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Journal of Rehabilitation Medicine

Hem
Sverige
Uppsala
Journal of Rehabilitation Medicine

Journal of Rehabilitation Medicine (JRM) is an international, non-profit, Open Access journal, publishing articles on a broad range of topics within the field.

The journal strives to provide its readers with a variety of topics, including: functional assessment and intervention studies, clinical studies in various patient groups, methodology in physical and rehabilitation medicine, epidemiological studies on disabling conditions and reports on vocational and sociomedical aspects of rehabilitation. The journal is read by a wide group of healthcare professionals including specialists in rehabilitation medicine, neurology, clinical neurophysiology, general medicine, psychologists, physiotherapists, occupational therapists and social workers.

28/01/2026

Correlation between controlled-pressure provocative test duration and electrodiagnostic severity in carpal tunnel syndrome

Authors: Apiphan Iamchaimongkol, Khanin Leeareekun, Waree Chira-Adisai, Apisara Keesukphan

Carpal tunnel syndrome is a condition in which the median nerve in the wrist is compressed, causing symptoms like numbness and tingling. This study investigated whether the time it takes for provoked symptoms during a controlled-pressure Carpal Compression Test is related to the severity of nerve damage, classified by electrodiagnosis study in 124 hands. The results showed no significant relationship between the time to symptom appearance and the severity of carpal tunnel syndrome. These findings suggest that the duration of the wrist pressure test may not be a reliable indicator of the severity of nerve damage in carpal tunnel syndrome.

https://doi.org/10.2340/jrm.v58.44203

28/01/2026

Associations between heart rate and physical activity in people with post-COVID-19 condition accounting for myalgic encephalomyelitis/chronic fatigue syndrome symptoms

Authors: Rachel Adodo, Antonio Sarmento Da Nobrega, Rodrigo Villar, Sandra C. Webber, Diana C. Sanchez-Ramirez

This study explored the associations between heart rate and physical activity in individuals with post-COVID-19 condition accounting for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome symptoms. Tachycardia (elevated heart rate) during mild activity or at rest is common among those with post-COVID-19 condition, and understanding this relationship is important for developing effective rehabilitation strategies. The study involved 16 adults with post-COVID-19 condition (81% females, average age 51 years) who wore a Garmin smartwatch and an ActiGraph accelerometer for 4 days to track their heart rate and daily physical activity. The study found that heart rate increased with higher levels of physical activity, from sedentary to moderate-to-vigorous physical activity. However, the percentage of time spent in tachycardia was significantly lower during moderate-to-vigorous physical activity compared with sedentary periods, even after adjusting for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome symptoms. The results suggest that individuals with post-COVID-19 condition experience more tachycardia when engaging in minimal physical activity, highlighting the importance of understanding heart rate-physical activity dynamics for better managing post-COVID-19 condition rehabilitation.

https://doi.org/10.2340/jrm.v58.43340

22/01/2026

Establishing levels of arm–hand activities in stroke patients: the arm-hand-activities-scale (AHAS)

Authors: Christina Hebenstreit, Miriam Binter, Jörg Wissel, Klemens Fheodoroff

Arm–hand use is limited in more than 65% of patients after stroke. Measuring activity is important for goal setting and treatment planning but can be time consuming and difficult to understand. The Arm-Hand Activities Scale was developed as an observational scale on 5 levels to classify arm–hand activities in a simple and comprehensible way. Here we investigated whether 2 or more people have the same understanding of the levels, whether they reach a similar rating, and whether this categorization is sensitive to changes in arm and hand activities. All tests achieved good to very good results. The Arm-Hand-Activities-Scale is therefore helpful in selecting appropriate treatments.

https://doi.org/10.2340/jrm.v58.44414

15/01/2026

Real-world use of botulinum toxin-A for post-stroke spasticity in the Netherlands: a retrospective claims study

Authors: Max van Wijk, Mary Verhoeven, Thom S. Lysen, Hanne van Ballegooijen, Alexander C.H. Geurts

After a stroke, patients can experience muscle stiffness, which is known as post-stroke spasticity. Botulinum toxin-A injections are commonly used to reduce symptoms, but real-world treatment patterns are not well studied. This study examined how botulinum toxin-A is used in patients with post-stroke spasticity in the Netherlands using insurance claims from 2012–2016. Of 60,222 patients with a stroke, only 1.7% were treated with botulinum botulinum toxin-A. A total of 2,855 botulinum toxin-A claims from 890 patients (1.5% of all patients in the database) were included in this study. These patients had an average age of 63.4 years at the time of the first botulinum toxin-A injection. Patients received up to 16 treatment cycles, with an average of 2 cycles and an interval of 17 weeks between cycles. Two formulations of botulinum toxin-A were available in the Netherlands between 2012 and 2016. Most patients (76.9%) received onabotulinum toxin-A at an average dose of 290 units, while the remaining patients received abobotulinum toxin-A at an average dose of 500 units. It is important to note that the dosing recommendations for onabotulinum toxin-A and abobotulinum toxin-A differ and cannot be directly compared. This study suggests potential undertreatment of spasticity with botulinum toxin-A and suboptimal treatment adherence in the Netherlands.

https://doi.org/10.2340/jrm.v58.43952

15/01/2026

Comparison of muscular activity and metabolic response between a novel handle-based and a push-rim wheelchair in a simulated daily mobility circuit

Authors: Georgios Aronis, Sebastian Pfau, Marvin Abass, Thomas Angeli, Margit Gföhler

Push-rim wheelchairs are widely used but are associated with low energy efficiency and a high risk of upper limb overuse injuries. To address these issues, we developed a novel handle-based wheelchair aimed at reducing joint strain and improving propulsion efficiency. This study compared muscular and metabolic demands between handle-based and push-rim configurations during an everyday wheelchair course. 22 healthy, wheelchair-naive participants completed a course, including ramps, obstacle avoidance, and directional changes, using 3 wheelchair configurations: 1 handle-based and 2 push-rim setups with different wheel sizes. Electromyographic recordings and continuous cardiopulmonary data were collected. The handle-based system resulted in a redistribution of muscle activity, with reductions in several key propulsion muscles and an overall decrease in metabolic demand compared with push-rim propulsion. These findings suggest that the handle-based wheelchair may offer a more energy-efficient and joint-friendly alternative to conventional push-rim designs, with potential benefits for long-term mobility and upper limb health.

https://doi.org/10.2340/jrm.v58.44397

15/01/2026

Evolution of bowel function and quality of life after spinal cord injury: a longitudinal registry and survey study

Authors: Charlotta Josefson, Katharina Stibrant Sunnerhagen

People with spinal cord injuries often struggle with bowel function, which can greatly affect their daily lives and overall well-being. We linked medical records from Sweden’s national rehabilitation registry with a community survey of 226 adults to see how bowel problems and quality of life changed over time. At first rehabilitation, 7 out of 10 participants had bowel issues and reported lower health and mobility. After several years, nearly 30% saw improvements in bowel function, but over 40% still had ongoing problems. Those with incomplete injuries were more likely to improve. We also found that severe bowel symptoms, such as incontinence and constipation, were closely tied to poorer quality of life both early on and at follow-up. These results show that bowel care is a lasting challenge for many people after spinal cord injury and highlight the importance of early, ongoing support and treatment to enhance well-being.

https://doi.org/10.2340/jrm.v58.44175

14/01/2026

The role of a multidisciplinary team in the rehabilitation of a patient with quadruple amputation

Authors: Oleh Burii, Roman Oliinyk, Serhii Dushenko, Denys Nahornyi, Mariia Kosovska, Volodymyr Lykhach, Nataliia Soroka

https://doi.org/10.2340/jrm.v58.44843

14/01/2026

Patient satisfaction with hospital-based outpatient rehabilitation after stroke in Sweden and its association with life satisfaction and health-related quality of life: a longitudinal national register study

Authors: Anna Bråndal, Britt-Marie Stålnacke, Gudrun M. Johansson

This study investigated satisfaction with rehabilitation, and how this relates to self-reported life satisfaction and health-related quality of life in 1,068 individuals with stroke in Sweden. Using data from a national quality register, we found that most patients were satisfied with their outpatient rehabilitation in hospital settings, both directly after the rehabilitation period and 1 year later. Those who were satisfied with the rehabilitation also reported better life satisfaction and better health-related quality of life. These relationships somewhat differed depending on s*x and age, which highlights the importance of individually tailored outpatient rehabilitation after stroke.

https://doi.org/10.2340/jrm.v58.43966

14/01/2026

Impact of multidisciplinary rehabilitation on functioning and quality of life in stroke survivors: a longitudinal retrospective analysis

• Functioning and Health-Related Quality of Life (HRQoL) improved significantly more in a multidisciplinary rehabilitation setting compared with primary care rehabilitation and no rehabilitation. Improvements were measured using the modified Rankin Scale (mRS), EQ-5D, and WHODAS 2.0.
• The mRS, WHODAS 2.0, and EQ-5D showed substantial correlation with one another. Correlations were weakest at the 3-month follow-up but improved significantly over time.
• Depression was the strongest predictor of changes in HRQoL. Addressing and managing depression is critical to improving quality of life after a stroke.
• Subacute and first-year stroke follow-up should be centred on multidisciplinary rehabilitation units, which prioritize addressing health-related quality of life and life satisfaction in their care models.

Authors: Aet Ristmägi, Hannu Heikkila, Olavi Airaksinen

https://doi.org/10.2340/jrm.v58.42921

07/01/2026

Latent profile analysis of social participation in stroke survivors with limb dysfunction: a mixed-methods study

Authors: Xuan Zhou, Ying Wang, Lanshu Zhou

Stroke often causes extremity disability, significantly impacting survivors’ ability to engage in social activities. This study aimed to understand the different ways stroke survivors participated in society. We surveyed 499 stroke survivors and interviewed 16 others. We identified 4 distinct patterns: “Active Integration” (actively engaged), “Contented Conservatism” (less active but satisfied), “Cautious Conservatism” (less active and dissatisfied), and “Alienated Disengagement” (largely withdrawn). The pattern a stroke survivor fell into was influenced not just by physical function but also by age, psychological resilience, and emotional outlook – particularly whether they focused on loss or on rebuilding their life after stroke. These findings highlight that personalized support plans, tailored to an individual’s specific needs and mindset, are crucial for effectively helping stroke survivors regain social connection and improve their quality of life.

https://doi.org/10.2340/jrm.v58.44832

07/01/2026

Longitudinal assessment of lower limb muscle quantity and quality in acute stroke patients

Authors: Wataru Yamauchi, Hiroshi Akima

This study aimed to determine the onset of skeletal muscle quality deterioration after stroke and to identify factors contributing to this change. Forty stroke patients were assessed for 10 days to evaluate change in muscle thickness, i.e., muscle quantity, and echo intensity, i.e., muscle quality, using ultrasound. Echo intensity is an index of skeletal muscle quality, with higher values indicating increased intramuscular fat and connective tissue. We found that the muscle thickness of both the paretic and non-paretic limbs decreased after 10 days, but the echo intensity increased only in the paretic limb. Importantly, patients who experienced greater decreases in muscle quantity also exhibited more pronounced deterioration in muscle quality, and the extent of change in echo intensity was closely correlated with the change in muscle thickness. These findings suggest that muscle quality deteriorates rapidly following stroke, and that preventing muscle quantity loss may be key to preserving muscle quality.

https://doi.org/10.2340/jrm.v58.44630

07/01/2026

Women and men profit equally from cardiac rehabilitation: a secondary analysis of the OPTICARE RCT

Authors: Nienke ter Hoeve, Marie de Bakker, Madoka Sunamura, Jeanine E. Roeters van Lennep, Eric Boersma, Rita J.G. van den Berg-Emons

This study investigated whether women and men benefit equally from cardiac rehabilitation. We followed 147 women and 642 men who participated in cardiac rehabilitation, measuring their aerobic fitness, cardiovascular health, and mental well-being at the start, end, and 18 months after the programme. Overall, both women and men showed similar improvements, with women experiencing greater improvements in depressive symptoms. Nevertheless, women continued to have more difficulties in meeting physical activity goals and were more affected by anxiety symptoms, while men were more often not meeting their aerobic fitness targets. These findings suggest that cardiac rehabilitation programmes may need to be adjusted to better address the specific needs of both women and men.

https://doi.org/10.2340/jrm.v58.44504

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