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OBJECTIVES: Tai Chi (TC) shows some beneficial effects in reducing pain in knee osteoarthritis (OA). However, the selection of criteria TC forms in previous studies were unclear and inconsistent, possibly accounting for the varying outcomes and rendering the training effects suboptimal. We have selected four optimal TC (OTC) forms based on the knee joint load and its association with pain. This pilot study sought to examine the effect of the OTC forms on reducing knee pain in individuals with knee OA. METHODS: Fifteen knee OA participants were recruited. Their knee joint pain level was rated by using the Visual Analogue Scale before and after two weeks of OTC training and compared between these two assessments. RESULTS: The two-week OTC training course was well accepted by our participants. The knee OA pain showed a significant reduction (median pain score: 5 ​cm before training and 1 ​cm post-training, Wilcoxon p ​

BackgroundRecent international health events have led to an increased proliferation of remotely delivered health interventions. Even with the pandemic seemingly coming under control, the experiences of the past year have fueled a growth in ideas and technology for increasing the scope of remote care delivery. Unfortunately, clinicians and health systems will have difficulty with the adoption and implementation of these interventions if ongoing and future clinical trials fail to report necessary details about execution, platforms, and infrastructure related to these interventions. The purpose was to develop guidance for reporting of telehealth interventions.MethodsA working group from the US Pain Management Collaboratory developed guidance for complete reporting of telehealth interventions. The process went through 5-step process from conception to final checklist development with input for many stakeholders, to include all 11 primary investigators with trials in the Collaboratory.ResultsAn extension focused on unique considerations relevant to telehealth interventions was developed for the Template for the Intervention Description and Replication (TIDieR) checklist.ConclusionThe Telehealth Intervention guideline encourages use of the Template for the Intervention Description and Replication (TIDieR) checklist as a valuable tool (TIDieR-Telehealth) to improve the quality of research through a reporting guide of relevant interventions that will help maximize reproducibility and implementation.

Hemodialysis (HD) is a burdensome clinical process that demands frequent and long visits to the clinic every week indefinitely, yet strict adherence to its regimen is paramount to overall health and wellbeing. Effective approaches are needed to not only reduce patients' rates of missed treatments but also ease the overall burden and stress associated with long-term HD use. The purpose of this qualitative study was to explore HD patients' attitudes toward a clinic-based animal-assisted intervention (AAI) to build an understanding of its perceived fit within this novel setting, as well as how this intervention could improve their treatment adherence. Patients from four outpatient clinics engaged in one-on-one, in-depth semi-structured interviews that were audio-recorded and transcribed verbatim. Within a framework of iterative thematic analysis, the Matrix Method was utilized in combination with line-by-line coding to thematically analyze data. A total of 20 patients (age M = 57, SD = 7.93) participated. Results are reflected in four main themes: (1) The dread and suffering of endless treatment; (2) Yearning for the presence of therapy dogs at the clinic; (3) Therapy dogs can aid in the internal battle of treatment adherence; (4) The logistics of incorporating therapy dogs into HD care routine. Participants' narratives collectively illustrate the perceived value of AAI in the HD clinic setting. This study improves not only our understanding of how HD patients perceive clinic-based therapy-dog visits but also offers helpful insights for implementing this intervention in future research. Incorporating therapy dogs into HD patients' healthcare routine may offer an innovative approach to improving patient outcomes, and the results of this study are a compelling prompt to empirically investigate the role of AAI in HD treatment adherence. [ABSTRACT FROM AUTHOR]

Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD); however, some patients do not improve to the same extent as others. It is important to understand potential factors that can be modified for better patient outcomes. This clinical trial implemented a three‐arm, equipoise‐stratified randomization design to allow for the accommodation of patient preference before randomization to one of three CPT treatment modalities: in‐home, in‐office, or telehealth. This study examined whether satisfaction with the modality, perceived stigma, expectations of therapy, and credibility of the therapist differed between modalities and whether these factors impacted treatment outcomes. We hypothesized that the contributions of these variables would depend upon whether participants opted out of any treatment arms and that these factors would predict treatment outcomes. Participants who endorsed less perceived stigma demonstrated larger reductions in PTSD symptom severity than those with similar levels of perceived stigma in the telehealth and in‐office conditions, η2 =.12–.18. Participants who endorsed lower satisfaction with their treatment modality and were assigned to the in‐home condition experienced larger PTSD symptom reductions than those with similar dissatisfaction in the telehealth and in‐office conditions, η2 =.20. The results show the robustness of evidence‐based therapies for PTSD given that dissatisfaction did not impede treatment success. In addition, they demonstrate that it is important for clinicians to address stigma before initiating evidence‐based therapies for PTSD. Strategies to address these factors are discussed. [ABSTRACT FROM AUTHOR]

Background: As the proportion of women and individuals who are underrepresented in medicine slowly rises, disparities persist in numerous arenas and specialties. In physical medicine and rehabilitation (PM&R), there is a continued need to focus on diversity among trainees. This study aims to evaluate diversity among PM&R applicants and residents over the past 6 years. Objective: To describe the demographic trends in PM&R over the last 6 years and compare those findings with trends in other specialties. Design: Surveillance. Setting: Analyses of national databases from self‐reported questionnaires. Participants: The study consists of 126,833 medical school matriculants, 374,185 resident applicants, and 326,134 resident trainees over the last 6 years. Main outcome measures: Self‐reported demographic data from the Association of American Medical Colleges and the Accreditation Council for Graduate Medical Education were analyzed for medical school matriculants, PM&R applicants, and current residents for the cycles of 2014–2015 to 2019–2020. The data were then comparatively reviewed between PM&R and other medical specialties. Results: In the 6 cycles evaluated, women accounted for 36%–39% of PM&R residents, but 47%–48% in non‐PM&R specialties. Women applicants to the PM&R specialty averaged 34.4% over the 6 years analyzed, which was the fourth lowest of the 11 specialties examined. Black or African American and Hispanic, Latino, or of Spanish Origin populations each accounted for only 6% of PM&R residents. PM&R demonstrated a noticeably higher proportion of White (62.1% vs. 60.3%) and an observably lower proportion of Black or African American (6.0% vs. 7.1%) and Hispanic, Latino, or of Spanish Origin (6.3% vs. 7.9%) residents compared with non‐PM&R specialties. Conclusion: There is underrepresentation of women and multiple racial and ethnic minority groups in the field of PM&R from applicants to trainees demonstrating a need to improve recruitment efforts. [ABSTRACT FROM AUTHOR]

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