Femoroacetabular impingement (FAI) syndrome is an important, yet underdiagnosed, etiology of hip pain in adolescents and young adults. This paper reviews our current understanding of the diagnosis and management of FAI syndrome, emphasizing recent updates. Treatment recommendations emphasize a trial of conservative measures first, followed by operative intervention if that fails. Physical therapy is the gold standard first line of treatment. Utilization of injectable medications can be helpful, but data remains limited. Comprehensive hip arthroscopy including cam/pincer resection and labral/cartilage repair is the established surgical treatment. Careful patient selection for surgery is increasingly recognized as a key determinant of successful outcomes. FAI syndrome is a common culprit of hip pain and onset of hip osteoarthritis in younger individuals. It is often underdiagnosed, and thus undertreated, resulting in delayed care. There are various treatment options, to include operative and non-operative interventions, which can drastically improve pain, function, and quality of life.
This narrative review synthesizes current evidence regarding the pathophysiology, diagnosis, management, and return-to-play (RTP) considerations for spondylolysis in adolescent athletes. We sought to clarify optimal imaging strategies, evaluate conservative and surgical treatment outcomes, and examine evidence guiding RTP decisions. MRI has emerged as the preferred diagnostic modality for early detection of pars interarticularis bone stress injuries, reducing reliance on CT and SPECT. Early initiation of physical therapy and criterion-based rehabilitation models demonstrate high rates of symptom resolution and RTP. Evidence supporting routine lumbar bracing remains inconclusive. Radiographic healing does not reliably predict functional recovery. Most adolescent athletes with spondylolysis achieve successful RTP with nonoperative, rehabilitation-focused management. Early diagnosis and timely, progressive loading strategies improve outcomes. Future research should focus on randomized trials evaluating bracing, rehabilitation timing, and standardized RTP criteria to optimize care.
To review the epidemiology, mechanisms, diagnosis, and management of distal biceps tendon ruptures (DBT) in athletes. We aim to evaluate how treatment strategies influence strength recovery, performance, return-to-sport, and long-term functional outcomes. DBT ruptures significantly affect athletes. Injuries typically occur in the dominant arm during forceful eccentric loading with the forearm supinated. The diagnosis is primarily clinical, but MRI is useful when diagnosis is uncertain clinically. Current evidence strongly favors timely surgical repair to optimize strength recovery, return to sport, and long-term function. Distal biceps ruptures have a significant influence on performance in athletes if not treated appropriately. Timely surgical repair provides durable outcomes in strength, return-to-sport and long-term prognosis when compared to nonoperative management. Understanding mechanisms of injury, refining surgical techniques, and optimizing rehabilitation protocols is essential to improving sport-specific outcomes and preserving athletic performance after injury.
This review examines the evolution of cancer survivorship from its conceptual foundations to implementation in contemporary cancer care, emphasizing integration of survivorship and cancer rehabilitation to optimize long‑term functional outcomes. Survivorship is increasingly defined as a longitudinal, multidimensional process beginning at diagnosis and extending across the lifespan. Many cancer survivors have persistent functional impairments, and cancer rehabilitation improves physical function, quality of life, and participation. Survivorship care delivery is shaped by accreditation requirements and national standards that promote interdisciplinary planning, structured programs, and coordinated care models to enhance quality and effectiveness. Cancer survivorship should be a standard component of comprehensive cancer care. Cancer rehabilitation is central to survivorship by addressing functional needs, promoting wellness, and supporting meaningful life participation. Integrated survivorship and rehabilitation models provide a scalable approach to improve outcomes, demonstrate value, and meet the needs of a growing survivor population.
The purpose of this review is to highlight considerations for prescribing exercise as a treatment for fatigue in cancer patients with medical comorbidities. Generic prescriptions may be incomplete and insufficient in patients with disabilities thus eliminating a subset from highly effective, low risk therapeutic modalities. This review aims to provide a clinically relevant summary for helping the physician promote safe exercise and therapy for cancer patients with comorbidities because of their treatment, or otherwise, to maximize benefit and promote sustainability for long term integration. Recent findings in this field continue to expand on the role of exercise as paramount to improve cancer related fatigue. Even in patients with multiple medical conditions or concern for frailty, debility, and disability, exercise therapy has been shown to produce many positive physiological and psychological outcomes. This review discusses the role of exercise in cancer related fatigue and how a provider can write a safe and effective exercise prescription. Exercise can be performed safely in all stages of cancer care so long as counseling and prescribing are approached mindfully and practically. Many cancer patients face the added challenge of medical comorbidities that contribute to fatigue. Fatigue can be debilitating to function and quality of life. Exercise is a crucial tool to help manage and treat fatigue, and cancer patients are often not prescribed or explicitly encouraged to meet appropriate exercise guidelines. Exercise, especially with appropriate modifications and considerations, is safe, effective, and helpful in cancer patients, even those undergoing treatment. The astute provider should work with patients on setting goals and drafting an exercise plan to help encourage safety, compliance, and promote support for the patient’s wellbeing and care.
This review aims to frame venous thromboembolism (VTE) in cancer-related spinal cord injury (crSCI) as a distinct, high-risk clinical entity. We sought to examine existing epidemiologic, mechanistic, and clinical evidence at the intersection of spinal cord injury (SCI) and malignancy, identify gaps in current prevention and treatment paradigms, and define priorities for future research. Recent literature reinforces that SCI and cancer independently confer profound and sustained VTE risk, yet patients with spinal tumors, epidural disease, and recent spinal surgery remain systematically excluded from major anticoagulation trials. No population-based studies directly quantify VTE incidence or outcomes in crSCI, and existing cancer or SCI risk models lack validation in this population. CrSCI represents a biologically plausible “stacked” Virchow triad with likely synergistic thrombotic risk. Current management relies on extrapolation rather than evidence. Dedicated registries, risk models, and inclusive trials, particularly evaluating prophylaxis duration, anticoagulant selection, and bleeding risk, are essential to guide future, data-driven care.
Venous thromboembolism (VTE) in cancer-related spinal cord injury (crSCI) likely reflects the convergence of malignant hypercoagulability, profound immobility, and frequent spine procedures, a combination that is biologically plausible but not yet defined as a distinct epidemiologic entity. Existing guidelines largely treat cancer and spinal cord injury (SCI) separately. This review aims to synthesize current evidence pertinent to crSCI across epidemiology, diagnosis, prophylaxis, and treatment, and to translate it into a practical clinical approach for prevention and management of VTE in this uniquely high-risk population. Recent systematic reviews confirm sustained, high VTE rates in both cancer and SCI, with emerging data highlighting substantial thrombotic risk after metastatic spine surgery and during inpatient rehabilitation. Contemporary oncology guidelines endorse low molecular weight heparin and direct oral anticoagulants as first-line therapy for prophylaxis and treatment of cancer-associated VTE but exclude most patients with spinal tumors, recent decompression, or epidural disease, leaving major evidence gaps for crSCI. CrSCI is best viewed as a high-risk clinical construct rather than a formally established epidemiologic category, in which standard cancer or SCI algorithms are insufficient, underscoring the need for phase-specific, individualized risk mitigation strategies that prioritizes early mechanical prophylaxis, timely but cautious initiation of chemoprophylaxis, and highly individualized decisions around screening, inferior vena cava filters, and peri-procedural management. Clarifying optimal screening practices, anticoagulant selection, and treatment duration in prospective crSCI cohorts is crucial to reduce VTE-related morbidity while minimizing catastrophic spinal bleeding.
Osteoarthritis (OA) is a leading cause of disability in the United States and cases of OA are expected to continue to rise over the next decade with a growing aging population. Nutritional supplements provide a non-pharmacological adjunct treatment option for patients. This review covers the current understanding of diet and nutrition supplementation and the recommendations for their use in OA treatment. Commonly used nutritional supplements include glucosamine and chondroitin, turmeric, ginger, omega-3 fatty acids, or various vitamins and herbal formulations. Many of these supplements work through the anti-inflammatory or inflammatory pathways within the body. Although supplements may be more accessible and affordable than other options, these adjunct treatments are only conditionally recommended due to the lack of randomized controlled trials and conclusive evidence. Identifying supplements that are effective in reducing pain and improving quality of life, whether used independently or in conjunction with other modalities, remains important for patients with OA.
Achilles tendon rupture (ATR) is a common athletic injury and management with operative and non-operative approaches remains a debated topic. The aim of this review is to summarize the current recommendations for prevention and management. While open surgical repair has been the gold standard for management of Achilles tendon rupture, non-surgical management has gained increasing acceptance following high-quality trials demonstrating comparable functional outcomes to surgery. Non-surgical management has a slightly higher re-rupture rate than surgical options; however, functional outcomes are comparable to surgery when combined with early mobilization. Prevention of ATR requires a multifactorial and individualized approach; effective strategies include gradual load progression, eccentric strengthening, and early management of Achilles tendinopathy. Recent high-quality trials have shown no differences in functional outcomes between surgical and non-surgical management when combined with progressive rehabilitation protocols. Future directions emphasize individualized treatment selection, strategies for early functional rehabilitation, and advances in minimally invasive techniques.
Balance training is an integral component of postoperative rehabilitation after total knee arthroplasty (TKA). This scoping review summarizes the existing methods for assessing and training static and dynamic balance after TKA, with special attention to virtual reality (VR)-based balance training. Proprioceptive insufficiency can be measured directly or indirectly as balance deficits using standardized functional performance tests or sophisticated posturographic instruments. Despite extensive evidence, there is no standardization regarding the optimum timing, duration, and dosage of balance training after TKA. Recent VR-based interventions use game-based exercises to train balance and proprioception, facilitating adherence and serving as a valuable alternative to conventional methods. Both static and dynamic balance components are invariably affected after TKA, hence the need for targeted training, extending well into the intermediate postoperative phase. Future studies should determine the optimum phase, mode, and dosage of balance training to develop standardized protocols for this population.
This review examines global inequalities in stroke rehabilitation in low- and middle-income countries (LMICs). It aims to identify key system-level determinants, including access to services, workforce capacity, financing, and policy frameworks—that contribute to disparities in post-stroke rehabilitation and long-term outcomes. Recent research demonstrates a growing mismatch between rehabilitation needs and service availability in LMICs. Persistent barriers include severe shortages of trained rehabilitation professionals, inadequate infrastructure, fragmented care pathways, and high out-of-pocket expenditures. Although task shifting, community-based rehabilitation, family-mediated therapy, and telerehabilitation have been introduced to mitigate these gaps, evidence for their scalability and sustained effectiveness remains heterogeneous. Stroke rehabilitation inequities in LMICs primarily reflect structural health system constraints rather than lack of therapeutic efficacy. Sustainable improvement requires integration of rehabilitation into universal health coverage, investment in workforce development, and strengthened post-acute care pathways. These findings highlight priorities for future implementation and health system research.
This manuscript synthesizes the relevant anatomy, pathophysiology, and diagnostic workup for proximal hamstring tendon injuries. Furthermore, we review the current evidence-based management strategies for these injuries in the athlete. Non-operative management with exercise-based rehabilitation remains the cornerstone of treatment for proximal hamstring injuries. Chronic injuries recalcitrant to initial treatments may benefit from interventions such as needle fenestration, platelet-rich plasma injections, or extracorporeal shockwave therapy. Proximal hamstring injuries are one of the most common causes of missed time from sport in athletes. They may occur acutely or after chronic biomechanical dysfunction following eccentric muscle strain. These injuries can have a prolonged recovery course and high risk of recurrence. Conservative management with activity modification and rehabilitation is appropriate for most injuries while procedural treatments are utilized for recalcitrant cases with promising efficacy. Although most injuries are treated non-operatively, surgical treatment may be required in avulsion tears or more severe myotendinous injuries.
Head and neck lymphedema (HNL) is a common early and late effect of head and neck cancer treatment that can involve both external tissues and internal pharyngeal and laryngeal structures, yet is frequently under-recognized. This review summarizes contemporary evidence on epidemiology, mechanisms, assessment, functional impact, management, and prevention-oriented surveillance. When systematically assessed, particularly with routine endoscopy, HNL is identified in the majority of survivors (approximately 70
While several validated bedside screenings exist for oropharyngeal dysphagia (especially in stroke patients), a specific scale for oropharyngeal dysphagia has not yet been validated for patients with severe acquired brain injury. Accurately assessing oropharyngeal dysphagia in these patients within the rehabilitation setting is crucial for developing tailored treatment. This review aims to summarise the evidence concerning available bedside screening tests to evaluate oropharyngeal dysphagia, focusing specifically on their sensitivity and specificity. Severe acquired brain injury generate a high burden of disability and long-term care needs. The use appropriate tools for evaluation, diagnosis and treatment may help to prevent additional health problems and correlated costs. Although SWADOC is the only screening test specifically designed for oropharyngeal dysphagia in patients with severe acquired brain injury, other high-quality tests, such as the Gugging Swallowing Screen, the Two-Step Thickened Water Test, and the Sapienza Global Bedside Evaluation of Swallowing are available and appear promising in this field.
This review aims to synthesize current evidence on the use of mobile applications (Apps) for post-stroke rehabilitation, focusing on measurable clinical outcomes related to motor, language, balance, and functional recovery. Several mobile Apps have been recently developed for post-stroke rehabilitation. Many studies show significant improvements in validated outcomes such as motor performance, speech intelligibility, and functional independence. Features like gamification, feedback, and virtual or augmented reality enhance engagement and adherence. Overall, app-based interventions appear effective and feasible both in clinical and home settings. From databases search, we found 18 relevant studies from 782 records. We examined study design, functionalities, and reported outcomes. The selected Apps addressed upper-limb rehabilitation, gait and balance training, language recovery, neglect therapy, and physical activity promotion. Significant improvements were consistently observed across validated measures, and immersive virtual or augmented reality systems produced measurable gains in motor performance, user engagement, and quality of life. We found that most interventions were tested in chronic, home-based contexts, and only a few studies were performed in an early acute–subacute inpatient setting, and this field should be better evaluated in future studies.
The objective of this study is to analyze five of the most common symptoms and treatment-related conditions in childhood cancer, along with their diagnosis and management within rehabilitation services. There is limited evidence on rehabilitation in pediatric cancer and the management of clinical problems in this population. Exercise is one of the non-pharmacological tools with the strongest supporting evidence; however, other approaches lack robust data. Therefore, it is essential to understand the current state of knowledge and define directions for future research. Despite strong evidence supporting rehabilitative interventions, these services remain underutilized in pediatric oncology. Interventions for symptoms and treatment-related conditions such as fatigue, pain, depression, peripheral neuropathy, and constipation are essential for early detection and optimal management. This review provides an in-depth analysis of the current evidence on non-pharmacological treatments and highlights the areas where further research is needed.
This review aims to synthesize current evidence on neuromuscular adaptations after transtibial amputation, with a focus on electromyographic patterns during gait. It addresses how muscle activation reorganizes in the absence of ankle function and how these changes influence rehabilitation strategies and prosthetic design. Recent studies consistently report earlier and prolonged activation of proximal muscle groups, increased coactivation around the knee during loading, and reduced or irregular tibialis anterior activity on the amputated limb. These findings highlight a redistribution of motor effort toward the hip and knee to compensate for the loss of distal control and sensory input. Advances in EMG-based prosthetic control and powered ankle technologies have renewed interest in understanding these activation patterns. Neuromuscular adaptations after transtibial amputation reflect compensatory strategies that maintain stability but increase mechanical and metabolic demand. Clarifying these patterns may guide targeted rehabilitation and inform next-generation prosthetic development.
This narrative review synthesizes the literature on sex- and gender-based disparities in rehabilitation medicine, highlighting inequities in access, treatment, and outcomes for women across the major rehabilitation domains of stroke, cardiac, traumatic brain injury, cancer, spinal cord injury, pain, rheumatic, musculoskeletal, and long COVID rehabilitation. Women experience lower referral and enrollment rates, delayed diagnoses, and worse functional outcomes throughout rehabilitation domains. Biological, psychosocial, and systemic factors—combined with underrepresentation in clinical research—contribute to inequities in evidence-based care. Intersectional identities further compound disparities in care. Emerging studies support tailored, multidisciplinary, and hybrid models to improve accessibility for women. Persistent inequities in rehabilitation medicine for women arise from barriers at the system, provider, and patient levels. Integrating sex- and gender-specific approaches into clinical practice, research design, education, and policy is essential to achieve equitable rehabilitation care. Expanding women’s representation in research and addressing structural barriers will advance functional outcomes and health equity.
To synthesize the available literature for evidence-based management of patellar tendinopathy (PT) among athletes and to provide a conceptual framework to help guide clinical decision-making when managing in-season and off-season athletes with PT. Physical therapy remains the first line treatment for PT. Several studies have reported no improvement or inferior outcomes in patients treated with corticosteroid injection. Preliminary studies show promising outcomes for athletes treated with tendon scraping and percutaneous ultrasonic tenotomy. Recent studies report high rates of return to sport with arthroscopic and open surgical treatments in refractory cases. Despite PT being a common condition affecting athletes, the optimal management remains undetermined. The location and severity of patellar tendon pathology, individual characteristics of the affected athlete, timeline of the athletic season, recovery time post-intervention, treatment efficacy, associated cost, and potential treatment side effects should be considered when determining management. Multiple effective and safe non-operative treatment options are available to manage this condition with surgery available for refractory cases. The treatment framework described here is based on a comprehensive review of the available evidence.
