The June 2026 issue of Rehab in Review (Volume 34, Number 6) brings together the most significant studies in physical medicine and rehabilitation, published in leading international scientific journals. Below is a comprehensive summary of every study covered in this issue.
1. Reducing Plastic-Associated Chemicals in Daily Living. Plastic-associated chemicals (PACs) including phthalates and bisphenols are created by food packaging, food processing and personal daily products. In the randomized controlled PERTH trial, 211 healthy Australian adults underwent a seven-day isocaloric trial with intervention arms replacing foods, beverages, kitchenware and personal care products with low-plastic alternatives. The intervention group showed decreased urinary mono-n-butyl phthalate by 37.5% (p=0.007), monobenzyl phthalate by 53.5% (p=0.005) and bisphenol A by 59.7% (p=0.033). Conclusion: extensively limiting plastic use in food systems, diet and daily life can meaningfully reduce urinary PAC levels. Harray, A., et al. Nature Med. 2026, May; 32:1871-1883.
2. Prognostic Ability of Salivary S100B in Traumatic Brain Injury. S100B is the most studied biomarker for prognosis in TBI. This prospective cohort study included 25 adults (18-60 years) with moderate-to-severe TBI (GCS 3-12), admitted within four hours of injury. Saliva was collected at 3 and 6 hours post-trauma; plasma at 3 hours. Salivary S100B at 6 hours was significantly higher in patients with unfavorable outcomes at discharge (p=0.0248). ROC analysis: AUC 0.76 at discharge, 0.70 at three months - superior to plasma S100B. Conclusion: salivary S100B at 6 hours has superior prognostic performance compared with plasma S100B. Fernandes, L., et al. Brain Inj. 2026, April; 40(6): 480-492.
3. Pregabalin Versus Duloxetine for Painful Diabetic Neuropathy. Meta-analysis of 19 studies involving 4,483 patients with mean follow-up of 3.4 months. No significant difference in VAS pain scores at 4 or 8 weeks. Combined pregabalin + duloxetine did not improve outcomes over monotherapy. Pregabalin was associated with higher rates of edema (RR 4.29) and weight gain (RR 9.25), but lower incidence of anorexia, decreased appetite, diarrhea, nausea and vomiting. Conclusion: pregabalin does not differ from duloxetine for pain relief at up to four months. Mansour, A., et al. Pain Med. 2026, May; 27(5): 574-592.
4. Weekly Methotrexate for Newly Diagnosed Polymyalgia Rheumatica. Randomized, double-blind, placebo-controlled trial of 64 patients (mean age 65) diagnosed with PMR within prior 12 weeks. Subjects received oral MTX 25 mg weekly (n=31) or placebo (n=33) for 52 weeks with standardized prednisolone taper. At one year, glucocorticoid-free remission was achieved by 80% of MTX vs 46% of placebo (RR 1.7). Relapse: 60% MTX vs 81% controls. Grade 2+ adverse events: 73% MTX vs 56% controls. Conclusion: weekly methotrexate improves glucocorticoid-free remission rates at one year. Bolhuis, T., et al. Ann Intern Med. 2026, April; 85(4): 761-770.
5. Hypertension Burden Increasing Worldwide. Systematic analysis of 287 studies involving approximately 6 million adults from 119 countries. Age-standardized hypertension prevalence decreased by 3% in high-income nations but absolute burden rose by 76 million cases. In low- and middle-income countries, prevalence increased by 6% and absolute burden rose by 651 million cases. In 2020, an estimated 1.7 billion adults (one in three worldwide) had hypertension, with 1.3 billion cases in low- and middle-income countries. O'Connell, S., et al. J Am Coll Cardiol. 2026; 87(18): 2338-2351.
6. Zodasiran for Cholesterol and Triglyceride Treatment. Zodasiran is an ANGPTL3-targeting siRNA. Phase 1 trial enrolled 32 patients with hyperlipidemia, familial hypercholesterolemia (FH) or moderate-to-severe hypertriglyceridemia receiving subcutaneous zodasiran (100, 200 or 300 mg) on days 1 and 29. All cohorts showed week-16 reductions in ANGPTL3 (up to 85.4%) and triglycerides (up to 67.1%). In FH patients, ANGPTL3 reductions were sustained to week 64. Dose-dependent reductions in LDL-C, non-HDL-C and ApoB. Watts, G., et al. Nat Med. 2026; 32: 1432-1443.
7. Ticagrelor with Aspirin Combined with IV Thrombolysis for Ischemic Stroke. Multicenter, double-blind, randomized TAPIS trial of 1,382 patients (NIHSS 4-10) treated with IV thrombolysis and assigned to early oral aspirin plus ticagrelor or placebo within 6 hours of stroke onset. Excellent functional outcome at 90 days (mRS 0-1): 68.7% DAPT vs 62% placebo (p=0.0089). Symptomatic intracranial hemorrhage at 36 hours: 0.9% vs 0.7% (p=0.76). Wang, A., et al. Lancet. 2026, May; 407(10542): 1919-1928.
8. Endovascular Treatment of Medium-Vessel-Occlusion Strokes. ORIENTAL-MeVO open-label randomized trial at 48 Chinese centers, 563 adults with NIHSS ≥6 with medium-vessel occlusion within 24 hours of last known well. Functional independence at 90 days (mRS 0-2): 58.6% thrombectomy vs 46.6% control (adjusted RR 1.24; p=0.004). Symptomatic intracranial hemorrhage: 4.7% vs 2.2%. Mortality at 90 days: 11.1% vs 10.2%. Hu, W., et al. N Engl J Med. 2026, May 14; 394(19): 1894-1904.
9. Novel Ultrasound-Guided Injection Strategy for Frozen Shoulder. Multicenter randomized trial of 139 patients comparing ultrasound-guided tendon surface injection (UGTS, n=49), manipulation under local anesthesia (MULA, n=43) and blind tender point injection (BTP, n=47). At one week, UGTS showed superior BFHS improvement (p<0.001), sustained at four weeks. Remission at 1 month: 59.2% vs 34.9% (MULA) vs 31.9% (BTP), p=0.013. Three months: 79.6% vs 69.8% vs 53.2% (p=0.021). Rates converged by 24 months. No UGTS-related rotator cuff injuries. Zhu, D., et al. Am J Sports Med. 2026, May; 54(6): 1324-1332.
10. Aquatic Exercise and Physical Function in Older Adults. Meta-analysis of 23 RCTs with 1,179 healthy elderly adults (≥60 years). Aquatic exercise improved static balance (p=0.007), dynamic balance (p=0.028), lower-limb strength (p<0.001), upper-limb strength (p<0.001), cardiopulmonary endurance (p<0.001), and lower-limb flexibility (p=0.024). Greatest gains: combined resistance plus aerobic training, interventions >12 weeks and frequency >2x/week. Wang, J., et al. BMC Sports Sci Med Rehabil. 2026; 18(1): 62.
11. Practice Acclimation Ramp Reduces Lower Extremity Strains in the NFL. Descriptive epidemiology study of 6,720 unique NFL athletes across 32 clubs (2018-2023). Teams using gradual ramps or varied practice lengths had significantly fewer LEX strains during training camp (p=0.01). After mandatory gradual acclimation ramp implementation in 2022, league-wide LEX strain incidence in training camp decreased from 288 (2021) to 215 (2022) and 186 (2023) - a 35% reduction. Recurrent LEX strains in regular season reduced 50%. Herzog, M., et al. Am J Sports Med. 2026; 54(6): 1461-1470.
12. Prevalence of Medial Meniscus Injury After Delayed ACL Reconstruction. Multicenter retrospective cohort of 2,033 patients (mean age 30.6) undergoing primary ACL reconstruction 2013-2023. Surgery delayed >120 days increased odds of medial meniscus tears by 80% (aOR 1.80; p<0.001). Male gender conferred 43% higher risk of medial tears, 61% higher risk of lateral tears, and 50% higher risk of combined tears. Nickelberry, C., et al. Am J Sports Med. 2026, May; 54(6): 1360-1364.
13. Heavy Sled Load Sprint Training on Acceleration in Adolescent Sprinters. 32 adolescent male sprinters randomized into 4 groups (25%, 40%, 50% body mass and non-resisted). Training: 2x/week for 8 weeks. The 40% and 50% body mass groups showed significant within-group improvements in 30 m sprint time (p<0.05) greater than NR group. The 25% body mass group improved 60 m sprint performance. Greater forward trunk lean and improved push-off angle in 40%/50% groups. Jia, L., et al. BMC Sports Sci Med Rehabil. 2025; 18: 8.
14. Blood Flow Restriction Resistance Exercise for Arm Muscle Strength. 22 healthy recreationally trained males (mean age 26.3) randomized to LL-BFRT (30% 1RM with progressive 30-50% arterial occlusion) or HL-RT (70% 1RM). 7 weeks, 2x/week. Both groups showed significant improvements (p<0.05). 1RM improvements 19.9-29.5% similar between groups. No adverse events. Conclusion: BFRT at 30% 1RM yields similar strength gains as traditional 70% 1RM training. Kocaman, H., et al. BMC Sports Sci Med Rehabil. 2026; 18: 202.
15. Risk Factors for Early-Onset and Late-Onset Dementia. Data pooled from 5 cohorts (UK Biobank and 4 US cohorts) - 544,442 participants, mean follow-up 13.7 years. 807 early-onset and 14,253 late-onset cases identified. Adjusted analysis: female sex protective for early-onset (HR 0.70); Black participants higher early dementia risk (HR 1.61); grade-school education or less (HR 1.99); diabetes (HR 2.45); depression (HR 2.73); current smoking (HR 1.86); obesity (HR 1.24); physical inactivity (HR 1.33); alcohol over-consumption (HR 1.22). Most factors had stronger associations with early-onset dementia. Giorgio, K., et al. Lancet Healthy Longev. 2026, March; 7(3): 100831.
16. Mediterranean Diet-Inspired Supplement Reduces Amyloid Deposits and Microglial Activation. 32 transgenic mice (16M/16F) randomized at 6 weeks to control diet or diet supplemented with Neurosyn240 (French Grape and North-American Wild Blueberry extract, saffron, green tea, olive leaf extract, trans-resveratrol, zinc, vitamins B5/B9/B12/C/D3/E) for 12 weeks. Treatment group showed significant increase in gut microbiome beta biodiversity. Hippocampal thioflavin S-positive amyloid deposits and Iba-1-positive microglia were reduced (both p<0.05). Connell, E., et al. Gut Microbes. 2026, Dec; 18(1): 2614030.
17. Antibiotic Use and Gut Microbiome Composition. Swedish Prescribed Drug Register combined with fecal metagenomes from 14,979 adults across SCAPIS, SIMPLER and MOS cohorts. Antibiotic use in all three periods (up to 8 years) was associated with reduced gut microbiome species diversity. Strongest effects: clindamycin, fluoroquinolones and flucloxacillin. Even a single antibiotic course 4-8 years prior linked to lower diversity and altered species abundances. Baldanzi, G., et al. Nat Med. 2026, April; 32: 1351-1361.
18. Circulatory Dietary and Gut-Derived Metabolites Predict Early Cognitive Decline. Overnight-fasted serum samples from 150 adults (50 healthy controls, 50 SCI, 50 MCI), matched for age/BMI/gender. SCI and MCI groups had lower neuroprotective metabolites: choline, 5-hydroxyindole acetic acid, indole-3-propionic acid; and elevated cytotoxic indoxyl sulfate (all p<0.05). Kynurenic acid higher in SCI (p=0.015). Random forest model: 6 metabolites distinguished control, SCI and MCI groups. Connell, E., et al. Gut Microbes. 2026, March; 18(1): 2649487.
19. Sweat Sensors for Continuous Glucose Monitoring. Systematic review of 25 studies (2016-2025) of non-enzymatic sweat-based glucose sensors for pediatric CGM. Scalable fabrication methods (screen printing, paper-based chips) achieved MARD <10.5%; complex approaches (liquid metal/3D printing) reached best MARD 6.5% but scored low on scalability. No pediatric sweat-based clinical validation reported. Bolaji, O., et al. BMC Biomed Eng. 2026; 8: 8.
20. Efficacy and Safety of an mRNA Seasonal Influenza Vaccine in Adults. Phase 3, double-blind, randomized, active-controlled trial at 301 sites in 11 Northern Hemisphere countries. 40,703 participants (median age 64) received single IM dose of mRNA-1010 or licensed standard-dose comparator. Confirmed influenza-like illness: 2.0% mRNA-1010 vs 2.8% comparator - 26.6% relative vaccine efficacy (p<0.001), meeting noninferiority and superiority criteria. Injection-site pain (65.8% vs 29.8%) and fatigue (45.1% vs 20.3%) more frequent with mRNA-1010 but mild and transient. Serious adverse events comparable (2.2% vs 1.9%). Leroux-Roels, I., et al. N Engl J Med. 2026; 394: 1803-1813.
21. Arthroscopic Platelet Rich Plasma Gel Augmentation in Rotator Cuff Repair. Retrospective cohort of 152 patients with full-thickness supraspinatus tears. PRP group (n=91) received thrombin-activated PRP gel at tendon-bone interface; control (n=61) standard repair. At 6 months PRP group showed greater improvement: CMS 23.33 vs 13.08 (p<0.01), ASES 45.56 vs 38.78 (p<0.01), SSV 82.97% vs 78.85% (p=0.006), VAS pain -3.97 vs -3.51 (p<0.01). Sugaya grades I/II: 89.0% vs 54.1% (p<0.001). Retear rates: 2.2% vs 13.1% (p<0.01). Zhang, J., et al. BMC Musculoskelet Disord. 2025, Dec; 27(1): 12.
22. Driving After Concussion on Simulated Driving Performance. Cross-sectional study of 49 young-adult patients diagnosed with concussion (mean age 19.3) who completed driving simulation 0-12 days post-injury. Primary outcomes: total collisions, speed exceedances, missed stop signs, centerline crossings, road edge excursions, total drive time, percent time over speed limit, percent time out of lane. Segment-specific speed and lateral lane position variability analyzed across 11 driving scenarios. Data examined for associations with days since concussion.
Editorial Board: Editor-in-Chief - David T. Burke, MD, MA (Emory University, Atlanta, GA). Executive Editor - Randolph L. Roig, MD (Emory University). Copy Editor - Roberta Bell, PhD. Assistant Copy Editor - Tracie E. McCargo, PhD (Harvard U. Ext. Sch.). Director of Global Distribution - John Burke, BA (Burke Foundation, Atlanta, GA). Contributing Editors from Casa Colina Hospital (Pomona, CA), Emory University School of Medicine, LSU Health Sciences Center (New Orleans), Nassau University Medical Center (East Meadow, NY), University of California Irvine, and University of Pennsylvania (Philadelphia).