Archives of Physical Medicine and Rehabilitation (ARCH PHYS MED REHAB )

Publisher: American Congress of Rehabilitation Medicine; American Congress of Physical Medicine and Rehabilitation; American Academy of Physical Medicine and Rehabilitation; American Society of Physical Medicine and Rehabilitation, Elsevier


Archives of Physical Medicine and Rehabilitation has distinguished itself through its coverage of the specialty of physical medicine and rehabilitation and of the more interdisciplinary field of rehabilitation. The journal publishes original articles that report on important trends and developments in these fields. Archives of Physical Medicine and Rehabilitation brings readers authoritative information on the therapeutic utilization of physical and pharmaceutical agents in providing comprehensive care for persons with disabilities and chronically ill individuals.

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    Archives of Physical Medicine and Rehabilitation website
  • Other titles
    Archives of physical medicine and rehabilitation
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    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

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    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
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Publications in this journal

  • Archives of Physical Medicine and Rehabilitation 01/2015;
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    ABSTRACT: Objective To investigate the effects of anodal transcranial direct current stimulation (a-tDCS) intensity on corticospinal excitability and affected muscle activation in individuals with chronic spinal cord injury (SCI). Design Single blind, randomized, sham-controlled, crossover study. Setting Medical Research Institute and Rehabilitation Hospital. Participants Nine volunteers with chronic SCI and motor dysfunction in wrist extensor muscles. Intervention Three single session exposures to 20 minutes of a-tDCS (anode over the extensor carpi radialis (ECR) muscle representation on the left primary motor cortex, cathode over the right supraorbital area), using 1 mA, 2 mA or sham stimulation, delivered at rest, with at least one week between sessions. Outcome Measures Corticospinal excitability was assessed with motor evoked potentials (MEPs) from the ECR muscle using surface electromyography (EMG) following transcranial magnetic stimulation. Changes in spinal excitability, sensory threshold and muscle strength were also investigated. Results Mean MEP amplitude significantly increased by ∼40% immediately following 2 mA a-tDCS (Pre 0.36±0.1 mV; Post 0.47±0.11 mV; p=0.001), but not with 1 mA or sham. Maximal voluntary EMG measures remained unaltered across all conditions. Sensory threshold significantly decreased over time following 1 mA (p=0.002) and 2 mA (p=0.039) a-tDCS, and did not change with sham. F-wave persistence showed a non-significant trend for increase (Pre: 32±12%; Post: 41±10%; Follow-up: 46±12%) following 2 mA stimulation. No adverse effects were reported with any of the experimental conditions. Conclusion Anodal-tDCS can transiently raise corticospinal excitability to affected muscles in chronic SCI patients following 2 mA stimulation. Sensory perception can improve with both 1 and 2 mA stimulation. This study gives support to the safe and effective use of a-tDCS using small electrodes in SCI patients, and highlights the importance of stimulation intensity.
    Archives of Physical Medicine and Rehabilitation 11/2014;
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    ABSTRACT: Objective To examine the effects of an anterior ankle-foot orthosis (AAFO) on walking mobility in stroke patients. Design Cross-sectional and repeated-measures study design. Setting A university’s neurological rehabilitation department in Taiwan. Participants Twenty one ambulant stroke patients. Interventions Not applicable. Main Outcome Measures Walking mobility was measured by the Timed Up and Go (TUG) test and the Timed Up and Down Stairs (TUDS) test. The paired t-test was used to determine the difference between the mobility performances measured with and without the AAFO. Results There were significant differences between mobility performances with and without an AAFO in the TUG test (p = 0.038) and the TUDS test (p = 0.000). Conclusions This study supports the effect of an AAFO on walking mobility in stroke patients. The findings demonstrate that the stroke patients wearing an AAFO may ambulate with greater speed and safety on level surfaces and stairs.
    Archives of Physical Medicine and Rehabilitation 11/2014;
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    ABSTRACT: Objective To study the immediate and short-term efficacy of adding transcutaneous electrical nerve stimulation (TENS) to standardized physical therapy on subacute spasticity within 6 months post-spinal cord injury Design Randomized controlled trial for 3 weeks Setting University hospital of Mandalay Subjects and intervention: Sixteen subjects with clinically determined spasticity were randomly assigned to experimental group (n=8, 60 minute sessions of TENS over the bilateral common peroneal nerves before 30 minutes of physical therapy) or control group (n=8, 30 minutes of physical therapy alone). All patients in both groups had access to standardized rehabilitation care. Outcome measures Composite spasticity score as primary end point to assess plantar flexor spasticity which included three sub-scores: ankle jerk, muscle tone and ankle clonus scores. These sub-scores were designated as secondary end points. Serial evaluations were made at baseline before study entry, immediately after the first and last sessions in both groups. Results On analysis for immediate effects, there was significant reduction only in composite spasticity score (mean difference 1.75 [99% confidence interval (CI) 0.47 to 3.03], p= 0.002) in the experimental group but no significant reduction was observed in all outcome variables in the control group. The significant difference of composite spasticity score (1.63[99% CI 0.14 to 3.11], p= 0.006) was observed between the two groups. After 15 sessions of treatment, significant reduction was determined in composite spasticity score (2.75[99% CI 1.31 to 4.19], p<0.001), muscle tone score (1.75 [99% CI 0.16 to 3.34], p=0.006) and ankle clonus score (0.75 [99% CI 0.18 to 1.32], p=0.003) in the experimental group while none of outcome variables revealed significant reduction in control group. The between-group difference was significant only in composite spasticity score (2.13 [99% CI 0.59 to 3.66], p= 0.001) and muscle tone score (1.50 [99% CI 0.15 to 2.85], p=0.005) after 15 intervention sessions. Conclusion Addition of TENS to standardized physical therapy had synergistically anti-spastic action, providing more effective reduction of clinical spasticity.
    Archives of Physical Medicine and Rehabilitation 11/2014;
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    ABSTRACT: Objective To verify that iterative proportional fitting (IPF) or raking has the desired effect of aligning estimates and parameters so that researches have confidence in population projections when weighting the Traumatic Brian Injury (TBI) Model Systems National Database. Design Secondary data analysis using IPF. Setting Inpatient rehabilitation. Participants People age 16 and over with a primary diagnosis of TBI receiving initial inpatient rehabilitation. Intervention N/A Main Outcome Measures Age at injury, race, gender, marital status, rehabilitation length of stay, payer source, and motor and cognitive FIMTM scores. Conclusion In general, IPF aligns population estimates based on weighted TBI Model Systems data and known population parameters. It is reasonable to assume IPF has the same effect on unknown variables. This provides confidence to researchers wishing to use IPF for making population projections in analyses.
    Archives of Physical Medicine and Rehabilitation 10/2014;
  • Archives of Physical Medicine and Rehabilitation 10/2014; 95(10):e91.
  • Archives of Physical Medicine and Rehabilitation 10/2014; 95(10):e94-e95.
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    ABSTRACT: To examine the impact of frequent knee pain (KP) and obesity on gait speed (GS) among older men and women.
    Archives of Physical Medicine and Rehabilitation 10/2014; 95(10):41.
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    ABSTRACT: Objective To identify the effective predictors for therapeutic outcomes based on intermittent theta-burst stimulation (iTBS). Design A sham-controlled, double-blind parallel study design. Setting A tertiary hospital. Participants Seventy-two people with stroke who presented with unilateral hemiplegia. Interventions Ten consecutive sessions of real or sham iTBS were implemented with the aim of enhancing hand function. Patients were categorized into 4 groups according to the presence (MEP+) or absence (MEP-) of motor-evoked potentials (MEP) and grip strength according to the Medical Research Council (MRC) scale. Outcome Measures Cortical excitability, Wolf Motor Function test (WFMT), finger tapping task (FT), and simple reaction time (RT), were performed before and after the sessions. Results MEP and the MRC were predictive of iTBS therapeutic outcomes. Group A (MEP+, MRC > 1) exhibited the greatest WMFT change (7.6 ± 2.3, P < .001), followed by Group B (MEP -, MRC > 1; 5.2 ± 2.2 score change), and Group C (MEP -, MRC = 0; 2.3 ± 1.5 score change). These improvements were correlated significantly with baseline motor function and ipsilesional MEPmax amplitude. Conclusions The effectiveness of iTBS modulation for poststroke motor enhancement depends on baseline hand grip strength and the presence of MEP. Our findings indicate that establishing neurostimulation strategies based on the proposed electrophysiological and clinical criteria can allow iTBS to be executed with substantial precision. Effective neuromodulatory strategies can be formulated by using electrophysiological features and clinical presentation information as guidelines.
    Archives of Physical Medicine and Rehabilitation 09/2014;
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    ABSTRACT: Objective To investigate the effect of cryotherapy after elbow arthrolysis on elbow pain, blood loss, analgesic consumption, range of motion and long-term elbow function. Design A prospective, single-blinded, and randomized controlled study. Setting An orthopedic unit at a university hospital. Participants Fifty-nine patients (27 females and 32 males) received elbow arthrolysis. Interventions Patients were randomly assigned into a cryotherapy group (n = 31, cryotherapy plus standard care) and a control group (n=28, standard care). Main Outcome Measures Elbow pain at rest and on motion was measured using visual analogue scale (VAS) on postoperative day (POD) 1 to POD 7, and at 2 weeks and 3 months after surgery. Blood loss and analgesic consumption were recorded postoperatively. Elbow range of motion (ROM) was measured before surgery and on POD 1, POD 7 and at 3 months after surgery. The Mayo Elbow Performance Score (MEPS) was evaluated preoperatively and 3 months postoperatively. Results VAS scores were significantly lower in the cryotherapy group during the first 7 postoperative days, both at rest and on motion (P < 0.05). There were no significant differences between the two groups in VAS scores at 2 weeks and 3 months after surgery. Less sufentanil was consumed by the cryotherapy group than by the control group for pain relief (P < 0.01). No significant differences were found in blood loss, ROM and MEPS between the two groups (P > 0.05). Conclusion Cryotherapy is effective in relieving pain and reducing analgesic consumption for patients received elbow arthrolysis. The application of cryotherapy will not affect blood loss, ROM or elbow function.
    Archives of Physical Medicine and Rehabilitation 09/2014;
  • Archives of Physical Medicine and Rehabilitation 09/2014; 95(9):1799–1800.
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    ABSTRACT: Objective To determine the safety and feasibility of neuromuscular electrical stimulation (NMES) from postoperative day (POD) 1 to 5 after cardiovascular surgery. Design Pre-post interventional study Setting Surgical intensive care unit and thoracic surgical ward of Nagoya University Hospital, Nagoya, Japan. Participants Patients (N=144) who underwent cardiovascular surgery were consecutively included. Patients with peripheral arterial disease, psychiatric disease, neuromuscular disease and dementia were excluded. Patients with severe chronic renal failure and those who required prolonged mechanical ventilation after surgery were also excluded because of the possibilities to affect the outcome of future main study. Interventions NMES was implemented to the lower extremities from POD 1 to 5. Main Outcome Measures Feasibility outcomes included compliance, the number of the patients who were manifested by changes in systolic blood pressure (BP) >±20 mmHg or increase in heart rate (HR) >+20 beats/min during NMES, and the incidence of temporary pacemaker malfunction or postoperative cardiac arrhythmias. Results Sixty-eight of 105 eligible patients participated in this study. Sixty-one of them (89.7%) completed NMES sessions. We found no patients who presented with excessive changes in systolic BP, increased HR, or pacemaker malfunction during NMES. Incidence of atrial fibrillation (AF) during the study period was 26.9% (7/26) in coronary artery bypass surgery, 18.2% (4/22) in valvular surgery, and 20.0% (4/20) in combined or aortic surgery. No sustained ventricular arrhythmia or ventricular fibrillation was observed. Conclusions The results of this study demonstrate that NMES can be safely implemented even in patients immediately after cardiovascular surgery.
    Archives of Physical Medicine and Rehabilitation 09/2014;
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    ABSTRACT: To determine whether delirium during the hospital stay predicted health-related quality of life (HRQOL) at 1-year following injury in trauma intensive care unit (ICU) survivors without intracranial hemorrhage. We also examined the association between depressive and post-traumatic stress disorder (PTSD) symptoms and each of the HRQOL domains at 1-year follow-up.
    Archives of Physical Medicine and Rehabilitation 08/2014;
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    ABSTRACT: To primarily explore the proportion and factors relating to failure on obstacle crossing in ambulatory participants with incomplete spinal cord injury (iSCI). Moreover, the study secondarily compared balance ability between participants who passed and failed on obstacle crossing.
    Archives of Physical Medicine and Rehabilitation 08/2014;
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    ABSTRACT: Objective To gain greater insight into the lived experience of individuals with spinal cord injury (SCI) and neurogenic bowel dysfunction (NBD). Design Qualitative (phenomenological) interviews and analysis. Setting Community. Participants Nineteen individuals with SCI and NBD residing in the community. Interventions Not applicable. Main Outcome Measure(s) Concerns related to living with neurogenic bowel dysfunction following SCI. Results Challenges related to living with SCI and NBD included costs & requirements, emotional impact, diet, education and employment, intimacy & interpersonal relationships, social participation, spontaneity and daily schedule, travel, lack of appropriate & consistent assistance, loss of autonomy (independence & privacy), lack of predictability & fear of incontinence, medical complications, pain or discomfort, physical effort of the bowel routine, physical experience, and time requirements. Conclusion(s) Living with NBD presents many challenges. When categorized according to the International Classification of Functioning, Disability and Health (ICF), identified domains include Body Functions & Structures, Activity, Participation, Environmental Factors, and Personal Factors. Identified issues have implications for improving clinical management, and should be assessed when determining the impact and efficacy of interventions.
    Archives of Physical Medicine and Rehabilitation 08/2014;
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    ABSTRACT: Objective To identify measures of adherence to non-pharmacological self-management treatments for chronic musculoskeletal (MSK) populations, and report on the measurement properties of identified measures. Data sources Five databases were searched for all study types that included a chronic MSK population, an unsupervised intervention and a measure of adherence. Study selection Two independent researchers reviewed all titles for inclusion using criteria: adult (>18yrs) participants with a chronic MSK condition; the intervention included an unsupervised self-management component; and it contained a measure of adherence to the unsupervised self-management component. Data extraction Descriptive data regarding populations, unsupervised components, measures of unsupervised adherence (items and response options) were collected from each study by one researcher and checked by a second for accuracy. Data synthesis No named or referenced adherence measurement tools were found, but a total of 47 ‘self-invented measures’ were identified. No ‘measure’ was used in more than a single study. In terms of methods they could be grouped into: home diaries (n=31); multi-item questionnaires (n=11) and single-item questionnaires (n=7). All measures varied in type of information requested and scoring method. The lack of established tools precluded quality assessment of the measurement properties using COSMIN methodology. Conclusions Despite the importance of adherence to self-management interventions, measurement appears to be conducted on an ad hoc basis. It is clear that there is no consistency among adherence measurement tools and that the construct is ill-defined. This study alerts the research community to the gap in measuring adherence to self-care in a rigorous and reproducible manner. Thus, we need to address this gap by using credible methods (e.g. the COSMIN guidelines) to develop and evaluate an appropriate measure of adherence for self-management.
    Archives of Physical Medicine and Rehabilitation 08/2014;