate the physical, visual, and verbal interaction of users in virtual worlds, and their safety while using the technology.Thirteen adults identifying as people without disability were exposed to VR via a head-mounted display. A video-review method was used to qualitatively code and analyse each participant’s communication, movement, orientation, and support needs.All participants oriented to their virtual environments sufficiently to use applications. Their spoken language was effective for interaction, although unconventional social behaviours were also observed. Two participants reported minor adverse reactions consistent with mild cybersickness. The results provide insight into the types of environments and characters that support the greatest communicative, physical, and visual interaction in immersive VR. The tested protocols are useful to assess safety when using VR, and to observe communicative, physical, and visual interaction with virtual environments and characters. Implications for future research and use of VR with people with communication, physical and visual disability are discussed.Safe use of virtual reality in rehabilitation requires careful assessment. Comprehensive observational protocols were sufficient to manage safety concerns.Rehabilitation applications need rapid responsivity in verbal interactions to ensure users are immersed in interactions.Non-verbal cues from virtual avatars best direct user attention in the environment.Novice virtual reality users largely controlled technology using their dominant hand. They could control VR successfully with one hand.Safe use of virtual reality in rehabilitation requires careful assessment. Comprehensive observational protocols were sufficient to manage safety concerns.Rehabilitation applications need rapid responsivity in verbal interactions to ensure users are immersed in interactions.Non-verbal cues from virtual avatars best direct user attention in the environment.Novice virtual reality users largely controlled technology using their dominant hand. They could control VR successfully with one hand. [ABSTRACT FROM AUTHOR]

BackgroundCase DescriptionOutcomesDiscussionConclusionHarlequin syndrome is a rare autonomic condition consisting of unilateral facial flushing and sweating induced by heat, emotion or physical activity. The affected side presents anhidrosis and midline facial pallor due to denervation of the sympathetic fibers.This case describes a patient who reported right-side redness of the face associated with hyperhidrosis during physical activity. She had two previous major motor vehicle accidents. The patient demonstrated difficulties in the visual accommodation of the left eye, but cranial nerve assessment was unremarkable; the patient was then referred to an ophthalmologist, who excluded any autonomic dysfunction as the primary cause of convergence and visual acuity.A left-sided sympathetic dysfunction with Harlequin sign diagnosis was made followed by a progressive compensatory adaptation of the right face. The patient was educated and reassured about the benign nature of her problem.Knowledge of the autonomic nervous system is still limited in clinical practice. Although challenging, physiotherapists should develop the knowledge and ability needed to perform appropriate assessment of autonomic dysfunctions.A dispositional reasoning model should be considered in differential diagnosis. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterial and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONSystematic reviews of interventions are published each year evaluating rehabilitation approaches such as exercise, manual therapy, or electrotherapy. Currently, important methodological approaches are available to make systematic reviews more robust and transparent. One of these approaches is the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) system.A perspective for rehabilitation was conducted aiming to (1) shed light on the meaning and relevance of the GRADE system in systematic reviews with meta-analysis of rehabilitation science, and (2) propose suggestions for helping clinicians improve the interpretation of the GRADE findings.The meaning and relevance of GRADE in rehabilitation science was discussed. Suggestions were proposed to help clinicians in the interpretation of the GRADE findings. We discussed the use of meta-analyses, meta-regressions, subgroups meta-analyses, and sensitivity analyses to increase the objectivity of the domains of GRADE. Finally, a future agenda was provided.The use of GRADE is essential for improving the synthesis of evidence that clinicians may often use in rehabilitation practice. However, GRADE is only one hallmark when the findings of systematic reviews are interpreted. The issues of sample size, futile research, pre-registration, switching outcomes, or narrative bias should be also considered.Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) is helpful in systematic reviews for understanding the certainty of evidence is analyzed.GRADE could detect limitation in the certainty of evidence helping clinicians to choose the best therapeutic option for their patients.Some domains of GRADE (indirectness and inconsistency) are particularly useful for clinicians who aim to translate the conclusions of a synthesis of evidence into clinical practice. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONNon-weight bearing is often recommended after humeral fractures. This review aims to summarise the extent and nature of the evidence for the feasibility, acceptability, safety, and effects of early weight bearing (EWB) in people with humeral fractures, treated operatively or non-operatively. Data sources identified published (PUBMED, EMBASE, CINAHL) and unpublished (ClinicalTrials.gov, CENTRAL, NIHR Open Research, OpenGrey) literature. Independent data extraction was conducted by two reviewers.13 901 records were retrieved. Ten studies, involving 515 post-operative patients and 351 healthcare professionals, were included. EWB was found to be feasible in nine studies. There was limited evidence regarding adherence to EWB. Trauma and orthopaedic surgeons reported that EWB was acceptable. This depended on surgery type and whether it was a post-operative polytrauma case. No acceptability data was reported from patients’ perspectives. Only one study reported two patients who developed unsatisfactory outcomes from excessive post-operative EWB. Positive effects of EWB were reported on disability level, pain, shoulder and elbow motion, and union.There is some evidence for the feasibility, safety, and effectiveness of post-operative EWB after humeral fractures. There was limited data on the acceptability of EWB. Heterogeneous study designs, and variations in EWB protocols limit conclusions.There is some evidence to support the feasibility, safety, and effectiveness of early weight bearing following operative management of humeral fractures.Early weight bearing after some humeral fractures is acceptable to some subspecialities of orthopaedic surgeons but is not universally accepted.Rehabilitation professionals should discuss the option of early weight bearing after operative management of humeral fracture with patients and their multidisciplinary team.There is some evidence to support the feasibility, safety, and effectiveness of early weight bearing following operative management of humeral fractures.Early weight bearing after some humeral fractures is acceptable to some subspecialities of orthopaedic surgeons but is not universally accepted.Rehabilitation professionals should discuss the option of early weight bearing after operative management of humeral fracture with patients and their multidisciplinary team. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONObjective: There is growing evidence that fear of falling (FOF) is common in people who use wheelchairs full-time and negatively influence their performance of daily activities and quality of life. The purpose of this study was to gain an in-depth understanding of perceptions related to FOF among people who use wheelchairs full-time.Methods: Mixed-method analysis was conducted using semi-structured interviews and surveys to gain insight into FOF. Surveys included demographic information; Spinal Cord Injury-Fall Concerns Scale (SCI-FCS); a questionnaire that directly assesses FOF and associated activity curtailment; and Fall Control Scale (FCS).Results: Among 39 participants (age = 43.1 ± 15.6 years, disability duration = 21.2 ± 11.1 years), 27 participants (69%) reported FOF. Participants with less perceived ability to control falls indexed by FCS reported higher SCI-FCS scores, indicating greater FOF (rs = −0.384, p = 0.016). Qualitative findings revealed that participants felt that FOF developed due to sustaining fall-related injuries or limited ability to recover from a fall. Some participants perceived falling as a part of their lives. They believed that it was not the cause of developing FOF.Conclusions: Among people who use wheelchairs full-time, FOF is prevalent and may develop due to fears of sustaining injuries or being unable to get up after falling. Developing an evidenced-based education protocol aimed at managing falls (e.g., establishing a fall recovery strategy and education on techniques to reduce injury during falls) is needed to minimize FOF people who use wheelchairs full-time.Fear of falling and associated activity curtailment are prevalent among people who use wheelchairs full-time.Fear of falling often develops as a result of prior fall-related injuries or the inability to recover from a fall independently.Evidence-based education protocols to reduce fear of falling among people who use wheelchairs full-time should contain content related to fall recovery and injury prevention.Fear of falling and associated activity curtailment are prevalent among people who use wheelchairs full-time.Fear of falling often develops as a result of prior fall-related injuries or the inability to recover from a fall independently.Evidence-based education protocols to reduce fear of falling among people who use wheelchairs full-time should contain content related to fall recovery and injury prevention. [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONPurpose: This study evaluates the effect of power wheelchair telemonitoring and battery charging training on user charging behavior and repair measures and assesses the relationship between wheelchair usage and repair measures to support technician-led servicing.Methods: This is a retrospective analysis of two matched cohorts with a total of n=237 users from the NHS service dataset. In the training cohort, a wheelchair usage telemonitoring device monitored the battery usage of n=119 power wheelchair users for 12 months. Users whose battery charging behavior was not optimal were instructed on appropriate charging practices. Wheelchair usage parameters of wheelchair drive and power time every month were used to predict repairs and associated costs.Results: Fifty-four out of 119 users in the training cohort did not charge batteries regularly and were instructed on appropriate charging. Twenty-six of them changed their behavior and charged their batteries every night. This cohort experienced reduced battery repairs by 18%, wheelchair repairs by 11%, and repair costs by £3,092 compared to a matched standard care cohort (n=118). User age and drive time were associated with repair measures. Drive time predicted time-to-failure for wheelchair parts and classified failure risk with the area under the receiver operating characteristic curve as 0.71 (95% CI 0.61 to 0.82; p<.001). Conclusions: By leveraging the significant relationships between wheelchair usage and repairs, wheelchair users at risk of part failures can be identified, and technician-led servicing tools for proactive interventions can be developed. Wheelchair battery health telemonitoring and instructing users on appropriate battery charging reduced repairs and associated costs.Proactive wheelchair servicing by repair technicians in collaboration with wheelchair users safeguards users against critical part failures and minimises repair-related operating costs for service providers.Providers should leverage wheelchair telemonitoring technologies and related research outputs to improve repair services and support their clients’ continued mobility and community participation.It is important that healthcare plans and policies recognise the benefits of proactive wheelchair servicing and use data as a tool to allocate device usage and performance-based reimbursements.Proactive wheelchair servicing by repair technicians in collaboration with wheelchair users safeguards users against critical part failures and minimises repair-related operating costs for service providers.Providers should leverage wheelchair telemonitoring technologies and related research outputs to improve repair services and support their clients’ continued mobility and community participation.It is important that healthcare plans and policies recognise the benefits of proactive wheelchair servicing and use data as a tool to allocate device usage and performance-based reimbursements. [ABSTRACT FROM AUTHOR]

AbstractPurposeMethodsResultsConclusions\nIMPLICATION FOR REHABILITATIONDigital health technologies have the potential to advance rehabilitation. The Virtual Engagement Rehabilitation Assistant (VERA) is a digital technology, co-designed to increase service-user engagement and promote self-management. This qualitative study explored staff and service-user perceptions of implementing VERA on a UK complex inpatient rehabilitation ward.Purposively sampled service-users were allocated to VERA for up to six weeks. The Non-adoption, Abandonment, Scale-up, Spread and Sustainability (NASSS) framework underpinned service-user post-intervention interviews and staff focus groups, and structured analysis of the data. Seven service-users were interviewed. Nine staff contributed to focus groups.A framework analysis identified themes (and subthemes) structured by the NASSS framework domains: 1. Nature of Clinical Condition, 2. Technology (Ease of Use, Holding Information/Resources in a single Digital Location, Appointments), 3. Value Proposition (Structuring Time, Feedback, Unexpected Benefits) 4. Adopters (Confidence in using Technology, Usefulness), 5. Wider Organisation. Ease of use and storage of key information in a single location were beneficial. Reliability, and provision of accurate and timely feedback to staff and service-users, were identified as essential.A blended approach is required to meet staff and service-user needs. The potential for VERA in a community setting was identified and requires further investigation. Learning from VERA will support development of other digital technologies and their implementation.Digital health technologies have the potential to positively impact rehabilitation but may not be suitable for all service-users.Digital health technologies for rehabilitation must be easy to use and reliable.Relevant and informative feedback from the digital health technology was considered essential by both staff and service-users.Utilising a theoretical framework that focuses on key components of implementation was instrumental for development and evaluation of Virtual Engagement Rehabilitation Assistant (VERA).Digital health technologies have the potential to positively impact rehabilitation but may not be suitable for all service-users.Digital health technologies for rehabilitation must be easy to use and reliable.Relevant and informative feedback from the digital health technology was considered essential by both staff and service-users.Utilising a theoretical framework that focuses on key components of implementation was instrumental for development and evaluation of Virtual Engagement Rehabilitation Assistant (VERA). [ABSTRACT FROM AUTHOR]

Abstract\nIMPLICATIONS FOR REHABILITATIONAdditive manufacturing (3D printing) is increasingly utilized in healthcare. Some rehabilitation professionals employ 3D printing for orthoses, prostheses, and assistive technologies (AT). However, anecdotal evidence suggests that many practitioners have reservations about adopting 3D printing into their practices, and empirical research in this area is limited. The aim of the study was to document my experience while learning 3D printing. In this autoethnographic study, journal entries and photos of the artifacts were collected during the process of learning 3D printing. These data were analyzed using reflexive thematic analysis. Three themes were identified: Being motivated to learn 3D printing, Experiencing challenges and implementing possible solutions, and Achieving developmental milestones in learning 3D printing. These milestones offered practical insights and solutions for new learners by providing a roadmap for navigating the journey of learning 3D printing. This personal experience offered opportunities and posed challenges in the context of learning to use 3D printing in the rehabilitation field. It is hoped that this study will inspire others to explore 3D printing and potentially contribute to the development of 3D printing training programs for students and rehabilitation professionals.The study contributes to understanding of 3D printers use for individuals with disabilities, whether in occupational therapy or non-occupational therapy contexts.By highlighting the issues and challenges documented in this study, individuals with no prior exposure to 3D printing can better manage their expectations when embarking on their own 3D printing journey.This experience can serve as an inspiration for occupational therapy students and other students in rehabilitation programs to share their own stories about their encounters with 3D printing, potentially sparking new approaches to practice.The knowledge and experience gained through 3D printing might help to develop a 3D printing training workshop.The study contributes to understanding of 3D printers use for individuals with disabilities, whether in occupational therapy or non-occupational therapy contexts.By highlighting the issues and challenges documented in this study, individuals with no prior exposure to 3D printing can better manage their expectations when embarking on their own 3D printing journey.This experience can serve as an inspiration for occupational therapy students and other students in rehabilitation programs to share their own stories about their encounters with 3D printing, potentially sparking new approaches to practice.The knowledge and experience gained through 3D printing might help to develop a 3D printing training workshop. [ABSTRACT FROM AUTHOR]

Chronic low back pain is a leading cause of disability worldwide. A clinical model for its cause is lacking. Defining a cause based clinical model and a framework of understanding back pain in terms of peripheral structural and central functional pain is essential for optimal management. We describe the results of the largest published audit of 41 chronic low back pain patients, receiving outpatient sublingual ketamine therapy for defined central functional pain along with conventional peripheral structural pain management. Our clinical model assigns Movement Dysfunction as the primary cause for low back pain symptoms and restores it with Movement Therapy focused rehabilitation which is also defined. Patients were derived from a tertiary single neurosurgical specialist practice in Brisbane Australia over a three year period. Severe pain and disability measurements more than halved and only 13% of patients ceased ketamine prematurely due to predominantly non-sinister side effects common to all pharmaceutical therapies. All other surveyed metrics of utility were highly favourable in this challenging cohort of chronic back pain patients biased to poor outcomes. Outpatient ketamine maintains high efficacy and safety used in conjunction with a unique clinical model that describes chronic low back pain. This paper builds on our previous publications that describe the disease of movement dysfunction as an integral factor to the development of a cause based clinical model for the condition of chronic low back pain symptoms. Our clinical application of this model, applying the necessary dual approach of controlling symptoms arising from peripheral structural pain and central functional pain in conjunction with elimination of root causation has shown favourable outcomes in patients with high levels of pain and disability based on their tertiary referral origin and high Oswestry Disability Scores. Removing chronic low back pain from its position as one of the world's leading causes of pain and disability is more likely if the rehabilitation industry can replicate and test treatment algorithms based around established clinical models of disease which is the important subject of this paper. [ABSTRACT FROM AUTHOR]

To identify barriers and enablers for access to and participation in rehabilitation for people with LLA in East, South, and Southeast Asian developing countries from the perspective of rehabilitation professionals. A mixed-method study involving an anonymous cross-sectional screening survey followed by in-depth interviews of rehabilitation professionals in these regions following the COREQ guidelines. Participants were surveyed online using convenience and snowball sampling techniques to inform a purposive heterogenic sample for semi-structured online interviews, between September 2021 to February 2022. Interview transcripts were analysed and thematically coded using the modified Health Care Delivery System Approach (HCDSA) framework. A total of 201 quantitative survey responses shaped the interview questions and participation of 28 participants from 13 countries for the qualitative investigation. Important factors at the patient level were sex, economics, health issues, language differences, and lack of awareness; at the care team level, peer and/or family support, referrals, and the gender of the professional; at the organizational level, service availability, resources, and quality; and at the environmental level, policies, supports, and physical and/or social accessibility. Identified interlinked factors at multiple levels of the HCDSA underpin the need for a systems approach to develop and address regional rehabilitation service provision but requires contextually adapted policy. Amputation rehabilitation practices need improvements in the developing Asian region including evaluation and redesign of, and processes and policies by, policy makers with increased support for those with lower limb amputation. The consistent factors identified in these regions as negatively impacting rehabilitation services suggest opportunities to collaborate and design common mitigation approaches between rehabilitation providers across countries. Unique local factors impacting rehabilitation in different countries suggest the necessity for customization in consultation with rehabilitation practitioners rather than the adoption of generic charitable models by external agencies. Rehabilitation professionals and others responsible for rehabilitation policy and practice should systematically target factors impacting rehabilitation outcomes for improvements at all levels within the health care systems. [ABSTRACT FROM AUTHOR]

Task-specific training generally targets motor function, with the ultimate goal of improving quality of life (QoL). This study aimed to determine whether motor function indirectly affects QoL through daily use of the affected arm and activities of daily living (ADL) in patients with chronic stroke. This was a retrospective cohort study of 155 patients who received training for 90–120 min/session, 3–5 sessions/week, for 4–6 weeks. The training involved specific mirror or robot-assisted therapy, followed by functional task practice for 15–30 min in each session. Patients were assessed before and after the intervention. At both pre-test and post-test, significant indirect effects of motor function on QoL through daily use of the affect arm and ADL were observed (β = 0.087–0.124). When the change scores of the measures between the pre-test and post-test were used, significant mediating effects of daily arm use on the relationship between motor function and QoL were identified (β = 0.094–0.103). Enhanced motor function after intervention may lead to an increase in arm use for daily activities and subsequently result in an improvement in QoL. These results highlight the critical role of daily arm use in task-specific training aimed at improving QoL. Task-specific training may improve motor function, daily arm use, activities of daily living, and quality of life in patients with mild-to-moderate arm hemiparesis. To improve quality of life in task-specific training, clinicians may work in sequence from motor function to daily arm use and then to activities of daily living. Emphasizing the use of the affected arm in daily life is critical to improve quality of life in task-specific training. [ABSTRACT FROM AUTHOR]

To assess the impact of increased physiotherapy capacity in an acute regional Neurosurgery Centre on outcomes for people with an acquired brain injury (ABI) requiring a tracheostomy. A service review of patients undergoing active tracheostomy weaning, admitted over two 15-week time periods; normal physiotherapy staffing with enhanced physiotherapy staffing. With a 50% increase in staffing, physiotherapy rehabilitation sessions increased from 2 to 4 times weekly. A mean improvement was found for patient outcomes; time with a tracheostomy in situ reduced by 11 days and the length of hospital stay reduced by 19 days. Functional status on discharge also improved, with 33% of patients able to mobilise on discharge with normal staffing levels and 77% of patients able to mobilise on discharge with enhanced staffing levels. A temporary increase in physiotherapy capacity gave the opportunity to evaluate the impact on physiotherapy rehabilitation frequency and patient outcomes. Results demonstrate the positive impact for this complex patient group on outcomes including rehabilitation frequency, length of stay, time to decannulation, and functional status on discharge. Early access to high-frequency specialist physiotherapy rehabilitation is a critical component of improving functional independence in people with an ABI requiring a tracheostomy. Increasing the capacity of specialist neurological physiotherapy treatment within this healthcare setting for people who have acquired a brain injury and require tracheostomy intervention may have a significant impact for patients and the NHS. Service improvement projects that use rigorous research methodology produce outcomes and evaluations that are robust and reliable. Supporting health and care professionals to use research methods within service improvement projects exposes them to the value of embedding research within their clinical environments. [ABSTRACT FROM AUTHOR]

Orthotic devices may be prescribed for the management of foot and ankle deformities caused by Charcot-Marie-Tooth disease (CMT). However, the actual use of these devices is variable. No studies have evaluated the impact of prescription, delivery and follow-up of orthotic devices on their use. We aimed to describe the relationship between the pathways followed by individuals with CMT and orthotic device use. Exploratory, cross-sectional, 35-item survey of orthotic device management. Individuals with CMT were recruited from CMT-France Association. Of the 940 respondents, 795 were included, mean age of 52.9 (SD 16.9) years. Rate of orthotic device use was 49.2% (391/795). The most frequent reason for non-use was a poor fit. Non-use was related to the orthotic device type, the health professionals consulted, and the severity of the CMT-related impairments. Follow-up visits (38.7%), re-evaluation of orthotic devices (25.3%) and consultations with the Physical and Rehabilitation Medicine physician were infrequent (28.3%). Orthotic devices are massively underused. Follow-up and re-evaluation are infrequent. Care pathways, prescription and delivery of orthotic devices must be optimized to meet the expectations of people with CMT. Device fitting, individual needs, and changes in the clinical state must be re-evaluated regularly by specialists to improve orthotic device use. Foot deformities and foot drop contribute to disability in people with Charcot Marie Tooth Disease but use of orthotic devices is poor. To improve orthotic device use, regular multidisciplinary consultations and regular re-evaluation of the device by specialists in neuro-orthopaedics are important. The device fit should be regularly re-evaluated by the prescribing doctor or the practitioner who made the device. Regular multimodal evaluation of foot deformity, including muscle strength and length, and the individual's needs and expectations is also important to improve orthotic device use. [ABSTRACT FROM AUTHOR]

This study explored rehabilitation of severely damaged bridge pier models using reinforced concrete jacketing method adopting a plastic hinge relocation technique. The test specimens were tested under cyclic loading. The important seismic performance parameters were evaluated for the rehabilitated specimen. A 3D finite element model was simulated considering concrete-rebar interaction and jacket-pier interface shear. Calibration of the numerically simulated model was done by comparing with experimentally observed responses. Additionally, a parametric study was conducted to investigate the effect of shear connectors on performance of the rehabilitated test specimen. Rehabilitation of severely damaged scaled bridge pier model by RC jacketing following a systematically adopted step-by-step procedure. Shifting of plastic hinge location from the pier-foundation interface. Calibration of numerical model of RC jacketed pier incorporating concrete-rebar interaction and jacket-pier interface shear by comparing with experimentally observed responses. A parametric study to investigate the effect of shear connectors on the performance of RC jacketed bridge pier model. [ABSTRACT FROM AUTHOR]

AbstractObjectivesDesignStudy sampleResultsConclusionSome adults experience challenges in successfully communicating their listening difficulties to their audiologist, and report feeling that they are not always listened to or understood. This project examined adults’ recollections of discussions with their audiologist to explore (1) how adults report describing their listening difficulties and (2) information that adults report they do not communicate, or do not communicate successfully, to their audiologist.Individual semi-structured interviews were conducted. Interview transcripts were analysed using a template analysis approach.Fifteen adults who self-report listening difficulties, and who had previously consulted an audiologist.Four themes were identified from adults’ recollections of how they describe their listening difficulties: (1) situation or context of listening difficulties, (2) behavioural responses, (3) impacts of listening difficulties and (4) contributing factors. Adults report not always successfully communicating (1) emotional concerns and impacts, (2) descriptions of sound quality and (3) descriptions of changed listening experiences.Results provide insights about the times when adults feel that communication with their audiologist is successful, or unsuccessful. The results are useful for informing interventions to help adults and audiologists communicate more effectively together. To further inform interventions, factors affecting adults’ communication should be explored. [ABSTRACT FROM AUTHOR]

Although sexuality has been shown to be negatively impacted in up to half of individuals who sustain traumatic brain injury (TBI), few studies have sought to evaluate the efficacy of targeted interventions. Gaining insight into the participant experience of undergoing treatment for post-TBI sexuality changes is a crucial aspect of intervention evaluation. This study aimed to investigate participants with TBI experience of undergoing eight sessions of a novel CBT intervention designed to help both couples and singles improve sexual wellbeing after TBI. Eight participants (50% male) with moderate-severe TBI, and a mean age of 46.38-years (SD = 13.54), completed a qualitative interview. A six-phase reflexive thematic analysis approach was used. Despite variability in participant characteristics, the findings suggested that participants with TBI experience reflected that of a positive treatment journey characterized by high levels of enjoyment and satisfaction. Key themes identified included contextual factors that preceded treatment, factors that facilitated treatment engagement, outcomes derived from the treatment experience, and feedback provided on reflection. The results not only provide an enriched understanding of the client experience of the intervention but provide corroborating preliminary evidence of efficacy for this novel CBT intervention in addressing complex and persistent sexuality problems after TBI. [ABSTRACT FROM AUTHOR]

During the early recovery period after traumatic brain injury (TBI), referred to as post-traumatic amnesia (PTA), approximately 44% of individuals may exhibit agitated behaviours. Agitation can impede recovery and poses a significant management challenge for healthcare services. As families provide significant support for their injured relatives during this time, this study aimed to explore the family's experience during PTA to better understand their role in agitation management. There were 20 qualitative semi-structured interviews conducted with 24 family members of patients exhibiting agitation during early TBI recovery (75% female, aged 30–71 years), predominantly parents (n = 12), spouses (n = 7) and children (n = 3). The interviews explored the family's experience of supporting their relative exhibiting agitation during PTA. The interviews were analyzed using reflexive thematic analysis, which revealed three key themes: family contributions to patient care, expectations of the health care service and supporting families to support patients. This study emphasized the significant role of families in managing agitation during early TBI recovery and highlighted that families who are well-informed and well-supported have the potential to minimize their relative's agitation during PTA, which may reduce the burden on healthcare staff and promote patient recovery. [ABSTRACT FROM AUTHOR]

The use of AI has progressed rapidly in recent years, and the notion of smartness is commonplace. However, while the topic of smart cities has received considerable research attention, there has been a lack of discussion about the use of smart technologies in prisons. While, especially in Eastern countries, AI in law enforcement is mainly used for security and control purposes (in Hong Kong, intelligent CCTV can detect unusual behaviour, and wristbands are used to collect data on prisoners), in Northern Europe the trend is to build smart prisons where AI is used as a rehabilitation tool (in Finland, Virtual Reality is employed to help rehabilitation). Adopting a comparative approach, the aim of this article is to demonstrate that AI is a transformative technology that is provoking structural changes in criminal law enforcement – especially in prisons – and that these changes express two opposing tendencies, that could transform the essence of penalties. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and MethodsResultsConclusion\nIMPLICATION FOR REHABILITATIONTo cross-culturally adapt the Patient-Specific Functional Scale (PSFS) into Italian and study its classic psychometric properties in subjects with shoulder pain (SP).The PSFS was translated into Italian and administered to 109 SP subjects. Acceptability (time to administer, floor and ceiling effects), reliability (internal consistency [Cronbach’s alpha], test-retest reliability [Intraclass Correlation Coefficient (ICC)], and measurement error [Standard Error of Measurement (SEM), Minimal Detectable Change, (MDC)]), were assessed. Moreover, construct validity was investigated through a-priori hypothesis testing, comparing the PSFS with the Disability of the Shoulder, Arm and Hand (DASH) scale, 36-item Short Form Health Survey (SF-36) and Numeric Pain Rating scale (NPRS).The PSFS was successfully adapted into Italian, and its acceptability was satisfied. Internal consistency was high (Cronbach’s alpha = 0.925), and test-retest reliability was good (ICC = 0.866, 95% CI = 0.749–0.931). A SEM of 0.7 points and an MDC of 1.9 points were obtained. We observed moderate evidence for construct validity, with 4/6 correlations between other measures being respected.This study provided reliability and validity of the PSFS in a sample of Italian SP subjects. Future studies should assess the responsiveness of using the PSFS as an outcome measure to capture clinical changes after treatment.The Patient-Specific Functional Scale is a reliable, and easy-to-use patient-reported outcome measure.The Patient-Specific Functional Scale was cross-cultural validated in the Italian language.The Patient-Specific Functional Scale has excellent internal consistency, high reliability, low measurement error, and moderate construct validity in subjects with shoulder pain.The Patient-Specific Functional Scale can be used in clinical practice by Italian physiotherapists to assess subjects with shoulder pain.The Patient-Specific Functional Scale is a reliable, and easy-to-use patient-reported outcome measure.The Patient-Specific Functional Scale was cross-cultural validated in the Italian language.The Patient-Specific Functional Scale has excellent internal consistency, high reliability, low measurement error, and moderate construct validity in subjects with shoulder pain.The Patient-Specific Functional Scale can be used in clinical practice by Italian physiotherapists to assess subjects with shoulder pain. [ABSTRACT FROM AUTHOR]