ASEAN Journal of Rehabilitation Medicine

Notes from the Editor-in-Chief

Kingkaew Pajareya — Wed, 02 Sep 2026 00:00:00 +0700

The Efficacy of Modified Total Contact Orthosis in Decreasing Pain While Walking Indoors in Patients with Posterior Tibial Tendon Dysfunction: A Prospective, Randomized, Double-Blind Controlled Trial

Wed, 02 Sep 2026 00:00:00 +0700

Objectives: To evaluate the effectiveness of a modified total contact orthosis (modified TCO) in reducing pain during indoor walking among patients with posterior tibial tendon dysfunction (PTTD). Patient satisfaction, complications, Foot Function Index (Thai version), and device compliance were also evaluated

Study design: A prospective, randomized, double-blind controlled trial

Setting: The Foot Clinic at Siriraj Hospital, a tertiary care academic medical center in Bangkok, Thailand

Participants: Forty-two patients aged 45–65 years with stage I–III PTTD lasting more than 6 weeks.

Methods: Participants were enrolled between November 2023 and June 2024 and randomized into two groups. The study group received a modified TCO, whereas the control group received a sham orthosis. Both groups used the orthoses indoors for 2 weeks. Pain scores, Foot Function Index (Thai version), satisfaction, and compliance were assessed at baseline and after 2 weeks.

Results: The participants, with a mean age of 62.2 (SD = 8.9) years in the study group and 63.2 (SD = 9.5) years in the control group, were predominantly female (90.5%) and had stage II PTTD. All participants completed the study. After 2 weeks, the study group reported significantly less pain at the posterior tibial tendon and demonstrated better total foot functionality compared to the control group (p < 0.001 and p = 0.03, respectively). Both groups expressed high satisfaction with the devices, using them for more than 80.0% of the time spent indoors.

Conclusions: A modified total contact orthosis can reduce pain at the posterior tibial tendon in PTTD patients during indoor walking and can improve the Foot Functional Index without serious adverse effects.

Improvements in Six-Minute Walk Distance and Functional Status following Phase II Cardiac Rehabilitation

Panida Poolpipat, Rachawan Suksathien — Wed, 02 Sep 2026 00:00:00 +0700

Objectives: To evaluate changes in 6-minute walk distance (6MWD) and New York Heart Association (NYHA) functional class (FC) among patients participating in an outpatient phase II cardiac rehabilitation (CR) program

Study design: Retrospective analytic study

Setting: Maharat Nakhon Ratchasima Hospital, a tertiary care hospital in Thailand

Participants: A total of 112 patients enrolled in the CR program between January 2022 and September 2024 and who had at least two 6MWD results available were included. Patients with incomplete data were excluded.

Methods: Demographics and clinical data were collected from the medical records of the patients. The 6MWD and the FC were assessed before and after CR program. The program also included exercise prescription, lifestyle and risk-factor modification.

Results: 97 patients (86.6%) had coronary artery disease, and 14 (12.5%) had congestive heart failure. Overall, 61.6% (95% CI: 52.4, 70.1) showed a ≥ 10% improvement in 6MWD from baseline. Prior to the outpatient phase II CR program, 18 patients were in FC I, 78 were in FC II, and 16 were in FC III. After the implementation of the CR program, 83 patients were classified as FC I, and none remained in FC III. In a modified Poisson regression analysis, intermediate-risk patients were 1.6 times more likely to improve than low-risk patients, while a baseline 6MWD < 300 m was independently associated with greater improvement (adjusted prevalence ratio, 1.7).

Conclusions: Participation in a structured CR program was associated with significant improvements in 6MWD and FC, with 61.6% of patients achieving ≥ 10% improvement in 6MWD from baseline. Patients with lower baseline 6MWD (< 300 m) and moderate risk stratification appeared to derive greater improvements.

Incidence and Risk Factors for Hip Displacement in Thai Children with Cerebral Palsy under a 10-Year Surveillance Program: A retrospective analytical study at Queen Sirikit National Institute of Child Health

Pattarapa Yamdee — Wed, 02 Sep 2026 00:00:00 +0700

Objectives: To evaluate the cumulative incidence of significant hip displacement, defined as a migration percentage (MP) > 40% or the requirement for hip reconstructive surgery among children with cerebral palsy (CP) enrolled in a 10-year institutional hip surveillance program, and to identify independent clinical predictors of displacement.

Study design: Retrospective cohort study

Setting: Queen Sirikit National Institute of Child Health

Participants: Children with cerebral palsy (CP) undergoing their first surveillance radiograph with baseline MP ≤ 40.0%.

Methods: This retrospective cohort study at Queen Sirikit National Institute of Child Health, a national tertiary referral center in Thailand (2016 to 2025), analyzed children with CP having baseline MP ≤ 40.0%. The primary outcome was the cumulative incidence of hip displacement (MP > 40% or surgery), estimated using Kaplan-Meier analysis. Multivariable Cox regression was used to identify risk factors, adjusting for Gross Motor Function Classification System (GMFCS) level, CP subtype, and epilepsy.

Results: A total of 265 patients were included. The cumulative incidence of significant hip displacement of the patients progressively increased over time: 17.8% at 2 years of follow-up, 30.5% at 4 years of follow-up, reaching 41.0% at 6 years of follow-up. Among the children who developed significant hip displacement during the surveillance period, the mean age at the time of initial documentation of displacement was 5.0 (SD = 2.2) years. Multivariable analysis identified GMFCS levels IV-V as the strongest independent predictor (adjusted Hazard Ratio [aHR] 3.09; 95% CI: 1.24, 7.70; p = 0.015) compared to levels I-III. Non-spastic CP subtypes were associated with a significantly lower risk (aHR 0.22; p = 0.017) compared to spastic diplegia. Epilepsy was not found to be an independent risk factor after adjusting for motor severity (aHR = 0.76; p = 0.407).

Conclusions: The cumulative risk of hip displacement in this surveillance cohort is high, particularly among children with severe motor impairment (GMFCS IV-V), reaching 41.0% at 6 years of follow-up. These findings underscore the necessity for rigorous, long-term surveillance stratified by GMFCS level and provide crucial data for prognostic counseling to facilitate timely interventions.

A Retrospective Analysis of Stroke Rehabilitation Outcomes in the Intermediate Care (IMC) Service Plan Comparing Home-based and Outpatient-Based Services Using Propensity Score Matching

Phuangphet Siriloetthananon, Nataporn Nakkaew — Wed, 02 Sep 2026 00:00:00 +0700

Objectives: To compare rehabilitation outcomes up to 24 weeks post-stroke, therapy exposure, and complication rates between home-based and outpatient-based IMC stroke rehabilitation programs, before and after propensity score matching in a hospital.

Study design: Retrospective observational cohort design with Propensity Score Matching

Setting: Department of Rehabilitation Medicine, Songkhla Hospital, a tertiary care hospital in southern Thailand

Participants: Intermediate care stroke patients who received rehabilitation services through either the home-based or outpatient-based model between October 2022 and September 2025.

Methods: This retrospective study analyzed stroke patients enrolled in the IMC program. Baseline characteristics, Barthel Index (BI) scores, dependency levels, complications, and therapy session counts were collected at baseline, 2 weeks, 12 weeks, and 24 weeks. Propensity score matching was conducted using initial BI, National Institutes of Health Stroke Scale (NIHSS), age, sex, and other key covariates to ensure baseline clinical balance.

Results: Before matching, the home-based group was older and predominantly female, while the outpatient-based group tended to present with more-severe strokes and lower initial BI scores. The outpatient-based group also received substantially more therapy (median PT: 10 vs. 3; OT: 8 vs. 1; both p < 0.001). After matching, therapy exposure remained higher in the outpatient-based group (PT: 1.6 [SD = 1.9] vs. 8.5 [SD = 6.6], SMD = –1.63; OT: 8.5 [SD = 6.2] vs. 9.2 [SD = 6.2], SMD = –1.43). Short- and intermediate-term BI gains were similar between the groups, with identical median gains during several intervals. Long-term BI gain (baseline–24 weeks) was greater in the outpatient-based group. The home-based group met non-inferiority criteria for BI gain at 24 weeks (p = 0.035), but not at 12 weeks. Trends toward higher pneumonia and pressure ulcer rates were observed in the home-based group, whereas recurrent stroke tended to be more common in the outpatient-based group, though neither reached statistical significance. At 6 months, 62.7% of the home-based and 63.7% of the outpatient-based group had achieved a level of mild or no disability.

Conclusions: Home-based and outpatient-based IMC rehabilitation yielded broadly comparable outcomes despite a substantially lower therapy dosage in the home-based group. Increasing therapy intensity and integrating advanced rehabilitation technologies could potentially further improve functional recovery within the IMC framework. The home-based group demonstrated statistically non-significant trends toward higher rates of preventable complications such as pneumonia and pressure ulcers.

Ambulation Outcomes After Robotic Gait Rehabilitation in a Regional Hospital: A 2-Year Retrospective Observational Study

Napatt Phusiripinyo, Rachawan Suksathien, Paveenrath Charussuriyong — Wed, 02 Sep 2026 00:00:00 +0700

Objectives: To evaluate changes in the level of walking ability as measured by the Functional Ambulation Category (FAC) following 10 sessions of robotic gait rehabilitation

Study design: A retrospective observational study

Settings: Department of Rehabilitation Medicine, Maharat Nakhon Ratchasima Hospital, a public regional hospital in Thailand

Participants: A total of 162 patients diagnosed with stroke, traumatic brain injury (TBI), or incomplete spinal cord injury (SCI), who presented with ambulation impairments and who received robotic gait rehabilitation at a regional hospital between November 2022 and November 2024.

Methods: Medical records of patients with ambulation impairments who received robotic gait rehabilitation at a regional hospital between November 2022 and November 2024, completed 10 training sessions, and had available pre- and post-training ambulation outcome data were included in the analysis. General demographic characteristics, diagnoses and ambulation outcomes, including the FAC, were collected. FAC scores before training and after 10 training sessions were compared. Associations between clinical variables and improvements in FAC were analyzed.

Result: Among the 162 patients who received robotic gait rehabilitation at a regional hospital, 48 were excluded due to incomplete training or missing data, leaving 114 patients for analysis. More than half of the patients (54%) demonstrated improvement in FAC scores after 10 training sessions. No patients experienced a reduction in FAC following training. Factors significantly associated with FAC improvement included the interval from the neurological event and the patients’ baseline FAC. Minor complications were reported, including muscle strain in eight patients and dizziness in one patient.

Conclusion: This retrospective analysis of 2 years of robotic gait rehabilitation services at a regional hospital demonstrated that more than half of the patients achieved at least a one level improvement in the FAC following training. Factors associated with FAC improvement included the interval from the neurological event and the patients’ baseline FAC.

Cross-Cultural Adaptation and Psychometric Properties of the Thai Version of the Short-Form Urinary Quality of Life Questionnaire (SF-Qualiveen) in Individuals with Neurogenic Lower Urinary Tract Dysfunction Following Spinal Cord Injury

Pasinee Theerapap, Chayaporn Chotiyarnwong, Thanitta Thanakiatpinyo — Wed, 02 Sep 2026 00:00:00 +0700

Objectives: To develop the Thai version of the short form of the Urinary Quality of Life Questionnaire (SF-Qualiveen) and evaluate its validity and reliability in patients with neurogenic lower urinary tract dysfunction following spinal cord injury

Study design: Cross-cultural adaptation and psychometric validation study

Setting: Department of Rehabilitation Medicine, Faculty of Med-cine Siriraj Hospital, Mahidol University, Thailand, a tertiary care university hospital

Participants: Patients with spinal cord injury and neurogenic lower urinary tract dysfunction who visited Siriraj Hospital between July and December 2024.

Methods: Following the translation of the SF-Qualiveen into Thai and its evaluation for content validity, 56 patients with spinal cord injury (SCI) (34 males, 22 females) were assessed using the Thai SF-Qualiveen to determine construct validity. This was done using Pearson’s correlation coefficient to analyze its positive correlation with the Urinary Distress Inventory-6 (UDI-6) and negative correlation with the WHOQOL-BREF-THAI. Reliability was evaluated through internal consistency and test-retest reliability with patients reassessed after one week.

Results: The Thai SF-Qualiveen demonstrated excellent content validity, with a Content Validity Index (CVI) of 1.00 after linguistic adjustment. Regarding construct validity, it showed a significant moderate positive correlation with the UDI-6 (r = 0.52, p < 0.001) and a low negative correlation with the WHOQOL-BREF-THAI (r = -0.46, p < 0.001). Internal consistency was very good with a Cronbach’s alpha of 0.86 (95% CI: 0.79, 0.91). Test-retest reliability was excellent, with an Intraclass Correlation Coefficient of 0.93 (95% CI: 0.89, 0.96).

Conclusions: The Thai SF-Qualiveen questionnaire is a valid and reliable instrument for assessing quality of life in Thai patients with neurogenic lower urinary tract dysfunction following spinal cord injury.