Rehabilitation Research

Trajectories of functional performance and muscle strength recovery differ after total knee and total hip replacement: a performance-based, longitudinal study Total joint replacement is indicated to alleviate pain and disability associated with hip and knee osteoarthritis. Arthroplasty outcomes are typically reported together, or anecdotal comparisons are made between total knee arthroplasty (TKA) and total hip arthroplasty (THA) recovery. Limited data quantifies differences in recovery trajectories, especially with respect to performance-based outcomes. Seventy-nine people undergoing total knee or THA were followed over 6 months. Functional performance was measured using the stair climb test, timed-up-and-go test, and 6-min walk test. Surgical limb isometric strength was also measured. All outcomes significantly declined 1 month after surgery. Participants in the TKA group showed a greater decline in climbing stairs (P < 0.001), timed-up-and-go (P = 0.01), and 6-min walk distance (P < 0.01). Further, the TKA group lost more strength (P < 0.001) and were weaker than those after THA (P < 0.001). Differences in postoperative outcomes between groups at 3 and 6 months were also observed. The TKA group experiences a greater decline in measured outcomes than the THA group, and muscle strength and functional recovery occurred differently in each group. These findings should be considered in rehabilitation priorities after arthroplasty surgery. Received 25 January 2019 Accepted 15 February 2019 Correspondence to Dana L. Judd, PT, DPT, PhD, Department of Physical Medicine and Rehabilitation, Physical Therapy Program, University of Colorado Anschutz Medical Campus, 13121 E. 17th Avenue, Mail Stop C244, Aurora, CO 80045, USA Tel: +1 303 724 8814; fax: +1 303 724 9016; e-mail: dana.judd@ucdenver.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

The effect of Tai Chi and Qigong on health-related quality of life in Parkinson's disease: a systematic review and meta-analysis of systematic reviews The overall aim of the treatment in Parkinson's disease is to optimize functional independence, safety, well-being and thereby health-related quality of life. Tai Chi and Qigong are widely used exercises in Parkinson's disease, but there is insufficient evidence to support or refute the efficacy of Tai Chi and Qigong, especially on health-related quality of life in patients with Parkinson's disease. The aim of this study was to conduct a systematic review and a meta-analysis from the systematic reviews that evaluate the effectiveness of Tai Chi and Qigong on health-related quality of life in Parkinson's disease. A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses by using Cochrane Library, MEDLINE, PubMed, etc., databases up to the end of November 2018. From 1504 articles, seven fulfilled the inclusion criteria and were included in our study. Five of the included systematic reviews were about Tai Chi, and two of them were about both Tai Chi and Qigong. According to our meta-analysis, there was no significant effect of Tai Chi and Qigong on health-related quality of life in patients with Parkinson's disease, when compared to the control group (standardized mean difference −0.166, 95% confidence interval −0.676 to 0.344; P = 0.523). In conclusion, our systematic review and meta-analysis showed no significant effect of Tai Chi and Qigong statistically on health-related quality of life in patients with Parkinson's disease, but the small effect size in our study favoured the potential benefit of Tai Chi and Qigong on health-related quality of life in Parkinson's disease. Received 14 March 2019 Accepted 7 May 2019 Correspondence to Bahar Aras, PhD, PT, Assist Prof, Faculty of Health Sciences, Evliya Celebi Campus, Kutahya Health Sciences University, Kutahya, Turkey, Tel: +90 274 2652191/1462; fax: +90 274 2652191; e-mail: dpuaras@yahoo.com Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Body weight supported treadmill vs. overground gait training for acute stroke gait rehabilitation The purpose of this study was to evaluate the clinical efficacy of body weight supported treadmill training for acute post-stroke rehabilitation, relative to conventional therapy. Forty individuals were randomized to receive either body weight supported treadmill training or conventional therapy as part of standard care at an acute rehabilitation facility. As part of normal care patients were evaluated using the Functional Independence Measure; gait units and length of stay were also recorded. Within 48 hours of discharge, participants were evaluated using a Qualisys motion capture system to measure spatiotemporal gait parameters. Participants allocated to the body weight supported treadmill training group had a significantly lower admission Functional Independence Measure, but had a longer length of stay, and did not have significantly different discharge Functional Independence Measure scores. Gait speed was the only spatiotemporal outcome that was significantly different at discharge, and was lower for the body weight supported treadmill training group. As seen in previous literature, the clinical efficacy of body weight supported treadmill training seems to be similar to that of conventional overground therapy. Accounting for difference in admission scores the body weight supported treadmill training and conventional therapy groups, both methods performed comparably. Received 26 February 2019 Accepted 2 May 2019 Correspondence to Derek J. Lura, PhD, Assistant Professor, Department of Bioengineering, Florida Gulf Coast University, 10501 FGCU Boulevard South, Fort Myers, FL 33965–6565, USA, Tel: +1 239 590 7832; fax: +1 239 590 7304; e-mail: dlura@fgcu.edu Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Some thoughts on bibliometrics, usage metrics and altmetrics concerning the International Journal of Rehabilitation Research No abstract available

Predictors of community reintegration and quality of life after hip fracture among community-dwelling older adults We aim to explore factors contributing to community reintegration and health-related quality of life (HRQoL) among community-dwelling older adults three months after discharge from inpatient rehabilitation following hip fracture. We performed a prospective cohort study with follow-up. Thirty-three consecutive patients (age 66–89) after surgery for hip fracture repair were recruited from an inpatient rehabilitation unit. Participants were 65+ years old, did not have dementia, and were independent in basic activities of daily living (BADL) at discharge. We examined the contribution of independent variables measuring BADL, cognition, emotional status, pain and social support to the explained variance of two main outcomes: the Reintegration to Normal Living Index (RNLI), measuring self-reported ability to participate in activities and return to life roles; and the Medical Outcomes Study Short-Form Health Survey (SF-12), assessing mental and physical aspects of HRQoL. Stepwise regression analyses revealed that: social support and pain while walking significantly explained 42.1% of variance in the RNLI; social support significantly explained 31.1% of the variance in the SF-12-physical subscale; the number of falls in the previous year, social support and executive functions assessed by the clock drawing test significantly explained 61.9% of the variance in the SF-12 mental subscale. Social support, pain while walking and the number of falls in the previous year can predict community reintegration and HRQoL among older adults three months after discharge from rehabilitation following a surgical hip fracture repair. These factors need to be addressed in rehabilitation programs. The work submitted is our own and copyright has not been breached in seeking its publication. The submitted work and its essential substance have not previously been published and are not being considered for publication elsewhere. Received 10 March 2019 Accepted 18 April 2019 Correspondence to Yafit Gilboa, OT, PhD, Faculty of Medicine, School of occupational therapy, Hebrew University of Jerusalem, Mount Scopus, Jerusalem 91240, Israel, Tel: +972 2 5845312; fax: +972 2 5324985; e-mail: Yafit.gilboa@mail.huji.ac.il Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

The Prosthetic Mobility Questionnaire, a tool for assessing mobility in people with lower-limb amputation: validation of PMQ 2.0 in Slovenia The aim of this study was to examine the metric properties of the Prosthetic Mobility Questionnaire, an outcome measure of mobility following lower-limb amputation, in Slovene outpatients undergoing rehabilitation. The 12-item Prosthetic Mobility Questionnaire was administered to 148 Slovene adults (74% men) with unilateral lower-limb amputation since >12 months and regularly wearing a prosthesis. The psychometric analysis included classical test theory methods and Rasch models. Rasch analysis disclosed two pairs of locally dependent items (same task but in opposite directions: walk up/down stairs; walk up/down a hill). Thus, we devised a new version (PMQ 2.0) assessing all 12 Prosthetic Mobility Questionnaire items but calculating the global score on only 10, i.e. considering–for each pair of locally dependent items–just the item with worst performance. The PMQ 2.0 demonstrated correct functioning of rating scale categories, construct validity (item fit, hierarchy of item difficulties), convergent validity, high-reliability indices and unidimensionality. In conclusion, the new 10-item PMQ 2.0 shows good reliability and validity, and an excellent overall metric quality for measuring perceived mobility capabilities in people with lower-limb amputation. Received 8 April 2019 Accepted 16 April 2019 Correspondence to Franco Franchignoni, MD, Istituti Clinici Scientifici Maugeri, IRCCS, Via Mons. Bernasconi, 16, 20851 Lissone (MB), Italy, Tel: 39 039 46571; e-mail: franco.franchignoni@icsmaugeri.it Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Simple and choice reaction times of healthy adults and patients after stroke during simulated driving We examined whether driving-related reaction times differ between 26 healthy adults (university students) and 26 patients after stroke, and how distractors and leg-dominance affect reaction time and correctness of reactions of healthy adults. Reaction times were measured with the Fiat Mediatester driving simulator using 18-lamps reaction test (simple reaction time measurement) and choice reaction test (scored as reaction time and number of correct reactions). There was no statistically significant difference between the groups in simple reaction time. As expected, choice reaction times of the healthy adults were shorter on average and their reactions more accurate than those of the patients. Under the influence of distractors, healthy adults had statistically significantly longer choice and simple reaction times and made fewer correct choices compared to normal conditions. Leg dominance statistically significantly affected choice reaction times and correctness of reactions, but not simple reaction times. Our results confirm validity and usefulness of the Fiat Mediatester driving simulator for research purposes. Received 6 March 2019 Accepted 2 April 2019 Correspondence to Gaj Vidmar, University Rehabilitation Institute, Republic of Slovenia, Linhartova 51, 1000 Ljubljana, Slovenia, Tel: +386 1 4758 440; fax: +386 1 4376589; e-mail: gaj.vidmar@ir-rs.si Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Prediction of functional outcome and discharge destination in patients with traumatic brain injury after post-acute rehabilitation As the survival rate of traumatic brain injury increases, the burden of care for patients with traumatic brain injury is emerging as a socioeconomic issue and the discharge destination is one of the important outcome measures in the post-acute rehabilitation unit. To investigate the predictors of functional outcome and discharge destination in patients with traumatic brain injury after post-acute rehabilitation. A retrospective review was performed on 86 patients who were admitted to the rehabilitation unit between January 2010 and June 2017. Multiple regression analysis was used as a statistical method to identify the factors affecting Modified Barthel Index and discharge destination. The number of days from traumatic brain injury onset to rehabilitation unit admission (odds ratio = 0.959, P = 0.049), brain surgery for traumatic brain injury management (odds ratio = 0.160, P = 0.021), initial Glasgow Coma Scale score (odds ratio = 1.269, P = 0.022) and Mini-Mental State Examination score at admission (odds ratio = 1.245, P < 0.001) were the predictive factors for higher Modified Barthel Index after rehabilitation. Underlying vascular risk factors (odds ratio = 0.138, P = 0.015), Modified Barthel Index score after rehabilitation (odds ratio = 1.085, P < 0.001) and deductible-free insurance (odds ratio = 0.211, P = 0.032) were the predictive factors of home discharge. The functional outcome of patients with traumatic brain injury after rehabilitation was related to the severity of initial injury, cognitive function at admission and rehabilitation timing. The discharge destination after rehabilitation was related to functional outcome, insurance issues and underlying vascular risk factors. Received 29 March 2019 Accepted 8 April 2019 Correspondence to Sung-Bom Pyun, MD, PhD, Department of Physical Medicine and Rehabilitation, Korea University College of Medicine, 73, Inchon-ro, Seongbuk-gu, Seoul 02841, Korea, Tel: +82-2-920-6483; fax: +82-2-929-9951; e-mail: rmpyun@korea.ac.kr Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Backward walking observational training improves gait ability in patients with chronic stroke: randomised controlled pilot study Backward walking has a positive effect on gait ability. Action observational training is an effective treatment method for stroke neurological disorders. This randomised comparator-controlled pilot study aimed to evaluate the feasibility of backward walking observational training on the gait ability of chronic stroke patients. Fourteen chronic stroke participants were randomly allocated to the experimental group (backward walking observation; n = 7) and control group (landscape observation; n = 7). Both groups performed conventional therapy 5 days/week; then the backward walking observation and landscape observation + backward walking training groups performed the observational training 3 days/week for 4 weeks. The primary outcome was measured dynamic gait index, 10-m walking test, and timed up and go test time. Both groups showed significant increases in dynamic gait index, 10-m walking test, and timed up and go test time. The experimental group showed more significant improvements in dynamic gait index (P = 0.04, η2 = 0.336), 10-m walking test (P = 0.04, η2 = 0.306), and timed up and go test time (P = 0.03, η2 = 0.334) than the control group. This pilot study demonstrated that conventional therapy with backward walking observational training improves gait ability. Our findings suggest that observing an action may have a positive effect on chronic stroke patients. Received 23 January 2019 Accepted 5 April 2019 Correspondence to Youngsook Bae, PT, PhD, Department of Physical Therapy, College of Health Science, Gachon University, 191, Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea, Tel: +82 32 820 4324; fax: +82 32 820 4420; e-mail: baeys@gachon.ac.kr Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Home visits by occupational therapists in acute hospital care: a systematic review The aim of this review was to determine the utility of home visits by occupational therapists before and after a patient is discharged from an acute care hospital. All relevant published studies were identified by searching the CENTRAL, MEDLINE, EMBASE, Occupational Therapy Systematic Evaluation of Evidence, and WHO International Clinical Trials Registry Platform databases. Randomized controlled trials were included regardless of sex, age, disease, and duration of acute hospitalization. The intervention was predischarge and postdischarge home visits made by an occupational therapist. The primary outcome was the ability to perform activities of daily living at 1 month after the intervention. We identified eight trials (including 1029 patients) that were eligible for inclusion. More than half of the trials had a low risk of bias in random sequence generation, and allocation concealment and the other half had a high risk of bias with regard to blinding of participants. However, the risk of bias in terms of blinding for outcomes assessment was low in more than half the studies. We found that home visits by an occupational therapist in a single study significantly reduced the prevalence of falls but had no significant effects on ability to perform activities of daily living, quality of life, or mood. We could not find adequate evidence to support routine home visits by an occupational therapist in the acute care. In the future, studies with larger sample sizes are needed to validate home visits by occupational therapists in patients after acute care hospitalization. Received 11 February 2019 Accepted 1 April 2019 Correspondence to Ryo Momosaki, Department of Rehabilitation Medicine, Teikyo University School of Medicine University Hospital, Mizonokuchi, 5-1-1 Futako, Takatsu-ku, Kawasaki, Kanagawa 213–8507, Japan, Tel: +81 44 844 3333; fax: +81 44 844 3201; e-mail: momosakiryo@gmail.com Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Alexandros Sfakianakis
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