Charles Benaim

Objective: To evaluate the sensitivity and ecological contribution of the Multiple Errands Test in a Professional Setting, a vocationally oriented executive function assessment, after traumatic brain injury (TBI), and explore its association with return to work (RTW). Setting: A Swiss neurorehabilitation center with an integrated vocational rehabilitation workshop. Participants: Fifty adults with TBI undergoing return-to-work rehabilitation and 40 control participants without brain lesions. Design: Single-center prospective psychometric study with retrospective use of previously collected data. Main Measures: Multiple Errands Test in a Professional Setting error scores, conventional executive and attentional tests, a clinic-adapted Multiple Errands Test, and RTW at 12 months. Results: Participants with TBI made significantly more rule-breaking, inefficiency, partial-realization, interpretation, and judgment errors than controls. Overall, 82% of participants with TBI failed at least one Multiple Errands Test in a Professional Setting measure, including more than 70% who succeeded on conventional executive or attentional assessments. Concordance with traditional assessment was statistically significant for total and attentional assessment but low. Multiple Errands Test in a Professional Setting performance had limited predictive value for RTW, whereas attentional impairment showed a stronger association with work status. Conclusion: Multiple Errands Test in a Professional Setting detects work-relevant executive difficulties often missed by standard tests and may support individualized vocational rehabilitation planning after TBI when interpreted within a broader clinical functional assessment framework.

Background and Aims: This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Persian Cognitive Assessment Scale for Stroke Patients (P‐CASP). Methods: In this cross‐sectional psychometric study, 136 individuals with stroke and 60 age‐ and sex‐matched healthy controls were enrolled. Translation and cultural adaptation followed the Beaton and Dewey protocol. Content validity was assessed using CVR and CVI based on ratings from 20 experts. Concurrent validity was assessed using Pearson's correlation with the MMSE, and known‐groups validity was examined by comparing stroke and control groups. Test–retest reliability was assessed in 76 participants over 2 weeks. Internal consistency was estimated using Guttman's lambda‐2 ( λ 2). Measurement error was assessed using MDC ₉₅ , and ROC analysis evaluated discrimination between groups. Results: CVR and CVI ranged from 0.70 to 1.00 and 0.95–1.00, respectively. P‐CASP scores correlated strongly with MMSE scores ( r = 0.886, p  < 0.001). Known‐groups validity was supported by a significant between‐group difference ( t = 7.508, p  < 0.001; Cohen's d = 1.36). Internal consistency was high ( λ 2 = 0.922), and test–retest reliability was excellent (ICC = 0.997, 95% CI: 0.996–0.998). MDC ₉₅ was 1.66 points. ROC analysis showed excellent discrimination (AUC = 0.980, 95% CI: 0.93–0.98); a cutoff of 31.25 yielded 100% sensitivity and 73.7% specificity. Conclusion: The P‐CASP demonstrated strong validity, high internal consistency, excellent test–retest reliability, and good discriminative performance. It may provide a practical cognitive assessment tool for individuals with stroke, including those with aphasia. Further factor‐analytic and longitudinal studies are warranted.

Background: Available evidence on the conservative treatment of knee osteoarthritis still leaves questions about the efficacy of platelet-rich plasma (PRP) and whether stromal vascular fraction (SVF) offers a superior therapeutic tool. Objective: This study aims to assess the clinical efficacy of SVF as adjuvant therapy to PRP on functionality and tissue regeneration for knee osteoarthritis. Methods: In a multicenter, randomized, triple-blind, controlled trial, 108 individuals with knee osteoarthritis will be block-randomized in a 1:1 ratio. Patients will receive an initial single PRP or PRP + SVF injection followed by PRP doses at 1 month and 2 months. The primary endpoint is functional improvement measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at the 6-month follow-up. Secondary endpoints, collected at the 1-month, 2-month, 3-month, 6-month, and 12-month follow-ups, will include the pain visual analogue scale during maximal physical activity, WOMAC score, length of time to return to work and sports in days, magnetic resonance imaging (MRI)–based Whole-Organ Magnetic Resonance Imaging Score (WORMS), Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, MRI Area Measurement and Depth and Underlying Structures (AMADEUS) score at 6 months and at 12 months, adverse events, and serious adverse events. Results: Participant recruitment and data collection are expected to begin in July 2025 and finish in July 2027. Final end points will be gathered in August 2027, and the results are expected to be published in late 2027. Conclusions: The study results will provide insight into the clinical efficacy of SVF as adjuvant therapy to PRP on functionality and tissue regeneration in patients with knee osteoarthritis. Trial Registration: ClinicalTrials.gov (NCT05660824); https://clinicaltrials.gov/study/NCT05660824 International Registered Report Identifier (IRRID): PRR1-10.2196/62659

BACKGROUND Available evidence on the conservative treatment of knee osteoarthritis still leaves questions about the efficacy of platelet-rich plasma (PRP) and whether stromal vascular fraction (SVF) offers a superior therapeutic tool. OBJECTIVE This study aims to assess the clinical efficacy of SVF as adjuvant therapy to PRP on functionality and tissue regeneration for knee osteoarthritis. METHODS In a multicenter, randomized, triple-blind, controlled trial, 108 individuals with knee osteoarthritis will be block-randomized in a 1:1 ratio. Patients will receive an initial single PRP or PRP + SVF injection followed by PRP doses at 1 month and 2 months. The primary endpoint is functional improvement measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at the 6-month follow-up. Secondary endpoints, collected at the 1-month, 2-month, 3-month, 6-month, and 12-month follow-ups, will include the pain visual analogue scale during maximal physical activity, WOMAC score, length of time to return to work and sports in days, magnetic resonance imaging (MRI)–based Whole-Organ Magnetic Resonance Imaging Score (WORMS), Magnetic Resonance Observation of Cartilage Repair Tissue (MOCART) score, MRI Area Measurement and Depth and Underlying Structures (AMADEUS) score at 6 months and at 12 months, adverse events, and serious adverse events. RESULTS Participant recruitment and data collection are expected to begin in July 2025 and finish in July 2027. Final end points will be gathered in August 2027, and the results are expected to be published in late 2027. CONCLUSIONS The study results will provide insight into the clinical efficacy of SVF as adjuvant therapy to PRP on functionality and tissue regeneration in patients with knee osteoarthritis. CLINICALTRIAL ClinicalTrials.gov (NCT05660824); https://clinicaltrials.gov/study/NCT05660824 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/62659

(1) Background: VR is based on a virtual world that creates sounds effects and videos that replace the real environment. Arising literature shows VR efficacy in the field of neurological rehabilitation (NR) and that its use is also taking a place in musculoskeletal rehabilitation (MSR), as a treatment of various disorders that cause disability and chronic pain. (2) Aim: We discuss the role of VR in MSR, presenting its use and development on acute and chronic musculoskeletal disorders, based on the most recent literature. (3) Design and Methods: Literature searches were conducted in the databases Pubmed and Medline up to 30 September 2023. The PRISMA-Scr Checklist was followed. (4) Results: A total of 51 records were included. The analysed studies were conducted within a variety of populations, musculoskeletal disorders, settings, and VR technologies. Only a few studies could statistically affirm the efficacy of VR in MSR, as mentioned for the rehabilitation of the upper limb. Nevertheless, the observed trend is an improvement of the global perceived effect compared to traditional rehabilitation. (5) Conclusion: VR allows for the personalisation of treatment with an adaptable treatment platform, which may improve the participation of the patient and increase acceptability and adherence to long-term rehabilitation programs. We provide recommendations and suggestions for future research and use of VR in musculoskeletal rehabilitation.

Background Occipito-mastoid structure normalization (OMSN) is an osteopathy manipulative treatment aiming at reducing tensions around the jugular foramen, where cranial nerves IX, X and XI come out of the skull. Tensions in this area may induce compressions of those nerves, which might imply symptoms related to those nerves dysfunctions (e.g., dysphagia, gastrointestinal issues, cardiac issues, upper body muscle pain, fatigue). Vagus nerve X is the main parasympathetic nerves of this area. Heart rate variability (HRV) is a surrogate for vagal modulation, and purpose of this study was to observe how HRV variables evolved before and after an OMSN. Methods Pre- and post- intervention HRV was analyzed in two randomly distributed groups of 15 participants. One received the OMSN and the other a SHAM technique. HRV was collected supine 5 min before and 5 min after a10-minute application of either OMSN or SHAM. HRV was analyzed on the last 4 minutes of the 5 minutes sample in time- and frequency-domain. Results HR significantly decreased in both groups (change in mean (CIM) -2.6 (4.3), and -2.3 (2.1) bpm, for NSOM and SHAM, respectively) but without difference between groups (p = 0.245). Vagally-related HRV variable root mean square of successive differences (RMSSD) increased in both groups, but in a significantly higher proportion in OMSN group (CIM 8.1 ±6.4 and 2.8 ±6.2 ms, p = 0.030 for NSOM and SHAM, respectively). No differences between groups were observed on frequency-domain analysis. Conclusion Compared to a SHAM technique, OMSN had a significant effect on HRV vagally-related metric RMSSD. This effect was measured in the very short term and thus, OMSN may be used to imply a short-term influence on parasympathetic ANS modulations. Further research are needed to investigate medium and long-term influences of this manipulation.

Purpose: Chronic pain is a complex phenomenon. Understanding its multiple dimensions requires the use of a combination of several patient-reported outcome measures (PROMs). However, completing multiple PROMs is time-consuming and can be a burden for patients. The objective of our study was to simultaneously reduce the French versions of the Pain Catastrophizing Scale (PCS) and Tampa Scale for Kinesiophobia (TSK) questionnaires to enable their use in an ambulatory and clinical settings. Patients and Methods: We conducted a clinical study between May 2014 and August 2020 in our rehabilitation center. 1428 chronic musculoskeletal pain patients (CMSP) were included. The originality of our approach is that the reduction method included qualitative as well as quantitative analyses. The study was divided into two parts: 1) reduction of the questionnaires (n=1363) based on internal consistency (item-to-total correlation), principal component analysis (item loadings), Rasch analysis (infit/outfit), floor and ceiling effect (quantitative analyses) and expert judgment of items (qualitative analysis), and 2) validation of the reduced questionnaires (n=65), including test–retest reliability (intraclass correlation coefficient [ICC]), homogeneity (Cronbach α), criterion validity (Pearson correlation [r] with the long-version score), determination of the pathological cutoff and Minimal Clinically Important Difference (MCID). The two full-length questionnaires include 30 items in total. Results: The reduction resulted in a 5-item PCS (score 0– 20) and 6-item TSK (score 0– 24). Psychometric properties of the reduced questionnaires were all acceptable as compared with other version (α=0.89 and 0.71, ICC=0.75 and 0.60, r=0.86 and 0.70, MCID=2 and 2 for PCS and TSK, respectively) while keeping the structure and coherence of the long versions. Conclusion: The two reduced versions of the PCS and TSK can be used in CMSP patient. As their administration only requires a few minutes, they can be implemented in outpatient consultation as well as in clinical settings.

Background and aims: While a causal relationship between pain‐related fear and spinal movement avoidance in patients with chronic low back pain (CLBP) has frequently been postulated, evidence supporting this relationship is limited. This study aimed to test if decreases in pain‐related fear or catastrophizing were associated with improvements in spinal biomechanics, accounting for possible changes in movement‐evoked pain.Methods: Sixty‐two patients with CLBP were assessed before and after an interdisciplinary rehabilitation program (IRP). Pain‐related fear was assessed with general and task‐specific measures. Lower and upper lumbar angular amplitude and velocity as well as paraspinal muscle activity were recorded during five daily‐life tasks to evaluate spinal biomechanics. Relationships were tested with multivariable linear regression analyses.Results: The large decreases in pain‐related fear and catastrophizing following the IRP were scarcely and inconsistently associated with changes in spinal biomechanics (< 3% of the models reported a statistically significant association). Results remained comparable for activities inducing more or less fear, for specific or general measures of pain‐related fear, and for analyses performed on the entire population or limited to subgroups of patients with higher levels of task‐specific fear. In contrast, reductions in task‐specific pain‐related fear were significantly associated with decreases in movement‐evoked pain in all tasks (r = 0.26–0.62, p ≤ 0.02).Conclusion: This study does not support an association between pain‐related fear and spinal movement avoidance. However, it provides evidence supporting a direct relationship between decreased pain‐related fear and decreased movement‐evoked pain, possibly explaining some mechanisms of the rehabilitation programs.