Implementing international classification of functioning disability and health in rehabilitation medicine: Preliminary considerations from a nation-wide Italian experience in routine clinical practice Anna Giardini, Caterina Pistarini The Journal of the International Society of Physical and Rehabilitation Medicine 2019 2(3):107-109

Screening for occult lower-extremity deep vein thrombosis on admission to acute inpatient rehabilitation: A cross sectional, prospective study Leila Ettefagh, Mairin A Jerome, Joseph Porter, Hassan H Monfared, David T Burke The Journal of the International Society of Physical and Rehabilitation Medicine 2019 2(3):110-113 Introduction and Background: Early detection and treatment of deep venous thrombosis (DVT) can decrease the morbidity of postthrombotic syndrome as well as the mortality and morbidity resulting from pulmonary embolism. Despite this risk, it is not the standard of care to screen patients for DVT on admission to an inpatient rehabilitation facility (IRF). There are few studies examining the prevalence of occult DVT on admission to acute IRF and the effect of this screening. Guidelines for the prophylaxis of hospitalized patients have informed patient's care for years. Recently, however, the patient population in the inpatient rehabilitation hospitals has changed, and new prophylactic medications have been introduced. Given these changes, the study reviewed the frequency of lower-extremity DVT among consecutive patients admitted to a university-based freestanding rehabilitation facility. Materials and Methods: This pilot, prospective observational cross-sectional study was designed to better understand the prevalence of occult DVT among patients admitted to a freestanding IRF and to identify associated clinical factors. All consecutive patients admitted to our university-based IRF between October and December 2017, excluding those with a preexisting DVT diagnosis or the inability to undergo lower-extremity ultrasound, were consented. All patients were assessed with a bilateral duplex ultrasound of the lower extremities within 72 h of admission. Results: Of 98 patients screened, 47 (48.0%) were male and 51 (53.1%) were female, with a mean age of 61.4 (±14.2) years. The most common admission diagnoses were ischemic stroke (23.5%), debility/medical complexity (22.4%), and hemorrhagic stroke (11.2%). One patient was positive for a lower-extremity DVT on admission screening duplex ultrasound, yielding an incidence of 1.02%. Conclusions: Our study suggests that DVT screening by duplex ultrasound for all patients admitted to an acute IRF does not seem clinically warranted.

Commentary on the screening for occult lower extremity deep vein thrombosis upon admission to the acute inpatient rehabilitation Manisha Bawa, Manuel F Mas The Journal of the International Society of Physical and Rehabilitation Medicine 2019 2(3):114-114

Commentary on the screening for occult lower-extremity deep-vein thrombosis upon admission to acute inpatient rehabilitation: A cross-sectional, prospective study Mansi M Jhaveri, Mary E Russell The Journal of the International Society of Physical and Rehabilitation Medicine 2019 2(3):115-116

Hospital versus home-based rehabilitation in patients undergoing knee arthroplasty: Evaluation of current evidence through meta-analysis approach Komal Shah The Journal of the International Society of Physical and Rehabilitation Medicine 2019 2(3):117-125 Background: Rehabilitation techniques have provided encouraging results in achieving functional goals in patients undergoing total hip &/or knee arthroplasty. Aims and Objectives: Current meta-analysis compares hospital-based rehabilitation techniques for improving pain score and functional status of patients undergoing hip and knee arthroplasty. Methods: From 1332 initial articles, 29 randomized controlled trials were included in quantitative synthesis. Results: Higher improvement in oxford knee score [MD = -0.60, 95% CI: -1.69 to 0.48, I2–58%, P = 0.05], 6 minutes' walk test [MD = 22.27, 95% CI: -1.96 to 46.49, I2–53%, P =0.06], mental health [MD = 3.56, 95% CI: -0.62 to -7.74, I2–88%, P < 0.00001] was observed with home as compared to hospital based rehabilitation. Greater cost reduction (P = 0.04) benefits were associated with home-based rehabilitation techniques. Conclusion: Home-based rehabilitation technique is clinical and cost-effective alternative of hospital-based rehabilitation in the patients undergoing knee arthroplasty.

Use of ergogenic supplements by young athletes in a sports specialized school Manuel F Mas, Joezer Lugo Ranal, Raúl A Rosario Concepcion, Lorena Gonzalez-Sepulveda, Sona Rivas-Tumanyan, Walter R Frontera, Edwardo Ramos The Journal of the International Society of Physical and Rehabilitation Medicine 2019 2(3):126-137 Background: Few studies have examined the use of ergogenic supplements (ESs) by young athletes residing in a sports specialized school. Methods: In this cross-sectional study, 120 students from a sports specialized school (ages 12–19) completed a questionnaire to assess the prevalence of use of ES according to sex, sport, type of supplement, reasons for use, knowledge of supplements, and sources of information. Results: Most athletes were males (55%) and participated in track and field (32%). Mean age was 14.7 ± 1.6 years. Approximately 98% of athletes indicated using one or more supplements. Sport beverages (95.0%), proteins/amino acids (57%), and vitamins (54%) were the most commonly used. Athletes practicing racquet sports were more likely to consume proteins/amino acids every day than those in any other type of sport (P < 0.05). The adjusted odds of using vitamins were 14% (95% confidence interval [CI]: 0.22–3.30) and 71% (95% CI: 0.09–0.96) lower among athletes practicing explosive sports and high intensity, respectively, as compared to those practicing endurance-intensive sports. On the other hand, the odds of using proteins/amino acids was higher for those practicing explosive (adjusted odds ratio [AOR]: 3.48, 95% CI: 1.02–11.86) and high-intensity (AOR: 2.88, 95% CI: 1.00–8.26) sports. Approximately 62% of athletes used supplements to improve performance. Only 8% of athletes were willing to use a prohibited substance to achieve participation in the Olympics. Conclusion: There was a very high prevalence of use of ES in a sports specialized school. Education regarding supplement use is warranted for athletes, coaches, and family.

ULIS (Upper Limb International Spasticity), a 10-year Odyssey: An international, multicentric, longitudinal cohort of person-centered spasticity management in real-life practice Lynne Turner-Stokes, Klemens Fheodoroff, Jorge Jacinto, Pascal Maisonobe, Stephen Ashford The Journal of the International Society of Physical and Rehabilitation Medicine 2019 2(3):138-150 Homer's Odyssey, one of the major Greek epic poems, tells the story of the hero Odysseus (or Ulysses in Roman versions) and his journey home to his wife Penelope. An epic poem is a long, narrative poem that is usually about heroic deeds and events that are significant to the culture of the poet. In keeping with this classic storytelling style, we describe the journey that the Upper Limb International Spasticity Study (ULIS) program has taken. The program was started in 2008 and has encountered a number of trials and obstacles along the way. This article sets out the history of development through its 10-year “Odyssey.” We use the benefit of hindsight to discuss how conducting large-scale, international observational studies can inform and influence routine practice in an area as diverse and complex as spasticity rehabilitation. We focus on the clinical pearls found within the now extensive ULIS dataset and how continually building upon the insights from each study can provide a real impetus for change.