mTBI evaluation, management, and referral to allied healthcare: practices of first-line healthcare professionals.

Primary Objective: To gain an understanding of current evaluation practices, post-injury recommendations, and referrals to allied healthcare professions (AHP) by first-line healthcare professionals (FHPs) providing care for people with mild traumatic brain injury (mTBI).

Research Design: Survey study.

Methods And Procedures: Physicians, physician assistants, nurse practitioners, nurses, and athletic trainers ( = 126) completed an online survey, including Likert scale and free response question relating to mTBI evaluation, management, and referral practices.

Developing an Inclusive Training Environment: Accommodations in Physical Medicine and Rehabilitation Residency Training for Residents With a Disability.

This study examines the challenges and accommodations for medical residents with disabilities within physical medicine and rehabilitation training programs. Medical residency presents unique stressors and responsibilities, with the potential for added complexities for residents with disabilities. Few data exist regarding the prevalence and experiences of people with disabilities as medical trainees and the limited studies available highlight an underrepresentation of individuals with disability in medical training and practice.

Transforming modeling in neurorehabilitation: clinical insights for personalized rehabilitation.

Practicing clinicians in neurorehabilitation continue to lack a systematic evidence base to personalize rehabilitation therapies to individual patients and thereby maximize outcomes. Computational modeling- collecting, analyzing, and modeling neurorehabilitation data- holds great promise. A key question is how can computational modeling contribute to the evidence base for personalized rehabilitation? As representatives of the clinicians and clinician-scientists who attended the 2023 NSF DARE conference at USC, here we offer our perspectives and discussion on this topic.

REPORT-SCS: minimum reporting standards for spinal cord stimulation studies in spinal cord injury.

Electrical spinal cord stimulation (SCS) has emerged as a promising therapy for recovery of motor and autonomic dysfunctions following spinal cord injury (SCI). Despite the rise in studies using SCS for SCI complications, there are no standard guidelines for reporting SCS parameters in research publications, making it challenging to compare, interpret or reproduce reported effects across experimental studies.To develop guidelines for minimum reporting standards for SCS parameters in pre-clinical and clinical SCI research, we gathered an international panel of expert clinicians and scientists.

Leveraging Emerging Technologies to Expand Accessibility and Improve Precision in Rehabilitation and Exercise for People with Disabilities.

Physical rehabilitation and exercise training have emerged as promising solutions for improving health, restoring function, and preserving quality of life in populations that face disparate health challenges related to disability. Despite the immense potential for rehabilitation and exercise to help people with disabilities live longer, healthier, and more independent lives, people with disabilities can experience physical, psychosocial, environmental, and economic barriers that limit their ability to participate in rehabilitation, exercise, and other physical activities. Together, these barriers contribute to health inequities in people with disabilities, by disproportionately limiting their ability to participate in health-promoting physical activities, relative to people without disabilities.

Implementation of telehealth and hybrid service delivery of interdisciplinary rehabilitation for military populations with traumatic brain injury.

Background: The COVID-19 pandemic necessitated the implementation of telehealth and hybrid service delivery models and provided an opportunity to study the impact of this care model in military populations with history of traumatic brain injury (TBI).

Objective: To present telehealth service utilization rates across rehabilitation specialties, treatment outcome indicators, and patient satisfaction outcomes from a retrospective clinical sample.

Methods: The study sample consists of 34 patients who underwent telehealth/hybrid Intensive Outpatient Programming (IOP) at a major rehabilitation hospital.

Mastering Our Own Magic in the Evolution Toward Precision Practice.

Edelle (Edee) Field-Fote, PT, PhD, FASIA, FAPTA, the 54th Mary McMillan lecturer, is director of the Shepherd Center Spinal Cord Injury Research Program & Hulse Laboratory; professor in the division of physical therapy at Emory University School of Medicine; and professor of the practice in the school of biological sciences at the Georgia Institute of Technology. In her role as the director of spinal cord injury (SCI) research at Shepherd Center, Field-Fote leads a team dedicated to improving motor function in people with SCI through the development of neuromodulation and neurorehabilitation approaches informed by the latest neuroscience research and guided by outcomes that have meaning for people with SCI. With a clinical background as a physical therapist, PhD training in a preclinical model of SCI, and postdoctoral training in motor control physiology, her 25-plus years of SCI research have spanned the breadth of basic and clinical/translational research related to SCI.

Level of Evidence of Telehealth Rehabilitation and Behavioral Health Services for Traumatic Brain Injury: A Scoping Review.

Traumatic brain injury (TBI) can result in significant impairments in functioning associated with partial or permanent disabilities. Examining the evidence for domain-specific telehealth interventions is necessary to guide the development of effective clinical and research programs for this population. The present scoping review characterizes the level of evidence across a range of TBI-related disabilities and impairments.

Training in Neurorehabilitation Psychology: Defining Competencies, Requisite Skill Sets, and a Proposed Developmental Pathway.

Psychologists have been applying neurorehabilitation models of care for many years. These practitioners come from different training backgrounds and use a variety of titles to refer to themselves despite considerable overlap in practice patterns, professional identification, and salary. Titles like 'neurorehabilitation psychologist' and 'rehabilitation neuropsychologist' are sometimes used by practitioners in the field to indicate their specialty area, but are not formally recognized by the American Psychological Association, the American Board of Professional Psychology, or by training councils in clinical neuropsychology (CN) or rehabilitation psychology (RP).

Pilot testing the SUCCESS peer mentoring program for students with concussion: the role of personas in mobile technology development.

Purpose: College students with concussion experience academic, cognitive and psychosocial challenges, yet frequently lack supports necessary for successful reintegration into school. Success in College after Concussion with Effective Student Supports (SUCCESS) is a virtual peer mentoring program designed to provide education, support and connection through a mobile application. The purpose of this study was to describe use of personas as components of mobile app development and conduct preliminary testing of SUCCESS using personas.

Development of an integrated conceptual model of multiple sclerosis spasticity.

Purpose: Spasticity is common in multiple sclerosis (MS), often leading to functional limitations and disability. We developed a conceptual model of spasticity in MS integrating expert opinion, recent literature, and experiences of clinicians and people with MS spasticity.

Methods: A conceptual model was developed based on a targeted literature review of articles published between 2014 and 2019, followed by input from clinicians, then input from participants with MS spasticity.

Soluble Nogo-Receptor-Fc decoy (AXER-204) in patients with chronic cervical spinal cord injury in the USA: a first-in-human and randomised clinical trial.

Background: Spinal cord injury (SCI) causes neural disconnection and persistent neurological deficits, so axon sprouting and plasticity might promote recovery. Soluble Nogo-Receptor-Fc decoy (AXER-204) blocks inhibitors of axon growth and promotes recovery of motor function after SCI in animals. This first-in-human and randomised trial sought to determine primarily the safety and pharmacokinetics of AXER-204 in individuals with chronic SCI, and secondarily its effect on recovery.

Longitudinal Assessment of Postconcussion Driving: Evidence of Acute Driving Impairment.

Background: Current medical practices and recommendations largely ignore the safety of postconcussion driving, even though commonly used measures of neurocognition, balance, and vestibulo-ocular function show impairment.

Purpose: To compare simulated driving between patients with concussion and controls throughout concussion recovery using a case-control design.

Study Design: Cohort study; Level of evidence, 2.

Demographics and baseline disease characteristics of Black and Hispanic patients with multiple sclerosis in the open-label, single-arm, multicenter, phase IV CHIMES trial.

Background: Black/African American patients with multiple sclerosis (BpwMS) and Hispanic/Latino patients with multiple sclerosis (HpwMS), who historically have been underrepresented in multiple sclerosis (MS) clinical trials, exhibit greater disease severity and more rapid disease progression than White patients with MS (WpwMS). The lack of diversity and inclusion in clinical trials, which may be due to barriers at the system, patient and study levels, impacts the ability to effectively assess risks, benefits and treatment responses in a generalized patient population.

Methods: CHIMES (Characterization of Ocrelizumab in Minorities With Multiple Sclerosis), an open-label, single-arm, multicenter, phase IV study of self-identified BpwMS and HpwMS aged 18-65 years with relapsing MS and an Expanded Disability Status Score (EDSS) of ≤5.

Visuo-vestibular and cognitive connections of the vestibular neuromatrix are conserved across age and injury populations.

Background And Purpose: Given the prevalence of vestibular dysfunction in pediatric concussion, there is a need to better understand pathophysiological disruptions within vestibular and associated cognitive, affective, and sensory-integrative networks. Although current research leverages established intrinsic connectivity networks, these are nonspecific for vestibular function, suggesting that a pathologically guided approach is warranted. The purpose of this study was to evaluate the generalizability of the previously identified "vestibular neuromatrix" in adults with and without postconcussive vestibular dysfunction to young athletes aged 14-17.

Assessment of Dorsiflexion Ability across Tasks in Persons with Subacute SCI after Combined Locomotor Training and Transcutaneous Spinal Stimulation.

In people with spinal cord injury (SCI), transcutaneous spinal stimulation (TSS) has an immediate effect on the ability to dorsiflex the ankle, but persistent effects are not known. Furthermore, TSS has been associated with improved walking, increased volitional muscle activation, and decreased spasticity when combined with locomotor training (LT). In this study, the persistent impact of combined LT and TSS on dorsiflexion during the swing phase of walking and a volitional task in participants with SCI is determined.

Neuropsychological deficit profiles for service members with mild traumatic brain injury.

Background: Neuropsychological deficits are generally assessed in terms of absolute level of functioning, e.g. high average, average, low average, although there is increased interest in calculating indices of relative degree of decline, e.

Reducing pressure with the goal of improving outcomes: a retrospective chart review of cushion evaluations and recommendations at one seating clinic.

Purpose: To describe the current seating recommendations made by a seating clinic for wheelchair users who presented with a Pressure Injury (PrI) or history of PrI.

Methods: Retrospective review of electronic medical records of 133 adults who used a wheelchair as their primary means of mobility who had a cushion evaluation during which interface pressure mapping data was documented.

Results: Clinicians adjusted 71% of participants' wheelchair cushions, including 49% who received a new cushion, and 37% of participants' wheelchairs.

The effects of sports-related concussion history on female adolescent brain activity and connectivity for bilateral lower extremity knee motor control.

Sports-related concussions (SRCs) are associated with neuromuscular control deficits in athletes following return to play. However, the connection between SRC and potentially disrupted neural regulation of lower extremity motor control has not been investigated. The purpose of this study was to investigate brain activity and connectivity during a functional magnetic resonance imaging (fMRI) lower extremity motor control task (bilateral leg press) in female adolescent athletes with a history of SRC.

The SUCCESS Peer Mentoring Program for College Students with Concussion: Preliminary Results of a Mobile Technology Delivered Intervention.

Concussions are caused by a hit or blow to the head that alters normal brain functioning. The Success in College after Concussion with Effective Student Supports (SUCCESS) program was developed to provide students with psychosocial support and resources-both key components of concussion management-to assist in recovery and return-to-learn following concussion. In this preliminary evaluation of intervention efficacy, SUCCESS was delivered through a mobile application connecting mentors (students who have recovered from concussion and successfully returned to school) with mentees who were currently recovering.