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Original Articles

Brain disorders

Identifying the Factors With Later Standing Acquisition in Patients With a Right-Hemisphere Stroke: A Cross-Sectional Study Using POSTIM Data
Karim Jamal, Stéphanie Leplaideur, Chloé Rousseau, Etienne Foussat, Solène Painchaud, Lisa Viallard, Isabelle Bonan
Ann Rehabil Med 2026;50(3):160-167.   Published online June 29, 2026
DOI: https://doi.org/10.5535/arm.250125
Objective
To identify factors associated with later standing acquisition in subacute post-stroke patients with right-hemisphere stroke.
Methods
This cross-sectional study used baseline data from the POSTIM multicenter randomized controlled trial (ClinicalTrials.gov: NCT01677091), involving eight rehabilitation units in France. Included patients were patient aged 18–80 with a first right supratentorial stroke (within 9 months), who could stand unassisted for at least 30 seconds with eyes closed but had <40% body weight bearing on the paretic leg during posturography. Evaluations included motor weakness, spasticity (triceps surae, quadriceps, adductors), epicritic and arthrokinetic sensitivity, spatial neglect, body representation, and balance. Logistic regression identified factors associated with later standing acquisition (>3 months).
Results
Among 86 participants (mean age 59.7±10.3 years; 68.6% male), 49 (57%) acquired standing capacity within 3 months, while 37 (43%) did so later. Those with later standing acquisition showed greater spasticity in all muscle groups (p<0.02), more severe motor weakness (p=0.003), and impaired arthrokinetic sensitivity (p=0.02). Balance was significantly worse in this group (p<0.005). Multivariate analysis identified three independent factors of later standing acquisition: spatial neglect (odds ratio [OR]=3.22; 95% confidence interval [CI], 1.09–9.51; p=0.03), ischemic stroke (OR=3.27; 95% CI, 1.08–9.90; p=0.04), and quadriceps spasticity (OR=1.98; 95% CI, 1.17–3.35; p=0.01).
Conclusion
In right-hemisphere stroke, ischemic etiology, quadriceps spasticity, and spatial neglect are significantly associated with later standing acquisition. These factors may be useful for identifying patients at risk of later standing acquisition and for guiding future interventional research.
  • 325 View
  • 13 Download

Pain & Musculoskeletal rehabilitation

Translation, Cross-Cultural Adaptation, and Validation of the Malay Version of the Roland-Morris Disability Questionnaire for Low Back Pain
Nur Sakinah Mohd Yasin, Erna Faryza Mohd Poot, Husna Ahmad Ainuddin, Noor Aziella Mohd Nayan, Mohammed Alrashdi, Nizam Baharom, Ahmad Zamir Che Daud
Ann Rehabil Med 2026;50(3):188-195.   Published online June 23, 2026
DOI: https://doi.org/10.5535/arm.250173
Objective
To translate, culturally adapt, and validate the Roland-Morris Disability Questionnaire (RMDQ) for Malay-speaking individuals with low back pain (LBP) in Malaysia.
Methods
A methodological study was conducted following established international guidelines for cross-cultural adaptation and psychometric validation. The process included forward–backward translation, expert review, content validation, face validation, and psychometric testing among individuals with LBP. Content and face validity indices were evaluated by rehabilitation professionals (n=8) and individuals with LBP (n=9). Psychometric testing was conducted with 102 participants to assess internal consistency, test-retest reliability (n=31), concurrent validity using the Malay Oswestry Disability Index, and known-groups validity.
Results
All items demonstrated excellent content and face validity (I-CVI, I-FVI, S-CVI/Ave, and S-FVI/Ave=1.00). The Malay RMDQ showed high internal consistency (Cronbach’s α=0.932) and excellent test-retest reliability (ICC=0.996). Concurrent validity with the Malay Oswestry Disability Index was moderate (r=0.742, p<0.001). A preliminary known-groups comparison showed a statistically significant difference in the Malay RMDQ scores between participants with LBP and those without LBP (p=0.03).
Conclusion
The Malay RMDQ demonstrated preliminary psychometric support, including evidence of reliability, validity, and cultural appropriateness, for assessing disability in individuals with LBP. Future research should explore its responsiveness and utility in broader populations.
  • 393 View
  • 11 Download

Review Article

Cancer rehabilitation

Enhancing Diagnostic Precision and Treatment Effectiveness Using Indocyanine Green Lymphography in Lymphedema
Hiroo Suami, Jin A Yoon
Ann Rehabil Med 2026;50(3):150-159.   Published online June 22, 2026
DOI: https://doi.org/10.5535/arm.260020
Indocyanine green (ICG) lymphography has rapidly emerged as a key imaging modality for improving the diagnosis and management of lymphedema. ICG lymphography offers superior sensitivity and detailed assessment of dermal backflow patterns, functional lymphatic channels, and collateral drainage routes. Evidence also supports its role in guiding targeted rehabilitation, including ICG-guided lymphedema treatment. Clinicians can enhance diagnostic precision and potentially improve therapeutic effectiveness by integrating ICG lymphography into clinical practice. This review summarizes current evidence on its clinical utility, highlighting how real-time visualization of superficial lymphatic pathways and lymph nodes allows for detection of dysfunction, and improved treatment planning. Future work should focus on standardizing protocols and developing quantitative metrics to expand its values in comprehensive lymphedema care.
  • 644 View
  • 41 Download

Original Articles

Spinal cord injury

Reconnecting Minds to the World: Patient Perspectives on Brain–Computer Interface After High Cervical Spinal Cord Injury
Youho Myong, Eunkyung Kim, Gain Shin, Eunseo Oh, Byung-Mo Oh
Ann Rehabil Med 2026;50(3):168-178.   Published online June 22, 2026
DOI: https://doi.org/10.5535/arm.260018
Objective
To explore the perspectives of individuals with high cervical spinal cord injury (C-SCI) regarding expectations, concerns, and desired applications of brain–computer interface (BCI).
Methods
A structured focus group interview was conducted with four individuals with chronic high cervical spinal cord injury, all with neurological levels of C4 or above. Pre- and post-interview questionnaires were administered to assess expectations, concerns, and acceptance of BCI before and after discussion. The interview was facilitated by experts in rehabilitation medicine and biomedical engineering, and qualitative data were analyzed inductively to identify key themes.
Results
Five major themes emerged: digital accessibility, offline physical activity, social interactions and psychological health, usability, and acceptance. Participants expressed strong interest in using BCI to improve digital independence, particularly for messaging, online banking, internet use, and smart home control. They also viewed BCI as a potential tool to enhance autonomy in daily activities and reduce reliance on caregivers. Most participants were open to training and, in some cases, invasive procedures; however, concerns regarding surgical safety, device maintenance, reliability, and practical usability were frequently raised. Views on the emotional and social impact of BCI varied across individuals. Questionnaire responses showed increased willingness to undergo invasive procedures after the focus group interview, while expected functional outcomes became more realistic, suggesting that structured group discussion may have shaped participants’ understanding of BCI.
Conclusion
BCI was perceived as a promising pathway to greater independence, participation, and autonomy among individuals with high C-SCI. These findings emphasize user-centered design and demonstrate how lived experience can guide assistive neurotechnology development in rehabilitation research.
  • 672 View
  • 41 Download

Physical therapy

Adding Extracorporeal Shockwave Therapy to Conventional Treatment Improves Pain, Function, and Electrophysiological Function in Females With Carpal Tunnel Syndrome: A Randomized Controlled Trial
Doha H. Al-Afify, Doaa Saeed, Fatma S. Zidan, Mina Magdy Wahba, Omnya Samy A. Ghoneim, Eman Naser Eid Sayed, Hanaa S. Mohamed
Ann Rehabil Med 2026;50(3):179-187.   Published online June 22, 2026
DOI: https://doi.org/10.5535/arm.260009
Objective
To determine whether adding extracorporeal shockwave therapy (ESWT) to conventional treatment enhances pain, function, and electrophysiological functionality in females with carpal tunnel syndrome (CTS).
Methods
One hundred females (25–40 years) diagnosed with CTS were randomly allocated to a control group that received conventional therapy and an experimental group that received the same program augmented with ESWT. Outcome measures included the symptom severity scale (SSS), function severity scale (FSS), pain intensity assessed using the visual analog scale (VAS). In addition, distal sensory latency/distal motor latency (DSL/DML), and sensory nerve conduction velocity/motor nerve conduction velocity (SNCV/MNCV) were measured using a nerve conduction velocity study.
Results
The experimental group exhibited significantly greater improvements in SSS, VAS, DSL, DML, SNCV, compared to controls (all p≤0.05). However, changes in MNCV and FSS were non-significant (p>0.05).
Conclusion
Integrating ESWT into rehabilitation enhances function, pain, and electrophysiological recovery in females with CTS.
  • 655 View
  • 26 Download

Review Articles

Pain & Musculoskeletal rehabilitation

Hormonal Shifts and Structural Strain: A Literature Review of Menopause and Perimenopause in Relation to Overuse Injuries and Stress Fractures
Mustafa Ansari, Faisal Hussain, Mutasem Shopon, Hanfa Ajmal, Mueez Asif, Sharon David
Ann Rehabil Med 2026;50(3):139-149.   Published online June 22, 2026
DOI: https://doi.org/10.5535/arm.250134
Musculoskeletal injury risk in midlife women has traditionally been attributed to estrogen decline, but this narrow focus overlooks the broader biomechanical, neuromuscular, and structural changes associated with menopause. Estrogen plays a multisystem role in maintaining trabecular bone integrity, collagen turnover, and neuromuscular coordination. Its abrupt loss causes bone demineralization (2%–5% annually in early menopause), impairs tendon repair, and contributes to sarcopenia. Fluctuating estradiol levels during perimenopause may transiently increase ligament laxity, further destabilizing joints. Common injuries such as Achilles and rotator cuff tendinopathies, plantar fasciitis, and stress fractures are amplified by low bone mineral density, prior fracture history, aromatase inhibitor use, and rapid increases in physical activity. Although early initiation of hormone replacement therapy reduces fracture risk by 20%–40%, it is not appropriate for all patients due to contraindications and individualized risk–benefit profiles. Non-hormonal strategies—including resistance training, nutritional optimization, and early screening with dual-energy X-ray absorptiometry and peripheral quantitative computed tomography—remain underutilized, particularly among marginalized populations. This structured narrative review synthesizes evidence from endocrinology, biomechanics, and musculoskeletal epidemiology to evaluate limitations in current research, including reliance on observational data, homogeneous cohorts, and technocentric approaches with limited generalizability. Future efforts should prioritize personalized, hormone-informed exercise prescriptions, biomarker-guided monitoring, and community-based prevention strategies. The prevailing estrogen-centric paradigm may benefit from a broader multidisciplinary framework integrating biological, mechanical, and social determinants of injury risk. We propose a hormone–tissue–load mismatch model that reframes menopause as a modifiable biomechanical window for injury prevention.
  • 776 View
  • 40 Download

Pediatric rehabilitation

Constraint-Induced Movement Therapy in Children With Hemiplegic Cerebral Palsy: A Scoping Review of Functional Outcomes and Neuroplasticity-Related Evidence
Maria Grazia Maggio, Maria Chiara Valeri, Raffaela Maione, Angela Militi, Alex Martino Cinnera, Irene Ciancarelli, Rocco Salvatore Calabrò, Giovanni Morone
Ann Rehabil Med 2026;50(2):94-104.   Published online April 22, 2026
DOI: https://doi.org/10.5535/arm.250165
Objective
To synthesize the available evidence on the effects of constraint-induced movement therapy (CIMT) in children with hemiplegic cerebral palsy (CP), focusing on upper limb functional outcomes and neuroplasticity-related changes assessed through direct or indirect measures.
Methods
This scoping review was conducted in accordance with PRISMA-ScR guidelines and was prospectively registered on the Open Science Framework (DOI: 10.17605/OSF.IO/DU8RE). A search of four databases (PubMed, Scopus, Embase, and Web of Science) was performed to identify studies involving children (0–18 years) with CP who received CIMT as the primary intervention. Eligible studies assessed neuroplasticity through neuroimaging or neurophysiological techniques.
Results
Eleven studies involving 221 children met the inclusion criteria. CIMT protocols varied in duration, intensity, and setting (e.g., clinical, home-based, camp-based). Across studies, CIMT was associated with improvements in upper limb function and spontaneous use. Neuroplastic changes included increased activation in the contralateral sensorimotor cortex, normalization of somatosensory responses, and structural brain adaptations. Adjunctive therapies such as repetitive transcranial magnetic stimulation, transcutaneous auricular vagus nerve stimulation, or occupational therapy further enhanced outcomes.
Conclusion
CIMT is an effective intervention that promotes cortical reorganization and improves motor function in children with hemiplegic CP. Customizing rehabilitation based on neurophysiological profiles may optimize clinical outcomes.
  • 1,651 View
  • 66 Download

Original Articles

Rehabilitation policy

Electrode Placement and Continence Outcomes in Pediatric Hirschsprung’s Disease: Rectal Versus Surface Stimulation After Trans-Anal Pull-Through Surgeries
Fathia Ahmed, Safi Ahmed, Hany Elgohary, Shymaa Salem, Enas Abutaleb, Mohamed Eldesoky
Ann Rehabil Med 2026;50(2):129-138.   Published online April 17, 2026
DOI: https://doi.org/10.5535/arm.250171
Objective
To compare the outcome of rectal and surface electrode stimulation, when performed concomitantly with routine anal sphincter (AS) exercises and bio-feedback training, in children who have received corrective surgery to address Hirschsprung disease (HD).
Methods
Sixty-seven patients (pediatric) who underwent corrective surgery due to HD were randomly assigned to Group A (rectal electrode, n=34) or Group B (surface electrode, n=33). The two groups were given the same protocols of AS and bio-feedback training. The Pediatric Quality of Life Inventory (PedsQL), Bowel Function Score (BFS), Pediatric Incontinence and Constipation Scoring System Scale (PICSS) were measured at baseline, post intervention and follow-up.
Results
There were significant improvements in both groups over time across all outcomes. PedsQL increased (d=0.42–1.28, η²p up to 0.37), BFS improved notably (d=1.21, η²p=0.35), and PICSS decreased (d up to 1.15, η²p=0.33). The greatest gains occurred from baseline to follow-up, with smaller but significant changes from post-treatment to follow-up, indicating sustained effects.
Conclusion
Electrical stimulation with rectal electrodes, combined with AS exercises and bio-feedback training, is a major way of improving bowel functioning, continence and quality of life in Hirschsprung child. Such results highlight the promise of multimodal rehabilitation and should be supported by additional multicenter studies.
  • 1,260 View
  • 36 Download

Dysphagia

Predictive Factors Associated With Dysphagia in Patients With Traumatic Brain Injury
Shu-Mei Yang, Ting-Ju Lai, Ya-Chu Hsu, Yu-Lin Lu, Hsing-Yu Chen, Hsiao-Ting Tsai, Sheng-Hao Cheng, Ming-Yen Hsiao, Meng-Ting Lin
Ann Rehabil Med 2026;50(2):117-128.   Published online April 17, 2026
DOI: https://doi.org/10.5535/arm.250157
Objective
To identify early clinical predictors associated with dysphagia and delayed swallowing recovery in patients with traumatic brain injury (TBI).
Methods
In this retrospective study, we enrolled adult TBI patients admitted to the rehabilitation unit of a tertiary medical center between June 2019 and June 2023. Data on baseline characteristics, neurological status, imaging findings, and rehabilitation-related variables were collected. Swallowing function was assessed using two indicators: (1) nasogastric (NG) tube retention and (2) the Functional Oral Intake Scale (FOIS) scores at 1, 4, and 12 weeks post-injury. Regression analyses were conducted to identify predictors associated with dysphagia and swallowing recovery.
Results
A total of 160 patients were included. At 1 week post-injury, longer intensive care unit (ICU) stay, poor initial sitting balance and use of sedative medication in ICU were associated with NG tube retention. At 4 weeks, lower initial Rancho Los Amigos Scale (RLAS) scores, immobility-related complications, longer hospitalization, and temporal lobe hematomas were associated with persistent NG tube dependence. By 12 weeks, older age, delayed ability to follow commands, and poor initial sitting balance remained associated with NG tube retention. FOIS outcomes were also associated with older age, delayed time to follow commands, impaired initial sitting balance, prolonged ICU stay, temporal lobe hematomas, lower initial RLAS scores, immobility-related complications, prolonged endotracheal tube placement and extended hospital stays.
Conclusion
Impaired cognitive status, poor physical function, immobility-related complications, and temporal lobe hematomas were key factors associated with dysphagia and delayed oral intake in individuals with TBI.
  • 1,434 View
  • 54 Download

Physical therapy

Eccentric Cycling Improves Cardiopulmonary Fitness, Respiratory Function, and Quality of Life in Chronic Kidney Disease: A Randomized Controlled Trial
Yu-Ting Huang, Hsin-Yeh Lee, Hui-Ching Cheng, Hsin-Lun Yang, Ching-Hsia Hung, Chien-Chou Su, Yu-Tzu Chang, Chien-Yao Sun, Kun-Ling Tsai
Ann Rehabil Med 2026;50(2):105-116.   Published online April 15, 2026
DOI: https://doi.org/10.5535/arm.250163
Objective
To compare the effects of eccentric cycling (ECC), concentric cycling (CON), and standard care (CTL) on cardiopulmonary capacity, respiratory health, and quality of life (QoL) in patients with chronic kidney disease (CKD).
Methods
Thirty-one CKD patients were divided into the CTL, CON, and ECC groups. The CON and ECC groups participated in 8-week, 24-session cycling programs. Outcomes were assessed through cardiopulmonary exercise tests, respiratory function tests, and the 36-Item Short Form Survey Instrument questionnaire.
Results
The ECC group achieved significant improvements in maximal oxygen uptake, while the CTL group showed a decline. For oxygen uptake efficiency slope, significant changes were observed only in the ECC group, with a group-by-time interaction effect compared to CTL. Furthermore, the ECC group demonstrated the most significant increase in diaphragm movement and a significant increase in diaphragm thickness, with comparisons indicating that ECC outperformed both CTL and CON. Regarding QoL, the ECC group exhibited significantly greater improvements in Physical Component Summary and Mental Component Summary, with statistically significant differences compared with the CTL and CON groups.
Conclusion
ECC is a low-effort, high-benefit exercise modality that significantly enhances cardiopulmonary fitness, respiratory function, and QoL in patients with CKD.
  • 1,750 View
  • 54 Download

Cardiopulmonary rehabilitation

Development and Validation of a Clinically Actionable Prediction Model for Postoperative Pulmonary Complications in Cardiac Surgery: A Focus on Modifiable Risk Factors
Ruoxi Li, Meice Tian, Chuangshi Wang, Yujia Huang, Weinan Chen, Ya Song, Bomiao Liu, Liu Du, Xue Feng
Ann Rehabil Med 2026;50(1):50-61.   Published online February 26, 2026
DOI: https://doi.org/10.5535/arm.250092
Objective
To develop and validate a clinically actionable prediction model for postoperative pulmonary complications (PPCs) in cardiac surgery patients, focusing on modifiable preoperative risk factors amenable to targeted optimization.
Methods
In this prospective observational cohort study, 492 adults undergoing open-chest cardiac surgery between August 15, 2023 and December 31, 2023 were analyzed. Prespecified predictors included gas exchange variables, pulmonary function, inspiratory muscle strength, and physical performance. Univariable and multivariable logistic regression analyses were used to develop the prediction model. Discrimination was assessed by the area under the receiver operating characteristic curve (AUC).
Results
A total of 90 patients (14.1%) developed PPCs after surgery. Five independent predictors were identified: elevated arterial PaCO2 (odds ratio [OR] 1.12, 95% confidence interval [CI] 1.00–1.26), oxygen desaturation (SpO2<93%) (OR 12.47, 95% CI 3.51–48.13), reduced gait speed (OR 0.17, 95% CI 0.04–0.71), lower FEV1/FVC ratio (OR 0.96, 95% CI 0.92–1.00), and diminished inspiratory muscle strength (MIP % predicted) (OR 0.96, 95% CI 0.92–0.99). The model demonstrated good discriminative ability with an AUC of 0.86 (95% CI 0.80–0.93) in the training cohort and 0.87 (95% CI 0.74–0.93) in the validation cohort.
Conclusion
This parsimonious model achieved high predictive accuracy using five modifiable physiological variables. By targeting abnormalities in gas exchange, pulmonary mechanics, muscle strength, and functional reserve, the model offers a practical tool to guide individualized prehabilitation strategies for reducing PPC risk in cardiac surgery patients.

Citations

Citations to this article as recorded by  
  • Preoperative Albumin Infusion Reduced Pulmonary Complications in Elderly Patients With Hypoalbuminemia Undergoing Cardiac Surgery: A Single‐Center, Randomized, Double‐Blind, Controlled Pilot Trial
    Jie Liu, Shiqiang Chen, Yunxiao Bai, Yong Lv, Yanting Wang, Zhenzhen Xu, Nianguo Dong, Qingping Wu
    MedComm.2026;[Epub]     CrossRef
  • 1,593 View
  • 24 Download
  • 1 Web of Science
  • 1 Crossref

Pain & Musculoskeletal rehabilitation

Assessment of Back Muscle Activity Using High-Density Surface Electromyography in Patients With Degenerative Thoracolumbar Kyphosis: A Preliminary Study
Yuki Kurokawa, Yuichi Nishikawa, Noriaki Yokogawa, Takaki Shimizu, Satoru Demura, Satoshi Kato
Ann Rehabil Med 2026;50(1):22-32.   Published online February 23, 2026
DOI: https://doi.org/10.5535/arm.250126
Objective
To examine back muscle activity and fatigue behavior in female patients with degenerative thoracolumbar kyphosis (DTK) using high-density surface electromyography (HDSEMG) and evaluate the effects of using a soft spinal orthosis.
Methods
Seven female participants with DTK (mean age: 73.6 years) were assessed during static standing and a weighted holding task with and without a soft spinal orthosis. HDSEMG signals were obtained from the lumbar erector spinae using a 64-electrode array. Time to fatigue (TTF), spatial displacement, and directional consistency of muscle activation were analyzed using the spatial center of activity (SCoA) and circular variance (CV).
Results
Orthosis use significantly reduced the sagittal vertical axis and low back pain. TTF was significantly prolonged during the weighted holding task with the orthosis (p=0.012), indicating delayed fatigue onset. SCoA displacement was significantly reduced in both tasks (p<0.001), whereas CV analysis demonstrated improved directional consistency of muscle activation.
Conclusion
HD-SEMG revealed early fatigue onset and unstable muscle activation patterns in patients with DTK, particularly during load-bearing tasks performed without orthotic support. Orthosis used improved endurance and neuromuscular efficiency by reducing spatial and directional variability in muscle recruitment. These findings underscore the utility of HDSEMG for elucidating the neuromuscular pathophysiology of DTK and support the use of spinal orthoses as a conservative treatment approach.
  • 1,850 View
  • 58 Download

Pain & Musculoskeletal rehabilitation

Psychometric Validation of the LBP-BSTv2 for Assessing Maladaptive Beliefs in Patients With Non-Specific Low Back Pain
Christophe Demoulin, Thibault Desjardins, Irène Salamun, Michael Norberg, Violaine Foltz, Florian Bailly, Laurent Pitance, Jean-François Kaux, Romain Artico
Ann Rehabil Med 2026;50(1):33-41.   Published online February 23, 2026
DOI: https://doi.org/10.5535/arm.250049
Objective
To assess maladaptive beliefs about low back pain (LBP), valid and reliable measurement tools are required. Although some tools exist to assess them, the Low Back Pain-related Beliefs Screening Tool (LBP-BST) was developed in order to explore all different categories of misbeliefs in individuals chronic low back pain (CLBP). This study aimed to evaluate the main psychometric properties of both the short and long versions of the revised LBPBSTv2.
Methods
A total of 108 patients with CLBP completed the LBP-BSTv2 to assess its potential floor/ceiling effects, internal consistency, and construct validity. The latter was evaluated by comparing scores with the Back Beliefs Questionnaire (BBQ). Test-retest reliability was assessed in 47 of the participants one week later.
Results
No floor or ceiling effects were observed. The short and long versions of the LBPBSTv2 showed strong construct validity, with significant correlations with BBQ scores. Internal consistency was acceptable to good (Cronbach’s alpha: 0.77–0.84), and test-retest reliability was high (intraclass correlation coefficient: 0.76–0.81).
Conclusion
The LBP-BSTv2 is a valid and reliable tool for assessing maladaptive beliefs in patients with CLBP. Its integration into clinical practice could help healthcare professionals identify and address unhelpful beliefs that may hinder rehabilitation. Further research is needed to confirm its usefulness in tracking changes over time and guiding individualized interventions and to study other psychometric properties such as responsiveness.
  • 1,584 View
  • 38 Download

Pain & Musculoskeletal rehabilitation

Impact of Social Restrictions During the Coronavirus Disease 2019 Pandemic on Functional Recovery After Musculoskeletal Surgery
Yuki Kurokawa, Satoshi Kato, Tamon Kabata, Hidenori Matsubara, Noriaki Yokogawa, Takaki Shimizu, Satoru Demura
Ann Rehabil Med 2026;50(1):12-21.   Published online February 19, 2026
DOI: https://doi.org/10.5535/arm.250137
Objective
To investigate the effects of social restrictions imposed during the coronavirus disease 2019 (COVID-19) pandemic on postoperative functional recovery in patients who underwent surgery for degenerative musculoskeletal disorders.
Methods
This longitudinal prospective cohort study included 291 patients categorized into pre-pandemic (surgery in 2018), early pandemic (2019), and late-pandemic (2020) groups based on their 1-year recovery period. The primary outcome was improvement in locomotive syndrome (LS) status 1 year after surgery. We analyzed the association between social limitations and LS improvement using multivariate logistic and segmented regression analyses.
Results
The late-pandemic group exhibited the lowest LS improvement rate (50.6%) and the highest prevalence of postoperative social contact limitations (61.0%). Multivariate analysis identified the absence of postoperative social contact limitation as a highly potent independent predictor of LS improvement (odds ratio, 10.01; 95% confidence interval, 5.40–19.34; p<0.01). Segmented regression analysis revealed a time lag: social contact limitations peaked in March 2020, whereas the decline in LS improvement rates began in October 2020.
Conclusion
Prolonged social restrictions negatively impacted functional recovery, particularly during the late phase of the pandemic. Social participation, specifically direct social contact, could be a critical and independent component of postoperative rehabilitation. These findings underscore the need to integrate psychosocial assessments into standard postoperative care to optimize patient outcomes.
  • 1,372 View
  • 35 Download

Physical therapy

Cross-Cultural Adaptation, Reliability, and Validity of Urdu Version of Örebro Musculoskeletal Pain Screening Questionnaire in Non-Specific Low Back Pain Patients
Aamer Naeem, Tanja Glucina, Muhammad Umar, Imran Khan Niazi, Imran Amjad
Ann Rehabil Med 2026;50(1):42-49.   Published online February 13, 2026
DOI: https://doi.org/10.5535/arm.250155
Objective
To translate the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) into Urdu and to determine the psychometric properties of its Urdu version.
Methods
This cross-sectional study recruited 300 participants (18–60 years) with non-specific low back pain (NSLBP), who were able to read Urdu. Test-retest reliability was assessed using intra-class correlation coefficient (ICC), and reproducibility through Cronbach’s α. Face and content validity were examined via individual interviews, and construct validity by correlating with relevant reference standards. Exploratory factor analysis (EFA) & confirmatory factor analysis (CFA) was also carried out
Results
ÖMPSQ was successfully translated into Urdu version with acceptable face and content validity. ÖMPSQ Urdu version showed acceptable internal consistency (α=0.789) & good test-retest reliability (ICC=0.784, 95% confidence interval, p<0.001) while good correlation was demonstrated between ÖMPSQ and Chronic Pain Grade Scale (pain and disability subscales i.e., r=0.809 and 0.807, respectively). However, Roland-Morris Disability Questionnaire showed moderate correlation (r=0.513). Additionally, no significant floor or ceiling effects were observed in the ÖMPSQ Urdu version. EFA revealed a five-factor solution using twenty items, 89.21% was the total item variance in the database, while CFA demonstrated good model fit with strong factor loadings and acceptable fit indices
Conclusion
The ÖMPSQ Urdu version is valid and reliable for assessing the risk of long-term disability & workplace absence in NSLBP patients.
  • 1,213 View
  • 30 Download

Dysphagia

Ultrasonographic Measurements of Tongue Thickness and Swallowing Dysfunction in Amyotrophic Lateral Sclerosis: A Feasibility Study
Min Soo Kim, Yunah Nam, Kyoung Tae Kim
Ann Rehabil Med 2026;50(1):71-79.   Published online February 13, 2026
DOI: https://doi.org/10.5535/arm.250135
Objective
To explore whether ultrasonographic measurements of tongue thickness are associated with swallowing function and related clinical domains in patients with amyotrophic lateral sclerosis (ALS), this feasibility study was conducted. Few studies have examined the usefulness of ultrasonographic tongue thickness measurement in patients with ALS, but its association with physiological measures remains unclear.
Methods
Ten patients with ALS underwent tongue thickness measurement using ultrasonography. Clinical assessments including the Korean version of the ALS Functional Rating Scale-Revised (K-ALSFRS-R), Functional Oral Intake Scale (FOIS), Eating Assessment Tool-10 (EAT-10), Dysphagia Handicap Index, Korean version of the Swallowing Quality of Life Questionnaire, Mini Nutritional Assessment–Short Form (MNA-SF), handgrip strength, and bioelectrical impedance analysis for skeletal muscle index (SMI) were performed. Swallowing physiology was evaluated using the Modified Barium Swallow Impairment Profile (MBSImP), Penetration-Aspiration Scale. Simple and partial Pearson’s correlation analyses as well as univariate regression were performed with adjustments for age, sex, and body mass index (BMI).
Results
Tongue thickness showed significant associations with multiple functional and systemic measures in the unadjusted analyses, including FOIS, EAT-10, MNA-SF, BMI, SMI, K-ALSFRS-R. After adjustment, the most consistent associations were observed with the MBSImP oral, pharyngeal, and combined phase scores.
Conclusion
Tongue ultrasonography may serve as a radiation-free method to preliminarily assess bulbar involvement in ALS. Tongue thickness was most specifically associated with dysphagia outcomes, particularly MBSImP. Given the feasibility design and small sample size, larger longitudinal studies are warranted to confirm its clinical utility in monitoring the progression of dysphagia in patients with ALS.
  • 1,422 View
  • 57 Download

Pain & Musculoskeletal rehabilitation

Differential Activation of the Multifidus and Erector Spinae During Asymmetric Spinal Stabilizing Exercise in Adolescent Idiopathic Scoliosis
Sangyoung Kim, Jee Hyun Suh, Ju Seok Ryu
Ann Rehabil Med 2026;50(1):1-11.   Published online February 11, 2026
DOI: https://doi.org/10.5535/arm.250148
Objective
To identify the asymmetric spinal stabilizing exercise (ASSE) postures that selectively activate the multifidus (Mu) relative to the erector spinae (ES) in patients with adolescent idiopathic scoliosis (AIS), thereby supporting the development of curve-specific exercise programs for three-dimensional spinal deformities.
Methods
Surface electromyography recordings were obtained bilaterally from the ES and Mu muscles during ASSE postures. Signals were normalized to the maximal voluntary isometric contraction. The asymmetry ratio, Mu/ES ratio, and additional asymmetric contraction of the Mu were analyzed.
Results
The study included 40 patients with AIS. The Mu demonstrated greater ipsilateral activation in the side-lying posture, whereas greater contralateral activation was observed during unilateral lower extremity lifting and combined upper–lower extremity lifting in the prone posture, as well as during combined upper–lower extremity lifting in the bird-dog posture. In the prone and bird-dog postures, the Mu/ES ratio exceeded 1.0, indicating relatively stronger Mu recruitment under rotational loading. Additional asymmetric contraction of the Mu was greatest in the side-lying posture (47%), with differences<15% in all other postures.
Conclusion
ASSE induces posture-specific asymmetric activation of the paraspinal muscles in patients with AIS. Although the side-lying posture produced the largest asymmetry, this reflected increased ES activity for trunk elevation rather than true selective Mu contraction. In contrast, the prone and bird-dog postures demonstrated a greater Mu contribution relative to the ES under rotational loading. These findings suggest that ASSE can be adapted to target specific paraspinal muscle components: side lying for lateral bending and bird-dog variations to enhance rotational stability.
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  • 71 Download
  • 1 Web of Science

Pediatric rehabilitation

Effectiveness of the National Health Screening Program for Infants and Children in Detecting Neurodevelopmental Disorders: A Nationwide Population-Based Analysis
Seong Woo Kim, Na Yoon Yoo, Yeji Kim, Taemi Youk, Seungbeen Hong
Ann Rehabil Med 2026;50(1):62-70.   Published online February 11, 2026
DOI: https://doi.org/10.5535/arm.250061
Objective
To evaluate the effectiveness of the National Health Screening Program for Infants and Children (NHSPIC) in the early diagnosis of neurodevelopmental disorders (NDDs) utilizing data from the National Health Insurance Database of South Korea.
Methods
We enrolled children born between 2011 and 2018 who completed the first to fourth stages of the NHSPIC. A positive finding was defined as a recommendation for further evaluation during one or more stages. Participants were categorized into the positive and negative finding groups. Following 1:1 propensity score matching, 82,138 participants were assigned to each group.
Results
Comparative analysis revealed that participants with positive findings exhibited a higher risk of developing all seven NDDs, particularly for autism spectrum disorder (hazard ratio [HR], 19.70; 95% confidence interval [CI], 17.48–22.20), intellectual disability (HR, 17.11; 95% CI, 14.69–19.93), developmental language disorder (HR, 11.74; 95% CI, 10.73– 12.84), and cerebral palsy (HR, 11.34; 95% CI, 8.67–14.84). The HR for learning disability was 4.31 (95% CI, 2.94–6.34), whereas attention-deficit hyperactivity disorder had an HR of 3.57 (95% CI, 3.37–3.78). Tic disorder had the lowest HR (HR, 1.64; 95% CI, 1.48–1.82). Additionally, HRs were calculated for each NHSPIC stage, demonstrating the utility of specific stages in the early detection of each NDD.
Conclusion
Developmental screening tests in the NHSPIC contributed to the early diagnosis of NDDs. This study underscores the significance of the NHSPIC and provides foundational evidence to inform and enhance policies related to child health screenings.
  • 1,390 View
  • 52 Download

Others

Limb Position Sense Across Multiple Proprioceptive Tasks in Healthy Adults
Seo Jung Yun, Sungwoo Park, Byung-Mo Oh, Han Gil Seo
Ann Rehabil Med 2026;50(1):80-88.   Published online February 6, 2026
DOI: https://doi.org/10.5535/arm.250105
Objective
To investigate and compare proprioception characteristics in healthy adults using different measurement methods.
Methods
Participants engaged in three tasks using a device developed to assess elbow joint proprioception: the ipsilateral matching task (IMT), contralateral matching task (CMT), and pointing task (PT). Each task was performed three times at different angles (30°, 50°, and 70°) in a randomised order for nine trials and tested for both the right and left arms. Activity level was measured using the International Physical Activity Questionnaire-Short Form.
Results
Twenty healthy adults (10 males, mean age: 39.80±12.19 years) were enrolled. The absolute error of the IMT was significantly lower than that of the CMT and PT (Bonferroni [Bonf.] p=0.029 and 0.016, respectively). PT showed a higher variable error than that of IMT and CMT (Bonf. p<0.001, and 0.040, respectively). There were no significant differences in errors across tasks based on sex or age. The total International Physical Activity Questionnaire- Short Form score showed statistically significant correlations with the absolute error (r=-.460, p=0.041) and constant error (r=-.469, p=0.037) of the CMT and variable error of the PT (r=-.478, p=0.033).
Conclusion
This study demonstrated that different proprioceptive tasks can assess the unique characteristics of proprioceptive function. The IMT produced lower error values than those of the CMT and PT, with the PT exhibiting higher variability. These differences may stem from distinct mechanisms that depend on the nature of each task and warrant further investigation.
  • 1,067 View
  • 54 Download

Case Report

Orthosis & Prosthesis

End-Effector Robot-Assisted Gait Training in Quadruple Amputees: Two Case Reports
Yeorin Kim, Yunji Oh, Seoyeon Shin, Dasom Oh, Sung Il Cho, Jihoon Jeong, Jeehyun Yoo
Ann Rehabil Med 2025;49(6):437-441.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250147
Quadruple amputation, defined as the loss of all four limbs, is an exceptionally rare condition. Conventional gait training is particularly challenging in this population because the absence of upper limbs limits the ability to grasp assistive devices that are essential for maintaining balance and stability during walking. End-effector robot-assisted gait training offers an alternative rehabilitation strategy that enables upright mobility and task-specific gait training for patients who experience substantial difficulty performing conventional gait training. This approach provides safe, repetitive, and hands-free gait training for individuals with quadruple amputation, resulting in measurable improvements in balance, ground reaction force, and functional mobility. We report two cases of successful amputee gait rehabilitation using an end-effector–type gait robot in two females (aged 72 and 51 years) with quadruple amputation.
  • 902 View
  • 40 Download

Original Articles

Pediatric / Dysphagia

Validation of the Korean Version of the Pediatric Eating Assessment Tool-10 (K-PEDI-EAT-10) with Correlation to Videofluoroscopic Swallowing Study
Sangyoung Kim, Hyung-Ik Shin, Hyun Iee Shin, Sung Eun Hyun
Ann Rehabil Med 2025;49(6):381-391.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250142
Objective
This cross-sectional pilot study aimed to translate, culturally adapt, and validate the Korean version of the Pediatric Eating Assessment Tool-10 (K-Pedi-EAT-10).
Methods
To translate, culturally adapt, and validate the Korean version of the Pediatric Eating Assessment Tool-10 (K-Pedi-EAT-10).
Results
The K-Pedi-EAT-10 demonstrated excellent internal consistency (Cronbach’s α=0.956) and strong test–retest reliability (ICC=0.988; 95% CI, 0.971–0.995). Content validity indices were high (I-CVI>0.80 for all items; S-CVI/Ave=0.92 for relevance, 0.88 for clarity). Children with dysphagia showed markedly higher K-Pedi-EAT-10 total scores (16.15±9.24) than controls (0.31±0.72; U=9.5, Z=-4.053, p<0.001), confirming discriminative validity. Higher K-Pedi-EAT-10 scores were observed in children with aspiration (Penetration-Aspiration Scale [PAS]≥6) than in those without (p<0.05). Significant correlations were found between K-Pedi-EAT-10 total and PAS scores (r=0.705, p=0.007), confirming its potential utility as a screening tool that reflects aspiration severity without radiation exposure from videofluoroscopic swallowing study. Receiver operating characteristic analysis yielded an area under the curve of 0.98 (95% CI, 0.95–1.00) and identified a cut-off score of 19 for predicting aspiration, with 100% sensitivity and 85.7% specificity.
Conclusion
The K-Pedi-EAT-10 is a reliable, valid, and non-invasive tool for screening pediatric dysphagia. Its strong psychometric performance supports its potential use for the early identification and timely intervention of children at risk for dysphagia in clinical practice.
  • 1,120 View
  • 44 Download

Pediatric rehabilitation

Effects and Predictors of Two-Person Small Group Speech Therapy in Children With Language Disorder: A Retrospective Observational Study
Chang Hee Lee, Jecheon Seong, Yun Jung Lee, Jeonghun Kim, Aram Kim
Ann Rehabil Med 2025;49(6):392-399.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250123
Objective
To investigate the effects of small group speech therapy consisting of two children in aspects of language and social development and identify powerful predictors for maximal therapeutic gains of two-person small-group speech therapy (2-SST).
Methods
We retrospectively reviewed the medical records of 51 children, who had participated in 2-SST. Language and social abilities of children were assessed using multiple scales at initial and follow-up visits after participating in 2-SST program. Receptive and expressive language were measured using the Preschool Receptive-Expressive Language Scale and the Receptive-Expressive Vocabulary Test, while social abilities were assessed with the Social Maturity Scale.
Results
Participants in the 2-SST showed significant improvements in all categories of receptive/ expressive language and social abilities. Multivariable linear regression analysis revealed that the same diagnosis and baseline receptive language ability difference and intellectual ability difference from paired-child were powerful predictors of improvement in receptive language ability. Younger age (≤5 years) was a powerful predictor of improvement in expressive language ability. Older age (>5 years) was an independent predictor of improvement in social ability.
Conclusion
The 2-SST can be an appropriate delivery model to improve language and social skills with advantages of both individual and group speech therapy. For maximal therapeutic gains of 2-SST, same diagnosis, similar language and cognitive level with paired-child, and age should be considered depending on the more specific goals of treatment.
  • 833 View
  • 54 Download

Review Article

Pain & Musculoskeletal rehabilitation

Global Overview of Acquired Upper Limb Amputation Epidemiology: A Systematic Review of Prevalence, Incidence, Level, and Etiology
Yoonjeong Choi, Eunkyung Kim, Byung-Mo Oh
Ann Rehabil Med 2025;49(6):335-359.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250106
Upper limb amputation leads to significant physical and psychosocial burden; however, it remains underrepresented in global epidemiological and rehabilitation studies. This study aimed to systematically review the global epidemiological data on upper limb amputation, focusing on its prevalence, incidence, anatomical levels, and etiology. According to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a comprehensive literature search was conducted using PubMed, Embase, Cochrane Library, and Regional Information Sharing Systems (up to May 2023). Two authors independently selected the studies, assessed their methodological quality, and summarized the evidence. Nineteen studies were finally included in this study. The prevalence of major upper limb amputation was higher in individuals with disabilities than in the general population. The prevalence in general population was 11.6 per 100,000 adults between 2006 and 2008 in Norway, whereas the prevalence in individuals with disabilities was 6.9 per 1,000 individuals in 2011 and increased to 11.3 per 1,000 individuals in 2020 in South Korea. The incidence rates were generally higher in the occupational population than in the general population. Below-elbow amputation was consistently the most common major amputation level reported. Although traumatic causes were predominant, medical conditions substantially contributed to upper limb impairment among individuals with disabilities. Upper limb amputation presents significant global variations in prevalence, incidence, anatomical level, and cause. The scarcity of standardized, disaggregated data limits effective planning for prosthetic services and rehabilitation. Future studies should prioritize comprehensive data collection to support equitable healthcare delivery and inform prosthetic innovation.

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    André Moreira, Marco Pinto, Miguel Fernandes, João Costa, Jorge Fidalgo, Alessandro Fantoni
    Machines.2026; 14(3): 355.     CrossRef
  • 3D printing and prostheses: The current state-of-the-art and future directions
    Catherine Stauffer, Nathan W. Brantly, Dylan W. Beam, Rohit Bose, Goeran Fiedler, Lee E Fisher
    Journal of Rehabilitation and Assistive Technologies Engineering.2026;[Epub]     CrossRef
  • Upper limb prostheses: a narrative review of hand, wrist, and elbow devices
    Alessio Fricano, Mattia Giuseppe Viva, Mario Vetrano, Marco Paoloni, Giuseppe Giannicola, Francesco Agostini, Giovanni Galeoto, Sveva Maria Nusca, Francescaroberta Panuccio, Irene Gennarelli, Massimiliano Murgia, Massimiliano Mangone
    Frontiers in Rehabilitation Sciences.2026;[Epub]     CrossRef
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Original Articles

Physical therapy

Cold Compression and Ischemic Preconditioning With Ice Therapy Enhance Muscle Recovery and Functionality Post-Exercise: A Randomized Study
Robert Trybulski, Adrian Kużdżał, Andryi Vovkanych, Yaroslav Svyshch, Gracjan Olaniszyn, Jakub Taradaj
Ann Rehabil Med 2025;49(6):411-425.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250090
Objective
To compare the immediate recovery effects of cold compression (CC) and ischemic preconditioning with ice (IPCice) on muscle recovery, this study was conducted.
Methods
Athletes were randomly assigned to CC (n=12), IPCice (n=12), or control (n=12) groups. All participants completed a fatigue-inducing jump rope protocol targeting the gastrocnemius prior to recovery interventions. CC involved 20 minutes of alternating pressure (25–75 mmHg) on the gastrocnemius muscles. IPCice involved thigh cuffs inflated to 200 mmHg (2 minutes on/off cycles for 20 minutes) with manual ice application. Thirty-six amateur mixed martial arts (MMA) athletes. Muscle pain, congestion, strength, creatine kinase, muscle stiffness, perfusion, pressure pain threshold, reactive strength index, and total quality recovery were assessed at rest, post-exercise, post-treatment, and 48 hours later.
Results
Post-treatment, CC significantly improved perfusion (p<0.001) and reduced muscle soreness in both legs compared to IPCice and control (p≤0.02). CC also resulted in significantly higher PPT values (p≤0.006). Benefits on some variables remained at 48 hours.
Conclusion
Both modalities enhanced recovery following fatiguing exercise; however, CC demonstrated superior effectiveness in attenuating fatigue-related impairments, particularly in perfusion, soreness, and muscle function, highlighting its practical advantage over IPCice for MMA athletes.
  • 1,785 View
  • 73 Download

Geriatric rehabilitation

Psychometric Properties of the Balance Self-Efficacy Scale in People With Stroke
Peiming Chen, Shamay S.M. Ng, Yee Lam Cheung, Hin Yam Hong, Sui Hin Law, Cynthia Y.Y. Lai
Ann Rehabil Med 2025;49(6):400-410.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250080
Objective
To investigate the psychometric properties of the balance self-efficacy (BSE) scale in people with stroke.
Methods
This is a cross-sectional study held in a university-based rehabilitation center. Sixty- three people with stroke and 30 healthy older adults were included from the community dwelling. The people with stroke underwent the following assessments in a random order: the BSE, Fugl-Meyer Assessment of Lower Extremity (FMA-LE), muscle strength of plantar flexors and dorsiflexors, Montreal Cognitive Assessment, Berg Balance Scale, Limit of Stability (LOS), Foot and Ankle Ability Measure (FAAM), 12-Item Short Form Survey (SF-12) version 2, and Oxford Participation and Activities Questionnaire (Ox-PAQ). The healthy older adults were assessed with BSE.
Results
The BSE scale demonstrated good test-retest reliability (intraclass correlation coefficient= 0.796) with minimal detectable change at a 95% confidence interval of 433.74 and cut-off score of 1,225, which best differentiated between people with stroke and healthy older adults. The BSE score was significantly correlated with the FMA-LE score, muscle strength of the affected side ankle dorsiflexor and plantar flexor, LOS parameter, FAAM, SF- 12, and Ox-PAQ scores.
Conclusion
The BSE scale is a reliable clinical tool with good test-retest reliability. The BSE scores were significantly correlated with other outcome measures that assess motor functions, balance, and quality of life. It is a simple and easy-to-administer outcome measure for assessing BSE in people with stroke.
  • 850 View
  • 37 Download

Orthosis & Prosthesis

Elastic Ankle Support Devices Effectively Promoted Walking Ability and Mobility of Ambulatory Individuals With Stroke
Thaksin Chanata, Wilairat Namwong, Thiwabhorn Thaweewanakij, Arpassanan Wiyanad, Pipatana Amatachaya, Sugalya Amatachaya
Ann Rehabil Med 2025;49(6):426-436.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250077
Objective
To compare the walking ability, mobility, and satisfaction among 24 ambulatory participants with stroke while walking under four conditions: without an ankle support device (ASD), with a plastic ankle-foot orthosis (AFO), and with two types of elastic ASDs— namely, a long ankle sling made from a 3- to 4-inch bandage, and elastic ankle support equipment (EASE) made from elastic bands with buttonholes and rivet buttons.
Methods
This crossover design study assessed spatiotemporal gait variables and mobility using the Timed Up and Go test (TUG) while participants walked under the four conditions in random order. They then completed a self-report questionnaire regarding satisfaction with the three ASDs. The findings were compared using the Friedman and Wilcoxon signed rank test.
Results
The participants’ spatiotemporal and TUG data improved significantly when walking with a long ankle sling and EASE compared to the other two conditions (p<0.05). Participants satisfied with the dimensions, weight, safety, security, and effectiveness of the long ankle sling and EASE (p<0.001). The EASE was also comfortable and easy to adjust, whereas the AFO was noted for its durability (p<0.01).
Conclusion
With the design to promote mobility during both the swing and stance phases, the present findings support the clinical benefits of elastic ASDs, specifically a long ankle sling and EASE. The EASE is also user-friendly; thus, it can be applied in various clinical and community settings, particularly in those with limited budget.
  • 1,025 View
  • 91 Download

Brain disorders

Artificial Intelligence-Guided Mobile Telerehabilitation for Individuals With Cognitive Impairment: A Feasibility Study
Suebeen Kim, Doo Young Kim, Si-Woon Park, Namo Jeon, Taeksoo Jeong, Min-Soo Kang, Sangwook Park
Ann Rehabil Med 2025;49(6):371-380.   Published online December 31, 2025
DOI: https://doi.org/10.5535/arm.250060
Objective
To test the feasibility and usability of an artificial intelligence (AI)-guided mobile cognitive telerehabilitation program for patients with stroke or older adults with mild cognitive impairment (MCI).
Methods
Thirteen participants with cognitive impairment (Mini-Mental State Examination [MMSE] score≤26; nine with stroke and four with MCI) were enrolled in the study. Each participant was provided with an AI-guided mobile cognitive rehabilitation program (Zenicog®). Participants were instructed to complete 24 sessions within 6 weeks, and those with sufficient adherence (≥70%, 17 sessions) were included in the analysis. Cognitive assessments included the MMSE, digit span, and Trail Making Tests A & B. The usability questionnaire investigated equitable use and flexibility in use, simple and intuitive use, perceptible information, tolerance for error, low physical effort, size and space for use, overall product quality, overall satisfaction.
Results
Eleven participants completed the study, and 10 participants met adherence criteria. The MMSE score increased significantly from 24.00 [21.00, 25.75] at baseline to 27.50 [26.00, 28.75] after intervention. The overall product quality (Likert scale: 1–5) score was 4.00±0.87. The lowest score in the usability questionnaire was for tolerance for error. Female participants and participants with <12 years’ education gave lower scores for tolerance for error and equitable/ flexibility in use, respectively.
Conclusion
The AI-guided mobile cognitive telerehabilitation program is feasible and potentially beneficial for improving cognitive function in patients with stroke or older adults with MCI. Individuals who are less familiar with electronic devices require special consideration to improve their usability.

Citations

Citations to this article as recorded by  
  • AI-driven telerehabilitation for older adults with mild cognitive impairment: a randomized controlled trial
    Minsong Kim, Doo Young Kim, Taeksoo Jeong, Si-Woon Park
    Frontiers in Neurology.2026;[Epub]     CrossRef
  • 1,546 View
  • 89 Download
  • 1 Web of Science
  • 1 Crossref

Brain disorders

Objective
To compare the effects of high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) on cardiovascular function, gait ability, and hematological variables in chronic stroke survivors.
Methods
Twenty-nine higher-functioning, ambulatory chronic stroke survivors were randomized to HIIT (n=15) or MICT (n=14). Participants underwent supervised training three times weekly for six weeks, consisting of 30 minutes conventional therapy followed by 40 minutes aerobic exercise (HIIT: six 1-minute high-intensity intervals at 80%–100% maximum heart rate (HRmax) with 4-minute active recovery; MICT: continuous exercise at 60%–80% HRmax). Outcomes included cardiovascular function (maximal oxygen uptake [VO2max], HRmax, walking heart rate), gait (10-Meter Walk Test, Timed Up and Go test, 6-Minute Walk Test), and lipid profiles (low-density lipoprotein, high-density lipoprotein, triglycerides).
Results
In this higher-functioning cohort (n=29), HIIT showed significantly greater improvements than MICT in VO2max (F=40.574, p=0.001), HR_max (F=24.661, p=0.001), walking heart rate (F=11.277, p=0.002), 10-Meter Walk Test (F=20.865, p=0.001), Timed Up and Go test (F=12.317, p=0.002), and 6-Minute Walk Test (F=9.742, p=0.004). Lipid profiles improved significantly within the HIIT group only (p<0.05), no between-group differences were observed.
Conclusion
In higher-functioning chronic stroke survivors, HIIT was superior to MICT for cardiovascular fitness and functional mobility under a matched exposure; lipid changes occurred within HIIT only without between-group effects. These findings support incorporating HIIT into stroke rehabilitation programs to enhance recovery outcomes.

Citations

Citations to this article as recorded by  
  • High-Intensity Interval Training on Cardiorespiratory Fitness, Cognitive Function, and Functional Capacity in Adults with Stroke: A Systematic Review and Meta-Analysis
    Javier Cano-Sánchez, Raquel Fábrega-Cuadros, Yulieth Rivas-Campo, Camila Perafan-Grajales, María del Carmen Carcelén-Fraile, Juan Miguel Muñoz-Perete
    Journal of Clinical Medicine.2026; 15(13): 4977.     CrossRef
  • 1,446 View
  • 133 Download
  • 1 Web of Science
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Review Article

Pediatric rehabilitation

Assessment and Management of Adolescent Idiopathic Scoliosis: From the Perspective of a Physiatrist
Yang-Chin Su, Chi-Kuang Feng, Tsui-Fen Yang
Ann Rehabil Med 2025;49(5):263-278.   Published online October 31, 2025
DOI: https://doi.org/10.5535/arm.250097
Adolescent idiopathic scoliosis (AIS) is the most encountered spinal deformity in growing children, which may bring significant impacts on patients’ physical function, appearance, and overall quality of life. A physiatrist plays a crucial role in the early diagnosis of AIS and longitudinal management through continuous care. Contemporary management for AIS is according to the skeletal maturity, the magnitude of the spinal curves, and the risk of progression. For mild curves, therapeutic exercises, particularly physiotherapeutic scoliosis-specific exercises (PSSE), are employed as a conservative approach to improve postural symmetry and reduce the risk of curve progression. Bracing is required for moderate curves from 25 to 45 degrees in skeletally immature cases. Strict compliance with bracing is critical for therapeutic success. In cases that are rapidly progressive or in severe curves exceeding 40 to 45 degrees, spinal fusion surgery is considered the definitive treatment. Recent advancements in non-fusion and motion-preserving techniques provide alternative options to traditional fusion surgery. To protect maximal neurological function, intraoperative neurophysiological monitoring (IONM) is currently the trend for spinal deformity correction surgery. The care for AIS patients is an individualized, multidisciplinary, patient-centered, growth-sensitive approach, aiming to optimize outcomes and minimize long-term complications. This review outlines a comprehensive rehabilitation-oriented strategy for AIS patients from the perspective of a physiatrist, encompassing clinical assessment, conservative management with observation, therapeutic exercises, bracing, and further considerations in referral to spinal surgery.

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  • Evaluating the Effectiveness of sEMG Biofeedback for Posture Training and Scoliosis Management
    Yiu-Hong Wong, Mei-chun Cheung, Qi-Wen Emma Lei, Joanne Yip, Yoel A. Klug
    BioMed Research International.2026;[Epub]     CrossRef
  • Interrelationships among 3D spinal alignment variables during active self-correction in adolescents with idiopathic scoliosis
    Arkadiusz Żurawski, Sun-Young Ha
    European Spine Journal.2026;[Epub]     CrossRef
  • Three-Dimensional Surface Topography for the Assessment of Spinal Alignment: A Cross-Sectional Study of Biomechanical Correlates
    Brigitte Osser, Csongor Toth, Gyongyi Osser, Laura Ioana Bondar, Liliana-Oana Pobirci, Florin Mihai Marcu, Ramona Nicoleta Suciu, Nicoleta Anamaria Pascalau, Adina Mincic, Corina Dalia Toderescu
    Diagnostics.2026; 16(10): 1445.     CrossRef
  • Economic evaluation of school scoliosis screening in Gannan Tibetan autonomous prefecture, Gansu Province: a cost-utility analysis based on decision tree-Markov model
    Shaobo Yang, Juan Wang, Peiji Miao, Chen Zhang, Jin Huang, Xiaoyun Yuan, Yanxiang Zhang, Xiaohui Dou, Zhenheng Zhang, Zhe Liu, Jianjun Duan, Xueting Xu, Jiantao Wen, Shunjun Cui, Xiaole Zhu
    Frontiers in Public Health.2026;[Epub]     CrossRef
  • Comment on “Automatic radiation-free evaluation of Cobb angle for spinal curvature based on fringe projection profilometry and deep learning technology”
    Y. M. Manu, Suresha Devaraju, B. M. Praveen
    Spine Deformity.2026;[Epub]     CrossRef
  • Factors Associated With Follow-Up Attendance After School Scoliosis Screening: A Pilot Cross-Sectional Study
    Takuya Nagai, Syuji Kurogi, Kiyoshi Higa, Shota Amano, Takayuki Matsumoto, Takumi Takahashi, Naosuke Kamei
    Cureus.2026;[Epub]     CrossRef
  • 6,979 View
  • 125 Download
  • 5 Web of Science
  • 6 Crossref

Original Articles

Cardiopulmonary rehabilitation

Comparison of Center-Based and Tele-Cardiac Rehabilitation in Coronary Artery Disease: Effects on Functional Capacity, QoL, and Kinesiophobia
Nihan Burhandağ Solhan, Levent Karataş, Ayça Utkan Karasu, İlknur Onurlu, Salih Topal, Nesrin Demirsoy
Ann Rehabil Med 2025;49(5):310-322.   Published online October 31, 2025
DOI: https://doi.org/10.5535/arm.250086
Objective
To compare the efficacy, safety, and patient compliance of tele-cardiac rehabilitation (T-CR) versus center-based cardiac rehabilitation (C-CR) in patients with coronary artery disease (CAD). A secondary aim was to assess the effects of both interventions on quality of life (QoL) and kinesiophobia.
Methods
This nonrandomized, patient-preference controlled trial included 40 CAD patients (83% post-myocardial infarction) at a university hospital. Participants selected either C-CR or T-CR. The four-week intervention included supervised in-hospital exercise (C-CR) or telemonitored exercise with heart rate feedback (T-CR). The primary outcome was peak oxygen uptake (VO2 peak). Secondary outcomes included VO2 at ventilatory anaerobic threshold (VO2 at VAT), time to VAT, oxygen pulse, QoL, Fear of Activity in Patients with Coronary Artery Disease (Fact-CAD) scores, and exercise adherence.
Results
Baseline VO2 peak was higher in the T-CR group (23.2±3.5 vs. 19.4±4.2, p=0.004). Rehabilitation improved VO2 peak (p<0.001), VO2 at VAT (p=0.004), and time to VAT (p<0.001) in both groups. Fact-CAD scores decreased (p=0.004), and QoL improved (p<0.001). However, C-CR led to greater kinesiophobia reduction (p=0.038) and slightly higher QoL improvements (p=0.05). T-CR participants completed more exercise sessions (14.9±2.9 vs. 12.0±0, p<0.001), with no serious adverse events reported.
Conclusion
T-CR is a safe and effective alternative to C-CR, providing similar physiological benefits. However, C-CR may be superior in reducing kinesiophobia. Future studies should assess long-term adherence and psychological outcomes in diverse populations.

Citations

Citations to this article as recorded by  
  • Intervention to improve kinesiophobia in patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials
    Lingqiao Gong, Panpan Xu, Xue Chen, Yue Kuang, Hong Tang
    BMC Cardiovascular Disorders.2026;[Epub]     CrossRef
  • 2,382 View
  • 65 Download
  • 1 Web of Science
  • 1 Crossref

Spinal cord injury

Factors Affecting Subjective Vitality and Mental Health After Spinal Cord Injury: A Cross-Sectional Study
Onyoo Kim, Jin-cheol Lim, Jinhee Jeong
Ann Rehabil Med 2025;49(5):290-301.   Published online October 31, 2025
DOI: https://doi.org/10.5535/arm.250044
Objective
To explore subjective vitality and mental health among individuals with spinal cord injury (SCI) in South Korea; specifically the relationship between subjective vitality and mental health and their associations with SCI-related factors, including health conditions, activity, environmental, and personal factors.
Methods
This cross-sectional study utilized data from the International Spinal Cord Injury Community Survey conducted in South Korea between March and October 2017. Data from 688 community-dwelling individuals with SCI were included in this study. Correlation and multiple regression analyses were conducted to investigate the relationships between vitality, mental health, and their associated factors.
Results
A strong positive correlation was identified between subjective vitality and mental health (r=0.78, p<0.001). In multiple regression analyses, common factors significantly associated with both domains included sleep problems, healthcare-related activities, financial burden, self-efficacy, and belongingness. Bowel problems were associated only with subjective vitality, while pressure injury and perceived social attitudes were associated only with mental health.
Conclusion
These findings highlight the importance of comprehensive approaches that address secondary health complications, promote healthcare education, and alleviate financial burdens to enhance both subjective vitality and mental health in individuals with SCI. Additionally, psychological interventions that foster belongingness and strengthen self-efficacy may further contribute to psychological well-being following SCI. Further research is needed to validate these associations and evaluate the long-term effects of such multidimensional strategies on subjective vitality and overall quality of life following SCI.

Citations

Citations to this article as recorded by  
  • Subjective Vitality and School Burnout Among Preadolescents: The Mediation Effect of Self-Efficacy
    Sayema Rahman Rathi, Sabeha Sanjana, Mahbuba Sultana
    Psychological Reports.2026;[Epub]     CrossRef
  • 2,096 View
  • 66 Download
  • 1 Web of Science
  • 1 Crossref

Pain & Musculoskeletal rehabilitation

The Advantage of Gait Pattern Assessment in Patients With Osteoarthritis Using Pearson Correlation Coefficient and SMAPE: A Case Series
Wiha Choi, Jaeho Jang, Sehoon Oh, Tae-Du Jung
Ann Rehabil Med 2025;49(5):323-333.   Published online October 31, 2025
DOI: https://doi.org/10.5535/arm.250023
Objective
To assess patient gait ability by capturing both trend and scale aspects, this study proposes a method using the Pearson correlation coefficient and symmetric mean absolute percentage error (SMAPE).
Methods
Gait patterns from three patients with hip osteoarthritis (OA) were analyzed using kinematic and kinetic data. In each case, using MAPE or Pearson correlation alone failed to provide a reliable assessment, revealing limitations in capturing the full characteristics of gait patterns.
Results
The combined use of Pearson and SMAPE effectively identified gait abnormalities across all cases. This integrated approach offered a more accurate and comprehensive evaluation than single-metric methods.
Conclusion
The findings highlight the importance of considering both trend and scale in gait analysis. The proposed dual-metric methodology overcomes the limitations of conventional and single-metric approaches, enabling a clearer understanding of gait characteristics in patients with hip OA.
  • 1,868 View
  • 60 Download

Neuromuscular disorders

Effect of Telerehabilitation Exercise Program on Sleep Quality and Fatigue in Individuals With Multiple Sclerosis
Abdulkerim Kaya, Evrim Karadağ-Saygı, Zeynep Kucukosmanoglu, Özge Keniş-Coşkun, Kadriye Ağan Yıldırım
Ann Rehabil Med 2025;49(5):302-309.   Published online October 31, 2025
DOI: https://doi.org/10.5535/arm.250010
Objective
To examine the effect of the telerehabilitation program on sleep quality and fatigue level in patients with multiple sclerosis (MS) was aimed in this study. MS is a demyelinating disease defined by various signs and symptoms that affects physical, emotional, social, and cognitive functioning. Fatigue, depression, sleep disturbance and cognitive impairment are the among common symptoms of MS.
Methods
The study implemented an individual exercise program for twice a week for 12 weeks via telerehabilitation. In the home-based video exercise group, the same exercises were given as video recordings and the patients were asked to do the exercises twice a week for 12 weeks. Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), Multiple Sclerosis Quality of Life Scale-54 and Timed 25 Foot Walk Test were used in the evaluation. The trial is registered with the number of NCT04979845 on ClinicalTrials.gov.
Results
PSQI scores changed from 5.6 (2.1) to 3.66 (2.09) in telerehabilitation group (p=0.03) while no significant change were seen in the video exercise group. Similarly FSS scores decreased from 4.37 (1.42) to 3.67 (1.68) in telerehabilitation group (p=0.04) while no significant changes were seen in the video based exercise group.
Conclusion
The telerehabilitation program is thought to be an effective and accessible non-pharmacological application that can be used in the treatment of sleep quality and fatigue in individuals with MS.

Citations

Citations to this article as recorded by  
  • Comparative efficacy of non- pharmacological interventions on sleep quality in patients with multiple sclerosis: a systematic review and network meta-analysis
    Yanping Liu, Xiaoli Zhao, Congying Luo, Ai Chen, Xiaopeng Zeng
    PeerJ.2026; 14: e20900.     CrossRef
  • FATIGUE IN MULTIPLE SCLEROSIS – MECHANISMS, DIAGNOSIS, AND TREATMENT OPTIONS
    Kornelia Kaźmierkiewicz-Makanga, Weronika Spychalska, Emilia Piotrowicz, Filip Witowicz, Julia Glińska, Aleksandra Krawczyk, Wiktoria Waldon, Paulina Sumlet, Maria Gofron, Michał Duliński
    International Journal of Innovative Technologies in Social Science.2025;[Epub]     CrossRef
  • 1,964 View
  • 53 Download
  • 1 Web of Science
  • 2 Crossref

Review Article

Pediatric rehabilitation

Management of upper limb deformities in patients with cerebral palsy is crucial, given its impact on activities of daily living, social interaction, and self-esteem. While medical management and rehabilitative therapy—including the use of assistive devices—remain the foundation of treatment, significant advancements have been made in surgical reconstruction techniques aimed at enhancing functional outcomes. Despite this, many eligible patients may miss the opportunity for surgical intervention due to limited awareness of appropriate indications, candidate selection criteria, and the availability of specialized expertise. This article provides an overview intended to guide pediatric rehabilitation physicians in recognizing common upper limb presentations in cerebral palsy, conducting appropriate assessments, selecting candidates, and understanding available surgical reconstructive options.
  • 2,723 View
  • 67 Download

Original Articles

Physical therapy

Comparing Multiple Versus Sustained Insertion Dry Needling Therapy for Myofascial Neck Pain: A Randomized Controlled Trial
Gracjan Olaniszyn, Adrian Kużdżał, Adam Kawczyński, Filip Matuszczyk, Kamil Gałęziok, Filipe Manuel Clemente, Robert Trybulski
Ann Rehabil Med 2025;49(4):208-225.   Published online August 29, 2025
DOI: https://doi.org/10.5535/arm.250052
Objective
To compare the Hong (GH) and sustained insertion (GS) dry needling methods in patients with myofascial neck pain, this experimental study was conducted.
Methods
A randomized controlled trial included 30 participants, assigned to either the GH (n=15) or GS (n=15) group. Each group received treatment on either the right or left side, with one side receiving experimental DN and the other receiving control (sham) DN. The GS method involved a single needle insertion per myofascial trigger point for one minute, while the GH method used multiple rapid needle insertions over two minutes without needle retention. Measurements were taken before therapy, 5 minutes post-DN session (post-5min), 24 hours post-session (post-24h), and 7 days post-session (post-7d). Muscle tension (MT) and muscle stiffness (MS) were measured with a myotonometer, pressure pain threshold (PPT) with an algometer, maximum isometric strength (Fmax) with a handheld dynamometer, and transcutaneous perfusion (PU) with laser Doppler flowmetry. Power Doppler Score (PDS) and minor adverse events were also recorded.
Results
Results showed that GH led to significantly higher MT and MS values at post-24h and post-7d (p<0.001). In contrast, GS showed greater PPT and Fmax at post-5min, post-24h, and post-7d (p<0.001). Additionally, GH exhibited higher PU values at post-5min and post-7d (p<0.001), while GS showed higher PDS values at post-5min and post-24h (p<0.001).
Conclusion
The GH method resulted in less favorable outcomes in terms of MT and MS, while the GS method showed superior improvements in pain relief and functional recovery.

Citations

Citations to this article as recorded by  
  • Clinical impact and relevance of dry needling site location in the management of chronic neck pain: a randomized controlled trial
    Fernando Piña-Pozo, Hermann Fricke-Comellas, Ángel Oliva Pascual-Vaca, Félix Paredes-López, Ana Isabel Hueso-Pérez, Alberto Marcos Heredia-Rizo
    Journal of Manual & Manipulative Therapy.2026; 34(4): 320.     CrossRef
  • Dry Needling Versus Kinesiotaping for Upper Trapezius Trigger Points: A Randomized Controlled Trial
    Hira Younis, Mohammad Ali Khan, Imrana Aziz
    Healer Journal of Biomedical and Health Sciences.2026; 2(1): 8.     CrossRef
  • Dry needling frequency and its effect on pain and disability in acute cervical myofascial pain: a multicenter study
    Gracjan Olaniszyn, Adrian Kużdżał, Filipe Manuel Clemente, Ana Filipa Silva, Robert Trybulski
    Annals of Physical and Rehabilitation Medicine.2026; 69(5): 102112.     CrossRef
  • 4,097 View
  • 108 Download
  • 2 Web of Science
  • 3 Crossref

Cardiopulmonary rehabilitation

Evaluation of the Psychometric Properties of the Thai Version of the Cardiac Rehabilitation Barriers Scale
Rakchanoke Kotcharoen, Kieratikan Payngulume, Teepatad Chintapanyakun
Ann Rehabil Med 2025;49(4):246-256.   Published online August 29, 2025
DOI: https://doi.org/10.5535/arm.250022
Objective
To increase participation in cardiac rehabilitation among outpatients with heart disease in Thailand. Factors contributing to low participation are poorly understood. A scale is needed to identify barriers to participation in cardiac rehabilitation. This study aimed to evaluate the psychometric properties of the newly translated Cardiac Rehabilitation Barriers Scale Thai version to justify its use in the Thai population with cardiovascular diseases.
Methods
Psychometric testing was conducted using a cross-sectional survey of 200 outpatients at a Bangkok hospital eligible for the cardiac rehabilitation program from April 2023 to mid-April 2024. Construct validity was evaluated using principal axis factor analysis and first- and second-order confirmatory factor analysis. Cronbach’s alpha assessed the scale’s internal consistency.
Results
The average age of the total sample was 62.60±12.37 years. Principal axis factoring with Oblimin rotation and Kaiser normalization extracted four components (subscales) that explained 61.8% of the cumulative percentage of variance. These were labeled work and time conflicts, lack of perceived need factors, comorbidities, and logistical barriers. Values for the confirmatory factor analysis goodness of fit indices exceeded recommended minimum thresholds. The internal consistencies for the total scale and the four components were entirely acceptable.
Conclusion
The Cardiac Rehabilitation Barriers Scale Thai version has acceptable psychometric properties for Thai outpatients with cardiovascular diseases. It may be used to identify barriers to participating in cardiac rehabilitation, promote rehabilitation attendance, and improve patient care.
  • 3,265 View
  • 79 Download

Dysphagia

Temporal and Kinematic Measurements of Hyoid Bone Excursion in Patients With Head and Neck Cancer
Sheng-Hao Cheng, Kuo-Chang Wei, Tyng-Guey Wang, Ming-Yen Hsiao
Ann Rehabil Med 2025;49(4):234-245.   Published online August 29, 2025
DOI: https://doi.org/10.5535/arm.250005
Objective
To investigate the temporal and kinematic parameters of hyoid bone excursion (HBE) in head and neck cancer (HNC) patients with and without aspiration.
Methods
Videofluoroscopic swallowing study images from 28 HNC patients were divided into aspiration and non-aspiration groups. The kinematic parameters of HBE, including displacement, instantaneous velocity, and instantaneous acceleration, as well as the timing of reaching maximal values in these parameters, were analyzed.
Results
The timings of reaching maximal horizontal (2.37±1.10 seconds vs. 1.09±1.58 seconds, p=0.010; 0.68±0.28 vs. 0.37±0.26, p=0.010 for percentage of time), vertical (1.83±2.06 seconds vs. 0.86±1.42 seconds, p=0.020) and hypotenuse instantaneous velocities (2.36±1.96 seconds vs. 0.79±1.20 seconds, p=0.006; 0.60±0.33 vs. 0.33±0.24, p=0.028 for percentage of time), as well as the timings of reaching maximal horizontal (2.22±1.50 seconds vs. 0.90±1.26 seconds, p=0.009; 0.60±0.32 vs. 0.37±0.29, p=0.041 for percentage of time), vertical (2.09±1.94 seconds vs. 0.83±1.19 seconds, p=0.003), and hypotenuse instantaneous accelerations (2.49±1.93 seconds vs. 0.81±1.24 seconds, p=0.004; 0.65±0.34 vs. 0.34±0.28, p=0.026 for percentage of time) were significantly prolonged in the aspiration group. After signal smoothing, the aspiration group exhibited delayed timing in reaching maximal horizontal instantaneous velocity (2.07±1.09 seconds vs. 0.74±1.10 seconds, p=0.004; 0.58±0.29 vs. 0.32±0.24, p=0.017 for percentage of time), as well as maximal horizontal (2.18±1.16 seconds vs. 1.12±1.46 seconds, p=0.008) and hypotenuse accelerations (2.21±2.50 seconds vs. 0.81±1.21 seconds, p=0.011). There were no significant between-group differences in other kinematic parameters, except for horizontal displacement (7.66±6.26 mm vs. 12.14±5.82 mm, p=0.042).
Conclusion
The timings of reaching maximal instantaneous velocities and accelerations of HBE, rather than the maximum values of these kinematic parameters, may be critical parameters related to aspiration in HNC patients.
  • 2,345 View
  • 45 Download

Physical therapy

Potential Effects of Computer-Based Cognitive Training on Postural Stability and Locomotion in Parkinson’s Disease Patients: A Randomized Controlled Trial
Engy BadrEldin S. Moustafa, Moshera H. Darwish, Mohammed S. El-Tamawy, Mohamed Mohamed Mazen, Nehad A. Abo-Zaid, Heba A. Khalifa
Ann Rehabil Med 2025;49(4):196-207.   Published online August 27, 2025
DOI: https://doi.org/10.5535/arm.250067
Objective
To examine the short-term and long-term effects of computer-based cognitive training on postural stability, locomotion, and cognitive performance in Parkinson’s disease (PD) patients.
Methods
Sixty-eight PD participated in this randomized-controlled trial, were randomly allocated into two groups; control group (GA) received a designed physiotherapy program for 60 minutes, and an experimental group (GB) got 30 minutes physiotherapy program as GA, along with 30 minutes of computerized cognitive training. Treatment sessions were three times/week for eight weeks. Primary outcomes were balance and spatiotemporal gait parameters; cognition was a secondary outcome. Primary and secondary measures were examined at baseline, immediately post-treatment, and three months post-treatment.
Results
From baseline to post-treatment, GB showed greater reductions in postural sway compared to GA. The mean differences in stability indices were 1.461±1.240, 0.982±1.185, and 1.006±0.982 in GB, vs. 0.581±1.503, 0.426±1.459, and 0.374±1.072 in GA. For gait parameters (gait velocity, stride length, and cadence), GB demonstrated larger improvements, with mean differences of -0.361±0.245, -0.242±0.158, and -11.606±12.628, compared to -0.155±0.254, -0.191±0.248, and -4.516±10.773 in GA. PD-Cognitive Rating Scale improved more substantially in GB (-16.091±6.978) than in GA (-1.129±4.552). These gains in postural stability, gait, and cognition were statistically significant (p<0.001) and sustained at the 3-month follow-up.
Conclusion
Computerized cognitive training as an add-on in the rehabilitation of PD is efficient in improving postural stability and locomotion, as well as the cognitive performance. The consistency of these findings for 3 months is an imperative point in the clinical course of PD patients.

Citations

Citations to this article as recorded by  
  • Efficacy of Adding Lower Extremity Weights on Balance and Gait Disturbances in Children with Ataxic Cerebral Palsy: A Randomized Controlled Trial
    Nehad A Abo-zaid, Heba A Khalifa, Tamer M Shousha, Mohamed Y Abdelsamee, Walaa E Heneidy
    NeuroRehabilitation.2026; 58(4): 579.     CrossRef
  • 3,132 View
  • 86 Download
  • 1 Web of Science
  • 1 Crossref

Physical therapy

Unilateral Vibratory Stimulation Inhibits Contralateral Spinal Anterior Horn Cells in Homonymous Muscles for the First 75 Seconds
Kenta Kunoh, Takahiro Takenaka, Daisuke Kimura, Toshiaki Suzuki
Ann Rehabil Med 2025;49(4):226-233.   Published online August 22, 2025
DOI: https://doi.org/10.5535/arm.240107
Objective
To investigate muscle tone changes over time in contralateral homonymous muscles when unilateral muscles are stimulated, using F-wave measurements, we examined whether vibratory stimulation on the contralateral homonymous muscle of the affected side may reduce spasticity, whose optimal duration remains unclear.
Methods
Vibratory stimulation was applied to the right hand of healthy adults, using parameters of 80 Hz frequency, 0.4 mm amplitude, 400 g load, and 195 seconds of duration on the abductor digiti minimi muscle. F-wave was measured in the left hand before stimulation, at seven intervals during stimulation, and immediately after.
Results
The F/M amplitude ratio decreased immediately at stimulation onset, at 30 seconds, and at 60 seconds compared to baseline. A least-squares analysis revealed a negative slope from baseline to 60 seconds (f(x)=-0.11x+1.12), while the slope became positive after 90 seconds, continuing after stimulation ended (f(x)=0.04x+0.82).
Conclusion
Unilateral vibratory stimulation may decrease excitability in the spinal anterior horn cells of the contralateral homonymous muscle for up to 75 seconds post-stimulation, suggesting a potential mechanism for spasticity management.
  • 3,292 View
  • 61 Download

Review Article

Others

Wearable Robots for Rehabilitation and Assistance of Gait: A Narrative Review
Jun Min Cha, Juntaek Hong, Jehyun Yoo, Dong-wook Rha
Ann Rehabil Med 2025;49(4):187-195.   Published online August 18, 2025
DOI: https://doi.org/10.5535/arm.250093
Wearable robotic exoskeletons have emerged as promising technologies for enhancing gait rehabilitation and providing mobility assistance in individuals with neurological and musculoskeletal disorders. This narrative review summarizes recent advances in wearable robots—including both rigid exoskeletons and soft exosuits—and evaluates their clinical application across diverse conditions such as stroke, spinal cord injury, cerebral palsy, and Parkinson’s disease. For rehabilitation purposes, these devices enable repetitive, task-specific gait training that promotes motor learning, reduces therapist burden, and facilitates improvements in walking speed, balance, and endurance. Rigid exoskeletons provide substantial joint support and are particularly effective for patients with severe gait impairments, whereas soft exosuits offer lightweight assistance suited to individuals with milder deficits or fatigue, albeit with limited capacity to deliver high-torque support. Beyond rehabilitation, wearable robots are increasingly used as assistive devices to compensate for permanent gait limitations and restore mobility in daily life. However, widespread clinical adoption remains constrained by several challenges, including a lack of standardized protocols; limited evidence from large-scale, multicenter studies; and practical issues such as device weight, comfort, and ease of use in community settings. Recent developments—such as adaptive control algorithms, volition-adaptive assistance, and artificial intelligence integration—are addressing these barriers by enabling more personalized and responsive support. With continued research investment, user-centered design, and supportive policies, wearable exoskeletons hold considerable potential to improve independence, participation, and quality of life for individuals across a broad spectrum of mobility impairments.

Citations

Citations to this article as recorded by  
  • The potential of robotics: A systematic review of neuroplastic changes following advanced lower limb rehabilitation in neurological disorders
    Rocco Salvatore Calabrò, Andrea Calderone, Laura Simoncini, Antonino Naro, Lorenzo Octavio Small Haughton, Angelo Quartarone, Carl Froilan D. Leochico
    Neuroscience & Biobehavioral Reviews.2026; 180: 106459.     CrossRef
  • A review of treatment methods for movement disorders
    Mahdi Khezri, Shakiba Afsar
    Behavioural Brain Research.2026; 500: 115979.     CrossRef
  • Transforming telemedicine through predictive, preventive, and personalized medicine (PPPM): innovations, challenges, and future directions
    Yufan Yang, Wangzheqi Zhang, Chang Liu, Haoling Zhang, Xinyu Shen, Yan Liao, Wenwen Shi, Li Gui
    EPMA Journal.2026; 17(1): 21.     CrossRef
  • Trust Isn’t Binary: Analysis of User Sentiment for Assistive Human–Robot Interaction
    Randyll Pandohie, Edgard M. Maboudou-Tchao, Nihad Habizada, Morris Beato, Aman Behal
    Machines.2026; 14(5): 488.     CrossRef
  • A Soft Wheel Robotic Cane for Light Mobility Disabilities
    Tomás Ferreira, João Silva Sequeira, Isabel Marques Santos, Ana Marques Oliveira
    Actuators.2026; 15(5): 232.     CrossRef
  • Interpretable side-aware kinematic-sEMG gait-state representations relevant to adaptive neurorobotic assistance after stroke: a public-dataset study
    Rocco Salvatore Calabrò, Andrea Calderone, Alessio Baricich, Andrea Santamato, Francesca Antonia Arcadi, Alessandro Marco De Nunzio, Angelo Quartarone
    Frontiers in Neurorobotics.2026;[Epub]     CrossRef
  • Design and analysis of lower limb rehabilitation exoskeleton based on pneumatic artificial muscle
    Tianhong Luo, Xiangyu Ma, Tianhao Feng, Yuan Li, Changdeng Hou
    Smart Materials and Structures.2026; 35(6): 065003.     CrossRef
  • Artificial Intelligence and Robotics in Geriatric Practice: Clinical Applications, Benefits, and Challenges
    Vipin Patidar, Laxmi Kant Goyal, Rakhi Gaur, Shiv Kumar Mudgal
    Journal of the Indian Academy of Geriatrics.2026; 22(2): 105.     CrossRef
  • Design, Simulation and Optimization of a Novel Knee-Rehabilitation Mechanism with Passive-Self-Alignment Segmented Redundant Joints for Stroke Patients
    Meng Gao, Hujiang Wang, Yaqi Wang, Da Jiang, Wen Zhang, Wentao Feng, Fuqun Zhao
    Electronics.2026; 15(13): 2878.     CrossRef
  • Adaptive observer-based integral sliding-mode control for performance-bounded knee rehabilitation exoskeleton tracking
    Hongyun Jia, Yifan Liu, Lina Hao
    Physica Scripta.2026; 101(26): 265005.     CrossRef
  • Comparative Efficacy of Robotic-assisted versus Conventional Orthotic Therapies in Cerebral Palsy Rehabilitation: A Narrative Review
    Rajesh Kumar Mohanty
    The Journal of Inclusion and Disability – Research, Neuro Rehabilitation and Empowerment.2026; 2(1): 41.     CrossRef
  • Effects of a Wearable Hip Exoskeleton on Gait Performance in Patients After Hip Surgery
    Hojin Choi, Sunghoon Jung
    Journal of Musculoskeletal Science and Technology.2026; 10(1): 52.     CrossRef
  • Neuroplasticity-Driven Rehabilitation Strategies in Disability-Related Locomotor Disorders: A ClinicalTrials.gov-Based Analysis
    Nasser M. Alorfi, Fahad S. Alshehri, Nouf M. Alourfi, Wajid Syed
    Journal of Disability Research.2026;[Epub]     CrossRef
  • Influence of Rehabilitation Aid Use on Obstacle Height During Gait in Patients with Foot Drop: A Case Series Study
    Joonsung Park, Himchan Shim, Changho Jang, Hanyang Yin, Jongbin Kim
    Healthcare.2025; 13(22): 2984.     CrossRef
  • A Wearable System for Knee Osteoarthritis: Based on Multimodal Physiological Signal Assessment and Intelligent Rehabilitation
    Jingyi Hu, Shuyi Wang, Yichun Shen, Xinrong Miao
    Sensors.2025; 25(23): 7334.     CrossRef
  • Ethical Horizons in Robotic Rehabilitation: Ensuring Safe AI Use Under the EU AI Act
    Rocco Salvatore Calabrò
    Medical Sciences.2025; 13(4): 317.     CrossRef
  • 11,254 View
  • 308 Download
  • 11 Web of Science
  • 16 Crossref

Clinical Practice Guideline

Clinical Practice Guidelines for Diagnosis and Non-Surgical Treatment of Primary Frozen Shoulder
Byung Chan Lee, Beom Suk Kim, Byeong-Ju Lee, Chang-Won Moon, Chul-Hyun Park, Dong Hwan Kim, Dong Hwan Yun, Donghwi Park, Doo Young Kim, Du Hwan Kim, Gi-Wook Kim, Hyun Jung Kim, Il-Young Jung, In Jong Kim, Jae Hyeon Park, Jae-Hyun Lee, Jaeki Ahn, Jae-Young Lim, Jin A Yoon, Jong Hwa Lee, Jong-Moon Hwang, Keewon Kim, Kyeong Eun Uhm, Kyoung Hyo Choi, Kyung Eun Nam, Kyunghoon Min, Min Cheol Chang, Myung Woo Park, Nackhwan Kim, Hyeng-Kyu Park, Seong Hun Kim, Seoyon Yang, Sun Jae Won, Sung Gyu Moon, Sung Joon Chung, Sungju Jee, Woo Hyung Lee, Yong Bok Park, Yoonju Na, Yu Hui Won, Yu Jin Im, Yu Sung Yoon, Yun Jung Lee, Yunsoo Soh, Jae-Young Han
Ann Rehabil Med 2025;49(3):113-138.   Published online June 30, 2025
DOI: https://doi.org/10.5535/arm.250057
Objective
Primary frozen shoulder causes significant pain and progressively restricts shoulder movements. Diagnosis is primarily clinically based on patient history and physical examination. Management is mainly non-invasive owing to its self-limiting clinical course. However, clinical practice guidelines for frozen shoulder have not yet been developed in Korea. The developed guidelines aim to provide evidence-based recommendations for the diagnosis and treatment of frozen shoulder.
Methods
A guideline development committee reviewed the literature from four databases (PubMed, Embase, Cochrane Library, and KMbase). Using the PICO (Population, Intervention, Comparator, and Outcome) framework, the committee formulated two backgrounds and 16 key questions to address common clinical concerns. Recommendations were made using the Grading of Recommendations, Assessment, Development, and Evaluation framework.
Results
Diabetes, thyroid disease, and dyslipidemia significantly increase the risk of developing a frozen shoulder. Although frozen shoulder is often self-limiting, some patients may experience long-term disabilities. Ultrasound and magnetic resonance imaging should be used as adjunctive tools alongside clinical diagnosis, and not as independent diagnostic methods. Noninvasive approaches, such as medications, physical modalities, exercises, electrical stimulation, and manual therapy, may reduce pain and improve shoulder function. Other noninvasive interventions have limited evidence, and their application should be based on clinical judgment. Intra-articular steroid injections are recommended for treatment, and physiotherapy or hydrodilatation with steroid injections can also be beneficial.
Conclusion
These guidelines provide evidence-based recommendations for diagnosing and treating primary frozen shoulder.

Citations

Citations to this article as recorded by  
  • Comparison of efficacy of intra-articular injection of platelet-rich plasma with bupivacaine and steroid combination in chronic shoulder pain
    Naveen Malhotra, Neha Sinha, Amit Kumar, Ritu, Disha Gupta, Naman Malhotra
    Journal of Anaesthesiology Clinical Pharmacology.2026; 42(1): 120.     CrossRef
  • Hyperlipidemia exacerbates frozen shoulder fibrosis by activating the TGF-β/Smad2/3 signaling pathway via the TBX5-TNC-Itgα2 axis
    Fan Jiang, Yi Zhang, Jinlong Ma, Tengbo Yu, Youliang Shen
    iScience.2026; 29(2): 114660.     CrossRef
  • Axillary Recess Capsular Edema Is Associated With Heterogeneity in Rehabilitation Response: Implications for a Magnetic Resonance Imaging–Based Stratified Treatment Strategy for Adhesive Capsulitis
    De-Ting Zhu, Yan-Qi Shan, Yan Wang, Chen Chen, Da-Dong Zhang, Xiu-Li Kan, Quan-Bing Zhang, Xue-Ming Li, Yun Zhou
    Archives of Physical Medicine and Rehabilitation.2026; 107(6): 1338.     CrossRef
  • Clinical efficacy of Mulligan mobilization with movement versus proprioceptive neuromuscular facilitation on pain reduction and shoulder mobility in patients with frozen shoulder
    Sylejman Miftari, Mejdi Aliu
    Health, sport, rehabilitation.2026;[Epub]     CrossRef
  • Rehabilitation of Frozen Shoulder: A Systematic Review and Meta‐Analysis of Multifactorial Interventions
    Dina Hamed-Hamed, Jose Javier Pérez Montilla, Fabrizio Brindisino, Filip Struyf, Santiago Navarro-Ledesma, Suraiya Saleem
    Pain Research and Management.2026;[Epub]     CrossRef
  • 41,159 View
  • 1,372 Download
  • 4 Web of Science
  • 5 Crossref

Original Article

Cancer rehabilitation

Effects of Home-Based Rehabilitation for Patients With Advanced Lung Cancer Undergoing Platinum-Based Chemotherapy: A Randomized Controlled Trial
Mi Jin Hong, Yung Jin Lee, Jong Bum Park, Sin Yung Woo, Seungcheol Lee, Hokwan Ko, Ji Woong Son
Ann Rehabil Med 2025;49(3):164-174.   Published online June 20, 2025
DOI: https://doi.org/10.5535/arm.240072
Objective
To investigate the effects of a home-based rehabilitation program on physical capacity, lung function, and health-related quality of life (QOL) in patients with advanced lung cancer undergoing platinum-based chemotherapy.
Methods
Between December 2021 and December 2023, participants were randomly assigned to exercise and control groups. The exercise group engaged in a home-based exercise program, including respiratory, aerobic, and resistance training, for 60 minutes per session, three times per week, before the first tumor response evaluation. Outcome evaluations included the 6-minute walk test, spirometry to measure lung function (specifically assessing forced expiratory volume in 1 second [FEV1] and forced vital capacity, hand grip strength, and QOL assessments using the Short Form 36-Item Health Survey and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Lung Cancer Module 29. Participants were assessed at baseline, post-intervention, and followed up for 1 year.
Results
Twenty-one of the 26 participants completed the study. The control group showed a significant decrease in FEV1 (p=0.011). Delays in chemotherapy occurred in 40.0% of participants in the control group but none in the exercise group (p=0.019). Mental health showed improvement in the exercise group (p=0.041), whereas adverse effects were more common in the control group (p=0.007), according to QOL questionnaire results.
Conclusion
Home-based rehabilitation during chemotherapy may help maintain lung function, improve mental health, and reduce side effects in patients with lung cancer, warranting further research.

Citations

Citations to this article as recorded by  
  • Nurse-supported hybrid home-based pulmonary rehabilitation improves psychological distress, quality of life, and functional performance in advanced lung cancer: A randomized controlled trial
    Wei-Ling Liu, Jung-Yien Chien, Yu-Ying Lu, Kuei-Fen Liu
    European Journal of Oncology Nursing.2026; 81: 103130.     CrossRef
  • The Role of Pulmonary Rehabilitation in Inoperable Advanced Lung Cancer: A Scoping Review
    Huang Yi, Zeng Fan, Feng Lijuan, Ricardo Santiago Gomez
    European Journal of Cancer Care.2026;[Epub]     CrossRef
  • Exercise during chemotherapy or chemoradiotherapy and treatment delivery and tumor response outcomes: a scoping review
    Takuya Fukushima, Jiro Nakano, Katsuyoshi Suzuki, Keiichi Osaki, Takashi Tanaka, Taro Okayama, Junichiro Inoue, Jack B. Fu, Shinichiro Morishita
    BMC Cancer.2026;[Epub]     CrossRef
  • Construction of the central symptom cluster management program for patients with lung cancer undergoing chemotherapy: a Delphi study
    Le Zhang, Yuanyuan Luo, Dongmei Mao, Benxiang Zhu, Zhihui Yang, Cui Cui, Jingxia Miao, Lili Zhang
    BMC Nursing.2025;[Epub]     CrossRef
  • 9,684 View
  • 159 Download
  • 5 Web of Science
  • 4 Crossref

Review Articles

Pain & Musculoskeletal rehabilitation

Hand-Related Activities of Daily Living Challenges Among Individuals With Diabetic Peripheral Neuropathy: A Scoping Review
Noor Aziella Mohd Nayan, Chi-Wen Chien, Najihah Lokman, Mohammed Alrashdi, Ahmad Zamir Che Daud
Ann Rehabil Med 2025;49(3):139-151.   Published online June 19, 2025
DOI: https://doi.org/10.5535/arm.250003
Diabetic peripheral neuropathy (DPN), a common complication of type 2 diabetes mellitus, leads to sensory and motor impairments that significantly affect fine motor skills, grip strength, and dexterity, limiting daily functioning. Understanding the impact of DPN on hand-related activities of daily living (ADLs) is crucial for improving patient care and outcomes. This review employed the International Classification of Functioning, Disability, and Health (ICF) framework to assess hand function issues. A systematic search of peer-reviewed studies was conducted across multiple databases to identify research examining the impact of DPN on hand-related ADLs. The findings were categorised using relevant ICF codes linked to hand function issues. The analysis identified four major themes: (1) the impact of DPN on daily activities and participation; (2) sensory impairments affecting hand function; (3) muscle weakness and functional limitations; and (4) unaddressed areas, such as structural changes, driving, assisting others, and preparing meals. DPN was found to significantly hinder hand function, reducing independence in ADLs and overall quality of life. This review highlights the need for comprehensive assessments that address not only impairments, but also activity limitations and participation restrictions, to capture the multifaceted challenges of DPN. Developing targeted assessments tailored to the specific needs of individuals with DPN is essential for improving intervention strategies and overall quality of care.

Citations

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  • Prediction of diabetic peripheral neuropathy in type 2 diabetes using high-frequency ultrasound and shear-wave elastography of the median and tibial nerves: a nomogram study
    Kunbin Wu, Jiaying Wang, Wenting Jiang, Xiaohan Cai, Lu Huang, Boyu She, Menglu Song, Zhenhan Lai, Guorong Lyu
    European Journal of Medical Research.2026;[Epub]     CrossRef
  • Rehabilitation interventions for upper limb dysfunction in type 2 diabetes mellitus, with or without diabetic peripheral neuropathy: a systematic review and meta-analysis
    Noor Aziella Mohd Nayan, Mohammed Alrashdi, Hakim Zulkarnaen, Setho Hadisuyatmana, Hazliza Razali, Ahmad Zamir Che Daud
    Disability and Rehabilitation.2026; : 1.     CrossRef
  • A Markerless RGB-Based Dataset of Continuous Hand Joint Kinematics in Functional Grasping Tasks
    Shubham Yadav, Jyotindra Narayan
    Data.2026; 11(6): 142.     CrossRef
  • Assessment of the Effect of Duration of Diabetes Mellitus on Dominant and Non -Dominant Hand Dexterity
    Mumtaz Gowhar, Sadaf ., Nabeela .
    International Journal of Health Sciences and Research.2026; : 100.     CrossRef
  • Hand function in immune-mediated inflammatory rheumatic diseases: assessment and rehabilitation approaches
    Umida Khojakulova, Olena Zimba, Mariusz Korkosz, Burhan Fatih Kocyigit
    Rheumatology International.2025;[Epub]     CrossRef
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Spinal cord injury

The Effects of Inspiratory Muscle Training in Individuals With Cervical Spinal Cord Injuries: A Systematic Review and Meta-Analysis
Dat Huu Tran, Ha Thi Le, Tho Thi Quynh Chu, Hung Thi Cam Pham, Anh Ngoc Van Le
Ann Rehabil Med 2025;49(3):152-163.   Published online June 17, 2025
DOI: https://doi.org/10.5535/arm.250013
Correction in: Ann Rehabil Med 2025;49(4):257
The effect of inspiratory muscle training (IMT) on cervical spinal cord injury (SCI) remains controversial. This study aimed to assess the efficacy of IMT in enhancing breathing muscle strength, pulmonary function, and quality of life (QoL) among patients with cervical SCI. A search was performed using the PubMed, Cochrane Library, Scopus, Embase, and Web of Science databases through December 2023. This review was conducted according to PRISMA guidelines and the Cochrane Library Handbook. The meta-analysis used mean differences (MDs) or standardized mean differences to pool the results. The Risk of Bias 2 and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) were used to assess the methodological quality of the included studies. This systematic review included five randomized controlled trials (202 participants). The results of the meta-analysis showed that IMT significantly improved maximal inspiratory pressure (MIP) with MD 12.13 cmH2O (95% confidence interval [CI] 4.22 to 20.03), maximal expiratory pressure (MEP) with MD 8.98 cmH2O (95% CI 6.96 to 11.00), and vital capacity (VC) with MD 0.25 L (95% CI 0.21 to 0.28). There were no significant improvements in forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and QoL. The quality of the evidence ranged from very low to moderate, owing to bias and heterogeneity. Our results showed that IMT may improve MIP, MEP, and VC, but not FEV1, FVC, or QoL, in patients with cervical SCI. Further large-scale studies are required to determine this effect’s optimal dosage and duration.

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  • Rewiring the Lung–CNS Axis After Spinal Cord Injury
    HaiRong Wu, Xiaolong Li, Wenjun Zhao, Yihan Li, Hang Zhang, Heng Yin, Xiaofeng Gu
    Journal of Inflammation Research.2026; Volume 19: 1.     CrossRef
  • Effects of whole-body vibration training on sarcopenia in older adults: a systematic review and meta-analysis of randomized controlled trials
    Jaewon Beom, Jae-Young Lim, Sang Yoon Lee
    Scientific Reports.2026;[Epub]     CrossRef
  • RESPIRATORY MUSCLE TRAINING IN SPORTS AND REHABILITATION: A LITERATURE REVIEW
    Martyna Łubianka, Wiktor Słyś
    International Journal of Innovative Technologies in Social Science.2026;[Epub]     CrossRef
  • Effects of Electrostimulation With the Laparoscopic Implantation of Neuroprosthesis Procedure Combined With Cardiorespiratory Physiotherapy on the Functional Rehabilitation of Individuals With Chronic Spinal Cord Injury: Quasirandomized Prospective Contro
    Wellington Contiero, Augusta Ribeiro Morgado, Victor Croos-Bezerra, Cristiano Soares Simões, João Angelo Ferres Brogin, Jean Faber, Nucelio Lemos
    Neuromodulation: Technology at the Neural Interface.2026;[Epub]     CrossRef
  • Determinants for improving respiratory muscle training after spinal cord injury using real-world clinical data
    Gabi Mueller, Marianne Tanner, Amelie Gruber, Sabrina Alessandri, Claudio Perret, Andreas Limacher
    Spinal Cord.2026;[Epub]     CrossRef
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Original Articles

Brain disorders

Objective
To examine the contribution of perceived upper limb function to participation and activity among community-dwelling people with chronic stroke.
Methods
A cross-sectional study was conducted with eighty-one people with stroke aged ≥50 years. The outcome measures included the Oxford Participation and Activities Questionnaire (Ox-PAQ), Arm Activity Measure (ArmA), Wolf Motor Function Test (WMFT), Timed Up and Go Test (TUG), and Geriatric Depression Scale (GDS).
Results
Correlation analyses revealed that perceived upper limb function, as measured using the ArmA, had the strongest and most significant correlations with the levels of participation and activity, as measured using the Ox-PAQ, among all of the tested variables (rs=0.35–0.59, p<0.01). Multiple linear regression analyses also showed that perceived upper limb function significantly associated the levels of participation and activity, accounting for 2.0% to 9.0% of the variance in the Ox-PAQ scores. The final model, which included TUG time, the GDS score, the WMFT score, and the ArmA score, could explain 54% and 28% of the variance in the routine activities and social engagement subscales of the Ox-PAQ, respectively. The model including the GDS score, the WMFT score, and the ArmA score explains 32% of the variance in the emotional well-being subscale of the Ox-PAQ.
Conclusion
Perceived upper limb function is a crucial determinant of participation and activity among community-dwelling people with chronic stroke. It could thus be a target component of stroke rehabilitation interventions to facilitate participation and activity after stroke.

Citations

Citations to this article as recorded by  
  • Upper Limb Capacity, Performance, and Leisure Participation in Children with Unilateral Cerebral Palsy
    Manel Abid, Isabelle Poitras, Léandre Gagné-Pelletier, Carole Rigourd, Charles Sèbiyo Batcho, Catherine Mercier
    Sensors.2025; 25(23): 7120.     CrossRef
  • 5,478 View
  • 88 Download
  • 1 Web of Science
  • 1 Crossref

Physical therapy

Effect of Extracorporeal Shock Wave Therapy on Post-Laminectomy Lumbar Epidural Fibrosis
Usama M. Rashad, Marwa Hany Abousenna, Amr K. Elsamman, Nagwa Ibrahim Rehab
Ann Rehabil Med 2025;49(2):81-90.   Published online April 30, 2025
DOI: https://doi.org/10.5535/arm.240118
Objective
To investigate the effectiveness of radial extracorporeal shock wave therapy (rESWT) on pain, lumbar range of motion (ROM) and F-wave minimal latency and F-chronodispersion in patients with post laminectomy epidural fibrosis.
Methods
Sixty patients complaining of low back pain and sciatica secondary to lumbar post laminectomy epidural fibrosis were allocated to one of the two equal groups (study and control groups). Pain intensity, lumbar ROM, and F-wave latency and F-chronodispersion were assessed pre- and posttreatment using visual analogue scale (VAS), Back ROM II device, and Neuro-MEP-Micro electromyography device, respectively.
Results
Posttreatment mean values showed statistically significant decrease in VAS mean scores in both groups, with more significant decrease posttreatment in favor of the study group. There was statistically significant increase in all lumbar ROM mean scores and statistically significant decrease in F-minimal latency and F-chronodispersion for both peroneal and tibial nerves in the study group only posttreatment. Also, the results showed that significant positive moderate correlation between VAS scores and F-chronodispersion for peroneal nerve, strong negative correlation between right side bending scores and F-wave minimal latency for peroneal nerve and moderate negative correlation between left side bending scores and F-wave minimal latency for peroneal nerve after treatment.
Conclusion
It was concluded that rESWT is a new and convenient modality, that would be beneficial if added to the conventional physical therapy protocols in managing patients with lumbar post-laminectomy epidural fibrosis.

Citations

Citations to this article as recorded by  
  • Soft-Tissue-Engineering in der Orthopädie
    Ludger Gerdesmeyer
    Die Orthopädie.2026; 55(7): 529.     CrossRef
  • 7,844 View
  • 115 Download
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Orthosis & Prosthesis

Korean Translation and Psychometric Properties of Self-Report Instrument for Mobility Measuring for Adults With Lower Limb Amputation
Jin Hong Kim, Sohye Jo, Gangpyo Lee
Ann Rehabil Med 2025;49(2):72-80.   Published online April 30, 2025
DOI: https://doi.org/10.5535/arm.240087
Objective
To assess mobility in prosthetic limb users, the Prosthetic Limb Users Survey of Mobility (PLUS-M) was developed as a brief item bank. The PLUS-M exhibits good reliability and has been translated into more than 15 languages; however, a Korean translation is not yet available. Therefore, this study translated the 44 items of PLUS-M into the Korean language and analysed the psychometric properties of the PLUS-M/Short Form 12 (PLUS-M/SF- 12) instrument through official procedures.
Methods
The process of Korean translation began with a consultation with the developer of the PLUS-M and included the first and second compatibility verification, back-translation, back-translation verification by the developer, and the final approval of the Korean version. This study tested validity using different instruments such as Activities-specific Balance Confidence scale, 2-Minute Walk Test, Timed Up and Go Test to assess various characteristics related to mobility. The translated version PLUS-M was then sent to two physical therapists working at Incheon Hospital and one prosthetist working at a Rehabilitation Engineering Center for them to assess the appropriateness of term use and understanding of the instrument.
Results
The study found excellent internal consistency and test-retest reliability of the PLUS-M/SF-12 Korean version questionnaire, indicating its reliability and predictability across repeated measurements.
Conclusion
This study provided a tool to assess the mobility of individuals with lower limb amputations.
  • 4,976 View
  • 48 Download

Brain disorders

Korean Version of the Confidence of Arm and Hand Movement Scale and Its Psychometric Properties
Hanna Kim, Yeajin Ham, Joon-Ho Shin
Ann Rehabil Med 2025;49(2):104-112.   Published online April 30, 2025
DOI: https://doi.org/10.5535/arm.240077
Objective
To investigate the impact of self-efficacy in using one’s upper limbs on the overall wellbeing of stroke patients, we developed the Korean version of the Confidence of Arm and Hand Movement (K-CAHM) scale by modifying the original CAHM to suit Korean cultural conditions.
Methods
This study was conducted from May 2022 to June 2023 at a rehabilitation hospital with 54 stroke patients. Participants with sufficient cognitive and verbal abilities were included, while those with severe comorbidities were excluded. For the translation and cultural adaptation of CAHM into Korean, permission was obtained from the original author. Two translators independently translated the questionnaire, followed by a consensus discussion and expert review to create K-CAHM version 1.0. After back-translation and further review, the final Korean version was completed. Reliability and validity were assessed using Cronbach’s alpha, intraclass correlation coefficient (ICC), exploratory factor analysis, Bland–Altman analysis, and Pearson correlation.
Results
The K-CAHM showed good reliability (Cronbach’s alpha=0.97; ICC=0.895). Bland–Altman plot analysis showed good agreement, indicating test-retest reliability. Moreover, K-CAHM showed good concurrent validity, demonstrated by its correlation with three domains of the International Classification of Functioning, Disability and Health: Fugl-Meyer assessment, the Jebsen-Taylor Hand Function Test, personal hygiene and bathing in the modified Barthel Index, and hand and stroke recovery domain in the Stroke Impact Scale.
Conclusion
The newly developed K-CAHM could complement other outcome measures, facilitating patient-centered rehabilitation in the Korean context.
  • 4,594 View
  • 50 Download

Pain & Musculoskeletal rehabilitation

Effect of Soft Surface Stepping Exercise on Physical Activity Among Community-Dwelling Elderly: A Prospective Randomized Controlled Trial
Chonticha Kaewjoho, Puttipong Poncumhak, Pacharee Manoy, Suphannika Ladawan, Narongsak Khamnon
Ann Rehabil Med 2025;49(2):91-103.   Published online April 22, 2025
DOI: https://doi.org/10.5535/arm.240119
Objective
To investigate the effects of modified stepping exercises over six weeks on functional mobility and individual lower extremity muscle strength in community-dwelling older individuals.
Methods
This prospective randomized controlled trial design was conducted in thirty-two older adults who completed a modified stepping exercises program (n=16 for soft-surface stepping exercise; n=16 for firm-surface stepping exercise). These exercises were practiced for 50 minutes/day, three days/week, over six weeks. They were assessed for their functional mobility relating to levels of independence at baseline, after 4 weeks, after 6 weeks of intervention, and at 1 month after the last intervention sessions.
Results
Both groups showed significant improvements in functional mobility, lower extremity muscle strength, and walking speed after 4 and 6 weeks of intervention, as well as at the one-month follow-up. However, the soft-surface stepping exercise group exhibited significantly greater improvements in dynamic balance (p=0.035) and lower extremity muscle strength (p=0.015) compared to the firm-surface stepping exercise group after 6 weeks of intervention. Additionally, the soft-surface group demonstrated superior gains in hip flexor (p=0.041), hip extensor (p=0.047), hip adductor (p=0.026), and hip abductor strength (p=0.046), with these enhancements maintained at the one-month follow-up.
Conclusion
Soft-surface stepping exercise that involves whole-body movements offers a promising alternative to promote independence and safety among community-dwelling older adults. This study underscores the need for future research to evaluate the sustained impact of these benefits post-intervention, particularly during a retention period following the intervention.
  • 6,028 View
  • 137 Download

Sports medicine

Squatting Posture Grading System for Screening of Limited Ankle Dorsiflexion
Ji Young Kim, Oh Kyung Lim, Ki Deok Park, Haeun Na, Ju Kang Lee
Ann Rehabil Med 2025;49(2):61-71.   Published online April 7, 2025
DOI: https://doi.org/10.5535/arm.230008
Objective
To evaluate the effectiveness of a squatting posture grading system established to screen for limited ankle dorsiflexion.
Methods
The squat posture grading system categorizes subjects’ squat posture into three grades. Grade 1 is defined as being able to maintain a squatting posture with heels on the ground in full ankle dorsiflexion without effort. Grade 2 is defined as being able to perform the same position, but unable to maintain the position for more than 5 seconds or requiring trunk and leg muscle efforts to maintain the position. Grade 3 is defined as being unable to maintain the same position and falling backwards immediately if attempted to touch the ground with heels. Next, subjects’ ankle dorsiflexion angles were directly measured in knee flexed and extended position by goniometer.
Results
Out of the 92 total subjects, 35 were in grade 1, 18 were in grade 2, and 39 were in grade 3. The average ankle dorsiflexion angle with knee flexed position were 23.13° for grade 1, 16.03° for grade 2, and 9.31° for grade 3. The average ankle dorsiflexion angle with knee extended position were 15.16° for grade 1, 7.92° for grade 2, and 3.40° for grade 3. Ankle dorsiflexion angles showed a significant decrease from grade 1 to 3 (p<0.05).
Conclusion
The squatting posture grading system defined in this study effectively graded the subjects based on the difference in their average ankle dorsiflexion angle. This system could be used as a quick screening method for limited ankle dorsiflexion.
  • 7,755 View
  • 87 Download
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