Rehabilitation Research Research Articles

Disability Research Principles

This paper presents lessons learned from a project titled Advocates Assembly: Disability Research from the Ground Up. Hosted by Ontario Tech University’s Institute for Disability and Rehabilitation Research (IDRR), the series featured representatives from disability-led activist and rights advocacy groups and disability-focused healthcare and social services providers. Across the series, speakers collectively articulated a number of key principles that ground disability research in community. In this paper the authors organize and analyze themes from these events, to show how community-based research principles have the power to confront and transform institutionally entrenched forms of disability research. Those principles are as follows: researchers should seek out contextually specific knowledge, researchers should unsettle their role as experts, researchers should acknowledge and enact their accountability, and researchers should commit to sustainable and transformational change, which challenges the temporal parameters to projects.

Research trends and hotspots in exercise rehabilitation for coronary heart disease: A bibliometric analysis.

Exercise rehabilitation can improve the prognosis of patients with coronary heart disease. However, a bibliometric analysis of the global exercise rehabilitation for coronary heart disease (CHD) research topic is lacking. This study investigated the development trends and research hotspots in the field of coronary heart disease and exercise rehabilitation. CiteSpace software was used to analyze the literature on exercise therapy for CHD in the Web of Science Core Collection database. We analyzed the data of countries/institutions, journals, authors, keywords, and cited references. A total of 3485 peer-reviewed papers were found, and the number of publications on the topic has steadily increased. The most productive country is the USA (1125), followed by China (477) and England (399). The top 3 active academic institutions are Research Libraries UK (RLUK) (236), Harvard University (152), and the University of California System (118). The most commonly cited journals are Circulation (2596), The most commonly cited references are "Exercise-based cardiac rehabilitation for coronary heart disease" (75), Lavie CJ had published the most papers (48). World Health Organization was the most influential author (334 citations). The research frontier trends in this field are body composition, participation, and function. Research on the effects of physical activity or exercise on patients with CHD is a focus of continuous exploration in this field. This study provides a new scientific perspective for exercise rehabilitation and CHD research and gives researchers valuable information for detecting the current research status, hotspots, and emerging trends for further research.

Research priorities in HIV, aging and rehabilitation: building on a framework with the Canada-International HIV and Rehabilitation Research Collaborative

BackgroundIn 2016, the Canada-International HIV and Rehabilitation Research Collaborative established a framework of research priorities in HIV, aging and rehabilitation. Our aim was to review and identify any new emerging priorities from the perspectives of people living with HIV, clinicians, researchers, and representatives from community organizations.MethodsWe conducted a multi-stakeholder international consultation with people living with HIV, researchers, clinicians and representatives of community-based organizations. Stakeholders convened for a one-day Forum in Manchester, United Kingdom (UK) to discuss research priorities via a web-based questionnaire and facilitated discussions. We analyzed data using conventional content analytical techniques and mapped emerging priorities onto the foundational framework.ResultsThirty-five stakeholders from the UK(n = 29), Canada(n = 5) and Ireland(n = 1) attended the Forum, representing persons living with HIV or representatives from community-based organizations(n = 12;34%), researchers or academics(n = 10;28%), service providers(n = 6;17%), clinicians(n = 4;11%); and trainees(n = 4;11%). Five priorities mapped onto the Framework of Research Priorities across three content areas: A–Episodic Health and Disability Aging with HIV (disability, frailty, social participation), B-Rehabilitation Interventions for Healthy Aging across the Lifespan (role, implementation and impact of digital and web-based rehabilitation interventions) and C–Outcome Measurement in HIV and Aging (digital and web-based rehabilitation health technology to measure physical activity). Stakeholders indicated methodological considerations for implementing digital and web-based rehabilitation interventions into research and practice and the importance of knowledge transfer and exchange among the broader community.ConclusionResults highlight the sustained importance of the Framework of Research Priorities and provide further depth and areas of inquiry related to digital and web-based rehabilitation interventions and technology aging with HIV.

Research trends and hotspots of post-stroke dysphagia rehabilitation: a bibliometric study and visualization analysis.

Post-stroke dysphagia (PSD) is one of the most prevalent stroke sequelae, affecting stroke patients' prognosis, rehabilitation results, and quality of life while posing a significant cost burden. Although studies have been undertaken to characterize the pathophysiology, epidemiology, and risk factors of post-stroke dysphagia, there is still a paucity of research trends and hotspots on this subject. The purpose of this study was to create a visual knowledge map based on bibliometric analysis that identifies research hotspots and predicts future research trends. We searched the Web of Science Core Collection for material on PSD rehabilitation research from its inception until July 27, 2023. We used CiteSpace, VOSviewer, and Bibliometrix R software packages to evaluate the annual number of publications, nations, institutions, journals, authors, references, and keywords to describe present research hotspots and prospective research orientations. This analysis comprised 1,097 articles from 3,706 institutions, 374 journals, and 239 countries or regions. The United States had the most publications (215 articles), and it is the most influential country on the subject. "Dysphagia" was the most published journal (100 articles) and the most referenced journal (4,606 citations). Highly cited references focused on the pathophysiology and neuroplasticity mechanisms of PSD, therapeutic modalities, rehabilitation tactics, and complications prevention. There was a strong correlation between the terms "validity" and "noninvasive," which were the strongest terms in PSD rehabilitation research. The most significant words in PSD rehabilitation research were "validity" and "noninvasive brain stimulation," which are considered two of the most relevant hotspots in the field. We reviewed the research in the field of PSD rehabilitation using bibliometrics to identify research hotspots and cutting-edge trends in the field, primarily including the pathogenesis and neurological plasticity mechanisms of PSD, complications, swallowing screening and assessment methods, and swallowing rehabilitation modalities, and this paper can provide in the follow-up research in the field of PSD rehabilitation. The results of this study can provide insightful data for subsequent studies in the field of PSD rehabilitation.

Repetitive transcranial magnetic stimulation (rTMS) as a tool for cognitive enhancement in healthy adults: a review study.

As human beings, we have always sought to expand on our abilities, including our cognitive and motor skills. One of the still-underrated tools employed to this end is repetitive transcranial magnetic stimulation (rTMS). Until recently, rTMS was almost exclusively used in studies with rehabilitation purposes. Only a small strand of literature has focused on the application of rTMS on healthy people with the aim of enhancing cognitive abilities such as decision-making, working memory, attention, source memory, cognitive control, learning, computational speed, risk-taking, and impulsive behaviors. It, therefore, seems that the findings in this particular field are the indirect results of rehabilitation research. In this review paper, we have set to investigate such studies and evaluate the rTMS effectuality in terms of how it improves the cognitive skills in healthy subjects. Furthermore, since the most common brain site used for rTMS protocols is the dorsolateral prefrontal cortex (DLPFC), we have added theta burst stimulation (TBS) wave patterns that are similar to brain patterns to increase the effectiveness of this method. The results of this study can help people who have high-risk jobs including firefighters, surgeons, and military officers with their job performance.

Conducting Rehabilitation Research Through Amazon Mechanical Turk: A User-Friendly Guide

Amazon Mechanical Turk (MTurk) is a crowdsourcing website that has become a popular participant recruitment tool in social science research. MTurk provides access to a large, diverse, and inexpensive pool of willing participants, and the unique clinical characteristics of MTurk participants may be of particular interest to rehabilitation researchers. In this article, the authors provide a step-by-step guide to set up and conduct a Qualtrics online survey study via MTurk. Several considerations including quality control of data, cost reduction, and ethical considerations are discussed, and strategies to improve data quality and promote research ethics are provided.

Patient Perceptions and Clinical Assessments of Cardiometabolic Disease After Subacute Spinal Cord Injury

ObjectivesTo investigate the effectiveness of health care team communication regarding cardiometabolic disease (CMD) risk factors with patients with subacute spinal cord injury (SCI). DesignMulti-site prospective cross-sectional study. SettingFive National Institute on Disability, Independent Living, and Rehabilitation Research Model SCI Rehabilitation Centers. ParticipantsNinety-six patients with subacute SCI, aged 18-70 years, with SCI (neurologic levels of injury C2-L2, American Spinal Injury Association Impairment Scale grades A-D), and enrolled within 2 months of initial rehabilitation discharge (N=96). InterventionsNone. Main Outcome Measure(s)Objective risk factors of CMD (body mass index, fasting glucose, insulin, high-density lipoprotein cholesterol, triglyceride levels, and resting blood pressure). Patient reported recall of these present risk factors being shared with them by their health care team. Medications prescribed to patients to address these present risk factors were checked against guideline- assessed risk factors. ResultsObjective evidence of 197 CMD risk factors was identified, with patients recalling less than 12% of these (P<.0001) being shared with them by their health care team. Thirty-one individuals (32%) met criteria for a diagnosis of CMD, with only 1 of these patients (3.2%) recalling that this was shared by their health care team (P<.0001). Pharmacologic management was prescribed to address these risk factors only 7.2% of the time. ConclusionsDespite high prevalence of CMD risk factors after acute SCI, patients routinely do not recall being told of their present risk factors. Multifaceted education and professionals’ engagement efforts are needed to optimize treatment for these individuals.

Medical and biological support of elite sports: recovery and rehabilitation measures

Purpose of the study: to analyze the content and systematize the scientific and methodological materials on research in recovery and rehabilitation in the medical and biological support (MBS) of elite sports. Materials and methods. The research included content analysis of literature sources. Articles included in the PubMed, Scopus, Google Scholar, and Russian Science Citation Index databases were examined. Total of 97 articles were analyzed, and 44 were selected. Results and discussion. Recovery and rehabilitation in sport includes a set of medical, professional, psychological, and pedagogical measures aimed at the restoration or compensation of impaired body functions and sports performance. Among the existing set of means and methods of rehabilitation used in medical practice in the medical and biological support of sports at the present time, the methods that allow quickly eliminating signs and consequences of physical and psychoemotional tension (stress) observed during sports activities, and restoring psychofunctional state through direct impact on regulatory systems (nervous, humoral, and hormonal systems) of the human body are of particular interest. There are active studies on the use of transcranial methods of electrical and magnetic stimulation, as well as biofeedback, which allow the development of the ability to control one’s psychophysiological functions. The analysis of recovery and rehabilitation methods of local impact on the musculoskeletal system has shown that there are very few developments and studies associated with the use of modern physiotherapy and mechanotherapy equipment adapted for application in sports. The use of natural healing resources for recovery and rehabilitation of the human body is sufficiently studied and substantiated by research conducted over the years. However, there are few studies on the influence of natural healing factors on the functional state of the body and the performance ability of athletes. Conclusion. The study has shown various recovery and rehabilitation technologies with application of total and local impact methods. However, there are gaps regarding a lack of studies on the scientific justification of applying natural healing resources and modern mechanotherapy measures with great possibilities for recovery and rehabilitation of the human body’s functional systems, adapted for use in sports, as well as the absence of a formed system for recovery and rehabilitation of athletes in conditions of training in middle altitude.

Improving Rehabilitation Research to Optimize Care and Outcomes for People with Chronic Primary Low Back Pain: Methodological and Reporting Recommendations from a WHO Systematic Review Series

Chronic primary low back pain (CPLBP) is a prevalent and disabling condition that often requires rehabilitation interventions to improve function and alleviate pain. This paper aims to advance future research, including systematic reviews and randomized controlled trials (RCTs), on CPLBP management. We provide methodological and reporting recommendations derived from our conducted systematic reviews, offering practical guidance for conducting robust research on the effectiveness of rehabilitation interventions for CPLBP. Our systematic reviews contributed to the development of a WHO clinical guideline for CPLBP. Based on our experience, we have identified methodological issues and recommendations, which are compiled in a comprehensive table and discussed systematically within established frameworks for reporting and critically appraising RCTs. In conclusion, embracing the complexity of CPLBP involves recognizing its multifactorial nature and diverse contexts and planning for varying treatment responses. By embracing this complexity and emphasizing methodological rigor, research in the field can be improved, potentially leading to better care and outcomes for individuals with CPLBP.

Social justice in higher education: The forgotten needs of students with visual impairments in Bangladesh

Students with disabilities face myriad barriers and hurdles to success in higher education settings. Institutions in developing nations often lack the necessary resources to provide accessible instruction, and the absence of clearly defined policies further impedes upholding the educational rights of such a special population. The purpose of this study was to examine how undergraduate students with visual impairments in Bangladesh felt about their experiences related to social justice and challenges in learning during the COVID-19 pandemic. A convenience sample of 133 students was recruited from two public universities. The authors developed two instruments, namely, the Social Justice Experiences in Higher Education Scale and the Social Justice Challenges in Higher Education Scale, to measure how the participants felt. The results showed that most of the participants experienced some sort of difficulty in receiving social justice in higher education. However, the differences in the group mean score on social justice experiences and challenges in higher education were not statistically significant between the male and female participants of this study. The outcomes of the study and their implications for rehabilitation research and practice have also been addressed in this paper.

Analysis of rehabilitation therapies for sports injuries

Sports injuries are a problem that often occurs in the sports environment, and its rehabilitation research is mostly theoretical or empirical research on a certain therapy, and lacks systematic research. In this study, the literature method and logical analysis method are used to search relevant literature in various databases, and summarize the rehabilitation therapies for sports injuries, the principles, contents and treatment sequence of rehabilitation plans, in order to conduct a systematic analysis of rehabilitation research on sports injuries. It finds that the rehabilitation for sports injuries took physical and mental rehabilitation, including physical rehabilitation and psychological rehabilitation. Rehabilitation programs should be based on principles of avoidance of injury deterioration, timing of treatment, adherence, individualization, specificity assessment, intensity of recovery plans, and overall health; cover muscle strength and endurance, range of motion and flexibility of joints, proprioceptive and neurological function, cardiorespiratory endurance rehabilitation content; follow the sequence of diagnosis, identify treatment goals, primary care, intermediate care, functional rehabilitation, and circulation assessment and maintenance therapy.

Mastering Our Own Magic in the Evolution Toward Precision Practice.

Edelle (Edee) Field-Fote, PT, PhD, FASIA, FAPTA, the 54th Mary McMillan lecturer, is director of the Shepherd Center Spinal Cord Injury Research Program & Hulse Laboratory; professor in the division of physical therapy at Emory University School of Medicine; and professor of the practice in the school of biological sciences at the Georgia Institute of Technology. In her role as the director of spinal cord injury (SCI) research at Shepherd Center, Field-Fote leads a team dedicated to improving motor function in people with SCI through the development of neuromodulation and neurorehabilitation approaches informed by the latest neuroscience research and guided by outcomes that have meaning for people with SCI. With a clinical background as a physical therapist, PhD training in a preclinical model of SCI, and postdoctoral training in motor control physiology, her 25-plus years of SCI research have spanned the breadth of basic and clinical/translational research related to SCI. Dr Field-Fote has conducted randomized clinical trials with funding from the National Institutes of Health since 1997; other clinical trials in her lab have been funded by the Department of Defense, the National Institute on Disability Independent Living and Rehabilitation Research, and numerous foundations. Field-Fote is the recipient of multiple honors from the American Physical Therapy Association (APTA) and its components. She is a Fellow of APTA and a Fellow of the American Spinal Injury Association. She has also served in numerous APTA and APTA component appointed or elected positions and as a member and president of the Foundation for Physical Therapy Research Board of Trustees.

Invited Symposium 1: Traumatic Brain Injury: Highlighting the Contributions of Dr. Harvey S. Levin Ph.D., ABPP-CN, FACSM 1946 - 2022

Invited Symposium 1: Traumatic Brain Injury: Highlighting the Contributions of Dr. Harvey S. Levin Ph.D., ABPP-CN, FACSM 1946 - 2022

Measuring Implicit Biases About Disability: A Scoping Review

Implicit biases about disability contribute to discriminatory behaviors and explicit attitudes toward people with disability, an issue that is of significant importance for rehabilitation researchers. The current study reviewed existing measures of implicit disability biases published between 2000 and April 2022. The search was conducted among seven databases, five major rehabilitation counseling journals, and relevant references in the retrieved articles. A total of 66 studies were identified and reviewed. Results showed that the implicit association test (IAT) was the most frequently used measure of implicit disability biases. A few studies used priming tasks, inhibition tasks, and other tasks based on rating scales to measure implicit disability biases. The strengths and limitations of the measures are discussed, and recommendations for rehabilitation practitioners, educators, and researchers are provided.

The perspectives of participants with traumatic brain injury on prospective memory rehabilitation incorporating compensatory and metacognitive skills training

ObjectivePatient feedback is rarely gathered systematically in cognitive rehabilitation research. This study examined the perceptions and experiences of people with traumatic brain injury (TBI) who participated in a trial of a 6-session educational program for the rehabilitation of prospective memory (PM) impairment. MethodsA mixed methods design was used with 47 participants with TBI who completed a compensatory strategy training program (COMP) or COMP plus metacognitive strategy training program (COMP-MST) delivered by an occupational therapist. Data were collected via a participant survey, extracts from progress notes, and audiotaped discussions about learnings from the program during the final session. ResultsParticipants from both programs were highly satisfied and perceived improvements in everyday PM performance post-intervention. Elements that were highly valued include setting individualised client-centred goals, repetitive training of strategy use, establishing habits and routines, and receiving experiential, verbal, and written feedback.Changes including more therapy sessions were recommended. ConclusionsBoth the COMP and COMP-MST programs were perceived as effective by participants with TBI in improving their PM performance in everyday life using compensatory strategies such as assistive technology. Practice implicationsRoutine collection of patient feedback on cognitive rehabilitation can provide valuable information to support person-centred implementation of clinical practice guidelines.

A translational roadmap for transcranial magnetic and direct current stimulation in stroke rehabilitation: Consensus-based core recommendations from the third stroke recovery and rehabilitation roundtable

Background and Aims: The purpose of this Third Stroke Recovery and Rehabilitation Roundtable (SRRR3) was to develop consensus recommendations to address outstanding barriers for the translation of preclinical and clinical research using the non-invasive brain stimulation (NIBS) techniques Transcranial Magnetic Stimulation (TMS) and Transcranial Direct Current Stimulation (tDCS) and provide a roadmap for the integration of these techniques into clinical practice. Methods: International NIBS and stroke recovery experts (N = 18) contributed to the consensus process. Using a nominal group technique, recommendations were reached via a five-stage process, involving a thematic survey, two priority ranking surveys, a literature review and an in-person meeting. Results and Conclusions: Results of our consensus process yielded five key evidence-based and feasibility barriers for the translation of preclinical and clinical NIBS research, which were formulated into five core consensus recommendations. Recommendations highlight an urgent need for (1) increased understanding of NIBS mechanisms, (2) improved methodological rigor in both preclinical and clinical NIBS studies, (3) standardization of outcome measures, (4) increased clinical relevance in preclinical animal models, and (5) greater optimization and individualization of NIBS protocols. To facilitate the implementation of these recommendations, the expert panel developed a new SRRR3 Unified NIBS Research Checklist. These recommendations represent a translational pathway for the use of NIBS in stroke rehabilitation research and practice.

Looking Beyond the Chair: Psycho-Perceptual Predictors of Sexual Distress and Sexual Satisfaction in Individuals with Spinal Cord Injury

ABSTRACT Despite a large body of biomedical research, little is known about the psychological and perceptual predictors of sexual satisfaction (SS) and sexual distress (SD) post spinal cord injury (SCI). Guided by a bio-psycho-perceptual framework, this cross-sectional research aimed at assessing SS and SD in a large SCI sample using validated patient-reported outcome measures (PROM). Significant correlates and predictors of SS and SD were also identified. Ninety-one men and women with SCI completed PROMs of SS and SD, as well as psychological (mood, sexual and body esteem) and perceptual (interoceptive awareness, trait mindfulness, sexual mindfulness) factors. Neurological profiles were also assessed, along with experience of orgasm. Correlates of SS and SD were first identified using Pearson’s correlations, then multiple hierarchical regression models were computed to isolate predictors. Orgasm experience and psychological factors emerged as moderate correlates of both SS and SD, while neurological factors did not. Interoceptive awareness and trait mindfulness showed weak associations with SD and none with SS. Among the tested predictors, experience of orgasm emerged as the strongest for SS (β = -.29, p < .01), followed by mood, which predicted SS and SD. Sexual and body esteem was predictive of SD only. In sexually active participants, sexual mindfulness predicted both SS (β = 0.55, p < .001) and SD (β = -0.56, p < .001) above and beyond all other variables. This study reveals unique aspects of SS and SD postinjury and supports further consideration of psychological and perceptual dimensions of SCI sexuality in rehabilitation research.

Clinical characteristics and proposed mechanism of pediatric spinal cord injury resulting from backbend practice.

Pediatric spinal cord injury without radiographic abnormality (SCIWORA) caused by backbend practice is increasing. This study proposed an underlying 'combined injury mechanism' related to the spinal cord and femoral nerve overstretching. Pediatric patients diagnosed with backbend-associated SCIWORA at the China Rehabilitation Research Center during 2017-2021 were recruited. Clinical and imaging data were collected, and each patient's clinical course and prognosis were determined. Healthy dancers were recruited to simulate the backbend, obtain images, and estimate the spinal cord and femoral nerve stretch ratio. A model for the 'combined injury mechanism' was established using 4-week-old SD rats. Forty-two SCIWORA female patients with an average age of 6 (SD 1) years and an average hospitalization time of 91 (SD 43) days were assessed. The primary initial symptom was pain in the back and/or lower extremities (33, 79%). The average time from injury onset to severe paralysis was 2.0 (SD 0.6) hours. Most patients had complete paraplegia (32, 76%), and neurological levels were distributed mainly in thoracic segments (38, 91%). Patients with elicited tendon reflexes on admission tended to have an incomplete spinal cord injury (p = 0.001) and improved motor recovery (p = 0.018). After one year, the most common complications were scoliosis (31, 74%) and abnormal hips (14, 33%). Injury of the caudal spinal cord torn by nerve roots was confirmed by surgical exploration in a case. The thoracic spinal cord and femoral nerves were overstretched by 148.8 ± 3.6% and111.7 ± 4.0%, respectively, in a full backbend posture. The 'combined injury mechanism' was partially replicated in the animal model. Spinal overstretch and transient dislocation are considered the primary mechanisms by which SCIWORA occurs in children. Overstretching the femoral nerve aggravates spinal cord injuries caused by backbend practice.

Developing cancer rehabilitation services and research in low-income and middle-income countries: the case for Zambia and key messages

Developing cancer rehabilitation services and research in low-income and middle-income countries: the case for Zambia and key messages

Suicide Attempts and Ideation Among Veterans/Service Members and Non-Veterans Over 5 Years Following Traumatic Brain Injury: A Combined NIDILRR and VA TBI Model Systems Study.

This study compared rates of suicide attempt (SA) and suicidal ideation (SI) during the first 5 years after traumatic brain injury (TBI) among veterans and service members (V/SMs) in the Veterans Affairs (VA) and the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) Model Systems National Databases to each other and to non-veterans (non-Vs) in the NIDILRR database. Twenty-one NIDILRR and 5 VA TBI Model Systems (TBIMS) inpatient rehabilitation facilities in the United States. Participants with TBI were discharged from rehabilitation alive, had a known military status recorded (either non-V or history of military service), and successful 1-, 2-, and/or 5-year follow-up interviews completed between 2009 and 2021. The year 1 cohort included 8737 unique participants (8347 with SA data and 3987 with SI data); the year 2 (7628 participants) and year 5 (4837 participants) cohorts both had similar demographic characteristics to the year 1 cohort. Longitudinal design with data collected across TBIMS centers at 1, 2, and 5 years post-injury. History of SA in past year and SI in past 2 weeks assessed by the Patient Health Questionnaire-9 (PHQ-9). Patient demographics, injury characteristics, and rehabilitation outcomes were also assessed. Full sample rates of SA were 1.9%, 1.5%, and 1.6%, and rates of SI were 9.6%, 10.1%, and 8.7% (respectively at years 1, 2, and 5). There were significant differences among groups based on demographic, injury-related, mental/behavioral health, and functional outcome variables. Characteristics predicting SA/SI related to mental health history, substance use, younger age, lower functional independence, and greater levels of disability. Compared with participants with TBI in the NIDILRR system, higher rates of SI among V/SMs with TBI in the VA system appear associated with risk factors observed within this group, including mental/behavioral health characteristics and overall levels of disability.