Physical Medicine

BFR training increases strength and function in neurological rehabilitation.

Systematic review of 37 studies (n = 963) found BFR produced a pooled strength effect size of 0.752 (95% CI 0.49–1.02) versus control. Functional outcomes improved, including balance, Fugl‑Meyer Lower Extremity, and Modified Barthel Index. No significant adverse events were reported across included studies, supporting short‑term safety. Caveat: study heterogeneity and variable trial quality mean protocols need refinement before routine widespread adoption. 1

Neuromechanics link shoulder load, trunk compensation, and upper‑limb nonuse after stroke.

In 22 stroke patients and 22 controls, reducing arm weight decreased nonuse in stroke survivors. Stroke increased trunk compensation, anterior deltoid activation, and perceived effort compared with controls. Heavier arm loads produced control patterns resembling poststroke compensation, supporting a neuromechanical basis. Implication: prioritize shoulder strengthening and interventions that reduce effective arm weight to limit compensation. 2

Multidisciplinary TEAM reduces long‑term work disability; ACT yields earlier symptom gains.

Randomized trial in women on long‑term sick leave compared ACT, multidisciplinary TEAM, and usual care with up to eight years follow‑up. Both ACT and TEAM reduced psychiatric symptoms at 1–2 years versus control. Only TEAM showed statistically significant reductions in work‑disability days at years 4, 7, and 8. Interpretation: multidisciplinary programs may produce delayed but durable work‑return benefits; resource needs should guide choice. 3