Journal of Rehabilitation Medicine

04/11/2025

JRM Newsletter November 2025

Optimizing the clinical functioning information tool (ClinFIT) in routine clinical practice: development of functional staging cutoff scores for rehabilitation provision and intensityBhasker Amatya, Adrian Martinez de la Torre , Masahiko Mukaino , Krystal Song, Melissa Selb, Gerold Stucki , Khan Far...

04/11/2025

Nelarabine-associated central nervous neurotoxicity inducing Guillain-Barre-like/myelopathy: inpatient rehabilitation and functional outcomes

Authors: Rachel M. Santiago, Grace Hartl, Cono Cirone, Laura White, Erin Y. Harmon

Nelarabine, a treatment for T-cell lymphoblastic lymphoma, can cause serious nerve damage in rare cases. This case report details the recovery of a 30-year-old woman who developed severe muscle weakness in all four limbs. Following completion of a long and intensive inpatient rehabilitation program, she regained strength and was able to return home with improved independence. Six months later, with ongoing outpatient therapies, she is still affected but has regained much of her independence in her community. Rehabilitation program details are outlined to guide rehabilitation specialists.

https://doi.org/10.2340/jrm-cc.v8.44071

03/11/2025

Influence of gait-synchronized functional electrical stimulation during exoskeleton-assisted ambulation on cardiorespiratory outcomes in individuals with incomplete spinal cord injury

Authors: Robert Voicu, Daniela B. Kuchen, Claudio Perret, Ines Bersch, Mario Widmer

People with incomplete spinal cord injury often experience reduced mobility and fitness. This study tested whether using functional electrical muscle stimulation while walking in a robotic exoskeleton would increase physical effort compared with walking with the exoskeleton without stimulation. Therefore, 11 participants walked with and without muscle stimulation using the exoskeleton. The results show that adding functional electrical stimulation while walking with a robotic exoskeleton significantly increased the amount of oxygen consumed by the body, indicating higher muscle activity. On average, oxygen consumption was increased by 6%. Heart rate and breathing also showed increases, suggesting a more intense workout. These findings are important because activating muscles more during rehabilitation may enhance gait function, weight management, and overall health in people with incomplete spinal cord injury. Our results support the use of exoskeleton therapy in combination with electrical muscle stimulation, but further research needs to evaluate the long-term impact.

https://doi.org/10.2340/jrm.v57.43423

31/10/2025

“What standard should we set?”: A qualitative study of rehabilitation professionals’ perspectives on rehabilitation needs after traumatic injuries

Authors: Emilie Isager Howe, Helene L. Søberg, Cecilie Røe, Marianne Løvstad, Nada Andelic

The aim of this study was to explore healthcare professionals’ perspectives on the rehabilitation needs of individuals with physical traumatic injuries. Rehabilitation professionals were interviewed regarding what rehabilitation services they thought the patients needed and whether current services are in line with those needs. They also reflected on reasons why services may not be in line with rehabilitation needs and ways these services can be improved. The participants specifically highlighted a need to improve rehabilitation services to individuals with traumatic injuries after they are discharged from hospital. Limited resources, lack of training and competency standards, and poor service organization were among the listed reasons for unmet rehabilitation needs. Suggestions for improvement included early assessment of needs, facilitating and strengthening the collaboration between specialized and community-based services, in addition to increased focus on rehabilitation within programmes training future rehabilitation professionals.

https://doi.org/10.2340/jrm.v57.44087

29/10/2025

Psychometric properties of the Danish version of the resilience scale for adults in individuals with acquired brain or spinal cord injury, and their family members

Authors: Karoline Yde Andersen, Anne Norup, Mia Moth Wolffbrandt, Fin Biering-Sørensen, Juan Carlos Arango-Lasprilla, Pernille Langer Soendergaard, Frederik Have Dornonville de la Cour

Acquiring a brain or spinal cord injury can have considerable impact on the person with the injury and their family members. Resilience is defined as a person’s ability to adapt and recover after facing challenges, stress, or trauma. This study examined how well the Danish version of the Resilience Scale for Adults works for people with acquired brain injury, spinal cord injury, and their family members. The scale was tested for its reliability and accuracy in measuring resilience. The Resilience Scale for Adults showed good reliability overall, but one subscale, Structured style, did not perform well. People who scored higher on resilience reported fewer symptoms of anxiety and depression. The Danish version of the Resilience Scale for Adults is a reliable tool for understanding resilience in individuals affected by acquired brain injury or spinal cord injury and their family members, except for the subscale Structured style.

https://doi.org/10.2340/jrm.v57.44078

29/10/2025

Optimizing the clinical functioning information tool (ClinFIT) in routine clinical practice: development of functional staging cutoff scores for rehabilitation provision and intensity

Authors: Bhasker Amatya, Adrian Martinez de la Torre, Masahiko Mukaino, Krystal Song, Melissa Selb, Gerold Stucki, Khan Fary

Clinical Functioning Information Tool (ClinFIT) is an instrument for clinicians to assess how health conditions affect a person’s ability to function in daily life. It provides a total raw score of 0–300, higher scores indicate greater functional impairment. This study developed cutoff scores for the ClinFIT to guide the level of rehabilitation support required for a patient in everyday rehabilitation practice. ClinFIT data from 270 adults in a rehabilitation unit were analysed at admission and discharge. Two key cutoff scores (135 and 192) were identified, dividing patients into light, moderate, and high rehabilitation intensity groups. These categories reflected differences in therapy needs and progress. This can guide clinical decision-making, help plan therapy intensity, and improve use of rehabilitation resources. This functional staging system can support more consistent and equitable rehabilitation care across different patient groups and settings.

https://doi.org/10.2340/jrm.v57.44170

29/10/2025

New clinical measures of hand and wrist proprioception: a pilot study for evaluating discriminative validity and test-retest reliability in individuals with wrist disability

Authors: Maria Sontag, Ulrik Röijezon, Christina Brogårdh, Elisabeth Ekstrand

Wrist injuries or instability can affect proprioception – the body’s ability to sense movement, position and force – leading to poorer control of hand movements and reduced joint stability. To support recovery, proprioception training is included in rehabilitation, and accurate clinical tests are needed to measure progress. This study evaluated 3 new clinical tests of proprioception in individuals with wrist disability due to trauma or instability: pointing acuity test (with eyes open and closed) and the ability to reposition the wrist-angle and reproduce grip force (with eyes closed). The tests were analysed for their ability to detect differences between injured and uninjured wrists and their reproducibility over time. The pointing acuity test with eyes closed and the wrist-angle reposition test in flexion showed the most promising results. This suggests that selected proprioception tests may support more precise clinical assessments and enable more targeted and effective rehabilitation for individuals with wrist injuries.

https://doi.org/10.2340/jrm-cc.v8.43929

27/10/2025

Muscle strength and stiffness of elbow muscles: correlation with upper limb motor functions in people with chronic stroke

Authors: Shamay S.M. Ng, Peiming Chen, Shun Hei Choi, Tung Ji Lam, Hei Yee Lau, Hing Ki Lau, Ho Yeung Law, Desmond Y.W. Lam, Cynthia Y.Y. Lai

This study investigated the strength and stiffness of elbow muscles in people who had had a stroke, compared with healthy older adults. The muscle strength and stiffness were assessed in both arms, and how well people with stroke could move and use their arms in daily life was also tested. We found that the muscles on the affected side after stroke were much weaker than on the unaffected side. However, the stiffness of the muscles was similar between the two sides. Compared with healthy people, people with stroke had weaker muscles, but similar stiffness. In summary, stronger muscles were associated with better arm movement and function in daily tasks. Muscle stiffness, however, was not clearly related to how well people could use their arms. Stroke affects muscle strength more than stiffness, and improving strength may help with better arm use in daily life.

https://doi.org/10.2340/jrm.v57.44075

27/10/2025

A comprehensive evidence-based intervention programme significantly reduces intensive care unit-acquired weakness and improves functional recovery: a retrospective analysis

Authors: Hongrui Zhu, Yueming Zhang, Yan Zhou, Hongxia Yan

When patients spend time in intensive care units, they often develop muscle weakness that makes it hard to move and care for themselves. This condition, called intensive care unit-acquired weakness, affects about 1 in 3 critically ill patients. In this study, we tested whether a comprehensive care program could help prevent and treat this weakness. The program included early physical exercises, breathing training, mental health support, and better nutrition planning. We compared 200 patients who received this special program with 220 patients who received standard intensive care unit care. Our results showed that patients in the special program were much less likely to develop severe weakness (32.5% versus 57.3%). They also got stronger faster, stayed in the hospital for shorter periods, and were better able to care for themselves when they left. This research suggests that a well-planned, multi-faceted approach to intensive care unit care can significantly improve patients' recovery and quality of life.

https://doi.org/10.2340/jrm.v57.43563

23/10/2025

Physical activity, sedentary time, and associated factors in post-COVID-19 condition: a cross-sectional study

Authors: Anna Törnberg, Anna Svensson-Raskh, Lucian Bezuidenhout, David Moulaee Conradsson, Annie Svensson, Judith Bruchfeld, Elisabeth Rydwik, Malin Nygren-Bonnier

After having COVID-19, many people continue to live with long-term symptoms, described as long COVID, that impact their everyday lives. In this study, we looked at how physically active participants with long COVID are, and how much time they spend sitting still. We used activity monitors to measure movement and sitting time. We found that many participants were not very active and spent large parts of the day being inactive. Some symptoms, such as feeling dizzy when standing up or having a racing heart, were linked to lower activity levels and more sitting time. Participants who were in better physical shape or had been more active before becoming ill tended to move more. These findings highlight the need to support people with long COVID in safely increasing their activity levels. Understanding how different symptoms affect movement can help healthcare professionals provide better, more personalized advice.

https://doi.org/10.2340/jrm.v57.43967

23/10/2025

From gains to decline: effects of structured pre-dialytic exercise training and detraining on physical fitness, quality of life, and inflammation in haemodialysis patients

Authors: Shu-Chun Huang, Ji-Tseng Fang, Yu-Chieh Huang, Chun-Yueh Lin, Ching-Chung Hsiao

People receiving maintenance haemodialysis often have low endurance, weak muscles, and reduced quality of daily life, leading to poorer health outcomes. While exercise during or on non-dialysis days has shown benefits, little is known about exercising just before dialysis. In this study, patients joined a 6-month supervised programme combining aerobic and strength exercises before dialysis. The programme improved endurance, strength, muscle mass, and quality of life. Most gains faded within 3 months after training ended, except muscle mass, which was maintained. Exercise before dialysis did not change blood markers of inflammation, suggesting minimal pro- or anti-inflammatory effects. Overall, this approach was effective, and easy to follow, providing a practical alternative to existing exercise models. Sustained strategies are needed to preserve the benefits.

https://doi.org/10.2340/jrm.v57.44067

22/10/2025

A cup half full: exploring the kinematic consequences of variations in the drinking task protocol

Authors: Justin Huber, Stacey M. Slone, Ann Stowe

Movement of the upper limb is commonly impaired after neurological injuries such as stroke. Rehabilitation is a cycle that relies on accurate assessment to guide treatments. Kinematic assessment of the upper limb involves measuring motion of the human body during movement. Kinematics of the drinking task have been recommended for use in the rehabilitation research community. However, performance of a task may depend on how the task is set up. Among prior studies, despite detailed descriptions of the drinking task setup, differences persist and their impact on kinematics is unclear. This pilot study explored how slight variations in the drinking task setup might impact kinematic assessment among 6 adults with typical neurological function. We found that every variation led to significant changes in at least 1 kinematic outcome. This suggests a need for continued refinement of the drinking task protocol to improve repeatability and to support uptake.

https://doi.org/10.2340/jrm.v57.43843