Time Post-Stroke and Upper Extremity Stroke Motor Recovery Rehabilitation: A Meta-Analysis.

Background: Understanding the impact of timing of post-stroke motor recovery research trials is critical for clinical care.

Objective: To examine and compare differences in Fugl-Meyer Assessment Upper Extremity (FMA-UE) scores at 2 different time points post-stroke on the effectiveness of upper extremity (UE) rehabilitation interventions compared to conventional care or sham therapy controls in stroke rehabilitation randomized controlled trials (RCTs).

Methods: A meta-analysis was conducted in accordance with PRISMA guidelines.

Pregnancy after amputation: A national survey of prosthetic and mobility outcomes in women with lived experience.

Background: In pregnancy, women with limb loss or deficiency or lower extremity amputations (LEAs) may experience physiologic changes affecting mobility, prosthesis use, and/or pain. However, little is known about the pregnancy-related experiences of these women.

Objective: The objective of this research was to characterize pregnancy-related experiences including complications, impact on prosthesis use, gait aid use, and mobility for women with LEAs.

Treatments of fatigue after spinal cord injury: a systematic review and meta-analysis.

Study Design: Systematic Review and Meta-analysis.

Setting: Canada.

Objectives: Fatigue is one of the most common consequences of spinal cord injury (SCI).

Choosing Wisely in Physical Medicine and Rehabilitation: Developing Canadian Recommendations for Resource Stewardship.

Choosing Wisely Canada aims to reduce potentially harmful or unnecessary diagnostic investigations and practices in healthcare delivery. A committee of the Canadian Association of Physical Medicine & Rehabilitation surveyed the general membership seeking suggestions on new or revised Physical Medicine & Rehabilitation Choosing Wisely Canada recommendations. Draft recommendations were revised and refined with an emphasis on resource stewardship and alignment with the Choosing Wisely Canada mission.

A retrospective evaluation of patient characteristics and recommendations of a novel multidisciplinary clinic for persons with advanced disability from multiple sclerosis.

Context: Persons with advanced multiple sclerosis (MS) require care beyond the disease modifying treatments offered in conventional MS clinics to address their complex physical and psychosocial needs. In the novel MS Comprehensive and Palliative Care (MSCPC) Program, an MS neurologist, palliative care specialist, and physiatrist collaborate to identify these needs and improve symptom control.

Objectives: To characterize the medical, physical, and psychosocial concerns of persons with advanced disability from MS and describe the recommended interventions of the MSCPC Program.

Are Women Physicians Underrecognized for National Awards in Neuromuscular and Electrodiagnostic Medicine? An Observational Study.

Introduction/aims: Institutions and organizations, including the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM), have committed to embracing principles of equity, diversity, and inclusion. Notwithstanding this commitment, studies repeatedly demonstrate that women physicians are less likely to receive awards in medicine and research compared to their male counterparts. Whether women physicians are less likely to be recognized with AANEM awards is unknown.

Overview of Medical, Surgical, and Rehabilitation Outcome Measures Used in Randomized Controlled Trials of Moderate to Severe Traumatic Brain Injury.

Optimal reporting of outcomes is critical for the interpretation of research findings. This review aimed to examine the utilization of outcome measures in randomized controlled trials of moderate to severe traumatic brain injury. Systematic searches were conducted up to December 2022 in MEDLINE, PubMed, Scopus, CINAHL, Embase, and PsycINFO, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

Taking risk to heart: An evaluation of cardiometabolic risk and screening guideline adherence in outpatients with spinal cord injury.

Objectives: To evaluate cardiometabolic disease (CMD) in outpatients with spinal cord injury/disease (SCI/D). The study aims were to (1) estimate the prevalence of CMD risk factors in a cohort of Canadian adults with SCI/D; (2) assess whether the frequency of CMD screening aligns with evidence-based guidelines; and (3) gain a preliminary understanding of the barriers to CMD screening and/or treatment within a rehabilitation program setting.

Design: Quality improvement initiative involving chart review extracting the presence of and frequency of screening for four CMD risk factors (obesity, hypertension, dyslipidemia, diabetes mellitus).

An Overview of Randomized Controlled Trials Examining Prescription and Nonprescription Pharmacological Interventions for Moderate to Severe Traumatic Brain Injury.

To characterize randomized controlled trials (RCTs) of pharmacological interventions (prescription medications, nonprescription medications, and supplements) for the management of moderate to severe traumatic brain injury (MSTBI). Systematic searches were conducted in MEDLINE, PubMed, Scopus, CINAHL, EMBASE, and PsycINFO for RCTs up to December 2022 inclusive in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inclusion criteria were RCT study design; participants' mean age ≥ 18 years and ≥ 50% had MSTBI; examined ≥ 1 pharmacological intervention(s), either alone or in combination with other interventions.

Sex Differences in Moderate-to-Severe Traumatic Brain Injury Randomized Controlled Trials.

Background: Understanding sex differences among persons with moderate-to-severe traumatic brain injury (TBI) is critical to addressing the unique needs of both males and females from acute care through to rehabilitation. Epidemiological studies suggest that 7 of every 10 persons with moderate-to-severe TBI are male, with females representing about 30%-33%.

Objective: To examine the proportion of female and male individuals included in randomized controlled trials (RCTs) of interventions for moderate-to-severe TBI.

Planetary Health in Rehabilitation: A Call to Arms… and Legs, Gait Aids, and Other Equipment.

Sometimes out of necessity and sometimes out of convenience, medicine is wasteful. Resource stewardship is a critical and expanding field for reducing wasteful practices. Numerous international organizations are driving resource stewardship globally, including >20 countries worldwide participating in Choosing Wisely initiatives.

Evidence-Based Review of Randomized Controlled Trials of Interventions for the Management of Behavioral Issues in Individuals With Moderate to Severe Traumatic Brain Injury.

Objective: To present an evidence-based review of randomized controlled trials (RCTs) evaluating interventions for the management of behavioral issues post moderate to severe traumatic brain injury (MSTBI), as part of an extensive database that has been conceptualized as a living systematic review.

Methods: Systematic searches were conducted in MEDLINE, PubMed, Scopus, CINAHL, EMBASE and PsycINFO, up to and including December 2022, for articles published in the English language, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The quality of RCT was assessed using the Physiotherapy Evidence Database (PEDro) scale, and level of evidence was assigned using a modified Sackett scale.

Evidence-Based Review of Randomized Controlled Trials of Interventions for Mental Health Management Post-Moderate to Severe Traumatic Brain Injury.

Objective: To present an evidence-based review of randomized controlled trials (RCTs) evaluating interventions for mental health post-moderate to severe traumatic brain injury (post-MSTBI), as part of an extensive database that has been conceptualized as a living systematic review.

Methods: Systematic searches were conducted for RCTs published in the English language in MEDLINE, PubMed, Scopus, CINAHL, EMBASE, and PsycINFO, up to and including December 2022, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The methodological quality of RCTs was assessed using the Physiotherapy Evidence Database scale, and the level of evidence was assigned using a modified Sackett scale.

Experiences and Challenges Updating a Living Evidence-Based Review of Randomized Controlled Trials on Mental Health and Behavioral Disorders in Individuals With Moderate to Severe Traumatic Brain Injury.

Objective: To describe experiences and challenges when updating a living evidence-based review database of randomized controlled trials (RCTs) on mental health and behavioral disorders in moderate to severe traumatic brain injury (MSTBI).

Method: This commentary derives from our experience developing an extensive database of RCTs on MSTBI that has been conceptualized as a living evidence-based review. Our working group focused on mental health and behavior RCTs and reflected upon their experiences and challenges using the living systematic approach.

The Changing Prevalence of Pressure Injury among Ontarians with SCI/D at Rehabilitation Admission: Opportunities for Improvement.

Background: Despite preventability, 20-50% of patients with acute spinal cord injury/disease (SCI/D) develop hospital-acquired pressure injuries (PIs). The Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC) aimed to mitigate PI risk through patient-reported daily skin checks alongside usual care.

Methods: This quality improvement initiative utilized an interrupted time series design, encompassing adults ≥ 18 years admitted for inpatient rehabilitation across five Ontario sites from 2020 to 2023.

Mortality and discharge disposition among older adults with moderate to severe traumatic brain injury.

Purpose: This study examined the research on older adults with a moderate to severe traumatic brain injury (TBI), with a focus on mortality and discharge disposition.

Method: Systematic searches were conducted in MEDLINE, CINAHL, EMBASE and PsycINFO for studies up to April 2022 in accordance with PRISMA guidelines.

Results: 64 studies, published from 1992 to 2022, met the inclusion criteria.

Comparing Randomized Controlled Trials of Moderate to Severe Traumatic Brain Injury in Lower to Middle Income Countries Versus High Income Countries.

Outcomes from traumatic brain injury (TBI) including death differ significantly between high-, middle-, and low-income countries. Little is known, however, about differences in TBI research across the globe. The objective of this article was to examine randomized controlled trials (RCTs) of moderate-to-severe TBI in high-income countries (HICs) compared with low- and middle-income countries (LMICs), as defined by the World Bank income per capita cutoff of $13,205 US dollars.

Assessment, patient selection, and rehabilitation of nerve transfers.

Peripheral nerve injuries are common and can have a devastating effect on physical, psychological, and socioeconomic wellbeing. Peripheral nerve transfers have become the standard of care for many types of peripheral nerve injury due to their superior outcomes relative to conventional techniques. As the indications for, and use of, nerve transfers expand, the importance of pre-operative assessment and post-operative optimization increases.

Fibre-rich diet attenuates chemotherapy-related neuroinflammation in mice.

The gastrointestinal microbiota has received increasing recognition as a key mediator of neurological conditions with neuroinflammatory features, through its production of the bioactive metabolites, short-chain fatty acids (SCFAs). Although neuroinflammation is a hallmark shared by the neuropsychological complications of chemotherapy (including cognitive impairment, fatigue and depression), the use of microbial-based therapeutics has not previously been studied in this setting. Therefore, we aimed to investigate the effect of a high fibre diet known to modulate the microbiota, and its associated metabolome, on neuroinflammation caused by the common chemotherapeutic agent 5-fluorouracil (5-FU).

Whey-based diet containing medium chain triglycerides modulates the gut microbiota and protects the intestinal mucosa from chemotherapy while maintaining therapy efficacy.

Cytotoxicity (i.e. cell death) is the core mechanism by which chemotherapy induces its anti-cancer effects.

Compound Kushen injection reduces severity of radiation-induced gastrointestinal mucositis in rats.

Mucositis, or damage/injury to mucous membranes of the alimentary, respiratory, or genitourinary tract, is the major side effect associated with anticancer radiotherapies. Because there is no effective treatment for mucositis at present, this is a particular issue as it limits the dose of therapy in cancer patients and significantly affects their quality of life. Gastrointestinal mucositis (GIM) occurs in patients receiving radiotherapies to treat cancers of the stomach, abdomen, and pelvis.