bims-ricfun Biomed News
on Rehabilitation ICF
Issue of 2025–09–07
seven papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica



  1. J Clin Ultrasound. 2025 Aug 30.
      
    Keywords:  asymptomatic; incidentaloma; musculoskeletal; overtreatment; ultrasound
    DOI:  https://doi.org/10.1002/jcu.70054
  2. Am J Phys Med Rehabil. 2025 Sep 01.
       OBJECTIVE: This study aims to compare the long-term results of cITB rehabilitation against those of conventional treatment for intractable spasticity in children with cerebral palsy using the International Classification of Functioning, Disability and Health of Children and Youth (ICF-CY).
    DESIGN: 5-year single-center retrospective cohort study.
    RESULTS: The ICF-CY data from 24 patients with CP of GMFCS levels IV-V (aged between 8 and 18 years) were retrospectively analyzed for 5 years. The results show different trends between the 12 patients who received cITB and the 12 who were excluded due to contraindications. The cITB group improved spasticity, pain and BMI z-scores over 12 months and during the 5-year follow-up with a continuous simple Baclofen administration at a maximum of 140 μg/d at a concentration of 2000 μg/mL.
    CONCLUSIONS: cITB improves Structure and Function, Autonomy, and Participation in both short and long term. Overall, the cITB group, with its characteristics of initially greater pain and hypertonia, benefited significantly from the efficacy of intrathecal Baclofen treatment compared with the control group, which continued to receive conventional treatment.The ICF-CY outcome measures demonstrated an inter-relationship between spasticity and weakness and disease progression over childhood to adolescence.Follow-up will be vital for effective personalized treatment, quality of life, and research.Long-term ICF-CY data collection is key to comparing treatment outcomes.
    Keywords:  BMI z-score; GMFCS; ICF-CY; LSS; care burden; cerebral palsy; intrathecal Baclofen; non-ambulatory; pain; physiotherapy; rehabilitation
    DOI:  https://doi.org/10.1097/PHM.0000000000002770
  3. Top Stroke Rehabil. 2025 Aug 29. 1-14
       BACKGROUND: A single session of perturbation-based training (PBT) reduces fall-risk and enhances reactive balance control in people with stroke (PwS). However, its long-term effect on clinical outcomes remains unclear. This study examined the retention effects of a single session of overground walk-PBT on clinical measures of body structure and function, activity limitation, and participation restriction in PwS.
    METHODS: Forty-eight PwS were randomized to training (n = 25) or control (n = 23) groups. Participants completed baseline, 6- and 12-month sessions, including reactive balance and clinical assessments. The training group underwent overground walk-PBT, while the control group completed unperturbed walking alone. Outcomes were assessed using the International Classification of Functioning, Disability, and Health (ICF) framework: body structure and function (Modified Rankin Scale, Activities-specific Balance Confidence - ABC), activity limitation (Berg Balance Scale, Timed Up and Go - TUG, 10-Meter Walk Test - 10MWT, 6-Minute Walk Test), and participation restriction (Community Integration Questionnaire - CIQ). A Two-way ANOVA examined group × time interactions on all outcomes followed by post-hoc comparisons.
    RESULTS: Significant group × time interactions were observed for ABC, TUG, 10MWT, and CIQ (p < 0.05). The training group demonstrated improvements from baseline to 6 months (p < 0.02), with no differences between the 6- and 12-month sessions (except improvements in CIQ) (p > 0.02). The control group showed no improvements (p > 0.02) and demonstrated a reduction in balance confidence from baseline to 6-months (p < 0.02).
    CONCLUSION: A single session of overground walk-PBT showed long-term improvements in outcomes across all ICF domains, highlighting its clinical utility as an effective rehabilitation strategy for PwS.
    Keywords:  Hemiparesis; balance; falls; mobility; retention; slip training; walking
    DOI:  https://doi.org/10.1080/10749357.2025.2547614
  4. Bone Jt Open. 2025 Sep 04. 6(9): 1031-1043
       Aims: The primary aims were to determine what outcome domains, outcome measurement instruments, and outcome measurement timepoints are reported in randomized controlled trials (RCTs) involving people with patellar dislocations. The secondary aims were to determine what primary outcomes were used and how a recurrent patellar dislocation was defined when this was used as an outcome.
    Methods: We searched MEDLINE, Embase, CINAHL, the Cochrane Database of Controlled Trials, and trial registries (last search: January 2024) for RCTs evaluating treatments for people with a patellar dislocation irrespective of age or sex. We identified the unique outcomes in included studies and mapped these onto the World Health Organization's International Classification of Functioning, Disability and Health (WHO ICF) framework to identify the measured domains. We synthesized results into tables, figures, and text. A critical appraisal of included studies was not required for this systematic review.
    Results: From the 70 included studies, we identified 141 unique outcomes. The most commonly used unique outcome was a recurrent ipsilateral patellar dislocation (used in 55 studies), but only 17/55 studies (31%) reported how this was defined (i.e. the criteria required for a recurrent ipsilateral patellar dislocation event to be recorded). Unique outcomes mapped onto 66 second-level domains of the WHO ICF framework, and 56% (593/1,052) in the 'activities and participation' domain. Included studies used 42 different patient-reported outcome measures (PROMs), most commonly the Kujala Patellofemoral Score (71%, 50/70 studies), but 28 PROMs (60%) were used only once. In all, 31 different primary outcomes were identified from 47 included studies, with 14 primary outcomes (45%) used only once among included studies. The Kujala Patellofemoral Score was also the most common primary outcome (38%, 18/47 studies). Outcome measurement timepoints varied, but the most common timeframe for primary outcome measurement was > one to three years (46%, 16/35 studies that provided data).
    Conclusion: The variability in the outcome domains, PROMs, and primary outcomes measured in RCTs evaluating patellar dislocation treatments highlights that a core outcome set is needed. This process is underway and is being informed by this systematic review's findings.
    DOI:  https://doi.org/10.1302/2633-1462.69.BJO-2025-0045.R1
  5. Am J Phys Med Rehabil. 2025 Aug 27.
      
    Keywords:  injuries; msk; pain; social media
    DOI:  https://doi.org/10.1097/PHM.0000000000002804
  6. J Pediatr Clin Pract. 2025 Sep;17 200172
       Objective: Perinatal brain injury can result in long-term neurodevelopmental sequelae. To examine the most significant consequences from a patient perspective, this questionnaire study explored the strengths and difficulties in daily functioning after perinatal brain injury, by child self-report and parent-proxy report.
    Study design: Cross-sectional questionnaire study of participants ≥8 years of age born with hypoxic-ischemic encephalopathy treated with therapeutic hypothermia, or with perinatal arterial ischemic stroke, and their parents. Open-ended questions regarding strengths and difficulties in daily functioning were analyzed by thematic analysis using the International Classification of Functioning, Disability and Health as coding framework.
    Results: Of the 102 participants (hypoxic-ischemic encephalopathy: n = 50, perinatal arterial ischemic stroke: n = 52) with a median age of 12.4 (range 8-25) years, 81% of the questionnaires (n = 83) were filled out by both participants and parents. Participants mainly reported participation in recreational activities and school-related learning abilities as strengths, while parents most frequently highlighted their child's personality traits. Difficulties were reported by 91% of participants and 76% of parents. Both parents and participants often mentioned difficulties with cognitive functioning including attention, memory, and processing speed. Furthermore, parents described social skills and movement difficulties, while participants mostly reported learning difficulties. Half of the parents reported that the difficulties significantly impacted their families' daily lives.
    Conclusions: Children and young adults with a history of perinatal brain injury face a variety of challenges in their everyday lives, emphasizing the importance of taking the full spectrum of sequelae into account in care, counseling, and future research.
    Keywords:  daily functioning; developmental health; neonatology; perinatal brain injury; psychosocial health; questionnaire study
    DOI:  https://doi.org/10.1016/j.jpedcp.2025.200172
  7. Am J Phys Med Rehabil. 2025 Aug 22.
      
    Keywords:  barriers; countries; language; translation
    DOI:  https://doi.org/10.1097/PHM.0000000000002847