Objective: Rehabilitation is a health strategy implemented with specific programmes across multiple health conditions. This study aimed to identify rehabilitation programmes' commonalities among health conditions and partners, as required by the PREPARE (Personalised REhabilitation via Novel AI PAtient StRatification StratEgies) project. Design: Qualitative study. Subjects/Patients: Seven rehabilitation programmes in Europe covering diverse health conditions were chosen according to PREPARE research needs for their availability of large clinical databases. Methods: The Guideline for Interventions Description in Rehabilitation (GUIDE-Rehab) was used to describe targets, components, and ingredients of rehabilitation programmes. These elements were mapped to the International Classification of Functioning, Disability, and Health (ICF) domains. Results: The programmes' interventions covered all ICF domains collectively, but not individually. Body functions and structures were the most frequent domains, whereas participation and contextual factors were underrepresented. Similar components (e.g., exercise, orthoses) were applied to different objectives depending on the underlying intervention theory. Pharmacological and surgical elements were also integral parts of rehabilitation programmes. Conclusion: We found differences and incomplete coverage of ICF domains in highly specialized programmes, incorporating organ-based and functioning-based approaches. Future studies should check (i) the generalizability and (ii) if results are justified by differences among health conditions or due to incomplete rehabilitation programmes/description.
Objective: To examine the associations of motor recovery stage, proprioceptive function, and working memory with motor imagery ability in patients with subacute stroke. Subjects/Patients: Forty patients with subacute stroke who had complete data. Methods: Motor imagery ability was assessed using mental chronometry during a Purdue Pegboard task. Associations with motor recovery stage, proprioceptive function, and working memory were examined using correlation and multiple regression analyses. An exploratory linear support vector machine analysis was performed to classify participants into groups with higher and lower motor imagery ability using these variables. Results: Motor imagery ability was significantly associated with motor recovery stage and proprioceptive function in the correlation analyses. However, these associations were no longer independently significant after adjustment in the multiple regression analysis. A linear support vector machine achieved an area under the curve of 0.716, with an accuracy of 0.700, sensitivity of 0.800, and specificity of 0.600. Permutation testing confirmed that the classification performance was above chance. Conclusion: Motor imagery ability may be related to a combination of motor, sensory, and cognitive functions rather than any single functional domain.
Objective: To examine whether community participation mediates the disability–life satisfaction association in working-age cancer survivors, and whether contextual factors moderate this pathway. Design: Cross-sectional online survey. Subjects: 2,999 working-age US cancer survivors, employed or seeking employment (mean age 42.8 years; 53.1% male; 75.7% in remission). Methods: Disability (World Health Organization Disability Assessment Schedule 2.0), perceived community participation (5-item Wisconsin Community Participation Scale), and life satisfaction (Satisfaction With Life Scale) were assessed. A single-mediator model was estimated with bias-corrected bootstrap; 7 moderators were tested with false-discovery-rate correction. Results: Disability was associated with lower participation (β = −0.14) and life satisfaction (β = −0.12); participation with greater life satisfaction (β = 0.57). The indirect association (β = −0.08, 95% CI −0.10 to −0.06) accounted for 39.8% of the modest total association, but for only 13.0% when the full 12-item participation scale was used. At high instrumental support the conditional indirect association was indistinguishable from zero; at high self-efficacy and hope it reversed in sign. Conclusion: In this cross-sectional study, community participation statistically accounted for a measure-dependent part of the disability–life satisfaction association, and contextual factors were associated with differential attenuation across pathway segments. These hypothesis-generating findings require longitudinal confirmation before informing practice.
Objective: To evaluate the measurement properties of patient-reported measures of depressive symptoms in adults with spinal cord injury and inform their purpose-specific selection and interpretation in clinical and research settings. Design: Systematic review. Subjects/Patients: Adults with traumatic or non-traumatic spinal cord injury. Methods: 10 databases were searched from inception to 25 June 2026, with reference checking, citation tracking, instrument websites, and targeted searches. Two reviewers independently selected reports, extracted data, assessed risk of bias, rated measurement properties, and graded certainty using current international guidance for outcome measurement instruments. Results: 28 reports evaluated 27 separately scored versions, forms, or depression subscales from 14 instrument families. The Spinal Cord Injury–Quality of Life Depression Item Bank had the strongest condition-specific development and internal-structure evidence, but evidence gaps and insufficient measurement invariance prevented recommendation. The English Patient Health Questionnaire-9 had sufficient case-finding evidence but insufficient structural validity for interpreting its conventional total score as a clearly unidimensional severity measure. The English depression subscale of the Hospital Anxiety and Depression Scale showed sufficient structural validity, internal consistency, and construct validity. Evidence for measurement error and responsiveness was scarce. Conclusion: No measure had sufficiently complete evidence for routine use across screening, severity assessment, and change measurement.
Objective: To evaluate the safety and effectiveness of “step-up dose” onabotulinumtoxinA (401–600 units per treatment session) in patients with upper and lower limb spasticity. Design: Multicentre, prospective, observational, single-arm investigation. Subjects: A convenience sample of 109 patients with upper and lower limb spasticity scheduled to receive their first or second step-up dose onabotulinumtoxinA. Methods: The study primarily evaluated the safety of step-up dose onabotulinumtoxinA by summarizing adverse events. Effectiveness was evaluated as a secondary objective. Results: Of the safety population comprising 107 patients, 49 (45.8%) experienced at least 1 adverse event, with coronavirus disease 2019 and nasopharyngitis being the most frequent. Five patients (4.7%) reported adverse events related to onabotulinumtoxinA or injection procedure. These safety findings were generally consistent with those previously reported, while reduction of muscle tone and subsequent clinical benefits were suggested by the Modified Ashworth Scale and patient/physician-reported outcomes. Conclusion: To the best of our knowledge, this is the first study to prospectively evaluate the safety and effectiveness of onabotulinumtoxinA at doses above 400 units given simultaneously for upper and lower limb spasticity. No new safety concern was identified for this “step-up dose” treatment.
