bims-ricfun 2025-08-17 papers

bims-ricfun

Biomed News

on Rehabilitation ICF

Issue of 2025–08–17
24 papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica

The impact of symptoms, proprioception, and electrodiagnostic findings on activity and participation in idiopathic carpal tunnel syndrome: an ICF framework approach.
Common Predictors of Return To Work across Cardiovascular Diseases.
Experience and needs of stroke patients in physical rehabilitation: a systematic review and meta-synthesis.
Classifying Patient Characteristics and Determining a Predictor in Acute Stroke Patients: Application of Latent Class Analysis in Rehabilitation Practice.
Tailored Rehabilitation Program and Dynamic Ultrasonography After Surgical Repair of Bilateral Simultaneous Quadriceps Tendon Rupture in a Patient Affected by Gout: A Case Report.
Virtual Reality for Patients With Chronic Musculoskeletal Pain and Disability: An Umbrella Review of Systematic Reviews.
Open-source customizable website to follow-up physical rehabilitation of cardiovascular patients at home.
Novel Sonoguided Digital Palpation and Ultrasound-Guided Hydrodissection of the Long Thoracic Nerve for Managing Serratus Anterior Muscle Pain Syndrome: A Case Report with Technical Details.
Nanomedicines and stroke: Advantages in chronic inflammation treatment and neural regeneration.
Current Perspectives on Rehabilitation Following Return of Spontaneous Circulation After Sudden Cardiac Arrest: A Narrative Review.
Rehabilitative Good Practices in the Treatment of Patients with Muscle Injuries.
Ultrasound in Adhesive Capsulitis: A Narrative Exploration from Static Imaging to Contrast-Enhanced, Dynamic and Sonoelastographic Insights.
Understanding patient needs and preferences for joint protection in hand osteoarthritis through mixed methods patient co-design.
Implementation of digital health in rural populations with chronic musculoskeletal conditions: a scoping review.
Summary of Best Evidence for Integrated Airway Management in ICU Tracheostomy Patients.
Dry Needling for Tension-Type Headache: A Scoping Review on Intervention Procedures, Muscle Targets, and Outcomes.
Calcification of the Lateral Collateral Ligament as a Rare Cause of Knee Pain and Its Treatment With Ultrasound-Guided Barbotage Procedure: A Case Report.
Patient, Family and Provider Priorities in ICU Rehabilitation: An Experience-Based Co-Design Study.
Extensor tendon repairs: consensus, current guidelines and recommendations.
Comparison of Suprascapular Nerve Block With Glenohumeral Joint Dilatation for the Treatment of Adhesive Capsulitis of the Shoulder Joint.
A survey of brain injury medicine fellowship graduates 2014-2023: Perceived strengths and opportunities for training based upon current practice trends.
Validity and reliability of modified box and block test and targeted box and block test in patients with stroke.
American Academy of Physical Medicine and Rehabilitation Position Statement on Opioid Prescribing.
Frameworks used to evaluate community-based rehabilitation interventions: A scoping review.

Physiother Theory Pract. 2025 Aug 12. 1-12

The impact of symptoms, proprioception, and electrodiagnostic findings on activity and participation in idiopathic carpal tunnel syndrome: an ICF framework approach.

Zeynep Sena Namaz, Emrah Afsar, Merve Akdeniz Leblebicier.

   BACKGROUND: The role of carpal tunnel syndrome (CTS) in activity and participation is critical for improving rehabilitation outcomes, but there is a gap in the literature on this subject. This study presents an innovative application of Structural Equation Modelling (SEM) within the framework of the International Classification of Functioning, Disability and Health (ICF) for CTS patients.
PURPOSE: The aim of this study was to examine the effects of symptoms, proprioception, electrodiagnostic findings, and activity/participation in idiopathic CTS.
METHODS: This cross-sectional study included 81 patients with mild to moderate idiopathic CTS. For the assessment of body structure/function, symptoms were measured by Visual Analogue Scale, Leeds Assessment of Neuropathic Symptoms and Signs, and Boston Carpal Tunnel Questionnaire - Symptom Severity Scale; proprioception by the force reproduction tests; and electrodiagnostic findings. Activity/participation were assessed using the Boston Carpal Tunnel Questionnaire - Functional Status Scale and the Quick Disability of the Arm, Shoulder, and Hand. SEM was used to examine the effect of body structure/function on activity/participation.
RESULTS: This study revealed that symptoms (standardized coefficient = 0.858, p < .001) and proprioception (0.207, p = .032) had a significant effect on activity/participation. Conversely, the model results indicated no significant effect of sensory nerve conduction findings (-0.031, p = .673) and motor nerve conduction findings (0.195, p = .170) on activity/participation.
CONCLUSION: Relying solely on electrodiagnostic findings may contribute to the underestimation or misinterpretation of activity/participation limitations in patients with CTS. The findings of this study suggest that reducing symptoms may enhance activity/participation. Incorporating proprioception into the management of CTS patients may offer promising benefits.

Keywords:  Carpal tunnel syndrome; International Classification of Functioning, Disability and Health; nerve conduction velocity; pain; proprioception

DOI:  https://doi.org/10.1080/09593985.2025.2547296
Eur J Prev Cardiol. 2025 Aug 15. pii: zwaf508. [Epub ahead of print]

Common Predictors of Return To Work across Cardiovascular Diseases.

Ellen Tisseghem, Zoë Vandamme, Elvi Lemmens, Helena Van Deynse, Kurt Barbé, Pieter Cornu, Johan De Sutter, Lode Godderis, Koen Putman.

   BACKGROUND: Return to work (RTW) after cardiovascular diseases (CVDs) is crucial to mitigating the societal and economic burden of productivity losses. This review of reviews explores common and disease-specific predictors of RTW within the framework of the International Classification of Functioning, Disability, and Health (ICF).
METHODS: A systematic review of systematic reviews was conducted to identify both common and disease-specific predictors of RTW for individuals with cardiovascular diseases (CVDs), including acute coronary syndrome (ACS), chronic coronary artery disease (CCAD), heart failure (HF), and stroke. Predictors were analysed across contextual domains (personal and environmental factors) and functional domains (body structure, body function, activities, and participation). The methodological quality of the included reviews was evaluated using the AMSTAR-2 tool.
RESULTS: A total of 28 reviews were included. Key common predictors included functional capacity, psychological well-being, work characteristics and social support, while disease-specific predictors involved the severity of disease and treatment characteristics. Modifiable factors, such as workplace accommodation and psychological challenges, were identified as critical targets for intervention.
CONCLUSIONS: Early identification of at-risk individuals and the integration of personalized rehabilitation strategies are critical for improving RTW outcomes and health-related quality of life. This review enhances the understanding of RTW predictors, contributing to optimized rehabilitation processes and reduced economic burden associated with CVDs. Future research should investigate the clinical applicability of these findings and explore the broader application of these common RTW predictors across other chronic conditions, to inform vocational reintegration strategies. (Word count: 238).

Keywords:  Cardiovascular disease; Predictors; Return to work; Stroke/cerebrovascular disease

DOI:  https://doi.org/10.1093/eurjpc/zwaf508
BMC Health Serv Res. 2025 Aug 12. 25(1): 1062

Experience and needs of stroke patients in physical rehabilitation: a systematic review and meta-synthesis.

Xueting Sun, Yage Shi, ChenJun Liu, Shuaiyou Wang, Dingding Li, Xinyi Zhu, Kun Pan, Hongru Wang, Huimin Zhang.

   BACKGROUND: As stroke is a disease with a high disability rate, stroke patients generally have an urgent need for physical rehabilitation to maximize functional independence. However, owing to the complexity of the stroke rehabilitation process and the limited knowledge of patients, patients are often confused and uncertain in the rehabilitation process, which in turn affects their compliance and hinders their rehabilitation process. Exploring the real experiences and unsatisfied needs of stroke patients in the process of physical rehabilitation is highly important for the optimization of future intervention strategies.
METHODS: Nine databases were searched from inception to September 2024, with an update in January 2025. Studies were critically appraised using the Critical Appraisal Skills Programme tool, and the data were thematically synthesized following the steps of the thematic synthesis method according to Thomas and Harden.
RESULTS: A total of 28 papers (n = 468) were included, and 117 findings were distilled into 24 new categories, which were synthesized into 4 integrated findings: (1) Body perceptionan and dynamic adaptation (Limb loading, Poorly designed rehabilitation equipment, Dynamic changes, Improvement in physical function); (2) Psychological course and emotional experience (Negative emotions and social avoidance, Desire for restoration of limb function, Confusion, Fear and self-doubt, Lack of therapeutic care, Loss of patience, Psychological adaptation and emotional transformation); (3) Multi-dimensional motivations and facilitators (Positive feedback, Diverse external support, Challenging design, Goal setting and sense of achievement, Positive emotional attitudes and personality traits, Avoiding disability labeling and functional degradation, Self-responsibility); (4) Unmet needs and directions for optimizing intervention strategies (Convenient and continuous demand for rehabilitation services, Access to rehabilitation information and resources, Individualized rehabilitation guidance, Socialization and group interaction between patients with similar experiences, Economic support and policy guarantees, Real-time feedback and intelligent adjustments).
CONCLUSION: Healthcare professionals should pay attention to stroke patients' real feelings and inner needs during exercise rehabilitation and their real dilemmas about participating in exercise rehabilitation. They should formulate personalized exercise rehabilitation boosting strategies for stroke patients to realize scientific and precise exercise rehabilitation and improve patients' long-term rehabilitation outcomes.
TRIAL REGISTRATION: PROSPERO [CRD42024594929].

Keywords:  Rehabilitation; Stroke; Systematic reviews and meta-synthesis

DOI:  https://doi.org/10.1186/s12913-025-13213-7
J Clin Med. 2025 Aug 04. pii: 5466. [Epub ahead of print]14(15):

Classifying Patient Characteristics and Determining a Predictor in Acute Stroke Patients: Application of Latent Class Analysis in Rehabilitation Practice.

Junya Uchida, Moeka Yamada, Hirofumi Nagayama, Kounosuke Tomori, Kohei Ikeda, Keita Yamauchi.

  Background/Objectives: Predicting comprehensive patient characteristics is essential for optimal individualized rehabilitation plans for acute stroke patients. However, current models primarily predict single outcomes. This study aimed to assess the applicability of latent class analysis (LCA) in rehabilitation practice by identifying comprehensive characteristics and associated predictors in acute stroke patients. Methods: We conducted a retrospective observational study using the Japan Association of Rehabilitation Database, including 10,270 stroke patients admitted to 37 acute-care hospitals between January 2005 and March 2016. Patients were classified using LCA based on outcomes at discharge, including Functional Independence Measure (FIM), National Institutes of Health Stroke Scale (NIHSS) subscales for upper-extremity function, length of hospitalization, and discharge destination. Predictor variables at admission included age, FIM scores, NIHSS subscales for upper-extremity function, stroke type, and daily rehabilitation volume. Results: 6881 patients were classified into nine distinct classes (class size: 4-29%). Class 1, representing the mildest cases, was noted for independent ambulation and good upper limb function. Class 2 comprised those with the most severe clinical outcome. Other classes exhibited a gradient of severity, commonly encountered in clinical practice. For instance, Class 7 included right-sided paralysis with preserved motor activities of daily living (ADLs) and modified dependence in cognitive functions, such as communication. All predictors at admission were significantly associated with class membership at discharge (p < 0.001). Conclusions: LCA effectively identified unique clinical subgroups among acute stroke patients and demonstrated that key admission variables could predict class membership. This approach offers a promising insight into targeted, personalized rehabilitation practice for acute stroke patients.

Keywords:  acute stroke; latent class analysis; occupational therapy; patient characteristics; physical therapy; rehabilitation; speech therapy

DOI:  https://doi.org/10.3390/jcm14155466
Healthcare (Basel). 2025 Jul 26. pii: 1830. [Epub ahead of print]13(15):

Tailored Rehabilitation Program and Dynamic Ultrasonography After Surgical Repair of Bilateral Simultaneous Quadriceps Tendon Rupture in a Patient Affected by Gout: A Case Report.

Emanuela Elena Mihai, Matei Teodorescu, Sergiu Iordache, Catalin Cirstoiu, Mihai Berteanu.

  Spontaneous quadriceps tendon rupture is a very rare occurrence, notably for bilateral simultaneous ruptures. Its occurrence is commonly linked to an underlying condition that may weaken the tendons leading to rupture. We report the case of a 68-year-old Caucasian male afflicted with long-term gout who presented a bilateral simultaneous quadriceps tendon rupture (BSQTR). We showcase the clinical presentation, the surgical intervention, rehabilitation program, dynamic sonographic monitoring, and home-based rehabilitation techniques of this injury, which aimed to improve activities of daily living (ADL) and quality of life (QoL). The patient was included in a 9-week post-surgical rehabilitation program and a home-based rehabilitation program with subsequent pain management and gait reacquisition. The outcome measures included right and left knee active range of motion (AROM), pain intensity measured on Visual Analogue Scale (VAS), functioning measured through ADL score, and gait assessment on Functional Ambulation Categories (FAC). All endpoints were measured at different time points, scoring significant improvement at discharge compared to baseline (e.g., AROM increased from 0 degrees to 95 degrees, while VAS decreased from 7 to 1, ADL score increased from 6 to 10, and FAC increased from 1 to 5). Moreover, some of these outcomes continued to improve after discharge, and the effects of home-based rehabilitation program and a single hip joint manipulation were assessed at 6-month follow-up. Musculoskeletal ultrasound findings showed mature tendon structure, consistent dynamic glide, and no scarring.

Keywords:  bilateral quadriceps tendon rupture; dynamic sonography; home-based rehabilitation; joint manipulation; simultaneous quadriceps tendon rupture

DOI:  https://doi.org/10.3390/healthcare13151830
Health Sci Rep. 2025 Aug;8(8): e71163

Virtual Reality for Patients With Chronic Musculoskeletal Pain and Disability: An Umbrella Review of Systematic Reviews.

Fahad Salman Alotibi, Walid Mohammed, Paul Hendrick, Fiona Moffatt.

   Background and Aim: Virtual reality (VR) has been proposed for the management of chronic musculoskeletal pain (MSKP). This umbrella review aimed to systematically search, critically appraise, summarize, and synthesize the current systematic reviews (SRs) on delivering VR interventions to rehabilitate patients with chronic primary MSKP and disability.
Method: Data were obtained from five databases. Only SRs were included. This umbrella review utilized the AMSTAR-2 to assess the methodological quality of the included SRs and the GRADE to assess the certainty in the body of evidence.
Results: Seven SRs were included. The overall confidence in the SRs ranged from low to critically low, whereas the certainty in the body of evidence ranged from moderate to very low. Whilst the majority of the SRs suggested that VR, standalone or adjunctive to other interventions, had a significant short-term positive effect on patient-reported outcomes for pain in patients with chronic primary MSKP, results on patient-reported outcomes for disability and kinesiophobia were inconsistent. Adverse events included motion sickness, nausea, and vertigo.
Conclusions: Although the current evidence indicates that VR may hold promise in patients with chronic primary MSKP, the included studies suffered from critical weaknesses that precluded this review from drawing a conclusive conclusion. It remains uncertain which VR interventions, including dosage, mode of delivery, supervision, frequency, duration, level of immersion, VR platform, displayed content, and mechanism of action, are more effective than the others. Future SRs should sub-group VR based on the treatment types. Further rigorously designed studies focusing on immersive VR, standalone or adjunctive to other interventions, with long-term follow-up, are warranted. It is worth repeating the call for an agreed consensus on a clear definition and classification of VR within the healthcare context.

Keywords:  chronic; exergame; immersive; low back pain; musculoskeletal; neck; pain; virtual reality

DOI:  https://doi.org/10.1002/hsr2.71163
Front Cardiovasc Med. 2025 ;12 1633106

Open-source customizable website to follow-up physical rehabilitation of cardiovascular patients at home.

Ariadna Sabala, Donough Mcbrearty, Raffaella Salama, Ramon Farré, Ailís Loughnane, Jorge Otero, Núria Farré.

   Background: Telemedicine home monitoring of physical rehabilitation in cardiovascular patients, which may substantially improve adherence and, thus, prognosis and quality of life, is an underused practice. Indeed, the Apps and websites available are generic and cannot be easily adapted to each specific rehabilitation protocol. We thus aimed at developing a flexible, low-cost, and open-source telemedicine tool that can be customized and operated by any healthcare professional with just user-level internet knowledge.
Methods: The website was co-designed by an interdisciplinary team, including website developers and clinical experts in physical rehabilitation programs for patients with cardiovascular diseases. The operability and robustness of the website were tested on simulated patients and health professionals, and the suitability of the tutorial for website customization was assessed.
Results: The website asks the patient to complete a periodic diary of physical activities (e.g., intensity, type, duration, warm-up, cool-down, subjective effort). At any time, the patient can see graphs of the different types of exercise performed during a selected period. The website allows healthcare professionals to browse patients' data, send feedback messages, and export data in a conventional spreadsheet format. The tutorial for website customization was prepared as a learning by doing tool.
Conclusions: The website developed can interest cardiovascular physical rehabilitation professionals aiming at quickly and cheaply setting up an approach for home monitoring programs. This telemedicine tool can also be customized to different clinical applications and is particularly well suited for low-resource settings.

Keywords:  cardiac rehabilitation; healthcare followup; home monitoring; low-cost; open-source website; telemedicine

DOI:  https://doi.org/10.3389/fcvm.2025.1633106
Diagnostics (Basel). 2025 Jul 28. pii: 1891. [Epub ahead of print]15(15):

Novel Sonoguided Digital Palpation and Ultrasound-Guided Hydrodissection of the Long Thoracic Nerve for Managing Serratus Anterior Muscle Pain Syndrome: A Case Report with Technical Details.

Nunung Nugroho, King Hei Stanley Lam, Theodore Tandiono, Teinny Suryadi, Anwar Suhaimi, Wahida Ratnawati, Daniel Chiung-Jui Su, Yonghyun Yoon, Kenneth Dean Reeves.

  Background and Clinical Significance: Serratus Anterior Muscle Pain Syndrome (SAMPS) is an underdiagnosed cause of anterior chest wall pain, often attributed to myofascial trigger points of the serratus anterior muscle (SAM) or dysfunction of the Long Thoracic Nerve (LTN), leading to significant disability and affecting ipsilateral upper limb movement and quality of life. Current diagnosis relies on exclusion and physical examination, with limited treatment options beyond conservative approaches. This case report presents a novel approach to chronic SAMPS, successfully diagnosed using Sonoguided Digital Palpation (SDP) and treated with ultrasound-guided hydrodissection of the LTN using 5% dextrose in water (D5W) without local anesthetic (LA), in a patient where conventional treatments had failed. Case Presentation: A 72-year-old male presented with a three-year history of persistent left chest pain radiating to the upper back, exacerbated by activity and mimicking cardiac pain. His medical history included two percutaneous coronary interventions. Physical examination revealed tenderness along the anterior axillary line and a positive hyperirritable spot at the mid axillary line at the 5th rib level. SDP was used to visualize the serratus anterior fascia (SAF) and LTN, and to reproduce the patient's concordant pain by palpating the LTN. Ultrasound-guided hydrodissection of the LTN was then performed using 20-30cc of D5W without LA to separate the nerve from the surrounding tissues, employing a "fascial unzipping" technique. The patient reported immediate pain relief post-procedure, with the pain reducing from 9/10 to 1/10 on the Numeric Rating Scale (NRS), and sustained relief and functional improvement at the 12-month follow-up. Conclusions: Sonoguided Digital Palpation (SDP) of the LTN can serve as a valuable diagnostic adjunct for visualizing and diagnosing SAMPS. Ultrasound-guided hydrodissection of the LTN with D5W without LA may provide a promising and safe treatment option for patients with chronic SAMPS refractory to conservative management, resulting in rapid and sustained pain relief. Further research, including controlled trials, is warranted to evaluate the long-term efficacy and generalizability of these findings and to compare D5W to other injectates.

Keywords:  5% dextrose in sterile water; chest pain; long thoracic nerve; myofascial trigger points; serratus anterior fascia; serratus anterior muscle pain syndrome; sonoguided digital palpation; ultrasound-guided hydrodissection

DOI:  https://doi.org/10.3390/diagnostics15151891
Neural Regen Res. 2025 Aug 13.

Nanomedicines and stroke: Advantages in chronic inflammation treatment and neural regeneration.

Chuhan Liu, Yuanyuan Ran, Changbin Hu, Mengjie Wang, Ning Li, Zhi Yang, Zitong Ding, Chenye Qiao, Jianing Xi, Wei Su, Lin Ye, Zongjian Liu.

  Stroke can be categorized as ischemic and hemorrhagic on the basis of its origin. The pathophysiology following a stroke is complex, and is characterized by ongoing inflammation, neuronal injury, and the accumulation of reactive oxygen species in the brain, all of which reflect a dynamic process of change. This complexity hinders achievement of significant therapeutic outcomes with standard stroke treatment procedures, limiting post-stroke recovery. This review presents an innovative post-stroke therapeutic approach that utilizes nanomedicines to modify the cerebral microenvironment. It highlights the primary roles of chronic inflammation and nerve repair issues in causing prolonged impairment in stroke patients. Traditional therapies show limited effectiveness in achieving neuroprotection, immunoregulation, and neural regeneration during the subacute and chronic phases of stroke. Therefore, effective stroke management requires the use of specific therapeutic strategies tailored to the pathological characteristics of each phase. Various types of nanomedicines possess distinct physicochemical properties and can be selected on the basis of the specific therapeutic needs. Surface-modification technologies have significantly enhanced the ability of nanomedicines to penetrate the blood-brain barrier and improve their targeting capabilities in drug administration. However, the stability, biocompatibility, and long-term safety of nanomedicines require further optimization for clinical application. Nanomedicines represent a novel approach to stroke treatment through targeted delivery and multifaceted regulatory mechanisms. These medicines provide distinct advantages, particularly in addressing chronic inflammation and promoting nerve regeneration. As a result, nanomedicines are expected to significantly improve rehabilitation outcomes and quality of life for stroke patients in the future, emerging as a crucial modality for stroke treatment.

Keywords:  blood-brain barrier; drug delivery; hemorrhagic stroke; ischemic stroke; nanomedicine; nanotechnology; neural regeneration; neuroimmunomodulation; regenerative medicine; stroke

DOI:  https://doi.org/10.4103/NRR.NRR-D-25-00120
Healthcare (Basel). 2025 Jul 30. pii: 1865. [Epub ahead of print]13(15):

Current Perspectives on Rehabilitation Following Return of Spontaneous Circulation After Sudden Cardiac Arrest: A Narrative Review.

Kamil Salwa, Karol Kaziród-Wolski, Dorota Rębak, Janusz Sielski.

  Background/Objectives: Sudden cardiac arrest (SCA) is a major global health concern with high mortality despite advances in resuscitation techniques. Achieving return of spontaneous circulation (ROSC) represents merely the initial step in the extensive rehabilitation journey. This review highlights the critical role of structured, multidisciplinary rehabilitation following ROSC, emphasizing the necessity of integrated physiotherapy, neurocognitive therapy, and psychosocial support to enhance quality of life and societal reintegration in survivors. Methods: This narrative review analyzed peer-reviewed literature from 2020-2025, sourced from databases such as PubMed, Scopus, Web of Science, and Google Scholar. Emphasis was on clinical trials, expert guidelines (e.g., European Resuscitation Council 2021, American Heart Association 2020), and high-impact journals, with systematic thematic analysis across rehabilitation phases. Results: The review confirms rehabilitation as essential in addressing Intensive Care Unit-acquired weakness, cognitive impairment, and post-intensive care syndrome. Early rehabilitation (0-7 days post-ROSC), focusing on parameter-guided mobilization and cognitive stimulation, significantly improves functional outcomes. Structured interdisciplinary interventions encompassing cardiopulmonary, neuromuscular, and cognitive domains effectively mitigate long-term disability, facilitating return to daily activities and employment. However, access disparities and insufficient randomized controlled trials limit evidence-based standardization. Discussion: Optimal recovery after SCA necessitates early and continuous interdisciplinary engagement, tailored to individual physiological and cognitive profiles. Persistent cognitive fatigue, executive dysfunction, and emotional instability remain significant barriers, underscoring the need for holistic and sustained rehabilitative approaches. Conclusions: Comprehensive, individualized rehabilitation following cardiac arrest is not supplementary but fundamental to meaningful recovery. Emphasizing early mobilization, neurocognitive therapy, family involvement, and structured social reintegration pathways is crucial. Addressing healthcare disparities and investing in rigorous randomized trials are imperative to achieving standardized, equitable, and outcome-oriented rehabilitation services globally.

Keywords:  ROSC; SCA; early mobilization; functional recovery; neurocognitive recovery; post-cardiac arrest rehabilitation

DOI:  https://doi.org/10.3390/healthcare13151865
J Clin Med. 2025 Jul 29. pii: 5355. [Epub ahead of print]14(15):

Rehabilitative Good Practices in the Treatment of Patients with Muscle Injuries.

Francesco Agostini, Alessandro de Sire, Nikolaos Finamore, Alessio Savina, Valerio Sveva, Andrea Fisicaro, Alessio Fricano, Umile Giuseppe Longo, Antonio Ammendolia, Andrea Bernetti, Massimiliano Mangone, Marco Paoloni.

  Background: The rehabilitative treatment of muscle injuries is mostly conservative, but it does not always follow precise protocols. Appropriate physiotherapy, exercises, and training are essential components of the rehabilitation and reconditioning of injured muscles. The purpose of this review is to assess the good rehabilitative practices in the treatment of patients affected by muscle injuries. Methods: We performed research on Medline and Cochrane Database. Guidelines focusing on the rehabilitative treatment of muscle injuries were evaluated for inclusion. Statements about non-rehabilitative treatments were also reported only for the guidelines that mainly focused on rehabilitative treatments. Results: Eight guidelines meeting the inclusion criteria were included in the review. Results were framed into a narrative overview. Two of them mainly focused on hamstring rehabilitation, the others focused on several muscular districts. Conclusions: Conservative treatment of muscle injuries is currently the gold standard, with good results in terms of both rehabilitation times and post-injury sports performance. However, there is not a complete agreement on the type of exercises and the timing of rehabilitation when these should be performed. More research is needed to draw conclusions about the use of physical therapy instruments and other rehabilitation approaches and techniques.

Keywords:  exercise; good practice; injury; muscle injuries; muscle lesions; rehabilitation

DOI:  https://doi.org/10.3390/jcm14155355
Diagnostics (Basel). 2025 Jul 31. pii: 1924. [Epub ahead of print]15(15):

Ultrasound in Adhesive Capsulitis: A Narrative Exploration from Static Imaging to Contrast-Enhanced, Dynamic and Sonoelastographic Insights.

Wei-Ting Wu, Ke-Vin Chang, Kamal Mezian, Vincenzo Ricci, Consuelo B Gonzalez-Suarez, Levent Özçakar.

  Adhesive capsulitis is a painful and progressive condition marked by significant limitations in shoulder mobility, particularly affecting external rotation. Although magnetic resonance imaging is regarded as the reference standard for assessing intra-articular structures, its high cost and limited availability present challenges in routine clinical use. In contrast, musculoskeletal ultrasound has emerged as an accessible, real-time, and cost-effective imaging modality for both the diagnosis and treatment guidance of adhesive capsulitis. This narrative review compiles and illustrates current evidence regarding the role of ultrasound, encompassing static B-mode imaging, dynamic motion analysis, contrast-enhanced techniques, and sonoelastography. Key sonographic features-such as thickening of the coracohumeral ligament, fibrosis in the axillary recess, and abnormal tendon kinematics-have been consistently associated with adhesive capsulitis and demonstrate favorable diagnostic performance. Advanced methods like contrast-enhanced ultrasound and elastography provide additional functional insights (enabling evaluation of capsular stiffness and vascular changes) which may aid in disease staging and prediction of treatment response. Despite these advantages, the clinical utility of ultrasound remains subject to operator expertise and technical variability. Limited visualization of intra-articular structures and the absence of standardized scanning protocols continue to pose challenges. Nevertheless, ongoing advances in its technology and utility standardization hold promise for the broader application of ultrasound in clinical practice. With continued research and validation, ultrasound is positioned to play an increasingly central role in the comprehensive assessment and management of adhesive capsulitis.

Keywords:  contrast-enhanced ultrasonography; dynamic examination; frozen shoulder; sonoelastography; sonography

DOI:  https://doi.org/10.3390/diagnostics15151924
Sci Rep. 2025 Aug 11. 15(1): 29346

Understanding patient needs and preferences for joint protection in hand osteoarthritis through mixed methods patient co-design.

Dimitra V Pouliopoulou, Joy C MacDermid, Nicole Billias, Victoria D'Alessandro, Emily Lalone, Ruby Grewal, Pavlos Bobos.

  Hand osteoarthritis (HOA) is a prevalent chronic condition that impairs quality of life and daily functioning. While joint protection programs (JPPs) offer symptom management, they remain outdated, inaccessible, and poorly tailored to patient needs. This study leverages patient co-design to develop a novel, inclusive, technology-enabled JPP. Using an explanatory sequential design, a survey of 196 participants (88% female, mean age 66 ± 8 years) identified priority activities and challenges for patients with HOA. Key activities of daily living and occupational and functional tasks were rated using a 5-point Likert scale, with a Relative Importance Index (RII) calculated for each item. Qualitative semi-structured interviews with 20 purposefully sampled participants provided in-depth insights into lived experiences with HOA and preferences in JPPs. Quantitative analysis identified high-importance tasks, such as buttoning, gripping, and twisting, with RII scores exceeding 0.8, indicating strong positive sentiment. Functional impairments included issues with precision grip and gross motor tasks, and pain interference disrupted daily activities and social roles. Qualitative themes revealed the importance of strategies for sustaining meaningful activities, patient support communities, and barriers related to accessibility, including technological literacy and caregiving responsibilities. Findings emphasize the importance of co-designing JPPs that address functional impairments, incorporate patient support communities, and consider intersectional barriers. This approach fosters accessibility, adherence, and relevance, paving the way for improved outcomes in patients with HOA.

Keywords:  Hand osteoarthritis; Joint protection; Mixed methods; Patient co-design

DOI:  https://doi.org/10.1038/s41598-025-13734-5
JBI Evid Synth. 2025 Aug 12.

Implementation of digital health in rural populations with chronic musculoskeletal conditions: a scoping review.

Lara Campos, Alexandre Moniz, Helena Donato, Baltazar Nunes, Eduardo B Cruz.

   OBJECTIVE: This scoping review aimed to comprehensively map the evidence regarding the implementation of digital health interventions in rural populations with chronic musculoskeletal conditions.
INTRODUCTION: Chronic musculoskeletal conditions are a significant global health concern, associated with high levels of disability and substantial impacts on health care systems. Rural populations, due to social determinants such as low education and limited health care access, bear an even greater burden of these conditions. Digital health technologies offer the potential to improve clinical outcomes for chronic musculoskeletal conditions and may help mitigate these determinants. Rural populations face unique barriers that can hinder the successful implementation of digital health technologies; therefore, it is crucial to explore the use of these technologies within the specific context of rural populations, focusing not only on clinical effectiveness but also on sustainable implementation and scalability in real-world settings.
ELIGIBILITY CRITERIA: Studies from 2000 onward, in any language, reporting the use of digital health interventions in rural areas for adults with chronic musculoskeletal conditions were considered for inclusion.
METHODS: This review followed the Arksey and O'Malley framework and JBI guidance for scoping reviews. Searches were conducted across PubMed, Embase.com, Web of Science Core Collection, Scopus, and gray literature sources. Two reviewers independently performed the screening process and data charting. Expert Recommendations for Implementing Change (ERIC) and Proctor's framework guided the charting and synthesis of implementation strategies and implementation outcomes, respectively. Content analysis was applied to interpret the qualitative data and align the findings with these frameworks.
RESULTS: Seventeen studies met the eligibility criteria, showcasing diverse digital programs and mapping a wide range of clinical outcomes. Concerning the implementation processes, 5 studies evaluated barriers and facilitators, but only 1 conducted the assessment before the implementation. A total of 22 discrete implementation strategies were described, and 8 studies evaluated implementation outcomes.
CONCLUSIONS: This scoping review highlights that digital health interventions for individuals with chronic musculoskeletal conditions in rural settings are increasingly being implemented and clinically evaluated; however, theory-informed implementation is lacking. Despite increasing importance in ensuring sustainable adoption and deployment of evidence-based interventions in real-world settings, implementation science principles are still poorly represented in the field of rural digital health for chronic musculoskeletal conditions.
REVIEW REGISTRATION: OSF https://osf.io/cwsqj.
SUPPLEMENTAL DIGITAL CONTENT: A Portuguese-language version of the abstract of this review is available at: http://links.lww.com/SRX/A111.

Keywords:  digital health; musculoskeletal; rural populations

DOI:  https://doi.org/10.11124/JBIES-24-00396
J Multidiscip Healthc. 2025 ;18 4613-4628

Summary of Best Evidence for Integrated Airway Management in ICU Tracheostomy Patients.

Jixiang Guo, Yiwen Li, Dongxue Xie, Mingyang Zhang, Simao Fu.

   Objective: The aim of this study was to comprehensively summarize the best currently available evidence by reviewing and analyzing the relevant literature in the area of care and maintenance of tracheostomy patients in the ICU. The evidence covers a wide range of aspects of postoperative care, complication prevention and management, rehabilitation support, and multidisciplinary collaboration for tracheostomy patients.
Methods: Using the "6S" evidence-based model, we searched multiple databases. The search focused on evidence related to the care of tracheostomy patients, including maintenance, nursing measures, multidisciplinary collaboration, and quality improvement, with the time frame ranging from the inception of the databases to March 14, 2025. Two researchers independently evaluated the quality of the literature, extracted data, and summarized evidence from publications meeting the inclusion criteria.
Results: A total of 12 relevant documents were retrieved, including 6 guidelines, 2 expert consensus papers, 1 best clinical practice guideline, 3 Meta-analyses. Through summarization and induction, 49 best evidence pieces were obtained across three major themes: maintenance and protection, nursing measures, and multidisciplinary collaboration and quality improvement. These were further divided into 15 sub-themes, covering equipment management, environmental optimization, infection prevention, postoperative care, airway humidification, suctioning, tracheostomy tube management, skin care, rehabilitation exercises, complication prevention, and daily assessments.
Conclusion: This research systematically compiles the optimal evidence regarding the care and management of tracheostomy patients, offering a comprehensive foundation for evidence-based clinical practice. It assists healthcare professionals in developing personalized care plans, improving patient safety, reducing complications, and promoting recovery. Future research should focus on optimizing multidisciplinary collaboration, exploring nurse-led interventions, and addressing cultural and resource limitations to further enhance the standardization and personalization of tracheostomy care.

Keywords:  best practices; care management; evidence summary; multidisciplinary collaboration; quality improvement; tracheostomy

DOI:  https://doi.org/10.2147/JMDH.S532895
J Clin Med. 2025 Jul 28. pii: 5320. [Epub ahead of print]14(15):

Dry Needling for Tension-Type Headache: A Scoping Review on Intervention Procedures, Muscle Targets, and Outcomes.

Ana Bravo-Vazquez, Ernesto Anarte-Lazo, Cleofas Rodriguez-Blanco, Carlos Bernal-Utrera.

  Background/Objectives: Tension-type headache (TTH) is the most prevalent form of primary headache. The etiology of TTH is not yet fully understood, although it is associated with the presence of myofascial trigger points (MTPs) in cervical and facial muscles. Dry needling (DN) therapy has emerged as an effective and safe non-pharmacological option for pain relief, but there are a lack of systematic reviews focused on its specific characteristics in TTH. The aim of this paper is to examine the characteristics and methodologies of DN in managing TTH. Methods: A scoping review was conducted with inclusion criteria considering studies that evaluated DN interventions in adults with TTH, reporting target muscles, diagnostic criteria, and technical features. The search was performed using PubMed, Embase, Scopus, and the Web of Science, resulting in the selection of seven studies after a rigorous filtering and evaluation process. Results: The included studies, primarily randomized controlled trials, involved a total of 309 participants. The most frequently treated muscles were the temporalis and trapezius. Identification of MTPs was mainly performed through manual palpation, although diagnostic criteria varied. DN interventions differed in technique. All studies included indicated favorable outcomes with improvements in headache symptoms. No serious adverse effects were reported, suggesting that the technique is safe. However, heterogeneity in protocols and diagnostic criteria limits the comparability of results. Conclusions: The evidence supports the use of DN in key muscles such as the temporalis and trapezius for managing TTH, although the diversity in methodologies and diagnostic criteria highlights the need for standardization. The safety profile of the method is favorable, but further research is necessary to define optimal protocols and improve reproducibility. Implementing objective diagnostic criteria and uniform protocols will facilitate advances in clinical practice and future research, ultimately optimizing outcomes for patients with TTH.

Keywords:  dry needling; headache; trigger points

DOI:  https://doi.org/10.3390/jcm14155320
J Clin Ultrasound. 2025 Aug 11.

Calcification of the Lateral Collateral Ligament as a Rare Cause of Knee Pain and Its Treatment With Ultrasound-Guided Barbotage Procedure: A Case Report.

Muhammed Oğuz, Mehmet Toktaş, Ayşenur Ada, Burak Tayyip Dede, Ebru Aytekin.

  Calcific periarthritis (CP) of the lateral collateral ligament (LCL) is a rare condition, and treatment protocols are unclear. A 48-year-old female patient presented with a 5-month history of localized pain in the lateral left knee. The clinical history, clinical findings, and imaging findings of the patient, in whom no abnormality was found in routine laboratory tests, were suggestive of CP. An ultrasound (US)-guided barbotage procedure was performed on the patient who did not respond to conservative treatment. This report aims to report the first case of successful treatment of CP of LCL with an US-guided barbotage procedure, which is a rare condition, and to discuss the available data in the literature.

Keywords:  calcific periarthritis; case report; lateral collateral ligament; pain management; ultrasound

DOI:  https://doi.org/10.1002/jcu.70038
Nurs Crit Care. 2025 Sep;30(5): e70151

Patient, Family and Provider Priorities in ICU Rehabilitation: An Experience-Based Co-Design Study.

Jiyeon Kang, Sun Ju Chang, Mi-Kyeong Jeon, Gee Young Suh, Chi Ryang Chung.

   BACKGROUND: Intensive care unit (ICU) rehabilitation has been shown to improve physical, psychological and functional outcomes in critically ill patients. However, implementation varies widely, and clinical practice guidelines (CPGs) are needed to ensure consistent, evidence-based care. Incorporating patient and public involvement (PPI) into CPG development is essential to reflect the lived experiences and priorities of service users.
AIM: To explore the experiences of ICU rehabilitation from the perspectives of patients, families and healthcare providers and to identify shared priorities that can inform the development of Korean CPGs for ICU rehabilitation and post-intensive care syndrome.
STUDY DESIGN: This study applied the Experience-Based Co-Design (EBCD) approach. We conducted observations of ICU rehabilitation practices through institutional educational video recordings, individual interviews with four ICU survivors and a focus group interview with five ICU healthcare professionals. A trigger audio recording, derived from the patient interviews, and thematic touchpoints from qualitative analysis were presented in a group feedback event. ICU clinicians involved in CPG development participated to validate the findings and identify shared priorities.
RESULTS: Four core priorities were identified: patients and families as partners, person-centred approach, fostering rehabilitation culture and teamwork, and ensuring sustainability of rehabilitation.
CONCLUSIONS: Successful ICU rehabilitation requires placing patients and families at the centre throughout the entire rehabilitation journey, from ICU admission to community reintegration. Structural support addressing workforce limitations and cost reimbursement issues, complemented by a culturally sensitive team approach, is essential for establishing effective linkages between ICU rehabilitation and community services.
RELEVANCE TO CLINICAL PRACTICE: ICU healthcare providers should create more opportunities for patient and family engagement in rehabilitation processes. A dynamic team approach that flexibly incorporates diverse staff is crucial for delivering person-centred services. Administrators and policymakers should develop comprehensive strategies and policies that facilitate seamless continuation of rehabilitation from ICU to community settings.

Keywords:  clinical practice guidelines; family; intensive care unit; rehabilitation; survivors

DOI:  https://doi.org/10.1111/nicc.70151
J Hand Surg Eur Vol. 2025 Aug 13. 17531934251363138

Extensor tendon repairs: consensus, current guidelines and recommendations.

Jin Bo Tang, Carlos Henrique Fernandes, Donald Lalonde, Koji Moriya, Esther Vögelin, Egemen Ayhan, Collaborators Sebastian von Unger, Nathaniel Orillaza, Simon Farnebo, Pasi Paavilainen.

  The current classification of extensor tendon zones has remained unchanged for several decades. In this article, a panel of international experts give their consensus and diverse views about the classification and suggest treatment guidelines for acute extensor tendon injuries for each zone. Collectively they recommend adaptation of a classification which is simpler and resembles that for flexor tendon classification. They outline specific areas of extensor tendon zones, i.e. the distal parts of the fingers, which need particular attention and specific treatment approaches. The treatment approaches of the other extensor tendon zones can generally follow the same or a similar surgical repair principle and methods, and rehabilitation protocols currently used for flexor tendon injuries. Consolidation of the classification, surgery and rehabilitation of both flexor and extensor tendons is expected to make surgical decision easier and allow wider adaptation of the clinical methods applicable to both flexors and extensors.

Keywords:  Classification of extensor tendons; extensor tendon injuries; extensor tendon repair; extensor tendon zones; rehabilitation

DOI:  https://doi.org/10.1177/17531934251363138
Cureus. 2025 Jul;17(7): e87646

Comparison of Suprascapular Nerve Block With Glenohumeral Joint Dilatation for the Treatment of Adhesive Capsulitis of the Shoulder Joint.

Madhumita Singha Roy, Anil K Gupta, Dileep Kumar, Sudhir Mishra, Ganesh Yadav, Anit Parihar, Anurug Biswas.

   BACKGROUND: Adhesive capsulitis (AC) of the shoulder is characterized by progressive pain and loss of active and passive range of motion (ROM). The purpose of this study was to identify a better approach to shoulder pain management and to eliminate unnecessary interventions. The objective was to assess the effect of ultrasound-guided suprascapular nerve block (SSNB), hydrodilatation (HD), and exercise in improving pain, ROM, and function of the shoulder joint.
METHOD: The study design included a single-blinded randomized controlled trial with an allocation ratio of 1:1:1. The study population consisted of patients attending the OPD and admitted to the ward. A total of 73 patients were analyzed in Group A (Nerve block + Exercise), Group B (Nerve block + HD + Exercise), and Group C (Exercise), using descriptive statistics to make comparisons among the various groups.
RESULTS: The changes were significant (p < 0.001) in all groups, with the maximum change in Group A and the minimum change in Group C. There were fewer significant changes in different ranges of motion, except for flexion, which showed significant improvement at every follow-up.
CONCLUSION: SSNB plus exercise program not only reduces pain but also reduces disability and improves function, making it an effective treatment for treatment for patients with AC.

Keywords:  idiopathic adhesive capsulitis; nerve block; pain; range of motion; shoulder

DOI:  https://doi.org/10.7759/cureus.87646
PM R. 2025 Aug 13.

A survey of brain injury medicine fellowship graduates 2014-2023: Perceived strengths and opportunities for training based upon current practice trends.

Arielle A Berkowitz, Kristen A Harris, Mikaela Raddatz, Hayk Petrosyan, Brian D Greenwald.

BACKGROUND: Brain injury medicine (BIM) is a medical subspecialty addressing the prevention, diagnosis, and treatment of individuals with brain injury. BIM fellowships have been accredited by the Accreditation Council for Graduate Medical Education (ACGME) since 2014.
OBJECTIVE: To identify practice patterns of physiatrists who have completed an ACGME-accredited BIM fellowship and assess the training satisfaction and potential opportunities for enhancement of BIM fellowship training.
DESIGN: Online cross-sectional survey.
SETTING: A national cross-sectional survey of BIM physiatrists was designed in conjunction with the American Board of Physical Medicine and Rehabilitation.
PARTICIPANTS: Physiatrists who had graduated from an ACGME-accredited BIM fellowship between 2014 and 2023.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURE(S): Demographic information, current practice patterns, and levels of satisfaction (very unsatisfied to very satisfied) with fellowship training in areas of core competency.
RESULTS: The survey was completed by 61 BIM fellowship graduates. Fifty-one percent of respondents identified as male, and 46% reported practicing in the Northeast. Seventy-seven percent of respondents held teaching roles at a medical school, and 82% were in a clinical leadership role. Eighty-seven percent reported performing botulinum toxin injections in their current practice. Overall, respondents reported a high degree of satisfaction with fellowship training.
CONCLUSIONS: Survey respondents work predominantly in the Northeast, in both inpatient and outpatient environments, and are more likely to work in academic medical centers. Survey respondents commonly held clinical and academic leadership roles. Phenol/alcohol neurolysis, respiratory complications, pain management, and special brain injury populations were identified as potential areas for further fellowship development.

DOI: https://doi.org/10.1002/pmrj.70005
Appl Neuropsychol Adult. 2025 Aug 11. 1-7

Validity and reliability of modified box and block test and targeted box and block test in patients with stroke.

Lütfiye Akkurt, Cihan Caner Aksoy, Fatıma Yaman.

   INTRODUCTION: The Box and Block Test (BBT) is commonly used to evaluate unilateral manual dexterity in patients with stroke. While the BBT is quick and simple to use, it causes large measurement variability because the administration is not standardized. In this study, we evaluated the validity and reliability of the modified BBT (mBBT) and a targeted BBT (tBBT) in patients with stroke.
METHOD: Our participants were 50 patients with stroke. We evaluated the criterion validity of the mBBT and tBBT through its correlations with scores on the 9-Hole Peg Test (9-HPT), the Fugl-Meyer Assessment-Upper Extremity test (FMA-UE) and BBT. We analyzed the reliability with test-retest reliability.
RESULTS: The mBBT was strongly and positively correlated with the 9 HPT (r = 0.823), and strongly negatively correlated the BBT (r = -0.870) for the more-affected hand (p < 0.001). The tBBT was also strongly positively correlated with the 9 HPT (r = 0.913), and the BBT (r = -0.889) for the more-affected hand (p < 0.001). The mBBT was moderately positively correlated with the FMA-UE (r = -0.574), and the tBBT was moderately correlated with (r = -0.604) for the more-affected hand (p < 0.001). The ICCs for the mBBT and the tBBT ranged from 0.86 to 0.97 for the more-affected hand.
CONCLUSION: In this sample, the mBBT and tBBT appeared to be valid and reliable for patients with stroke.

Keywords:  Reliability; stroke; upper extremity assessment; validity

DOI:  https://doi.org/10.1080/23279095.2025.2545543
PM R. 2025 Aug 15.

American Academy of Physical Medicine and Rehabilitation Position Statement on Opioid Prescribing.

Anthony E Chiodo, Thiru M Annaswamy, Diane W Braza, Melanie Dolak, Andrew S Friedman, J Jason Miller, Carolyn Millett, Ameet S Nagpal, Samman Shahpar, Saloni Sharma, Kayla Martin.

DOI: https://doi.org/10.1002/pmrj.70000
Afr J Disabil. 2025 ;14 1546

Frameworks used to evaluate community-based rehabilitation interventions: A scoping review.

Sarah M Manig, Liezel Ennion, Michael Rowe, Luc de Witte.

   Background: Community-based rehabilitation (CBR) interventions are important for improving the well-being of people with disabilities. However, there is no universally accepted framework for evaluating these interventions, which limits their effectiveness and integration into policy.
Objectives: To explore theoretical frameworks used in evaluating CBR interventions, assessing their suitability, context-specific applicability and cultural relevance.
Method: A scoping review methodology was employed to examine the literature. Databases searched included PubMed, CINAHL, EBSCOhost and Web of Science. Broad search terms and keywords used were CBR, analytical and/or methodological and/or theoretical and/or conceptual and/or evaluation framework, impact and evaluation. Only full-text articles written in English and published between 2000 and 2020 were included. Data were analysed using a narrative synthesis method.
Results: No single framework has been widely recognised as the superior or most effective standard for evaluating CBR interventions. Instead, a combination of the CBR matrix and CBR guidelines was frequently used and adapted to be context-specific.
Conclusion: While cultural relevance and context specificity are recognised as essential to the evaluation process - and measuring outcomes at the individual level is viewed as most appropriate - there remains a need for a certain level of standardisation.
Contribution: The study highlights the need for context-specific and culturally relevant evaluation frameworks for CBR interventions, including appropriate outcome measures and/or evaluation instruments.

Keywords:  community-based rehabilitation; evaluation; framework; impact assessment; rehabilitation evaluation; scoping review; theoretical framework

DOI:  https://doi.org/10.4102/ajod.v14i0.1546