Rehabilitation Literature Research Articles

A Concept Analysis: Tenacity of Post-Stroke Patients in Rehabilitation Programs

Stroke is a major global health issue, with rehabilitation offering significant benefits. However, adherence is often compromised. Tenacity, defined by persistence and determination, is essential for effective rehabilitation but is often overlooked and poorly evaluated in clinical settings. This analysis aims to clarify the concept of tenacity in post-stroke rehabilitation and assess its impact on outcomes. Walker and Avant's eight-step framework is used to examine tenacity, drawing data from relevant stroke rehabilitation literature. The analysis reveals that tenacity has several key attributes, including adaptability, self-motivation, determination, perseverance, resilience, and persistence. Antecedents of tenacity include factors such as the severity of the stroke, family support, and access to rehabilitation resources. High levels of tenacity lead to improved rehabilitation outcomes, such as enhanced mobility and quality of life. Tenacity is an essential component in the rehabilitation of post-stroke patients that can significantly improve rehabilitation outcomes. A better understanding of tenacity can aid healthcare professionals in designing more effective interventions to support patients in their rehabilitation programs. Further research is needed to develop valid and reliable tools for assessing tenacity and to evaluate interventions that can enhance patient tenacity.

The Role of Bio-Inspired Soft Robotic Gloves in Stroke Rehabilitation: A Comprehensive Analytical Review

Stroke is a leading cause of long-term disability, with many survivors experiencing impaired motor function. Traditional rehabilitation methods often face limitations in achieving full functional recovery. In recent years, bio-inspired soft robotic gloves have emerged as a promising solution for enhancing stroke rehabilitation, mimicking the natural movement and adaptability of biological systems. This paper provides a comprehensive analytical review of bio-inspired soft robotic gloves designed for stroke rehabilitation, focusing on their development, fabrication methods and therapeutic applications. The primary objective of this review is to evaluate the role of bio-inspired designs in the creation of soft robotic gloves and assess their effectiveness in facilitating motor recovery post-stroke. A systematic analysis of existing literature is conducted, exploring various fabrication techniques, including soft material integration, actuators and sensors, as well as the application of these gloves in clinical and therapeutic settings. Findings from this review reveal that bio-inspired soft robotic gloves show significant potential in improving patient outcomes by enhancing finger and hand movement through assisted motor control. These devices offer advantages in terms of comfort, flexibility and adaptability, allowing for prolonged and intensive rehabilitation sessions. However, limitations remain, such as the high cost of fabrication, challenges in achieving precise motor control and the lack of large-scale clinical trials to validate long-term efficacy. The research has several implications: (1) Theoretical: advancing the understanding of bio-inspired design principles in soft robotics; (2) Methodological: highlighting fabrication techniques that enhance glove performance and user adaptability. This review offers original value by consolidating and analysing recent developments in bio-inspired soft robotic gloves, contributing to both the academic literature and practical applications in stroke rehabilitation. It emphasizes the necessity of future research to address current limitations, especially in optimizing performance and reducing production costs, while enhancing patient outcomes.

Lower Extremity Osseointegration Postoperative Rehabilitation Protocols: A Scoping Review.

Lower-extremity transcutaneous osseointegration is a rehabilitation alternative to socket-suspended prostheses. The rehabilitation process, philosophies, and routines remain under-described. This review, primarily, identifies commonalities and differences among protocols. Secondarily, strategies are proposed to streamline future research of post-osseointegration surgery rehabilitation. Two differently phrased queries of Google Scholar, Pubmed, Embase, and Web of Science were performed. First using either "osseointegration" or "osseointegrated" or "bone anchored prosthesis" AND [last name]. Second, replacing author name with "physical therapy" or "rehabilitation." Six hundred eighty-eight articles were identified describing lower-extremity rehabilitation following osseointegration. Following software-based deduplication, manual abstract and full-text review, article reference evaluation, and use of Google Scholar's "Cited by" feature, 35 studies were fully analyzed. First, a consolidated summary was made of protocols focusing on stages, timing, and other descriptions of postoperative rehabilitation. Subsequently, strengths and limitations of protocols were considered to propose potential strategies to investigate and optimize postoperative rehabilitation. All articles describe rehabilitation having this same order of goal progression: from surgery to gradual weight bearing and final goal of independent ambulation. The most impactful difference influencing the stated final goal of independent ambulation was whether 1 or 2 surgical stages were performed. No articles reported patient success rate achieving proposed goals and timing, or challenges during rehabilitation. Therefore, the first research suggestion is to investigate actual success rates achieving proposed goals and timing. Second, to further explore rehabilitation of performance deficits, beyond unaided ambulation. Finally, to incorporate technology such as mobility trackers to more objectively understand prosthesis use and mobility. All lower-extremity osseointegration rehabilitation literature recommends identical goal progression order. No studies evaluate patient challenges or variation. Understanding and addressing such challenges may enhance postoperative rehabilitation. This article consolidates published rehabilitation protocols post-osseointegration surgery. Specific analysis and experimentation of the protocols may enhance the uniformity and potential of patient rehabilitation.

From bars to breakthroughs: the application of self-determination theory to offender programs

ABSTRACT The forensic rehabilitation literature is replete with studies that delve into the effectiveness of offending programs while also critiquing claims about their efficacy. Consideration of the efficacy of offending programs aimed at reducing recidivism among the forensic population is crucial, however, what appears to be consistently overlooked is the incorporation of underlying behaviour change theories into the development of these programs. Specifically, there is a notable lack of research exploring the mechanisms of behavioural change within offending programs, as well as the maintenance of these changes to ultimately facilitate desistance. This paper considers current program shortcomings, suggests the adoption of Self-Determination Theory as a potential theoretical foundation for offending programs, and explores how this theory could be applied to programs for the forensic population.

Goal Setting for Participatory Person-Centered Geriatric Rehabilitation-From Function-Centered Rehabilitation towards Digitally Supported Personalized and Integrated Care for Older People.

As chronic illness is common among older people, self-care practices for older people are needed to control health status, to prevent possible complications and to ensure optimal quality of life. The literature has demonstrated that integrated care approaches are one key success factor for delivering person-centered and sustainable care for older people, with rehabilitation being a cornerstone in tertiary care prevention for older citizens. The current paper addresses the state of the literature for person-centered geriatric rehabilitation (GR) and the importance of personalized and participatory goal setting. In accordance with the bio-psycho-social model of the International Classification of Functioning, Disability and Health (ICF), social participation and the related goals are of particular importance for the entire rehabilitation process. The social participation of individuals enrolled into GR is therefore one of the milestones to be achieved during GR. Personalized goal setting during the entire rehabilitation process, Comprehensive Geriatric Assessment (CGA) and shared decision making allow a comprehensive care approach separate from solely function-based rehabilitation. The review also focusses on recent developments in digitalization in healthcare and delivers insights into how healthcare professionals' collaborative practice supports sustainable rehabilitation results in patients of advanced chronological age.

Physical Activity and Sports for Children With Juvenile Idiopathic Arthritis.

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease of childhood, presenting clinically as inflammatory arthritis in children younger than 16 years. To date, while evidence supports physical activity for children with JIA, there is limited evidence on the recommended approach to physical activity and sports participation in this population, and no single structured therapeutic exercise program has been established as best practice. This review article presents what is known on the management of physical activity in children with JIA, including recommendations from the pediatric rheumatology and rehabilitation literature, where available, for sports participation, structured therapeutic exercise programs, and return to activity.

Extracorporeal Shockwave Treatment as Additional Therapy in Patients with Post-Stroke Spasticity of Upper Limb-A Narrative Review.

Stroke is a severe injury of the central nervous system (CNS) and one of the leading causes of long-term disability and mortality. One of the main symptoms of neurological diseases is spasticity. This is defined as a motor condition characterized by a velocity-dependent increase in tonic stretch reflexes with exaggerated tendon jerks and resulting in the hyperexcitability of the stretch reflex. Rehabilitation after a stroke is focused on relearning lost skills and regaining independence. Many new methods in neurorehabilitation have been introduced. This review concentrates on the current evidence for extracorporeal shockwave therapy (ESWT) as a noninvasive alternative to treat spasticity. We present the effect of EWST and radial EWST interventions to post-stroke patients with spasticity in the upper limb. Our collected data suggest that different parameters of shockwaves can be used to achieve functional improvementsin the upper limb after a stroke. Our accumulated data imply that ESWT is safe and can be used for pain relief, reduced muscle tension, and an increased range of motion. According to many studies, complications after shockwave treatment are infrequent. Transient complications after shockwave therapy (ESWT) include redness, tingling, pain, and bruising. We reviewed clinical trials that present the possible benefits in upper-limb function after shockwave therapy for post-stroke patients. In this article, we used many database search engines, including PEDro. In the stroke rehabilitation literature, a key methodological problem is the design of double-blind studies, which very often are not feasible.

Delivering Multidisciplinary Rehabilitation Care in Parkinson's Disease: An International Consensus Statement.

Parkinson's disease (PD) is a complex neurodegenerative disorder impacting everyday function and quality of life. Rehabilitation plays a crucial role in improving symptoms, function, and quality of life and reducing disability, particularly given the lack of disease-modifying agents and limitations of medications and surgical therapies. However, rehabilitative care is under-recognized and under-utilized in PD and often only utilized in later disease stages, despite research and guidelines demonstrating its positive effects. Currently, there is a lack of consensus regarding fundamental topics related to rehabilitative services in PD. The goal of the international Parkinson's Foundation Rehabilitation Medicine Task Force was to develop a consensus statement regarding the incorporation of rehabilitation in PD care. The Task Force, comprised of international multidisciplinary experts in PD and rehabilitation and people directly affected by PD, met virtually to discuss topics such as rehabilitative services, existing therapy guidelines and rehabilitation literature in PD, and gaps and needs. A systematic, interactive, and iterative process was used to develop consensus-based statements on core components of PD rehabilitation and discipline-specific interventions. The expert-based consensus statement outlines key tenets of rehabilitative care including its multidisciplinary approach and discipline-specific guidance for occupational therapy, physical therapy, speech language pathology/therapy, and psychology/neuropsychology across all PD stages. Rehabilitative interventions should be an essential component in the comprehensive treatment of PD, from diagnosis to advanced disease. Greater education and awareness of the benefits of rehabilitative services for people with PD and their care partners, and further evidence-based and scientific study are encouraged.

What is Task-Oriented Training? A Scoping Review

Task-Oriented Training (TOT) is an proven stroke rehabilitation intervention with significant evidence-based research that supports its effectiveness. The absence of a clear definition has led to variability in research reporting and subsequent confusion with practical implementation. A consistent definition seeks to remedy this ambiguity to facilitate knowledge translation. The objective of this study was to determine a comprehensive definition of TOT that encapsulates previous definitions and descriptions in the literature. In order to derive this definition, a two stage scoping review process was conducted across four databases searching for articles on the use of TOT in adult stroke rehabilitation therapy. The analysis of this scoping review included 174 articles. Commonly found words used to define TOT included: repetitive, functional, task practice, task specific, task oriented, intensity, and client-centered. Other salient words that aligned with the principles of neuroplasticity and key components of TOT were meaningful, progressive, graded, variable, and feedback. Based on these findings, a comprehensive proposed definition is as follows: Task-oriented training is an effective stroke rehabilitation intervention that focuses on the use of client-centered, repetitive practice of activities that are of high intensity and meaningful to the client. In conclusion, although similar principles were described in the TOT literature, there was no consistent and comprehensive definition of TOT. This scoping review identified key concepts from TOT methodology, and discussion sections in rehabilitation literature to generate a proposed comprehensive definition of TOT to guide research and practice.

Addressing Power, Privilege, and Oppression in Rehabilitation Counselors’ Multicultural Education: A Multilevel Approach

Rehabilitation counselor education must provide students with effective multicultural training to ensure optimal consumer outcomes at different levels; however, the current focus on multicultural competencies is not enough to prepare students to meet the needs of individuals with multiple marginalized identities. Issues related to power, oppression, and privilege need to be addressed through an intersectional decolonization lens. Thus, the article aims to examine current rehabilitation literature and incorporate cultural humility, intersectionality, and decolonization into multicultural training in the rehabilitation field with a multilevel approach. Recommendations are provided at department and program, and individual levels.

Current and future utility of ultrasound imaging in upper extremity musculoskeletal rehabilitation: A scoping review

Study DesignThis study was a scoping review. BackgroundContinued advances in musculoskeletal sonography technology and access have increased the feasibility of point-of-care use to support day-to-day clinical care and decision-making. Sonography can help improve therapeutic outcomes in upper extremity (UE) rehabilitation by enabling clinicians to visualize underlying structures during treatment. Purpose of the StudyThis study aimed to (1) evaluate the growth, range, extent, and composition of sonography literature supporting UE rehabilitation; (2) identify trends, gaps, and opportunities with regard to anatomic areas and diagnoses examined and ultrasound techniques used; and (3) evaluate potential research and practice utility. MethodsSearches were completed in PubMed, CINAHL, SPORTDiscus, PsycINFO, and BIOSIS. We included data-driven articles using ultrasound imaging for upper extremity structures in rehabilitation-related conditions. Articles directly applicable to UE rehabilitation were labeled direct articles, while those requiring translation were labeled indirect articles. Articles were further categorized by ultrasound imaging purpose. Article content between the two groups was descriptively compared, and direct articles underwent an evaluation of evidence levels and narrative synthesis to explore potential clinical utility. ResultsAverage publication rates for the final included articles (n = 337) steadily increased. Indirect articles (n = 288) used sonography to explore condition etiology, assess measurement properties, inform medical procedure choice, and grade condition severity. Direct articles (n = 49) used sonography to assess outcomes, inform clinical reasoning, and aid intervention delivery. Acute UE conditions and emerging sonography technology were rarely examined, while tendon, muscle, and soft tissue conditions and grayscale imaging were common. Rheumatic and peripheral nerve conditions and Doppler imaging were more prevalent in indirect than direct articles. Among reported sonography service providers, there was a high proportion of nonradiologist clinicians. ConclusionSonography literature for UE rehabilitation demonstrates potential utility in evaluating outcomes, informing clinical reasoning, and assisting intervention delivery. A large peripheral knowledge base provides opportunities for clinical applications; however, further research is needed to determine clinical efficacy and impact for specific applications.

Scoping review of return-to-work interventions for persons with traumatic brain injury

Purpose The study approach sought to understand which vocational rehabilitation (VR) strategies are available for individuals seeking return to work (RTW) following traumatic brain injury (TBI). Secondly, the review aimed to identify how these RTW interventions and outcomes are evaluated. Materials and Methods Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) approach, the scoping review began by identifying relevant English language articles via PubMed, CINAHL, PsycINFO, and Embase databases for peer-reviewed journal articles published from January 2013 to September 2021. The review focused on identifying studies with a sample population of people with moderate to severe TBI. Results A total of 23 studies met the search criteria. For each included study, the following data were extracted: (a) country of origin, (b) sample size, (c) civilian or military sample population, (d) age, (e) participant gender, (f) RTW definition, (g) intervention approach, and (h) RTW outcome. The results were synthesized by placement into one of four categories as a function of the study’s underlying methodological approach Conclusions The development of effective RTW approaches has largely been neglected in the rehabilitation literature for persons with TBI in civilian and military populations. Effective strategies do exist to help guide efforts to return this population to productive activity, including work. Implications for Rehabilitation Lack of productive engagement in work and school among persons with traumatic brain injury (TBI) presents a chronic challenge in rehabilitation systems internationally. Rehabilitation professionals should utilize multidisciplinary and integrated return-to-work (RTW) interventions given the varied areas of function that can result from TBI. Rehabilitation professionals should apply RTW interventions that promote on-site training and workplace integration. Given the idiosyncratic nature of TBI, RTW interventions should be tailored to meet the specific needs of the person seeking support.

Development of an online intervention for the Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN) trial.

Up to half of people hospitalised with COVID-19 report diverse and persistent symptoms affecting quality of life for months and sometimes years after discharge (long-COVID). We describe the development of an online group exercise and behavioural support intervention for people who continue to experience such physical and/or emotional health problems more than three months after hospital discharge. Intervention development was informed by the Medical Research Council framework for complex interventions. Our multidisciplinary team of academics, clinicians, and people with long-COVID, had collective expertise in the development and testing of complex interventions. We integrated a bio-psycho-social model of care drawing on rehabilitation literature for long-term health conditions and experiences from our pre-pilot study. Multiple stakeholder meetings were held to refine the intervention which was designed to be deliverable within the UK National Health Service. We adhere to TIDieR guidance for transparent and explicit reporting of telehealth interventions. The final REGAIN online exercise and behavioural support intervention consisted of an initial 1:1 consultation with a trained practitioner, followed by eight online group exercise, and six group support, sessions delivered over eight weeks. Participants could also access an online library of on-demand exercise and support videos. The final REGAIN intervention, combining exercise and behavioural support, is fully manualised with clear pathways to delivery and implementation. It is currently being tested in a randomised controlled trial. The intervention, developed with extensive patient and stakeholder engagement, could be incorporated into existing NHS rehabilitation programmes, should it prove to be clinically and cost-effective for people with long-COVID. International Standard Randomised Controlled Trial Number (ISRCTN) 11466448: Rehabilitation exercise and psychological support after COVID-19 infection: REGAIN.

Pilot of a person-centred, interdisciplinary approach to goal setting in Ireland’s National Rehabilitation Hospital: a study protocol

Background: Research has emphasized the value of a person-centered, interdisciplinary approach to structured goal setting in rehabilitation; yet these approaches are not consistently implemented in clinical practice, limiting the effect that goal setting can have on rehabilitation. The introduction of a new interdisciplinary, person-centered goal setting process to Ireland’s national rehabilitation hospital offers an opportunity to gain novel insight into barriers to implementing and normalising IDT goal setting in complex, specialist rehabilitation services. Methods: The goal setting process was collaboratively designed based on iterative rounds of patient and staff feedback. It will be piloted in three different units of the hospital. The outlined study was co-designed by embedded academic researchers and knowledge stakeholders (the quality improvement team responsible for introducing the new process; and two former patients). The aim is to use a mixed methods approach to capture patient and staff experiences and perspectives of the new process. Data will be collected by embedded researchers with a combination of self-report measures and qualitative interviews with both staff and patients. Self-report measures focus on capturing person centeredness of goals, shared decision making, interprofessional socialization and process normalization. Quantitative data will be represented using descriptive and inferential statistics; qualitative data will be analysed using reflexive thematic analysis. Discussion & Conclusion: From this data the researchers aim to present a holistic view of the patient and staff experiences of the goal setting process. This may further illuminate challenges and potential solutions to implementing changes to goal setting within this context. Findings will be used to inform implementation within the hospital and will contribute to knowledge for rehabilitation practice around implementing IDT goal setting. This will add an Irish perspective to existing goal setting rehabilitation literature.

Supporting Women and Children Returning from Violent Extremist Contexts: Proposing a 5R Framework to Inform Program and Policy Development

ABSTRACT Women and children returning from areas formerly controlled by the Islamic State typically have experienced high levels of trauma and indoctrination, further complicating politically fraught efforts at reintegration and resettlement. Consequently, countries around the world are grappling with how best to manage the return of these women and children. To help better understand which types of programming can contribute to the successful, non-violent reintegration of these individuals, we incorporated ideas from existing Repatriation and Rehabilitation (R&R) literature, field practitioners, R&R subject matter experts, and literature from adjacent fields (e.g., refugee resettlement, criminal justice, psychological resilience) into a recommended best practice approach to supporting returning women and children. We propose a shift from “R&R” programming to what we call the “5R” framework: Repatriation/Resettlement, Reintegration, Rehabilitation, and Resilience. This shift provides conceptual clarity related to how different program elements target proximal goals (e.g., wellbeing and personal safety, belonging and opportunity, non-violence, and dignity), and how programming can shift from more centrally- and government-held services to informal and community-based supports.

Development of an online intervention for the Rehabilitation Exercise and psycholoGical support After covid-19 InfectioN (REGAIN) trial

Background Up to half of people hospitalised with COVID-19 report diverse and persistent symptoms affecting quality of life for months and sometimes years after discharge (long-COVID). We describe the development of an online group exercise and behavioural support intervention for people who continue to experience such physical and/or emotional health problems more than three months after hospital discharge. Methods Intervention development was informed by the Medical Research Council framework for complex interventions. Our multidisciplinary team of academics, clinicians, and people with long-COVID, had collective expertise in the development and testing of complex interventions. We integrated a bio-psycho-social model of care drawing on rehabilitation literature for long-term health conditions and experiences from our pre-pilot study. Multiple stakeholder meetings were held to refine the intervention which was designed to be deliverable within the UK National Health Service. We adhere to TIDieR guidance for transparent and explicit reporting of telehealth interventions. Results The final REGAIN online exercise and behavioural support intervention consisted of an initial 1:1 consultation with a trained practitioner, followed by eight online group exercise, and six group support, sessions delivered over eight weeks. Participants could also access an online library of on-demand exercise and support videos. Conclusions The final REGAIN intervention, combining exercise and behavioural support, is fully manualised with clear pathways to delivery and implementation. It is currently being tested in a randomised controlled trial. The intervention, developed with extensive patient and stakeholder engagement, could be incorporated into existing NHS rehabilitation programmes, should it prove to be clinically and cost-effective for people with long-COVID. Trial registration International Standard Randomised Controlled Trial Number (ISRCTN) 11466448: Rehabilitation exercise and psychological support after COVID-19 infection: REGAIN.

Experiential peers cultivate a participation culture in youth justice

PurposeThe purpose of this viewpoint paper is to explore the concept of experiential peer support, which involves individuals who have lived experiences of using care and justice services. This paper discusses whether experiential peer support can contribute to developing a participatory culture in youth justice practice.Design/methodology/approachThis viewpoint paper will critically evaluate the relational power of experiential peers. Particular attention will be paid to the key components of relational practices by reflecting on ways to enhance the voice of the child within participatory and child first approaches. The paper draws on a range of evidence and research to explore whether inclusion of a lived experience perspective can foster participatory cultures.FindingsExperiential peers can create a participatory youth justice culture, which can positively impact on desistance for justice involved children.Research limitations/implicationsFurther research needs to be undertaken to extrapolate the key characteristics of effective experiential peer support. This includes discussion on whether recruitment of wounded healers into professional youth justice roles can enhance participation in youth justice settings and construct conditions for social growth to develop in youth justice practice.Originality/valueThe author of this viewpoint paper has personal experience of care, youth incarceration and professional experience of youth justice participation practice, providing a unique vantage point and contribution to the desistance and rehabilitation literature.

Treating distressing islands of memory: severe TBI and EMDR treatment for distressing experiences during post traumatic amnesia

‘Severe’ Traumatic Brain Injury (TBI) survivors are likely to be hospitalised and experience Post Traumatic Amnesia (PTA): a transient state of confusion, disorientation and memory loss, until the return of continuous memory. Survivors often experience distressing ‘islands’ of memory during PTA, and this can exacerbate psychological deterioration and lead to additional poor outcomes if left untreated. The literature for neuropsychological rehabilitation is well established in the multidisciplinary delivery of services for severe TBI, but the alleviation of post-traumatic distress caused during PTA has received little attention to date. This case report demonstrates how Eye Movement Desensitisation Reprocessing (EMDR) therapy might provide psychological improvement in clients who sustain severe TBI with distressing ‘islands’ of memory during PTA and provides a 4 year follow up to measure sustained benefits.

Patient Experience Feedback In Rehabilitation Quality Improvement And Codesign Activities: Scoping Review

<h3>Research Objectives</h3> To characterize the literature, including reported enablers and gaps, on the use of patient experience (Px) feedback in rehabilitation codesign and quality improvement (QI) activities. <h3>Design</h3> Scoping review. <h3>Setting</h3> Data sources: Scientific databases (PubMed, CINAHL, Rehabdata, Scopus, Web-of-Science, ProQuest); Greylit database, website searches (e.g., Beryl Institute), snowballing, and key-informant recommendations. <h3>Participants</h3> Study Selection: Two independent reviewers performed title-and-abstract screenings and full-text reviews. Eligibility criteria focused on English-language, peer-reviewed (all time) and grey literature (last 5 years) that engage Px feedback in rehabilitation QI or codesign activities. <h3>Interventions</h3> N/A. <h3>Main Outcome Measures</h3> Data extraction: The QI aims, settings, methods, patient engagement strategies, findings, implications, and reported limitations were extracted, followed by a content analysis identifying reported enablers and gaps. <h3>Results</h3> Data synthesis: Of 851 unique references and 50 full texts reviewed, ten papers were included: six used codesign to engage patients in QI activities; four used Px survey data to inform and evaluate QI activities. Implementation enablers included securing managerial support, having a designated methodology and facilitator - including for balancing power in codesign, using efficient processes, engaging staff experience feedback, and using appreciative inquiry. Gaps included limited follow-up, low sample sizes, analytical limitations, difficulties engaging patients with severe limitations, or lack of reported limitations. <h3>Conclusions</h3> Conclusion: Few examples of Px feedback engagement in QI or codesign activities were found in the rehabilitation literature, either scientific or grey. Px improvement activities were merely informed by Px survey data, not qualitative or participatory approaches which are often more actionable. The identified enablers and gaps can support the design, use, evaluation, and report of person-centered QI activities that meaningfully engage and use Px feedback. <h3>Author(s) Disclosures</h3> The authors declare no conflict of interest.

Rehabilitation of motor function after stroke: A bibliometric analysis of global research from 2004 to 2022.

The mortality rate of stroke has been increasing worldwide. Poststroke somatic dysfunctions are common. Motor function rehabilitation of patients with such somatic dysfunctions enhances the quality of life and has long been the primary practice to achieve functional recovery. In this regard, we aimed to delineate the new trends and frontiers in stroke motor function rehabilitation literature published from 2004 to 2022 using a bibliometric software. All documents related to stroke rehabilitation and published from 2004 to 2022 were retrieved from the Web of Science Core Collection. Publication output, research categories, countries/institutions, authors/cocited authors, journals/cocited journals, cocited references, and keywords were assessed using VOSviewer v.1.6.15.0 and CiteSpace version 5.8. The cocitation map was plotted according to the analysis results to intuitively observe the research hotspots. Overall, 3,302 articles were retrieved from 78 countries or regions and 564 institutions. Over time, the publication outputs increased annually. In terms of national contribution, the United States published the most papers, followed by China, Japan, South Korea, and Canada. Yeungnam University had the most articles among all institutions, followed by Emory University, Fudan University, and National Taiwan University. Jang Sung Ho and Wolf S.L. were the most productive (56 published articles) and influential (cited 1,121 times) authors, respectively. "Effect of constraint-induced movement therapy on upper extremity function 3-9 months after stroke: the Extremity Constraint Induced Therapy Evaluation randomized clinical trial" was the most frequently cited reference. Analysis of keywords showed that upper limbs, Fugl-Meyer assessment, electromyography, virtual reality, telerehabilitation, exoskeleton, and brain-computer interface were the research development trends and focus areas for this topic. Publications regarding motor function rehabilitation following stroke are likely to continuously increase. Research on virtual reality, telemedicine, electroacupuncture, the brain-computer interface, and rehabilitation robots has attracted increasing attention, with these topics becoming the hotspots of present research and the trends of future research.