bims-ricfun Biomed News
on rehabilitation ICF
Issue of 2025–08–03
34 papers selected by
Gerardo Amilivia, Médica Uruguaya Corporación de Asistencia Médica
  1. Translation, Cultural Adaptation, and Field Testing of the Korean Version of the HEAR-COMMAND Tool: A Self-Rated ICF-Based Questionnaire for Assessing Hearing, Communication, and Conversation Disabilities in Korean-Speaking Populations.
  2. Assessment of the external construct validity of the Brief International Classification of Functioning, Disability, and Health Core Set for chronic ischemic heart disease in a Turkish population.
  3. Systematic review of the use and challenges of electronic health records in physiotherapy practice.
  4. Assessment of functionality using the WHODAS 2.0 in community-dwelling elderly individuals: A scoping review.
  5. Advancing Competency: Current Evidence and Future Directions for Mastery Learning in PM&R Residency Education.
  6. Patients' Experiences of the Treatment Received During Their Stay in the Stroke Unit at Spanish Healthcare Centers: A Qualitative Approach.
  7. [Beyond Subjective Impressions: Results of an online survey over outcome measures among the Rehabilitation Doctors in Spain].
  8. Role of Motion Tracking in Tele-Assessment of Functional Impairments in Individuals With Knee Osteoarthritis: A Scoping Review Protocol.
  9. Assessing Quality of Life Among Women with Urinary Incontinence-Medical, Psychological, and Sociodemographic Determinants.
  10. The Effects of Pilates in Parkinson's Disease-A Narrative Review.
  11. Improving Access to Stroke Rehabilitation and Recovery: A Policy Statement From the American Heart Association/American Stroke Association.
  12. Patient and Practitioner Perspectives on the Definition and Measurement of Therapeutic Empathy: Qualitative Study.
  13. An overview of pectus deformities and rehabilitation approaches.
  14. Trends and advances in cardiac rehabilitation for congenital heart disease: a bibliometric analysis.
  15. Rehabilitation in a case with cauda equina syndrome after spinal manipulation: A long and difficult process.
  16. Innovations In Physical Medicine and Rehabilitation: Advances in the Diagnosis, Treatment, and Care of Amyotrophic Lateral Sclerosis.
  17. Outcome Measures in the Management of Low Back Pain-A Systematized Review.
  18. Supporting Communication Access of People With Communication Disabilities and Communication Differences in UNCRPD-Ratified Countries: An Integrative Review.
  19. Mind-body training outperforms other physical activities in reducing frailty and enhancing quality of life in older adults: a network meta-analysis.
  20. Effects of a 12-week physiotherapist-supervised home-based rehabilitation program on the functional exercise capacity in people with systemic sclerosis.
  21. Anxiety and adjustment following SCI: a transdiagnostic psychological intervention combining Cognitive Behavioural Therapy (CBT) and Coping Effectiveness Training (CET).
  22. Management of adolescent scoliosis: a comprehensive review of etiology and rehabilitation.
  23. Research progress on rehabilitation programs for dysphagia in patients with ischemic stroke: A Narrative review.
  24. Making Room for Every Voice: Reimagining Person-Centred Care in the Neurosciences.
  25. Precision Rehabilitation Through Mathematical Modeling: A New Frontier in Medicine.
  26. Sexual and reproductive health in neurological disorders: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).
  27. Psychometric Evaluation of the Turkish Classification and Assessment of Occupational Dysfunction Scale.
  28. Lower Extremity Orthotic Device Prescriptions: Basics of Evaluation and Management.
  29. A Comprehensive Review of Elbow Exoskeletons: Classification by Structure, Actuation, and Sensing Technologies.
  30. Meeting exercise guidelines during pregnancy associates with less lumbopelvic disability and fear avoidance.
  31. Social Listening and its Issues: What can the Precautionary Principle Advice?
  32. Centralisation of specialised healthcare services: a scoping review of definitions, types, and impact on outcomes.
  33. The evolving landscape of health and social care integration: in search of a unifying theory.
  34. Reimagining Social Value to Consider the Environment: How Should We Judge the Magnitude of Benefits in Health Research?
  1. J Audiol Otol. 2025 Jul;29(3): 197-204
    Translation, Cultural Adaptation, and Field Testing of the Korean Version of the HEAR-COMMAND Tool: A Self-Rated ICF-Based Questionnaire for Assessing Hearing, Communication, and Conversation Disabilities in Korean-Speaking Populations.
    Razan Alfakir, Lily Dunaway, JungMoon Hyun, Hae Sagong, Tahereh Afghah, Soyean Kang.
       BACKGROUND AND OBJECTIVES: Despite the growing Korean population in the USA, barriers to healthcare access persist due to widespread limited English proficiency, particularly in hearing healthcare. A lack of culturally competent, multilingual resources has exacerbated these challenges. This study aimed to translate the HEAR-COMMAND Tool into Korean, adapt it culturally, and assess its comprehensibility, readability, and relevance to Korean individuals.
    SUBJECTS AND METHODS: A systematic six-step methodology led by a team of four Korean faculty members was used for the translation process. Two nursing faculty members drafted the first version, ensuring alignment with the original content. A bilingual linguist specializing in English-Korean translation reviewed the draft, followed by a speech-language and hearing sciences faculty member who assessed its cultural appropriateness. The translated tool was tested by 10 Korean-speaking participants to evaluate its readability, linguistic and cultural suitability, and accessibility, leading to further refinement. Finally, five Korean American healthcare and academic professionals provided additional inputs, resulting in a beta version of the HEAR-COMMAND Tool-Korean.
    RESULTS: The beta version of the HEAR-COMMAND Tool-Korean was generally found to be feasible, comprehensible, and engaging. Ten of the 15 participants found the items easy to understand, although some had difficulties with specific terms and sentence structures. Notably, 14 of the 15 participants reported that the tool would likely motivate them to seek professional help for hearing concerns.
    CONCLUSIONS: The translation and cultural adaptation of the HEAR-COMMAND Tool into Korean represents an advancement in addressing the hearing healthcare needs of the Korean population in the USA. Grounded in the International Classification of Functioning, Disability and Health (ICF), this tool facilitates hearing-related assessments that can be used more broadly among all Korean-speaking individuals worldwide. Future research should validate this tool and examine its impact in clinical and community settings.
    Keywords:  HEAR-COMMAND tool; Hearing healthcare access; Hearing loss; International Classification of Functioning, Disability and Health; Korean
    DOI:  https://doi.org/10.7874/jao.2025.00136
  2. Turk J Phys Med Rehabil. 2025 Jun;71(2): 226-236
    Assessment of the external construct validity of the Brief International Classification of Functioning, Disability, and Health Core Set for chronic ischemic heart disease in a Turkish population.
    Didem Sezgin Ozcan, Belma Fusun Koseoglu, Sinem Kocer Akselim, Ozgur Ulas Ozcan.
       Objectives: This study aimed to validate the Brief International Classification of Functioning, Disability, and Health (ICF) Core Set for chronic ischemic heart disease (CIHD) in a Turkish patient population, identifying the most common problems in ICF categories and testing its construct validity.
    Patients and methods: A total of 85 patients (28 males, 57 females; mean age: 64.4±12.2 years; range, 37 to 88 years) diagnosed with CIHD who were referred to our cardiac rehabilitation outpatient clinic were included in the cross-sectional study between February 2014 and August 2015. Brief ICF Core Set for CIHD, which includes 36 second-level categories, was used to assess the most common impairments. Correlations between these impairments and various clinical assessment scales were analyzed to test construct validity.
    Results: The most impaired categories in body functions were heart functions, blood pressure functions, exercise tolerance functions, blood vessel functions, sensations associated with cardiovascular and respiratory functions, and energy and drive functions. In the body structure component, the structure of the cardiovascular system was identified as a problem in 97.6% of patients. The activities and participation component revealed that moving around, remunerative employment, and carrying out daily routines were frequently problematic. All of the environmental factors were identified as both barriers and facilitators. Significant correlations were found between these categories and various clinical assessment scales.
    Conclusion: The Brief ICF Core Set for CIHD is a valid tool for assessing the multifaceted impact of CIHD in a Turkish patient population. This validation supports its use for comprehensive, patient-centered evaluations in clinical settings, emphasizing the need for a holistic approach to managing CIHD.
    Keywords:  Chronic ischemic heart disease; ICF core set; disability; validation.
    DOI:  https://doi.org/10.5606/tftrd.2025.16125
  3. BMJ Open. 2025 Jul 30. 15(7): e097649
    Systematic review of the use and challenges of electronic health records in physiotherapy practice.
    Sara Vaz, Carlos Rodrigues, Carla Pereira, André Moreira-Rosário.
       OBJECTIVE: To synthesise current evidence on physiotherapists' use of electronic health records (EHRs), with a focus on the determinants of adoption, implementation processes and associated implementation outcomes.
    DESIGN: A systematic review employing a narrative synthesis approach.
    DATA SOURCES: PubMed, Cochrane, Scopus and Web of Science, covering all records from the inception of each database to 10 May 2024.
    ELIGIBILITY CRITERIA: Studies conducted in physiotherapy clinical settings and using the International Classification of Functioning, Disability and Health (ICF).
    DATA EXTRACTION AND SYNTHESIS: Two authors independently screened articles and assessed methodological quality. Risk of bias was assessed using the Critical Appraisal Skills Programme tool for qualitative and for cohort studies, the Mixed Methods Appraisal Tool for mixed-methods studies and the JBI Critical Appraisal Checklist for analytical cross-sectional studies.
    RESULTS: From 3820 records screened, 9 observational studies met inclusion criteria. Key factors influencing EHR adoption included organisational readiness, perceived usefulness, managerial support and training availability. Implementation patterns clustered into three domains: recorded content, ICF framework integration and record quality. Reported outcomes focused on care quality metrics and evidence of clinical effectiveness.
    CONCLUSIONS: Persistent challenges in physiotherapy EHR use were identified, notably in data quality, completeness and alignment with the ICF framework. Improving EHR practices is crucial to improve clinical assessment and support digital health integration. However, limited evidence and methodological heterogeneity remain key limitations.
    PROSPERO REGISTRATION NUMBER: CRD42023420267.
    Keywords:  Electronic Health Records; Health informatics; Physical Therapy Modalities
    DOI:  https://doi.org/10.1136/bmjopen-2024-097649
  4. Medicine (Baltimore). 2025 Jul 25. 104(30): e43372
    Assessment of functionality using the WHODAS 2.0 in community-dwelling elderly individuals: A scoping review.
    José Felipe Costa da Silva, Luciana Araújo Dos Reis, Catharinne Angélica Carvalho de Farias, Silvana Loana de Oliveira-Sousa, Felipe León Morillas, Thaiza Teixeira Xavier Nobre.
      In elderly individuals, it is more common to observe a decline in their functionality, resulting in difficulties in performing daily activities and participating in the community. To mitigate this decline, longitudinal monitoring of the elderly individual is necessary, along with the use of instruments such as the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0), which evaluates functionality across various aspects. The scope is to analyze the use of WHODAS 2.0 as an instrument for assessing functionality in community-dwelling elderly individuals. A scoping review was conducted on WHODAS 2.0 as an instrument for assessing functionality in community-dwelling elderly individuals. The descriptors "Disability Assessment Schedule II"; "WHODAS 2.0"; "WHODAS"; "Aged"; "Elderly"; "Aging"; "Primary Health Care"; "Primary Care"; "Primary Healthcare" were used in the following databases: Medline, Embase, CINAHL, Scopus, Web Of Science, Embase, Science Direct, and Google Scholar. The initial collection resulted in a total of 425 studies addressing the topic. After readings using inclusion and exclusion criteria, 14 studies were included for analysis. The majority of studies were conducted in primary healthcare, with a greater number of women in various countries. The domains that most impacted functionality were mobility, activities of daily living, and social participation. Conversely, interpersonal relationships and self-care were the least affected domains. It is notable that WHODAS 2.0 is an instrument that can be used in community-dwelling elderly individuals. The domains that most negatively influenced functionality were mobility, activities of daily living, and social participation.
    Keywords:  disability and health; elderly; elderly health; international classification of functioning; primary health care
    DOI:  https://doi.org/10.1097/MD.0000000000043372
  5. Am J Phys Med Rehabil. 2025 Jul 24.
    Advancing Competency: Current Evidence and Future Directions for Mastery Learning in PM&R Residency Education.
    Leslie Rydberg, Dana Branch, Samuel K Chu, Emily Kivlehan, Jacqueline Neal.
       ABSTRACT: Mastery learning can be an effective method to ensure learner competence for specific procedures and skills. It has been used effectively in different fields of medicine. There is limited data within the field of Physical Medicine and Rehabilitation (PM&R) relating to the use of mastery learning, although a few early studies have shown promise and feasibility. PM&R requires expertise in a broad range of procedures and skills. Structured mastery learning programs may serve as a valuable tool to help PM&R learners achieve competency.
    Keywords:  Clinical Competence; Competency-Based Education; Graduate Medical Education; Physical Medicine and Rehabilitation
    DOI:  https://doi.org/10.1097/PHM.0000000000002827
  6. Medicina (Kaunas). 2025 Jun 29. pii: 1185. [Epub ahead of print]61(7):
    Patients' Experiences of the Treatment Received During Their Stay in the Stroke Unit at Spanish Healthcare Centers: A Qualitative Approach.
    Sagrario Pérez-de la Cruz.
      Background and Objectives: Stroke is a condition that seriously impairs the personal, family, social and professional lives of those affected. The aim of this study was to explore the perceptions of patients who have experienced a stroke and received care in stroke units across various health centers in Spain, as well as to gain insight into their rehabilitation process. Materials and Methods: A qualitative study was carried out with individual interviews involving 30 patients who voluntarily wished to collaborate, recounting their personal experience of the treatment and professionalism with which they were treated in these units. Results: Four themes emerged in this study: healthcare, the role of health professionals in the rehabilitation process, the professional-patient relationship, and barriers and facilitators of this relationship. The participants showed the variability in the care protocols for acute stroke patients, as well as the importance of a close relationship with physiotherapists and the demand for professionalism. Conclusions: The heterogeneity in the implementation of action protocols by healthcare professionals in stroke units has been demonstrated, leading to inequality in the approach and treatment of these patients. These findings may be useful to identify ways of approaching acute patients in stroke units and to design a comprehensive and coordinated rehabilitation program for these patients.
    Keywords:  healthcare; physiotherapy; qualitative research; relationship; stroke; treatment
    DOI:  https://doi.org/10.3390/medicina61071185
  7. Rehabilitacion (Madr). 2025 Jul 29. pii: S0048-7120(25)00047-7. [Epub ahead of print]59(3): 100927
    [Beyond Subjective Impressions: Results of an online survey over outcome measures among the Rehabilitation Doctors in Spain].
    G Arrieta-Bartolomé, M Supervía, S Laxe.
       INTRODUCTION: Measurement in rehabilitation is a fundamental pillar for objectifying the functional status of patients, determining and evaluating interventions, and monitoring treatment progress. However, its use in clinical practice is not yet sufficiently widespread among physicians.
    OBJECTIVE: To describe the usage habits of measurement instruments, particularly validated scales, in the clinical practice of Spanish physical and rehabilitation medicine (PRM) physicians.
    METHODS: A structured survey was designed and distributed, consisting of 11 mandatory Likert-type questions related to clinical practice, available time, use of scales and assessment tools, perceived barriers, and training needs. Data were analyzed using descriptive statistics and correlation analysis.
    RESULTS: Out of 390 professionals, 61.8% (n=241) reported using some type of measurement tool systematically. A total of 53 different scales were reported, with the Barthel Index being the most frequently used (42.3%, n=103). Those who did not use scales (n=95) relied on anamnesis and physical examination to assess patient progress. The main barrier identified was lack of time (78.4%, n=135). A significant association was observed between longer consultation times and routine use of scales (P<.001). Additionally, 76.9% (n=297) cited lack of training as a barrier, and 94.8% (n=365) expressed interest in receiving specific training.
    CONCLUSION: Although a majority of PRM physicians use measurement scales, important barriers such as limited time and lack of training remain. Addressing these factors through organizational and educational strategies could help promote wider adoption of measurement tools in clinical practice.
    Keywords:  Assessment scales; Calidad asistencial; Escalas; Indicadores rehabilitación; Outcome evaluation; Quality of life; Rehabilitación; Rehabilitation; Rehabilitation indicators; Valoración funcional
    DOI:  https://doi.org/10.1016/j.rh.2025.100927
  8. Musculoskeletal Care. 2025 Sep;23(3): e70171
    Role of Motion Tracking in Tele-Assessment of Functional Impairments in Individuals With Knee Osteoarthritis: A Scoping Review Protocol.
    Himanshu Gakhar, Himanshu Rakheja.
       INTRODUCTION: Knee osteoarthritis (KOA) is a prevalent cause of disability, marked by functional impairments that significantly reduce quality of life. Emerging digital health tools-particularly artificial intelligence (AI) and motion tracking technologies-present promising avenues for remote assessment of these impairments. Despite growing interest, there is a lack of comprehensive synthesis on how these technologies are utilised in remote KOA assessment.
    OBJECTIVE: This scoping review aims to systematically map existing literature on the use of AI and motion tracking technologies for remote assessment of functional impairments in individuals with KOA.
    METHODS: The review will follow the Arksey and O'Malley methodological framework enhanced by the Joanna Briggs Institute (JBI) guidelines and reported in adherence to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). Inclusion criteria will be guided by the Population-Concept-Context (PCC) framework: adults (≥ 18 years) diagnosed with KOA (Population), remote assessment using AI and/or motion tracking (Concept), in any healthcare or home-based setting (Context). A systematic search will be conducted across PubMed, Embase, CINAHL, Scopus, IEEE Xplore, and grey literature sources. Screening and data extraction will be performed independently by two blinded reviewers using Covidence, with narrative synthesis and visual mapping of findings.
    TARGET AUDIENCE: This review is intended to inform clinicians, rehabilitation specialists, digital health innovators, and researchers interested in musculoskeletal care and remote assessment technologies.
    DISSEMINATION: Findings will be disseminated through peer-reviewed journals, academic conferences, and stakeholder-focused briefs, aiming to inform clinical practice and guide future innovation in digital musculoskeletal health.
    Keywords:  artificial intelligence; digital health; knee osteoarthritis; motion tracking; rehabilitation technology; remote assessment; scoping review
    DOI:  https://doi.org/10.1002/msc.70171
  9. J Clin Med. 2025 Jul 08. pii: 4839. [Epub ahead of print]14(14):
    Assessing Quality of Life Among Women with Urinary Incontinence-Medical, Psychological, and Sociodemographic Determinants.
    Beata Pilarska, Katarzyna Strojek, Agnieszka Radzimińska, Magdalena Weber-Rajek, Piotr Jarzemski.
      Introduction: Urinary incontinence (UI) is associated with uncontrolled urine leakage and is treated as a serious disability that prevents the fulfillment of life roles and negatively affects quality of life. Many women do not have knowledge about the nature of UI and treatment options, and the embarrassing nature of the disease makes it difficult to seek specialist care. The aim of this study was to assess quality of life among women with UI and how it affects various areas of their daily functioning. Defining factors that modify the impact of UI on quality of life can provide prognostic information about functional limitations, which will facilitate the rapid implementation of preventive and therapeutic measures. Methods: This study included 158 women with UI. Patients were asked to complete a set of questionnaires, including the Questionnaire for Urinary Incontinence Diagnosis (QUID), Revised Urinary Incontinence Scale (RUIS), King's Health Questionnaire (KHQ), Acceptance of Illness Scale (AIS), Inventory for Measuring Coping with Stress (Mini-COPY), and Set of Scales for Self-Assessment of the relationship with a partner. Results: Based on the analyses, it was determined that women with MUI experienced a lower quality of life, greater limitations in daily activities, and greater physical limitations compared to women with UUI and SUI. There was a correlation between the severity of UI, the duration of the disease, the level of acceptance of the disease, the education level of the subjects, and quality of life in all areas of functioning. Conclusions: Numerous functional limitations and reduced quality of life have been observed among patients with UI. As part of UI management in clinical practice, it seems reasonable to include measures aimed at identifying patients who are likely to experience more severe consequences of UI so that they can receive targeted care.
    Keywords:  quality of life; urinary incontinence in women
    DOI:  https://doi.org/10.3390/jcm14144839
  10. Life (Basel). 2025 Jun 29. pii: 1035. [Epub ahead of print]15(7):
    The Effects of Pilates in Parkinson's Disease-A Narrative Review.
    Józef Alfons Opara, Jarosław Wojciech Szczygieł, Krzysztof Mehlich, Katarzyna Szczygieł.
      Parkinson's disease (PD) is one of the most well-known neurodegenerative diseases. Axial symptoms of PD include tremors in the arms and legs, stiffness of the muscles in the limbs and trunk, slow movement, impaired coordination, and balance disorders. Progressive disability increases the risk of falls and leads to immobilization of the patient. Comprehensive rehabilitation plays a very important role in the treatment process and serves mainly to improve motor functions and balance. In recent years, traditional methods of rehabilitation have been enriched by sometimes unconventional modern methods, which are attractive to patients. Unfortunately, current scientific evidence for the effectiveness of these methods is insufficient. Unconventional methods being used increasingly often in the rehabilitation of patients with PD include mind-body interventions. One of these interventions is Pilates exercise, which works on a physical and mental level. In this narrative review, we present the state of the art on the effects of Pilates exercise on balance and motor functions in PD. Previous studies, the results of which are available in scientific reports, have not provided convincing evidence for the effectiveness of these methods. Between 2019 and 2024, four systematic reviews and meta-analyses on the use of Pilates in the rehabilitation of patients with PD were published. Most of the reports show many shortcomings: too small groups of patients; frequent methodological errors, such as a lack of randomization and insufficient inclusion and exclusion criteria; imprecise descriptions of the interventions; different intensities and frequencies of exercises; too different outcome measures; and poorly chosen methods of statistical evaluation. Therefore, many authors emphasize the need for further, better-planned research.
    Keywords:  PD; Parkinson’s disease; Pilates; balance; body–mind interventions; motor functions
    DOI:  https://doi.org/10.3390/life15071035
  11. Stroke. 2025 Jul 31.
    Improving Access to Stroke Rehabilitation and Recovery: A Policy Statement From the American Heart Association/American Stroke Association.
    Nneka L Ifejika, Oluwole O Awosika, Terrie Black, Pamela W Duncan, Richard L Harvey, Douglas I Katz, Teresa J Kimberley, Barbara Lutz, Flannery O'Neil, Joel Stein, Anil V Yallapragada, Mathew J Reeves.
      Stroke rehabilitation is an integral component of comprehensive stroke care. Inequities in access to stroke rehabilitation can further widen the disability gap and disproportionately affect underinsured patients, patients living in rural areas, and patients from underrepresented races and ethnicities. However, even insured patients face obstacles to receiving stroke rehabilitation. The prior authorization process, peer-to-peer reviews, and subsequent appeals to health care insurers for the provision of postacute rehabilitation increase length of the acute care stay, placing pressure on health systems to expedite the transition of care, to the detriment of appropriate postacute rehabilitation placement. This policy statement focuses on (1) the provision of quality stroke rehabilitation to prevent complications, facilitate recovery, and limit disability, (2) the creation of evidence-based policies to improve equitable access, effectiveness, and efficiency of postacute care, (3) the development and use of performance measures that are aligned with the American Heart Association/American Stroke Association Guidelines for Adult Stroke Rehabilitation and Recovery to incentivize optimal patient care, and (4) identification of research priorities targeted to improve stroke rehabilitation access. This policy statement is a call for positive and sustained action. Stroke rehabilitation is the lifeline of hope for survivors, their caregivers, and their communities in the days, months, and years after stroke. It is imperative that governments and other funding agencies balance the support needed for acute stroke and stroke rehabilitation treatment, and that organizations, including the American Heart Association/American Stroke Association-an unrelenting advocate for improved brain health-advance the importance of stroke rehabilitation throughout the continuum of care.
    Keywords:  AHA Scientific Statements; delivery of health care; public policy; quality of health care; stroke; stroke rehabilitation
    DOI:  https://doi.org/10.1161/STR.0000000000000493
  12. J Particip Med. 2025 Jul 31. 17 e71610
    Patient and Practitioner Perspectives on the Definition and Measurement of Therapeutic Empathy: Qualitative Study.
    Amber Bennett-Weston, Jeremy Howick.
       Background: Most definitions of therapeutic empathy are based on practitioners' perspectives, and few account for patients' views. Therefore, we do not understand what therapeutic empathy means to patients. Given that therapeutic empathy involves a relationship between patients and practitioners, the underrepresentation of the patient voice threatens to undermine the validity of therapeutic empathy definitions and subsequently, how the concept is measured, taught, and practiced.
    Objective: The aim of the study is to explore the perspectives of patients and practitioners on the definition of therapeutic empathy and how it should therefore be measured.
    Methods: A qualitative study, underpinned by a social constructivist stance, was conducted. Patients and practitioners were purposively sampled from a medical school and a school of health care to represent a diversity of lived experiences and health care professions. In-depth, semistructured interviews were undertaken, and the data were analyzed using reflexive thematic analysis. Data collection ceased upon reaching meaning saturation.
    Results: In total, 16 participants (8 patients and 8 practitioners) were interviewed in June and July 2024. Reflexive thematic analysis generated three overarching themes that synthesize the views of patients and practitioners on therapeutic empathy and how it should be measured: (1) therapeutic empathy involves the practitioner showing the patient (that they are interested in the patient as a person, that they are actively listening, that they understand, that they are emotionally engaged, and that they are responding to their needs), (2) context matters (eg, the clinical scenario, time, and the patient), and (3) short, simple scales are a pragmatic approach to measurement.
    Conclusions: Patients and practitioners have similar views about what empathy is and define therapeutic empathy as involving the practitioner demonstrating specific attitudes and behaviors to their patients. These attitudes and behaviors should be included in interventions to enhance therapeutic empathy and in measures of the concept. However, contextual factors may influence the expression of therapeutic empathy in practice. The findings highlight the need for, and can inform the development of, a short therapeutic empathy scale that allows the comparison of scores between patients, practitioners, students, and observers.
    Keywords:  definition; empathy; measurement; patient-practitioner communication; therapeutic empathy
    DOI:  https://doi.org/10.2196/71610
  13. Turk J Phys Med Rehabil. 2025 Jun;71(2): 131-138
    An overview of pectus deformities and rehabilitation approaches.
    Birkan Sonel Tur, Aysun Genç.
      Pectus deformities, particularly pectus excavatum and pectus carinatum, are among the most common congenital chest wall abnormalities in children. These deformities may have varying degrees of physical, psychological, and functional effects. This review provides a concise overview of the current state of knowledge regarding the history, epidemiology, etiopathogenesis, clinical presentation, classification, and rehabilitation of these deformities, focusing on the pediatric population.
    Keywords:  Deformity; exercise; pectus carinatum; pectus excavatum; rehabilitation.
    DOI:  https://doi.org/10.5606/tftrd.2025.16840
  14. J Cardiothorac Surg. 2025 Jul 28. 20(1): 316
    Trends and advances in cardiac rehabilitation for congenital heart disease: a bibliometric analysis.
    Haojie Zhou, Yuyang Huang, Weizhi Zhang, Hanyi Yao, Zhangqing Yi, Dongping Li.
       BACKGROUND: Congenital heart disease (CHD) survivors often suffer from impaired health-related quality of life (HRQoL), requiring cardiac rehabilitation (CR) as an additional intervention. CR involves various modalities and has been demonstrated to reduce mortality and improve HRQoL in cardiovascular diseases. However, there is a lack of systematic analysis and summary of the accumulated literature on cardiac rehabilitation for congenital heart disease (CRfCHD). This study aimed to provide a comprehensive overview of the literature on cardiac rehabilitation for congenital heart disease. By analyzing research trends and hotspots, it also sought to highlight key developments and suggest future directions in this growing field.
    METHODS: A systematic search of the Web of Science Core Collection was performed to identify publications related to CRfCHD. Bibliometric tools, including CiteSpace and VOSviewer, were used to visualize co-authorship networks, keyword clusters, and citation patterns.
    RESULTS: A total of 218 articles were included in the analysis. The number of research papers on CRfCHD has shown an increasing trend over time, with a significant rise in publications since 2019. The United States has the highest number of publications, while the most cited paper focuses on the effects of physical exercise training in CHD patients. Keyword analysis reveals hotspots in the field such as congenital heart disease, physical activity, children, and adolescents.
    CONCLUSION: This bibliometric study analyzed the development of CRfCHD from 2003 to 2022, and overviewed the evolution and frontiers in this promising field. Future research should focus on developing comprehensive and effective CRfCHD programs. Home-based cardiac rehabilitation and mental health research in CHD patients require more attention.
    Keywords:  Bibliometrics; Cardiac rehabilitation; Family practice; Mental health; Physical activity; Quality of life
    DOI:  https://doi.org/10.1186/s13019-025-03562-z
  15. Turk J Phys Med Rehabil. 2025 Jun;71(2): 250-254
    Rehabilitation in a case with cauda equina syndrome after spinal manipulation: A long and difficult process.
    Burak Kamil Turan, Birkan Sonel Tur.
      In this case report, the rehabilitation process of a 38-year-old female patient who developed cauda equina syndrome due to spinal manipulation for the treatment of lumbar disc herniation was presented. The aim was to discuss the outcomes of rehabilitation after cauda equina syndrome, as well as the challenges associated with it. Despite the difficulties experienced during the rehabilitation process, a comprehensive multidisciplinary rehabilitation program is beneficial in terms of gaining independence and returning to daily activities, social life, and work for patients with cauda equina syndrome.
    Keywords:  Cauda equina syndrome; intervertebral disc herniation; rehabilitation; spinal manipulation.
    DOI:  https://doi.org/10.5606/tftrd.2024.14930
  16. Mo Med. 2025 May-Jun;122(3):122(3): 199-205
    Innovations In Physical Medicine and Rehabilitation: Advances in the Diagnosis, Treatment, and Care of Amyotrophic Lateral Sclerosis.
    W David Arnold, Ryan Castoro, Smita Saxena.
      Amyotrophic lateral sclerosis (ALS) is a progressive motor neuron disease that causes loss of upper and lower motor neurons, leading to muscle weakness and ultimately death. This review highlights recent advancements in Neuromuscular Medicine and Physical Medicine and Rehabilitation (PM&R), emphasizing innovations in the diagnosis, treatment, and care delivery for ALS. The field of PM&R emphasizes a multidisciplinary, patient-centered approach, incorporating advanced diagnostic tools, therapeutic strategies, adaptive equipment, and telerehabilitation to optimize function. Neuromuscular PM&R physicians play a key role in managing symptoms and maximizing functional independence. Current disease-modifying therapies include riluzole and edaravone which provide only modest benefits, but emerging gene therapies like tofersen for SOD1-related ALS offer promise for targeted treatment for genetic forms of ALS. Future advancements in regenerative therapies, biotechnologies, and digital health integration hold the potential to improve care and enhance the quality of life and functional independence of individuals living with ALS.
  17. Musculoskeletal Care. 2025 Sep;23(3): e70161
    Outcome Measures in the Management of Low Back Pain-A Systematized Review.
    Acharya Jahnavi Jagadish, Kalashree Hadya Ananda.
       BACKGROUND: Low back pain (LBP) is a prevalent condition that affects a significant portion of the population, leading to substantial healthcare costs and impact on quality of life. Effective management of LBP requires robust outcome measures to assess the efficacy of various treatment modalities.
    OBJECTIVE: This systematized review aimed to identify and evaluate the outcome measures used in the management of low back pain, focusing on their validity, reliability, sensitivity, and clinical relevance.
    METHODS: A comprehensive search of electronic databases, including PubMed, was conducted to identify studies that assessed the measurement properties of outcome measures used in the management of LBP. Data extraction focused on the types of outcome measures used and their psychometric properties. Data analysis was done after quantitatively pooling based on COSMIN guidelines.
    RESULTS: The database search and reference check resulted in 808 unique abstracts, of which 240 were assessed for full text eligibility. Ultimately, 124 articles describing 56 unique PROM's measuring different proposed domains were included in this systematized review. The review identified a range of outcome measures employed in LBP management under each proposed domain based on the millennial recommendations. This review also mentioned several new outcome measures such as Physical activity decline (PAD) score, Backache Disability Index (BADIX), Working Alliance Inventory (WAI), return-to-work self-efficacy (RTWSE-19) questionnaire, The NIH task force's minimum data set and World Health Organisation Disability Assessment Schedule (WHODAS 2.0) with sufficient measurement properties. This review highlighted gaps in the sensitivity of some measures to detect clinically meaningful changes and emphasized the need for standardization in outcome reporting.
    INTERPRETATION AND CONCLUSION: Effective management of LBP relies on the use of validated and reliable outcome measures. While traditional PROM's like the ODI and RMDQ remain prevalent, emerging tools may offer enhanced sensitivity and comprehensiveness. Future research should aim to standardize outcome measures and assess their psychometric properties to facilitate comparisons across studies and improve the quality of evidence in LBP management.
    Keywords:  low back pain; measurement properties; outcome measures; patient‐reported outcome measures; psychometric properties; reliability; responsiveness; validity
    DOI:  https://doi.org/10.1002/msc.70161
  18. Int J Lang Commun Disord. 2025 Sep-Oct;60(5):60(5): e70098
    Supporting Communication Access of People With Communication Disabilities and Communication Differences in UNCRPD-Ratified Countries: An Integrative Review.
    Áine Kearns, Caroline Jagoe, Rachael Stockdale, Dorothy Clarke, Molly Manning, Ruth Mc Menamin, Yvonne Fitzmaurice, James Green, Orla Duffy, Helen Kelly.
       BACKGROUND: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) recognizes communication accessibility as a fundamental human right. Communication plays a key role in facilitating belonging, sharing and engaging with communities, allowing individuals to connect and forge relationships. Communication is fundamental to well-being and building a sense of self and identity, as well as establishing and maintaining social roles and vocation. Those with communication disabilities or differences can face many barriers to social participation, inclusion and potential financial implications.
    AIMS: This integrative review explores policy, practices and guidelines that support communication access of adults with communication disabilities and differences in selected English-speaking countries with UNCRPD-ratified status and well-established speech and language therapy services.
    METHODS: An integrative review of the literature was undertaken. A systematic search of the published, peer-reviewed literature was conducted for empirical research, and a manual search was undertaken to obtain policy, practice, or guidelines, to support communication access at a sectoral/service or community level. A multi-scalar approach situates the findings within several contexts: international law, national legislation and policy, professional guidelines and evidence from local/national projects.
    MAIN CONTRIBUTIONS: A multi-scalar map was developed that positions the findings on communication access within the included countries (Republic of Ireland, Northern Ireland, United Kingdom, Canada, Australia and New Zealand), across local/national programmes and projects (n = 11), professional body and civil society guidance, regional/national legislation and policy specific to communication access and finally the international normative instrument of the UNCRPD. The findings indicate that communication accessibility is recognised as a fundamental human right, but signatory states are required to take appropriate measures to ensure access to information and communication for persons with disabilities. National legislation, policy and practice need further scrutiny in this regard.
    CONCLUSIONS: This review examines the complex phenomenon of communication access for people with communication disabilities and differences. The findings of this review can inform and shape practice with regard to communication accessibility as well as support advocacy efforts and future research in this area.
    WHAT THIS PAPER ADDS: What is already known on the subject Communication accessibility is a fundamental human right. It can be characterized by the respectful and responsive treatment of individuals with communication disabilities and differences, along with the implementation of strategies and resources and the adaptation of environments, process and systems to facilitate effective communication. What this paper adds to existing knowledge A multi-scalar map was developed that situates the findings on communication access within the included countries (Republic of Ireland, Northern Ireland, United Kingdom, Canada, Australia and New Zealand), across local/national programmes and projects (n = 11), professional body and civil society guidance, regional/national legislation and policies specific to communication access, and finally the international normative instrument of the UNCRPD. There is a lack of a shared understanding of communication access within empirical research, policy and local and national guidelines across the included countries. In addition, the focus on the right to communication is addressed more explicitly in some groups (and country contexts) than others. What are the practical and clinical implications of this work? This review highlights how multimodal communication is important for accessible communication. Co-design can also be harnessed to enhance communication access. The review provides an integrated set of data (empirical research, policy and guidelines) that can be used in future research, practice development and advocacy.
    Keywords:  UNCRPD; accessibility; communication access; integrative review; multi‐scalar map
    DOI:  https://doi.org/10.1111/1460-6984.70098
  19. Front Public Health. 2025 ;13 1578791
    Mind-body training outperforms other physical activities in reducing frailty and enhancing quality of life in older adults: a network meta-analysis.
    Guangwen Liu, Renkai Ge, Huiling Zhu.
       Background: Physical activity is an effective strategy for treating and intervening in frailty syndrome, which leads to functional decline, increased hospitalization rates, and heightened mortality risks among older adult people. However, the relative effectiveness of different types of physical activity modalities in mitigating frailty and enhancing activities of daily living (ADLs) and quality of life (QoL) remains insufficiently explored. This network meta-analysis quantified and compared the effects of different physical activities on frailty, ADLs, and QoL, providing an evidence base for targeted interventions.
    Methods: Following the PRISMA-NMA guidelines, we conducted systematic searches of PubMed, Embase, and CNKI to identify 35 randomized controlled trials (N = 2,905) between January 2000 and August 2024. We employed the frequency science network meta-analysis model to quantify the relative efficacy of various physical activities in enhancing frailty management, ADLs, and QoL in older people.
    Results: The analysis revealed that Mind-body training (e.g., Taiji, Baduanjin), a traditional Chinese exercise that integrates gentle body movements with breath regulation, significantly alleviated debilitating conditions (SMD = -0.71, 95% CI: -1.22 to -0.21) and markedly improved quality of life (SMD = 1.02, 95% CI: 0.89 to 1.15). This modality proved to be the most effective of all the interventions studied. Aerobic training was particularly beneficial for enhancing the ability to perform ADLs (SMD = 0.89, 95% CI: 0.06 to 1.72). Although mixed physical activity exhibited overall efficacy across all health indicators (p < 0.05), its benefits did not exceed those of mind-body training. Further analysis indicated that the intervention regimen consisting of 50-60 min of training per session, 2-3 times per week, yielded the most significant improvements.
    Conclusion: This study employed network meta-analysis to compare the effects of various physical activities on frailty, ADLs, and QoL in older adults. The findings suggest that both mental and physical training significantly ameliorate frailty and enhance QoL, whereas aerobic training enhances daily living capabilities. Clinical interventions should prioritize tailored mental and physical training, considering individual differences. Future studies should focus on long-term effects and dose-response relationships to optimize frailty management and health promotion in older adult individuals.
    Keywords:  activities of daily living; frailty; older adults; physical activity; quality of life
    DOI:  https://doi.org/10.3389/fpubh.2025.1578791
  20. J Scleroderma Relat Disord. 2025 Jul 28. 23971983251360912
    Effects of a 12-week physiotherapist-supervised home-based rehabilitation program on the functional exercise capacity in people with systemic sclerosis.
    Samantha Gomes de Alegria, Matheus Mello da Silva, Beatriz Luiza Pinheiro Alves Azevedo, Jéssica Gabriela Messias Oliveira, Iasmim Maria Pereira Pinto Fonseca, Isabelle da Nóbrega Ferreira, Patrícia Frascari Litrento, Cláudia Henrique da Costa, Agnaldo José Lopes.
       Objective: There is still a wide variation in the rehabilitation programs developed for systemic sclerosis, which makes it urgent to develop feasible and easy-to-use protocols using tools capable of measuring the response to rehabilitation. The Glittre-ADL test assesses functional exercise capacity using activities of daily living and is useful due to the hands involvement. This study aimed to evaluate the effects of a physiotherapist-supervised home-based rehabilitation program on functional exercise capacity in women with systemic sclerosis using the Glittre-ADL test. A secondary aim was to evaluate the association between the Glittre-ADL test and handgrip strength, hand function, physical function, quality of life, and lung function.
    Methods: This is a quasi-experimental study in which 33 women with systemic sclerosis underwent a physiotherapist-supervised home-based rehabilitation program for 12 weeks. The following pre- and post-physiotherapist-supervised home-based rehabilitation program assessments were performed: Glittre-ADL test, Health Assessment Questionnaire Disability Index, Cochin Hand Functional Scale, Short Form 36 Health Survey, handgrip strength, and spirometry.
    Results: There was a significant increase in Glittre-ADL test time after physiotherapist-supervised home-based rehabilitation program (p = 0.036). There was a significant decrease in manual time of the Glittre-ADL test between pre- and post-physiotherapist-supervised home-based rehabilitation program (p = 0.001). For Health Assessment Questionnaire Disability Index, there was a significant decrease from 1.13 (0.5-1.8) points before physiotherapist-supervised home-based rehabilitation program to 1.0 (0.4-1.3) points after physiotherapist-supervised home-based rehabilitation program (p = 0.004). For the Cochin Hand Functional Scale, there was a decrease from 14 (5-35) points before physiotherapist-supervised home-based rehabilitation program to 7 (3-21) points after physiotherapist-supervised home-based rehabilitation program (p = 0.0002). There was a significant increase in handgrip strength between pre- and post-PHPR (p = 0.008). The delta for Glittre-ADL test time (%predicted) was significantly correlated with the delta for handgrip strength (rs  = -0.360, p = 0.039).
    Conclusion: After physiotherapist-supervised home-based rehabilitation program, women with systemic sclerosis require less time to complete the Glittre-ADL test tasks. Physiotherapist-supervised home-based rehabilitation program improves manual function, physical function, handgrip strength, lung function, and quality of life. There is a relationship between Glittre-ADL test time and handgrip strength. These results suggest that a 12-week physiotherapist-supervised home-based rehabilitation program could be a beneficial non-pharmacological therapy that reduces functional limitations and improves quality of life in systemic sclerosis.
    Keywords:  Systemic sclerosis; functional exercise capacity; pulmonary function; quality of life; rehabilitation
    DOI:  https://doi.org/10.1177/23971983251360912
  21. Spinal Cord Ser Cases. 2025 Jul 25. 11(1): 22
    Anxiety and adjustment following SCI: a transdiagnostic psychological intervention combining Cognitive Behavioural Therapy (CBT) and Coping Effectiveness Training (CET).
    J Duff, L C Grant.
       INTRODUCTION: Spinal cord injury (SCI) is a life-changing experience which can result in a substantial range of psychological challenges. Although anxiety is elevated following SCI, evidence suggests that it is underreported and underdiagnosed, with consequences for long-term physical and mental health. In the UK, Cognitive Behavioural Therapy (CBT) is recommended as the first-line intervention for anxiety. However, people with SCI often face additional and complex challenges, which can limit the efficacy of protocol-delivered CBT. Pre-injury vulnerabilities can compound psychological challenges by influencing primary and secondary appraisals and perceived manageability of injury, resulting in poorer mental health and rehabilitation outcomes.
    CASE PRESENTATION: A transdiagnostic treatment intervention using a SCI-specific adjustment model alongside CBT and Coping Effectiveness Training (CET) of an adult with post-injury anxiety and adjustment difficulties (as measured by the GAD-7 and the ADAPSS), and history of depression (as measured by the PHQ-9). Individual psychological treatment for anxiety maintenance cycles, low mood and reduction of threat appraisals are reported, alongside multidisciplinary collaboration to enhance engagement. Outcomes included improved symptoms of anxiety, reduction of loss appraisals and development of resilience appraisals.
    DISCUSSION: Case studies of psychological treatment are sparse within the SCI literature. This case provides a detailed application of one of the most recognised psychological treatment modalities - CBT - and its integration with CET within an adjustment model for SCI. This study also highlights the importance of providing psychological support, psychoeducation and self-management strategies for all individuals with SCI, that is not dependent upon the degree of psychological morbidity.
    DOI:  https://doi.org/10.1038/s41394-025-00713-1
  22. Front Pediatr. 2025 ;13 1596400
    Management of adolescent scoliosis: a comprehensive review of etiology and rehabilitation.
    Hongwei Kuang, Luolan Chen, Miao Huang, Jianbin Chen.
      Adolescent scoliosis (AS) is a complex spinal deformity characterized by a curvature exceeding 10 degrees, affecting 1%-3% of adolescents globally. Despite extensive research, its etiology remains multifactorial, involving genetic, biomechanical, neuromuscular, and environmental factors. This review synthesizes recent advances in understanding the pathogenesis of AS and explores the latest developments in non-surgical rehabilitation strategies, including physical therapy, bracing, exercise therapy, and psychological interventions. Emerging technologies, such as artificial intelligence, wearable devices, and virtual reality, are revolutionizing diagnostic accuracy and treatment personalization. The review also highlights the critical role of multidisciplinary collaboration and psychological support in improving patient outcomes. By identifying key research gaps and proposing innovative future directions-such as the integration of epigenetics, advanced biomechanical modeling, and AI-driven precision rehabilitation-this article aims to provide clinicians and researchers with a comprehensive framework for managing AS. Ultimately, this review underscores the importance of early detection, personalized treatment, and long-term follow-up in enhancing the quality of life for adolescents with scoliosis.
    Keywords:  adolescent scoliosis; bracing; etiology; physical therapy; rehabilitation
    DOI:  https://doi.org/10.3389/fped.2025.1596400
  23. Pak J Med Sci. 2025 Jul;41(7): 2144-2151
    Research progress on rehabilitation programs for dysphagia in patients with ischemic stroke: A Narrative review.
    Wenbin Jiang, Junhe Chen, Ting Xue, Yongmei Jiang.
      This review aims to explore the various symptoms caused by ischemic stroke and summarize current clinical care and rehabilitation treatment options for post-stroke dysphagia. Stroke is the second leading cause of death and a leading cause of long-term disability worldwide, with the highest prevalence in developing countries. Among them, ischemic stroke is the most common type, accounting for more than 80% of the total number of strokes and is the focus of current stroke research. More than one-third of ischemic stroke patients will be affected by post-stroke functional impairments, including but not limited to claudication, upper limb dysfunction, visual impairment, swallowing dysfunction, etc. Swallowing disorders refer to symptoms such as pain, weakness in chewing, prolonged swallowing time, choking when eating or drinking, and coughing due to abnormal function of the swallowing center and motor-sensory pathways and reduced control of the oral and throat muscles. Severe dysphagia will not only affect the patient's nutritional intake and cause malnutrition, but may also cause serious complications such as dehydration, aspiration pneumonia, and suffocation, leading to poor prognosis and even death. Therefore, the care and rehabilitation treatment of such patients have important clinical significance. The treatment strategies integrated in this review provide a variety of approaches for the rehabilitation of patients with post-stroke dysphagia, emphasizing the importance of personalized medicine and the necessity of multidisciplinary collaboration. Future studies should establish standardized research designs and evaluation indicators to improve the reproducibility of the research and the reliability of the results, hoping to provide more references for the treatment of swallowing dysfunction and the improvement of subsequent clinical care programs.
    Keywords:  Dysphagia; Ischemic stroke; Nursing; Recovery treatment; Thrombus
    DOI:  https://doi.org/10.12669/pjms.41.7.9657
  24. Health Expect. 2025 Aug;28(4): e70350
    Making Room for Every Voice: Reimagining Person-Centred Care in the Neurosciences.
    Miguel Toribio-Mateas, Gareth Noble.
       BACKGROUND: This Special Issue of Health Expectations brings together 38 articles that exemplify the growing commitment to person-centred care in the neurosciences. Moving beyond a historically brain-centric model, these contributions reflect a more human discipline that values lived experience alongside clinical expertise.
    METHODS/RESULTS: Spanning a wide range of neurological conditions, life stages and care settings, the papers explore interconnected themes including co-creation, identity, equity, communication, service redesign, emotional well-being, innovation and community engagement. The authors in this collection demonstrate that care becomes not only more effective but also more ethical when people are recognised as active partners rather than passive recipients. From co-designed tools and culturally responsive resources to narrative inquiry and community-led research, these works reveal the transformative power of relational approaches that reorient systems, promote autonomy and respond to what truly matters to those living with neurological conditions.
    CONCLUSIONS: Together, these articles challenge longstanding hierarchies and power dynamics, advocating for care that is grounded in trust, reciprocity and compassion. They are more than a snapshot of current practice; they are a call to action, a provocation to imagine what neurological care could become. At its heart, this Special Issue invites researchers, clinicians and communities to co-create a neuroscience that is more advanced and more attuned to the lives it seeks to serve.
    PATIENT OR PUBLIC CONTRIBUTION: This Special Issue was developed with a focus on highlighting the voices, experiences and expertise of people living with neurological conditions, their families and communities. Many of the 38 articles featured were co-produced or co-authored with individuals with lived experience, and we, as Guest Editors, have intentionally curated the issue to centre these perspectives. While patients or members of the public were not directly involved in the writing of this Editorial, their contributions are reflected throughout the Special Issue in the form of participatory research, co-created resources and narrative accounts. The Editorial itself is informed by these works and seeks to honour their insights by amplifying their relevance and impact within the broader neuroscientific community.
    Keywords:  community engagement; co‐creation; equity in healthcare; lived experience; neurosciences; person‐centred care
    DOI:  https://doi.org/10.1111/hex.70350
  25. Cureus. 2025 Jun;17(6): e86965
    Precision Rehabilitation Through Mathematical Modeling: A New Frontier in Medicine.
    Raktim Swarnakar.
      Rehabilitation medicine is undergoing a significant transformation with the integration of precision-based approaches grounded in mathematical modeling. Traditional rehabilitation protocols, often generalized and uniform, fail to capture the diverse recovery patterns seen in patients with neurological and musculoskeletal injuries such as stroke, spinal cord injury, or traumatic brain injury. To address this variability, mathematical modeling can be used to predict functional recovery over time through a differential equation that incorporates therapy intensity, baseline function, individual recovery potential, and the natural recovery plateau. Key parameters include functional ability at time t (F(t)), baseline function (B), therapy intensity (T), recovery potential (R), therapy efficacy (α), and recovery plateau rate (λ). These variables can be estimated using clinical data, validated prediction models, and modern machine learning algorithms trained on large datasets. Such models enable clinicians to forecast outcomes, individualize treatment plans, compare intervention strategies, and set realistic recovery goals. Rather than replacing clinical expertise, mathematical modeling enhances it by providing a quantitative framework to guide decision-making. As healthcare continues to evolve, these models can form the basis for real-time, adaptive rehabilitation strategies integrated with electronic health records and wearable technologies. From now on, precision rehabilitation supported by mathematical modeling offers a practical and evidence-based path toward more personalized and effective patient care.
    Keywords:  individualized therapy; mathematical modeling; outcome measurements; precision therapy; rehabilitation
    DOI:  https://doi.org/10.7759/cureus.86965
  26. Sex Med Rev. 2025 Jul 29. pii: qeaf030. [Epub ahead of print]
    Sexual and reproductive health in neurological disorders: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024).
    Stacy Elliott, Veronika Birkhäuser, Frederique Courtois, Murat Gül, Emad Ibrahim, Carlotte Kiekens, Peter Wayne New, Mst Clin Epi, Dana A Ohl, Mikkel Fode.
       INTRODUCTION: Neurological disorders impact both the central and peripheral nervous systems, often leading to sexual dysfunction (SD). These conditions affect not only genital function but also sensory and motor abilities, pain perception, bladder and bowel control, mood, and hormonal balance. Despite the significance of sexual health for overall quality of life, SD in individuals with neurological conditions remains an under addressed issue.
    OBJECTIVES: This review aims to provide an overview of SD in individuals with neurological disorders, examining underlying neurophysiological mechanisms, the impact of various neurological conditions, and available treatment strategies. The goal is to offer clinically relevant recommendations to healthcare professionals managing SD in these patients.
    METHODS: A panel of experts reviewed and synthesized the literature on SD in neurological disorders, with an emphasis on randomized controlled trials and high-quality evidence. The review covers central and peripheral neural control of sexual function, SD associated with specific neurological disorders, and diagnostic and treatment approaches.
    RESULTS: Sexual dysfunction in neurological disorders varies by condition. For example, erectile dysfunction (ED) and anejaculation are common in spinal cord injury, while Parkinson's disease may be associated with hypersexuality and orgasmic disorders. Brain injuries such as traumatic brain injury, stroke, and neurodegenerative diseases can reduce libido and satisfaction, and multiple sclerosis is associated with ED and reduced genital arousal. Pharmacological and nonpharmacological interventions, including phosphodiesterase-5 inhibitors, vibratory stimulation, hormonal therapy, pelvic floor therapy, and assistive devices, demonstrate variable efficacy depending on the neurological condition. A multidisciplinary approach, including medical, psychological, and rehabilitative interventions, is crucial for optimizing sexual health in these patients.
    CONCLUSION: Sexual dysfunction is a prevalent consequence of neurological disorders. Proper assessment, should include a sexual history and neurological examination with specific attention to genital sensation and reflex testing. Effective management requires a holistic, multidisciplinary approach. Addressing sexual health should be a core component of neurological rehabilitation to enhance patients' quality of life.
    Keywords:  ejaculatory dysfunction; erectile dysfunction; female sexual dysfunction; libido disorders; multidisciplinary care; neurological disorders; neurophysiology; physiological; rehabilitation; sexual dysfunction; spinal cord injuries
    DOI:  https://doi.org/10.1093/sxmrev/qeaf030
  27. OTJR (Thorofare N J). 2025 Jul 30. 15394492251359205
    Psychometric Evaluation of the Turkish Classification and Assessment of Occupational Dysfunction Scale.
    Gülşah Zengin Yazıcı, Müberra Tanrıverdi, Güleser Güney Yılmaz, Muhammed Rohat Yazıcı.
      Occupational dysfunction affects daily life and well-being, requiring valid assessment tools. Cross-cultural adaptation ensures their applicability across populations. This study adapts the Classification and Assessment of Occupational Dysfunction into Turkish (CAOD-T) and evaluates its validity, reliability, psychometric evaluation and clinical compatibility. A total of 224 participants were recruited, including 179 individuals without disabilities and 45 individuals with physical disabilities. Construct validity was tested via confirmatory factor analysis (CFA). Known-groups validity compared scores between groups. Reliability was assessed using Cronbach's alpha, intraclass correlation coefficient (ICC), and McDonald's ω. Sensitivity and specificity were analyzed via receiver operating characteristic (ROC) analysis. CFA confirmed the four-factor structure (comparative fit index [CFI] = 0.934, root mean square error of approximation [RMSEA] = 0.0373). CAOD-T demonstrated strong internal consistency (α = .758), test-retest reliability (ICC = .756), and clinical compatibility (area under the curve [AUC] = 0.953, sensitivity = 93.3%, specificity = 91.11%). CAOD-T is a valid, reliable, and clinically applicable tool for assessing occupational dysfunction in Turkish populations. Future studies should explore its use across different age groups and cultures.
    Keywords:  occupational alienation; occupational deprivation; occupational imbalance; occupational marginalization; psychometrics
    DOI:  https://doi.org/10.1177/15394492251359205
  28. Mo Med. 2025 May-Jun;122(3):122(3): 206-210
    Lower Extremity Orthotic Device Prescriptions: Basics of Evaluation and Management.
    Benjamin Boyett, Paul S Jones.
      This paper provides a basic overview for the role of some lower extremity orthotic devices in the rehabilitation and support of the maximization of function for individuals with neuromusculoskeletal conditions. It provides a comprehensive overview of orthotic principles, designs, indications, and limitations, emphasizing the importance of thorough patient assessment in device prescription. Key terminology, including definitions of orthoses and the role of certified orthotists, is clarified. The paper discusses various types of orthotic devices, comparing custom-made to off-the-shelf options, and examines the materials used, such as leather, metal alloys, and thermoplastics, each with distinct characteristics. Additionally, this article highlights functional considerations, fitting protocols, and the need for ongoing follow-up care to prevent complications like pressure injuries. The conclusion underscores the necessity of individualized orthotic prescriptions, addressing specific patient needs to optimize rehabilitation outcomes and enhance mobility while acknowledging the trade-offs in energy expenditure and gait velocity associated with orthotic use.
  29. Sensors (Basel). 2025 Jul 09. pii: 4263. [Epub ahead of print]25(14):
    A Comprehensive Review of Elbow Exoskeletons: Classification by Structure, Actuation, and Sensing Technologies.
    Callista Shekar Ayu Supriyono, Mihai Dragusanu, Monica Malvezzi.
      The development of wearable robotic exoskeletons has seen rapid progress in recent years, driven by the growing need for technologies that support motor rehabilitation, assist individuals with physical impairments, and enhance human capabilities in both clinical and everyday contexts. Within this field, elbow exoskeletons have emerged as a key focus due to the joint's essential role in upper limb functionality and its frequent impairment following neurological injuries such as stroke. With increasing research activity, there is a strong interest in evaluating these systems not only from a technical perspective but also in terms of user comfort, adaptability, and clinical relevance. This review investigates recent advancements in elbow exoskeleton technology, evaluating their effectiveness and identifying key design challenges and limitations. Devices are categorized based on three main criteria: mechanical structure (rigid, soft, or hybrid), actuation method, and sensing technologies. Additionally, the review classifies systems by their supported range of motion, flexion-extension, supination-pronation, or both. Through a systematic analysis of these features, the paper highlights current design trends, common trade-offs, and research gaps, aiming to guide the development of more practical, effective, and accessible elbow exoskeletons.
    Keywords:  actuator; assistive; augmentation; elbow exoskeleton; rehabilitation; sensor
    DOI:  https://doi.org/10.3390/s25144263
  30. Womens Health (Lond). 2025 Jan-Dec;21:21 17455057251321019
    Meeting exercise guidelines during pregnancy associates with less lumbopelvic disability and fear avoidance.
    Traci A McCarthy, Adrienne H Simonds, Sarah Velez, Andrea M Spaeth.
       BACKGROUND: Sixty-three percent of pregnant persons report experiencing lumbopelvic pain (LPP), which can negatively impact quality of life and lead to the development of fear avoidance behaviors. Exercise is a safe, non-pharmacological treatment for reducing and preventing the development of pain, but the volume of exercise required for one to benefit from it is unknown.
    OBJECTIVES: Determine whether meeting exercise guidelines during pregnancy associates with LPP, disability, and fear avoidance behaviors.
    DESIGN: Cross-sectional study.
    METHODS: Pregnant persons (n = 50, 32.0 ± 4.2 years, 28-32 weeks of gestation) were included. Participants completed questionnaires assessing second-trimester physical activity (PPAQ), current pain, lumbopelvic disability, and fear avoidance and then underwent a physical examination for the presence of LPP. Participants who met exercise guidelines (>150 min moderate intensity physical activity/week, PA, n = 24) were compared with those who were not physically active (<90 min moderate intensity physical activity/week, NPA, n = 26). Nonparametric tests compared groups on outcomes with significance set at p < 0.05. Post hoc odds ratios were calculated for moderate disability status. Spearman's rho correlations were conducted between physical activity (MET min/week), pain, and disability.
    RESULTS: NPA participants reported more disability due to LPP (p = 0.02), more fear avoidance behaviors (p = 0.03), and more provoked LPP (p = 0.09) than PA participants. NPA participants were also more likely to report LPP disability (OR = 3.89, 95% CI: 1.19-12.68) and fear avoidance behaviors (OR = 4.38, 95% CI: 1.03-18.56). In all participants, more moderate intensity physical activities were associated with less disability (ps < 0.05) and fewer fear avoidance behaviors (p = 0.06). Pain severity did not differ between groups (ps > 0.05).
    CONCLUSION: Meeting pregnancy exercise guidelines throughout the second trimester associated with less LPP disability, fewer fear avoidance behaviors, and less-provoked pain, but did not associate with pain severity.
    Keywords:  exercise physiology; low back; peripartum; sacroiliac joints
    DOI:  https://doi.org/10.1177/17455057251321019
  31. Asian Bioeth Rev. 2025 Jul;17(3): 401-423
    Social Listening and its Issues: What can the Precautionary Principle Advice?
    Hai Thanh Doan.
      The World Health Organization (WHO) has recently initiated "social listening". The first section of this paper investigates conceptual aspects of social listening. It demonstrates that the WHO's descriptions of social listening are vague and inconsistent. Notwithstanding this, possibly, the WHO-envisaged social listening is constituted by three core components: (i) listening and monitoring, (ii) understanding, and (iii) engaging and nudging. It follows that there is an inherent relatedness between WHO-envisaged social listening and other "social-listening" activities. It follows that to investigate issues of or related to social listening, the inquiry should be broadened to general practices of "social listening", and experiences related to these must be considered. In the second section, this paper finds several issues with or related to social listening, including bad faith uses, the difficulty of identifying misinformation and punishing it, the echo chambers problem, issues concerning nudging, concerns about policy preset position, concerns for the management and prioritization of resources, and concerns about overlapping between social listening activities. Thus, social listening should be subject to certain rules. In the third section, this paper argues that social listening should be subject to the precautionary principle. Doan, Nie, and Fenton projected that the central teleology, the purpose, and the modus operandi of the precautionary principle could be identified in various policy and legal instruments and propositions, accordingly, the precautionary principle entails, inter alia, proactive preparation for public health matters, specifically emergencies, and assessment, e.g. risk-benefit analysis, taking into account uncertainty and past experiences. They showed the normative validity and necessity of applying the precautionary principle in its "moderate versions" to public health matters. It follows from this and the rationale underlying and the range of rules of the precautionary principle that the precautionary principle can offer some insights, solutions, and mechanisms to remedy issues posed by or related to social listening.
    Keywords:  COVID- 19; Mass mobilization (Dân vận); Precautionary principle; Social listening; Surveillance
    DOI:  https://doi.org/10.1007/s41649-025-00369-x
  32. Health Soc Care Deliv Res. 2025 Jul 30. 1-70
    Centralisation of specialised healthcare services: a scoping review of definitions, types, and impact on outcomes.
    Angus Ig Ramsay, Sonila M Tomini, Saheli Gandhi, Naomi J Fulop, Stephen Morris.
       Background: Centralising specialised healthcare services into high-volume centres is proposed to improve patient outcomes and efficiency. Most reviews focus on relatively few conditions and a limited range of outcomes.
    Objectives: To review the evidence on centralisation of a range of specialised acute services, to analyse (1) how centralisations are defined; (2) how centralisations are organised and delivered; and (3) the relationship between centralisation and several key outcomes.
    Design: Scoping review, conducted in November 2020.
    Setting: Specialised acute healthcare services.
    Intervention: Centralisation of services into a reduced number of high-volume units.
    Findings: We included 93 papers covering specialised emergency and elective acute healthcare services, published to November 2020. Definitions of centralisation commonly lacked detail, but, where available, covered centralisation's form, objectives, mechanisms and drivers. We proposed a typology of four forms of centralisation, reflecting the number and functions of specialist units (centralisation of whole pathway, centralisation of pathway components, hierarchy of specialist units, partial centralisation). For most outcomes, the majority of papers suggested a positive impact of centralisation: mortality (33/55 papers), survival (19/25), morbidity (17/27), quality of life (6/7), quality of care (22/30), length of stay (17/26), cost-effectiveness (3/3) and patient experience (3/3). Centralisation was associated with increased patient travel (9/12); 3/5 papers suggested no impact on inequalities.
    Limitations: This review was conducted in November 2020 and did not include grey literature or studies that did not analyse outcomes, so more recent and further evidence - for example, on types of centralisation model and how centralisation was implemented - may exist. As this was a scoping review, we did not conduct a quality assessment, which may reduce the confidence with which we may view the presented impacts of centralisation.
    Conclusions: Centralisation is commonly associated with improved care and outcomes. However, research seldom describes centralised services in sufficient detail, rarely compares different service models and tends to focus on a narrow range of outcomes. Therefore, understanding the extent and nature of centralisation's impact - and the mechanisms by which it is achieved - remains elusive. By addressing these gaps, future research may of greater use to all stakeholders with an interest in centralisation.
    Future research: Should provide clearer descriptions of centralisations, compare different centralisation models and study a wider range of important outcomes, including patient experience and cost-effectiveness.
    Funding: This article presents independent research funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme as award number NIHR133613.
    Keywords:  CENTRALISATION; OUTCOMES; REGIONALISATION; SCOPING REVIEW; SPECIALISED ACUTE HEALTHCARE SERVICES
    DOI:  https://doi.org/10.3310/REMD6648
  33. Front Med (Lausanne). 2025 ;12 1464699
    The evolving landscape of health and social care integration: in search of a unifying theory.
    Kheng Hock Lee, Chien Earn Lee.
      This paper explores the co-evolution of theoretical paradigms and care models within health and social care through the lens of complexity science. It argues that this co-evolution, characterized by a dynamic interplay between abstract principles and tangible practices, propels health systems toward greater human-centeredness and interconnectedness. Theories, acting as "attractors," shape the landscape of possible care models, while the implementation and evaluation of these models, in turn, refine theoretical understanding. This continuous feedback loop, driven by emergent properties within the complex system of healthcare, fosters a dynamic evolution toward more holistic and effective care. The paper proposes a unifying framework to understand this ongoing process, emphasizing the interconnectedness of individual, community, and societal well-being. While further research is needed to validate this conceptual framework, it offers a valuable lens for analyzing historical trends and guiding future developments in health and social care.
    Keywords:  care model; complexity; complexity science; health system; social prescribing
    DOI:  https://doi.org/10.3389/fmed.2025.1464699
  34. Bioethics. 2025 Jul 27.
    Reimagining Social Value to Consider the Environment: How Should We Judge the Magnitude of Benefits in Health Research?
    Bridget Pratt, Rieke van der Graaf.
      Growing recognition of intersections between our health and the environment, healthcare systems and the environment, and health research and the environment has led bioethics scholars to advocate that the field readopt a broader perspective that considers nature. As part of doing so, we urgently need to reimagine research ethics concepts and frameworks so that they account for the environment. This paper focuses on how we should reinterpret the ethical concept of social value in health research. The concept is understood in absolute and relative terms, and both must be revised. The absolute social value of health research is determined by judging its magnitude of benefits and likelihood of benefits. This paper aims to generate considerations for judging health research's magnitude of benefits that capture its environmental benefits. We start from the most comprehensive definition of absolute social value to-date and show how it falls short of adequately capturing the magnitude of potential benefits generated by health research that yields knowledge related to nature. Based on that analysis, we propose how to revise the definition of absolute social value to better account for the environment. To conclude, we highlight questions that our suggested revisions raise for making relative social value assessments that consider the environment.
    Keywords:  climate change; environment; health research; research ethics; social value; sustainability
    DOI:  https://doi.org/10.1111/bioe.70018
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