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Sample records for providing transitional rehabilitation

  1. Primary care provider perceptions of intake transition records and shared care with outpatient cardiac rehabilitation programs

    Directory of Open Access Journals (Sweden)

    Jamnik Veronica

    2011-09-01

    Full Text Available Abstract Background While it is recommended that records are kept between primary care providers (PCPs and specialists during patient transitions from hospital to community care, this communication is not currently standardized. We aimed to assess the transmission of cardiac rehabilitation (CR program intake transition records to PCPs and to explore PCPs' needs in communication with CR programs and for intake transition record content. Method 144 PCPs of consenting enrollees from 8 regional and urban Ontario CR programs participated in this cross-sectional study. Intake transition records were tracked from the CR program to the PCP's office. Sixty-six PCPs participated in structured telephone interviews. Results Sixty-eight (47.6% PCPs received a CR intake transition record. Fifty-eight (87.9% PCPs desired intake transition records, with most wanting it transmitted via fax (n = 52, 78.8%. On a 5-point Likert scale, PCPs strongly agreed that the CR transition record met their needs for providing patient care (4.32 ± 0.61, with 48 (76.2% reporting that it improved their management of patients' cardiac risk. PCPs rated the following elements as most important to include in an intake transition record: clinical status (4.67 ± 0.64, exercise test results (4.61 ± 0.52, and the proposed patient care plan (4.59 ± 0.71. Conclusions Less than half of intake transition records are reaching PCPs, revealing a large gap in continuity of patient care. PCP responses should be used to develop an evidence-based intake transition record, and procedures should be implemented to ensure high-quality transitional care.

  2. Providing rehabilitation online

    DEFF Research Database (Denmark)

    Bødker, Malene; Juul, Annegrete

    2015-01-01

    Purpose – Telecare promises to deliver healthcare services more efficiently while, at the same time, improving the quality of care. The purpose of this paper is to challenge these promises by analysing the implications of introducing telecare in the rehabilitation of patients suffering from chron...

  3. Parents' perceptions of the services provided to children with cerebral palsy in the transition from preschool rehabilitation to school-based services

    NARCIS (Netherlands)

    Alsem, M. W.; Verhoef, M.|info:eu-repo/dai/nl/290465508; Gorter, J. W.; Langezaal, L. C M; Visser-Meily, J. M A|info:eu-repo/dai/nl/180428047; Ketelaar, M.|info:eu-repo/dai/nl/180866850

    2016-01-01

    Aim: To describe the course of parents' perceptions of the family centredness of rehabilitation services provided to their children with cerebral palsy (CP) before and after the transition from preschool to school-based services. Background: Parents of 59 children with CP aged 2.5 to 4.5 years

  4. Transitions of care and rehabilitation after fragility fractures.

    Science.gov (United States)

    Eslami, Michelle; Tran, Hong-Phuc

    2014-05-01

    Transitions in care are a vulnerable time period for patients during which unintended errors may occur. This article discusses potential risks that could occur during care transitions, suggested improvements, and the transition from hospital to skilled nursing facilities for patients needing rehabilitation after their discharge from the hospital. Different rehabilitation settings and their reimbursement are reviewed. Common potential medical conditions arising in patients undergoing rehabilitation, rehabilitation goals, and secondary prevention also are discussed. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Polytrauma transitional rehabilitation programs: Comprehensive rehabilitation for community integration after brain injury.

    Science.gov (United States)

    Duchnick, Jennifer J; Ropacki, Susan; Yutsis, Maya; Petska, Kelly; Pawlowski, Carey

    2015-08-01

    When the U.S. Congress passed the Veterans Health Programs Improvement Act of 2004 and the Consolidated Appropriations Act in 2005, Veterans Affairs (VA) traumatic brain injury centers responded by establishing and developing the polytrauma rehabilitation centers and polytrauma transitional rehabilitation programs (PTRPs) across 4 sites in Minneapolis, Minnesota, Palo Alto, California, Richmond, Virginia, and Tampa, Florida, in 2007. The 5th PTRP was opened in 2011 in San Antonio, Texas. This article presents the context of establishing these programs within a VA system, describes aspects of programmatic design, and shares characteristics and outcomes of individuals served by the first 4 national centers. PTRPs provide specialized, interdisciplinary brain injury rehabilitation to active-duty service members and veterans with complex rehabilitation needs. A total of 286 individuals participated in the first 4 PTRPs during the first 3 years. Admission and discharge data were collected as part of routine care, and data review focused on describing the demographic, injury, and neurobehavioral functioning outcomes across 4 sites. Mayo-Portland Adaptability Inventory Abilities, Adjustment, and Participation subscales and total scale T-scores served as primary functioning outcome measures. Mean scores are presented. Statistical analysis found a significant change in total scale T-score from admission to discharge, consistent with improved patient functional ability. Challenges associated with the development and implementation of programs are discussed. Elements of programming may be applicable for other health care organizations that seek to improve rehabilitation care delivery. (c) 2015 APA, all rights reserved).

  6. OSERS (Office of Special Education and Rehabilitative Services) Transition Data Fact Sheet

    Science.gov (United States)

    Office of Special Education and Rehabilitative Services, US Department of Education, 2015

    2015-01-01

    The Office of Special Education and Rehabilitative Services (OSERS) administers programs that assist in educating children and youth with disabilities and provides funding for vocational rehabilitation (VR) services for youth and adults with disabilities. OSERS established the Transition Steering Committee to focus specifically on the services,…

  7. Using attribution theory to examine community rehabilitation provider stigma.

    Science.gov (United States)

    Strauser, David R; Ciftci, Ayse; O'Sullivan, Deirdre

    2009-03-01

    This study builds on existing research investigating the stigma-reducing strategies specific to rehabilitation service providers by comparing differences in education levels and degree of contact among rehabilitation service providers. Rehabilitation service providers with master's level and bachelor level education showed significant differences in their stigmatizing tendencies on subscales of controllability and stability for different categories of disabilities. Specifically, service providers with a master's degree had more stigmatizing beliefs for psychosis and cocaine addiction, compared with service providers with a bachelor's degree. Service providers with either a bachelor's degree or master's degree reported lower levels of stigma overall for five of the six categories of disability compared with their community college student counterparts. No differences were found for length of time working with persons with psychiatric disabilities.

  8. Overcoming Barriers to Employment: Strategies of Rehabilitation Providers

    Science.gov (United States)

    Crudden, Adele; Sansing, William; Butler, Stacy

    2005-01-01

    Focus groups of rehabilitation providers identified barriers to the employment of persons who are visually impaired and strategies to overcome them. The barriers included negative attitudes of employers and of persons with visual impairments, inadequate transportation, the lack of access to print, and administrative issues. Strategies for…

  9. Providing Effective Early Intervention Vocational Rehabilitation at the Community Level

    Science.gov (United States)

    Allaire, Saralynn J.; Niu, Jingbo; Zhu, Yanyan; Brett, Belle

    2011-01-01

    The purpose of this study was to evaluate the translation of positive research findings about a job retention intervention for persons with chronic illnesses to rehabilitation practice. A program to provide the intervention was developed and marketed in the community. Fifty-seven consumers with chronic illnesses received the intervention provided…

  10. Warrior Transition Leader: Medical Rehabilitation Handbook

    Science.gov (United States)

    2011-01-01

    expansion of PM&R has resulted from the wars of the 20th century causing unique and complex injuries. Better methods of rehabilitation were needed, and...als. Accessed June 20, 2011. war-rElatEd injuriES and illnESSES h 99 39. Schwarz A. Linking head trauma and ALS in military. New York Times...cognitive deficits. Likewise, warning signs on potentially dangerous materials, substances, and appliances can help maintain safety.59 Smart phones

  11. South African healthcare provider perspectives on transitioning ...

    African Journals Online (AJOL)

    Previous research has investigated the HIV healthcare transition in North America and Europe, yet none has been conducted in SA. Our study is the first to describe the ... Analysis of interview transcripts revealed several overarching perspectives that were corroborated by survey responses. One barrier identified was the ...

  12. South African healthcare provider perspectives on transitioning ...

    African Journals Online (AJOL)

    regarded their patients as particularly vulnerable, they felt a strong and protective attachment towards them. A second barrier identified was a lack of .... parents to keep their children in adolescent care. Youth healthcare providers aimed to ... Patient attachment to adolescent healthcare providers and facilities. In all five sites ...

  13. Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes.

    Science.gov (United States)

    Jesus, Tiago Silva; Silva, Isabel Lopes

    2016-04-01

    There is a growing interest in linking aspects of patient-provider communication to rehabilitation outcomes. However, the field lacks a conceptual understanding on: (a) 'how' rehabilitation outcomes can be improved by communication; and (b) through 'which' elements in particular. This article elaborates on the conceptual developments toward informing further practice and research. Existing models of communication in healthcare were adapted to rehabilitation, and its outcomes through a comprehensive literature review. After depicting mediating mechanisms and variables (e.g. therapeutic engagement, adjustment toward disability), this article presents the '4 Rehab Communication Elements' deemed likely to underpin rehabilitation outcomes. The four elements are: (a) knowing the person and building a supportive relationship; (b) effective information exchange and education; (c) shared goal-setting and action planning; and (d) fostering a more positive, yet realistic, cognitive and self-reframing. This article describes an unprecedented, outcomes-oriented approach toward the design of rehabilitation communication, which has resulted in the development of a new intervention model: the '4 Rehab Communication Elements'. Further trials are needed to evaluate the impact of this whole intervention model on rehabilitation outcomes. © The Author(s) 2015.

  14. Transitions in Pediatric Gastroenterology: Results of a National Provider Survey.

    Science.gov (United States)

    Bensen, Rachel; McKenzie, Rebecca B; Fernandes, Susan M; Fishman, Laurie N

    2016-11-01

    Transition and transfer to adult-oriented health care is an important yet challenging task for adolescents and young adults with chronic medical conditions. Transition practices vary widely, but a paucity of data makes determination of best practices difficult. We described North American pediatric gastroenterologists' preferences and present transition practice patterns and explored whether experience affected providers' perspectives. An online survey was distributed via e-mail to members of the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition. Participation was voluntary and answers were anonymous. Quantitative and qualitative analysis was performed. Almost three quarters of the 175 respondents describe providing transition or self-care management education, but only 23% use structured readiness assessments. Most respondents (88%) report having age cutoffs above which they no longer accept new referrals, with the most common age being 18 years (57%). One third report the ability to provide age-appropriate care to patients older than 21 years. Only 6% indicate that their practice or institution should provide care for individuals older than 25 years. Many (63%) indicate that their practice or institution has a policy regarding age of transfer, but most (79%) are flexible. Provider preferences for triggers to transfer to adult care diverge widely between age, milestones, and comorbidities. Overall, parent (81%) and patient (74%) attachment to pediatric health care providers are cited as the most common barriers to transition. Preferences and practices surrounding transition preparation and transfer to adult care vary widely, reflecting continued uncertainty regarding optimal transition strategies.

  15. Medically unexplained chronic pain in Australia: difficulties for rehabilitation providers and workers in pain.

    Science.gov (United States)

    Wales, Coralie; Matthews, Lynda R; Donelly, Michelle

    2010-01-01

    In Australia, evidence of an ageing population and a skills shortage are imminent challenges for employers [5,50]. A further concern arises from the work injury and motor accident compensation schemes, where many claims for soft tissue injuries result in permanent impairment depriving the community of otherwise productive workers [85]. In many cases, it is chronic pain that becomes the major barrier to a return to productive work. This study will review the operation of rehabilitation within Australian Workers' and Motor Accidents compensation systems in order to identify values and attitudes underpinning the vocational rehabilitation ethos. The models underlying current practice will also be identified. A comprehensive review of published literature and policy documents was undertaken. We identified a variety of contextual factors that influenced progress back into the workforce for people living with persistent pain. The conceptual models underpinning these factors within rehabilitation systems were explored. They were all driven by a strong focus on early return to work and at the same time the sustainability of rehabilitation as a profitable industry. Implications of these findings on the relationship between the rehabilitation provider and the person in pain are discussed. Rehabilitation professionals are influenced by and in turn influence the context in which chronic pain is experienced. Empirical data about the experiences of vocational rehabilitation professionals in Australian personal injury rehabilitation systems is lacking, yet the implications of the cost of chronic pain to the nation are significant. It is recommended that rehabilitation providers increase their awareness of the perhaps unforeseen traps within the various practice models they might be using on the goal of sustainable return to work for people living with pain.

  16. Perceptions of Supported Employment Providers: What Students with Developmental Disabilities, Families, and Educators Need to Know for Transition Planning

    Science.gov (United States)

    Moon, Sherril; Simonsen, Monica L.; Neubert, Debra A.

    2011-01-01

    The purpose of this exploratory study was to survey community rehabilitation providers (CRPs) to determine their perceptions of the skills, experiences, and information that transitioning youth with developmental disabilities (DD) and their families need to access supported employment (SE) services. Supervisors of SE from 12 CRPs across one state…

  17. Patients’ and nurses’ views on providing psychological support within cardiac rehabilitation programmes: a qualitative study

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-01-01

    Objective To explore patients’ and nurses’ views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. Design In-depth interviews analysed thematically. Participants 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Setting Cardiac services based in the South West of England and the East Midlands, UK. Results Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients’ accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual’s mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Conclusions Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. Trial registration number ISCTRN34701576. PMID:28864707

  18. Rehabilitation

    Science.gov (United States)

    ... doing things you did before. This process is rehabilitation. Rehabilitation often focuses on Physical therapy to help your ... who has had a stroke may simply want rehabilitation to be able to dress or bathe without ...

  19. 78 FR 28949 - Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation)

    Science.gov (United States)

    2013-05-16

    ... Homeless Providers Grant and Per Diem Program, Department of Veterans Affairs, 10770 North 46th Street... AFFAIRS Fund Availability Under VA's Homeless Providers Grant and Per Diem Program (Rehabilitation) AGENCY... grantee facilities originally funded under VA's Homeless Providers Grant and Per Diem Program (see funding...

  20. Elements of patient-health-care provider communication related to cardiovascular rehabilitation referral.

    Science.gov (United States)

    Pourhabib, Sanam; Chessex, Caroline; Murray, Judy; Grace, Sherry L

    2016-04-01

    Cardiovascular rehabilitation has been designed to decrease the burden of cardiovascular disease. This study described (1) patient-health-care provider interactions regarding cardiovascular rehabilitation and (2) which discussion elements were related to patient referral. This was a prospective study of cardiovascular patients and their health-care providers. Discussion utterances were coded using the Roter Interaction Analysis System. Discussion between 26 health-care providers and 50 patients were recorded. Cardiovascular rehabilitation referral was related to greater health-care provider interactivity (odds ratio = 2.82, 95% confidence interval = 1.01-7.86) and less patient concern and worry (odds ratio = 0.64, 95% confidence interval = 0.45-0.89). Taking time for reciprocal discussion and allaying patient anxiety may promote greater referral. © The Author(s) 2014.

  1. Improving Stroke Caregiver Readiness for Transition From Inpatient Rehabilitation to Home.

    Science.gov (United States)

    Lutz, Barbara J; Young, Mary Ellen; Creasy, Kerry Rae; Martz, Crystal; Eisenbrandt, Lydia; Brunny, Jarrett N; Cook, Christa

    2017-10-01

    As the population ages, older adults are more often living with functional limitations from chronic illnesses, such as stroke, and require assistance. Because stroke occurs suddenly, many stroke family caregivers in the United States are unprepared to assume caregiving responsibilities post-discharge. Research is limited on how family members become ready to assume the caregiving role. In this study, we developed a theoretical model for improving stroke caregiver readiness and identifying gaps in caregiver preparation. We interviewed 40 stroke family caregivers caring for 33 stroke survivors during inpatient rehabilitation and within 6 months post-discharge for this grounded theory study. Data were analyzed using dimensional analysis and constant comparative techniques. Caregivers identified critical areas where they felt unprepared to assume the caregiving role after discharge from inpatient rehabilitation. Steps to improve preparation include (a) conducting a risk assessment of the patient and caregiver; (b) identifying and prioritizing gaps between the patient's needs and caregiver's commitment and capacity; and (c) developing a plan for improving caregiver readiness. The model presented provides a family-centered approach for identifying needs and facilitating caregiver preparation. Given recent focus on improving care coordination, care transitions, and patient-centered care to help improve patient safety and reduce readmissions in this population, this research provides a new approach to enhance these outcomes among stroke survivors with family caregivers.

  2. Achieving Community Membership through Community Rehabilitation Provider Services: Are We There Yet?

    Science.gov (United States)

    Metzel, Deborah S.; Boeltzig, Heike; Butterworth, John; Sulewski, Jennifer Sullivan; Gilmore, Dana Scott

    2007-01-01

    Findings from an analysis of the characteristics and services of community rehabilitation providers (CRPs) in the early years of the 21st century are presented. Services provided by CRPs can be categorized along two dimensions: purpose (work, nonwork) and setting (facility-based, community). The number of individuals with disabilities present…

  3. Use of outcome measures in stroke rehabilitation in the transition from hospital to home-based rehabilitation

    DEFF Research Database (Denmark)

    Maribo, Thomas; Nielsen, Claus Vinther

    treating stroke patients at home in three regions in Denmark. The three regions have a total population of three million. The survey was targeted at health care professionals that typically take part in municipal health service: nurses, physiotherapists, occupational therapists, speech......-language pathologists, nursing assistants and neuropsychologists. The questionnaire had one open-ended question: “Which instruments, outcome measures or tests are commonly used to describe functioning in persons with stroke?”. The questionnaire underlined that only instruments routinely used to assess functioning were......Relevance: Stroke is one of the major chronic diseases leading to long-term disability. Stroke treatment has improved and in-hospital stays have been reduced, leading to increasing emphasis on home-based rehabilitation. The transition from hospital to home-based rehabilitation is critical, as vital...

  4. Care Transitions in Childhood Cancer Survivorship: Providers' Perspectives.

    Science.gov (United States)

    Mouw, Mary S; Wertman, Eleanor A; Barrington, Clare; Earp, Jo Anne L

    2017-03-01

    Most adolescent and young adult (AYA)-aged childhood cancer survivors develop physical and/or psychosocial sequelae; however, many do not receive long-term follow-up (LTF) critical for screening, prevention, and treatment of late effects. To develop a health services research agenda to optimize care models, we conducted qualitative research with LTF providers examining existing models, and successes and challenges in maintaining survivors' connections to care across their transition to adulthood. We interviewed 20 LTF experts (MDs, RNs, social workers, education specialists, psychologists) from 10 Children's Oncology Group-affiliated institutions, and analyzed data using grounded theory and content analysis techniques. Participants described the complexity of survivors' healthcare transitions. Survivors had pressing educational needs in multiple domains, and imparting the need for prevention was challenging. Multidisciplinary LTF teams focused on prevention and self-management. Care and decisions about transfer were individualized based on survivors' health risks, developmental issues, and family contexts. An interplay of provider and institutional factors, some of which were potentially modifiable, also influenced how transitions were managed. Interviewees rarely collaborated with community primary care providers to comanage patients. Communication systems and collective norms about sharing care limited comanagement capacity. Interviewees described staffing practices, policies, and informal initiatives they found reduced attrition. Results suggest that survivors will benefit from care models that better connect patients, survivorship experts, and community providers for uninterrupted LTF across transitions. We propose research priorities, framing attrition from LTF as a public health concern, transition as the central challenge in LTF, and transition readiness as a multilevel concept.

  5. Patients' and nurses' views on providing psychological support within cardiac rehabilitation programmes: a qualitative study.

    Science.gov (United States)

    Turner, Katrina M; Winder, Rachel; Campbell, John L; Richards, David A; Gandhi, Manish; Dickens, Chris M; Richards, Suzanne

    2017-09-01

    To explore patients' and nurses' views on the feasibility and acceptability of providing psychological care within cardiac rehabilitation services. In-depth interviews analysed thematically. 18 patients and 7 cardiac nurses taking part in a pilot trial (CADENCE) of an enhanced psychological care intervention delivered within cardiac rehabilitation programmes by nurses to patients with symptoms of depression. Cardiac services based in the South West of England and the East Midlands, UK. Patients and nurses viewed psychological support as central to good cardiac rehabilitation. Patients' accounts highlighted the significant and immediate adverse effect a cardiac event can have on an individual's mental well-being. They also showed that patients valued nurses attending to both their mental and physical health, and felt this was essential to their overall recovery. Nurses were committed to providing psychological support, believed it benefited patients, and advocated for this support to be delivered within cardiac rehabilitation programmes rather than within a parallel healthcare service. However, nurses were time-constrained and found it challenging to provide psychological care within their existing workloads. Both patients and nurses highly value psychological support being delivered within cardiac rehabilitation programmes but resource constraints raise barriers to implementation. Consideration, therefore, should be given to alternative forms of delivery which do not rely solely on nurses to enable patients to receive psychological support during cardiac rehabilitation. ISCTRN34701576. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. MagicMirror: designing for transitions as they play out in everyday physical rehabilitation

    DEFF Research Database (Denmark)

    Bagalkot, Naveen L.; Sokoler, Tomas

    2011-01-01

    In this paper we report our initial experiences in designing digital technology for facilitating various kinds of transitions that elderly citizens and therapists manage, as they go about the rehabilitation process in the clinic and beyond. Specifically we detail MagicMirror as an example sketch...

  7. Experiences of patients and service providers with out-patient rehabilitation services in a rehabilitation centre in the Western Cape Province

    Directory of Open Access Journals (Sweden)

    Anne Kumurenzi

    2015-02-01

    Full Text Available Background: Rehabilitation is important for persons with disabilities as it contributes to their sense of autonomy, self-worth and social participation, and improves their quality of life. Improving the quality of rehabilitation services requires the dialogue of patients’ perceptions with those of service providers, in order to recommend informed reform. Objective: The objective was to explore the experiences of persons with physical disabilities and service providers, regarding the multi-disciplinary rehabilitation services provided at a community-based out-patient rehabilitation centre. Methods: A qualitative, exploratory study design was used to collect the data. A focus group was conducted with conveniently selected persons with physical disabilities. Three in-depth interviews were conducted with purposively selected key informants. All ethical considerations were adhered to during the implementation of the study.Results: Patients and service providers had different experiences regarding accessibility to rehabilitation services, and similar experiences with patient education and intensity of rehabilitation. Although the patients experienced that the service providers had sufficient knowledge and skills to manage them, services providers expressed that they lacked certain skills.Conclusions: The experiences expressed highlighted the need to improve rehabilitation services in terms of increasing the capacity of service providers and providing transport services for persons with disabilities.

  8. Critical Transitions: A Mixed Methods Examination of Sleep from Inpatient Alcohol Rehabilitation Treatment to the Community.

    Directory of Open Access Journals (Sweden)

    Alyssa Todaro Brooks

    Full Text Available This prospective, repeated measures study utilized a convergent parallel mixed methods approach to assess sleep experiences among individuals who were alcohol-dependent undergoing inpatient detoxification and treatment at a clinical research facility across the transition periods associated with the rehabilitation process: the initial adjustment to becoming an inpatient and the transition from inpatient to outpatient status.This study included individual semi-structured interviews and quantitative measures relating to psychological distress, sleep quality, daytime sleepiness, and sleep-related beliefs and behavior (n = 33; 66.7% male. Interviews were conducted and questionnaires were administered within one week of participants' scheduled discharge date and again four to six weeks post-discharge when they returned for a follow-up visit (or via phone.Participants self-reported significant sleep disturbances at both study time points. Of those participants with valid data at both time points (n = 28, there were no significant changes in mean scores from pre- to post-discharge with the exception of self-efficacy for sleep (SE-S being significantly higher post-discharge. Preliminary qualitative findings suggested differences between those with ongoing sleep disturbances, those whose sleep disturbances had resolved, and those with no sleep disturbances at either time point.This analysis highlights individual variation in sleep throughout the process of inpatient treatment and transition to outpatient aftercare in individuals with alcohol dependence. Collecting quantitative and qualitative data concurrently and combining emerging themes from qualitative data with quantitative analyses allowed for a more thorough examination of this relatively novel area of research and provided information that can be utilized to inform future behavioral sleep interventions.

  9. Critical Transitions: A Mixed Methods Examination of Sleep from Inpatient Alcohol Rehabilitation Treatment to the Community.

    Science.gov (United States)

    Brooks, Alyssa Todaro; Krumlauf, Michael; Fryer, Craig S; Beck, Kenneth H; Yang, Li; Ramchandani, Vijay A; Wallen, Gwenyth R

    2016-01-01

    This prospective, repeated measures study utilized a convergent parallel mixed methods approach to assess sleep experiences among individuals who were alcohol-dependent undergoing inpatient detoxification and treatment at a clinical research facility across the transition periods associated with the rehabilitation process: the initial adjustment to becoming an inpatient and the transition from inpatient to outpatient status. This study included individual semi-structured interviews and quantitative measures relating to psychological distress, sleep quality, daytime sleepiness, and sleep-related beliefs and behavior (n = 33; 66.7% male). Interviews were conducted and questionnaires were administered within one week of participants' scheduled discharge date and again four to six weeks post-discharge when they returned for a follow-up visit (or via phone). Participants self-reported significant sleep disturbances at both study time points. Of those participants with valid data at both time points (n = 28), there were no significant changes in mean scores from pre- to post-discharge with the exception of self-efficacy for sleep (SE-S) being significantly higher post-discharge. Preliminary qualitative findings suggested differences between those with ongoing sleep disturbances, those whose sleep disturbances had resolved, and those with no sleep disturbances at either time point. This analysis highlights individual variation in sleep throughout the process of inpatient treatment and transition to outpatient aftercare in individuals with alcohol dependence. Collecting quantitative and qualitative data concurrently and combining emerging themes from qualitative data with quantitative analyses allowed for a more thorough examination of this relatively novel area of research and provided information that can be utilized to inform future behavioral sleep interventions.

  10. Providing Sources of Self-Efficacy Through Technology Enhanced Post-Stroke Rehabilitation in the Home.

    Science.gov (United States)

    Parker, Jack; Mawson, Susan

    2017-01-01

    This research explores the impact of receiving feedback through a Personalised Self-Managed Rehabilitation System (PSMrS) for home-based post-stroke rehabilitation on the users' self-efficacy; more specifically, mastery experiences and the interpretation of biomechanical data. Embedded within a realistic evaluation methodological approach, exploring the promotion of self-efficacy from the utilisation of computer-based technology to facilitate post-stroke upper-limb rehabilitation in the home included; semi-structured interviews, quantitative user data (activity and usage), observations and field notes. Data revealed that self-efficacy was linked with obtaining positive knowledge of results feedback. Encouragingly, this also transferred to functional activities such as, confidence to carry out kitchen tasks and bathroom personal activities. Findings suggest the PSMrS was able to provide key sources of self-efficacy by providing feedback which translated key biomechanical data to the users. Users could interpret and understand their performance, gain a sense of mastery and build their confidence which in some instances led to increased confidence to carry out functional activities. However, outcome expectations and socio-structural factors impacted on the self-efficacy associated with the use of the system. Increasing the understanding of how these factors promote or inhibit self-management and self-efficacy is therefore crucial to the successful adoption of technology solutions and promotion of self-efficacy.

  11. Participant and service provider perceptions of an outpatient rehabilitation program for people with acquired brain injury.

    Science.gov (United States)

    Poncet, Frédérique; Pradat-Diehl, Pascale; Lamontagne, Marie-Eve; Alifax, Anne; Fradelizi, Pascaline; Barette, Maude; Swaine, Bonnie

    2017-09-01

    A holistic, intensive and interdisciplinary rehabilitation program for people with acquired brain injury (ABI) was developed at the Pitié-Salpêtrière Hospital, France (5 days/week for 7 weeks). This program, recently demonstrated effective, aimed to optimize the ability of people with ABI to perform activities and improve their participation by using individual and group interventions involving ecologically valid activities inside (e.g., in the gym and kitchen) and outside the hospital. However, the perception of the quality of the program by participants and service providers has not yet been reported. This study had 3 objectives: (1) report the perception of participants (adults with ABI) in terms of service quality of the program, (2) report the strengths, weaknesses, opportunities, and threats (SWOT analysis) of the program as perceived by service providers, and (3) triangulate findings to draw conclusions about the program's quality and provide recommendations for quality improvement. We used a mixed-methods design with a validated questionnaire (Perception of Quality of Rehabilitation Services [PQRS-Montreal]) and interviews (structured around a SWOT analysis) involving program participants and service providers. We included 33 program participants (mean age 43.6 years) and 12 service providers (mean years with program 7.6 years). In general, study participants showed a convergence of opinion about the high quality of the program, particularly regarding the team and its participant-focused approach. Specific aspects of the program were viewed more negatively by both participants and service providers (i.e., addressing sexuality, family involvement and return to work/volunteer work/school). Participant and service provider perceptions of the rehabilitation program under study were generally positive. A reliable and valid questionnaire and interviews helped identify aspects of the program that worked well and those that could be targeted for future quality

  12. Romania's Railways under Transition: Reorganisation Rehabilitation and Regional Development

    Directory of Open Access Journals (Sweden)

    David Turnock

    2003-07-01

    Full Text Available The paper attempts a review of the Romanian Railwaysduring transition. The first half of the paper considers the fall intraffic and the resulting financial problems which have made itdifficult to maintain the system and continue with any development.The organisation has been restructured so that separatefreight and passenger companies can now concentrate on specificbusiness and compete on the market while the infrastructurecompany is catching up on the maintenance backlog andis proceeding slowly with further electrification. The secondsection concentrates on the European project for high-speedtransport corridors and especially the interest of Romania'srailways in Corridors Four and Nine. Although there have beendelays over several years in starting the complex work of upgrading,contracts for the first phase of Corridor Four (Bucharest-Ctimpina have now been signed, a new passenger coachrunning 200 km/his in service and locomotive upgrades are underway.The significance of all this for regional developmentlies in the fact that remarkably little of the 1989 network hasbeen closed and the system has remained basically intact tocope with the upswing in the economy that has taken placefrom 2000 onwards. The high-speed corridors, which include anumber of variants, comprise suffteient axes to afford directlinks with the economic macro regions while additional projectsare on hand to improve cohesion on the eastern frontier wherethe most serious development challenges exist.

  13. Patients' and providers' perceptions of the impact of health literacy on communication in pulmonary rehabilitation.

    Science.gov (United States)

    Sadeghi, Shiva; Brooks, Dina; Goldstein, Roger S

    2013-05-01

    Chronic obstructive pulmonary disease (COPD) is the most prevalent form of chronic respiratory diseases worldwide. Pulmonary rehabilitation, including self-management education, highlights the importance of good patient-provider communication in establishing optimal care. There is a growing awareness of the potential impact of health literacy (HL) on the patients' access to and understanding of medical information. This study was designed to explore the patients' and health care professionals' (HCPs) perceptions of the role of HL in health communication. Semi-structured interviews and focus groups were conducted with 12 patients and 20 HCPs at a Pulmonary Rehabilitation Center in Metropolitan Toronto. Although the term health literacy was not familiar to many patients, the contribution of knowledge to patient well-being was consistently identified by patients and HCPs. Barriers to communication included provider time constraints and the use of medical jargon. For providers they also included patient characteristics, language, culture and awareness of health resources. Approaches that might improve communication incorporated family support, peer support, better print and visual teaching material and a trusting empathic patient-provider relationship. The findings provide an increased understanding of patients' and providers' perceptions of HL as a barrier to effective communication of medical information to patients with COPD as well as approaches that might improve this communication.

  14. [Comprehensibility of patient education in orthopaedic rehabilitation: a qualitative study on patients and providers].

    Science.gov (United States)

    Nagl, M; Ullrich, A; Farin, E

    2013-02-01

    An important requirement for achieving postulated goals in the context of patient education is that patient education be conducted in a way that the patients can understand it. It is the objective of this explorative study to examine how patients and providers evaluate the comprehensibility and patients' comprehension of patient education under routine conditions during orthopaedic rehabilitation. Furthermore, we aim to explore the influencing factors that patients and providers describe as conducive and counterproductive to the comprehensibility of patient education, and the ideas or desires they have as to how patient education can be made more comprehensible. We conducted guided focus groups with 50 patients with chronic back pain or osteoarthritis aged between 22 and 71 years (M=50.4, SD=9.4) and 35 patient education providers aged between 26 and 61 years (M=44.9, SD=9.8) in a total of 9 orthopaedic rehabilitation centres. Qualitative analyses of the interview transcripts were conducted according to Mayring's content analytic approach using Atlas.ti software. Patients and providers evaluate patient education as generally comprehensible. The involvement of patients in patient education is reported by both patients and providers as the main conducive factor. Patients describe poor (e. g. superficial or contradictory) information as counterproductive regarding comprehensibility, while providers tend to mention patients' lack of motivation and of taking personal responsibility as hindering patients' comprehension. Patients' and providers' proposals and ideas can be organized in the topics patient education (e. g. stronger reference to patients' everyday life), providers (e. g. improving providers' tutoring skills), information (e. g. more information), patient involvement (e. g. stronger consideration of patients' interests), organization (e. g. smaller groups), and goal clarification (e. g. consideration of patients' expectations). Our results reveal that good

  15. Rehabilitering

    DEFF Research Database (Denmark)

    Hørdam, Britta

    2008-01-01

    En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser.......En interviewundersøgelse af patienter, der får gennemført hofteoperation, en opgørelse af deres selvvurdere helbredsstatus med henblik på at tilrettelægge rehabilitering baseret på patienternes egne præmisser....

  16. Gender Differences in Vocational Rehabilitation Service Predictors of Successful Competitive Employment for Transition-Aged Individuals with Autism

    Science.gov (United States)

    Sung, Connie; Sánchez, Jennifer; Kuo, Hung-Jen; Wang, Chia-Chiang; Leahy, Michael J.

    2015-01-01

    As males and females with autism spectrum disorder (ASD) experience different symptomology, their needs for vocational rehabilitation (VR) are unique as they transition into adulthood. This study examined the effects of gender differences in VR service predictors on employment outcomes for transition-aged individuals with ASD. A total of 1696…

  17. Variation in patient perceptions of healthcare provider endorsement of cardiac rehabilitation.

    Science.gov (United States)

    Tsui, Courtney Kwan-Yee; Shanmugasegaram, Shamila; Jamnik, Veronica; Wu, Gilbert; Grace, Sherry L

    2012-01-01

    Cardiac rehabilitation (CR) is significantly underutilized. However, physician endorsement promotes greater patient utilization. This study examined perceptions of provider endorsement by patients (1) of sociodemographic groups who are often less represented in CR and by clinical indication and (2) by type of healthcare provider and place of referral. Referred cardiac (N = 1156) inpatients from 11 hospitals across Ontario completed a sociodemographic survey inhospital and a mailed followup survey 1 year later. Respondents self-reported perceived healthcare provider endorsement of CR on a 5-point Likert scale, type of referring healthcare provider, and where the referral was initiated. The overall perceived strength of healthcare provider endorsement to CR was 3.75 ± 1.15. Patients who perceived greater endorsement were significantly more likely to enrol (OR = 2.07) and attend a greater percentage of CR sessions (P endorsement of CR than their respective counterparts. Perception of CR endorsement did not differ significantly on the basis of location of referral initiation (P ≥ .05), but those who discussed CR with family doctors (P endorsement than those discussing CR with nurses. Given the proven benefits of CR, all healthcare providers are recommended to universally and strongly encourage CR participation among their patients in order to optimize utilization and subsequent recovery.

  18. Rehabilitering

    DEFF Research Database (Denmark)

    Caswell, Dorte; Høybye-Mortensen, Matilde; Dall, Tanja

    2013-01-01

    Rehabilitering som både begreb og indsats har været genstand for stigende fokus i de seneste år, på både politisk, organisatorisk og praksis-niveau. Fra januar 2013 træder en større reform af førtidspension og fleksjob i kraft, og med reformen etableres ’rehabilitering’ som både mål og middel i...

  19. Pulmonary rehabilitation and COPD: providing patients a good environment for optimizing therapy

    Directory of Open Access Journals (Sweden)

    Corhay JL

    2013-12-01

    Full Text Available Jean-Louis Corhay, Delphine Nguyen Dang, Hélène Van Cauwenberge, Renaud Louis Department of Pneumology, Centre Hospitalier Universitaire du Sart-Tilman Liège, Liège, Belgium Abstract: Chronic obstructive pulmonary disease (COPD is an obstructive and progressive airway disease associated with an important reduction in daily physical activity and psychological problems that contribute to the patient's disability and poor health-related quality of life (HRQoL. Nowadays, pulmonary rehabilitation (PR plays an essential role in the management of symptomatic patients with COPD, by breaking the vicious circle of dyspnea–decreased activity–deconditioning–isolation. Indeed the main benefits of comprehensive PR programs for patients with COPD include a decrease in symptoms (dyspnea and fatigue, improvements in exercise tolerance and HRQoL, reduction of health care utilization (particularly bed-days, as well as an increase in physical activity. Several randomized studies and meta-analyses greatly established the benefits of PR, which additionally, is recommended in a number of influential guidelines. This review aimed to highlight the impact of PR on COPD patients, focusing on the clinical usefulness of PR, which provides patients a good support for change. Keywords: chronic obstructive pulmonary disease, exercise training, physical activity, quality of life

  20. Transition-Age Youths with Visual Impairments in Vocational Rehabilitation: A New Look at Competitive Outcomes and Services

    Science.gov (United States)

    Giesen, J. Martin; Cavenaugh, Brenda S.

    2012-01-01

    Introduction: Given the low rate of closure of cases for employment, the study presented here analyzed the characteristics of consumers and services that predict competitive employment for youths with visual impairments who are making the transition from secondary education to employment in the vocation rehabilitation program. Methods: Using data…

  1. From cradle to commencement: transitioning pediatric sickle cell disease patients to adult providers.

    Science.gov (United States)

    Doulton, Donna M

    2010-01-01

    Children with sickle cell disease (SCD) are surviving past childhood and well into adulthood. Concerns are raised as to who is going to care for these children as they reach adulthood. We have developed a 2-part transition program. We have transitioned 20 of our 18- to 27-year-old patients to adult providers recognizing that early preparation is essential. At the newborn's initial visit or transfer from another clinic the transition program is explained to the family. At age 13 years, all our patients are given a "Preparation for Transition" binder. This binder is reviewed in detail with the patient and parent on a regular basis. At 18 years of age, coordinating with the milestone of graduating from high school and depending on developmental age, the transition is completed. The goal is a continuum of care in the transition process.

  2. Resident Dyads Providing Transition Care to Adolescents and Young Adults With Chronic Illnesses and Neurodevelopmental Disabilities.

    Science.gov (United States)

    Chung, Richard J; Jasien, Joan; Maslow, Gary R

    2017-04-01

    Youth with special health care needs often experience difficulty transitioning from pediatric to adult care. These difficulties may derive in part from lack of physician training in transition care and the challenges health care providers experience establishing interdisciplinary partnerships to support these patients. This educational innovation sought to improve pediatrics and adult medicine residents' interdisciplinary communication and collaboration. Residents from pediatrics, medicine-pediatrics, and internal medicine training programs participated in a transitions clinic for patients with chronic health conditions aged 16 to 26 years. Residents attended 1 to 4 half-day clinic sessions during 1-month ambulatory rotations. Pediatrics/adult medicine resident dyads collaboratively performed psychosocial and medical transition consultations that addressed health care navigation, self-care, and education and vocation topics. Two to 3 attending physicians supervised each clinic session (4 hours) while concurrently seeing patients. Residents completed a preclinic survey about baseline attitudes and experiences, and a postclinic survey about their transitions clinic experiences, changes in attitudes, and transition care preparedness. A total of 46 residents (100% of those eligible) participated in the clinic and completed the preclinic survey, and 25 (54%) completed the postclinic survey. A majority of respondents to the postclinic survey reported positive experiences. Residents in both pediatrics and internal medicine programs reported improved preparedness for providing transition care to patients with chronic health conditions and communicating effectively with colleagues in other disciplines. A dyadic model of collaborative transition care training was positively received and yielded improvements in immediate self-assessed transition care preparedness.

  3. Heart shaking transitions - A phenomenological-hermeneutic study of patients´ experiences in cardiac rehabilitation

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.

    enrolled in the cardiac rehabilitation programme. The data underwent interpretation consisting of three phases: naïve reading, structural analysis and comprehensive interpretation. Results. The preliminary findings are that the patients go through a Heart Shaking Journey in Cardiac Rehabilitation. Three...

  4. HEART SHAKING TRANSITIONS - A PHENOMENOLOGICAL-HERMENEUTIC STUDY OF PATIENTS’ EXPERIENCES IN CARDIAC REHABILITATION

    DEFF Research Database (Denmark)

    Simonÿ, Charlotte; Dreyer, Pia; Pedersen, Birthe D.

    in the cardiac rehabilitation programme. The data underwent interpretation consisting of three phases: naïve reading, structural analysis and comprehensive interpretation. Results. The preliminary findings are that the patients go through a Heart Shaking Journey in Cardiac Rehabilitation. Three themes emerged...

  5. Transitions from hospital to community care: the role of patient-provider language concordance.

    Science.gov (United States)

    Rayan, Nosaiba; Admi, Hanna; Shadmi, Efrat

    2014-01-01

    Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients' discharge from hospital to community care, specifically examining the relationship between patient-provider language concordance and the quality of transitional care. This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0-100 scale)) and on the primary-care post-discharge visit. Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient-provider language concordance was present in 49% of minority patients' discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P <0.001). Other aspects significantly associated with CTM scores: extent of discharge explanations (P <0.05), quality of discharge briefing (P <0.001), and post-discharge explanations by the primary care physician (P <0.01). Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients.

  6. Meeting the Challenge: Innovation in One State Rehabilitation System's Approach to Transition

    Science.gov (United States)

    Jorgensen-Smith, Tammy; Lewis, Sandra

    2004-01-01

    This article describes a pilot program that used local rehabilitation facilities to address the career education needs of visually impaired students aged 14-21 in three Florida communities. The extensive planning, data collection, and evaluation process will allow this project to be improved and expanded throughout the state.

  7. Transitions from hospital to community care: the role of patient–provider language concordance

    Science.gov (United States)

    2014-01-01

    Background Cultural and language discordance between patients and providers constitutes a significant challenge to provision of quality healthcare. This study aims to evaluate minority patients’ discharge from hospital to community care, specifically examining the relationship between patient–provider language concordance and the quality of transitional care. Methods This was a multi-method prospective study of care transitions of 92 patients: native Hebrew, Russian or Arabic speakers, with a pre-discharge questionnaire and structured observations examining discharge preparation from a large Israeli teaching hospital. Two weeks post-discharge patients were surveyed by phone, on the transition from hospital to community care (the Care Transition Measure (CTM-15, 0–100 scale)) and on the primary-care post-discharge visit. Results Overall, ratings on the CTM indicated fair quality of the transition process (scores of 51.8 to 58.8). Patient–provider language concordance was present in 49% of minority patients’ discharge briefings. Language concordance was associated with higher CTM scores among minority groups (64.1 in language-concordant versus 49.8 in non-language-concordant discharges, P <0.001). Other aspects significantly associated with CTM scores: extent of discharge explanations (P <0.05), quality of discharge briefing (P <0.001), and post-discharge explanations by the primary care physician (P <0.01). Conclusion Language-concordant care, coupled with extensive discharge briefings and post-discharge explanations for ongoing care, are important contributors to the quality of care transitions of ethnic minority patients. PMID:25075273

  8. Back home after an acquired brain injury: building a "low-cost" team to provide theory-driven cognitive rehabilitation after routine interventions.

    Science.gov (United States)

    Pierini, Davide; Hoerold, Doreen

    2014-01-01

    Individuals with Acquired Brain Injury (ABI) could benefit from further cognitive rehabilitation, after they have returned home. However, a lack of specialist services to provide such rehabilitation often prevents this. This leads to reduced reintegration of patients, increased social disadvantages and ultimately, higher economic costs. 10 months post-stroke, a 69 year-old woman was discharged from an inpatient rehabilitation program and returned home with severe cognitive impairments. We describe a pilot project which provided an individualised, low cost rehabilitation program, supervised and trained by a neuropsychologist. Progress was monitored every 3 months in order to decide on continuation of the program, based on the achieved results and predicted costs. Post intervention, despite severe initial impairment, cognitive and most notably daily functioning had improved. Although the financial investment was moderately high for the family, the intervention was still considered cost-effective when compared with the required costs of care in a local non-specialist care home. Moreover, the pilot experience was used to build a "local expert team" available for other individuals requiring rehabilitation. These results encourage the development of similar local "low cost" teams in the community, to provide scientifically-grounded cognitive rehabilitation for ABI patients returning home.

  9. Pediatric Orthopaedic Providers' Views on Transition From Pediatric to Adult Care.

    Science.gov (United States)

    Fishman, Laurie N; DiFazio, Rachel; Miller, Patricia; Shanske, Susan; Waters, Peter M

    2016-09-01

    Surgical specialties are underrepresented in the discussions regarding transition and transfer of patients to adult care. We sought the pediatric orthopaedic perspective on types of patients seen into adulthood, age cut-offs, triggers for transfer, and barriers to transition. We examined provider demographic factors that may influence perspectives. An internet-based survey was sent to all members of the Pediatric Orthopaedic Society of North America and the Pediatric Orthopaedic Practitioner Society. Responses were voluntary and anonymous. Response rates were 27% for the Pediatric Orthopaedic Society of North America and 24% for the Pediatric Orthopaedic Practitioner Society. Most respondents (70%) care for patients over the age of 25 years and many (35%) for patients over the age of 40. The most common conditions cared for were neuromuscular and congenital disorders. Respondents who worked in a fully salaried model reported caring for fewer of these adult patients compared with those working in other types of payment structure (Ppatients over 30 years old compared with nonchildren's hospital settings (Ptransfer to adult providers were: (1) adult comorbidities; (2) transition to medical specialist; and (3) institutional policy. The top barriers to transfer were: (1) lack of qualified adult providers; (2) institutional policy; and (3) on-going surgical issues. Many providers care for older patients, often using external triggers for transfer to adult care. Financial considerations may need to be further explored. Variation in care may be aided by national society guidelines. Level III-survey research.

  10. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal ... Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions ...

  11. Perspectives of school-work transitions among youth with spina bifida, their parents and health care providers.

    Science.gov (United States)

    Lindsay, Sally; McPherson, Amy C; Maxwell, Joanne

    2017-04-01

    Purpose Youth with disabilities encounter many challenges in finding employment and transitioning to post-secondary education. In this article, we explore the nature of school-work transitions for youth with spina bifida, which few studies have previously addressed. Method We conducted in-depth interviews with 44 participants (nine youth and 12 young adults with spina bifida, 11 parents and 12 clinicians). We analyzed our data using a qualitative content analysis approach. Results We identified several enablers to school-work transitions, including professional support, social support and school accommodations. Lacking such support created several challenges for youth with spina bifida. We also identified several barriers to school-work transitions, including lack of education and information on finances, housing and transportation; discrimination and stigma; and challenges coping with spina bifida at school and work. Conclusions Although some supports are available, youth with spina bifida encounter many challenges in transitioning to post-secondary education and employment. With clinicians at the helm, efforts should be put in place within the health and social services system to better prepare youth, as they transition to adulthood, to become connected to appropriate information and resources to help them to succeed in their school and employment goals. Implications for Rehabilitation Youth with spina bifida encounter many challenges in transitioning to post-secondary education or work. Clinicians, educators and parents should continue to support youth with spina bifida in choosing their vocations, setting career goals and developing career plans. Starting from a young age, parents, clinicians and educators should help youth with spina bifida prepare for school work transitions by fostering their independence, life skills and self-management of spina bifida-related symptoms. Clinicians and educators should help connect youth with spina bifida to appropriate

  12. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW ...

  13. Barriers and facilitators to successful transition from pediatric to adult inflammatory bowel disease care from the perspectives of providers.

    Science.gov (United States)

    Paine, Christine W; Stollon, Natalie B; Lucas, Matthew S; Brumley, Lauren D; Poole, Erika S; Peyton, Tamara; Grant, Anne W; Jan, Sophia; Trachtenberg, Symme; Zander, Miriam; Mamula, Petar; Bonafide, Christopher P; Schwartz, Lisa A

    2014-11-01

    For adolescents and young adults (AYA) with inflammatory bowel disease (IBD), the transition from pediatric to adult care is often challenging and associated with gaps in care. Our study objectives were to (1) identify outcomes for evaluating transition success and (2) elicit the major barriers and facilitators of successful transition. We interviewed pediatric and adult IBD providers from across the United States with experience caring for AYAs with IBD until thematic saturation was reached after 12 interviews. We elicited the participants' backgrounds, examples of successful and unsuccessful transition of AYAs for whom they cared, and recommendations for improving transition using the Social-Ecological Model of Adolescent and Young Adult Readiness to Transition framework. We coded interview transcripts using the constant comparative method and identified major themes. Participants reported evaluating transition success and failure using health care utilization outcomes (e.g., maintaining continuity with adult providers), health outcomes (e.g., stable symptoms), and quality of life outcomes (e.g., attending school). The patients' level of developmental maturity (i.e., ownership of care) was the most prominent determinant of transition outcomes. The style of parental involvement (i.e., helicopter parent versus optimally involved parent) and the degree of support by providers (e.g., care coordination) also influenced outcomes. IBD transition success is influenced by a complex interplay of patient developmental maturity, parenting style, and provider support. Multidisciplinary IBD care teams should aim to optimize these factors for each patient to increase the likelihood of a smooth transfer to adult care.

  14. Providing Students with an Easystart to Higher Education: The Emerging Role of Digital Technologies to Facilitate Students' Transitions

    Science.gov (United States)

    Hamshire, Claire; Cullen, W. Rod

    2014-01-01

    The transition to higher education can be problematic for some students as they adapt to institutional procedures and degree level working at the same time as developing new social networks. To help facilitate these complex transitions institutions are increasingly turning towards digital technologies to provide both flexible access to resources…

  15. A model of cell biological signaling predicts a phase transition of signaling and provides mathematical formulae.

    Directory of Open Access Journals (Sweden)

    Tatsuaki Tsuruyama

    Full Text Available A biological signal is transmitted by interactions between signaling molecules in the cell. To date, there have been extensive studies regarding signaling pathways using numerical simulation of kinetic equations that are based on equations of continuity and Fick's law. To obtain a mathematical formulation of cell signaling, we propose a stability kinetic model of cell biological signaling of a simple two-parameter model based on the kinetics of the diffusion-limiting step. In the present model, the signaling is regulated by the binding of a cofactor, such as ATP. Non-linearity of the kinetics is given by the diffusion fluctuation in the interaction between signaling molecules, which is different from previous works that hypothesized autocatalytic reactions. Numerical simulations showed the presence of a critical concentration of the cofactor beyond which the cell signaling molecule concentration is altered in a chaos-like oscillation with frequency, which is similar to a discontinuous phase transition in physics. Notably, we found that the frequency is given by the logarithm function of the difference of the outside cofactor concentration from the critical concentration. This implies that the outside alteration of the cofactor concentration is transformed into the oscillatory alteration of cell inner signaling. Further, mathematical stability kinetic analysis predicted a discontinuous dynamic phase transition in the critical state at which the cofactor concentration is equivalent to the critical concentration. In conclusion, the present model illustrates a unique feature of cell signaling, and the stability analysis may provide an analytical framework of the cell signaling system and a novel formulation of biological signaling.

  16. Development of an MR-compatible hand exoskeleton that is capable of providing interactive robotic rehabilitation during fMRI imaging.

    Science.gov (United States)

    Kim, Sangjoon J; Kim, Yeongjin; Lee, Hyosang; Ghasemlou, Pouya; Kim, Jung

    2017-07-15

    Following advances in robotic rehabilitation, there have been many efforts to investigate the recovery process and effectiveness of robotic rehabilitation procedures through monitoring the activation status of the brain. This work presents the development of a two degree-of-freedom (DoF) magnetic resonance (MR)-compatible hand device that can perform robotic rehabilitation procedures inside an fMRI scanner. The device is capable of providing real-time monitoring of the joint angle, angular velocity, and joint force produced by the metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of four fingers. For force measurement, a custom reflective optical force sensor was developed and characterized in terms of accuracy error, hysteresis, and repeatability in the MR environment. The proposed device consists of two non-magnetic ultrasonic motors to provide assistive and resistive forces to the MCP and PIP joints. With actuation and sensing capabilities, both non-voluntary-passive movements and active-voluntary movements can be implemented. The MR compatibility of the device was verified via the analysis of the signal-to-noise ratio (SNR) of MR images of phantoms. SNR drops of 0.25, 2.94, and 11.82% were observed when the device was present but not activated, when only the custom force sensor was activated, and when both the custom force sensor and actuators were activated, respectively.

  17. Flapless CAD/CAM-guided surgery for staged transition from failing dentition to complete arch implant rehabilitation: a 3-year clinical report.

    Science.gov (United States)

    Papaspyridakos, Panos; White, George Shelby; Lal, Kunal

    2012-03-01

    The transition of patients from failing dentition to complete arch implant rehabilitation often requires that the patient be rendered edentulous and has to wear a complete removable dental prosthesis for varying periods of time. This is objectionable to many patients. A staged treatment approach allows a fixed interim restoration, patient comfort, and prosthodontic control throughout the rehabilitation process. CAD/CAM-guided flapless implant surgery has the advantage of prosthetically driven implant placement and minimal postoperative sequelae. A patient with a failing dentition was treated with this combined protocol and was followed up for 3 years after loading. Implant and prosthesis survival rates were 100%, with no technical complications encountered up to the last recall. The purpose of this clinical report is to describe a combination of CAD/CAM-guided flapless surgery and a staged treatment approach, thereby giving the patient a tooth-supported or implant-supported fixed interim prosthesis during the entire rehabilitation process. The various surgical, laboratory, and prosthetic stages are illustrated for the complete arch prosthetic rehabilitation, and the 3-year follow-up outcome is reported. Copyright © 2012 The Editorial Council of the Journal of Prosthetic Dentistry. Published by Mosby, Inc. All rights reserved.

  18. Healthcare Provider Views on Transitioning From Task Shifting to Advanced Practice Nursing in Tanzania.

    Science.gov (United States)

    Mboineki, Joanes Faustine; Zhang, Weihong

    The Tanzanian health sector suffers from shortages of healthcare workers as well as uneven distribution of healthcare workers in urban and rural areas. Task shifting-delegation of tasks from professionals to other healthcare team members with less training, such as medical attendants-is practiced, compromising quality of care. Advanced practice nursing is underutilized. The purpose of this study was to explore the views of nurses and physicians on current responses to shortages of healthcare workers and the potential for utilization of advanced practice nurses. A descriptive, qualitative design was used. Purposeful sampling was used to select 20 participants. An in-depth interview guide was used to obtain information. Interviews were conducted in Swahili or English. Content analysis was used to identify themes. Shortage of human resources in rural primary healthcare facilities was identified as a major rationale for implementation of the advanced practice nurse practitioner role because the current health providers in rural health facilities are less trained and doctors are not ready to work in these settings. Opposition from physicians is expected during the course of implementing the nurse practitioner role. Professional bodies and government should reach consensus before the implementation of this role in such a way that they should agree on scope and standards of practice of nurse practitioners in Tanzania. Shortage of human resources for health is greater in rural primary healthcare facilities. Task shifting in Tanzania is neither effective nor legally recognized. Transition to advanced practice nursing roles-particularly the nurse practitioner role-can facilitate provision of optimal care. Nurse practitioners should be prepared to work in rural primary healthcare facilities.

  19. Budget Impact Analysis of a Pharmacist-Provided Transition of Care Program.

    Science.gov (United States)

    Ni, Weiyi; Colayco, Danielle; Hashimoto, Jonathan; Komoto, Kevin; Gowda, Chandrakala; Wearda, Bruce; McCombs, Jeffrey

    2018-02-01

    Postdischarge medication management services have been shown to reduce the incidence of medication-related problems during the transition from inpatient to outpatient care. A pharmacist-run transition of care (TOC) program has been developed to reduce the unplanned readmissions of a high-risk managed Medicaid population after hospitalization. To estimate the budget impact of adding an outpatient pharmacy-based TOC program to a medical benefit from the payer perspective. A budget impact analysis was conducted using a decision-tree model developed in Microsoft Excel. The effect on inpatient and total health care costs from the payer perspective was estimated for the 2-year period following initial hospital discharge. Inputs were based on a total plan population of 240,000 lives, with a high-risk population of 7.5%, of whom 37% were hospitalized and potentially qualified for TOC services, resulting in an eligible population of 6,660 patients. The TOC program was assumed to initially cover 30% of the eligible population, with expansion to 60% over the 2 years. We previously reported that this program reduced the risk of readmission by 32% within 6 months and saved the health plan $2,139 per patient referred to the program, inclusive of program cost, compared with patients receiving usual discharge care. Sensitivity analyses were performed to test the impact of uncertainty of model inputs on the results, with the cost of TOC services ranging from $99 to $2,000 per patient referred. The model showed that the TOC program was cost saving at over $3 per member per month in the first 6 months, which translates to over $25 million in total health care cost savings over 2 years. These results were primarily driven by the estimated reduction in inpatient costs associated with the program, which were estimated at $20 million over the 2 years. Sensitivity analyses illustrated that within all the reasonable ranges of model input parameters, including the upper limit of TOC

  20. Adolescent and Adult HIV Providers' Definitions of HIV-Infected Youths' Successful Transition to Adult Care in the United States.

    Science.gov (United States)

    Philbin, Morgan M; Tanner, Amanda E; Ma, Alice; Chambers, Brittany D; Ware, Samuella; Kinnard, Elizabeth N; Hussen, Sophia A; Lee, Sonia; Fortenberry, J Dennis

    2017-10-01

    It is important for both individual- and population-level health that HIV-infected individuals progress through the Care Continuum. However, HIV-infected youth frequently disengage from care during transition from pediatric/adolescent to adult care; only 50% remain in adult care after 1 year. Understanding how providers define and approach a successful healthcare transition can improve the delivery of HIV-related services during critical years of HIV treatment. We conducted 58 staff interviews across 14 Adolescent Trials Network clinics (n = 30) and 20 adult clinics (n = 28). We used the constant comparative method to examine how providers defined and approached youths' successful transition. Providers identified four components critical to successful transition: (1) clinical outcomes (e.g., medication adherence and viral suppression); (2) youth knowing how to complete treatment-related activities (e.g., refilling prescriptions and making appointments); (3) youth taking responsibility for treatment-related activities and their overall health (e.g., "when they stop reaching out to the adolescent [clinic] to solve all their problems."); and (4) youth feeling a connection and trust toward the adult clinic (e.g., "they feel safe here"), with some providers even prioritizing connectedness over clinical outcomes (e.g., "Even if they're not taking meds but are connected [to care], …that's a success."). The identification of key components of successful transition can guide focused interventions and resources to improve youth maintenance in the HIV Care Continuum as they transition to adult care. Identifying what facilitates successful transitions, and the gaps that interventions can target, will help to ensure HIV-infected youth remain healthy across their lifespan.

  1. A Vesicle-to-Worm Transition Provides a New High-Temperature Oil Thickening Mechanism.

    Science.gov (United States)

    Derry, Matthew J; Mykhaylyk, Oleksandr O; Armes, Steven P

    2017-02-06

    Diblock copolymer vesicles are prepared via RAFT dispersion polymerization directly in mineral oil. Such vesicles undergo a vesicle-to-worm transition on heating to 150 °C, as judged by TEM and SAXS. Variable-temperature 1 H NMR spectroscopy indicates that this transition is the result of surface plasticization of the membrane-forming block by hot solvent, effectively increasing the volume fraction of the stabilizer block and so reducing the packing parameter for the copolymer chains. The rheological behavior of a 10 % w/w copolymer dispersion in mineral oil is strongly temperature-dependent: the storage modulus increases by five orders of magnitude on heating above the critical gelation temperature of 135 °C, as the non-interacting vesicles are converted into weakly interacting worms. SAXS studies indicate that, on average, three worms are formed per vesicle. Such vesicle-to-worm transitions offer an interesting new mechanism for the high-temperature thickening of oils. © 2017 Wiley-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Rehabilitation robotics.

    Science.gov (United States)

    Krebs, H I; Volpe, B T

    2013-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician's toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual's functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. Copyright © 2013 Elsevier B.V. All rights reserved.

  3. Rehabilitation robotics

    Science.gov (United States)

    KREBS, H.I.; VOLPE, B.T.

    2015-01-01

    This chapter focuses on rehabilitation robotics which can be used to augment the clinician’s toolbox in order to deliver meaningful restorative therapy for an aging population, as well as on advances in orthotics to augment an individual’s functional abilities beyond neurorestoration potential. The interest in rehabilitation robotics and orthotics is increasing steadily with marked growth in the last 10 years. This growth is understandable in view of the increased demand for caregivers and rehabilitation services escalating apace with the graying of the population. We will provide an overview on improving function in people with a weak limb due to a neurological disorder who cannot properly control it to interact with the environment (orthotics); we will then focus on tools to assist the clinician in promoting rehabilitation of an individual so that s/he can interact with the environment unassisted (rehabilitation robotics). We will present a few clinical results occurring immediately poststroke as well as during the chronic phase that demonstrate superior gains for the upper extremity when employing rehabilitation robotics instead of usual care. These include the landmark VA-ROBOTICS multisite, randomized clinical study which demonstrates clinical gains for chronic stroke that go beyond usual care at no additional cost. PMID:23312648

  4. A molecular phylogeny of Dorylus army ants provides evidence for multiple evolutionary transitions in foraging niche

    DEFF Research Database (Denmark)

    Kronauer, Daniel J C; Schöning, Caspar; Vilhelmsen, Lars

    2007-01-01

    in the leaf-litter and some as conspicuous swarm raiders on the forest floor and in the lower vegetation (the infamous driver ants). Here we use a combination of nuclear and mitochondrial DNA sequences to reconstruct the phylogeny of the Dorylus s.l. army ants and to infer the evolutionary transitions...... in foraging niche and associated morphological adaptations. RESULTS: Underground foraging is basal and gave rise to leaf-litter foraging. Leaf-litter foraging in turn gave rise to two derived conditions: true surface foraging (the driver ants) and a reversal to subterranean foraging (a clade with most...

  5. Providing environmental training in the context of Ukraine's transition to sustainable development

    Directory of Open Access Journals (Sweden)

    V.M. Bogoliubov

    2016-12-01

    Full Text Available The article analyzes the problems of Ukraine's transition to sustainable development. Recognized priority implementation of the UNECE Strategy for Education for Sustainable Development in the system Education of Ukraine. The necessity of introduction in the educational process of preparation environmentalists, teachers and civil servants elements of education for sustainable development. The paper analyzes the teaching materials issued in Ukraine for the past 10 years regarding education for sustainable development. An optimal, in our view, the content of curriculum subjects with generalized entitled “Sustainable Development Strategy”.

  6. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Adult Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from ... Rosenberg, PsyD Understanding SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa ...

  7. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children ...

  8. Electrostatic transition state stabilization rather than reactant destabilization provides the chemical basis for efficient chorismate mutase catalysis.

    Science.gov (United States)

    Burschowsky, Daniel; van Eerde, André; Ökvist, Mats; Kienhöfer, Alexander; Kast, Peter; Hilvert, Donald; Krengel, Ute

    2014-12-09

    For more than half a century, transition state theory has provided a useful framework for understanding the origins of enzyme catalysis. As proposed by Pauling, enzymes accelerate chemical reactions by binding transition states tighter than substrates, thereby lowering the activation energy compared with that of the corresponding uncatalyzed process. This paradigm has been challenged for chorismate mutase (CM), a well-characterized metabolic enzyme that catalyzes the rearrangement of chorismate to prephenate. Calculations have predicted the decisive factor in CM catalysis to be ground state destabilization rather than transition state stabilization. Using X-ray crystallography, we show, in contrast, that a sluggish variant of Bacillus subtilis CM, in which a cationic active-site arginine was replaced by a neutral citrulline, is a poor catalyst even though it effectively preorganizes chorismate for the reaction. A series of high-resolution molecular snapshots of the reaction coordinate, including the apo enzyme, and complexes with substrate, transition state analog and product, demonstrate that an active site, which is only complementary in shape to a reactive substrate conformer, is insufficient for effective catalysis. Instead, as with other enzymes, electrostatic stabilization of the CM transition state appears to be crucial for achieving high reaction rates.

  9. A molecular phylogeny of Dorylus army ants provides evidence for multiple evolutionary transitions in foraging niche

    Directory of Open Access Journals (Sweden)

    Vilhelmsen Lars B

    2007-04-01

    Full Text Available Abstract Background Army ants are the prime arthropod predators in tropical forests, with huge colonies and an evolutionary derived nomadic life style. Five of the six recognized subgenera of Old World Dorylus army ants forage in the soil, whereas some species of the sixth subgenus (Anomma forage in the leaf-litter and some as conspicuous swarm raiders on the forest floor and in the lower vegetation (the infamous driver ants. Here we use a combination of nuclear and mitochondrial DNA sequences to reconstruct the phylogeny of the Dorylus s.l. army ants and to infer the evolutionary transitions in foraging niche and associated morphological adaptations. Results Underground foraging is basal and gave rise to leaf-litter foraging. Leaf-litter foraging in turn gave rise to two derived conditions: true surface foraging (the driver ants and a reversal to subterranean foraging (a clade with most of the extant Dorylus s.s. species. This means that neither the subgenus Anomma nor Dorylus s.s. is monophyletic, and that one of the Dorylus s.s. lineages adopted subterranean foraging secondarily. We show that this latter group evolved a series of morphological adaptations to underground foraging that are remarkably convergent to the basal state. Conclusion The evolutionary transitions in foraging niche were more complex than previously thought, but our comparative analysis of worker morphology lends strong support to the contention that particular foraging niches have selected for very specific worker morphologies. The surprising reversal to underground foraging is therefore a striking example of convergent morphological evolution.

  10. Paralysis: Rehabilitation

    Science.gov (United States)

    ... Forum About Us Donate Living with Paralysis > Rehabilitation Rehabilitation Rehabilitation and exercise are key to enhancing your health and quality of life. Find a rehabilitation center near you and become familiar with different ...

  11. An imaging informatics-based ePR (electronic patient record) system for providing decision support in evaluating dose optimization in stroke rehabilitation

    Science.gov (United States)

    Liu, Brent J.; Winstein, Carolee; Wang, Ximing; Konersman, Matt; Martinez, Clarisa; Schweighofer, Nicolas

    2012-02-01

    Stroke is one of the major causes of death and disability in America. After stroke, about 65% of survivors still suffer from severe paresis, while rehabilitation treatment strategy after stroke plays an essential role in recovery. Currently, there is a clinical trial (NIH award #HD065438) to determine the optimal dose of rehabilitation for persistent recovery of arm and hand paresis. For DOSE (Dose Optimization Stroke Evaluation), laboratory-based measurements, such as the Wolf Motor Function test, behavioral questionnaires (e.g. Motor Activity Log-MAL), and MR, DTI, and Transcranial Magnetic Stimulation (TMS) imaging studies are planned. Current data collection processes are tedious and reside in various standalone systems including hardcopy forms. In order to improve the efficiency of this clinical trial and facilitate decision support, a web-based imaging informatics system has been implemented together with utilizing mobile devices (eg, iPAD, tablet PC's, laptops) for collecting input data and integrating all multi-media data into a single system. The system aims to provide clinical imaging informatics management and a platform to develop tools to predict the treatment effect based on the imaging studies and the treatment dosage with mathematical models. Since there is a large amount of information to be recorded within the DOSE project, the system provides clinical data entry through mobile device applications thus allowing users to collect data at the point of patient interaction without typing into a desktop computer, which is inconvenient. Imaging analysis tools will also be developed for structural MRI, DTI, and TMS imaging studies that will be integrated within the system and correlated with the clinical and behavioral data. This system provides a research platform for future development of mathematical models to evaluate the differences between prediction and reality and thus improve and refine the models rapidly and efficiently.

  12. Experiences of patients with traumatic brain injury and their carers during transition from in-patient rehabilitation to the community: a qualitative study.

    Science.gov (United States)

    Abrahamson, Vanessa; Jensen, Jan; Springett, Kate; Sakel, Mohamed

    2017-08-01

    To explore the experiences of individuals who have had a severe traumatic brain injury (TBI) and their carers in the first month post-discharge from in-patient rehabilitation into living in the community. Using a qualitative approach underpinned by critical realism, we explored the narratives of 10 patients and nine carers using semi-structured interviews approximately one month post-discharge. Thematic analysis was carried out independently by two researchers. Firstly, perceptions of support were mixed but many patients and carers felt unsupported in the inpatient phase, during transitions between units and when preparing for discharge. Secondly, they struggled to accept a new reality of changed abilities, loss of roles and loss of autonomy. Thirdly, early experiences post-discharge exacerbated fears for the future. Most patients and carers struggled to identify a cohesive plan that supported their transition to living in the community. Access to services required much persistence on the part of carers and tended to be short-term, and therefore did not meet their long-term needs. We propose the need for a case manager to be involved at an early stage of their rehabilitation and act as a key point for information and access to on-going rehabilitation and other support services. Implications for Rehabilitation Traumatic Brain Injury (TBI) is a major cause of long-term disability. It can affect all areas of daily life and significantly reduce quality of life for both patient and carer. Professionals appear to underestimate the change in abilities and impact on daily life once patients return home. Community services maintain a short-term focus, whereas patients and carers want to look further ahead - this dissonance adds to anxiety. The study's findings on service fragmentation indicate an urgent need for better integration within health services and across health, social care and voluntary sectors. A link person/case manager who oversees the patient journey from

  13. Exercise-based oncology rehabilitation: leveraging the cardiac rehabilitation model.

    Science.gov (United States)

    Dittus, Kim L; Lakoski, Susan G; Savage, Patrick D; Kokinda, Nathan; Toth, Michael; Stevens, Diane; Woods, Kimberly; OʼBrien, Patricia; Ades, Philip A

    2015-01-01

    The value of exercise and rehabilitative interventions for cancer survivors is increasingly clear, and oncology rehabilitation programs could provide these important interventions. However, a pathway to create oncology rehabilitation has not been delineated. Community-based cardiac rehabilitation (CR) programs staffed by health care professionals with experience in providing rehabilitation and secondary prevention services to individuals with coronary heart disease are widely available and provide a potential model and location for oncology rehabilitation programs. Our purpose was to outline the rehabilitative needs of cancer survivors and demonstrate how oncology rehabilitation can be created using a CR model. We identify the impairments associated with cancer and its therapy that respond to rehabilitative interventions. Components of the CR model that would benefit cancer survivors are described. An example of an oncology rehabilitation program using a CR model is presented. Cancer survivors have impairments associated with cancer and its therapy that improve with rehabilitation. Our experience demonstrates that effective rehabilitation services can be provided utilizing an existing CR infrastructure. Few adjustments to current CR models would be needed to provide oncology rehabilitation. Preliminary evidence suggests that cancer survivors participating in an oncology rehabilitation program experience improvements in psychological and physiologic parameters. Utilizing the CR model of rehabilitative services and disease management provides a much needed mechanism to bring oncology rehabilitation to larger numbers of cancer survivors.

  14. Graftless Full-Arch Implant Rehabilitation with Interantral Implants and Immediate or Delayed Loading-Part II: Transition from the Failing Maxillary Dentition.

    Science.gov (United States)

    Busenlechner, Dieter; Mailath-Pokorny, Georg; Haas, Robert; Fürhauser, Rudolf; Eder, Carina; Pommer, Bernhard; Watzek, Georg

    2016-01-01

    To compare long-term survival and marginal bone loss of immediate interantral implants in the nonaugmented maxilla subjected to immediate vs delayed loading. Graftless maxillary cross-arch rehabilitation was performed in a total of 362 patients in the years 2004 to 2013 (1,797 implants). Of the 240 patients with immediate implants replacing their failing maxillary dentition, 81% were subjected to immediate loading and 19% to delayed loading of their 4 to 6 interantral implants (980 and 235 implants, respectively). Kaplan-Meier survival estimates were computed and marginal bone loss was evaluated in a stratified random sample of 20 patients per group. Thirty-one of 1,215 implants failed within the mean observation period of 3.9 years, and no difference in 8-year survival estimates could be seen between immediate (97.6% [95% CI: 96.7 to 98.6]) and delayed (96.6% [95% CI: 94.3 to 98.9]) loading protocols (P = .359). Mean marginal bone resorption following implant insertion did not differ significantly between the groups (1.5 ± 1.7 mm vs 0.7 ± 1.1 mm, P = .379); however, it was significantly associated with a reduced number of implants (P = .017) and patient history of periodontal disease (P Immediate loading of interantral implants yields satisfactory results in the transition of patients from a failing maxillary dentition to full-arch implant rehabilitation and thus may be favored over delayed loading concepts.

  15. Stroke rehabilitation: should physiotherapy intervention be provided at a primary health care centre or the patients' place of domicile?

    Science.gov (United States)

    Olaleye, Olubukola A; Hamzat, Talhatu K; Owolabi, Mayowa O

    2014-01-01

    This randomized controlled trial compared the outcomes of physiotherapy intervention on selected indices of recovery for stroke survivors treated at a primary health centre group (PHCG) with those treated in their respective places of domicile group (DG). Participants were 52 individuals comprising 24 males and 28 females who had suffered a stroke and were recently discharged from two inpatient health facilities in Ibadan, Nigeria. They were randomly assigned into either the PHCG (n = 25) or DG (n = 27) and treated twice weekly for 10 consecutive weeks using a physiotherapy intervention protocol comprising a battery of task-specific exercises. The outcomes measured were motor function, balance and handicap assessed using the modified motor assessment scale (MMAS), short-form postural assessment scale for stroke (SF-PASS) and reintegration to normal living index (RNLI), respectively, as well as walking speed which was assessed using a standard technique. Between-group comparison using the General Linear Model revealed no statistically significant difference in both the pre- and post-intervention scores of the two groups on the MMAS, SF-PASS, RNLI and walking speed in both PHCG and DG (p > 0.05). However, within-group comparison yielded a statistically significant difference in each of the indices of stroke recovery measured across the 10-week period in both groups. Physiotherapy intervention at the primary health care centre and respective homes of stroke survivors similarly improved clinical outcomes. Treatment at any of these locations may enhance access to physiotherapy after stroke in a low-income community like Nigeria. Physiotherapy protocol comprising 10-week task-specific battery of exercises produced significant improvement in walking speed, balance, motor function and community reintegration of stroke survivors. Physiotherapy post-stroke can be provided at either a primary health centre or the domicile of the individual. In a low-income country

  16. Factors predicting resilience in people with spinal cord injury during transition from inpatient rehabilitation to the community.

    Science.gov (United States)

    Guest, R; Craig, A; Tran, Y; Middleton, J

    2015-09-01

    This is a longitudinal design study. The objective of this study was to determine factors that predict resilience in people with spinal cord injury (SCI) at discharge from inpatient rehabilitation and after reintegration into the community 6 months post discharge. This study was conducted in SCI rehabilitation units and the community in New South Wales, Australia. Participants included 88 adults with SCI admitted over almost 3 years into three SCI Units in Sydney. Standardized self-report and clinician-based measures were used. Longitudinal assessment occurred up to 6 months post discharge. Sociodemographic, injury and psychological variables were assessed at admission, before discharge and 6 months post discharge. Standard multiple regression was used to determine factors that predict resilience at discharge from hospital and 6 months post discharge. Almost 70% of the participants were classified as resilient at discharge and 66% after 6 months of living in the community. Multiple factors significantly predicted resilience at discharge and 6 months post discharge, including self-efficacy, low levels of negative mood and lower functional independence, whereas social support and low severity of secondary conditions trended to significance. Demographic and injury variables did not contribute significantly. Self-efficacy and low levels of negative mood states strongly contribute to resilience. The determination of these predictors will assist in improving rehabilitation programs to strengthen the resilience of people with SCI. However, given that 40-44% of the variance in resilience was explained by the group of factors entered, future longitudinal research is needed to determine not only whether resilience correlates but also whether these associations change over time.

  17. Subjectivity construction in school failure paths. Transition pathways provided for labour insertion for adolescents at risk

    Directory of Open Access Journals (Sweden)

    Míriam Abiétar-López

    2017-03-01

    Full Text Available The modernization of the vocational education system in Spain dates back to the 90s. Since then, it has evolved significantly, taking the European directives as a frame of reference. With the extension of compulsory schooling until the age of 16, in 1994 a vocational training scheme was introduced within the education system at a very low level of qualification, particularly designed for adolescents classified as low academic performers in secondary education and for adolescents in situation of social vulnerability. Such training scheme was reshaped in 2006 and 2013. Our contribution is framed in a wider research developed within a European Project, aiming to provide a review of the literature produced around these programs, in order to compare the evolution of those 3 types of training provision in terms of the educational possibilities each one has provided for the adolescents that have participated in them. In light of these data and those produced by our research, in this paper we argue how adolescent subjectivities are produced. We rely upon the speech of teachers, head teachers and guidance teams that deal with young people in such training provision in the city of Valencia.

  18. The transition from learner to provider/teacher: The learning needs of new orthopaedic consultants

    Directory of Open Access Journals (Sweden)

    Elliot Katy

    2005-05-01

    Full Text Available Abstract Background Given the relatively sudden change from learner to teacher-provider that new consultants experience and the likely clinical and managerial challenges this may pose, there is a relative dearth of research into the problems they may have in relation to their new roles, or how supported they feel by senior colleagues acting in a mentoring role. This research sought to determine new consultants views on the quality and relevance of their training, its relationship to their confidence in clinical and managerial skills and their views on mentorship by senior colleagues. Methods Detailed postal questionnaire to new consultants using open and closed questions. Open questionnaire to established consultants to validate new consultant responses. Results Respondents felt their clinical training was good and were generally confident in most clinical skills although some perceived deficiencies in more complex procedures and specialist areas. Most lacked confidence in many managerial skills. These perceptions were verified by established consultants. Although no relationship was found between total training time or quality of training with confidence, extra training in specific sub-specialities improved confidence in these areas. While most established consultants thought that mentorship would be useful for new consultants, only 52% of them shared this view. Conclusion Training and experience in management should be given greater emphasis. There may be a need for specific, targeted training in complex procedures for doctors who experience lack of confidence in these areas. Mentorship should be offered to new consultants and recognised in the job-plan of the new consultant contract.

  19. Fire rehabilitation decisions at landscape scales: utilizing state-and-transition models developed through disturbance response grouping of ecological sites

    Science.gov (United States)

    Recognizing the utility of ecological sites and the associated state-and-transition model (STM) for decision support, the Bureau of Land Management in Nevada partnered with Nevada NRCS and the University of Nevada, Reno (UNR) in 2009 with the goal of creating a team that could (1) expedite developme...

  20. Un Abrazo Para La Familia: an evidenced-based rehabilitation approach in providing cancer education to low-SES Hispanic co-survivors.

    Science.gov (United States)

    Marshall, Catherine A; Curran, Melissa A; Koerner, Susan Silverberg; Kroll, Thilo; Hickman, Amy C; García, Francisco

    2014-12-01

    We discuss Un Abrazo Para La Familia as an effective, rehabilitation-informed evidence-based model of education, information-sharing, and skill teaching for use with low-income Hispanic co-survivors of cancer. Over 2 years, 120 co-survivors participated in the intervention. The majority of participants (96 %) were women and all but one reported being Hispanic. Both in years 1 and 2, we followed the same pre- and post-intervention evaluation design. Based on pre- and post-intervention assessments of cancer-related knowledge and self-efficacy, the percentage of questions answered correctly about cancer significantly increased for co-survivors. Self-efficacy significantly increased as well. Using item analysis, we explored skill teaching as a mechanism for the effective delivery of Un Abrazo and recommend the use of promotoras in providing the intervention. Of the 12 cancer knowledge items resulting in statistically significant increases of cancer knowledge, 5 were taught via interactive skill teaching. Given the projected rise in the incidence of cancer in Hispanic populations, coupled with the fact that people from low-income backgrounds face unique challenges in cancer prevention and management, implications of the Un Abrazo model for future research and policy regarding cancer and families are considered.

  1. Transition of care for acute stroke and myocardial infarction patients: from hospitalization to rehabilitation, recovery, and secondary prevention.

    Science.gov (United States)

    Olson, DaiWai M; Bettger, Janet Prvu; Alexander, Karen P; Kendrick, Amy S; Irvine, Julian R; Wing, Liz; Coeytaux, Remy R; Dolor, Rowena J; Duncan, Pamela W; Graffagnino, Carmelo

    2011-01-01

    OBJECTIVES To review the available published literature to assess whether evidence supports a beneficial role for coordinated transition of care services for the postacute care of patients hospitalized with first or recurrent stroke or myocardial infarction (MI). This review was framed around five areas of investigation: (1) key components of transition of care services, (2) evidence for improvement in functional outcomes, morbidity, mortality, and quality of life, (3) associated risks or potential harms, (4) evidence for improvement in systems of care, and (5) evidence that benefits and harms vary by patient-based or system-based characteristics. DATA SOURCES MEDLINE(®), CINAHL(®), Cochrane Database of Systematic Reviews, and Embase(®). REVIEW METHODS We included studies published in English from 2000 to 2011 that specified postacute hospitalization transition of care services as well as prevention of recurrent stroke or MI. RESULTS A total of 62 articles representing 44 studies were included for data abstraction. Transition of care interventions were grouped into four categories: (1) hospital -initiated support for discharge was the initial stage in the transition of care process, (2) patient and family education interventions were started during hospitalization but were continued at the community level, (3) community-based models of support followed hospital discharge, and (4) chronic disease management models of care assumed the responsibility for long-term care. Early supported discharge after stroke was associated with reduced total hospital length of stay without adverse effects on functional recovery, and specialty care after MI was associated with reduced mortality. Because of several methodological shortcomings, most studies did not consistently demonstrate that any specific intervention resulted in improved patient-or system -based outcomes. Some studies included more than one intervention, which made it difficult to determine the effect of individual

  2. Rehabilitation Options

    Science.gov (United States)

    ... for e-updates Please leave this field empty Rehabilitation Options SHARE Home > Treatment and Care > Continuum of Care > Rehabilitation Options Listen Beginning the Healing Process After undergoing ...

  3. The jungle book of neuropsychology: Disentangling the influence of feral childhood from adult brain injury in order to provide effective rehabilitation.

    Science.gov (United States)

    McIntosh, C J; James, A I W

    2018-03-01

    This article considers the complexities of neuropsychological assessment and rehabilitation in brain injury when the client is illiterate, is from a foreign culture with English as a second language, and reports highly atypical childhood feral experiences prior to injury. MC was a 63-year-old woman referred for neuropsychological rehabilitation with a diagnosis of suspected St Louis encephalitis and global cognitive impairment. In formulating her clinical presentation, consideration was given to a reported history of feral childhood living with monkeys in the Colombian jungle and subsequent physical and emotional abuse. MC participated in comprehensive neuropsychological assessment and then targeted rehabilitation. Neuroimaging documented relatively focal damage in the right temporal lobe. MC's family described her as "the same but worse"; assessment and formulation indicated an exacerbation of attentional, pragmatic, arousal and executive weaknesses but with new memory and emotion recognition impairments. Rehabilitation techniques for communication and executive difficulties were successful despite the complexities of the case. The importance of carefully considered assessment and formulation in understanding MC's presentation is discussed. To the authors' knowledge, this is the only case of neuropsychological assessment and rehabilitation in brain injury involving a history of feral childhood.

  4. The Polaris Oncology Survivorship Transition (POST) System: A Patient- and Provider-Driven Cancer Survivorship Planning Program.

    Science.gov (United States)

    O'Hea, Erin; Wu, Juliet; Dietzen, Laura; Harralson, Tina; Boudreaux, Edwin D

    2016-11-01

    It is strongly recommended that individuals ending treatment for cancer have a "survivorship plan," and new standards require survivorship planning for accreditation, However, a comprehensive plan is often neglected. To present the development and field test results of a web-based, breast cancer survivorship care planning system. The Polaris Oncology Survivorship Transition (POST) blends input from the electronic health record (EHR), oncology care providers (OCPs), and patients to create a survivorship care plan (SCP). The content of the POST program was created with the assistance of end-user input (patients, oncologists, and primary care providers (PCPs)) and the full program was piloted on women ending treatment for breast cancer. This paper presents the pilot study that field-tested the POST In a clinical setting. Patients were recruited from outpatient care clinics and chemotherapy units in a comprehensive care center. The study included 25 women ending treatment for breast cancer in the past year, 4 OCPs, and PCPs. Patients received the POST computeπzed assessment and a tailored SCP. The POST assists providers in crafting efficient and comprehensive SCPs and was rated highly satisfactory by all end-users. The POST program can be used as a cancer survivorship planning program to assist OCPs in care planning for their patients ending treatment for breast cancer. This study provides support for Incorporating computerized SCP programs into clinical practice. Use of the POST in clinical practice has the potential to improve survivorship planning.

  5. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features ... facility. Who Needs to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may ...

  6. Transitions between marine and freshwater environments provide new clues about the origins of multicellular plants and algae

    OpenAIRE

    Dittami, Simon M; Heesch, Svenja; Olsen, Jeanine L.; Collén, Jonas

    2017-01-01

    International audience; Marine-freshwater and freshwater-marine transitions have been key events in the evolution of life, and most major groups of organisms have independently undergone such events at least once in their history. Here we first compile an inventory of bidirectional freshwater and marine transitions in multicellular photosynthetic eukaryotes. While green and red algae have mastered multiple transitions in both directions, brown algae have colonized fresh water on a maximum of ...

  7. Pediatric provider's perspectives on the transition to adult health care for youth with autism spectrum disorder: current strategies and promising new directions.

    Science.gov (United States)

    Kuhlthau, Karen A; Warfield, Marji E; Hurson, Jill; Delahaye, Jennifer; Crossman, Morgan K

    2015-04-01

    Few youth with autism spectrum disorder (ASD) nationally report receiving services to help them transition from the pediatric health care system to the adult health care system. For example, only one-fifth (21.1%) of youth with ASD receive any transition planning services. To better understand why the transition from pediatric to adult health care is so difficult, we interviewed pediatric health care providers with extensive experience serving youth with ASD. We gathered information about the strategies and interventions they use to transition their patients with ASD to an adult provider. Five interventions or strategies are currently being used. These include providing families with written medical summaries to give to adult providers, compiling lists of available adult providers or community resources, coordinating care and communication between individual pediatric and adult providers, making transition-specific appointments, and using checklists to track transition progress. Other interventions or strategies were identified as needed but not currently in practice, and these focused on education and training. For example, informational workshops were suggested to train families and youth about transition. Training adult providers and medical students was also seen as important. Several respondents additionally identified the need for a transition center where all services could be coordinated in one place. With large numbers of youth with ASD becoming young adults, it seems that pediatric practices might want to consider some of the activities described here. Some of these activities, such as family educational seminars and written medical summaries, are likely relatively easy for a practice to implement. © The Author(s) 2014.

  8. The Role of Health Advocacy in Transitions from Pediatric to Adult Care for Children with Special Health Care Needs: Bridging Families, Provider and Community Services.

    Science.gov (United States)

    Okumura, Megumi J; Saunders, Mara; Rehm, Roberta S

    2015-01-01

    Youth and young adults with special healthcare needs (YASHCN) experience challenges during transition from pediatric to adult care. Prior studies have not examined how community and healthcare resources can work together to assist YASHCN in transitioning from child-focused care and services to adult-oriented providers. The aim of this study was to develop a theoretical understanding of how family, healthcare providers and community supports can assist YASHCN during the transition from pediatric to adult healthcare and services. We conducted 41 semi-structured interviews with YASHCN aged 16-25, their family members and healthcare and community providers. We focused our interviews on support mechanisms, both within the traditional healthcare system, and those available in the community. Using grounded theory methods, we performed a multi-step analysis process. The theoretical code "Transition Advocacy" was developed from the data. This theoretical perspective arose from three major categories, which were developed in the analysis: "Fighting for healthcare", "Obtaining resources", and "Getting ready to transition". Transition Advocacy consists of the presence of, or need for, a healthcare "advocate" who did or can assist the YASHCN with the healthcare transition, particularly to navigate complex health or community services. The "advocate" role was performed by family members, healthcare or agency professionals, or sometimes the YASHCN themselves. If advocates were identified, youth were more likely to obtain needed services. Parents, health providers, and community agencies are potentially well-poised to assist transitioning YASHCN. Efforts to encourage development of strong advocacy skills will facilitate better transitions for YASHCN. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Allen Heinemann, PhD How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation Sara Klaas, MSW Transitions for Children with Spinal Cord Injury Patricia Mucia, RN Family ...

  10. You never transition alone! Exploring the experiences of youth with chronic health conditions, parents and healthcare providers on self-management.

    Science.gov (United States)

    Nguyen, T; Henderson, D; Stewart, D; Hlyva, O; Punthakee, Z; Gorter, J W

    2016-07-01

    Recent evidence suggests that fostering strategies to enable youth with chronic health conditions to work towards gradual self-management of their health is key in successful transition to adult healthcare. To date, there is limited research on self-management promotion for youth. The purpose of this study is to explore self-management from the perspectives of youth, parents and healthcare providers in transition to adult healthcare. Part of a larger longitudinal transition (TRACE-2009-2013) study, interpretive phenomenology was used to explore the meaning of the lived experiences and perceptions of youth, parents, and healthcare providers about transition to adult healthcare. Purposeful sampling was utilized to select youth with a range of chronic health conditions from the TRACE cohort (spanning 20 diagnoses including developmental disabilities and chronic conditions), their parents and healthcare providers. The emerging three themes were: increasing independence of youth; parents as safety nets and healthcare providers as enablers and collaborators. The findings indicate that the experiences of transitioning youth, parents and service providers are interconnected and interdependent. Results support a dynamic and developmentally appropriate approach when working with transitioning youth and parents in practice. As youth depend on parents and healthcare providers for support in taking charge of their own health, parents and healthcare providers must work together to enable youth for self-management. At a policy level, adequate funding, institutional support and accreditation incentives are recommended to allow for designated time for healthcare providers to foster self-management skills in transitioning youth and parents. © 2016 The Authors. Child: Care, Health and Development published by John Wiley & Sons Ltd.

  11. Rehabilitation Engineering: What is Rehabilitation Engineering?

    Science.gov (United States)

    ... Parents/Teachers Resource Links for Students Glossary Rehabilitation Engineering What is rehabilitation engineering? How can future rehabilitation ... the area of rehabilitation engineering? What is rehabilitation engineering? Powered prosthetic leg. Source : M. Goldfarb, Vanderbilt U. ...

  12. Using a complex adaptive system lens to understand family caregiving experiences navigating the stroke rehabilitation system.

    Science.gov (United States)

    Ghazzawi, Andrea; Kuziemsky, Craig; O'Sullivan, Tracey

    2016-10-01

    Family caregivers provide the stroke survivor with social support and continuity during the transition home from a rehabilitation facility. In this exploratory study we examined family caregivers' perceptions and experiences navigating the stroke rehabilitation system. The theories of continuity of care and complex adaptive systems were integrated to examine the transition from a stroke rehabilitation facility to the patient's home. This study provides an understanding of the interacting complexities at the macro and micro levels. A convenient sample of family caregivers (n = 14) who provide care for a stroke survivor were recruited 4-12 weeks following the patient's discharge from a stroke rehabilitation facility in Ontario, Canada. Interviews were conducted with family caregivers to examine their perceptions and experiences navigating the stroke rehabilitation system. Directed and inductive content analysis and the theory of Complex Adaptive Systems were used to interpret the perceptions of family caregivers. Health system policies and procedures at the macro-level determined the types and timing of information being provided to caregivers, and impacted continuity of care and access to supports and services at the micro-level. Supports and services in the community, such as outpatient physiotherapy services, were limited or did not meet the specific needs of the stroke survivors or family caregivers. Relationships with health providers, informational support, and continuity in case management all influence the family caregiving experience and ultimately the quality of care for the stroke survivor, during the transition home from a rehabilitation facility.

  13. [In-patient (early) rehabilitation].

    Science.gov (United States)

    Wallesch, Claus-W; Lautenschläger, Sindy

    2017-04-01

    It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to a range of partially rehabilitative complex interventions, the system recognizes three main forms of early rehabilitative interventions: geriatric, neurological/neurosurgical, and interdisciplinary and others. In this article, the appropriate definitions and cost-effectiveness of these procedures are analyzed and compared. The early rehabilitative interventions are characterized by constant cooperation in the therapeutic team, especially neurological early rehabilitation through the incorporation of nursing as a therapeutic profession. Whereas geriatric and neurological early rehabilitation are reflected in the DRG system, the former provided in many general hospitals and the latter mainly in specialized institutions, interdisciplinary early rehabilitation has only occasionally been represented in the DRG system so far. If all acute in-patients who require early rehabilitation should receive such an intervention, an additional fee must be implemented for this this interdisciplinary service.

  14. Rehabilitative bodywork

    DEFF Research Database (Denmark)

    Hansen, Agnete Meldgaard

    2016-01-01

    ‘rehabilitative’ care practices aiming to empower, train and activate elderly citizens provides opportunities for homecare workers to renegotiate their status and reconstruct their work and occupational identities with a ‘cleaner’ and more optimistic image. Drawing on ethnographic fieldwork in two Danish homecare...... units, this article analyses how rehabilitative care practices, drawing on a narrative of the third age, provide an optimistic and anti-ageist framing of homecare work that informs the development of new occupational identities for care workers as coaches rather than carers in relation to citizens......Care work for elderly people has been characterised as dirty work, owing to its proximity to the (dys)functions and discharges of aged bodies and the notions of disease, decay and death associated with the idea of ‘old age’. However, a wave of reform programmes in Danish municipalities promoting...

  15. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation Psychological Realities after Spinal Cord Injury Toby Huston, PhD ... not provide medical advice, recommend or endorse health care products or services, or control the information found ...

  16. Development of quality indicators for transition from pediatric to adult care in sickle cell disease: A modified Delphi survey of adult providers.

    Science.gov (United States)

    Sobota, Amy E; Shah, Nishita; Mack, Jennifer W

    2017-06-01

    Transition from pediatric to adult care is a vulnerable time for young adults with sickle cell disease (SCD); however, improvements in transition are limited by a lack of quality indicators. The purpose of this study was to establish quality indicators for transition in SCD and to determine the optimal timing between the final pediatric visit and the first adult provider visit. We conducted a modified Delphi survey to reach a consensus on which quality indicators are most important for a successful transition. Our expert panel consisted of members of the Sickle Cell Adult Provider Network. In the first round, the participants ranked a list of quality indicators by importance. In the second round, the participants chose their "top 5" quality indicators in terms of importance and also ranked them on feasibility. The response rates for the two rounds were 68 and 96%, respectively. Nine quality indicators were chosen as "top 5" by a majority of respondents, including communication between pediatric and adult providers, timing of first adult visit, patient self-efficacy, quality of life, and trust with their adult provider. Based on the comments from round 1, respondents were also asked for the optimal timing between leaving pediatric care and entering adult care. Most recommended a first adult visit within 2 months of the final pediatric visit. By using these quality indicators chosen by the majority of respondents, we can better develop and evaluate transition programs for young adults with SCD and improve health outcomes for these vulnerable patients. © 2016 Wiley Periodicals, Inc.

  17. Care provided and care setting transitions in the last three months of life of cancer patients: a nationwide monitoring study in four European countries.

    NARCIS (Netherlands)

    Ko, W.; Deliens, L.; Miccinesi, G.; Giusti, F.; Moreels, S.; Donker, G.A.; Owuteaka-Philipsen, B.; Zurriaga, O.; Lopéz-Maside, A.; Block, L. van den

    2014-01-01

    Background: This is an international study across four European countries (Belgium[BE], the Netherlands[NL], Italy[IT] and Spain[ES]) between 2009 and 2011, describing and comparing care and care setting transitions provided in the last three months of life of cancer patients, using representative

  18. Care provided and care setting transitions in the last three months of life of cancer patients: a nationwide monitoring study in four European countries

    NARCIS (Netherlands)

    Ko, W.; Deliens, L.; Miccinesi, G.; Giusti, F.; Moreels, S.; Donker, G.A.; Onwuteaka-Philipsen, B.D.; Zurriaga, O.; Lopez-Maside, A.; Block, L.

    2014-01-01

    Background: This is an international study across four European countries (Belgium[BE], the Netherlands[NL], Italy[IT] and Spain[ES]) between 2009 and 2011, describing and comparing care and care setting transitions provided in the last three months of life of cancer patients, using representative

  19. A link between lipid metabolism and epithelial-mesenchymal transition provides a target for colon cancer therapy

    DEFF Research Database (Denmark)

    Sánchez-Martínez, Ruth; Cruz-Gil, Silvia; Gómez de Cedrón, Marta

    2015-01-01

    an epithelial-mesenchymal transition (EMT) program that promotes migration and invasion of colon cancer cells. The mesenchymal phenotype produced upon overexpression of these enzymes is reverted through reactivation of AMPK signaling. Furthermore, this network expression correlates with poorer clinical outcome...... of stage-II colon cancer patients. Finally, combined treatment with chemical inhibitors of ACSL/SCD selectively decreases cancer cell viability without reducing normal cells viability. Thus, ACSL/SCD network stimulates colon cancer progression through conferring increased energetic capacity and invasive...... and migratory properties to cancer cells, and might represent a new therapeutic opportunity for colon cancer treatment....

  20. Biofeedback in rehabilitation

    OpenAIRE

    Giggins, Oonagh M; Persson, Ulrik McCarthy; Caulfield, Brian

    2013-01-01

    This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-tim...

  1. Cardiac Rehabilitation.

    Science.gov (United States)

    Thoreson, Richard W.; And Others

    1981-01-01

    Describes rehabilitation implications associated with psychosocial factors, patient reaction, and family adjustment to coronary heart disease. Patient education and counseling must stress specific long-term care and follow-up and deal with family anxiety and depression. The rehabilitation counselor can help patients incorporate medical…

  2. Coronary Rehabilitation

    OpenAIRE

    Dworkind, Michael

    1986-01-01

    This paper describes a team approach to coronary rehabilitation in a tertiary care hospital and the unique role of the family physician in a shared, multi-disciplinary service for in- and out-patients. Primary care physicians facilitate and supplement the work of the coronary-unit team in establishing an optimal rehabilitative program for MI patients and their families.

  3. 20 CFR 702.506 - Vocational rehabilitation; training.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Vocational rehabilitation; training. 702.506... Rehabilitation § 702.506 Vocational rehabilitation; training. Vocational rehabilitation training shall be planned... shall apply in arranging for or providing training: (a) The vocational rehabilitation adviser shall...

  4. Development status and prospect of rehabilitation clinical nurse specialist

    Directory of Open Access Journals (Sweden)

    Xiao-ping WANG

    2014-04-01

    Full Text Available Through access to a lot of relevant information on the role of the rehabilitation nurse specialist functions, explore how rehabilitation specialist nurse qualifications provides a basis for our rehabilitation specialist nurse cultivating and development.

  5. Arbejdsrettet Rehabilitering

    DEFF Research Database (Denmark)

    Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard

    2014-01-01

    Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....

  6. Arbejdsrettet rehabilitering

    DEFF Research Database (Denmark)

    Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard

    2014-01-01

    Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....

  7. Vocational rehabilitation

    DEFF Research Database (Denmark)

    Labriola, Merete; Thielen, Karsten; Eplov, Lene Falgaard

    2014-01-01

    Work is known to be one of the main sources of human identity. It might be threatened when ill-health impairs individual labour market participation. Vocational rehabilitation, which is based on the bio-psycho-social model of health and function, is the systematic approach to improve employability...... for those who suffer from health-related disabilities. This article gives a short historical overview about vocational rehabilitation in Denmark, describes the current structural and political framework and gives practice examples of local multidisciplinary and intersectoral rehabilitation efforts....

  8. Cardiac Rehabilitation

    Science.gov (United States)

    Cardiac rehabilitation (rehab) is a medically supervised program to help people who have A heart attack Angioplasty or coronary artery bypass grafting for coronary heart disease A heart valve repair or replacement A ...

  9. Cardiac rehabilitation

    Science.gov (United States)

    ... ncbi.nlm.nih.gov/pubmed/25503364 . Balady GJ, Williams MA, Ades PA, et al. Core components of ... ncbi.nlm.nih.gov/pubmed/22070836 . Thompson PD. Exercise-based, comprehensive cardiac rehabilitation. In: Mann DL, Zipes ...

  10. Skilled nursing and rehabilitation facilities - choosing

    Science.gov (United States)

    ... gov/ency/patientinstructions/000436.htm Choosing a skilled nursing and rehabilitation facility To use the sharing features ... you may need to go to a skilled nursing or rehabilitation facility . Skilled nursing facilities provide care ...

  11. Stroke Rehabilitation.

    Science.gov (United States)

    Belagaje, Samir R

    2017-02-01

    Rehabilitation is an important aspect of the continuum of care in stroke. With advances in the acute treatment of stroke, more patients will survive stroke with varying degrees of disability. Research in the past decade has expanded our understanding of the mechanisms underlying stroke recovery and has led to the development of new treatment modalities. This article reviews and summarizes the key concepts related to poststroke recovery. Good data now exist by which one can predict recovery, especially motor recovery, very soon after stroke onset. Recent trials have not demonstrated a clear benefit associated with very early initiation of rehabilitative therapy after stroke in terms of improvement in poststroke outcomes. However, growing evidence suggests that shorter and more frequent sessions of therapy can be safely started in the first 24 to 48 hours after a stroke. The optimal amount or dose of therapy for stroke remains undetermined, as more intensive treatments have not been associated with better outcomes compared to standard intensities of therapy. Poststroke depression adversely affects recovery across a variety of measures and is an important target for therapy. Additionally, the use of selective serotonin reuptake inhibitors (SSRIs) appears to benefit motor recovery through pleiotropic mechanisms beyond their antidepressant effect. Other pharmacologic approaches also appear to have a benefit in stroke rehabilitation. A comprehensive rehabilitation program is essential to optimize poststroke outcomes. Rehabilitation is a process that uses three major principles of recovery: adaptation, restitution, and neuroplasticity. Based on these principles, multiple different approaches, both pharmacologic and nonpharmacologic, exist to enhance rehabilitation. In addition to neurologists, a variety of health care professionals are involved in stroke rehabilitation. Successful rehabilitation involves understanding the natural history of stroke recovery and a

  12. Rehabilitation Research for Older Adults

    Directory of Open Access Journals (Sweden)

    Salima Suleman

    2014-11-01

    Full Text Available In this article, we describe a knowledge translation symposium focused on rehabilitation research for older adults. The symposium consisted of presentations on rehabilitation research, followed by roundtable discussions designed to solicit perspectives of public stakeholders. Eighty-eight people attended the event, most with backgrounds in health care service provision. The participants evaluated the event and provided feedback on research topics related to rehabilitation of older adults. Lessons learned from this event may be useful in the design of future knowledge translation symposia and to facilitate involvement of public stakeholders in design, implementation, and dissemination of rehabilitation research for older adults.

  13. SERIES "NOVELTIES IN PULMONARY REHABILITATION" New tools in pulmonary rehabilitation

    NARCIS (Netherlands)

    Wijkstra, P. J.; Wempe, J. B.

    2011-01-01

    In patients with more severe chronic obstructive pulmonary disease ( COPD), the benefits of rehabilitation might not be clear and, therefore, new treatment options have been developed to increase the benefits of rehabilitation. This review provides an overview of new approaches being developed as an

  14. Rehabilitation and Prosthetic Services

    Science.gov (United States)

    ... Sensory Aids Service » Prosthetic & Sensory Aids Service (PSAS) Rehabilitation and Prosthetic Services Menu Menu Rehabilitation and Prosthetics Rehabilitation and Prosthetic Services Home Amputation ...

  15. 34 CFR 361.49 - Scope of vocational rehabilitation services for groups of individuals with disabilities.

    Science.gov (United States)

    2010-07-01

    ... is used to provide vocational rehabilitation services that promote integration and competitive... agencies in planning for the transition of students with disabilities from school to post-school activities... groups of individuals, it must— (1) Develop and maintain written policies covering the nature and scope...

  16. Patient and provider perspectives on quality and health system effectiveness in a transition economy: evidence from Ukraine.

    Science.gov (United States)

    Luck, J; Peabody, J W; DeMaria, L M; Alvarado, C S; Menon, R

    2014-08-01

    Facing a severe population health crisis due to noncommunicable diseases, Ukraine and other former Soviet republics and Eastern European countries have a pressing need for more effective health systems. Policies to enhance health system effectiveness should consider the perspectives of different stakeholder groups, including providers as well as patients. In addition, policies that directly target the quality of clinical care should be based on objective performance measures. In 2009 and 2010 we conducted a coordinated series of household and facility-level surveys to capture the perspectives of Ukrainian household members, outpatient clinic patients, and physicians regarding the country's health system overall, as well as the quality, access, and affordability of health care. We objectively measured the quality of care for heart failure and chronic obstructive pulmonary disease using CPV(®) vignettes. There was broad agreement among household respondents (79%) and physicians (95%) that Ukraine's health system should be reformed. CPV(®) results indicate that the quality of care for common noncommunicable diseases is poor in all regions of the country and in hospitals as well as polyclinics. However, perspectives about the quality of care differ, with household respondents seeing quality as a serious concern, clinic patients having more positive perceptions, and physicians not viewing quality as a reform priority. All stakeholder groups viewed affordability as a problem. These findings have several implications for policies to enhance health system effectiveness. The shared desire for health system reform among all stakeholder groups provides a basis for action in Ukraine. Improving quality, strengthening primary care, and enhancing affordability should be major goals of new health policies. Policies to improve quality directly, such as pay-for-performance, would be mutually reinforcing with purchasing reforms such as transparent payment mechanisms. Such policies

  17. Investigating the anatomy of the helping relationship in the context of psychiatric rehabilitation: the relation between working alliance, providers' recovery competencies and personal recovery.

    Science.gov (United States)

    Moran, Galia; Mashiach-Eizenberg, Michal; Roe, David; Berman, Yael; Shalev, Anat; Kaplan, Zeev; Garber Epstein, Paula

    2014-12-15

    Professional helping relationships established with mental health consumers are vital in mental health recovery processes. However, little is known about how the constructs of alliance building and providers' recovery promoting strategies relate to each other and play a role in supporting recovery. To this end, we examined associations between consumer-reported working alliance, perceived providers' recovery competencies, and personal recovery. In a cross-sectional study design, 72 mental health consumers who established relationships with providers through a psycho-educational intervention over a period of 10 months in hourly weekly sessions were examined as part of a larger study conducted in mental health community settings in Israel. Participants filled in the Working Alliance Inventory (Tracey and Kokotovic, 1989), the Recovery Promoting Relationships Scale (Russinova et al., 2013), and Recovery Assessment Scale (Corrigan et al., 2004). Pearson correlations and linear regression analysis showed positive correlations between relational variables and recovery. A mediating model was identified whereby providers' recovery strategies positively impact the working alliance, which, in turn, positively impact consumers' recovery. Implications of the current study for future research and clinical practice are discussed, emphasizing the importance of examining recovery strategies and the working alliance with regard to the process of mental health recovery. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Cooling Mediterranean Sea surface temperatures during the Late Miocene provide a climate context for evolutionary transitions in Africa and Eurasia

    Science.gov (United States)

    Tzanova, Alexandrina; Herbert, Timothy D.; Peterson, Laura

    2015-06-01

    In the Late Miocene, grasslands proliferated, succulent plants diversified in the mid-latitudes, and the desert-like conditions appeared in the Sahara. Despite this major environmental change on land, the coeval deep-sea oxygen isotope record does not provide evidence for significant high latitude cooling or continental ice growth, making it difficult to relate widespread terrestrial environmental change to global climatic changes. A U37K‧ -derived sea surface temperature (SST) reconstruction spanning 13 to 6 Ma from uplifted hemipelagic sediments in Northern Italy provides the first continuous mid-latitude temperature record with which to compare the evolution of aridity and biotic events at similar latitudes in Northern Africa and Pakistan. Between 13 and 8.8 Ma, Mediterranean SST lay near the upper limit of the alkenone temperature proxy (∼28 °C), exceeding modern SST at the site by as much as 10 °C. Throughout the record, sapropel layers correspond to local SST maxima, suggesting that Late Miocene hydrological conditions in the Mediterranean responded to insolation forcing via mechanisms similar to those documented for the Plio-Pleistocene. Mediterranean SST cooled rapidly beginning at ∼8 Ma, with an episode of intense cooling to ∼19 °C between 7.2 Ma and 6.6 Ma, followed by a rebound to ∼25 °C preceding the Messinian Salinity Crisis at 5.9 Ma. These observations establish, for the first time, a direct relationship between increasing aridity in the Northern hemisphere mid-latitudes and significant cooling. Evidently, this cooling was not accompanied by significant growth in continental ice volume. The extreme warmth and subsequent cooling of the Mediterranean Sea are not well-represented in current Late Miocene climate models, which our results suggest underestimate regional warmth prior to the Late Miocene cooling. Evidence of secular cooling during the Late Miocene gives new support to the much-debated link between a possible decline in

  19. Problematising risk in stroke rehabilitation.

    Science.gov (United States)

    Egan, Mary Y; Kessler, Dorothy; Ceci, Christine; Laliberté-Rudman, Debbie; McGrath, Colleen; Sikora, Lindsey; Gardner, Paula

    2016-11-01

    Following stroke, re-engagement in personally valued activities requires some experience of risk. Risk, therefore, must be seen as having positive as well as negative aspects in rehabilitation. Our aim was to identify the dominant understanding of risk in stroke rehabilitation and the assumptions underpinning these understandings, determine how these understandings affect research and practise, and if necessary, propose alternate ways to conceptualise risk in research and practise. Alvesson and Sandberg's method of problematisation was used. We began with a historical overview of stroke rehabilitation, and proceeded through five steps undertaken in an iterative fashion: literature search and selection; data extraction; syntheses across texts; identification of assumptions informing the literature and; generation of alternatives. Discussion of risk in stroke rehabilitation is largely implicit. However, two prominent conceptualisations of risk underpin both knowledge development and clinical practise: the risk to the individual stroke survivor of remaining dependent in activities of daily living and the risk that the health care system will be overwhelmed by the costs of providing stroke rehabilitation. Conceptualisation of risk in stroke rehabilitation, while implicit, drives both research and practise in ways that reinforce a focus on impairment and a generic, decontextualised approach to rehabilitation. Implications for rehabilitation Much of stroke rehabilitation practise and research seems to centre implicitly on two risks: risk to the patient of remaining dependent in ADL and risk to the health care system of bankruptcy due to the provision of stroke rehabilitation. The implicit focus on ADL dependence limits the ability of clinicians and researchers to address other goals supportive of a good life following stroke. The implicit focus on financial risk to the health care system may limit access to rehabilitation for people who have experienced either milder or

  20. Burn Rehabilitation

    Directory of Open Access Journals (Sweden)

    Koray Aydemir

    2011-07-01

    Full Text Available Burn injuries are important in terms of causing serious disability and threatening life. With the establishment of modern burn treatment units and advances in acute care management contributed to a reduced mortality rate over the last decades. As a result of improved outcome, more attention has to be given to a comprehensive burn rehabilitation program. Burn rehabilitation is a process that starts from day of admission and continues for months or sometimes years after the initial event. The term ‘burn rehabilitation’ incorporates the physical, physiological and social aspects of care. Burns can leave a patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Burn rehabilitation aims to prevent the possible complications, minimalize joint contractures and deformities, increase range of motion, control hypertrophic scarring, achieve the best possible functional capacity and to regain the patients vocational and recreational activities. (Journal of the Turkish Society Intensive Care 2011; 9 Suppl: 70-7

  1. Introduction to Positive Psychology in Rehabilitation

    Science.gov (United States)

    Chou, Chih-Chin; Chan, Fong; Phillips, Brian; Chan, Jacob Yui Chung

    2013-01-01

    Positive psychology has received increasing attention in rehabilitation counseling research and practice. The rehabilitation counseling philosophy shares a similar emphasis of personal assets and strengths, which provides a solid foundation for the integration of positive psychology into the professional practice of rehabilitation counseling. In…

  2. Pediatric Provider's Perspectives on the Transition to Adult Health Care for Youth with Autism Spectrum Disorder: Current Strategies and Promising New Directions

    Science.gov (United States)

    Kuhlthau, Karen A.; Warfield, Marji E.; Hurson, Jill; Delahaye, Jennifer; Crossman, Morgan K.

    2015-01-01

    Few youth with autism spectrum disorder (ASD) nationally report receiving services to help them transition from the pediatric health care system to the adult health care system. For example, only one-fifth (21.1%) of youth with ASD receive any transition planning services. To better understand why the transition from pediatric to adult health care…

  3. A case study review of technical and technology issues for transition of a utility load management program to provide system reliability resources in restructured electricity markets

    Energy Technology Data Exchange (ETDEWEB)

    Weller, G.H.

    2001-07-15

    Utility load management programs--including direct load control and interruptible load programs--were employed by utilities in the past as system reliability resources. With electricity industry restructuring, the context for these programs has changed; the market that was once controlled by vertically integrated utilities has become competitive, raising the question: can existing load management programs be modified so that they can effectively participate in competitive energy markets? In the short run, modified and/or improved operation of load management programs may be the most effective form of demand-side response available to the electricity system today. However, in light of recent technological advances in metering, communication, and load control, utility load management programs must be carefully reviewed in order to determine appropriate investments to support this transition. This report investigates the feasibility of and options for modifying an existing utility load management system so that it might provide reliability services (i.e. ancillary services) in the competitive markets that have resulted from electricity industry restructuring. The report is a case study of Southern California Edison's (SCE) load management programs. SCE was chosen because it operates one of the largest load management programs in the country and it operates them within a competitive wholesale electricity market. The report describes a wide range of existing and soon-to-be-available communication, control, and metering technologies that could be used to facilitate the evolution of SCE's load management programs and systems to provision of reliability services. The fundamental finding of this report is that, with modifications, SCE's load management infrastructure could be transitioned to provide critical ancillary services in competitive electricity markets, employing currently or soon-to-be available load control technologies.

  4. Identifying Challenges Associated With the Care Transition Workflow From Hospital to Skilled Home Health Care: Perspectives of Home Health Care Agency Providers.

    Science.gov (United States)

    Nasarwanji, Mahiyar; Werner, Nicole E; Carl, Kimberly; Hohl, Dawn; Leff, Bruce; Gurses, Ayse P; Arbaje, Alicia I

    2015-01-01

    Older adults discharged from the hospital to skilled home health care (SHHC) are at high risk for experiencing suboptimal transitions. Using the human factors approach of shadowing and contextual inquiry, we studied the workflow for transitioning older adults from the hospital to SHHC. We created a representative diagram of the hospital to SHHC transition workflow, we examined potential workflow variations, we categorized workflow challenges, and we identified artifacts developed to manage variations and challenges. We identified three overarching challenges to optimal care transitions-information access, coordination, and communication/teamwork. Future investigations could test whether redesigning the transition from hospital to SHHC, based on our findings, improves workflow and care quality.

  5. Pediatric burn rehabilitation: Philosophy and strategies

    Directory of Open Access Journals (Sweden)

    Shohei Ohgi

    2013-09-01

    Full Text Available Burn injuries are a huge public health issue for children throughout the world, with the majority occurring in developing countries. Burn injuries can leave a pediatric patient with severely debilitating and deforming contractures, which can lead to significant disability when left untreated. Rehabilitation is an essential and integral part of pediatric burn treatment. The aim of this article was to review the literature on pediatric burn rehabilitation from the Medline, CINAHL, and Web of Science databases. An attempt has been made to present the basic aspects of burn rehabilitation, provide practical information, and discuss the goals and conceptualization of rehabilitation as well as the development of rehabilitation philosophy and strategies.

  6. Patient preferences for stroke rehabilitation.

    Science.gov (United States)

    Gregory, Patricia; Edwards, Lloyd; Faurot, Keturah; Williams, Sharon W; Felix, Ana C G

    2010-01-01

    Early aggressive rehabilitation therapies maximize functional recovery. We examined patient-reported preferences for their initial rehabilitation therapy setting during their acute stroke hospitalization and whether there was an association between their preferences and their actual discharge destination. Eligible stroke patients were surveyed during their acute hospital stay at either a primary stroke center or a rural community hospital in North Carolina. Patients were questioned about their knowledge of inpatient rehabilitation, preferences for the initial rehabilitation therapy setting and intensity, and how far from home they were willing to travel to receive therapies. The primary outcome was their actual discharge destination. The exposure variable was their preference for initial rehabilitation therapy setting. Logistic regression models assessed the relationship between the outcome and exposure while controlling for other variables of interest. Among 53 patients surveyed in the study, 85% preferred to be discharged home. After controlling for other factors, discharge to the actual destination of home was associated with a preference for an initial rehabilitation therapy setting of home (OR, 7.19; 95% CI, 1.10-46.89). Patient preference for the initial rehabilitation therapy setting is home. Providers should inquire about patient preference and provide information about treatment options to help inform decision making.

  7. Can administrative claim file review be used to gather physical therapy, occupational therapy, and psychology payment data and functional independence measure scores? Implications for rehabilitation providers in the private health sector.

    Science.gov (United States)

    Riis, Viivi; Jaglal, Susan; Boschen, Kathryn; Walker, Jan; Verrier, Molly

    2011-01-01

    Rehabilitation costs for spinal-cord injury (SCI) are increasingly borne by Canada's private health system. Because of poor outcomes, payers are questioning the value of their expenditures, but there is a paucity of data informing analysis of rehabilitation costs and outcomes. This study evaluated the feasibility of using administrative claim file review to extract rehabilitation payment data and functional status for a sample of persons with work-related SCI. Researchers reviewed 28 administrative e-claim files for persons who sustained a work-related SCI between 1996 and 2000. Payment data were extracted for physical therapy (PT), occupational therapy (OT), and psychology services. Functional Independence Measure (FIM) scores were targeted as a surrogate measure for functional outcome. Feasibility was tested using an existing approach for evaluating health services data. The process of administrative e-claim file review was not practical for extraction of the targeted data. While administrative claim files contain some rehabilitation payment and outcome data, in their present form the data are not suitable to inform rehabilitation services research. A new strategy to standardize collection, recording, and sharing of data in the rehabilitation industry should be explored as a means of promoting best practices.

  8. Telecommunications technology in cognitive rehabilitation.

    Science.gov (United States)

    Caltagirone, Carlo; Zannino, Gian Daniele

    2008-01-01

    Cognitive disorders are a common long-term consequence of many forms of acquired neurological damage of different aetiology. The already high prevalence of diseases causing cognitive deficits (in particular stroke) is expected to increase in the near future, leading to a greater need for cognitive rehabilitation. The impact of cognitive impairment on daily functioning may be even greater than that of physical limitations in affected patients, contributing to the high cost of brain disorders. New technologies, including telerehabilitation, may provide an effective response to this challenge, allowing increased access to rehabilitation services as well as reduced care costs for individuals needing cognitive rehabilitation.

  9. What Is Cardiac Rehabilitation?

    Science.gov (United States)

    ANSWERS by heart Treatments + Tests What Is Cardiac Rehabilitation? A cardiac rehabilitation (rehab) program takes place in a hospital or ... special help in making lifestyle changes. During your rehabilitation program you’ll… • Have a medical evaluation to ...

  10. Smart portable rehabilitation devices

    Directory of Open Access Journals (Sweden)

    Leahey Matt

    2005-07-01

    Full Text Available Abstract Background The majority of current portable orthotic devices and rehabilitative braces provide stability, apply precise pressure, or help maintain alignment of the joints with out the capability for real time monitoring of the patient's motions and forces and without the ability for real time adjustments of the applied forces and motions. Improved technology has allowed for advancements where these devices can be designed to apply a form of tension to resist motion of the joint. These devices induce quicker recovery and are more effective at restoring proper biomechanics and improving muscle function. However, their shortcoming is in their inability to be adjusted in real-time, which is the most ideal form of a device for rehabilitation. This introduces a second class of devices beyond passive orthotics. It is comprised of "active" or powered devices, and although more complicated in design, they are definitely the most versatile. An active or powered orthotic, usually employs some type of actuator(s. Methods In this paper we present several new advancements in the area of smart rehabilitation devices that have been developed by the Northeastern University Robotics and Mechatronics Laboratory. They are all compact, wearable and portable devices and boast re-programmable, real time computer controlled functions as the central theme behind their operation. The sensory information and computer control of the three described devices make for highly efficient and versatile systems that represent a whole new breed in wearable rehabilitation devices. Their applications range from active-assistive rehabilitation to resistance exercise and even have applications in gait training. The three devices described are: a transportable continuous passive motion elbow device, a wearable electro-rheological fluid based knee resistance device, and a wearable electrical stimulation and biofeedback knee device. Results Laboratory tests of the devices

  11. Concussion knowledge among rehabilitation staff

    OpenAIRE

    Salisbury, David; Kolessar, Michael; Callender, Librada; Bennett, Monica

    2017-01-01

    A concussion knowledge survey was completed by 561 rehabilitation professionals across a wide range of disciplines in a nationwide rehabilitation hospital system. Item questions were structured to reflect key areas of concussion knowledge targeted in a prior consensus statement. The vast majority of staff provided responses consistent with the current concussion literature regarding concussion diagnosis and symptom presentation immediately after concussion. Greater variability was seen for it...

  12. International Rehabilitation Network

    National Research Council Canada - National Science Library

    Smith, William

    2001-01-01

    The International Rehabilitation Network's goal is to improve the quality of services for land mine survivors and other amputee's through the dissemination of educational programs to rehabilitation professionals...

  13. EVALUATING PATIENTS’ NEEDS AMONG REHABILITATION SETTING

    Directory of Open Access Journals (Sweden)

    Mohammed M. J. Alqahtani

    2015-09-01

    Full Text Available Patient’ needs have been found to be crucial to the success of rehabilitation and recovery. To understand what patients want from their rehabilitation services should be addressed in the rehabilitation intervention. This study aims to examine patients’ needs for rehabilitation services as well as to examine the validity of a self-report questionnaire that developed to measure what patient needs from rehabilitation services in Saudi Arabia. Tow hundreds-eighty patients, from inpatients and outpatients, with stroke, spinal cord and brain injury completed the Patient’s Needs Questionnaire (PNQ. In general, the result showed that patients are in highly needs for Psychological Interventions, even before Rehabilitation and Treatment component. In detail, Psychological Intervention and Emotional Support were significantly greater in inpatients than in outpatients. Outpatients, in contrast, affirmed the Religious Support component significantly more than inpatients did. The statistical analysis of PNQ yielded four components: psychological interventions, rehabilitation and treatment, religious support, and explanation/reassurance. These components accounted for 48.71% of the total variances. Rehabilitation services is not only the component of rehabilitation intervention and medical treatments, indeed, it is a holistic intervention that understand the psychological, religious, and reassurance demands. The health provider in Saudi Arabia should develop a rehabilitation goal menu based on patient-centred care needs. The PNQ is a valuable and practical tool for the identification of patients’ needs from rehabilitation services.

  14. People with stroke spend more time in active task practice, but similar time in walking practice, when physiotherapy rehabilitation is provided in circuit classes compared to individual therapy sessions: an observational study.

    Science.gov (United States)

    English, Coralie; Hillier, Susan; Kaur, Gurpreet; Hundertmark, Laura

    2014-03-01

    Do people with stroke spend more time in active task practice during circuit class therapy sessions versus individual physiotherapy sessions? Do people with stroke practise different tasks during circuit class therapy sessions versus individual physiotherapy sessions? Prospective, observational study. Twenty-nine people with stroke in inpatient rehabilitation settings. Individual therapy sessions and circuit class therapy sessions provided within a larger randomised controlled trial. Seventy-nine therapy sessions were video-recorded and the footage was analysed for time spent engaged in various categories of activity. In a subsample of 28 videos, the number of steps taken by people with stroke per therapy session was counted. Circuit class therapy sessions were of a longer duration (mean difference 38.0minutes, 95% CI 29.9 to 46.1), and participants spent more time engaged in active task practice (mean difference 23.8minutes, 95% CI 16.1 to 31.4) compared with individual sessions. A greater percentage of time in circuit class therapy sessions was spent practising tasks in sitting (mean difference 5.3%, 95% CI 2.4 to 8.2) and in sit-to-stand practice (mean difference 2.7%, 95% CI 1.4 to 4.1), and a lower percentage of time in walking practice (mean difference 19.1%, 95% CI 10.0 to 28.1) compared with individual sessions. PARTICIPANTS took an average of 371 steps (SD 418) during therapy sessions and this did not differ significantly between group and individual sessions. People with stroke spent more time in active task practice, but a similar amount of time in walking practice when physiotherapy was offered in circuit class therapy sessions versus individual therapy sessions. There is a need for effective strategies to increase the amount of walking practice during physiotherapy sessions for people after stroke. Copyright © 2014 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

  15. Long-term efficacy of pulmonary rehabilitation in patients with occupational respiratory diseases.

    Science.gov (United States)

    Ochmann, Uta; Kotschy-Lang, Nicola; Raab, Wolfgang; Kellberger, Jessica; Nowak, Dennis; Jörres, Rudolf A

    2012-01-01

    Pulmonary rehabilitation is a well-recognized treatment option in chronic obstructive lung disease improving exercise performance, respiratory symptoms and quality of life. In occupational respiratory diseases, which can be rather cost-intensive due to the compensation needs, very little information is available. This study aims at the evaluation of the usefulness of pulmonary rehabilitation in patients with occupational respiratory diseases, partly involving complex alterations of lung function and of the sustainability of effects. We studied 263 patients with occupational respiratory diseases (asthma, silicosis, asbestosis, chronic obstructive pulmonary disease) using a 4-week inpatient rehabilitation program and follow-up examinations 3 and 12 months later. The outcomes evaluated were lung function, 6-min walking distance (6MWD), maximum exercise capacity (Wmax), skeletal muscle strength, respiratory symptoms, exacerbations and associated medical consultations, quality of life (SF-36, SGRQ), anxiety/depression (HADS) and Medical Research Council and Baseline and Transition Dyspnea Index scores. Compared to baseline, there were significant (p rehabilitation, and these were maintained over 12 months (p rehabilitation. No changes were seen in the questionnaire outcomes. Pulmonary rehabilitation is effective even in the complex settings of occupational respiratory diseases, providing sustained improvement of functional capacity and reducing health care utilization. Copyright © 2012 S. Karger AG, Basel.

  16. Rehabilitation after Articular Cartilage Repair of the Knee in the Football (Soccer) Player

    Science.gov (United States)

    Silvers, Holly Jacinda; Steinwachs, Matthias

    2012-01-01

    Background: Participation in football can put both male and female players at an increased risk for knee osteoarthritis. There is a higher prevalence of focal chondral defects in the knee of athletes compared to nonathletes. The management of chondral defects in the football player is complex and multifactorial. Objective: The aim of this study is to provide an overview of the current strategies for rehabilitation after articular cartilage repair of the knee in the football player. Design: A review of current literature and the scientific evidence for rehabilitation after articular cartilage repair of the knee. Conclusions: Articular cartilage repair has been shown to allow return to sport but rehabilitation timescales are lengthy. Successful rehabilitation for a return to football after articular cartilage repair of the knee requires the player to be able to accept the load of the sport. This necessitates a multidisciplinary approach to rehabilitation, especially in the transition from therapy to performance care. It should be recognized that not all players will return to football after articular cartilage repair. The evidence base for rehabilitative practice after articular cartilage repair is increasing but remains sparse in areas. PMID:26069608

  17. [Rehabilitation in Alzheimer's dementia].

    Science.gov (United States)

    Cicconetti, P; Fionda, A; Zannino, G; Ettorre, E; Marigliano, V

    2000-09-01

    Alzheimer's disease is a neurodegenerative disease that causes a progressive decline of cognitive and behavioural functions. The simultaneous presence of these disorders requires a treatment not only for cognitive decline, but also for behavioural symptoms, depression and caregiver's stress. Research has made many efforts to develop a wide range of treatments, different from current pharmacological therapy, which is not resolutive, owing to the absence of an exact etiopathogenetic mechanism. Since new drugs have not been shown to be really effective in slowing cognitive impairment, various forms of rehabilitative interventions have been proposed in order to treat Alzheimer's disease. Their efficacy in the improvement of cognitive functions is still not completely clear. Surely, interesting results have been obtained from studies about Reality Orientation Therapy, Occupational Therapy and Memory Training. Music therapy might provide a new form of rehabilitative intervention, especially acting on the reducing of behavioural symptoms. These alternative forms of non pharmacological treatment may have a positive effect on caregiver. The heavy emotional burden of seeing a loved one becoming confused and isolated and of having to accept new responsibilities, may be reduced by rehabilitative supports, complementary to the pharmacological therapy. Caregiver stress could be reduced in two ways: by promoting the hope that something is being done for the patient and providing free time for himself.

  18. [Is rehabilitation worth it? : Review of economic evaluations of rehabilitation in Germany].

    Science.gov (United States)

    Krauth, Christian; Bartling, Tim

    2017-04-01

    Because of demographic change, the rehabilitation sector in Germany is going to face increasing demands in the future. Limited budgets make the optimal allocation of resources a top priority. To support decisions about the optimal scope and design of rehabilitation, studies on health economics are of utmost importance. The aim of this article is to provide an overview of the evaluation of rehabilitation with regard to health economics in Germany.Based on a comprehensive literature research, 17 studies on the cost-effectiveness of rehabilitation in Germany were identified. The health economics evaluation focuses on four main topics: patient education (5 studies), the comparison of outpatient and inpatient rehabilitation (7 studies), medico-occupational rehabilitation programs (2 studies) and aftercare programs (3 studies). All four topics show that innovative rehabilitation technologies can be cost-effective. Significant potential savings in program costs of 25-35% are demonstrated in outpatient rehabilitation (with comparable effectiveness with inpatient care). Designated patient education programs often lead to significant savings with indirect costs, by reducing periods of unfitness to work and extending the long-term ability to work. This review article also points out that some relevant areas of rehabilitation, such as the flexibilization of rehabilitation programs or the efficient organization of access to rehabilitation, have not been evaluated sufficiently on the basis of health economics. This article ends with the requirement to carry out more economics-based rehabilitation studies.

  19. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Sores Mary Zeigler, MS Transition from Hospital to Home Kim Eberhardt Muir, MS Coping with a New ... not provide medical advice, recommend or endorse health care products or services, or control the information found ...

  20. Comprehensive Outpatient Rehabilitation Program: Hospital-Based Stroke Outpatient Rehabilitation.

    Science.gov (United States)

    Rice, Danielle; Janzen, Shannon; McIntyre, Amanda; Vermeer, Julianne; Britt, Eileen; Teasell, Robert

    2016-05-01

    Few studies have considered the effectiveness of outpatient rehabilitation programs for stroke patients. The objective of this study was to assess the effectiveness of a hospital-based interdisciplinary outpatient stroke rehabilitation program with respect to physical functioning, mobility, and balance. The Comprehensive Outpatient Rehabilitation Program provides a hospital-based interdisciplinary approach to stroke rehabilitation in Southwestern Ontario. Outcome measures from physiotherapy and occupational therapy sessions were available at intake and discharge from the program. A series of paired sample t-tests were performed to assess patient changes between time points for each outcome measure. A total of 271 patients met the inclusion criteria for analysis (56.1% male; mean age = 62.9 ± 13.9 years). Significant improvements were found between admission and discharge for the Functional Independence Measure, grip strength, Chedoke-McMaster Stroke Assessment, two-minute walk test, maximum walk test, Timed Up and Go, Berg Balance Scale, and one-legged stance (P stroke. A hospital-based, stroke-specific rehabilitation program should be considered when patients continue to experience deficits after inpatient rehabilitation. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  1. Trends in pediatric rehabilitation.

    Science.gov (United States)

    Burkett, K W

    1989-03-01

    health procedures such as tube feedings and clean intermittent catherization have become routine for many children and their families. Advanced technology has also benefited the child who is ventilator dependent, although not without some limitations to the child, family, and society. Limited financial and psychosocial resources create a burden on both the family and society as the child continues to require high technology care. The relatively new field of head-injury rehabilitation provides an arena for pediatric rehabilitation nurses to define specific interventions for the child who is rapidly evolving through the stages of cognitive and motor recovery.(ABSTRACT TRUNCATED AT 400 WORDS)

  2. Psychosocial rehabilitation and democratic development in Nepal

    DEFF Research Database (Denmark)

    Triantafillou, Peter; Sassene, Michel

    2011-01-01

    Today, centres and programmes for the rehabilitation of torture victims are found all over the world. In Nepal, one of the world's poorest countries, the Centre for Victims of Torture (CVICT) has since 1990 provided advanced psychosocial rehabilitation programmes. These and similar psychosocial...... interventions have made critics proclaim that Western psychosocial expertise subjects the bereaved of the Third World to repressive administrative power by objectifying and colonizing their minds. Meanwhile, advocates of psychosocial rehabilitation maintain that such criticisms fail to appreciate the ability...

  3. Genome-wide transcriptomic analyses provide insights into the lifestyle transition and effector repertoire of Leptosphaeria maculans during the colonization of Brassica napus seedlings.

    Science.gov (United States)

    Haddadi, Parham; Ma, Lisong; Wang, Haiyan; Borhan, M Hossein

    2016-10-01

    Molecular interaction between the causal agent of blackleg disease, Leptosphaeria maculans (Lm), and its host, Brassica napus, is largely unknown. We applied a deep RNA-sequencing approach to gain insight into the pathogenicity mechanisms of Lm and the defence response of B. napus. RNA from the infected susceptible B. napus cultivar Topas DH16516, sampled at 2-day intervals (0-8 days), was sequenced and used for gene expression profiling. Patterns of gene expression regulation in B. napus showed multifaceted defence responses evident by the differential expression of genes encoding the pattern recognition receptor CERK1 (chitin elicitor receptor kinase 1), receptor like proteins and WRKY transcription factors. The up-regulation of genes related to salicylic acid and jasmonic acid at the initial and late stages of infection, respectively, provided evidence for the biotrophic and necrotrophic life stages of Lm during the infection of B. napus cotyledons. Lm transition from biotrophy to necrotropy was also supported by the expression function of Lm necrosis and ethylene-inducing (Nep-1)-like peptide. Genes encoding polyketide synthases and non-ribosomal peptide synthetases, with potential roles in pathogenicity, were up-regulated at 6-8 days after inoculation. Among other plant defence-related genes differentially regulated in response to Lm infection were genes involved in the reinforcement of the cell wall and the production of glucosinolates. Dual RNA-sequencing allowed us to define the Lm candidate effectors expressed during the infection of B. napus. Several candidate effectors suppressed Bax-induced cell death when transiently expressed in Nicotiana benthamaina leaves. © 2015 Her Majesty The Queen in Right of Canada Molecular Plant Pathology © 2015 BSPP and John Wiley & Sons Ltd Reproduced with the permission of the Minister of Agriculture and Agri-Food Canada.

  4. Hand Rehabilitation Robotics on Poststroke Motor Recovery

    Directory of Open Access Journals (Sweden)

    Zan Yue

    2017-01-01

    Full Text Available The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers’ view or on the training paradigms on the clinicians’ view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots. An overview of hand rehabilitation robotics is provided in this paper firstly, to give a general view of the relationship between subjects, rehabilitation theories, hand rehabilitation robots, and its evaluation. Secondly, the state of the art hand rehabilitation robotics is introduced in detail according to the classification of the hardware system and the training paradigm. As a result, the discussion gives available arguments behind the classification and comprehensive overview of hand rehabilitation robotics.

  5. Hand Rehabilitation Robotics on Poststroke Motor Recovery.

    Science.gov (United States)

    Yue, Zan; Zhang, Xue; Wang, Jing

    2017-01-01

    The recovery of hand function is one of the most challenging topics in stroke rehabilitation. Although the robot-assisted therapy has got some good results in the latest decades, the development of hand rehabilitation robotics is left behind. Existing reviews of hand rehabilitation robotics focus either on the mechanical design on designers' view or on the training paradigms on the clinicians' view, while these two parts are interconnected and both important for designers and clinicians. In this review, we explore the current literature surrounding hand rehabilitation robots, to help designers make better choices among varied components and thus promoting the application of hand rehabilitation robots. An overview of hand rehabilitation robotics is provided in this paper firstly, to give a general view of the relationship between subjects, rehabilitation theories, hand rehabilitation robots, and its evaluation. Secondly, the state of the art hand rehabilitation robotics is introduced in detail according to the classification of the hardware system and the training paradigm. As a result, the discussion gives available arguments behind the classification and comprehensive overview of hand rehabilitation robotics.

  6. Developing concepts in the pulmonary rehabilitation of COPD

    NARCIS (Netherlands)

    Ambrosino, N.; Casaburi, R.; Ford, G.; Goldstein, R.; Morgan, M. D. L.; Rudolf, M.; Singh, S.; Wijkstra, P. J.

    Randomised trials have demonstrated that pulmonary rehabilitation (PR) can improve dyspnoea, exercise tolerance and health related quality of life. Rehabilitation has traditionally been provided in secondary care to patients with moderate to severe disease. Current concepts are however recommending

  7. Readiness for cancer rehabilitation in Denmark

    DEFF Research Database (Denmark)

    Kristiansen, Maria; Adamsen, Lis; Hendriksen, Carsten

    2013-01-01

    Rehabilitation is a key element in most cancer care policies in recognition of the often unmet physical, psychological and social needs among the rising numbers of patients with cancer. A systematic assessment of patients' needs and available rehabilitation services constitute the foundation...... for timely, comprehensive and coordinated cancer rehabilitation. This study aims to provide insight into the current organisation and practice of cancer rehabilitation in Denmark with special emphasis placed on the assessment of patients' needs and availability of services across the cancer treatment...

  8. Intentions and realities in rehabilitation service in Denmark

    DEFF Research Database (Denmark)

    Pallesen, Palle Bo; Lynge, Elsebeth

    2011-01-01

    We used Danish register data on rehabilitation benefits paid from 1994 to 2005. The purpose was to compare actual payments of rehabilitation benefits with intentions in the law. Legally, rehabilitation benefits should be used for providing living expenses during a planned rehabilitation period...... facilitating the recipients' return to the labor market. We found that one third of recipients were paid for less than 3 months, and half of remaining recipients had time gaps in their payments. The findings indicated that rehabilitation benefits were not paid only for planned rehabilitation periods...

  9. Transition of care provided for adolescents with special health care needs. American Academy of Pediatrics Committee on Children with Disabilities and Committee on Adolescence.

    Science.gov (United States)

    1996-12-01

    This policy statement describes how the pediatrician can work closely with patients with special health care needs and their families as an advocate and educator to help them adapt positively to an adult-focused system of health care. Issues in health care transitions including independence and dependence, education and vocational issues, insurance issues and limitations, Social Security, and hospitalization are outlined.

  10. Rehabilitation centers in change: participatory methods for managing redesign and renovation.

    Science.gov (United States)

    Lahtinen, Marjaana; Nenonen, Suvi; Rasila, Heidi; Lehtelä, Jouni; Ruohomäki, Virpi; Reijula, Kari

    2014-01-01

    The aim of this article is to describe a set of participatory methods that we have either developed or modified for developing future work and service environments to better suit renewable rehabilitation processes. We discuss the methods in a larger framework of change process model and participatory design. Rehabilitation organizations are currently in transition; customer groups, financing, services, and the processes of rehabilitation centers are changing. The pressure for change challenges the centers to develop both their processes and facilities. There is a need for methods that support change management. Four participatory methods were developed: future workshop, change survey, multi-method assessment tool, and participatory design generator cards. They were tested and evaluated in three rehabilitation centers at the different phases of their change process. The developed methods were considered useful in creating a mutual understanding of the change goals between different stakeholders, providing a good picture of the work community's attitudes toward the change, forming an integrated overview of the built and perceived environment, inspiring new solutions, and supporting the management in steering the change process. The change process model described in this article serves as a practical framework that combined the viewpoints of organizational and facility development. However, participatory design continues to face challenges concerning communication between different stakeholders, and further development of the methods and processes is still needed. Intervention studies could provide data on the success factors that enhance the transformations in the rehabilitation sector. Design process, methodology, organizational transformation, planning, renovation.

  11. Occupational therapists' evaluation of haptic motor rehabilitation.

    Science.gov (United States)

    Kayyali, Ruba; Alamri, Atif; Eid, Mohamad; Iglesias, Rosa; Shirmohammadi, Shervin; El Saddik, Abdulmotaleb; Lemaire, Edward

    2007-01-01

    Haptic-based virtual rehabilitation systems have recently become a subject of interest. In addition to the benefits provided by virtual rehabilitation, the haptic-based systems offer force and tactile feedback which can be for upper and lower extremity rehabilitation. In this paper, we present a system that uses haptics, in conjunction with virtual environments, to provide a rich media environment for motor rehabilitation of stroke patients. The system also provides Occupational Therapists (OTs) with a Graphical User Interface (GUI) that enables them to configure the hardware and virtual exercises and to monitor patients' performance. We also present an analysis of the system by a group of OTs from the Ottawa General Hospital, Rehabilitation Center. The OT's feedback, both the positives and negatives, and the results of the assessment test are also presented.

  12. 38 CFR 21.283 - Rehabilitated.

    Science.gov (United States)

    2010-07-01

    ... Induction into A Rehabilitation Program § 21.283 Rehabilitated. (a) General. For purposes of chapter 31 a...), (2)) (b) Definition. The term “suitably employed” includes employment in the competitive labor market... or she: (1) Is employed in the occupational objective for which a program of services was provided or...

  13. Biofeedback in rehabilitation.

    Science.gov (United States)

    Giggins, Oonagh M; Persson, Ulrik McCarthy; Caulfield, Brian

    2013-06-18

    This paper reviews the literature relating to the biofeedback used in physical rehabilitation. The biofeedback methods used in rehabilitation are based on biomechanical measurements and measurements of the physiological systems of the body. The physiological systems of the body which can be measured to provide biofeedback are the neuromuscular system, the respiratory system and the cardiovascular system. Neuromuscular biofeedback methods include electromyography (EMG) biofeedback and real-time ultrasound imaging (RTUS) biofeedback. EMG biofeedback is the most widely investigated method of biofeedback and appears to be effective in the treatment of many musculoskeletal conditions and in post cardiovascular accident (CVA) rehabilitation. RTUS biofeedback has been demonstrated effective in the treatment of low back pain (LBP) and pelvic floor muscle dysfunction. Cardiovascular biofeedback methods have been shown to be effective in the treatment of a number of health conditions such as hypertension, heart failure, asthma, fibromyalgia and even psychological disorders however a systematic review in this field has yet to be conducted. Similarly, the number of large scale studies examining the use of respiratory biofeedback in rehabilitation is limited. Measurements of movement, postural control and force output can be made using a number of different devices and used to deliver biomechanical biofeedback. Inertial based sensing biofeedback is the most widely researched biomechanical biofeedback method, with a number of studies showing it to be effective in improving measures of balance in a number of populations. Other types of biomechanical biofeedback include force plate systems, electrogoniometry, pressure biofeedback and camera based systems however the evidence for these is limited. Biofeedback is generally delivered using visual displays, acoustic or haptic signals, however more recently virtual reality (VR) or exergaming technology have been used as biofeedback

  14. Neuropsychological rehabilitation for traumatic brain injury patients

    Directory of Open Access Journals (Sweden)

    Marzena Chantsoulis

    2015-05-01

    Full Text Available The aim of this review is to discuss the basic forms of neuropsychological rehabilitation for patients with traumatic brain injury (TBI. More broadly, we discussed cognitive rehabilitation therapy (CRT which constitutes a fundamental component in therapeutic interaction at many centres worldwide. Equally presented is a comprehensive model of rehabilitation, the fundamental component of which is CRT. It should be noted that the principles of this approach first arose in Poland in the 1970s, in other words, several decades before their appearance in other programmemes. Taken into consideration are four factors conditioning the effectiveness of such a process: comprehensiveness, earlier interaction, universality and its individualized character. A comprehensive programmeme of rehabilitation covers: cognitive rehabilitation, individual and group rehabilitation with the application of a therapeutic environment, specialist vocational rehabilitation, as well as family psychotherapy. These training programmemes are conducted within the scope of the ‘Academy of Life,’ which provides support for the patients in their efforts and shows them the means by which they can overcome existing difficulties. Equally emphasized is the close cooperation of the whole team of specialists, as well as the active participation of the family as an essential condition for the effectiveness of rehabilitation and, in effect, a return of the patient to a relatively normal life. Also presented are newly developing neurothechnologies and the neuromarkers of brain injuries. This enables a correct diagnosis to be made and, as a result, the selection of appropriate methods for neuropsychological rehabilitation, including neurotherapy.

  15. Rehabilitation of a patient with stroke

    Directory of Open Access Journals (Sweden)

    Apurba Barman

    2013-01-01

    Full Text Available Stroke is a significant cause of long-term disability world-wide. The post-stroke disabilities are due to loss of locomotion, activity of daily living, cognition and communication skills. Rehabilitation is an integral part of medical management and continues longitudinally through acute care, post-acute care and community reintegration. The objectives of stroke rehabilitation are to maximize the functional independence, minimize the disabilities, reintegrate back into the home and community and improve the self-esteem of patient. A comprehensive stroke rehabilitation service should provide early assessment of impairments and disabilities, management and prevention of complications and well-organized rehabilitation program in both in-patient and out-patient settings. A multidisciplinary or interdisciplinary team approach is necessary to reduce the post-stroke disabilities. It has many members, including physicians, physical therapists, occupational therapists, speech and language pathologists, orthotist, psychotherapists, social workers, vocational rehabilitation therapists, rehabilitation nurse, patients, families and other caregivers. Physicians caring for patients with stroke during rehabilitation must be aware of potential medical complications, as well as a number of special problems that may complicate recovery, including cognitive deficits, aphasia, dysphagia, urinary incontinence, shoulder pain, spasticity, falls and depression. Involvement of patient and caregivers in the rehabilitation process is essential. This article outlines the salient features of the early comprehensive rehabilitation after stroke.

  16. Feeding behaviour in a ‘basal’ tortoise provides insights on the transitional feeding mode at the dawn of modern land turtle evolution

    OpenAIRE

    Natchev, Nikolay; Tzankov, Nikolay; Werneburg, Ingmar; Heiss, Egon

    2015-01-01

    Almost all extant land turtles are highly associated with terrestrial habitats and the few tortoises with high affinity to aquatic environment are found within the genus Manouria. Manouria belongs to a clade which forms the sister taxon to all remaining tortoises and is suitable to be used as a model for studying evolutionary transitions from water to land within modern turtles. We analysed the feeding behaviour of M. emys and due to its phylogenetic position, we hypothesise that the species ...

  17. Consumers' understanding and expectations of a community-based recovery-oriented mental health rehabilitation unit: a pragmatic grounded theory analysis.

    Science.gov (United States)

    Parker, Stephen; Dark, Frances; Newman, Ellie; Hanley, Dominic; McKinlay, William; Meurk, Carla

    2017-12-04

    Incorporating consumer perspectives into mental health services design is important in working to deliver recovery-oriented care. One of the challenges faced in mental health rehabilitation services is limited consumer engagement with the available support. Listening to consumers' expectations of mental health services, and what they hope to achieve, provides an opportunity to examine the alignment between existing services and the priorities and preferences of the people who use them. We explored consumer understandings and expectations of three recovery-oriented community-based residential mental-health rehabilitation units using semi-structured interviews; two of these units were trialling a staffing model integrating peer support with clinical care. Twenty-four consumers completed semi-structured interviews with an independent interviewer during the first 6 weeks of their stay at the rehabilitation unit. Most participants had a primary diagnosis of schizophrenia or a related psychotic disorder (87%). A pragmatic approach to grounded theory guided the analysis, facilitating identification of content and themes, and the development of an overarching conceptual map. The rehabilitation units were considered to provide a transformational space and a transitional place. The most common reason given for engagement was housing insecurity or homelessness rather than the opportunity for rehabilitation engagement. Differences in expectations did not emerge between consumers entering the clinical and integrated staffing model sites. Consumers understand the function of the rehabilitation service they are entering. However, receiving rehabilitation support may not be the key driver of their attendance. This finding has implications for promoting consumer engagement with rehabilitation services. The absence of differences between the integrated and clinical staffing models may reflect the novelty of the rehabilitation context. The study highlights the need for staff to find

  18. Medicare Program; hospital inpatient prospective payment systems for acute care hospitals and the long-term care hospital prospective payment system changes and FY2011 rates; provider agreements and supplier approvals; and hospital conditions of participation for rehabilitation and respiratory care services; Medicaid program: accreditation for providers of inpatient psychiatric services. Final rules and interim final rule with comment period.

    Science.gov (United States)

    2010-08-16

    : We are revising the Medicare hospital inpatient prospective payment systems (IPPS) for operating and capital-related costs of acute care hospitals to implement changes arising from our continuing experience with these systems and to implement certain provisions of the Affordable Care Act and other legislation. In addition, we describe the changes to the amounts and factors used to determine the rates for Medicare acute care hospital inpatient services for operating costs and capital-related costs. We also are setting forth the update to the rate-of-increase limits for certain hospitals excluded from the IPPS that are paid on a reasonable cost basis subject to these limits. We are updating the payment policy and the annual payment rates for the Medicare prospective payment system (PPS) for inpatient hospital services provided by long-term care hospitals (LTCHs) and setting forth the changes to the payment rates, factors, and other payment rate policies under the LTCH PPS. In addition, we are finalizing the provisions of the August 27, 2009 interim final rule that implemented statutory provisions relating to payments to LTCHs and LTCH satellite facilities and increases in beds in existing LTCHs and LTCH satellite facilities under the LTCH PPS. We are making changes affecting the: Medicare conditions of participation for hospitals relating to the types of practitioners who may provide rehabilitation services and respiratory care services; and determination of the effective date of provider agreements and supplier approvals under Medicare. We are also setting forth provisions that offer psychiatric hospitals and hospitals with inpatient psychiatric programs increased flexibility in obtaining accreditation to participate in the Medicaid program. Psychiatric hospitals and hospitals with inpatient psychiatric programs will have the choice of undergoing a State survey or of obtaining accreditation from a national accrediting organization whose hospital accreditation

  19. Rehabilitation Counselor Education and the New Code of Ethics

    Science.gov (United States)

    Glosoff, Harriet L.; Cottone, R. Rocco

    2010-01-01

    The purpose of this article is to discuss recent changes in the Commission on Rehabilitation Counselor Certification "Code of Professional Ethics for Rehabilitation Counselors", effective January 1, 2010, that are most relevant to rehabilitation counselor educators. The authors provide a brief overview of these key changes along with implications…

  20. 24 CFR 401.452 - Property standards for rehabilitation.

    Science.gov (United States)

    2010-04-01

    ... rehabilitation. 401.452 Section 401.452 Housing and Urban Development Regulations Relating to Housing and Urban... PROGRAM (MARK-TO-MARKET) Restructuring Plan § 401.452 Property standards for rehabilitation. The restructuring plan must provide for the level of rehabilitation needed to restore the property to the non-luxury...

  1. Understanding male cancer patients' barriers to participating in cancer rehabilitation

    DEFF Research Database (Denmark)

    Handberg, Charlotte; Lomborg, Kirsten; Nielsen, Claus Vinther

    2015-01-01

    : ‘Autonomy and purpose’, ‘Solidarity and fellowship’ and ‘Forget and move on’. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation...

  2. Basics of SCI Rehabilitation

    Science.gov (United States)

    ... menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David Chen, ... Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation Psychological Realities after Spinal Cord Injury Toby Huston, ...

  3. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David Chen, ... Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation Psychological Realities after Spinal Cord Injury Toby Huston, ...

  4. Armenia - Rural Road Rehabilitation

    Data.gov (United States)

    Millennium Challenge Corporation — The key research questions guiding our design of the RRRP evaluation are: • Did rehabilitating roads affect the quality of roads? • Did rehabilitating roads improve...

  5. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ... Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal ...

  6. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation ...

  7. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal ...

  8. Inpatient paediatric rehabilitation in chronic respiratory disorders.

    Science.gov (United States)

    Jung, Andreas; Heinrichs, Irmela; Geidel, Christian; Lauener, Roger

    2012-06-01

    Inpatient pulmonary rehabilitation programs have evolved from tuberculosis sanatoriums to modern medical centres providing standardized comprehensive care in a multidiciplinatory environment. Goals of rehabilitation programs for children and adolescents include restoration of professional activity, improvement of health condition, compliance and disease management as well as restoration of quality of life. Eligibility for an intervention is assessed by defined social and medical criteria. Comprehensive pulmonary rehabilitation programs provide a wide range of health care recourses, including diagnostic procedures, specific medical care, educational interventions and a multiprofessional team. Paediatric rehabilitation programs for chronic respiratory diseases, such as asthma or cystic fibrosis, have been shown to reduce symptoms, increase aerobic fitness and physical strength, improve pulmonary function and inflammation and enhance compliance, self-management, quality of life and psychological symptoms. Regional climatic effects have demonstrated an additional positive effect on the rehabilitation outcome. In addition, first evidence suggests an overall reduction of health care costs. Copyright © 2011 Elsevier Ltd. All rights reserved.

  9. Knowledge Translation in Rehabilitation: A Shared Vision.

    Science.gov (United States)

    Moore, Jennifer L; Shikako-Thomas, Keiko; Backus, Deborah

    2017-07-01

    Advances in rehabilitation provide the infrastructure for research and clinical data to improve care and patient outcomes. However, gaps between research and practice are prevalent. Knowledge translation (KT) aims to decrease the gap between research and its clinical use. This special communication summarizes KT-related proceedings from the 2016 IV STEP conference, describes current KT in rehabilitation science, and provides suggestions for its application in clinical care. We propose a vision for rehabilitation clinical practice and research that includes the development, adaptation, and implementation of evidence-based practice recommendations, which will contribute to a learning health care system. A clinical research culture that supports this vision and methods to engage key stakeholders to innovate rehabilitation science and practice are described. Through implementation of this vision, we can lead an evolution in rehabilitation practice to ultimately prevent disabilities, predict better outcomes, exploit plasticity, and promote participation.

  10. The house as a space of rehabilitation: the CARE project

    Directory of Open Access Journals (Sweden)

    Alberto Arenghi

    2015-04-01

    Full Text Available Rehabilitation aims to recover all the possible abilities of a patient in order to reinsert him in the everyday life with the highest degree of autonomy. If that intent can be reached completely for many patients, for those who remain with a disability, a longer and tiring process is necessary, with the objective to maximize the remaining capacity “expendable” in the daily life environments, in order to allow the widest "participation" of a disabled person. The home is definitely the main daily living environment and the rehabilitation process should consider it pivotal, so that the disabled person can re appropriate it, with the highest level of autonomy.The CARE project was conceived in this perspective. It derives from an interdisciplinary work where the medical knowledge, guided by the ICF, and the design knowledge, based on the principles of the Universal Design, were compared to give an effective response to the difficulties encountered by patients in transition from a protected hospital environment to a domestic environment. This step is crucial, so that the disabled person does not give up the painstakingly autonomy just recovered with significant economic and social costs, gendering re-hospitalization phenomena. The main objectives of CARE project are: provide to patient "real spaces" where they can exercise, through an occupational therapy the daily living activities, where the medical team can measure the development progress of the rehabilitation plan.

  11. Rehabilitation of cancer patients.

    Directory of Open Access Journals (Sweden)

    Pandey M

    2001-01-01

    Full Text Available With the developments in cancer treatment, more and more patients are surviving their disease. However, very little emphasis is being placed to rehabilitate these cancer survivors. Ignorance, social structure, stigma attached in seeking psychological help, and poor communication skills of oncology staff all contribute to poor rehabilitative efforts. The priority of governmental agencies and health efforts to fight rampant communicable diseases, malnutrition, maternal health, and the frequent natural calamities, puts rehabilitation movements in the back seat. Treatment and prevention of disability and its rehabilitation requires comprehensive and multidisciplinary approach. There is an urgent need to promote physical and psychological rehabilitation.

  12. Cancer rehabilitation in Denmark

    DEFF Research Database (Denmark)

    Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine

    2008-01-01

    A fundamental assumption behind cancer rehabilitation in many Western societies is that cancer survivors can return to normal life by learning to deal with the consequences of their illness and their treatment. This assumption is supported by increasing political attention to cancer rehabilitation...... and a growth in residential cancer-rehabilitation initiatives in Denmark (Danish Cancer Society 1999; Government of Denmark 2003). On the basis of their ethnographic fieldwork in residential-cancer rehabilitation courses, the authors examine the new rehabilitation discourse. They argue that this discourse has...

  13. [Rehabilitation standards for follow-up treatment and rehabilitation of patients with ventricular assist device (VAD)].

    Science.gov (United States)

    Willemsen, Detlev; Cordes, C; Bjarnason-Wehrens, B; Knoglinger, E; Langheim, E; Marx, R; Reiss, N; Schmidt, T; Workowski, A; Bartsch, P; Baumbach, C; Bongarth, C; Phillips, H; Radke, R; Riedel, M; Schmidt, S; Skobel, E; Toussaint, C; Glatz, J

    2016-03-01

    The increasing use of ventricular assist devices (VADs) in terminal heart failure patients provides new challenges to cardiac rehabilitation physicians. Structured cardiac rehabilitation strategies are still poorly implemented for this special patient group. Clear guidance and more evidence for optimal modalities are needed. Thereby, attention has to be paid to specific aspects, such as psychological and social support and education (e.g., device management, INR self-management, drive-line care, and medication).In Germany, the post-implant treatment and rehabilitation of VAD Patients working group was founded in 2012. This working group has developed clear recommendations for the rehabilitation of VAD patients according to the available literature. All facets of VAD patients' rehabilitation are covered. The present paper is unique in Europe and represents a milestone to overcome the heterogeneity of VAD patient rehabilitation.

  14. Rehabilitation on Geriatric Rheumatology

    Directory of Open Access Journals (Sweden)

    Cristiane Isabela de Almeida

    2008-03-01

    Full Text Available Elders are the most representative installment among the universe ofdefi ciency bearer persons. Advanced age contributes for the advent ofdefi ciencies in general. Rehabilitation of elderly patients is imperativefor quality of life of the patient and for the society. Rehabilitation isable to help basically in four fronts: prevention of wounds, minimize,revert and adaptation to sequels. The elder is always prone to receivebenefi ts from rehabilitation. However, he tends to react more slowlyto the rehabilitative interventions. The objective of Physical Medicineand Rehabilitation is to insert independence and quality in the lifewhose duration was prolonged by the advancements of science.The success of Rehabilitation depends on many variables, including:the nature and severity of the illness or wound, kind and severity ofremaining incapacities, global health of the patient and support of thefamily. In this article, the main characteristics of the rehabilitation inGeriatric Rheumatology are described.

  15. Lower-Limb Rehabilitation Robot Design

    Science.gov (United States)

    Bouhabba, E. M.; Shafie, A. A.; Khan, M. R.; Ariffin, K.

    2013-12-01

    It is a general assumption that robotics will play an important role in therapy activities within rehabilitation treatment. In the last decade, the interest in the field has grown exponentially mainly due to the initial success of the early systems and the growing demand caused by increasing numbers of stroke patients and their associate rehabilitation costs. As a result, robot therapy systems have been developed worldwide for training of both the upper and lower extremities. This paper investigates and proposes a lower-limb rehabilitation robot that is used to help patients with lower-limb paralysis to improve and resume physical functions. The proposed rehabilitation robot features three rotary joints forced by electric motors providing linear motions. The paper covers mechanism design and optimization, kinematics analysis, trajectory planning, wearable sensors, and the control system design. The design and control system demonstrate that the proposed rehabilitation robot is safe and reliable with the effective design and better kinematic performance.

  16. National Institutes of Health Research Plan on Rehabilitation: NIH Medical Rehabilitation Coordinating Committee.

    Science.gov (United States)

    O'Mara, Ann; Rowland, Julia H; Greenwell, Thomas N; Wiggs, Cheri L; Fleg, Jerome; Joseph, Lyndon; McGowan, Joan; Panagis, James S; Washabaugh, Charles; Peng, Grace C Y; Bray, Rosalina; Cernich, Alison N; Cruz, Theresa H; Marden, Sue; Michel, Mary Ellen; Nitkin, Ralph; Quatrano, Louis; Spong, Catherine Y; Shekim, Lana; Jones, Teresa L Z; Juliano-Bult, Denise; Panchinson, David M; Chen, Daofen; Jakeman, Lyn; Knebel, Ann; Tully, Lois A; Chan, Leighton; Damiano, Diane; Tian, Biao; McInnes, Pamela; Khalsa, Partap; Reider, Eve; Shurtleff, David; Elwood, William; Ballard, Rachel; Ershow, Abby G; Begg, Lisa

    2017-04-01

    One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation.This article is being published almost simultaneously in the following six journals: American Journal of Occupational Therapy, American Journal of Physical Medicine and Rehabilitation, Archives of Physical Medicine and Rehabilitation, Neurorehabilitation and Neural Repair, Physical Therapy, and Rehabilitation Psychology. Citation information is as follows: NIH Medical Rehabilitation Coordinating Committee. Am J Phys Med Rehabil. 2017;97(4):404-407. Copyright © Wolters Kluwer Health, Inc. 2017.

  17. Web-based collaboration in individual care planning challenges the user and the provider roles – toward a power transition in caring relationships

    Directory of Open Access Journals (Sweden)

    Bjerkan J

    2014-12-01

    Full Text Available Jorunn Bjerkan,1,2 Solfrid Vatne,3 Anne Hollingen4 1Norwegian Research Centre for Electronic Health Records (EHR, Medical Faculty, Norwegian University of Science and Technology, Trondheim, 2Faculty of Health Science, Nord-Trøndelag University College, Levanger, 3Faculty of Health Science, Molde University College, 4Møre og Romsdal Hospital Trust, Molde, Norway Background and objective: The Individual Care Plan (ICP was introduced in Norway to meet new statutory requirements for user participation in health care planning, incorporating multidisciplinary and cross-sector collaboration. A web-based solution (electronic ICP [e-ICP] was used to support the planning and documentation. The aim of this study was to investigate how web-based collaboration challenged user and professional roles. Methods: Data were obtained from 15 semistructured interviews with users and eight with care professionals, and from two focus-group interviews with eight care professionals in total. The data were analyzed using systematic text condensation in a stepwise analysis model. Results: Users and care professionals took either a proactive or a reluctant role in e-ICP collaboration. Where both user and care professionals were proactive, the pairing helped to ensure that the planning worked well; so did pairings of proactive care professionals and reluctant users. Proactive users paired with reluctant care professionals also made care planning work, thanks to the availability of information and the users' own capacity or willingness to conduct the planning. Where both parties were reluctant, no planning activities occurred. Conclusion: Use of the e-ICP challenged the user–professional relationship. In some cases, a power transition took place in the care process, which led to patient empowerment. This knowledge might be used to develop a new understanding of how role function can be challenged when users and care professionals have equal access to health care

  18. User-centered virtual environment design for virtual rehabilitation.

    Science.gov (United States)

    Fidopiastis, Cali M; Rizzo, Albert A; Rolland, Jannick P

    2010-02-19

    As physical and cognitive rehabilitation protocols utilizing virtual environments transition from single applications to comprehensive rehabilitation programs there is a need for a new design cycle methodology. Current human-computer interaction designs focus on usability without benchmarking technology within a user-in-the-loop design cycle. The field of virtual rehabilitation is unique in that determining the efficacy of this genre of computer-aided therapies requires prior knowledge of technology issues that may confound patient outcome measures. Benchmarking the technology (e.g., displays or data gloves) using healthy controls may provide a means of characterizing the "normal" performance range of the virtual rehabilitation system. This standard not only allows therapists to select appropriate technology for use with their patient populations, it also allows them to account for technology limitations when assessing treatment efficacy. An overview of the proposed user-centered design cycle is given. Comparisons of two optical see-through head-worn displays provide an example of benchmarking techniques. Benchmarks were obtained using a novel vision test capable of measuring a user's stereoacuity while wearing different types of head-worn displays. Results from healthy participants who performed both virtual and real-world versions of the stereoacuity test are discussed with respect to virtual rehabilitation design. The user-centered design cycle argues for benchmarking to precede virtual environment construction, especially for therapeutic applications. Results from real-world testing illustrate the general limitations in stereoacuity attained when viewing content using a head-worn display. Further, the stereoacuity vision benchmark test highlights differences in user performance when utilizing a similar style of head-worn display. These results support the need for including benchmarks as a means of better understanding user outcomes, especially for patient

  19. Concrete structures protection, repair and rehabilitation

    CERN Document Server

    Woodson, R Dodge

    2009-01-01

    The success of a repair or rehabilitation project depends on the specific plans designed for it. Concrete Structures: Protection, Repair and Rehabilitation provides guidance on evaluating the condition of the concrete in a structure, relating the condition of the concrete to the underlying cause or causes of that condition, selecting an appropriate repair material and method for any deficiency found, and using the selected materials and methods to repair or rehabilitate the structure. Guidance is also provided for engineers focused on maintaining concrete and preparing concrete investigation r

  20. 34 CFR 385.1 - What is the Rehabilitation Training program?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false What is the Rehabilitation Training program? 385.1... § 385.1 What is the Rehabilitation Training program? (a) The Rehabilitation Training program is designed... assistance is provided through six categories of training programs: (1) Rehabilitation Long-Term Training (34...

  1. EFFECT OF REHABILITATION DURING INTERIM STAY IN AALBORG MUNICIPALITY, DENMARK: A STUDY PROTOCOL

    DEFF Research Database (Denmark)

    Villumsen, Sidsel Maria Monrad; Villumsen, Morten

    2016-01-01

    are available in the systems, containing information on rehabilitation services rendered during interim stays. However, available data on the effect of the rehabilitation are currently unstructured in free-text, which impedes the assessment of rehabilitation effect and thereby the quality assurance. Objectives...... will provide information on the association between the rehabilitation provided during the interim stays, based on structured data from the records, and the rehabilitation effect based on the unstructured free-text from the rehabilitation records. Clinical implications: This study will provide novel...... with the rehabilitation services offered by Aalborg Municipality, Denmark [2]. However, user satisfaction solely may not re ect the actual rehabilitation effect. The effect of rehabilitation needs to be addressed in order to ensure high quality in the rehabilitation services offered. Currently, highly structured data...

  2. Homeless Center: Transitional Housing for Homeless Families

    OpenAIRE

    McMillan, Alexis Sakile

    2017-01-01

    Homelessness in DC has been on the rise for a while but now it is getting to the point where it is becoming a major issue. The Mayor has proposed a plan to end homelessness with seven shelters, one in each ward of DC. The shelter this thesis is proposing would be a combination of a typical homeless center with the added benefits of an overall rehabilitation center. These features combined will provide a place where the homes can transition from their current state to a state where they can th...

  3. Feeding behaviour in a 'basal' tortoise provides insights on the transitional feeding mode at the dawn of modern land turtle evolution.

    Science.gov (United States)

    Natchev, Nikolay; Tzankov, Nikolay; Werneburg, Ingmar; Heiss, Egon

    2015-01-01

    Almost all extant testudinids are highly associated with terrestrial habitats and the few tortoises with high affinity to aquatic environments are found within the genus Manouria. Manouria belongs to a clade which forms a sister taxon to all remaining tortoises and is suitable as a model for studying evolutionary transitions within modern turtles. We analysed the feeding behaviour of Manouria emys and due to its phylogenetic position, we hypothesise that the species might have retained some ancestral features associated with an aquatic lifestyle. We tested whether M. emys is able to feed both in aquatic and terrestrial environments. In fact, M. emys repetitively tried to reach submerged food items in water, but always failed to grasp them-no suction feeding mechanism was applied. When feeding on land, M. emys showed another peculiar behaviour; it grasped food items by its jaws-a behaviour typical for aquatic or semiaquatic turtles-and not by the tongue as generally accepted as the typical feeding mode in all tortoises studied so far. In M. emys, the hyolingual complex remained retracted during all food uptake sequences, but the food transport was entirely lingual based. The kinematical profiles significantly differed from those described for other tortoises and from those proposed from the general models on the function of the feeding systems in lower tetrapods. We conclude that the feeding behaviour of M. emys might reflect a remnant of the primordial condition expected in the aquatic ancestor of the tortoises.

  4. Feeding behaviour in a ‘basal’ tortoise provides insights on the transitional feeding mode at the dawn of modern land turtle evolution

    Directory of Open Access Journals (Sweden)

    Nikolay Natchev

    2015-08-01

    Full Text Available Almost all extant testudinids are highly associated with terrestrial habitats and the few tortoises with high affinity to aquatic environments are found within the genus Manouria. Manouria belongs to a clade which forms a sister taxon to all remaining tortoises and is suitable as a model for studying evolutionary transitions within modern turtles. We analysed the feeding behaviour of Manouria emys and due to its phylogenetic position, we hypothesise that the species might have retained some ancestral features associated with an aquatic lifestyle. We tested whether M. emys is able to feed both in aquatic and terrestrial environments. In fact, M. emys repetitively tried to reach submerged food items in water, but always failed to grasp them—no suction feeding mechanism was applied. When feeding on land, M. emys showed another peculiar behaviour; it grasped food items by its jaws—a behaviour typical for aquatic or semiaquatic turtles—and not by the tongue as generally accepted as the typical feeding mode in all tortoises studied so far. In M. emys, the hyolingual complex remained retracted during all food uptake sequences, but the food transport was entirely lingual based. The kinematical profiles significantly differed from those described for other tortoises and from those proposed from the general models on the function of the feeding systems in lower tetrapods. We conclude that the feeding behaviour of M. emys might reflect a remnant of the primordial condition expected in the aquatic ancestor of the tortoises.

  5. A haptic device for wrist and elbow rehabilitation

    Directory of Open Access Journals (Sweden)

    Jun Jiang

    2015-01-01

    Full Text Available Interest in the devices for rehabilitation applications has been increasing. And the devices before have proved that they might assist in and quantify the rehabilitation for upper limb disability caused by stroke. This paper is to introduce rehabilitation application of a haptic device based on virtual reality technology, which is compact, portable, and modular. The focus here is a device with force feedback designed to provide five degrees of freedom, which are rotation, opposition, translation, pitch, and yaw. With five degrees of freedom above, the device can help individuals with arm weakness do their exercise and make patients achieve favorable rehabilitation efficacy during their upper limb rehabilitation.

  6. Disability and rehabilitation in the dizzy patient.

    Science.gov (United States)

    Cohen, Helen S

    2006-02-01

    This review focuses on prospective studies of vertigo and balance therapy in the past 3 years, including advances in vertigo-habituation exercises for adults, pediatric intervention, and virtual reality techniques, and, in more depth, the literature pertinent to driving motor vehicles. Increased support has been generated for the efficacy of a minimal, home-based vertigo-habituation program for adults with peripheral vestibular disorders. Vestibular rehabilitation has been shown to be associated with improvements in independence and dynamic visual acuity. Community-based vestibular rehabilitation has been shown to be efficacious for selected patients, after careful screening, when trained personnel provide intervention. Vestibular rehabilitation has been incorporated into the rehabilitation program for head-injured military personnel who will be returned to duty, and multifactorial balance rehabilitation has been shown to be useful for children with hearing and balance impairments. Virtual reality techniques have made significant advances, so immersive environments have potential for rehabilitation for patients with vestibular disorders and for developing training regimens for astronauts to ameliorate some effects of exposure to microgravity. Driving skill, in general, is affected by use of benzodiazepines. For many patients with vestibular impairments driving is a particularly problematic activity of daily living. Progress has been made in studies of acute care, community-based, and pediatric vestibular rehabilitation. Work on simulator-based paradigms has moved toward readiness for implementation. Studies of driving have provided some insight into the problems of these patients. More work remains to be done on all of these problems.

  7. The ritualization of rehabilitation

    DEFF Research Database (Denmark)

    Tjørnhøj-Thomsen, Tine; Hansen, Helle Ploug

    2013-01-01

    There is widespread and increasing political interest in devising plans to support people who have or have had cancer to recover and recommence 'normal' lives. Educating cancer patients for this purpose is a central element in cancer rehabilitation in both Europe and the United States. One...... of the challenges in intervention research pertaining to rehabilitation is how to measure and explain the effects of a particular rehabilitation program. The social processes of particular programs are often a 'closed box' and not taken into consideration methodologically or analytically. In this article, we unpack...... and explicate the 'closed box' of a particular cancer rehabilitation program in Denmark by drawing on approaches from the study of ritual. By analyzing rehabilitation as a ritual and as ritualization, we identify and conceptualize some of the transformative activities involved in cancer rehabilitation. We...

  8. Aerobic exercise in pulmonary rehabilitation

    Directory of Open Access Journals (Sweden)

    Thiago Brasileiro de Vasconcelos

    2013-01-01

    Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.

  9. AEROBIC EXERCISE IN PULMONARY REHABILITATION

    Directory of Open Access Journals (Sweden)

    Thiago Brasileiro de Vasconcelos

    2013-05-01

    Full Text Available The aim of this study was to conduct a literature review on the usefulness of aerobic exercise in pulmonary rehabilitation. This is an exploratory study of literature through the electronic databases Medline, Lilacs, Scielo, Pubmed and Google Scholar, published between 1996 and 2012, conducted during the period February to May 2012 with the following keywords: COPD, pulmonary rehabilitation, aerobic exercises, physical training, quality of life. The change in pulmonary function and dysfunction of skeletal muscles that result in exercise intolerance and reduced fitness and may cause social isolation, depression, anxiety and addiction. The training exercise is the most important component of the program of pulmonary rehabilitation where the aerobic training provides consistent results in clinical improvement in levels of exercise tolerance and decreased dyspnea generating more benefits to the body, reducing the chance of cardiovascular disease and improves quality and expectation of life. We demonstrated that the use of aerobic exercise in pulmonary rehabilitation program, allows an improvement of motor skills, decreased muscle fatigue and deconditioning, reducing sedentary lifestyle; however, has little or no effect on the reduction of strength and atrophy muscle.

  10. Pediatric dental rehabilitation procedures in the OR.

    Science.gov (United States)

    Haskins, D R

    1996-10-01

    Children with significant baby bottle tooth decay and children who are challenged by significant physical and emotional limitations are candidates for dental rehabilitaion procedures with general anesthesia. Rehabilitation of children's primary teeth is important to prevent pain, infection, and tooth loss. To provide skilled care for children undergoing dental rehabilitation procedures, perioperative nurses must understand normal dentition, tooth anatomy, and caries prevention and formation and be able to meet children's developmental and emotional needs. Perioperative nurses also must collaborate with dentists to maintain appropriate supply inventories that are unique to dental rehabilitation procedures.

  11. Georgia - Energy Rehabilitation

    Data.gov (United States)

    Millennium Challenge Corporation — Gustavson Associates was retained by Millennium Challenge Georgia (MCG) to prepare a model to calculate the economic rate of return (ERR) for rehabilitation work...

  12. Robotics in shoulder rehabilitation

    Science.gov (United States)

    Sicuri, Chiara; Porcellini, Giuseppe; Merolla, Giovanni

    2014-01-01

    Summary In the last few decades, several researches have been conducted in the field of robotic rehabilitation to meet the intensive, repetitive and task-oriented training, with the goal to recover the motor function. Up to now, robotic rehabilitation studies of the upper extremity have generally focused on stroke survivors leaving less explored the field of orthopaedic shoulder rehabilitation. In this review we analyse the present status of robotic technologies, in order to understand which are the current indications and which may be the future perspective for their application in both neurological and orthopaedic shoulder rehabilitation. PMID:25332937

  13. [Neurorehabilitation, neurology, rehabilitation medicine].

    Science.gov (United States)

    Urbán, Edina; Szél, István; Fáy, Veronika; Dénes, Zoltán; Lippai, Zoltán; Fazekas, Gábor

    2013-05-30

    We have read several publications of great authority on the neurological profession in the last two years in which were expressed assessments of the current situation combined with opinions about neurology and the necessity to reorganize neurological patient care. These articles took up the question of neurorehabilitation too. The authors, who on a daily basis, deal with the rehabilitation of people with disabilities as a consequence of neurological conditions, summarize some important definitions of rehabilitation medicine and the present system of neurological rehabilitation, as it is defined by the rehabilitation profession.

  14. 75 FR 36237 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

    Science.gov (United States)

    2010-06-24

    ... conduct research, knowledge translation, training, dissemination, and technical assistance within a... authorized under the Rehabilitation Act of 1973, as amended, through advanced research, training, technical... provide rehabilitation services to individuals with disabilities; Provide technical assistance to...

  15. An advanced rehabilitation robotic system for augmenting healthcare.

    Science.gov (United States)

    Hu, John; Lim, Yi-Je; Ding, Ye; Paluska, Daniel; Solochek, Aaron; Laffery, David; Bonato, Paolo; Marchessault, Ronald

    2011-01-01

    Emerging technologies such as rehabilitation robots (RehaBot) for retraining upper and lower limb functions have shown to carry tremendous potential to improve rehabilitation outcomes. Hstar Technologies is developing a revolutionary rehabilitation robot system enhancing healthcare quality for patients with neurological and muscular injuries or functional impairments. The design of RehaBot is a safe and robust system that can be run at a rehabilitation hospital under the direct monitoring and interactive supervision control and at a remote site via telepresence operation control. RehaBot has a wearable robotic structure design like exoskeleton, which employs a unique robotic actuation--Series Elastic Actuator. These electric actuators provide robotic structural compliance, safety, flexibility, and required strength for upper extremity dexterous manipulation rehabilitation training. RehaBot also features a novel non-treadmill paddle platform capable of haptics feedback locomotion rehabilitation training. In this paper, we concern mainly about the motor incomplete patient and rehabilitation applications.

  16. Facilities of Early Rehabilitation post Stroke in Poland 2010

    DEFF Research Database (Denmark)

    Opara, Jozef; Langhorne, Peter; Larsen, Torben

    2012-01-01

    Rationale -The aim of this work was to survey the contemporary facilities for early poststroke rehabilitation in Poland. The main research questions were: what is the availability of inpatient rehabilitation for post-stroke patients in neurological departments and in rehabilitation departments......? Aims - Growing costs of health care are encouraging healthcare planners to look for new organizational solutions of services which could enable rehabilitation as early as possible after disease onset. Early post-stroke rehabilitation consists of many elements that provide for early onset rehabilitation...... and its continuation after discharge from stroke unit. Participants - Two questionnaires evaluating neurorehabilitation of people who underwent stroke was designed and distributed: first to 221 neurological wards and second to 154 rehabilitation departments in Poland. Design - We asked about delay before...

  17. Determination of Pavement Rehabilitation Activities through a Permutation Algorithm

    Directory of Open Access Journals (Sweden)

    Sangyum Lee

    2013-01-01

    Full Text Available This paper presents a mathematical programming model for optimal pavement rehabilitation planning. The model maximized the rehabilitation area through a newly developed permutation algorithm, based on the procedures outlined in the harmony search (HS algorithm. Additionally, the proposed algorithm was based on an optimal solution method for the problem of multilocation rehabilitation activities on pavement structure, using empirical deterioration and rehabilitation effectiveness models, according to a limited maintenance budget. Thus, nonlinear pavement performance and rehabilitation activity decision models were used to maximize the objective functions of the rehabilitation area within a limited budget, through the permutation algorithm. Our results showed that the heuristic permutation algorithm provided a good optimum in terms of maximizing the rehabilitation area, compared with a method of the worst-first maintenance currently used in Seoul.

  18. Research progress of new technologies in stroke rehabilitation

    Directory of Open Access Journals (Sweden)

    Lin MENG

    2017-03-01

    Full Text Available Survivors of stroke commonly experience a different range of dysfunction, and recovery can be slow and incomplete, which lead to a serious and long-term impact on patients themselves and their families. Although the treatment of stroke patients relies mainly on rehabilitation intervention, but the rehabilitation needs of discharged patients are not fully met due to lots of restrictions, such as the lack of professional rehabilitation services, the difficulty and inconvenience in transportation from home to hospital, therefore their prognosis of rehabilitation are affected. At present a number of new rehabilitation technologies, including telerehabilitation (TR, virtual reality (VR, robotics, electronic textiles (E-textiles, etc., are coming into being and may solve these problems. This article tries to discuss the research progress of these new rehabilitation technologies, and provide a new perspective for the rehabilitation intervention of stroke patients. DOI: 10.3969/j.issn.1672-6731.2017.03.003

  19. Sports participation after rehabilitation: Barriers and facilitators.

    Science.gov (United States)

    Jaarsma, Eva A; Dekker, Rienk; Geertzen, Jan H B; Dijkstra, Pieter U

    2016-01-01

    To analyse barriers to, and facilitators of, sports participation among people with physical disabilities after rehabilitation and to compare differences between inactive and active participants regarding these experienced barriers and facilitators. Participants were 1,223 adults (mean age 51.6 years, standard deviation 15.1 years) treated in the Rehabilitation Centre of the University Medical Center Groningen, who completed a questionnaire. The questionnaire consisted of a self-constructed questionnaire regarding barriers and facilitators. Fifty-eight percent of the participants were active in sports after their rehabilitation. Younger age and a higher level of education were positively associated with sports participation, whereas using assistive devices and experiencing environmental barriers were negatively associated. Facilitators of sports participation were health, fun and increasing physical strength, and advice from rehabilitation professionals. Rehabilitation professionals should emphasize the health benefits of, and enjoyment from, sports participation for people with physical disabilities. They should repeatedly remind people with physical disabilities to stay/become active after completing their rehabilitation programme. Rehabilitation professionals should also provide information about strategies to reduce environmental barriers to sports participation, which could help people using assistive devices to overcome these barriers.

  20. Harbour seals (Phoca vitulina and rehabilitation

    Directory of Open Access Journals (Sweden)

    Nynke Osinga

    2010-09-01

    Full Text Available Throughout the past few decades, rehabilitation of seals has become an activity that is anchored in the present day society of many countries. Seals are primarily rehabilitated to help individual animals in distress. At the same time, the release of seals which would have otherwise died can be considered as a contribution to the population. Most rehabilitated seals are animals under one year of age. They are mainly orphans, weaned seals with complications and seals with a parasiticbronchopneumonia. For the optimal handling of seals and their diseases, centralised operations with quality standards are essential. Rehabilitation provides an instrument to monitor the health of the seal population and its ecosystem. Changes in stranding trends or the appearance of new diseases can be monitored. Moreover, rehabilitation is important to show the general public thestate of the marine environment. In the Netherlands there is significant social support for the rehabilitation of seals. Experience obtained with seal care is of importance in countries where urgent help of threatened seal species is required. Here individual seals are also ambassadors to raise support for the protection of this species in general. Given that the anthropogenic impact on the seals and their environment is extensive in the Wadden Sea, rehabilitation centres can compensate the consequences of this impact on individual seals as well as the population as a whole.

  1. Patientdeltagelse under rehabilitering efter en rygmarvsskade

    DEFF Research Database (Denmark)

    Angel, Sanne

    2010-01-01

    insight into patient participation. The ability and need for participation changed through the six-phased process of regaining meaning after a spinal cord injury; no will to participate, developing/generating strength to participate, need for participation and will to participate in decision......This paper investigates the patient's ability and need for participation during rehabilitation. The application of Ricoeur's phenomenological-hermeneutic interpretation theory with a narrative approach revealed that the rehabilitation process of 12 persons was successful in providing specific...

  2. A conceptual model for vision rehabilitation

    Science.gov (United States)

    Roberts, Pamela S.; Rizzo, John-Ross; Hreha, Kimberly; Wertheimer, Jeffrey; Kaldenberg, Jennifer; Hironaka, Dawn; Riggs, Richard; Colenbrander, August

    2017-01-01

    Vision impairments are highly prevalent after acquired brain injury (ABI). Conceptual models that focus on constructing intellectual frameworks greatly facilitate comprehension and implementation of practice guidelines in an interprofessional setting. The purpose of this article is to provide a review of the vision literature in ABI, describe a conceptual model for vision rehabilitation, explain its potential clinical inferences, and discuss its translation into rehabilitation across multiple practice settings and disciplines. PMID:27997671

  3. Ethical Perspectives on Knowledge Translation in Rehabilitation

    OpenAIRE

    Banja, John D.; Eisen, Arri

    2012-01-01

    Although the literature on the ethical dimensions of knowledge creation, use, and dissemination is voluminous, it has not particularly examined the ethical dimensions of knowledge translation in rehabilitation. Yet, whether research is done in a wet lab or treatments are provided to patients in therapeutic settings, rehabilitation professionals commonly use (as well as create) knowledge and disseminate it to peers, patients, and various others. This article will refer to knowledge creation, u...

  4. A transactional framework for pediatric rehabilitation: shifting the focus to situated contexts, transactional processes, and adaptive developmental outcomes.

    Science.gov (United States)

    King, Gillian; Imms, Christine; Stewart, Debra; Freeman, Matt; Nguyen, Tram

    2017-04-11

    A paradigm shift is taking place in pediatric rehabilitation research, practice, and policy - a shift towards the real-life contexts of clients rather than requiring clients to navigate the world of pediatric rehabilitation. This article proposes a conceptual framework to bring about a broader awareness of clients' lives and transactional processes of change over the life course. The framework draws attention to transactional processes by which individuals, situated in life contexts, change and adapt over the life course and, in turn, influence their contextual settings and broader environments. This framework is based on (a) basic tenets derived from foundational theories taking a life course perspective to change, and (b) transactional processes identified from relevant pediatric rehabilitation models that bring these foundational theories into the pediatric rehabilitation sphere. The framework identifies three types of transactional processes relevant to pediatric rehabilitation: facilitative, resiliency, and socialization processes. These processes describe how contexts and people mutually influence each other via opportunities and situated experiences, thus facilitating capacity, adaptation to adversity, and socialization to new roles and life transitions. The utility of the framework is considered for research, practice, service organizations, and policy. Implications for Rehabilitation The framework supports practitioners going beyond person and environment as separate entities, to provide services to the "situated person" in real-life contexts The framework shifts the focus from "body structures/functions" and "person in activity" to "person in changing and challenging life contexts" Working from a transactional perspective, practitioner-client conversations will change; practitioners will view client situations through a lens of opportunities and experiences, assess client experiences in real-life contexts, and strive to create context-based therapy

  5. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David Chen, ... Meade, PhD Jonathon Rose, PhD The Basics of Spinal Cord Injury Rehabilitation Kristine Cichowski, MS Occupational Therapy after Spinal Cord ...

  6. Humanoid assessing rehabilitative exercises.

    Science.gov (United States)

    Simonov, M; Delconte, G

    2015-01-01

    This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation". The article presents the approach in which the rehabilitative exercise prepared by healthcare professional is encoded as formal knowledge and used by humanoid robot to assist patients without involving other care actors. The main objective is the use of humanoids in rehabilitative care. An example is pulmonary rehabilitation in COPD patients. Another goal is the automated judgment functionality to determine how the rehabilitation exercise matches the pre-programmed correct sequence. We use the Aldebaran Robotics' NAO humanoid to set up artificial cognitive application. Pre-programmed NAO induces elderly patient to undertake humanoid-driven rehabilitation exercise, but needs to evaluate the human actions against the correct template. Patient is observed using NAO's eyes. We use the Microsoft Kinect SDK to extract motion path from the humanoid's recorded video. We compare human- and humanoid-operated process sequences by using the Dynamic Time Warping (DTW) and test the prototype. This artificial cognitive software showcases the use of DTW algorithm to enable humanoids to judge in near real-time about the correctness of rehabilitative exercises performed by patients following the robot's indications. One could enable better sustainable rehabilitative care services in remote residential settings by combining intelligent applications piloting humanoids with the DTW pattern matching algorithm applied at run time to compare humanoid- and human-operated process sequences. In turn, it will lower the need of human care.

  7. Is Rehabilitation Dead?

    Science.gov (United States)

    Halleck, Seymour L.; Witte, Ann D.

    1977-01-01

    This paper examines rising crime rates, findings on the relative effectiveness of deterrence and rehabilitation, and the rise of a civil rights movement in correction, all of which have led to greater emphasis on deterrence and incapacitation and less emphasis on rehabilitation in correctional philosophy and practice. (Author)

  8. [Rehabilitation and work participation].

    Science.gov (United States)

    Bethge, Matthias

    2017-04-01

    Work participation is increasingly seen as a primary outcome of rehabilitation measures. Randomised controlled trials from several different countries and the reviews and meta-analyses based on them show that multidisciplinary rehabilitation programmes improve work participation, return-to-work rates, and reduce sickness absence in patients with back pain, depression, and cancer. In Germany, such programmes were implemented as work-related medical rehabilitation. This intervention targets patients with poor work ability and an increased risk of permanent work disability. Randomised controlled trials have confirmed a reduction of sickness absence and increased rates of sustainable work participation in favour of work-related medical rehabilitation as compared to common medical rehabilitation. Dissemination of these programmes and translation of research evidence into practice progresses. An additional important strategy to support returning to work following rehabilitation is graded return to work. There is emerging evidence of sustainable employment effects in favour of graded return to work. A direct involvement of the workplace and a closer cooperation with employers and occupational health physicians may further improve the outcomes of rehabilitation programmes. Strategies that synergistically integrate safety, health promotion and rehabilitation may achieve more favourable outcomes than separated actions.

  9. Rehabilitering ved spiseforstyrrelser

    DEFF Research Database (Denmark)

    Lau, Marianne Engelbrecht; Waaddegaard, Mette

    2010-01-01

    Psykiatrisk & psykosocial rehabilitering - en recoveryorienteret tilgang beskriver rehabilitering til mennesker med sindslidelser. Udgangspunktet er en indsats med fokus på den enkeltes egne mål og ressourcer. Bogen bidrager bl.a. med metoder og teoretiske forudsætninger for en national psykiatri...

  10. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

    Meillier, Lucette Kirsten; Nielsen, Kirsten Melgaard; Larsen, Finn Breinholt

    2012-01-01

    Aim: The comprehensive cardiac rehabilitation (CR) programme after myocardial infarction (MI) improves quality of life and results in reduced cardiac mortality and recurrence of MI. Hospitals worldwide face problems with low participation rates in rehabilitation programmes. Inequality...... cardiac rehabilitation programme. Methods: From 1 September 2002 to 31 December 2005, 388 first-incidence MI patients ≤75 years were hospitalised. Register check for newly hospitalised MI patients, screening interview, and systematic referral were conducted by a project nurse. Patients were referred...... to a standard rehabilitation programme (SRP). If patients were identified as socially vulnerable, they were offered an extended version of the rehabilitation programme (ERP). Excluded patients were offered home visits by a cardiac nurse. Concordance principles were used in the individualised programme elements...

  11. Ambivalence in rehabilitation

    DEFF Research Database (Denmark)

    Christensen, Jan; Langberg, Henning; Doherty, Patrick

    2017-01-01

    BACKGROUND: Knowledge about the organization and factors of importance to rehabilitation of veterans with lower limb amputation is sparse. The aim of this study was, therefore, to improve understanding of the influences of "military identity" on the organization of rehabilitation services and to ...... observation. Data were generated using in-depth semi-structured interviews (n = 6) exploring in-hospital and post-hospital rehabilitation in Danish veterans after unilateral lower limb amputation due to trauma. We conducted four sessions of participant observation, during weekly post......-hospitalization rehabilitation and included field notes in the dataset. RESULTS: Two main themes emerged: "experiencing different identities" and "experiencing discontinuity in rehabilitation." The first theme illustrated how veterans actively shift between the identities of disabled person, wounded veteran and athlete...

  12. Rehabilitation and multiple sclerosis

    DEFF Research Database (Denmark)

    Dalgas, Ulrik

    2011-01-01

    In a chronic and disabling disease like multiple sclerosis, rehabilitation becomes of major importance in the preservation of physical, psychological and social functioning. Approximately 80% of patients have multiple sclerosis for more than 35 years and most will develop disability at some point...... of their lives, emphasising the importance of rehabilitation in order to maintain quality of life. An important aspect of multiple sclerosis rehabilitation is the preservation of physical functioning. Hot topics in the rehabilitation of physical function include (1) exercise therapy, (2) robot-assisted training...... and (3) pharmacological interventions. Exercise therapy has for many years been a controversial issue in multiple sclerosis rehabilitation and the advice generally given to patients was not to participate in physical exercise, since it was thought to lead to a worsening of symptoms or fatigue. However...

  13. Motor rehabilitation using virtual reality

    Directory of Open Access Journals (Sweden)

    Sveistrup Heidi

    2004-12-01

    Full Text Available Abstract Virtual Reality (VR provides a unique medium suited to the achievement of several requirements for effective rehabilitation intervention. Specifically, therapy can be provided within a functional, purposeful and motivating context. Many VR applications present opportunities for individuals to participate in experiences, which are engaging and rewarding. In addition to the value of the rehabilitation experience for the user, both therapists and users benefit from the ability to readily grade and document the therapeutic intervention using various systems. In VR, advanced technologies are used to produce simulated, interactive and multi-dimensional environments. Visual interfaces including desktop monitors and head-mounted displays (HMDs, haptic interfaces, and real-time motion tracking devices are used to create environments allowing users to interact with images and virtual objects in real-time through multiple sensory modalities. Opportunities for object manipulation and body movement through virtual space provide frameworks that, in varying degrees, are perceived as comparable to similar opportunities in the real world. This paper reviews current work on motor rehabilitation using virtual environments and virtual reality and where possible, compares outcomes with those achieved in real-world applications.

  14. Motor rehabilitation using virtual reality.

    Science.gov (United States)

    Sveistrup, Heidi

    2004-12-10

    Virtual Reality (VR) provides a unique medium suited to the achievement of several requirements for effective rehabilitation intervention. Specifically, therapy can be provided within a functional, purposeful and motivating context. Many VR applications present opportunities for individuals to participate in experiences, which are engaging and rewarding. In addition to the value of the rehabilitation experience for the user, both therapists and users benefit from the ability to readily grade and document the therapeutic intervention using various systems. In VR, advanced technologies are used to produce simulated, interactive and multi-dimensional environments. Visual interfaces including desktop monitors and head-mounted displays (HMDs), haptic interfaces, and real-time motion tracking devices are used to create environments allowing users to interact with images and virtual objects in real-time through multiple sensory modalities. Opportunities for object manipulation and body movement through virtual space provide frameworks that, in varying degrees, are perceived as comparable to similar opportunities in the real world. This paper reviews current work on motor rehabilitation using virtual environments and virtual reality and where possible, compares outcomes with those achieved in real-world applications.

  15. Specialized stroke rehabilitation services in seven countries: Preliminary results from nine rehabilitation centers.

    Science.gov (United States)

    Langhammer, Birgitta; Becker, Frank; Sunnerhagen, Katharina S; Zhang, Tong; Du, Xiaoxia; Bushnik, Tamara; Panchenko, Maria; Keren, Ofer; Banura, Samir; Elessi, Khamis; Luzon, Fuad; Lundgren-Nilsson, Åsa; Li, Xie; Sällström, Susanne; Stanghelle, Johan Kvalvik

    2015-12-01

    There is a lack of defined levels of rehabilitation, indicating possibly random content and access to specialized services. The aim of the study was to perform a multinational descriptive study of specialized rehabilitation in persons with stroke, to elucidate what the different centers define as prerequisites for specialized rehabilitation, and to analyze whether these descriptions map to currently applied standards or constructs of specialized rehabilitation. A secondary aim was to look for similarities and differences between therapies and services for persons with stroke in the sub-acute stage in the different institutions. Descriptive data of the collaborating centers regarding structure and processes of services were recorded and compared with the British Society of Rehabilitation Medicine and Specialized Services National Definitions sets. Comparisons of the definitions showed that all centers admitted severely disabled persons with stroke, in need of complex rehabilitation, and provided high levels of physical services, with specialized equipment and facilities. However, funding, size, university affiliation, quality accreditation, staffing levels, specialist training, cognitive and vocational services, coordination of the professional teams, admission procedures, time and type of therapies, estimated length of stay, and follow-up procedures differed between the centers. This multinational study of specialized stroke rehabilitation centers shows that a universal definition of specialized rehabilitation is possible, even in quite different countries and settings, in terms of general principles. There were however differences in structures and procedures, which may influence patients' outcomes, indicating a need for refinement of the definitions to be globally applicable. © 2015 World Stroke Organization.

  16. Estimating the Costs and Benefits of Providing Free Public Transit Passes to Students in Los Angeles County: Lessons Learned in Applying a Health Lens to Decision-Making

    Directory of Open Access Journals (Sweden)

    Lauren N. Gase

    2014-10-01

    Full Text Available In spite of increased focus by public health to engage and work with non-health sector partners to improve the health of the general as well as special populations, only a paucity of studies have described and disseminated emerging lessons and promising practices that can be used to undertake this work. This article describes the process used to conduct a Health Impact Assessment of a proposal to provide free public transportation passes to students in Los Angeles County. This illustrative case example describes opportunities and challenges encountered in working with an array of cross-sector partners and highlights four important lessons learned: (1 the benefits and challenges associated with broad conceptualization of public issues; (2 the need for more comprehensive, longitudinal data systems and dynamic simulation models to inform decision-making; (3 the importance of having a comprehensive policy assessment strategy that considers health impacts as well as costs and feasibility; and (4 the need for additional efforts to delineate the interconnectivity between health and other agency priorities. As public health advances cross-sector work in the community, further development of these priorities will help advance meaningful collaboration among all partners.

  17. Cooperatives as a social enterprise in Italy: a place for social integration and rehabilitation.

    Science.gov (United States)

    Savio, M; Righetti, A

    1993-10-01

    This article analyses the history and development of an integrated cooperative established in 1981 in northern Italy. Integrated cooperatives, otherwise known as social enterprises, are among the most interesting activities developed in the area of social assistance and rehabilitation in recent years in Italy. In particular, they acquired relevance in the care of mentally disordered people by providing them with job opportunities, which is an important rehabilitative and integrative factor. The aim of social enterprises is two-fold. They have the economic goal of offering remunerative work just as any other commercial enterprise, as well as the social mandate of promoting the physical, social, and mental health of their members. A positive coexistence between market competition and rehabilitation is therefore constantly pursued. This research aimed at analysing the working and social experience of people employed by the cooperative during its 10-year life. The study was limited to those who had a social or health problem when entering the cooperative. The investigation was promoted by cooperative members, who felt the need to document their experience and to undertake initiatives towards evaluating the rehabilitative value of the social enterprise. The results show that cooperative members come from different marginalized areas of social and health distress, of which the two largest are social service users and psychiatric service users. There is a noticeable turn-over rate, which underlines one function of the cooperative as being a transitional working context from which users can gain access to other more rewarding job opportunities in the labour market.

  18. Rehabilitation following carpal tunnel release.

    Science.gov (United States)

    Peters, Susan; Page, Matthew J; Coppieters, Michel W; Ross, Mark; Johnston, Venerina

    2016-02-17

    . There is limited and, in general, low quality evidence for the benefit of the reviewed interventions. People who have undergone CTS surgery should be informed about the limited evidence of effectiveness of postoperative rehabilitation interventions. Until researchers provide results of more high-quality trials that assess the effectiveness and safety of various rehabilitation treatments, the decision to provide rehabilitation following CTS surgery should be based on the clinician's expertise, the patient's preferences and the context of the rehabilitation environment. It is important for researchers to identify patients who respond to a particular treatment and those who do not, and to undertake high-quality studies that evaluate the severity of iatrogenic symptoms from surgery, measure function and return-to-work rates, and control for confounding variables.

  19. Rural transit emergency planning guidance.

    Science.gov (United States)

    2008-07-01

    Providing safe, reliable transportation has long been a priority at all levels of the transit industry including the Federal Transit Administration (FTA), California Department of Transportation (Caltrans) and individual transit providers. Over the l...

  20. Therapeutic music and nursing in poststroke rehabilitation.

    Science.gov (United States)

    Knight, Andrew J; Wiese, Nikki

    2011-01-01

    Individuals who experience stroke undergo a critical rehabilitation process with the aid of professionals including physical, occupational, and speech therapists, as well as primary care from nursing staff. However, the extent of the role that music can play in facilitating the rehabilitation process is unknown. Board-certified music therapists are employed in several capacities within the rehabilitation environment. There is a need for nursing professionals in this area to better understand the role a music therapist may play and how they can assist clients in using music in a therapeutically beneficial way. The purpose of this article is to educate nurses about music therapy and provide evidence for the therapeutic use of music in the rehabilitation setting for victims of stroke.

  1. Ethical perspectives on knowledge translation in rehabilitation.

    Science.gov (United States)

    Banja, John D; Eisen, Arri

    2013-01-01

    Although the literature on the ethical dimensions of knowledge creation, use, and dissemination is voluminous, it has not particularly examined the ethical dimensions of knowledge translation in rehabilitation. Yet, whether research is done in a wet lab or treatments are provided to patients in therapeutic settings, rehabilitation professionals commonly use (as well as create) knowledge and disseminate it to peers, patients, and various others. This article will refer to knowledge creation, use, and transfer as knowledge translation and examine some of its numerous ethical challenges. Three ethical dimensions of knowledge translation will particularly attract our attention: (1) the quality of knowledge disseminated to rehabilitationists; (2) ethical challenges in being too easily persuaded by or unreasonably resistant to putative knowledge; and (3) organizational barriers to knowledge translation. We will conclude with some recommendations on facilitating the ethical soundness of knowledge translation in rehabilitation. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. 42 CFR 485.717 - Condition of participation: Rehabilitation program.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Rehabilitation program... PROVIDERS Conditions of Participation for Clinics, Rehabilitation Agencies, and Public Health Agencies as Providers of Outpatient Physical Therapy and Speech-Language Pathology Services § 485.717 Condition of...

  3. H. R. 99: an act to provide for the conservation, rehabilitation, and improvement of natural and cultural resources located on public or Indian lands, and for other purposes. Introduced in the Senate of the United States, Ninety-Ninth Congress, First Session, July 15, 1985

    Energy Technology Data Exchange (ETDEWEB)

    1985-01-01

    The American Conservation Corps Act of 1985 is a response to the finding that providing young men and women with the education and employment associated with conserving and rehabilitating public and Indian lands will help the country. The bill also provides assistance to state and local projects on non-federal public land. The bill defines various terms and outlines how to establish and administer the programs. Examples of projects the legislation covers include wildlife habitat, rangeland, recreational areas, urban areas, fisheries, roads and trails, and land reclamation. Programs with long-term public benefits, that instill the enrollee with a work ethic and sense of public service, that are labor intensive, and have a short lead time will receive preference. The agency will also develop volunteer services if they do not displace paid enrollees. Pay scales will be 95% of base pay of the armed forces.

  4. [Social rehabilitation through sports].

    Science.gov (United States)

    Strohkendl, H

    1995-11-01

    The contribution community disabled sports is making towards comprehensive rehabilitation of people with disabilities is interpreted much too narrowly by the statutory definition of rehabilitation sports. In the member clubs of Deutscher Behinderten-Sportverband, the German disabled sports association, severely disabled individuals rediscover their potential and self-worth, which may entail self-determination, solidarity with others, and genuine social integration. Renewed awareness of the traditional values of German disabled sports as a self-help movement of those concerned, and characterization of rehabilitation as a complex learning process towards regaining personal autonomy--both call for a thorough reconsideration of ambulatory disabled sports in organizational and funding respects.

  5. Benchmarking rehabilitation practice in the intensive care unit.

    Science.gov (United States)

    Knott, Anna; Stevenson, Matt; Harlow, Stephanie Km

    2015-02-01

    Early rehabilitation in critically ill patients has been demonstrated to be safe and is associated with many positive outcomes. Despite this, there are inconsistencies in the early active rehabilitation that patients receive on intensive care units. The aims of this study were to quantify the amount of active rehabilitation provided for patients in a District General Hospital intensive care unit and to identify specific barriers encountered. Data were collected over a six-week period during March and April 2013. All patients admitted to the intensive care unit at St Peter's Hospital for more than 48 h were included. For every treatment session, the treating physiotherapist recorded what type of treatment took place. Treatments were classified as either non-active or active rehabilitation. Non-active rehabilitation included chest physiotherapy, passive range of movement exercises and hoisting to a chair. Active rehabilitation was defined as any treatment including active/active-assisted exercises, sitting on the edge of the bed, sitting to standing, standing transfers, marching on the spot or ambulation. Classification of rehabilitation was based upon internationally agreed intensive care unit activity codes and definitions. All barriers to active rehabilitation were also recorded. The study included 35 patients with a total of 194 physiotherapy treatment sessions. Active rehabilitation was included in 51% of all treatment sessions. The median time to commencing active rehabilitation from intensive care unit admission was 3 days (range 3-42 [IQR 3-7]). The most frequent barriers to active rehabilitation were sedation and endotracheal tubes, which together accounted for 50% of the total barriers. The study provides useful benchmarking of current rehabilitation activity in a District General Hospital intensive care unit and highlights the most common barriers encountered to active rehabilitation. Longer duration studies incorporating larger sample sizes are

  6. A comparison of stroke rehabilitation; data from two national cohorts.

    Science.gov (United States)

    Bērziņa, G; Vētra, A; Sunnerhagen, K S

    2016-10-01

    Inpatient rehabilitation is a commonly used complex intervention to improve a person's independence after stroke. Evaluation and comparison of the effects of routine clinical practice could provide a contribution towards optimization of stroke care. The aim of this study is to describe results of inpatient rehabilitation as a complex intervention for persons after stroke and explore possible differences between two countries. Data from 1055 Latvian and 1748 Swedish adult patients after stroke receiving inpatient rehabilitation, during 2011-2013, were used for this retrospective cohort study. Qualitative description of systems, as well as information on basic medical and sociodemographic information, and organizational aspects were reported. Change in the Functional Independence Measure during rehabilitation was investigated. In six domains of the instrument, the shifts for three levels of dependence were analysed using ordinal regression analysis. The components of stroke care seem to be similar in Latvia and Sweden. However, the median time since stroke onset until the start of rehabilitation was 13 weeks in Latvia and 2 weeks in Sweden. The median length of rehabilitation was 12 and 49 days, respectively. The level of dependency at start, time since stroke onset and length of the period had an impact on the results of the rehabilitation. Although components of the rehabilitation are reported as being the same, characteristics and the outcome of the inpatient rehabilitation are different. Therefore, comparison of stroke rehabilitation between countries requires caution. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Self-efficacy, imagery use, and adherence during injury rehabilitation.

    Science.gov (United States)

    Wesch, N; Hall, C; Prapavessis, H; Maddison, R; Bassett, S; Foley, L; Brooks, S; Forwell, L

    2012-10-01

    Previous observational studies examining imagery, self-efficacy, and adherence during injury rehabilitation have been cross-sectional and thus have not provided a clear representation of what occurs over the course of the rehabilitation period. The objectives of this research were (1) to examine the temporal patterns of imagery, self-efficacy, and rehabilitation adherence during an 8-week rehabilitation program and (2) to identify the time-order relationships between imagery, self-efficacy, and adherence. The design of the study was prospective and observational. 90 injured people (n=57 males; n=33 females) aged 18-78 years attending an injury rehabilitation clinic participated. The main outcome measures were imagery (cognitive, motivational, and healing), self-efficacy (task and coping), and rehabilitation adherence (duration, quality, and frequency). Results indicated that task efficacy, imagery use, and adherence levels remained stable, while coping efficacy declined over time. During the course of rehabilitation, moderate to strong reciprocal relationships existed between self-efficacy and adherence to rehabilitation. Weak to moderate relationships were found between imagery use and rehabilitation adherence. The results of this study can be used to inform the development of interventions steeped in self-efficacy and imagery aimed at improving rehabilitation adherence and treatment outcome. © 2011 John Wiley & Sons A/S.

  8. Understanding male cancer patients' barriers to participating in cancer rehabilitation.

    Science.gov (United States)

    Handberg, C; Lomborg, K; Nielsen, C V; Oliffe, J L; Midtgaard, J

    2015-11-01

    The aim was to describe male cancer survivors' barriers towards participation in cancer rehabilitation as a means to guiding future targeted men's cancer rehabilitation. Symbolic Interactionism along with the interpretive descriptive methodology guided the study of 35 male cancer survivors representing seven cancer types. Data were generated through a 5-month fieldwork study comprising participant observations, semi-structured individual interviews and informal conversations. The analyses revealed two overarching findings shedding light on male cancer survivors' barriers to rehabilitation: 'Fear of losing control' and 'Striving for normality'. While 'Fear of losing control' signified what the men believed rehabilitation would invoke: 'Reduced manliness', 'Sympathy and dependency' and 'Confrontation with death', 'Striving for normality' was based on what the men believed rehabilitation would hinder: 'Autonomy and purpose', 'Solidarity and fellowship' and 'Forget and move on'. This study of male cancer survivors' and cancer rehabilitation documents how masculine ideals may constitute barriers for participation in rehabilitation and provides insights about why men are underrepresented in rehabilitation. The findings can guide practice to develop research-based rehabilitation approaches focused on preserving control and normality. Further empirical evidence is needed to: (1) explore the conduct of health professionals' towards male cancer patients and (2) address gender inequalities in cancer rehabilitation. © 2015 John Wiley & Sons Ltd.

  9. Inpatient Rehabilitation Facility - Conditions

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of inpatient rehabilitation facilities with data on the number of times people with Medicare who had certain medical conditions were treated in the last year.

  10. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD Understanding SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, ...

  11. Patients' views of rehabilitation.

    Science.gov (United States)

    Sheppard, B

    Patients and nurses may not appreciate the differences between acute care settings and rehabilitation units. The relative informality and 'hands-off' approach of nurses in the latter can lead to confusion and misunderstanding for people whose exclusive experience of nursing is in the acute sector. At the behest of concerned nurses on a rehabilitation unit, the author conducted interviews with discharged patients to try to establish what their perceptions of the unit were, and how these influenced their progress. The results suggested that the patients' misconceptions may have been hindering their rehabilitation potential. The nurses subsequently devised an action plan to improve understanding of the unit's aims and practices. Follow-up interviews after the plan's implementation showed that it had been successful in improving patients' understanding and engagement with the rehabilitation process.

  12. Rehabilitation Robot RRH1

    National Research Council Canada - National Science Library

    Kaczmarski, Marcin; Granosik, Grzegorz

    2011-01-01

    The paper presents a prototype of a rehabilitation robot for lower extremities. It is created on the basis of cylindrical kinematic model, equipped with two rigid arms, special handles and fixtures...

  13. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Founding Director, Life Center, Rehabilitation Institute of Chicago play_arrow What's the most important thing for families to know right away? play_arrow What are the main concerns of the ...

  14. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences by Topic Resources Peer Counseling Blog About Media Donate close search Understanding Spinal Cord Injury What ...

  15. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 David ...

  16. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... SCI Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, ... OT Anne Bryden, OT The Role of the Social Worker after Spinal Cord Injury Patti Rogers, SW ...

  17. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD ... Rehabilitation Donald Peck Leslie, MD Adjusting to Social Life in a Wheelchair Lisa Rosen, MS Spasticity, Physical ...

  18. Physical medicine and rehabilitation

    Science.gov (United States)

    ... disability Muscular dystrophy or other neuromuscular disorders Sensory deprivation disorder, autism or developmental disorders Speech disorders and ... or more parts of the body. Rehabilitation experts use many tests to evaluate a person's problems and ...

  19. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Resources Peer Counseling Blog About Media Donate Spinal Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries Spinal Cord Injury 101 ...

  20. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Medical Expert Videos Topics menu Topics The Basics of Spinal Cord Injury Rehabilitation Adult Injuries ... Therapy-Lokomat T. George Hornby, PhD, PT Empowering the Patient After Spinal Cord Injury Guy W. Fried, ...

  1. [Characteristics of art therapists in rehabilitative therapy].

    Science.gov (United States)

    Oster, Jörg

    2017-09-01

    Characteristics of art therapists in rehabilitative therapy Objectives: This study examines the sociodemographic, qualification- and activity-related characteristics of art therapists working in the field of rehabilitation. In 2013, an analysis of occupational groups was carried out in Germany, with the objective of describing the art therapists working there.A total of 2,303 complete datasets were submitted. From this group, those therapists mainly working in the field of rehabilitation/follow-up care/participation of disabled persons (according to Social Security Code VI and IX, n = 302) were selected and described. Most art therapists are female (average age 45 years) and largelywork part-time. Music and art therapy are the most common venues.More than 80% have a graduate degree. Methods of quality management are used.More than half of the therapists working in rehabilitation hospitals are employed in the field of psychosomatic medicine. Both individual and group therapy (each patient attending 1-2 times a week) are common. The results provide an overview of art therapy in the field of rehabilitation and show the spread in rehabilitation. Further research is indicated.

  2. Prediction of everyday verbal communicative ability of aphasic stroke patients after inpatient rehabilitation

    NARCIS (Netherlands)

    Blom-Smink, Marieke R M A; van de Sandt-Koenderman, Mieke W M E; Kruitwagen, Cas L J J; El Hachioui, Hanane; Visch-Brink, Evy G.; Ribbers, Gerard M.

    2017-01-01

    Background: Early accurate prediction of verbal communicative ability at discharge from inpatient rehabilitation is essential for rehabilitation professionals to provide reliable prognostic information to the aphasic patient and family, and to make appropriate treatment decisions. Aims: To develop a

  3. 75 FR 32164 - Office of Special Education and Rehabilitative Services; Overview Information; Regional...

    Science.gov (United States)

    2010-06-07

    ... Office of Special Education and Rehabilitative Services; Overview Information; Regional Interpreter... organizations, community resources, service providers (especially vocational rehabilitation (VR) agencies), VR... and linguistic backgrounds in diverse environments (i.e., urban, rural, low socioeconomic, territories...

  4. Task-oriented rehabilitation robotics.

    Science.gov (United States)

    Schweighofer, Nicolas; Choi, Younggeun; Winstein, Carolee; Gordon, James

    2012-11-01

    Task-oriented training is emerging as the dominant and most effective approach to motor rehabilitation of upper extremity function after stroke. Here, the authors propose that the task-oriented training framework provides an evidence-based blueprint for the design of task-oriented robots for the rehabilitation of upper extremity function in the form of three design principles: skill acquisition of functional tasks, active participation training, and individualized adaptive training. The previous robotic systems that incorporate elements of task-oriented trainings are then reviewed. Finally, the authors critically analyze their own attempt to design and test the feasibility of a TOR robot, ADAPT (Adaptive and Automatic Presentation of Tasks), which incorporates the three design principles. Because of its task-oriented training-based design, ADAPT departs from most other current rehabilitation robotic systems: it presents realistic functional tasks in which the task goal is constantly adapted, so that the individual actively performs doable but challenging tasks without physical assistance. To maximize efficacy for a large clinical population, the authors propose that future task-oriented robots need to incorporate yet-to-be developed adaptive task presentation algorithms that emphasize acquisition of fine motor coordination skills while minimizing compensatory movements.

  5. Physical rehabilitation at Parkinson's

    OpenAIRE

    Мітько [Elena Mitko], Олена Володимирівна; Авраменко [Ol’ga Avramenko], Ольга Миколаївна; Дугіна [Liana Dugina], Ліана В'ячеславівна

    2013-01-01

    Questions touching a physical rehabilitation at Parkinson's disease are considered in the article. Modern data over are brought about etiopathogenesis, clinical flow of disease. Purpose of work – on the basis of analysis of modern scientific-methodical literature to describe the method of physical rehabilitation of patients sufferings illness of Parkinsona. Methods are researches, applied in-process: the analysis of literary sources and practical experience is accumulated by us at a robot wit...

  6. Rehabilitation following meniscal repair

    OpenAIRE

    Cavanaugh, John T.; Killian, Sarah E.

    2012-01-01

    It has become increasingly more evident that the meniscus plays an important role in contributing to knee joint longevity. Advances in surgical techniques by orthopaedic surgeons to repair traumatized menisci have led to better long term outcomes, decreasing the incidence of articular cartilage degeneration. Advances have also been made in rehabilitative techniques following meniscal repair. These techniques along with sound rehabilitation principles to include a criteria based progression ha...

  7. Alexithymia in respiratory rehabilitation.

    Science.gov (United States)

    Mazzarella, Federica; Alesii, Annalisa; Dall'armi, Valentina; Rubino, Salvatore; Ferri, Luigi

    2010-01-01

    To date, there are no studies that have investigated the role of alexithymia in respiratory rehabilitation. We aimed to observe the prevalence of alexithymia in patients attending respiratory rehabilitation and to verify the presence of a difference between alexithymics and non-alexithymics responsiveness to the respiratory rehabilitation standard protocol. A prospective cohort study evaluating the influence of alexithymia on functional recovery of in-patients afferent to the Respiratory Rehabilitation Unit of IRCCS San Raffaele Pisana. Sixty patients were consecutively enrolled into the study and evaluated for alexithymia, anxiety and depression. Functional recovery was assessed with the six-minute walking test (6MWT). Prior and post-completion of this test dyspnoea, oxygen saturation and cardiac frequency were recorded. Alexithymia was not found to be significantly affecting the functional recovery of participants in respiratory rehabilitation. The distance walked at the 6MWT (6MWD) increased in both alexithymics and non-alexithymics (p(alexithymics) = 0.014; p(non-alexithymics) respiratory rehabilitation.

  8. Myoelectrically controlled wrist robot for stroke rehabilitation.

    Science.gov (United States)

    Song, Rong; Tong, Kai-yu; Hu, Xiaoling; Zhou, Wei

    2013-06-10

    Robot-assisted rehabilitation is an advanced new technology in stroke rehabilitation to provide intensive training. Post-stroke motor recovery depends on active rehabilitation by voluntary participation of patient's paretic motor system as early as possible in order to promote reorganization of brain. However, voluntary residual motor efforts to the affected limb have not been involved enough in most robot-assisted rehabilitation for patients after stroke. The objective of this study is to evaluate the feasibility of robot-assisted rehabilitation using myoelectric control on upper limb motor recovery. In the present study, an exoskeleton-type rehabilitation robotic system was designed to provide voluntarily controlled assisted torque to the affected wrist. Voluntary intention was involved by using the residual surface electromyography (EMG) from flexor carpi radialis(FCR) and extensor carpi radialis (ECR)on the affected limb to control the mechanical assistance provided by the robotic system during wrist flexion and extension in a 20-session training. The system also applied constant resistant torque to the affected wrist during the training. Sixteen subjects after stroke had been recruited for evaluating the tracking performance and therapeutical effects of myoelectrically controlled robotic system. With the myoelectrically-controlled assistive torque, stroke survivors could reach a larger range of motion with a significant decrease in the EMG signal from the agonist muscles. The stroke survivors could be trained in the unreached range with their voluntary residual EMG on the paretic side. After 20-session rehabilitation training, there was a non-significant increase in the range of motion and a significant decrease in the root mean square error (RMSE) between the actual wrist angle and target angle. Significant improvements also could be found in muscle strength and clinical scales. These results indicate that robot-aided therapy with voluntary participation of

  9. Clients becoming teachers: Speech-language pathology students' understanding of rehabilitation following clinical practicum in a rehabilitation setting.

    Science.gov (United States)

    Attrill, Stacie; Gunn, Simon

    2010-04-01

    There has been limited research investigating the conceptual development of rehabilitation in speech-language pathology (SLP) students. The aim of this study was to describe SLP students' understanding of rehabilitation following completion of a clinical practicum in a rehabilitation setting. This study was conducted using a qualitative approach according to grounded theory methodology. Semi-structured interviews were conducted with 10 SLP students who had completed a practicum in a rehabilitation setting. Interview data analysis revealed the emergence of five axial categories. Clients becoming teachers was identified as the core category, as the notion that clients were fundamental to students' understanding of rehabilitation occurred reliably throughout the data and related to all other categories. A theoretical model was proposed that demonstrated successive levels of support to students in the acquisition of their understanding of rehabilitation on practicum. Students' understanding of rehabilitation was derived from client-related interactions and factors experienced on practicum in rehabilitation settings. Rehabilitation practicum provided students with a rich and complex learning environment that may facilitate the development of the "core skills" identified for rehabilitation practice.

  10. Rehabilitative ultrasound imaging.

    Science.gov (United States)

    Teyhen, Deydre; Koppenhaver, Shane

    2011-01-01

    Neuromuscular deficits have been linked with chronic musculoskeletal conditions. The use of ultrasound imaging(USI) to aid rehabilitation of neuromusculoskeletal disorders has been called rehabilitative ultrasound imaging (RUSI)and defined as ‘a procedure used by physical therapists to evaluate muscle and related soft tissue morphology and function during exercise and physical tasks. RUSI is used to assist in the application of therapeutic interventions,providing feedback to the patient and physical therapist (Teyhen 2006). Brightness mode (b-mode) USI is the most common form used by physical therapists and will be the focus of this summary. USI can distinguish between healthy adults and those with low back pain (LBP). Those with LBP have decreased muscle thickness, side-to-side asymmetry,and decreased ability to thicken the muscles during a contraction (Teyhen et al 2009). Moreover, when measured by USI, lumbar multifidus muscle asymmetry appears to be predictive of future episode of LBP up to three years later(Hides et al 2001). Finally, USI can distinguish between changes in muscle thickness during common LBP exercises when performed by healthy adults (Teyhen et al 2008) and is preliminarily supported as a biofeedback tool to enhance exercise effectiveness (Henry and Teyhan 2007). CRITERION-RELATED VALIDITY: In a recent systematic review Koppenhaver et al (2009a) concluded that b-mode USI when applied in a rehabilitative setting is a valid tool to measure trunk muscle size and muscle activation during most submaximal contracted states. When comparing muscle thickness obtained by magnetic resonance imaging and USI, researchers have demonstrated substantial agreement(ICC 0.84 to –0.95) with only minimal differences between the modalities (0.03 to 0.21 cm2) (Hides et al 1995, 2006). Although comparisons between electromyography and change in muscle thickness obtained by USI have most often demonstrated a curvilinear relationship (Hodges et al 2003), the ability

  11. Conceptualizing Transitions to Adulthood

    Science.gov (United States)

    Wyn, Johanna

    2014-01-01

    This chapter provides an overview of theories of the transition to young adulthood. It sets out the argument for conceptual renewal and discusses some implications of new patterns of transition for adult education.

  12. Stroke rehabilitation reaches a threshold.

    Directory of Open Access Journals (Sweden)

    Cheol E Han

    2008-08-01

    Full Text Available Motor training with the upper limb affected by stroke partially reverses the loss of cortical representation after lesion and has been proposed to increase spontaneous arm use. Moreover, repeated attempts to use the affected hand in daily activities create a form of practice that can potentially lead to further improvement in motor performance. We thus hypothesized that if motor retraining after stroke increases spontaneous arm use sufficiently, then the patient will enter a virtuous circle in which spontaneous arm use and motor performance reinforce each other. In contrast, if the dose of therapy is not sufficient to bring spontaneous use above threshold, then performance will not increase and the patient will further develop compensatory strategies with the less affected hand. To refine this hypothesis, we developed a computational model of bilateral hand use in arm reaching to study the interactions between adaptive decision making and motor relearning after motor cortex lesion. The model contains a left and a right motor cortex, each controlling the opposite arm, and a single action choice module. The action choice module learns, via reinforcement learning, the value of using each arm for reaching in specific directions. Each motor cortex uses a neural population code to specify the initial direction along which the contralateral hand moves towards a target. The motor cortex learns to minimize directional errors and to maximize neuronal activity for each movement. The derived learning rule accounts for the reversal of the loss of cortical representation after rehabilitation and the increase of this loss after stroke with insufficient rehabilitation. Further, our model exhibits nonlinear and bistable behavior: if natural recovery, motor training, or both, brings performance above a certain threshold, then training can be stopped, as the repeated spontaneous arm use provides a form of motor learning that further bootstraps performance and

  13. Measure Guideline: Window Repair, Rehabilitation, and Replacement

    Energy Technology Data Exchange (ETDEWEB)

    Baker, P.

    2012-12-01

    This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

  14. Medical rehabilitation after natural disasters: why, when, and how?

    Science.gov (United States)

    Rathore, Farooq A; Gosney, James E; Reinhardt, Jan D; Haig, Andrew J; Li, Jianan; DeLisa, Joel A

    2012-10-01

    Natural disasters can cause significant numbers of severe, disabling injuries, resulting in a public health emergency and requiring foreign assistance. However, since medical rehabilitation services are often poorly developed in disaster-affected regions and not highly prioritized by responding teams, physical and rehabilitation medicine (PRM) has historically been underemphasized in global disaster planning and response. Recent development of the specialties of "disaster medicine" and "disaster rehabilitation" has raised awareness of the critical importance of rehabilitation intervention during the immediate postdisaster emergency response. The World Health Organization Liaison Sub-Committee on Rehabilitation Disaster Relief of the International Society of Physical and Rehabilitation Medicine has authored this report to assess the role of emergency rehabilitation intervention after natural disasters based on current scientific evidence and subject matter expert accounts. Major disabling injury types are identified, and spinal cord injury, limb amputation, and traumatic brain injury are used as case studies to exemplify the challenges to effective management of disabling injuries after disasters. Evidence on the effectiveness of disaster rehabilitation interventions is presented. The authors then summarize the current state of disaster-related research, as well as lessons learned from PRM emergency rehabilitation response in recent disasters. Resulting recommendations for greater integration of PRM services into the immediate emergency disaster response are provided. This report aims to stimulate development of research and practice in the emerging discipline of disaster rehabilitation within organizations that provide medical rehabilitation services during the postdisaster emergency response. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. Inpatient stroke rehabilitation in Ontario: are dedicated units better?

    Science.gov (United States)

    Foley, Norine; Meyer, Matthew; Salter, Katherine; Bayley, Mark; Hall, Ruth; Liu, Ying; Willems, Deborah; McClure, J Andrew; Teasell, Robert

    2013-08-01

    The superiority of dedicated stroke rehabilitation over generalized rehabilitation services has been suggested by the literature; however, these models of service delivery have not been evaluated in terms of their relative effectiveness in situ. A comparison of the process indicators associated with these two models of service provision was undertaken within the Ontario healthcare system. All adults admitted with a diagnosis of stroke for inpatient rehabilitation in Ontario, Canada during the years 2006-2008 were identified from the National Rehabilitation Reporting System database. Each of the admitting institutions was classified as providing rehabilitation services on either a stroke dedicated or nondedicated unit. A dedicated unit was identified by the presence of a collection of geographically distinct, stroke-dedicated beds and dedicated therapists. Selected process indicators from the National Rehabilitation Reporting System database were compared between the two facility types. Sixty-seven facilities provided stroke rehabilitation services to 6709 adult stroke patients during the years 2006-2008. Of the total number of patients who entered inpatient rehabilitation, 1725 (25·7%) received care in eight facilities that met basic criteria for a dedicated stroke rehabilitation unit. On average, these patients took significantly longer to arrive for inpatient rehabilitation (37·2 ± 155·5 vs. 22·8 ± 95·0 days, P  0·001) compared with patients who were admitted to nondedicated units. The proportion of patients admitted to a dedicated unit and subsequently discharged home was similar to that of patients discharged from nondedicated units (70·5% vs. 68·8%, P = 0·206). In Ontario, patients admitted to dedicated stroke rehabilitation units fared no better on commonly-used process metrics compared with patients admitted to nondedicated rehabilitation units. © 2012 The Authors. International Journal of Stroke © 2012 World Stroke

  16. [Research and Development of A Kinect Based Virtual System for Upper Limb Rehabilitation].

    Science.gov (United States)

    Ding, Weili; Zheng, Yazhuo; Su, Yuping; Li, Xiaoli; Wei, Xiuli

    2015-06-01

    We developed a rehabilitation system by using the virtual reality technique and the Kinect in this paper. The system combines rehabilitation training with HMI and serious game organically, and provides a game and motion database to meet different patients' demands. Extended interface of game database is provided in two ways: personalized games can be developed by Virtools and Flash games which are suitable for patients' rehabilitation can be download from the Internet directly. In addition, the system provides patients with flexible interaction and easy control mode, and also presents real time data recording. An objective and subjective evaluation method is proposed to review the effectiveness of the rehabilitation training. According to the results of short questionnaires and the evaluation results of patients' rehabilitation training, the system compared with traditional rehabilitation can record and analyze the training data, which is useful to make rehabilitation plans. More entertainment and lower cost will increase patients' motivation, which helps to increase the rehabilitation effectiveness.

  17. A review: Motor rehabilitation after stroke with control based on human intent.

    Science.gov (United States)

    Li, Min; Xu, Guanghua; Xie, Jun; Chen, Chaoyang

    2018-02-01

    Strokes are a leading cause of acquired disability worldwide, and there is a significant need for novel interventions and further research to facilitate functional motor recovery in stroke patients. This article reviews motor rehabilitation methods for stroke survivors with a focus on rehabilitation controlled by human motor intent. The review begins with the neurodevelopmental principles of motor rehabilitation that provide the neuroscientific basis for intuitively controlled rehabilitation, followed by a review of methods allowing human motor intent detection, biofeedback approaches, and quantitative motor rehabilitation assessment. Challenges for future advances in motor rehabilitation after stroke using intuitively controlled approaches are addressed.

  18. A comprehensive assessment of family caregivers of stroke survivors during inpatient rehabilitation.

    Science.gov (United States)

    Young, Mary Ellen; Lutz, Barbara J; Creasy, Kerry Rae; Cox, Kim J; Martz, Crystal

    2014-01-01

    Stroke caregivers have been identified as a group at high risk for poor outcomes as a result of the suddenness of stroke and a potentially high level of care needed due to significant functional limitations of the patient. However, there is little research on the assessment of family members who will assume the caregiving role prior to patient discharge from rehabilitation. The purpose of this article is to delineate critical assessment domains identified by a subset of spousal stroke caregivers. Semi-structured interviews were conducted pre- and post-discharge from rehabilitation as part of a larger study that focused on identifying caregiver and stroke survivor needs as they transitioned home from inpatient rehabilitation. For this study, two semi-structured interviews with 14 spousal caregivers were analyzed using grounded theory methods. Long-term stroke survivor outcomes were dependent upon the commitment, capacity and preparedness of the family caregiver. Twelve domains of assessment were identified and presented. A comprehensive, systematic caregiver assessment to understand the caregiver's concerns about stroke should be conducted during rehabilitation to help the team to develop a plan to address unmet needs and better prepare family caregivers to take on the caregiving role. Stroke is a sudden event that often leaves stroke survivors and their families in crisis. The needs of stroke family caregivers are not often systematically assessed as part of inpatient rehabilitation. Long-term stroke survivor outcomes are dependent upon the commitment, capacity and preparedness of the family caregiver. Stroke caregiver assessment should include the commitment, capacity and preparedness to provide care, and the overall impact of stroke in order to develop discharge plans that will adequately address the needs of the stroke survivor/caregiver dyad.

  19. Yoga for stroke rehabilitation.

    Science.gov (United States)

    Lawrence, Maggie; Celestino Junior, Francisco T; Matozinho, Hemilianna Hs; Govan, Lindsay; Booth, Jo; Beecher, Jane

    2017-12-08

    Stroke is a major health issue and cause of long-term disability and has a major emotional and socioeconomic impact. There is a need to explore options for long-term sustainable interventions that support stroke survivors to engage in meaningful activities to address life challenges after stroke. Rehabilitation focuses on recovery of function and cognition to the maximum level achievable, and may include a wide range of complementary strategies including yoga.Yoga is a mind-body practice that originated in India, and which has become increasingly widespread in the Western world. Recent evidence highlights the positive effects of yoga for people with a range of physical and psychological health conditions. A recent non-Cochrane systematic review concluded that yoga can be used as self-administered practice in stroke rehabilitation. To assess the effectiveness of yoga, as a stroke rehabilitation intervention, on recovery of function and quality of life (QoL). We searched the Cochrane Stroke Group Trials Register (last searched July 2017), Cochrane Central Register of Controlled Trials (CENTRAL) (last searched July 2017), MEDLINE (to July 2017), Embase (to July 2017), CINAHL (to July 2017), AMED (to July 2017), PsycINFO (to July 2017), LILACS (to July 2017), SciELO (to July 2017), IndMED (to July 2017), OTseeker (to July 2017) and PEDro (to July 2017). We also searched four trials registers, and one conference abstracts database. We screened reference lists of relevant publications and contacted authors for additional information. We included randomised controlled trials (RCTs) that compared yoga with a waiting-list control or no intervention control in stroke survivors. Two review authors independently extracted data from the included studies. We performed all analyses using Review Manager (RevMan). One review author entered the data into RevMan; another checked the entries. We discussed disagreements with a third review author until consensus was reached. We used

  20. [Rehabilitation in the German statutory accident insurance. Guide to the new outpatient and inpatient structures].

    Science.gov (United States)

    Simmel, S; Bühren, V

    2015-02-01

    The German statutory accident insurance (DGUV) has the statutory mandate to eliminate or to prevent an aggravation of the consequences of accidents by all appropriate means and is based on the principle of rehabilitation before pension. For this, special methods have been developed in recent decades, such as employer's mutual insurance inpatient further treatment (BGSW, Berufsgenossenschaftliche Stationäre Weiterbehandlung) and extended outpatient physiotherapy (EAP, Erweiterte Ambulante Physiotherapie). In 2012 the workplace-related musculoskeletal rehabilitation (ABMR, Arbeitsplatz-bezogene muskuloskelettale Rehabilitation) was added to these complex treatments. For complex injuries and delayed healing these methods approach their limits. The accident clinics of the Association of Clinics in Statutory Accident Insurance (KUV, Klinikverbund der gesetzlichen Unfallversicherung) provide a number of specialized rehabilitation measures in order to ensure an optimal seamless rehabilitation of the severely injured. In addition to complex inpatient rehabilitation (KSR, Komplexe Stationäre Rehabilitation) integrated special rehabilitation procedures, such as neurorehabilitation for severely traumatic brain injured patients and rehabilitation after spinal cord injury and other special rehabilitation methods, such as occupation-oriented rehabilitation (TOR, Tätigkeitsorientierte Rehabilitation) and pain rehabilitation, ensure that the German Society for Trauma Surgery (DGU) phase model of trauma rehabilitation is implemented. This provides an early start in the context of acute treatment as so-called early rehabilitation. After a specialized post-acute rehabilitation, additional therapeutic options are often required. An appropriate treatment of severely injured patients is important, for example through rehabilitation managers, which must not end with discharge from the rehabilitation hospital. The aim of all efforts is the reintegration into the working and social

  1. 78 FR 35758 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-06-14

    ... CFR Chapter III Final Priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and Rehabilitative Services... Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers...

  2. 78 FR 12002 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-02-21

    ... CFR Chapter III Proposed Priority--National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and Rehabilitative Services... and Rehabilitative Services proposes a priority for the Rehabilitation Research and Training Center...

  3. 78 FR 29237 - Final Priority; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-05-20

    ... CFR Chapter III Final Priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and Rehabilitative Services... Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers...

  4. 78 FR 26560 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-05-07

    ... CFR Chapter III Proposed Priority--National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and Rehabilitative Services... and Rehabilitative Services proposes a priority for the Rehabilitation Research and Training Center...

  5. 78 FR 27038 - Final Priorities; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-05-09

    ... CFR Chapter III Final Priorities; National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and Rehabilitative Services... Rehabilitative Services announces priorities for the Disability and Rehabilitation Research Projects and Centers...

  6. Building Collaboration in Substance Abuse Treatment and Vocational Rehabilitation

    Science.gov (United States)

    Glenn, Margaret K.; Moore, Lucas C.

    2008-01-01

    This study explored the perceived external and internal issues that may have an effect on collaborative ventures designed to provide vocational rehabilitation services to persons with substance use disorders. Participants in the study were professionals from substance abuse (SA) treatment and vocational rehabilitation (VR) agencies in 1 state…

  7. Problems of Hemophilia and the Role of the Rehabilitation Counselor.

    Science.gov (United States)

    Carrai, Edward B.; Handford, H. Allen

    1983-01-01

    Because of the multiple problems associated with hemophilia, optimal treatment is usually provided in a comprehensive care setting by a team of medical and nonmedical professionals. The rehabilitation counselor contributes expertise to that of other team members in development and implementation of an individual rehabilitation plan for…

  8. Fulbright project focuses on rehabilitation technician education and ...

    African Journals Online (AJOL)

    and enthusiastic clinicians, motivated to provide practical and high-quality rehabilitation services, which includes duties not only supporting the practice of physiotherapy, but also occupational therapy, and minimally, speech/language therapy. However, at their level of education, rehabilitation technicians are not qualified to ...

  9. Effects of soil compaction on pasture growth during rehabilitation of ...

    African Journals Online (AJOL)

    Reports the results of a study conducted to provide an initial assessment of the severity of the problem of soil compaction in the rehabilitation of strip mined land. Presents results from the first season of growth only; Compaction of soils by heavy earth moving equipment is an endemic problem in the rehabilitation of land after ...

  10. 20 CFR 702.507 - Vocational rehabilitation; maintenance allowance.

    Science.gov (United States)

    2010-04-01

    ... allowance. 702.507 Section 702.507 Employees' Benefits EMPLOYMENT STANDARDS ADMINISTRATION, DEPARTMENT OF... PROCEDURE Vocational Rehabilitation § 702.507 Vocational rehabilitation; maintenance allowance. (a) An... section 44 of the Act, 33 U.S.C. 944. The maximum maintenance allowance shall not be provided on an...

  11. Final priority. Rehabilitation Training: Job-Driven Vocational Rehabilitation Technical Assistance Center. Final priority.

    Science.gov (United States)

    2014-08-19

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Rehabilitation Training program to establish a Job-Driven Vocational Rehabilitation Technical Assistance Center (JDVRTAC). The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus on training in an area of national need. Specifically, this priority responds to the Presidential Memorandum to Federal agencies directing them to take action to address job-driven training for the Nation's workers. The JDVRTAC will provide technical assistance (TA) to State vocational rehabilitation (VR) agencies to help them develop for individuals with disabilities training and employment opportunities that meet the needs of today's employers.

  12. [Investigation of burn rehabilitation development of China in 2014].

    Science.gov (United States)

    Ao, M; Wu, J; Chen, J

    2017-05-20

    treatment units were divided into less than 500 cases group (n=8), 501-1 000 cases group (n=11), 1 001-1 500 cases group (n=10), and more than 1 500 cases group (n=6) according to the number of annual admitted patients. The number of authorized beds of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group (t=4.563, Pnurses of units in 1 001-1 500 cases group was significantly more than that in less than 500 cases group (t=2.837, Pnurses and that of rehabilitation therapists of units in more than 1 500 cases group were significantly more than those in the other 3 groups (with t values from 1.762 to 4.789, P values below 0.05). (3) The 35 burn treatment units were able to provide at least one rehabilitation treatment for patients, among which body positioning, motion of joint exercise, infrared ray irradiation, hydrotherapy, function training, activities of daily life training, scar massage, and drug injection in scar were carried out well, while psychological therapy, music therapy, occupational rehabilitation, and social rehabilitation were mostly not carried out. (4) Only 9 (25.7%) burn treatment units started rehabilitation treatment for patients within 3 days after injury. (5) Twenty-seven (77.1%) burn treatment units could carry out body positioning in ICU. (6) Twenty-three burn treatment units had full-time rehabilitation treating personnel, and the units were divided into less than 500 cases group (n=1), 501-1 000 cases group (n=8), 1 001-1 500 cases group (n=9), and more than 1 500 cases group (n=5) according to the number of annual admitted patients. The ratio of beds to doctors of units in more than 1 500 cases group was significantly higher than that in 501-1 000 cases group (t=2.810, P0.05). The ratios of beds to nurses and beds to full-time burn rehabilitation treating personnel in 4 groups were similar (with F values respectively 0.783 and 0.434, P values above 0.05). (7) Twenty burn treatment units had rehabilitation

  13. 34 CFR 388.1 - What is the State Vocational Rehabilitation Unit In-Service Training program?

    Science.gov (United States)

    2010-07-01

    ... program of vocational rehabilitation services or in skill areas that will enable staff personnel to... rehabilitation professionals; (b) To provide for succession planning; (c) To provide for leadership development...

  14. Rehabilitation Charges Associated With Anterior Cruciate Ligament Reconstruction.

    Science.gov (United States)

    Zhang, Joanne Y; Cohen, Jeremiah R; Yeranosian, Michael G; Lord, Elizabeth L; Wang, Jeffrey C; Petrigliano, Frank A; McAllister, David R

    2015-01-01

    Pre- and postoperative rehabilitation are important to the management of patients with anterior cruciate ligament (ACL) reconstruction, but little attention has been given to the costs. This study evaluated the pre- and postoperative rehabilitation charges in patients with ACL reconstruction in the United States. Patients receive preoperative rehabilitation less commonly than postoperative rehabilitation. Retrospective database study. Level 4. Using the PearlDiver database, we identified patients undergoing ACL reconstruction from 2007 through 2011 using Current Procedural Terminology codes. The associated rehabilitation charges billed to insurance providers for 90 days preoperatively and 6 months postoperatively were categorized as physical therapy or as durable medical equipment (DME). The charges were examined by year and geographic region and represented as per-patient average charges (PPACs). A total of 92,179 patients were identified in the study period. The PPAC for rehabilitation was $241 during the 90-day preoperative period and $1876 for the 6-month postoperative period. Patients averaged 2 preoperative sessions for physical therapy, with 44% of patients receiving preoperative rehabilitation in contrast with an average of 17 postoperative sessions per patient in 93% of patients. Rehabilitation charges were greater postoperatively than preoperatively (P postoperatively. Preoperative rehabilitation PPACs were highest in the Northeast, followed by Midwest, South, and West (P postoperative rehabilitation PPACs for geographic region (P = 0.43). Preoperative rehabilitation charges were lower than postoperative charges. A patient undergoing ACL reconstruction typically received 9 times more sessions of postoperative physical therapy than preoperative. This study found that preoperative supervised rehabilitation for patients with ACL reconstruction was infrequent across the United States. © 2015 The Author(s).

  15. Pediatric rehabilitation: 4. Prescribing assistive technology to promote community integration.

    Science.gov (United States)

    Trovato, Melissa; Kim, Heakyung; Moberg-Wolff, Elizabeth; Murphy, Nancy; Kim, Chong Tae

    2010-03-01

    This self-directed learning module highlights the equipment and assistive technology needs of children and youth with disabilities. This article specifically focuses on preparing families and patients for equipment transitions that occur over the course of childhood and adolescence including progressing from stroller to wheelchair to powerchair, as well as job training and use of augmentative communication. It is part of the study guide on pediatric rehabilitation in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation and pediatric medicine. The goal of this article is to modify the learner's current practice techniques to ensure that assistive technology is used to promote community integration from early childhood through transition and into adulthood. Copyright 2010 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  16. Status of marine turtle rehabilitation in Queensland

    Directory of Open Access Journals (Sweden)

    Jaylene Flint

    2017-03-01

    Full Text Available Rehabilitation of marine turtles in Queensland has multifaceted objectives. It treats individual animals, serves to educate the public, and contributes to conservation. We examined the outcome from rehabilitation, time in rehabilitation, and subsequent recapture and restranding rates of stranded marine turtles between 1996 and 2013 to determine if the benefits associated with this practice are cost-effective as a conservation tool. Of 13,854 marine turtles reported as stranded during this 18-year period, 5,022 of these turtles were stranded alive with the remainder verified as dead or of unknown condition. A total of 2,970 (59% of these live strandings were transported to a rehabilitation facility. Overall, 1,173/2,970 (39% turtles were released over 18 years, 101 of which were recaptured: 77 reported as restrandings (20 dead, 13 alive subsequently died, 11 alive subsequently euthanized, 33 alive and 24 recaptured during normal marine turtle population monitoring or fishing activities. Of the turtles admitted to rehabilitation exhibiting signs of disease, 88% of them died, either unassisted or by euthanasia and 66% of turtles admitted for unknown causes of stranding died either unassisted or by euthanasia. All turtles recorded as having a buoyancy disorder with no other presenting problem or disorder recorded, were released alive. In Queensland, rehabilitation costs approximately $1,000 per animal per year admitted to a center, $2,583 per animal per year released, and $123,750 per animal per year for marine turtles which are presumably successfully returned to the functional population. This practice may not be economically viable in its present configuration, but may be more cost effective as a mobile response unit. Further there is certainly benefit giving individual turtles a chance at survival and educating the public in the perils facing marine turtles. As well, rehabilitation can provide insight into the diseases and environmental

  17. Status of marine turtle rehabilitation in Queensland

    Science.gov (United States)

    Flint, Mark; Limpus, Colin James; Mills, Paul

    2017-01-01

    Rehabilitation of marine turtles in Queensland has multifaceted objectives. It treats individual animals, serves to educate the public, and contributes to conservation. We examined the outcome from rehabilitation, time in rehabilitation, and subsequent recapture and restranding rates of stranded marine turtles between 1996 and 2013 to determine if the benefits associated with this practice are cost-effective as a conservation tool. Of 13,854 marine turtles reported as stranded during this 18-year period, 5,022 of these turtles were stranded alive with the remainder verified as dead or of unknown condition. A total of 2,970 (59%) of these live strandings were transported to a rehabilitation facility. Overall, 1,173/2,970 (39%) turtles were released over 18 years, 101 of which were recaptured: 77 reported as restrandings (20 dead, 13 alive subsequently died, 11 alive subsequently euthanized, 33 alive) and 24 recaptured during normal marine turtle population monitoring or fishing activities. Of the turtles admitted to rehabilitation exhibiting signs of disease, 88% of them died, either unassisted or by euthanasia and 66% of turtles admitted for unknown causes of stranding died either unassisted or by euthanasia. All turtles recorded as having a buoyancy disorder with no other presenting problem or disorder recorded, were released alive. In Queensland, rehabilitation costs approximately $1,000 per animal per year admitted to a center, $2,583 per animal per year released, and $123,750 per animal per year for marine turtles which are presumably successfully returned to the functional population. This practice may not be economically viable in its present configuration, but may be more cost effective as a mobile response unit. Further there is certainly benefit giving individual turtles a chance at survival and educating the public in the perils facing marine turtles. As well, rehabilitation can provide insight into the diseases and environmental stressors causing

  18. Occupational rehabilitation in Singapore and Malaysia.

    Science.gov (United States)

    Chan, Kay-Fei; Tan, Charlie W C; Yeo, Doreen S C; Tan, Heidi S K; Tan, F L; Tan, E W; Szeto, Grace P Y; Cheng, Andy S K

    2011-03-01

    Asia is the new and favored magnet of economic attention and foreign investments after it made an almost uneventful rebound from the depths of financial crisis of 2008/2009. Not many Western observers fully understand the diversity that is Asia other than perhaps its 2 growing economic giants of China and India. Indeed many smaller countries like Singapore and Malaysia in South East Asia along with Australia and Hong Kong (a Special Administrative Region within China) look to symbiotic relationships with these two economic giants. The purpose of this discussion paper is to examine the current issues related to the development and provision of occupational rehabilitation services in Singapore and Malaysia with a forward-looking view of how Asia's different developing societies could potentially benefit from better alignment of occupational rehabilitation practices and sharing of expertise through international collaboration and dialogue platforms. Seven therapists and one physician who are frequently involved in occupational rehabilitation services in their home countries critically reviewed the current issues in Singapore and Malaysia which included analysis of the prevalence and cost of occupational injury; overview of workers' compensation system; current practices, obstacles, and challenges in providing occupational rehabilitation and return to work practices. They also offered opinions about how to improve the occupational rehabilitation programs of their two home countries. Even though Malaysia and Singapore are two different countries, in many ways their current provision of occupational rehabilitation services and the problems they face with are very similar. There is a lot of room for systemic improvements that require government support and action. Most prominently, the training of more healthcare professionals in the assessment and rehabilitation of the injured worker should be encouraged. There could be better liaison between the many stakeholders and

  19. Comprehensive cardiac rehabilitation

    DEFF Research Database (Denmark)

    Kruse, Marie; Hochstrasser, Stefan; Zwisler, Ann-Dorthe O

    2006-01-01

    OBJECTIVES: The costs of comprehensive cardiac rehabilitation are established and compared to the corresponding costs of usual care. The effect on health-related quality of life is analyzed. METHODS: An unprecedented and very detailed cost assessment was carried out, as no guidelines existed...... for the situation at hand. Due to challenging circumstances, the cost assessment turned out to be ex-post and top-down. RESULTS: Cost per treatment sequence is estimated to be approximately euro 976, whereas the incremental cost (compared with usual care) is approximately euro 682. The cost estimate is uncertain...... and may be as high as euro 1.877. CONCLUSIONS: Comprehensive cardiac rehabilitation is more costly than usual care, and the higher costs are not outweighed by a quality of life gain. Comprehensive cardiac rehabilitation is, therefore, not cost-effective....

  20. Gas turbine combustor transition

    Science.gov (United States)

    Coslow, Billy Joe; Whidden, Graydon Lane

    1999-01-01

    A method of converting a steam cooled transition to an air cooled transition in a gas turbine having a compressor in fluid communication with a combustor, a turbine section in fluid communication with the combustor, the transition disposed in a combustor shell and having a cooling circuit connecting a steam outlet and a steam inlet and wherein hot gas flows from the combustor through the transition and to the turbine section, includes forming an air outlet in the transition in fluid communication with the cooling circuit and providing for an air inlet in the transition in fluid communication with the cooling circuit.

  1. Increasing client involvement in vocational rehabilitation: an expectations-based approach to assessment and planning.

    Science.gov (United States)

    Koch, L C; Williams, C L; Rumrill, P D

    1998-01-01

    The article provides a rationale for according greater attention to the expectations of vocational rehabilitation (VR) clients. Based on counseling theory, rehabilitation philosophy, federal regulatory mandates, and counseling process and outcome studies, the authors' thesis is that an expectations-based approach to rehabilitation counseling will increase client involvement in all phases of the VR process.

  2. 42 CFR 485.58 - Condition of participation: Comprehensive rehabilitation program.

    Science.gov (United States)

    2010-10-01

    ... rehabilitation program that includes, at a minimum, physicians' services, physical therapy services, and social... contraindications to any treatment modality. (iv) Rehabilitation goals, if determined. (2) Services may be provided... rehabilitation program. 485.58 Section 485.58 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT...

  3. Advancing research and practice in HIV and rehabilitation: a framework of research priorities in HIV, disability and rehabilitation.

    Science.gov (United States)

    O'Brien, Kelly K; Ibáñez-Carrasco, Francisco; Solomon, Patricia; Harding, Richard; Cattaneo, Jessica; Chegwidden, William; Gahagan, Jacqueline; Baxter, Larry; Worthington, Catherine; Gayle, Patriic; Merritt, Brenda; Baltzer-Turje, Rosalind; Iku, Nkem; Zack, Elisse

    2014-12-31

    HIV increasingly is experienced as a complex chronic illness where individuals are living longer with a range of physical, cognitive, mental and social health-related challenges associated with HIV, comorbidities and aging, a concept that may be termed 'disability'. Rehabilitation such as physical therapy and occupational therapy can help address disability and has the potential to improve quality of life in people living with HIV. Hence, the role for rehabilitation in the context of HIV, aging and comorbidities is emerging. Our aim was to establish a framework of research priorities in HIV, disability and rehabilitation. We convened people living with HIV, clinicians, researchers, service providers, representatives from community-based organizations and policy and funding stakeholders to participate in the first International Forum on HIV and Rehabilitation Research. We conducted a multi-stakeholder consultation to identify current and emerging issues in HIV, disability and rehabilitation. Data were collated and analyzed using content analytical techniques. Ninety-two participants attended the Forum from Canada, United Kingdom (UK), Ireland and the United States. Situated within three overarching themes (episodic health and disability across the life course; rehabilitation; and methodological advances), the Framework of Research Priorities in HIV, Disability and Rehabilitation includes six research priorities: 1) episodic health and disability; 2) aging with HIV across the life course; 3) concurrent health conditions; 4) access to rehabilitation and models of rehabilitation service provision; 5) effectiveness of rehabilitation interventions; and 6) enhancing outcome measurement in HIV and rehabilitation research. The Framework includes methodological considerations and environmental and personal contextual factors (or lenses) through which to approach research in the field. Knowledge translation should be implemented throughout the development and application of

  4. Rehabilitation courses for road users.

    NARCIS (Netherlands)

    2010-01-01

    Rehabilitation courses are educational measures directed at deviant driving behaviour of car drivers. The Netherlands has four rehabilitation courses: EMA (Educational Measure Alcohol and traffic), LEMA (Lighter version of EMA), EMG (Educational Measure Behaviour and traffic) and ASP (Alcohol

  5. O efeito da assistência psicológica em um programa de reabilitação pulmonar para pacientes com doença pulmonar obstrutiva crônica The effect of psychotherapy provided as part of a pulmonary rehabilitation program for the treatment of patients with chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    Dagoberto Vanoni de Godoy

    2005-12-01

    were applied. The distance walked-weight product was also calculated. RESULTS: Statistically significant absolute improvements in exercise capacity were found for groups 1 and 2, although not for group 3 (p = 0.007, p = 0.008 and p = 0.06, respectively. In groups 1 and 2, levels of anxiety and depressions were also significantly reduced (group 1: p = 0.0000 and p < 0.0003; group 2: p = 0.0001 and p = 0.0014, and quality of life was significantly improved (p = 0.0007 and p = 0.002, respectively. Anxiety levels were also reduced in group 3 (p = 0.03, although levels of depression were not, and quality of life was unaffected. CONCLUSION: Psychotherapy sessions provided as part of a pulmonary rehabilitation program assist patients with chronic obstructive pulmonary disease in coping with disease-related limitations by reducing behavioral symptoms, especially depression, thereby influencing exercise capacity and health-related quality of life.

  6. Qualitative research in rehabilitation science: opportunities, challenges, and future directions.

    Science.gov (United States)

    VanderKaay, Sandra; Moll, Sandra E; Gewurtz, Rebecca E; Jindal, Pranay; Loyola-Sanchez, Adalberto; Packham, Tara L; Lim, Chun Y

    2018-03-01

    Qualitative research has had a significant impact within rehabilitation science over time. During the past 20 years the number of qualitative studies published per year in Disability and Rehabilitation has markedly increased (from 1 to 54). In addition, during this period there have been significant changes in how qualitative research is conceptualized, conducted, and utilized to advance the field of rehabilitation. The purpose of this article is to reflect upon the progress of qualitative research within rehabilitation to date, to explicate current opportunities and challenges, and to suggest future directions to continue to strengthen the contribution of qualitative research in this field. Relevant literature searches were conducted in electronic data bases and reference lists. Pertinent literature was examined to identify current opportunities and challenges for qualitative research use in rehabilitation and to identify future directions. Six key areas of opportunity and challenge were identified: (a) paradigm shifts, (b) advancements in methodology, (c) emerging technology, (d) advances in quality evaluation, (e) increasing popularity of mixed methods approaches, and (f) evolving approaches to knowledge translation. Two important future directions for rehabilitation are posited: (1) advanced training in qualitative methods and (2) engaging qualitative communities of research. Qualitative research is well established in rehabilitation and has an important place in the continued growth of this field. Ongoing development of qualitative researchers and methods are essential. Implications for Rehabilitation Qualitative research has the potential to improve rehabilitation practice by addressing some of the most pervasive concerns in the field such as practitioner-client interaction, the subjective and lived experience of disability, and clinical reasoning and decision making. This will serve to better inform those providing rehabilitation services thereby benefiting

  7. Triceps tendon rupture: repair and rehabilitation.

    Science.gov (United States)

    Kocialkowski, Cezary; Carter, Rebecca; Peach, Chris

    2018-01-01

    Triceps tendon ruptures are rare injuries and are frequently missed on initial presentation to the emergency department. In cases of complete rupture, surgical repair is recommended but no guidelines exist on the optimum reconstructive technique or rehabilitation. We present a surgical technique and rehabilitation programme for the management of these injuries. A midline posterior incision is performed, the ruptured triceps tendon is identified and mobilized, and the tendon footprint is prepared. The tendon is then repaired using bone suture anchors, with a parachute technique, and held in 40° of flexion. The rehabilitation programme is divided into five phases, over a period of 12 weeks. Range of movement is gradually increased in a brace for the first 6 weeks. Rehabilitation is gradually increase in intensity, progressing from isometric extension exercises to weight-resisted exercises, and finally plyometrics and throwing exercises. Our surgical technique provides a solid tendon repair without the need for further metalwork removal. The graduated rehabilitation programme also helps to protect the integrity of the repair at the same time as enabling patients to gradually increase the strength of the triceps tendon and ultimately return to sport activities.

  8. When self-tracking enters physical rehabilitation

    DEFF Research Database (Denmark)

    Schwennesen, Nete

    2017-01-01

    In this paper, I explore what happens when self-tracking technologies and devices travel into the context of physical rehabilitation and come to constitute what Lupton has called ‘pushed’ self-tracking. By unpacking the processes through which a self-tracking technology is put to use in physical...... rehabilitation in Denmark, and the kind of relationships patients and healthcare providers establish with and through this technology, I illustrate how a new geography of responsibility is constituted, where responsibility for professional guidance is delegated to the technology and patients are expected...

  9. Implant rehabilitation of partial maxillectomy edentulous patien

    Directory of Open Access Journals (Sweden)

    Mahesh E Gowda

    2013-01-01

    Full Text Available Edentulous patients with maxillectomy defects present a significant challenge for prosthetic rehabilitation and the adaptive capabilities of the patient as retention is highly compromised. Hence, the option of using endosseous implants to increase obturator retention has been used. A patient of mucormycosis of the left maxilla was treated with surgical excision. After satisfactory healing, definitive implant supported magnet retained prosthesis was fabricated for the patient. Implants with magnetic units offer a practical method of improving the retention of obturators provided acceptable prosthetic protocols are followed for the rehabilitation.

  10. Shoulder-elbow exoskeleton as rehabilitation exerciser

    Science.gov (United States)

    Ianoşi, A.; Dimitrova, A.; Noveanu, S.; Tătar, O. M.; Mândru, D. S.

    2016-08-01

    This paper presents a 2 degree of freedom exoskeleton designed for the rehabilitation of the shoulder and elbow movement in the sagittal plane; a semi-portable design strategy was chosen, which enables an easy attachment to a standard medical chair as well as the patient upper limb. A dedicated driver enables the control from a graphical user interface, which also provides the option of customized rehabilitation exercises. The potential of future improvements is assessed, and recommendations of research direction are made in order to broaden the usability of the proposed device.

  11. Rehabilitation as a positive obligation

    NARCIS (Netherlands)

    Meijer, S.

    2017-01-01

    Although the emphasis in European penal policy now lies on the rehabilitative aim of imprisonment, the concept of rehabilitation remains vague and is being interpreted differently in different European countries. This paper looks at rehabilitation from a legal perspective and aims to clarify the

  12. [Rehabilitation and nursing-care robots].

    Science.gov (United States)

    Hachisuka, Kenji

    2016-04-01

    In the extremely aged society, rehabilitation staff will be required to provide ample rehabilitation training for more stroke patients and more aged people with disabilities despite limitations in human resources. A nursing-care robot is one potential solution from the standpoint of rehabilitation. The nursing-care robot is defined as a robot which assists aged people and persons with disabilities in daily life and social life activities. The nursing-care robot consists of an independent support robot, caregiver support robot, and life support robot. Although many nursing-care robots have been developed, the most appropriate robot must be selected according to its features and the needs of patients and caregivers in the field of nursing-care.

  13. Achieving a holistic perspective in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Lund, Hans; Jones, Dorrie

    2015-01-01

    Background/Aims: Holistic, multidisciplinary rehabilitation is often the most appropriate for stroke patients. The World Health Organization’s International Classification of Functioning, Disability and Health (ICF) provides a comprehensive conceptual framework and systematic terminology used...... by health professionals worldwide. The purpose of this study was to explore how the components of the ICF were addressed by physiotherapists and occupational therapists in stroke rehabilitation. Methods: A prospective cohort study, including all service levels within Danish stroke rehabilitation......, was carried out. Consecutive patients with a diagnosis of stroke (n=131; 70 males and 61 females; mean age: 72 years) admitted to a university hospital between May and December 2012 were enrolled by 13 physiotherapists and occupational therapists. Physiotherapist and occupational therapist documentation...

  14. 'The horse has bolted I suspect': A qualitative study of clinicians' attitudes and perceptions regarding palliative rehabilitation.

    Science.gov (United States)

    Runacres, Fiona; Gregory, Heidi; Ugalde, Anna

    2017-07-01

    Palliative care patients have numerous rehabilitation needs that increase with disease progression. Palliative rehabilitation practices and perceptions of palliative medicine physicians towards the role of rehabilitation are largely unstudied. To explore palliative medicine physicians' attitudes and perceptions towards rehabilitation delivered within inpatient palliative care units. Qualitative study utilizing semi-structured interviews. Transcribed interviews were analysed using thematic analysis and major themes reported as results. Australian palliative medicine physicians working in inpatient palliative care units. In total, 20 physicians participated, representing specialist palliative care services across Australia. A total of 11 (55%) were males with an average of 12.5 years' experience working in palliative care. Most participants believed rehabilitation was an important aspect of palliative care; however, few felt adequate rehabilitation programmes were available. Participants varied in their concepts of what palliative rehabilitation entailed. The term rehabilitation was seen by some as helpful (fostering hope and aiding transitions) and by others to be misleading (creating unrealistic expectations). Four key themes emerged when describing physicians' attitudes, including (1) integrating rehabilitation within palliative care, (2) the intervention, (3) possibilities and (4) the message of rehabilitation. A lack of consensus exists among palliative medicine specialists regarding the definition and scope of palliative rehabilitation. Participants generally expressed a wish to offer enhanced rehabilitation interventions, however described resource and skill-set limitations as significant barriers. Further research is required to establish an evidence base for palliative rehabilitation, to support its acceptance and widespread integration within specialist inpatient palliative care.

  15. Workplace rehabilitation and supportive conditions at work: a prospective study.

    Science.gov (United States)

    Ahlstrom, Linda; Hagberg, Mats; Dellve, Lotta

    2013-06-01

    To investigate the impact of rehabilitation measures on work ability and return to work (RTW), specifically the association between workplace rehabilitation/supportive conditions at work and work ability and RTW over time, among women on long-term sick leave. Questionnaire data were collected (baseline, 6 and 12 months) from a cohort of women (n = 324). Linear mixed models were used for longitudinal analysis of the repeated measurements of work ability index (WAI), work ability score and working degree. These analyses were performed with different models; the explanatory variables for each model were workplace rehabilitation, supportive conditions at work and time. The individuals provided with workplace rehabilitation and supportive conditions (e.g. influence at work, possibilities for development, degree of freedom at work, meaning of work, quality of leadership, social support, sense of community and work satisfaction) had significantly increased WAI and work ability score over time. These individuals scored higher work ability compared to those individuals having workplace rehabilitation without supportive conditions, or neither. Additionally, among the individuals provided with workplace rehabilitation and supportive conditions, working degree increased significantly more over time compared to those individuals with no workplace rehabilitation and no supportive conditions. The results highlight the importance of integrating workplace rehabilitation with supportive conditions at work in order to increase work ability and improve the RTW process for women on long-term sick leave.

  16. Models for integrating rehabilitation and primary care: a scoping study.

    Science.gov (United States)

    McColl, Mary Ann; Shortt, Samuel; Godwin, Marshall; Smith, Karen; Rowe, Kirby; O'Brien, Patti; Donnelly, Catherine

    2009-09-01

    To describe the scope and breadth of knowledge currently available regarding the integration of rehabilitation and primary care services. Peer-reviewed journals were searched using CINAHL, MEDLINE, and EBM Reviews for the years 1995 through 2007. This process identified 172 items. To be considered for the subsequent review, the article had to describe a service delivery program that offered primary care and rehabilitation, or services specifically designed for people with chronic conditions/disabilities. Further, it had to be available in English or French. No methodological limitations were applied to screen for levels of evidence. Based on these criteria, 38 articles remained that pertained to both primary care and rehabilitation. These were reviewed, sorted, and categorized to discover commonalities and differences among the approaches used to integrating rehabilitation into primary care. In consultation with the team of investigators, it was determined that there were 6 different models for providing primary health care and rehabilitation services in an integrated approach: clinic, outreach, self-management, community-based rehabilitation, shared care, and case management. In addition, a number of themes were identified across models that may act as either supports or impediments to the integration of rehabilitation services into primary care settings: team approach, interprofessional trust, leadership, communication, compensation, accountability, referrals, and population-based approach. Rehabilitation providers interested in working in the primary care sector may be assisted in conceptualizing the benefits that they bring to the setting by considering these models and issues.

  17. Medicare Provider Data - Hospice Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Hospice Utilization and Payment Public Use File provides information on services provided to Medicare beneficiaries by hospice providers. The Hospice PUF...

  18. COMMUNITY BASED REHABILITATION

    African Journals Online (AJOL)

    PROF. OLAOGUN

    subject of substantial international research, development and technical assistance by governments and international non-government organizations. In 1951, the UNO established a Rehabilitation Unit, with the aim of facilitating the transfer of these new medical and technical advances to developing countries. The main ...

  19. Rehabilitating torture survivors

    DEFF Research Database (Denmark)

    Sjölund, Bengt H; Kastrup, Marianne; Montgomery, Edith

    2009-01-01

    Refugees have often been exposed to torture in their countries of origin. A core issue is the resulting multifaceted presentation of somatic, psychological and social problems in the same individual, leading to severe activity limitations and participation restrictions. An international conferenc...... of a successful rehabilitation process, and great attention should be paid to contextual components....

  20. Penile Rehabilitation and Neuromodulation

    Directory of Open Access Journals (Sweden)

    Fernando Facio

    2009-01-01

    Full Text Available Erectile dysfunction (ED following treatment for clinically localized prostate cancer, particularly radical prostatectomy (RP, is a major quality of life issue that remains unsatisfactorily addressed. With the introduction and use of cavernous nerve–sparing procedures over the past 25 years, many men recover erections postoperatively that enable sexual intercourse unlike in the prior surgical era, when permanent ED postoperatively was certain. Despite this advance, 26–100% of these patients may never recover normal erectile function (EF. Recent advances in the understanding of ED after RP have stimulated great attention to develop penile rehabilitation programs and neuromodulation. The purpose of penile rehabilitation is to prevent adverse corpus cavernosal tissue structural alterations and thereby maximize the chances of recovering functional erections. Rehabilitation programs are common in clinical practice, but there is no definitive evidence to support their efficacy. Neuromodulation represents another strategy for promoting erection recovery postoperatively. This therapy involves the application of neuroprotective interventions, conceivably targeting biological elements involved in the erection response that are affected by neuropathic injury. Well-conducted, controlled trials with adequate follow-up are required in order to determine the erection preservative benefits of these therapeutic strategies. The purpose of this essay is to describe the mechanisms related to post-RP ED, assess the need for penile rehabilitation and neuromodulation following surgery, and analyze the basic science and clinical trial evidence associated with these applications for preserving EF following prostate cancer treatment.

  1. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Cord Injury Diane M. Rowles, MS, NP How Family Life Changes After Spinal Cord Injury Nancy Rosenberg, PsyD ... Children with Spinal Cord Injury Patricia Mucia, RN Family Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  2. [Psychosocial rehabilitation in France].

    Science.gov (United States)

    Vidon, Gilles

    2015-01-01

    For a long time in France, readaptation and reinsertion have been considered separately. While readaptation focuses on the way the patient "adapts again", reintegration looks at the place of the readaptation, the society or the group. Today, psychosocial rehabilitation encompasses both of these notions by taking into account the medical and social aspects. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  3. Games for Rehabilitation

    DEFF Research Database (Denmark)

    Petersson, Eva; Brown, David

    This anthology on games for rehabilitation contains a serious chapters on game methods and apps or research that compares game systems or modified games or interface devices (Wii, Eyetoy, Kinect, DDR) applied across all areas of clinical care and clinically focused research....

  4. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... overcome in rehabilitation? play_arrow How soon should people return to school or work after a spinal cord injury? play_arrow What’s important to know about sex and intimacy after a spinal cord injury? play_ ...

  5. DEPARTMENT OF EDUCATION AND REHABILITATION AT THE UNIVERSITY OF SARAJEVO, BOSNIA AND HERZEGOVINA

    Directory of Open Access Journals (Sweden)

    Haris MEMIŠEVIC

    2017-03-01

    early childhood period, through the school years and high school years all the way to supporting them in the transitional period (finding employment. The programs offered at the Department are aimed at equipping the students to work with a heterogeneous group of children and to respond to a wide variety of educational challenges that they might face in everyday work. Thus, for example, the Department offers courses on evidence-based educational strategies in work with children with Autistic Spectrum Disorder such as Applied Behaviour Analysis, courses on methods of work with children with Attention Deficit Hyperactivity Disorder etc. One of the newly designed courses is Cognitive Rehabilitation that teaches students some practical strategies on how to improve certain cognitive domains (attention, memory, executive functions of children with developmental disabilities. Of the old, well-established courses, there are the ones that deal with sensory impairments such as Sign Language and Braille’s alphabet. All in all, the staff at the Department believes that the graduates will be fully competent in dealing with current educational challenges and be able to provide full educational and rehabilitation support to all children with developmental disabilities. In this academic year (2016/2017, 20 students enrolled at the Department. In the academic 2017/2018 the Department plans to enrol 65 students. We wish all the best to all our current and prospective students and invite all to consider the Department of Education and Rehabilitation at the University of Sarajevo as the next step in their careers.

  6. Carers' Experiences, Needs, and Preferences During Inpatient Stroke Rehabilitation: A Systematic Review of Qualitative Studies.

    Science.gov (United States)

    Luker, Julie; Murray, Carolyn; Lynch, Elizabeth; Bernhardsson, Susanne; Shannon, Michelle; Bernhardt, Julie

    2017-09-01

    To report and synthesize the experiences, needs, and preferences of carers of stroke survivors undergoing inpatient rehabilitation. MEDLINE, CINAHL, Embase, PsycINFO, and Web of Science were searched to March 2016. Reference lists of relevant publications were searched. No language restrictions were applied. Eligible qualitative studies reported the experiences of carers of stroke survivors who underwent inpatient rehabilitation. The search yielded 3532 records; 93 full-text publications were assessed for eligibility, and 34 documents (33 studies) were included. Comprehensiveness of reporting was assessed using the Consolidated Criteria for Reporting Qualitative Health Research framework. Data on the characteristics of included studies were independently extracted by 2 authors. Differences in data extraction between authors were resolved through discussion or by a third author. All text in studies' results and discussion sections were extracted for analysis. Extracted texts were analyzed inductively using thematic synthesis. Seven analytical themes were developed that related to the carers' experiences, needs, and preferences: (1) overwhelmed with emotions; (2) recognition as a stakeholder in recovery; (3) desire to be heard and informed; (4) persisting for action and outcomes; (5) being legitimate clients; (6) navigating an alien culture and environment; and (7) managing the transition home. This systematic review provides new insights into the experiences, needs, and preferences of carers of stroke survivors undergoing inpatient rehabilitation. Carers experienced distress as they navigated a foreign culture and environment without adequate communication and processes in place for their inclusion. We recommend deliberate efforts to provide a more inclusive environment that better supports and prepares carers for their new role. Copyright © 2017 American Congress of Rehabilitation Medicine. All rights reserved.

  7. Mangrove rehabilitation in high erosion areas: Assessment using bioindicators

    Science.gov (United States)

    Thornton, Stephen Ryan; Johnstone, Ron William

    2015-11-01

    This study identifies a potentially effective rehabilitation technique for implementation in high erosion areas through the use of bioindicators. This is significant given that one third of mangroves have been cleared globally with clearing continuing at a rate of 1-2% per annum. There have been various attempts to rehabilitate degraded mangrove forests, however the success or failure of these is mostly unclear due to a lack of assessment. The two rehabilitation techniques assessed in this study were a basic fence system and another more elaborate fence technique designed by the Kien Giang Biosphere Reserve Project (KGBRP), Vietnam. The assessment was conducted by comparing vegetation and faunal communities in rehabilitation areas to those in adjacent old-growth areas. The indicators included: tree and understory plant diversity and density; forest cover and the density of crabs, mudskippers and gastropods. The results show the KGBRP rehabilitation fence technique delivered tree diversity, plant diversity, tree density and forest cover that most closely resembled old-growth areas. This suggests that the additional protection provided by the KGBRP fence was instrumental in achieving these results. In terms of total mudskipper, Boleophthalmus spp., Periophthalmodon spp. and ocypodid crab density, the KGBRP rehabilitation was most similar to the old-growth areas. This similarity is thought to be related to the comparable forest cover at these sites. The density of large crab holes was much higher in old-growth areas than in basic or KGBRP rehabilitation areas. The disparity between large crab hole density at KGBRP rehabilitation and old-growth areas, despite similar levels of forest cover, is thought to be linked to the immaturity of the KGBRP rehabilitation sites. As the KGBRP rehabilitation is most similar in terms of vegetation and faunal communities to the old-growth areas, it appears to be the most successful rehabilitation.

  8. Integration of healthcare rehabilitation in chronic conditions

    Directory of Open Access Journals (Sweden)

    Anne Frølich

    2010-02-01

    Full Text Available Introduction: Quality of care provided to people with chronic conditions does not often fulfil standards of care in Denmark and in other countries. Inadequate organisation of healthcare systems has been identified as one of the most important causes for observed performance inadequacies, and providing integrated healthcare has been identified as an important organisational challenge for healthcare systems. Three entities—Bispebjerg University Hospital, the City of Copenhagen, and the GPs in Copenhagen—collaborated on a quality improvement project focusing on integration and implementation of rehabilitation programmes in four conditions. Description of care practice: Four multidisciplinary rehabilitation intervention programmes, one for each chronic condition: chronic obstructive pulmonary disease, type 2 diabetes, chronic heart failure, and falls in elderly people were developed and implemented during the project period. The chronic care model was used as a framework for support of implementing and integration of the four rehabilitation programmes. Conclusion and discussion: The chronic care model provided support for implementing rehabilitation programmes for four chronic conditions in Bispebjerg University Hospital, the City of Copenhagen, and GPs' offices. New management practices were developed, known practices were improved to support integration, and known practices were used for implementation purposes. Several barriers to integrated care were identified.

  9. Biofeedback for robotic gait rehabilitation

    Directory of Open Access Journals (Sweden)

    Colombo Gery

    2007-01-01

    Full Text Available Abstract Background Development and increasing acceptance of rehabilitation robots as well as advances in technology allow new forms of therapy for patients with neurological disorders. Robot-assisted gait therapy can increase the training duration and the intensity for the patients while reducing the physical strain for the therapist. Optimal training effects during gait therapy generally depend on appropriate feedback about performance. Compared to manual treadmill therapy, there is a loss of physical interaction between therapist and patient with robotic gait retraining. Thus, it is difficult for the therapist to assess the necessary feedback and instructions. The aim of this study was to define a biofeedback system for a gait training robot and test its usability in subjects without neurological disorders. Methods To provide an overview of biofeedback and motivation methods applied in gait rehabilitation, previous publications and results from our own research are reviewed. A biofeedback method is presented showing how a rehabilitation robot can assess the patients' performance and deliver augmented feedback. For validation, three subjects without neurological disorders walked in a rehabilitation robot for treadmill training. Several training parameters, such as body weight support and treadmill speed, were varied to assess the robustness of the biofeedback calculation to confounding factors. Results The biofeedback values correlated well with the different activity levels of the subjects. Changes in body weight support and treadmill velocity had a minor effect on the biofeedback values. The synchronization of the robot and the treadmill affected the biofeedback values describing the stance phase. Conclusion Robot-aided assessment and feedback can extend and improve robot-aided training devices. The presented method estimates the patients' gait performance with the use of the robot's existing sensors, and displays the resulting biofeedback

  10. [Social inequality in medical rehabilitation].

    Science.gov (United States)

    Deck, Ruth; Hofreuter-Gätgens, Kerstin

    2016-02-01

    The analysis of inequalities in health care provision in Germany is of high sociopolitical relevance. For medical rehabilitation, which is an essential part of health care provision, only a few studies exist. With the example of psychosomatic and orthopedic medical rehabilitation, the present article investigates how features of social inequality influence different aspects of medical rehabilitation. The database consists of a written survey on the quality assurance of medical rehabilitation in northern Germany that includes 687 patients aged between 21 and 87 years. Aspects of the access to rehabilitation (e.g., the motivation for application), the process (participation in therapies) and the outcomes (e.g., subjective health and occupational risk) of rehabilitation were investigated in relation to social inequality. Social inequality was measured by means of a social class index. For the analysis, Chi-squared tests, t tests and a repeated measures analysis of variance, adjusted for sex and age, were conducted. Initially, the analyses indicate that social inequality is of minor importance for access to rehabilitation and processes within rehabilitation. As subjective health is unequally distributed at the beginning of rehabilitation, however, equal treatment has to be discussed critically in terms of demand-driven treatment. In rehabilitation outcome distinct differences between social classes exist. To reduce these differences, rehabilitation aftercare close to the individual's living environment is necessary, which promotes the empowerment of vulnerable social groups in burdensome living conditions.

  11. Rehabilitation time before disability pension.

    Science.gov (United States)

    Støver, Morten; Pape, Kristine; Johnsen, Roar; Fleten, Nils; Sund, Erik R; Claussen, Bjørgulf; Ose, Solveig Osborg; Bjørngaard, Johan Håkon

    2012-10-30

    The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.

  12. Perceptions of cardiac rehabilitation patients, specialists and rehabilitation programs regarding cardiac rehabilitation wait times

    Directory of Open Access Journals (Sweden)

    Grace Sherry L

    2012-08-01

    Full Text Available Abstract Background In 2006, the Canadian Cardiovascular Society (CCS Access to Care Working Group recommended a 30-day wait time benchmark for cardiac rehabilitation (CR. The objectives of the current study were to: (1 describe cardiac patient perceptions of actual and ideal CR wait times, (2 describe and compare cardiac specialist and CR program perceptions of wait times, as well as whether the recommendations are appropriate and feasible, and (3 investigate actual wait times and factors that CR programs perceive to affect these wait times. Methods Postal and online surveys to assess perceptions of CR wait times were administered to CR enrollees at intake into 1 of 8 programs, all CCS member cardiac specialists treating patients indicated for CR, and all CR programs listed in Canadian directories. Actual wait times were ascertained from the Canadian Cardiac Rehabilitation Registry. The design was cross-sectional. Responses were described and compared. Results Responses were received from 163 CR enrollees, 71 cardiac specialists (9.3% response rate, and 92 CR programs (61.7% response rate. Patients reported that their wait time from hospital discharge to CR initiation was 65.6 ± 88.4 days (median, 42 days, while their ideal median wait time was 28 days. Most patients (91.5% considered their wait to be acceptable, but ideal wait times varied significantly by the type of cardiac indication for CR. There were significant differences between specialist and program perceptions of the appropriate number of days to wait by most indications, with CR programs perceiving shorter waits as appropriate (p  Conclusions Wait times following access to cardiac rehabilitation are prolonged compared with consensus recommendations, and yet are generally acceptable to most patients. Wait times following percutaneous coronary intervention in particular may need to be shortened. Future research is required to provide an evidence base for wait time

  13. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients.

    Science.gov (United States)

    Chen, Jia-Ching; Shaw, Fu-Zen

    2014-08-16

    Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into "a training package", based on the patient's functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients.

  14. Robotics in Lower-Limb Rehabilitation after Stroke.

    Science.gov (United States)

    Zhang, Xue; Yue, Zan; Wang, Jing

    2017-01-01

    With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

  15. Robotics in Lower-Limb Rehabilitation after Stroke

    Directory of Open Access Journals (Sweden)

    Xue Zhang

    2017-01-01

    Full Text Available With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots.

  16. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients

    Science.gov (United States)

    Chen, Jia-Ching; Shaw, Fu-Zen

    2014-01-01

    Impaired motor and functional activity following stroke often has negative impacts on the patient, the family and society. The available rehabilitation programs for stroke patients are reviewed. Conventional rehabilitation strategies (Bobath, Brunnstrom, proprioception neuromuscular facilitation, motor relearning and function-based principles) are the mainstream tactics in clinical practices. Numerous advanced strategies for sensory-motor functional enhancement, including electrical stimulation, electromyographic biofeedback, constraint-induced movement therapy, robotics-aided systems, virtual reality, intermittent compression, partial body weight supported treadmill training and thermal stimulation, are being developed and incorporated into conventional rehabilitation programs. The concept of combining valuable rehabilitative procedures into “a training package”, based on the patient’s functional status during different recovery phases after stroke is proposed. Integrated sensorimotor rehabilitation programs with appropriate temporal arrangements might provide great functional benefits for stroke patients. PMID:25133141

  17. Robotics in Lower-Limb Rehabilitation after Stroke

    Science.gov (United States)

    2017-01-01

    With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, training paradigm, and control strategy of the lower-limb rehabilitation robots in the reviewed literature. A brief review on the gait detection technology of lower-limb rehabilitation robots is also presented. Finally, we discuss the future directions of the lower-limb rehabilitation robots. PMID:28659660

  18. Osteoarthritis year in review: rehabilitation and outcomes.

    Science.gov (United States)

    Davis, A M

    2012-03-01

    This review highlights seminal publications of rehabilitation interventions and outcomes in osteoarthritis (OA) of the hip or knee. Medline, CINAHL, and Embase databases from September 2010 through August 2011 were searched using the key words 'osteoarthritis', rehabilitation, physical therapy, exercise, and outcome(s), limited to human and English. Rehabilitation intervention studies were included if they were randomized trials (RCT), systematic reviews or meta-analyses. Studies of surgical interventions were excluded unless they included evaluation of a rehabilitation intervention. Outcome studies were included if they contributed methodologically to advancing outcome measurement. Reviews of measurement properties of outcomes were excluded. Eight publications were selected and reviewed that relate to interventions evaluating manual therapy in hip or knee OA, tele-rehabilitation and performance and participation measures as outcomes. One systematic review of hip and knee OA, one meta-analysis of knee OA provide limited support for the benefit of manual therapy with exercise for improving pain and function to a lesser extent in the short-term (3 months). Study quality overall was low. One high quality RCT in knee replacement of usual outpatient physiotherapy vs internet-based tele-rehabilitation based on a non-inferiority analysis demonstrated comparable outcomes on Western Ontario McMaster Universities' Osteoarthritis questionnaire (WOMAC) pain and function and performance measures. Three studies demonstrated that observed performance measures such as timed walk tests and stair-climbing and timed-up-and-go measure concepts differ from self-report of difficulty with physical function. Additionally, two studies showed differential times of recovery following total knee replacement (TKR). Two studies evaluated participation. One demonstrated the conceptual distinction of activity limitations and participation and a second re-analyzed trial data from knee OA studies

  19. Multifamily Housing Rehabilitation Process Improvements

    Energy Technology Data Exchange (ETDEWEB)

    Sweet, Marshall L. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Francisco, Abby [Partnership for Home Innovation, Upper Marlboro, MD (United States); Roberts, Sydney G. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2016-03-01

    Rea Ventures Group, LLC, (Rea Ventures) partnered with Southface Energy Institute (Southface) on the rehabilitation of 418 low-income rental multifamily apartments located at 14 different properties in Georgia (Climate Zones 2-4). These 22-year old, individually-metered units were arranged in rowhouse or townhouse style units. Rehabilitation plans were developed using a process prescribed by the US Department of Agriculture (USDA) Rural Development program, who partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide. In 2012, over $100 million was allocated in grants and loans. Due to the unique financing mechanism as well as long-term ownership requirements, property owners are especially motivated to invest in upgrades that will increase durability and tenant retention. These buildings represent a large stock of rural affordable housing that have the potential for significant energy and cost savings for property owners and tenants. Southface analyzed the energy upgrade potential of one stereotypical property in the Rea Ventures portfolio. This study will provide insight into the most cost-effective, implementable energy efficiency and durability upgrades for this age multifamily housing, having an enormous impact not only on the portfolio of Rea Ventures but on the vast USDA and larger Federal portfolio. Additionally, Southface will identify gaps in the current capital needs assessment process, examine available audit and simulation tools and protocols, and evaluate additional auditor training or certification needs.

  20. Need for strengthened focus on cancer rehabilitation in Danish municipalities

    DEFF Research Database (Denmark)

    Kristiansen, Maria; Adamsen, Lis; Brinkmann, Fie Kjær

    2015-01-01

    INTRODUCTION: Danish municipalities have recently been given a mandate to organise cancer rehabilitation services. Knowledge is therefore needed about the services provided and their utilisation. The aim of this national Danish baseline survey was to explore the availability, utilisation, content...

  1. A survey on robotic devices for upper limb rehabilitation

    National Research Council Canada - National Science Library

    Maciejasz, Paweł; Eschweiler, Jörg; Gerlach-Hahn, Kurt; Jansen-Troy, Arne; Leonhardt, Steffen

    2014-01-01

    .... The purpose of this paper is to document a review of robotic devices for upper limb rehabilitation including those in developing phase in order to provide a comprehensive reference about existing...

  2. Characterization of Pulmonary Rehabilitation Programs in Canada in 2005

    Directory of Open Access Journals (Sweden)

    Dina Brooks

    2007-01-01

    Full Text Available BACKGROUND: Pulmonary rehabilitation (PR is recognized as the prevailing standard of care for patients with chronic respiratory conditions. National surveys of PR programs provide important information regarding the structure, content and organization of these programs.

  3. 42 CFR 482.56 - Condition of participation: Rehabilitation services.

    Science.gov (United States)

    2010-10-01

    ..., physical therapist assistants, occupational therapists, occupational therapy assistants, speech-language... provides rehabilitation, physical therapy, occupational therapy, audiology, or speech pathology services... to properly supervise and administer the services. (2) Physical therapy, occupational therapy, speech...

  4. [Rehabilitation for Pain Relief: Preface and Comments].

    Science.gov (United States)

    Hanaoka, Kazuo

    2015-07-01

    Chronic intractable pain is difficult to manage as the mechanisms of chronic pain are complicated. Recently rehabilitation is used in patients with chronic pain not responding to NSAIDs, non-opioids, anti-depressants and so on. Rehabilitation includes acute, recovery and maintained modes of rehabilitation. This review is focused on the concept of rehabilitation, rehabilitation therapy, rehabilitation during recovery period, nerve rehabilitation, music-trampoline therapy and so on.

  5. Measuring family satisfaction with inpatient rehabilitation care.

    Science.gov (United States)

    Angelino, Elisabetta; Gragnano, Andrea; Miglioretti, Massimo

    2016-01-01

    The purpose of this paper is to investigate the psychometric characteristics of the Questionnaire of Family members' Satisfaction about the Rehabilitation (QFSR), a new questionnaire assessing the satisfaction of patients' families with the in-hospital rehabilitation service, i.e., the organizational procedure, medical treatment, relationship with nurses/other health workers, and outcome. The QFSR (13 items) was administered to 1,226 (F=60.4 percent; mean age=57.4, SD 15 years) family members of patients admitted to two units for inpatient rehabilitation, i.e., cardiovascular and neuromotor. Confirmatory factor analysis (CFA) confirmed the theoretical four-factor structure of the questionnaire in a subsample of 308 respondents randomly selected from the sample (SB χ² (61)=57.4, p=0.61; RMSEA=0.0; 90 percent CI [0.0, 0.031], CFI=1.00). The remaining 708 respondents (393 relatives of cardiovascular unit inpatients and 315 relatives of neuromotor unit inpatients) were used to test measurement invariance between the groups of family members with patients in the two units. The configurial, scalar, and strict factorial invariance provided a good fit to the data. The QFSR, specifically developed to measure the satisfaction of family members of patients undergoing rehabilitation, appears to be a promising brief questionnaire that can provide important indications for continuous improvement in the delivery of healthcare.

  6. Rehabilitation of compensable workplace injuries: effective payment models for quality vocational rehabilitation outcomes in a changing social landscape.

    Science.gov (United States)

    Matthews, Lynda R; Hanley, Francine; Lewis, Virginia; Howe, Caroline

    2015-01-01

    With social and economic costs of workplace injury on the increase, efficient payment models that deliver quality rehabilitation outcomes are of increasing interest. This paper provides a perspective on the issue informed by both refereed literature and published research material not available commercially (gray literature). A review of payment models, workers' compensation and compensable injury identified relevant peer-reviewed and gray literature that informed our discussion. Fee-for-service and performance-based payment models dominate the health and rehabilitation literature, each described as having benefits and challenges to achieving quality outcomes for consumers. There appears to be a movement toward performance-based payments in compensable workplace injury settings as they are perceived to promote time-efficient services and support innovation in rehabilitation practice. However, it appears that the challenges that arise for workplace-based rehabilitation providers and professionals when working under the various payment models, such as staff retention and quality of client-practitioner relationship, are absent from the literature and this could lead to flawed policy decisions. Robust evidence of the benefits and costs associated with different payment models - from the perspectives of clients/consumers, funders and service providers - is needed to inform best practice in rehabilitation of compensable workplace injuries. Available but limited evidence suggests that payment models providing financial incentives for stakeholder-agreed vocational rehabilitation outcomes tend to improve service effectiveness in workers' compensation settings, although there is little evidence of service quality or client satisfaction. Working in a system that identifies payments for stakeholder-agreed outcomes may be more satisfying for rehabilitation practitioners in workers' compensation settings by allowing more clinical autonomy and innovative practice. Researchers

  7. Standards in Neurological Rehabilitation, June 1997

    Directory of Open Access Journals (Sweden)

    Michael P. Barnes

    1997-01-01

    neurological services. We believe that disabled individuals should have access to a regional specialist service as well as a local community service. The regional specialist service would cater for people with more complicated and severe disabilities, including spinal injury and severe brain injury. The regional centres would provide specialist expertise for wheelchairs and special seating, orthotics, continence and urological services, aids and equipment including communication aids and environmental controls, prosthetics and driving assessment. The Task Force additionally endorses the development of local and community based rehabilitation teams with clear links to the regional centre. (6 The Task Force recognizes the limited amount of rehabilitation research and encourages individuals, universities and governments to invest more in rehabilitation research. Such investment should produce benefits for disabled people and their carers and in the long term benefits for the national economy. (7 The Task Force realizes that neurological rehabilitation is poorly developed both in Europe and the world as a whole. We firmly endorse international co-operation in this field and are happy to co-operate with any international organization in order to develop such links for clinical, educational or research initiatives. (8 The Task Force encourages individual countries to produce a document summarizing their own situation with regard to these standards and to produce a timetable for action to improve their situation. The EFNS Task Force would be pleased to assist in the publication of such deliberations or to act as a focus for international education and research or for sharing of examples of good practice.

  8. Rehabilitation for postpolio sequelae.

    Science.gov (United States)

    Khan, Fary

    2004-08-01

    Postpolio sequelae (PPS) are new, late manifestations that occur many years after the initial poliomyelitis infection. Recurrence of symptoms and fear of reactivation of the polio virus is particularly distressing to polio survivors. This article outlines the diagnosis, pathophysiology, and management of PPS disabilities using a case vignette. Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. Diagnosis can be complicated particularly in nonparalytic cases of poliomyelitis. Disabilities in PPS may not be obvious to the observer but significantly affect the quality of life of the PPS patient. Previous rehabilitation intervention focussed on physical effort and determination to overcome disability at all costs. The treatment in PPS is now modified, and aggressive physical measures that may exacerbate muscle weakness are avoided. Most disabilities in PPS can be well managed with rehabilitation interventions that address limitations in patient activities of daily living, mobility and cardiopulmonary fitness.

  9. SEFRE: Semiexoskeleton Rehabilitation System

    Directory of Open Access Journals (Sweden)

    Winai Chonnaparamutt

    2016-01-01

    Full Text Available SEFRE (Shoulder-Elbow-Forearm Robotics Economic rehabilitation system is presented in this paper. SEFRE Rehab System is composed of a robotic manipulator and an exoskeleton, so-called Forearm Supportive Mechanism (FSM. The controller of the system is developed as the Master PC consisting of five modules, that is, Intelligent Control (IC, Patient Communication (PC, Training with Game (TG, Progress Monitoring (PM, and Patient Supervision (PS. These modules support a patient to exercise with SEFRE in six modes, that is, Passive, Passive Stretching, Passive Guiding, Initiating Active, Active Assisted, and Active Resisted. To validate the advantages of the system, the preclinical trial was carried out at a national rehabilitation center. Here, the implement of the system and the preclinical results are presented as the verifications of SEFRE.

  10. [Supported aftercare into psychosomatic rehabilitation - transfer of "new credo"].

    Science.gov (United States)

    Deck, R; Hüppe, A

    2014-10-01

    In recent years the prevalence of psychosomatic illnesses increased considerably, therefore the relevance of medical rehabilitation is also increasing. The effectiveness of psychosomatic medical rehabilitation has been demonstrated, but only a small proportion of rehabilita-tion patients manage to transfer the rehabilita-tion success into the daily routine. Numerous -aftercare offers should stabilize the effects of -rehabilitation. Against this background, a new -rehabilitation aftercare strategy ("New Credo"), initially developed and evaluated with good -results for orthopedic indications, was tested for psychosomatic indications. The aim of the present study was to test the concept in a psychosomatic rehabilitation clinic in terms of feasibility (feasibility-study). Further an evaluation of the results of the new credo can be made by the use of a "historical" control group. In a longitudinal feasibility study with 3 points of measurement (before and after rehab as well as after 4 months) the feasibility and acceptance of the new credo was examined. One psychosomatic rehabilitation clinic in Schleswig-Holstein participated in the study, included were rehabilitation patients with depressive disorders (F32.x, F33.x und F40; ICD-10). The new credo philosophy was implemented in the clinical routine as well as the supporting materials were -applied during the project duration. During the study period the clinic was provided with a person in charge for the aftercare program. Psychological symptom severity (BSI) was defined as primary outcome variable. Secondary outcome variables were the subjective health, restriction in participation as well as health-related quality of life. Complete data were available for 91 rehabilitation patients. They were compared with matched data in terms of age, gender and school education from the "Qualitätsgemeinschaft medizinische Rehabilitation in Schleswig-Holstein". The new credo is also in psychosomatic rehabilitation well-accepted by

  11. Integral Rehabilitation in Dentistry

    OpenAIRE

    Lamas Lara, César; Cirujano Dentista, Diplomado en Odontología Restauradora y Estética de la Facultad de Odontología de la UNMSM. Docente del Curso de Operatoria Dental I y II ULADECH Católica.; Paz Fernández, Juan José; Cirujano Dentista, Especialista en Rehabilitación Oral, Docente del Área de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.; Paredes Coz, Gerson; Cirujano Dentista, Especialista en Rehabilitación Oral, Docente del Área de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.; Angulo de la Vega, Giselle; Cirujano Dentista, Estudios de Especialidad de Rehabilitación Oral de la Facultad de Odontología de la UNMSM.; Cardoso Hernández, Sully; Estudiante de internado de la Facultad de Odontología de la UNMSM.

    2014-01-01

    Nowadays is fundamental the interrelationship of the diverse specialities of dentistry for the resolution of the treatments realized in the patients who come to the odontologic consultation, since the vision slanted of some area can deprive to offer a better possibility of treatment. Working with specialists in different areas carries to orientating adequately the treatments and to optimizing results. In the present article the integral rehabilitation of a patient is detailed by the participa...

  12. Early rehabilitation after stroke

    OpenAIRE

    Bernhardt, Julie; Godeckeb, Erin; Johnson, Liam; Langhorne, Peter

    2017-01-01

    Purpose of review: \\ud Early rehabilitation is recommended in many guidelines, with limited evidence to guide practice. Brain\\ud neurobiology suggests that early training, at the right dose, will aid recovery. In this review, we highlight\\ud recent trials of early mobilization, aphasia, dysphagia and upper limb treatment in which intervention is\\ud commenced within 7 days of stroke and discuss future research directions.\\ud Recent findings: \\ud Trials in this early time window are few. Althou...

  13. [Cardiac rehabilitation in women].

    Science.gov (United States)

    Ghannem, M; Ghannem, L; Lamouchi, S; Justin, K D; Meimoun, P; Ghannem, L

    2016-12-01

    Coronary artery disease (CAD) occurs later in life in women when compared to men (10 years later). The FAST-MI study has shown that the profile of women with CAD has changed in the past 15 years, they are younger, more obese, and usually smokers. Whatever the age at which CAD occurs in women, the prognosis tends to be worse than in men, despite a higher frequency of acute coronary syndrome (ACS) with angiographically normal coronary arteries in women. In women without significant lesion at coronary angiography, the WISE study has shown abnormalities of the coronary vasomotricy. Despite its beneficial effect on morbidity and mortality, cardiac rehabilitation is underused particularly in women. Indeed, several factors do not encourage a woman to follow a cardiac rehabilitation program, even after an ACS. These factors may be cultural, domestic, familial, orthopedic, or even the fear of exercising. Therefore, physicians have to be particularly convincing in women, in order to have them participating in rehabilitation programs. Physical capacity is lower in women when compared to men. However, the weaker the physical capacity, the better the benefit of cardiac rehabilitation. Physical endurance training continuously or in interval, associated to muscle strengthening can improve the physical capacity in women. Vascular risk factors correction is also an important step for the management of women with CAD. Therapeutic education and several available workshops help women to better understand their disease and to improve their self-management when they return home. Anxiety, depression, and sexual dysfunction frequently deteriorate the quality of life of our patients. Therefore, psychological management is also essential in our departments. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. REHABILITATION PRACTICAL PROGRAMME

    Directory of Open Access Journals (Sweden)

    Suzana KRANJC JOLDIKJ

    Full Text Available Centre for Education and Rehabilitation of Physi­cally Handicapped Children and Adolescents Kamnik (Zavod za usposabljanje invalidne mlad­ine Kamnik; hereinafter: ZUIM perform verified or state-ap­proved programme the Rehabilitation practical pro­gramme. The programme is intended for all those young people, who have completed primary school education, but cannot continue regular schooling in secondary school pro­grammes. The programme con­sists of several equivalent parts: education, practical work, train­ing work, health, therapeutic, psychologi­cal, and other activities. For every beginner in the first month of education members of the operative team create an individualized programme, which in­cludes individualized school work, individualized training programme, and other expert activities. The programme can last for 6 years maximum, it can however be completed earlier, when the op­erative team feels the training is no longer neces­sary. Pro­gress of a young person is what matters the most, and if there is no progress, the training is brought to an end. Training of young people in the Rehabilitation practical programme is only the be­ginning. The country will have to start considering social enter­prises, which are found elsewhere in the world, for example in Scandinavian countries and in the USA.

  15. [Cognitive rehabilitation of amusia].

    Science.gov (United States)

    Weill-Chounlamountry, A; Soyez-Gayout, L; Tessier, C; Pradat-Diehl, P

    2008-06-01

    The cognitive model of music processing has a modular architecture with two main pathways (a melody pathway and a time pathway) for processing the musical "message" and thus enabling music recognition. It also features a music-specific module for tonal encoding of pitch which stands apart from all other known cognitive systems (including language processing). To the best of our knowledge, rehabilitation therapy for amusia has not yet been reported. We developed a therapeutic method (inspired by work on word deafness) in order to determine whether specific rehabilitation based on melody discrimination could prompt the regression of amusia. We report the case of a patient having developed receptive, acquired amusia four years previously. His tone deafness disorder was assessed using the Montreal Battery of Evaluation of Amusia (MBEA), which revealed impairment of the melody pathway but no deficiency in the time pathway. A computer-assisted rehabilitation method was implemented; it used melody discrimination tasks and an errorless learning paradigm with progressively fading visual cues. After therapy, we noted an improvement in the overall MBEA score and its component subscores which could not be explained by spontaneous recovery (in view of the number of years since the neurological accident). The improvement was maintained at seven months post-therapy. Although post-therapy improvement in daily life was not systematically assessed, the patient started listening to his favourite music again. Specific amusia therapy has shown efficacy.

  16. Commentary on Stiers and colleagues' guidelines for competency development and measurement in rehabilitation psychology postdoctoral training.

    Science.gov (United States)

    Hatcher, Robert L

    2015-05-01

    Comments on the article, "Guidelines for competency development and measurement in rehabilitation psychology postdoctoral training," by Stiers et al. (see record 2014-55195-001). Stiers and colleagues have provided a thorough and well-conceived set of guidelines that lay out the competencies expected for graduates of postdoctoral residencies in rehabilitation psychology, accompanied by a set of more specific, observable indicators of the residents' competence level. This work is an important aspect of the broader project of the Rehabilitation Psychology Specialty Council (APA Division 22, the American Board of Rehabilitation Psychology, the Foundation for Rehabilitation Psychology, the Academy of Rehabilitation Psychology, and the Council of Rehabilitation Psychology Postdocotral Training Programs) to develop overall guidelines for programs providing postdoctoral training in this field (Stiers et al., 2012). (c) 2015 APA, all rights reserved).

  17. Globalizing rehabilitation psychology: Application of foundational principles to global health and rehabilitation challenges.

    Science.gov (United States)

    Bentley, Jacob A; Bruyère, Susanne M; LeBlanc, Jeanne; MacLachlan, Malcolm

    2016-02-01

    This article reviewed foundational principles in rehabilitation psychology and explored their application to global health imperatives as outlined in the World Report on Disability (World Health Organization & World Bank, 2011). Historical theories and perspectives are used to assist with conceptual formulation as applied to emerging international rehabilitation psychology topics. According to the World Report on Disability (World Health Organization & World Bank, 2011), there are approximately 1 billion individuals living with some form of disability globally. An estimated 80% of persons with disabilities live in low- to middle-income countries (WHO, 2006). The primary messages and recommendations of the World Report on Disability have been previously summarized as it relates to potential opportunities for contribution within the field of rehabilitation psychology (MacLachlan & Mannan, 2014). Yet, undeniable barriers remain to realizing the full potential for contributions in low- to middle-income country settings. A vision for engaging in international capacity building and public health efforts is needed within the field of rehabilitation psychology. Foundational rehabilitation psychology principles have application to the service of individuals with disabilities in areas of the world facing complex socioeconomic and sociopolitical challenges. Foundational principles of person-environment interaction, importance of social context, and need for involvement of persons with disabilities can provide guidance to the field as it relates to global health and rehabilitation efforts. The authors illustrate the application of rehabilitation psychology foundational principles through case examples and description of ongoing work, and link foundational principles to discreet domains of intervention going forward. (c) 2016 APA, all rights reserved).

  18. Occupational rehabilitation in Hong Kong: current status and future needs.

    Science.gov (United States)

    Kwok, H K H; Szeto, G P Y; Cheng, A S K; Siu, H; Chan, C C H

    2011-03-01

    This paper reviews the development of occupational rehabilitation in Hong Kong, both in terms of the science as well as the service for injured workers. Besides, it also reviews the existing Employees' Compensation Ordinance for work injury to illustrate how the policy could influence the success and development of the discipline. Five experienced occupational rehabilitation providers, including 1 occupational medicine specialist, 3 occupational therapists, and 1 physiotherapist critically reviewed the past and current development of occupational rehabilitation in Hong Kong as well as the local contextual factors, which could influence its future development. Since the enactment of the Employees' Compensation Ordinance in the 1950s, there have been progressive improvements in the field of occupational rehabilitation in Hong Kong. Services in the early years were mostly based on the biomedical model, where doctors and patients tended to focus on clinical symptoms and physical pathology when making clinical decisions. Since then, remarkable academic achievements have been made in the field locally, from the validation of clinical instruments for assessment of work capacity, assessment of employment readiness to the evaluation of efficacy of interventional programs for injured workers focusing on work related outcomes. However, there has been a relatively lack of progress in the development of related policies and implementation of related programs for occupational rehabilitation. There is no built in linkage between rehabilitation, compensation and prevention in the current system in Hong Kong, and there is no rehabilitation policy specific to those workers with occupational diseases and injuries. There are still deficiencies in the development and provision of occupational rehabilitation services in Hong Kong. Incorporation of requirements for occupational rehabilitation at the legislation and policy levels should be seriously considered in the future. Besides, the

  19. [Treadmills in rehabilitation medicine: technical characteristics and selection criteria].

    Science.gov (United States)

    Capodaglio, P; Vercelli, S; Colombo, R; Capodaglio, E M; del Moro, V Mattai; Franchignoni, F

    2008-01-01

    The treadmill is a commonly used means of testing and training patients with cardiopulmonary diseases. There is growing interest in the use of the treadmill also for rehabilitation of patients with orthopaedic and neurological diseases. Commercially available treadmills show wide differences in terms of structure and function that have a direct impact on the specific rehabilitation protocols. The aims of this paper are: a) to briefly review the physiology and biomechanics of treadmill exercise as compared to overground walking; b) to point out the technical specifications of treadmills suitable for rehabilitation settings; c) to provide guidelines for treadmill selection in the different categories of rehabilitation patients. First, the different physiological and biomechanical characteristics of walking on a treadmill and overground are discussed. Uphill and downhill walking as well as backward walking are also presented together with the spin-offs for rehabilitation practice. Then, the technical features of treadmills (treadbelt, frame, bars, deck, rollers, shock absorption, elevation motor, drive motor, flywheel, display) are described and the specific requisites for the different patient categories undergoing rehabilitation are discussed in detail. Finally, guidelines and a flow-chart for identifying the main technical requisites for appropriate treadmill selection in the different disabilities are provided. A summary table of the technical specifications of the commercially available rehabilitation treadmills is also included.

  20. Recent Development of Rehabilitation Robots

    Directory of Open Access Journals (Sweden)

    Zhiqin Qian

    2015-02-01

    Full Text Available We have conducted a critical review on the development of rehabilitation robots to identify the limitations of existing studies and clarify some promising research directions in this field. This paper is presented to summarize our findings and understanding. The demands for assistive technologies for elderly and disabled population have been discussed, the advantages and disadvantages of rehabilitation robots as assistive technologies have been explored, the issues involved in the development of rehabilitation robots are investigated, some representative robots in this field by leading research institutes have been introduced, and a few of critical challenges in developing advanced rehabilitation robots have been identified. Finally to meet the challenges of developing practical rehabilitation robots, reconfigurable and modular systems have been proposed to meet the identified challenges, and a few of critical areas leading to the potential success of rehabilitation robots have been discussed.

  1. Evolution of orthopaedic rehabilitation care.

    Science.gov (United States)

    Gordon, Wade T; Stannard, James P; Pasquina, Paul F; Archer, Kristin R

    2012-01-01

    Rehabilitation following surgical reconstruction for combat-related extremity injuries sustained in the current conflicts in Iraq and Afghanistan has been challenging. The goal of rehabilitation is to restore limb function to facilitate the reintegration of patients with these severe injuries into society. The US Department of Defense has developed a network of rehabilitation centers of excellence within the military healthcare system in collaboration with the US Department of Veterans Affairs to optimize outcomes using technologic and systemic advances in prostheses in patients who have undergone limb salvage procedures or amputation. Managing pain during rehabilitation and optimizing function following high bilateral lower extremity amputation remains a clinical challenge. However, continued research is likely to improve outcomes in this severely injured patient population. To that end, two research consortia, the Bridging Advanced Developments for Exceptional Rehabilitation and the Center for Rehabilitation Sciences Research, have recently been created to address identified knowledge gaps.

  2. 38 CFR 21.70 - Vocational rehabilitation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Vocational rehabilitation...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Duration of Rehabilitation Programs § 21.70 Vocational rehabilitation. (a) General. The goal of a...

  3. 48 CFR 871.208 - Rehabilitation facilities.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Rehabilitation facilities... DEPARTMENT SUPPLEMENTARY REGULATIONS LOAN GUARANTY AND VOCATIONAL REHABILITATION AND EMPLOYMENT PROGRAMS Vocational Rehabilitation and Employment Service 871.208 Rehabilitation facilities. Charges by rehabilitation...

  4. Rehabilitative Soft Exoskeleton for Rodents.

    Science.gov (United States)

    Florez, Juan Manuel; Shah, Manan; Moraud, Eduardo Martin; Wurth, Sophie; Baud, Laetitia; Von Zitzewitz, Joachim; van den Brand, Rubia; Micera, Silvestro; Courtine, Gregoire; Paik, Jamie

    2017-02-01

    Robotic exoskeletons provide programmable, consistent and controllable active therapeutic assistance to patients with neurological disorders. Here we introduce a prototype and preliminary experimental evaluation of a rehabilitative gait exoskeleton that enables compliant yet effective manipulation of the fragile limbs of rats. To assist the displacements of the lower limbs without impeding natural gait movements, we designed and fabricated soft pneumatic actuators (SPAs). The exoskeleton integrates two customizable SPAs that are attached to a limb. This configuration enables a 1 N force load, a range of motion exceeding 80 mm in the major axis, and speed of actuation reaching two gait cycles/s. Preliminary experiments in rats with spinal cord injury validated the basic features of the exoskeleton. We propose strategies to improve the performance of the robot and discuss the potential of SPAs for the design of other wearable interfaces.

  5. Adapting Playware to Rehabilitation Practices

    DEFF Research Database (Denmark)

    Nielsen, Camilla Balslev; Lund, Henrik Hautop

    2012-01-01

    We describe how playware and games may become adaptive to the interaction of the individual user and how therapists use this adaptation property to apply modular interactive tiles in rehabilitation practices that demand highly individualized training. Therapists may use the interactive modular...... tiles to provide treatment for a large number of patients who receive hospital, municipality or home care, although the tiles can as well be used for prevention with elderly or for fitness with normal people. In this paper, we describe the extensive use of the modular tiles with cardiac patients, smoker......’s lung (COLD) patients and stroke patients in hospitals and in the private homes of patients and elderly. Through a qualitative research methodology of the new practice with the tiles, we find that therapists are using the modular aspect of the tiles for personalized training of a vast variety of elderly...

  6. Adapting Playware to Rehabilitation Practices

    DEFF Research Database (Denmark)

    Nielsen, Camilla Balslev; Lund, Henrik Hautop

    2011-01-01

    We describe how playware and games may become adaptive to the interaction of the individual user and how therapists use this adaptation property to apply modular interactive tiles in rehabilitation practices that demand highly individualized training. Therapists may use the interactive modular...... tiles to provide treatment for a large number of patients who receive hospital, municipality or home care, although the tiles can as well be used for prevention with elderly or for fitness with normal people. In this paper, we describe the extensive use of the modular tiles with cardiac patients, smoker......’s lung (COLD) patients and stroke patients in hospitals and in the private homes of patients and elderly. Through a qualitative research methodology of the new practice with the tiles, we find that therapists are using the modular aspect of the tiles for personalized training of a vast variety of elderly...

  7. Psychology in sports injury rehabilitation.

    Science.gov (United States)

    Concannon, Michael; Pringle, Bob

    Using the case study of an 18-year-old track athlete with a chronic Achilles tendinopathy, this article identifies risk factors associated with training for major athletic events, such as the forthcoming Olympic Games, and presents evidence for adopting a multidisciplinary approach to the treatment and management of athletic injury, addressing the physical aspects of the injury, as well as the psychological needs of the athlete. The athlete's GP and practice nurse, as well as a podiatrist and sport psychologist, are all involved in providing an accurate clinical diagnosis, effective physical intervention, and psychological skills training to address emotional issues and encourage adherence to the rehabilitation programme. Nurses, in both secondary and primary care, can play a crucial role; in this case, the practice nurse recognised the adverse impact that the injury was having on the athlete's emotional wellbeing before making a referral to a trained sport psychologist.

  8. A systematic review of cardiac rehabilitation registries.

    Science.gov (United States)

    Poffley, Alison; Thomas, Emma; Grace, Sherry L; Neubeck, Lis; Gallagher, Robyn; Niebauer, Josef; O'Neil, Adrienne

    2017-10-01

    Introduction Despite cardiac rehabilitation being recommended in clinical practice guidelines internationally these services are underutilised, programmes are not standardised and quality improvement methods and outcomes are rarely published. National registries are an important strategy to characterise service delivery, quality and outcomes, yet the number, type and components of national cardiac rehabilitation registries have not been reported. Aims To identify and describe national and international cardiac rehabilitation registries, and summarise their key features. Methods We systematically reviewed the literature reporting on cardiac rehabilitation registries at a national and international level. A search of four databases was conducted in July 2016, with two reviewers independently screening titles/abstracts and full texts for inclusion. Data were extracted from included studies, independently checked by a second reviewer and synthesised qualitatively. Results Eleven articles were included in the review comprising seven national registries and one international registry (of 12 European countries) for a total sample of 265,608 patients. Data were most commonly provided to the registry by a web-based application, and included individual-level data (i.e. sociodemographic characteristics, medical history, and clinical measurements). When reported, service-level data most commonly included wait times, programme enrolment and completion. The overarching governance, funding modes (e.g. industry ( n = 2), government ( n = 1)), and incentives for registry participation (e.g. benchmarking, financial reimbursement, or mandatory requirement) varied widely. Conclusion The use of national and international registries for characterising cardiac rehabilitation and providing a benchmark for quality improvement is in its early stages but shows promise for national and global benchmarking.

  9. Cupping for stroke rehabilitation: a systematic review.

    Science.gov (United States)

    Lee, Myeong Soo; Choi, Tae-Young; Shin, Byung-Cheul; Han, Chang-ho; Ernst, Edzard

    2010-07-15

    Cupping is often used for stroke rehabilitation in Asian countries. Currently, no systematic review of this topic is available. The aim of this systematic review is to summarize and critically evaluate the evidence for and against the effectiveness of cupping for stroke rehabilitation. Thirteen databases were searched from their inception through March of 2010 without language restrictions. Prospective clinical trials were included if cupping was tested as the sole treatment or as an adjunct to other conventional treatments for stroke rehabilitation. We found 43 potentially relevant articles, of which 5 studies including 3 randomized clinical trials (RCTs) and 2 uncontrolled observational studies (UOSs) met our inclusion criteria. Cupping was compared with acupuncture, electro-acupuncture and warm needling. Some superior effects of cupping were found in two of the RCTs when compared to acupuncture in hemiplegic shoulder pain and high upper-limb myodynamia after stroke. The other RCT failed to show favorable effects of cupping when compared to acupuncture and warm needling in patients with hemiplegic hand edema. The two UOSs reported favorable effects of cupping on aphasia and intractable hiccup after stroke. There are not enough trials to provide evidence for the effectiveness of cupping for stroke rehabilitation because most of the included trials compared the effects with unproven evidence and were not informative. Future RCTs seem warranted but must overcome the methodological shortcomings of the existing evidence. Copyright 2010 Elsevier B.V. All rights reserved.

  10. [Contribution of psychomotricity in respiratory rehabilitation programs].

    Science.gov (United States)

    Aumignon, M; Kreutz, G; Beauchet, K; Gindre, D

    2002-02-01

    Pulmonary rehabilitation traditionally benefits COPD patients through physical training, optimization of medical treatment, education and nutritional advice. In this paper we introduce psychomotricity which provides these with a more global approach to pulmonary rehabilitation. This approach takles postural tone, mobility, anxiety and self-confidence in order to improuve control of breathing and perception of breathlessness. Consequently handicap is reduced and its adverse effects are curbed. Psychomotricity, through corporeal techniques and relaxation, complements the other components of pulmonary rehabilitation. We report on our experience with ninety patients. All the assessments were carried out before and after the program. This study showed significant improvement in many outcomes including psychomotricity assessments, quality-of-life questionnaire scores and visual analogue scales. Psychomotricity, when incorporated into a multi-disciplinary rehabilitation program, appears to help patients regain self-confidence and use their capacities in a better way. This technique gives patients better control over their handicap and allows them to face the future with more dignity.

  11. Teaching the foundational principles of rehabilitation psychology.

    Science.gov (United States)

    Stiers, William

    2016-02-01

    Wright (1983) described 20 "value-laden beliefs and principles" that form the foundational principles of rehabilitation psychology, and the education and training of rehabilitation psychologists necessitates that they acquire the specialty-specific knowledge and attitudes/values related to these principles. This article addresses 2 questions about how these principles can be taught in rehabilitation psychology training: (a) What are the core theories and evidence supporting these foundational principles, and what should be the content of a "core curriculum" for teaching these?; and (b) What is known about the most effective methods for teaching these foundational principles, including questions of how to teach values? The foundational principles were grouped into 3 categories: individual psychological processes, social psychological processes, and values related to social integration. A literature review was conducted in these 3 categories, and the results are summarized and discussed. A core curriculum is discussed for teaching about disability-specific individual psychological processes, social psychological processes, and values related to social integration, including methods to reduce group prejudice and promote values relevant to the foundational principles. Specific suggestions for training program content and methods are provided. It is hoped that effective teaching of Wright's (1983) value-laden beliefs and principles will help rehabilitation psychology trainers and trainees focus on the key knowledge and attitude-value competencies that are to be acquired in training. (c) 2016 APA, all rights reserved).

  12. Medical phenomenology and stroke rehabilitation: an introduction.

    Science.gov (United States)

    Goldberg, Gary

    2011-01-01

    This issue of Topics in Stroke Rehabilitation explores the theme of medical phenomenology and stroke rehabilitation through open peer commentary format. The theme is introduced by a brief summary and overview of phenomenology as a branch of philosophy whose focus is the development of methodology for describing and ordering human experience. The application of this philosophical approach to medicine in general and stroke rehabilitation in particular is then considered. An approach to patients informed by both phenomenology and science provides a more complete, holistic, and humanistic framework than science alone. Phenomenology helps the clinician to understand the importance of narrative, the process of adaptation at the level of the integrated whole person, and the important role of context in determining how recovery unfolds. Embodiment is presented as an organizing principle that links the nature of conscious experience in the lived body and the basic transformation in experience and function associated with an acquired pathology such as stroke. Finally, the nature of open peer commentary is considered and introduced in terms of how it has been specifically implemented in this issue of Topics in Stroke Rehabilitation.

  13. Spinal cord lesions - The rehabilitation perspective.

    Science.gov (United States)

    Faria, Filipa

    2006-02-01

    The present study provides an overview of the spinal cord injury focusing mainly on aspects related to rehabilitation. Spinal cord injury affects young people in an active phase of life, determining severe handicaps. Most of the lesions are traumatic, caused by car accidents. Until fifty years ago, the survival of individuals with spinal cord injury was very reduced and the leading cause of death was renal failure. Due to developments in medical knowledge and technical advances, the survival rates have significantly improved. The causes of death have also changed being respiratory complications, particularly pneumonia, the leading causes. Immediately after a spinal cord lesion there is a phase of spinal shock which is characterized by flaccid paralysis and bladder and bowel retention. Progressively there is a return of the spinal cord automatism with the beginning of some reflex activities. Based on neurological evaluation it is pos-sible to predict motor and functional recovery and establish the rehabilitation program. We can consider three phases on the rehabilitation program: the first while the patient is still in bed, directed to prevent or treat complications due to immobility and begin sphincters reeducation; the second phase is intended to achieve wheelchair autonomy; the last phase is training in ortostatism. The rehabilitation program also comprises sports and recreational activities, psychological and social support in order to achieve an integral of the individual with a spinal cord injury. © 2006 Sociedade Portuguesa de Pneumologia/SPP.

  14. Psychosocial factors in sports injury rehabilitation and return to play.

    Science.gov (United States)

    Podlog, Leslie; Heil, John; Schulte, Stefanie

    2014-11-01

    This article discusses the principles and practices that guide psychological intervention with injury, and encourages a psychological approach to injury for clinicians. Part 1 reviews the research literature, and serves as a foundation for the review of clinical practices in part 2. Examination of the research literature highlights 4 areas: (1) psychological factors influencing rehabilitation, (2) social factors affecting rehabilitation, (3) performance concerns among returning athletes, and (4) tools/inventories for assessing psychological readiness to return. A synopsis of an injury intervention plan is provided, and the influence of pain and fear in the rehabilitation process is described. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. [Rehabilitation care for children after trauma in the earthquake disaster].

    Science.gov (United States)

    Yang, Zhi-Quan; Zhang, Qing-Min

    2013-06-01

    For the children who suffer trauma in earthquake, rehabilitation care aims to promote functional recovery, shorten hospital stay, and reduce the incidence of complications or disability by evidence-based, multidisciplinary, and comprehensive early rehabilitation intervention on the basis of first aid and clinical treatment. Children are likely to suffer traumatic brain injury, spinal cord injury, peripheral nerve injury, limb fracture, and amputation in the earthquake disaster, so the clinical rehabilitation care designed considering the characteristics of children should be provided immediately after acute phase of trauma to promote functional recovery.

  16. Center for Rehabilitation Sciences Research

    Data.gov (United States)

    Federal Laboratory Consortium — The Center for Rehabilitation Sciences Research (CRSR) was established as a research organization to promote successful return to duty and community reintegration of...

  17. Penile rehabilitation after radical prostatectomy

    DEFF Research Database (Denmark)

    Fode, Mikkel; Ohl, Dana A; Ralph, David

    2013-01-01

    The pathophysiology of erectile dysfunction after radical prostatectomy (RP) is believed to include neuropraxia, which leads to temporarily reduced oxygenation and subsequent structural changes in penile tissue. This results in veno-occlusive dysfunction, therefore, penile rehabilitation programmes...... compared with placebo. The effects of prostaglandin and vacuum erection devices are questionable and high-quality studies are lacking. Better documentation for current penile rehabilitation and/or better rehabilitation protocols are needed. One must be careful not to repeat the statement that penile...... rehabilitation improves erectile function after RP so many times that it becomes a truth even without the proper scientific backing....

  18. New methodologies for patients rehabilitation.

    Science.gov (United States)

    Fardoun, H M; Mashat, A S; Lange, B

    2015-01-01

    The present editorial is part of the focus theme of Methods of Information in Medicine titled "New Methodologies for Patients Rehabilitation", with a specific focus on technologies and human factors related to the use of Information and Communication Technologies (ICT) for improving patient rehabilitation. The focus theme explores different dimensions of empowerment methodologies for disabled people in terms of rehabilitation and health care, and to explores the extent to which ICT is a useful tool in this process. The focus theme lists a set of research papers that present different ways of using ICT to develop advanced systems that help disabled people in their rehabilitation process.

  19. Exercise rehabilitation for smartphone addiction

    National Research Council Canada - National Science Library

    Hyunna Kim

    2013-01-01

    Internet addiction after launching smartphone is becoming serious. Therefore this paper has attempted to sketch out the diverse addiction treatment and then check the feasibility of exercise rehabilitation...

  20. Optimizing engagement in goal pursuit with youth with physical disabilities attending life skills and transition programs: an exploratory study.

    Science.gov (United States)

    Smart, Eric; Aulakh, Adeeta; McDougall, Carolyn; Rigby, Patty; King, Gillian

    2017-10-01

    Identify strategies youth perceive will optimize their engagement in goal pursuit in life skills and transition programs using an engagement framework involving affective, cognitive, and behavioral components. A qualitative descriptive design was used. Two semi-structured interviews were conducted with seven youth. The first was informed by a prior observation session, and the second occurred after the program ended and explored youths' perceptions of whether and how their engagement changed. Data were analyzed using thematic analysis. The analysis generated eight strategies youth considered effective. These were categorized under the three components of engagement. Affective strategies: (1) building a relationship on familiarity and reciprocity; and (2) guiding the program using youths' preferences and strengths. Cognitive strategies: (3) assisting youth to envision meaningful change; (4) utilizing youths' learning styles; and (5) promoting awareness of goal progress. Behavioral strategies: (6) ensuring youth access to a resource network; (7) providing youth multiple decision opportunities; and (8) enabling youth to showcase capabilities. Service providers together with youth are encouraged to consider the role of context and self-determination needs in order to optimize youth engagement in goal pursuit. Systematic approaches to studying engagement are necessary to learn how to maximize rehabilitation potential. Implications for Rehabilitation Service providers are encouraged to be aware of the nature of engagement strategies identified by youth. Comprehensive frameworks of engagement are essential to generate knowledge on the range of strategies service providers can use to engage clients in rehabilitation services. Strategies perceived by youth to optimize their engagement in goal pursuit in life skills and transition programs have subtle yet significant differences with strategies used in other rehabilitation settings like mental health and adult healthcare

  1. Rehabilitation after arthroscopic rotator cuff repair: current concepts review and evidence-based guidelines.

    Science.gov (United States)

    van der Meijden, Olivier A; Westgard, Paul; Chandler, Zachary; Gaskill, Trevor R; Kokmeyer, Dirk; Millett, Peter J

    2012-04-01

    To provide an overview of the characteristics and timing of rotator cuff healing and provide an update on treatments used in rehabilitation of rotator cuff repairs. The authors' protocol of choice, used within a large sports medicine rehabilitation center, is presented and the rationale behind its implementation is discussed. If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment. It is evident that a successful outcome after surgical rotator cuff repair is as much dependent on surgical technique as it is on rehabilitation. To this end, rehabilitation protocols have proven challenging to both the orthopaedic surgeon and the involved physical therapist. Instead of being based on scientific rationale, traditionally most rehabilitation protocols are solely based on clinical experience and expert opinion. A review of currently available literature on rehabilitation after arthroscopic rotator cuff tear repair on PUBMED / MEDLINE and EMBASE databases was performed to illustrate the available evidence behind various postoperative treatment modalities. There is little high-level scientific evidence available to support or contest current postoperative rotator cuff rehabilitation protocols. Most existing protocols are based on clinical experience with modest incorporation of scientific data. Little scientific evidence is available to guide the timing of postsurgical rotator cuff rehabilitation. To this end, expert opinion and clinical experience remains a large facet of rehabilitation protocols. This review describes a rotator cuff rehabilitation protocol that incorporates currently available scientific literature guiding rehabilitation.

  2. Ethical considerations in transition.

    Science.gov (United States)

    Kaufman, Hannah; Horricks, Laurie; Kaufman, Miriam

    2010-01-01

    The objective of this paper is to explore ethical issues in the provision of transitional care. Using five case studies a number of ethical issues in transition and transition care are discussed. These issues include: 1) preserving, promoting and ensuring dignity and respect for patients; 2) fostering and supporting the trusting relationships that young people and their parents have for pediatric providers to their new adult providers by using a graduated system of transfer; 3) recognizing graduated capacity; 4) promoting autonomy and self-management; 5) duties of beneficence and non-maleficence; 6) truthtelling; 7) duty to provide developmentally appropriate care; and 8) duty of pediatric providers to advocate for transitioning patients in the adult system. Attention to the ethical issues surrounding these complex cases has the potential to positively influence a successful transition to adult-oriented health care.

  3. Overview of Disability Employment Policy and Rehabilitation Practice in Australia: Implications for Rehabilitation Counselor Education

    Science.gov (United States)

    Matthews, Lynda R.; Buys, Nicholas J.; Crocker, Ruth; Degeneffe, Charles Edmund

    2007-01-01

    This article provides an overview of the development of disability employment policy and rehabilitation services in Australia. In particular, it focuses on recent legislative and policy changes that attempt to address the high rates of welfare dependency, low employment rates and workplace discrimination experienced by people with disabilities. An…

  4. Female urinary incontinence rehabilitation.

    Science.gov (United States)

    Di Benedetto, P

    2004-08-01

    Pelvic floor rehabilitation (PFR) is an important and recommended strategy for the treatment of many urogynecological disorders including urinary incontinence (UI). The recognised pioneer of PFR is the American gynecologist Arnold Kegel who, over 50 years ago, proposed pelvic floor muscle exercises (PFME) to prevent and/or treat female UI. Kegel's techniques were successfully used by others too, but as the years passed these techniques sank into unjustified oblivion. In the 1980s in Europe the medical world's interest in PFME techniques gained ground, contemporaneously with functional electrical stimulation (FES) and biofeedback (BFB). As a general rule, the least invasive and least dangerous procedure for the patient should be the first choice, and behavioural and rehabilitative techniques should be considered as the first line of therapy for UI. The behavioural approaches in women with UI and without cognitive deficits are tailored to the patient's underlying problem, such as bladder training or retraining (BR) for urge UI. BR has many variations but generally consists of education, scheduled voiding, and positive reinforcements. The rehabilitative approaches comprise BFB, FES, PFME, and vaginal cones (VC). BFB allows the subject to modify the unconscious physiological events, while FES is aimed at strengthening perineal awareness, increasing the tone and trophism of the pelvic floor, and inhibiting detrusor overactivity. PFME play an extremely important role in the conservative treatment of UI and overactive bladder, and many studies have demonstrated their effectiveness. Many authors have used the different methods for PFR in a heterogeneous manner: the best results were obtained when protocols requiring the contemporary use of 2 or more techniques were followed.

  5. Rehabilitation of Achilles tendon ruptures: is early functional rehabilitation daily routine?

    Science.gov (United States)

    Frankewycz, B; Krutsch, W; Weber, J; Ernstberger, A; Nerlich, M; Pfeifer, Christian G

    2017-03-01

    Ruptures of the Achilles tendon are the most common tendon injuries of the lower extremities. Besides the initial operative or non-operative treatment, rehabilitation of patients plays a crucial role for tendon healing and long-term outcome. As only limited evidence is available for optimized rehabilitation regimen and guidelines for the initial (e.g., first 6 weeks) rehabilitation are limited, this study investigated the current rehabilitation concepts after Achilles tendon rupture. We analyzed 213 written rehabilitation protocols that are provided by orthopedic and trauma surgery institutions throughout Germany in terms of recommendations for weight-bearing, range of motion (ROM), physiotherapy, and choice of orthosis. All protocols for operatively and non-operatively treated Achilles tendon ruptures were included. Descriptive analysis was carried out and statistical analysis applied where appropriate. Of 213 institutions, 204 offered rehabilitation protocols for Achilles tendon rupture and, therefore, 243 protocols for operative and non-operative treatment could be analyzed. While the majority of protocols allowed increased weight-bearing over time, significant differences were found for durations of fixed plantar flexion between operative (o) and non-operative (n) treatments [fixed 30° (or 20)° to 15° (or 10)°: 3.6 weeks (±0.1; o) vs 4.7 weeks (±0.3; n) (p ≤ 0.0001) and fixed 15° (or 10)° to 0°: 5.8 weeks (±0.1; o) vs 6.6 weeks (±0.2; n) (p ≤ 0.001)]. The mean time of the recommended start of physiotherapy is at 2.9 weeks (±0.2; o) vs 3.3 weeks (±0.4; n), respectively. Our study shows that a huge variability in rehabilitation after Achilles tendon rupture exists. This study shows different strategies in rehabilitation of Achilles tendon ruptures using a convertible vacuum brace system. To improve patient care, further clinical as well as biomechanical studies need to be conducted. This study might serve as basis for prospective

  6. Low Vision Aids and Low Vision Rehabilitation

    Science.gov (United States)

    ... Low Vision Aids Low Vision Resources Low Vision Rehabilitation and Low Vision Aids Leer en Español: La ... that same viewing direction for other objects. Vision rehabilitation: using the vision you have Vision rehabilitation is ...

  7. Rehabilitation in Parkinson Disease

    OpenAIRE

    Dobosiewicz, Anna Maria; Chyba, Piotr; Duda, Grzegorz; Jankiewicz, Małgorzata; Puszcz, Karolina; Zmaczyńska, Teresa

    2017-01-01

    Dobosiewicz Anna Maria, Chyba Piotr, Duda Grzegorz, Jankiewicz Małgorzata, Puszcz Karolina, Zmaczyńska Teresa. Rehabilitation in Parkinson Disease. Journal of Education, Health and Sport. 2017;7(6):244-264. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.804633 http://ojs.ukw.edu.pl/index.php/johs/article/view/4531         The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journa...

  8. Rehabilitation of basketball injuries.

    Science.gov (United States)

    Malanga, Gerard A; Chimes, Gary P

    2006-08-01

    Basketball is one of the most popular sports in the United States and throughout the world, and therefore represents one of the most common sources of sports-related injuries. Basketball injuries should be managed by the same general rehabilitation principles as other sports injuries. Additionally, the clinician should be aware not only of general sports injuries but of those injuries most commonly seen in basketball players. By maintaining knowledge of the most common basketball injuries as well as their diagnosis and treatment, the clinician can help to optimize the athlete's return to play and enjoyment of the sport.

  9. Educational and rehabilitation service utilization in adolescents born preterm or with a congenital heart defect and at high risk for disability.

    Science.gov (United States)

    Majnemer, Annette; Dahan-Oliel, Noemi; Rohlicek, Charles; Hatzigeorgiou, Sean; Mazer, Barbara; Maltais, Desiree B; Schmitz, Norbert

    2017-10-01

    This historical cohort study describes the use of educational and rehabilitation services in adolescents born preterm or with a congenital heart defect (CHD). Parents of 76 young people (mean age 15y 8mo [SD 1y 8mo]) with CHD and 125 born ≤29 weeks gestational age (mean age 16y [SD 2y 5mo]) completed a demographics questionnaire including educational and rehabilitation resource utilization within the previous 6 months. Rehabilitation services included occupational therapy, physical therapy, speech language pathology, psychology. Developmental (Leiter Brief IQ, Movement-ABC, Strengths and Difficulties Questionnaire) and functional (Vineland) status of the young people was assessed. Pearson χ(2) tests were used to perform simple pairwise comparisons of categorical outcomes across the two groups (CHD, preterm). Univariate logistic regression was used to examine predictors of service utilization. Developmental profiles of the two groups (CHD/preterm) were similar (29.9%/30% IQeducational supports or attended segregated schools. Only 16% (preterm) and 26.7% (CHD) were receiving rehabilitation services. Services were provided predominantly in the school setting, typically weekly. Few received occupational therapy or physical therapy (1.3-7.6%) despite functional limitations. Leiter Brief IQeducational supports (CHD: OR 5.53, 95% CI 1.29-23.68; preterm: OR 14.63, 3.10-69.08) and rehabilitation services (CHD: OR 4.46, 1.06-18.88; preterm: OR 5.11, 1.41-18.49). Young people with motor deficits were more likely to require educational (CHD: OR 5.72, 1.99-16.42; preterm: OR 3.11, 1.43-6.77) and rehabilitation services (preterm: OR 3.97, 1.21-13.03). Although young people with impairments were more likely to receive educational and rehabilitation services, many may not be adequately supported, particularly by rehabilitation specialists. Rehabilitation services at this important transition phase could be beneficial in optimizing adaptive functioning in the home, school, and

  10. What Do Stroke Patients Look for in Game-Based Rehabilitation

    Science.gov (United States)

    Hung, Ya-Xuan; Huang, Pei-Chen; Chen, Kuan-Ta; Chu, Woei-Chyn

    2016-01-01

    Abstract Stroke is one of the most common causes of physical disability, and early, intensive, and repetitive rehabilitation exercises are crucial to the recovery of stroke survivors. Unfortunately, research shows that only one third of stroke patients actually perform recommended exercises at home, because of the repetitive and mundane nature of conventional rehabilitation exercises. Thus, to motivate stroke survivors to engage in monotonous rehabilitation is a significant issue in the therapy process. Game-based rehabilitation systems have the potential to encourage patients continuing rehabilitation exercises at home. However, these systems are still rarely adopted at patients’ places. Discovering and eliminating the obstacles in promoting game-based rehabilitation at home is therefore essential. For this purpose, we conducted a study to collect and analyze the opinions and expectations of stroke patients and clinical therapists. The study is composed of 2 parts: Rehab-preference survey – interviews to both patients and therapists to understand the current practices, challenges, and expectations on game-based rehabilitation systems; and Rehab-compatibility survey – a gaming experiment with therapists to elaborate what commercial games are compatible with rehabilitation. The study is conducted with 30 outpatients with stroke and 19 occupational therapists from 2 rehabilitation centers in Taiwan. Our surveys show that game-based rehabilitation systems can turn the rehabilitation exercises more appealing and provide personalized motivation for various stroke patients. Patients prefer to perform rehabilitation exercises with more diverse and fun games, and need cost-effective rehabilitation systems, which are often built on commodity hardware. Our study also sheds light on incorporating the existing design-for-fun games into rehabilitation system. We envision the results are helpful in developing a platform which enables rehab-compatible (i.e., existing

  11. Advanced robotics for medical rehabilitation current state of the art and recent advances

    CERN Document Server

    Xie, Shane

    2016-01-01

    Focussing on the key technologies in developing robots for a wide range of medical rehabilitation activities – which will include robotics basics, modelling and control, biomechanics modelling, rehabilitation strategies, robot assistance, clinical setup/implementation as well as neural and muscular interfaces for rehabilitation robot control – this book is split into two parts; a review of the current state of the art, and recent advances in robotics for medical rehabilitation. Both parts will include five sections for the five key areas in rehabilitation robotics: (i) the upper limb; (ii) lower limb for gait rehabilitation (iii) hand, finger and wrist; (iv) ankle for strains and sprains; and (v) the use of EEG and EMG to create interfaces between the neurological and muscular functions of the patients and the rehabilitation robots. Each chapter provides a description of the design of the device, the control system used, and the implementation and testing to show how it fulfils the needs of that specific ...

  12. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to Home Kim Eberhardt Muir, MS Coping with ... Disabilities Photography by Rona Talcott Website by Mobile Marketing LLC Understanding Spinal Cord Injury About Us Expert ...

  13. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Living with SCI Personal Experiences by Topic Resources Peer ... Injuries Spinal Cord Injury 101 David Chen, MD Preventing Pressure Sores Mary Zeigler, MS Transition from Hospital to ...

  14. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Injury Chart Spinal Cord Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury ... Pressure Sores Mary Zeigler, MS Transition from Hospital to Home Kim Eberhardt Muir, MS Coping with a New ...

  15. Theoretical aspects of goal-setting and motivation in rehabilitation.

    Science.gov (United States)

    Siegert, Richard J; Taylor, William J

    2004-01-07

    The purpose of this article is to provide rehabilitation theorists and researchers with an introduction to some key theories of goals and motivation from the field of social cognition and to argue for increased dialogue between the two disciplines. The use of goals and goal-setting in rehabilitation is briefly surveyed and the somewhat ambivalent attitude toward the concept of motivation in the rehabilitation literature is highlighted. Three major contributors to the study of goals and motivation from the field of social cognition are introduced and their work summarized. They include: (i) Deci and Ryan's Self-Determination Model; (ii) Emmons' work on goals and personal strivings, and (iii) Karniol and Ross' discussion of temporal influences on goal-setting. It is argued that there is a need for a greater emphasis upon theory development in rehabilitation research and that closer collaboration between researchers in rehabilitation and social psychology offers considerable promise. Instances where the three theories from social cognition might have relevance to clinical rehabilitation settings are described. Some possible directions for research are also briefly sketched. Both rehabilitation and social cognition have much to gain from increased dialogue.

  16. [Sequelae of severe injuries : consequences for trauma rehabilitation].

    Science.gov (United States)

    Simmel, S; Bühren, V

    2013-09-01

    Consequences of accidents are found not only in physical but also in psychological and social areas. The quality of life of severely injured patients is significantly reduced compared with the normal population even years after the trauma. Subjective experiences of severely injured patients during and after hospitalization have a major impact on the subsequent quality of life. Knowledge of these factors is essential for the planning, organization and implementation of rehabilitation after severe injury. The phase model of rehabilitation after trauma requires early initiation of therapy even during acute treatment as so-called early rehabilitation. After a specialized post-acute rehabilitation additional therapeutic options are often required. Besides pain management the focus lies especially in work-related rehabilitation and psychological support which is also decisive for the success of rehabilitation of accident victims. For severely injured patients it is important to provide sufficient support, e.g. through a case manager which does not end with discharge from the rehabilitation facility. The aim of all efforts is reintegration into the working and social environment and the best possible quality of life.

  17. Attitude to rehabilitative counselling in southwestern Nigerian prisons.

    Science.gov (United States)

    A Alao, Kayode; F Adebowale, Olusegun

    2014-01-01

    The purpose of this paper was to examine the attitudes of prison inmates and warders (prison staff) to rehabilitative counselling and its relationship to their prison status on one hand and their educational attainment on the other. The study adopts a descriptive survey research design. In all 123 prison inmates and 110 warders were selected by stratified random sampling from Osogbo prison headquarters, as well as Ilesa and Ile-Ife prisons in southwestern Nigeria. Data were collected through a self-constructed questionnaire titled "inmate and prison staff attitude to rehabilitation counselling". Data collected were analysed using percentages and χ2 statistics. The results showed that the prison inmates and staff possessed positive attitude to rehabilitative counselling. No significant difference was found between the attitudes of prison inmates and staff members or on the basis of their prison statuses. However, the study found a significant relationship between the prison inmates' attitude to rehabilitative counselling and their educational attainment. Research LIMITATIONS/IMPLICATIONS: Statutory provision needs be made for professional rehabilitative counselling in Nigerian prisons in contrast to the religious instructions currently being allowed prisoners. Educational opportunities should be provided to ensure that the knowledge so obtained complements the rehabilitative counselling. Originality/value - This paper fulfils an identified need to study the attitude towards rehabilitative counselling.

  18. Rehabilitation for Shoulder Instability - Current Approaches.

    Science.gov (United States)

    Jaggi, Anju; Alexander, Susan

    2017-01-01

    The shoulder relies predominantly on dynamic muscular control to provide stability. Successful treatment is highly dependent upon the correct clinical diagnosis, identification of anatomical structural defects and abnormal movement patterns so that rehabilitation programs can be designed accordingly and individualised to the patient. A systematic outline is provided to guide the clinician on how to identify muscular insufficiencies both local to the shoulder joint and global muscles that can influence shoulder instability. Management is based on expert experience and current literature. The Stanmore classification helps to correctly diagnose the type of instability and prioritise management. Symptom modification tests can help to guide management, however assessing individual muscle groups local to glenohumeral control is also recommended. Physical and psychosocial factors can influence motor control in the presence of pain and injury. A multi-disciplinary approach is required to avoid recurrence of symptoms with rehabilitation focusing on kinetic chain, scapular and gleno-humeral control.

  19. Rehabilitation for Shoulder Instability – Current Approaches

    Science.gov (United States)

    Jaggi, Anju; Alexander, Susan

    2017-01-01

    Background: The shoulder relies predominantly on dynamic muscular control to provide stability. Successful treatment is highly dependent upon the correct clinical diagnosis, identification of anatomical structural defects and abnormal movement patterns so that rehabilitation programs can be designed accordingly and individualised to the patient. Method: A systematic outline is provided to guide the clinician on how to identify muscular insufficiencies both local to the shoulder joint and global muscles that can influence shoulder instability. Management is based on expert experience and current literature. Results: The Stanmore classification helps to correctly diagnose the type of instability and prioritise management. Symptom modification tests can help to guide management, however assessing individual muscle groups local to glenohumeral control is also recommended. Conclusion: Physical and psychosocial factors can influence motor control in the presence of pain and injury. A multi-disciplinary approach is required to avoid recurrence of symptoms with rehabilitation focusing on kinetic chain, scapular and gleno-humeral control. PMID:28979601

  20. Robotics in Lower-Limb Rehabilitation after Stroke

    OpenAIRE

    Xue Zhang; Zan Yue; Jing Wang

    2017-01-01

    With the increase in the elderly, stroke has become a common disease, often leading to motor dysfunction and even permanent disability. Lower-limb rehabilitation robots can help patients to carry out reasonable and effective training to improve the motor function of paralyzed extremity. In this paper, the developments of lower-limb rehabilitation robots in the past decades are reviewed. Specifically, we provide a classification, a comparison, and a design overview of the driving modes, traini...

  1. Socially assistive robotics for post-stroke rehabilitation

    OpenAIRE

    Feil-Seifer David J; Eriksson Jon; Matarić Maja J; Winstein Carolee J

    2007-01-01

    Abstract Background Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot...

  2. Rehabilitation centers: marketing analysis and future challenges.

    Science.gov (United States)

    Chandra, Ashish; Stroube, William B; Willis, William K

    2014-01-01

    A rehabilitation center is another form of health care organization that specializes in providing care for particular conditions of patients. Patients admitted in rehab centers range from being accident victims to those suffering with a specific illness. These organizations are becoming extremely valuable in providing patient care services. However, they have not marketed themselves as aggressively as other health care organizations. This article provides an insight regarding rehab centers and examines marketing issues using a SWOT (strengths, weaknesses, opportunities, and threats) analysis. It further provides some future prospects and challenges for marketers of these organizations.

  3. Exploring views on long term rehabilitation for people with stroke in a developing country: findings from focus group discussions

    Science.gov (United States)

    2014-01-01

    Background The importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable. Methods Focus group discussions were conducted involving 15 rehabilitation professionals and eight long term stroke survivors. All recorded conversations were transcribed verbatim and analysed using the principles of qualitative research. Results Both groups agreed that people with stroke may benefit from more rehabilitation compared to the amount of rehabilitation services presently provided. Views regarding the unavailability of long term rehabilitation services due to multi-factorial barriers were recognised. The groups also highlighted the urgent need for the establishment of community-based stroke rehabilitation centres. Family-assisted home therapy was viewed as a potential approach to continued rehabilitation for long term stroke survivors, given careful planning to overcome several family-related issues. Conclusions Barriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors. PMID:24606911

  4. Caltrans : transit funding manual : managing the delivery of transit projects

    Science.gov (United States)

    2001-05-01

    This manual attempts to provide a step by step transit funding process. Included in this manual : is an overview of Caltrans Division of Mass Transportation, roles and responsibilities in : assisting local agencies to deliver transit projects. Transi...

  5. Medical rehabilitation of spinal cord injury following earthquakes in rehabilitation resource-scarce settings: implications for disaster research.

    Science.gov (United States)

    Gosney, J E; Reinhardt, J D; von Groote, P M; Rathore, F A; Melvin, J L

    2013-08-01

    Narrative literature review. To (1) summarize epidemiological and scientific research on spinal cord injury (SCI) populations from three severe earthquakes (EQs) in rehabilitation resource-scarce settings; (2) summarize SCI rehabilitation services by local and foreign providers in response to these EQs and (3) provide implications including research gaps for a supporting global scientific research agenda. International. A literature review was conducted using PubMed to identify epidemiological studies reporting data on SCI survivors of the 2005 Kashmir EQ in Pakistan, the Sichuan EQ of 2008 in China and the 2010 Haiti EQ. A follow-up review on the SCI rehabilitation services provided by local and foreign providers in response to these EQs was also performed. Review of the scientific literature revealed the qualitative trends in focused EQ victim epidemiological data, including SCI classification and types of medical complications. Selected EQ country narratives showed that post-disaster SCI rehabilitation services were expanded by adapting local resources with international assistance to manage the significant numbers of SCI survivors. The resulting SCI research was limited. A global disaster research agenda for SCI in EQs in rehabilitation resource-scarce settings is needed to strengthen the evidence base for improvement of clinical management and outcomes for SCI EQ survivors. Expansion of this limited narrative review into a systematic review to identify additional research gaps is a proposed next step. Effective disaster setting data management and research collaborations of foreign and local SCI disability and rehabilitation stakeholders will be required for agenda implementation.

  6. Grassland rehabilitation (Rehabilitacion de Pastizales)

    Science.gov (United States)

    Mario Royo

    2006-01-01

    The main goal of grassland rehabilitation is to reestablish vegetation, with the objectives of reducing soil erosion, incorporating more rainwater into the soil and aquifer, maintaining biodiversity, restoring scenic beauty, and attaining a site's forage potential, as well as maintaining and reproducing the native fauna. Pastures can be rehabilitated naturally by...

  7. Cancer rehabilitation indicators for Europe

    NARCIS (Netherlands)

    Baili, Paolo; Hoekstra-Weebers, Josette; Van Hoof, Elke; Bartsch, Hans Helge; Travado, Luzia; Garami, Miklos; Di Salvo, Francesca; Micheli, Andrea; Veerus, Piret

    Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel

  8. Rehabilitation following carpal tunnel release

    NARCIS (Netherlands)

    Peters, Susan; Page, Matthew J.; Coppieters, Michel W.; Ross, Mark; Johnston, Venerina

    2016-01-01

    Background: Various rehabilitation treatments may be offered following carpal tunnel syndrome (CTS) surgery. The effectiveness of these interventions remains unclear. This is the first update of a review first published in 2013. Objectives: To review the effectiveness and safety of rehabilitation

  9. 34 CFR 303.653 - Transitional services.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 2 2010-07-01 2010-07-01 false Transitional services. 303.653 Section 303.653 Education Regulations of the Offices of the Department of Education (Continued) OFFICE OF SPECIAL EDUCATION AND REHABILITATIVE SERVICES, DEPARTMENT OF EDUCATION EARLY INTERVENTION PROGRAM FOR INFANTS AND...

  10. [Optimal rehabilitation of patients with coronary heart disease in outpatient setting].

    Science.gov (United States)

    Korzhenkov, N P; Kuzichkina, S F; Shcherbakova, N A; Kukhaleishvili, N R; Iarlykov, I I

    2012-01-01

    The problem of invalid rehabilitation in Russia is an important state task and dictates necessity of design of an effective state program of primary prevention of cardiovascular diseases. Common global practice of medico-social model is based on complex detailed medico-social aid. Rehabilitation of postmyocardial infarction patients consists of three phases (stages): hospital posthospital (readaptation) and postreconvalescent (supportive). The program includes physical, psychological and pharmacological rehabilitation. Departments of readaptation and medico-social rehabilitation provide effective conduction of all kinds of rehabilitation. The Moscow North-East Regional Administration has a rich experience in organization of departments of readaptation and medico-social rehabilitation. The departments practice an individual approach to the patients and work in a close contact with bureaus of medico-social commission of experts. Management of patients by cardiologist, rehabilitation specialist and outpatient clinic's physicians provides uninterrupted staged rehabilitation, timely correction of pharmacotherapy, early patient referral to invasive investigations and treatment of coronary heart disease. A course of rehabilitative measures lasts 2 months. Setting up departments of medico-social rehabilitation in outpatient clinics provides more effective use of money assigned by the state for social support of invalids.

  11. Motivational Rehabilitation using Serious Games

    Directory of Open Access Journals (Sweden)

    Antoni Jaume i Capó

    2013-11-01

    Full Text Available Research studies show that serious games help to motivate users in rehabilitation processes, and rehabilitation results are better when users are motivated. In long term rehabilitation for maintaining capacities, the demotivation of chronic patients is common. In this work, we have implemented balance rehabilitation video game for cerebral palsy patients. The video game was developed using the prototype development paradigm and following desirable features for rehabilitation serious games presented in the literature. We have tested the video game with a set of users who abandoned therapy due to demotivation in the previous year. Results show that the set of users improved their balance and motivation.

  12. Cancer rehabilitation indicators for Europe

    DEFF Research Database (Denmark)

    Baili, Paolo; Hoekstra-Weebers, Josette; Van Hoof, Elke

    2013-01-01

    Little is known of cancer rehabilitation needs in Europe. EUROCHIP-3 organised a group of experts to propose a list of population-based indicators used for describing cancer rehabilitation across Europe. The aim of this study is to present and discuss these indicators. A EUROCHIP-3 expert panel...... reached agreement on two types of indicators. (a) Cancer prevalence indicators. These were proposed as a means of characterising the burden of cancer rehabilitation needs by time from diagnosis and patient health status. These indicators can be estimated from cancer registry data or by collecting data...... on follow-up and treatments for samples of cases archived in cancer registries. (b) Indicators of rehabilitation success. These include: return to work, quality of life, and satisfaction of specific rehabilitation needs. Studies can be performed to estimate these indicators in individual countries...

  13. Rehabilitation Traumatology: A Narrative Review.

    Science.gov (United States)

    Bloodworth, Donna; Pandit, Sindhu; Mullan, Patrick; Chiou-Tan, Faye

    2017-09-01

    Rehabilitation traumatology has developed within the field of physical medicine and rehabilitation as a specialized area of knowledge in which the physiatrist works with the traumatology team to enhance the functional outcome of trauma patients. Based on the definition of traumatology in the American Heritage Dictionary, the authors propose rehabilitation traumatology be "the branch of medicine that deals with the treatment of serious wounds, injuries, and disabilities," "to restore [the patient] to good health or useful life." This article reviews the history of traumatology, special considerations of the traumatology patient through the continuum of care, and concepts toward the creation of a rehabilitation traumatology program. V. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  14. [Cardiac rehabilitation after myocardial infarction].

    Science.gov (United States)

    Ghannem, M; Ghannem, L; Ghannem, L

    2015-12-01

    Although the proofs of the benefits of cardiac rehabilitation accumulate, many patients are not sent to rehabilitation units, especially younger and very elderly patients. As the length of stay in acute care units decreases, rehabilitation offers more time to fully assess the patients' conditions and needs. Meta-analyses of randomised trials suggest that mortality can be improved by as much as 20-30%. In addition, rehabilitation helps managing risk factors, including hyperlipidemia, diabetes, smoking and sedentary behaviours. Physical training also helps improving exercise capacity. Because of all of these effects, cardiac rehabilitation for post-myocardial infarction patients has been given a class IA recommendation in current guidelines. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Arthritis-related work transitions: a prospective analysis of reported productivity losses, work changes, and leaving the labor force.

    Science.gov (United States)

    Gignac, Monique A M; Cao, Xingshan; Lacaille, Diane; Anis, Aslam H; Badley, Elizabeth M

    2008-12-15

    To prospectively examine arthritis-related productivity losses, work changes, and leaving employment, the relationships among these work transitions, and the factors associated with them. Participants with inflammatory arthritis or osteoarthritis were interviewed at 4 time points, 18 months apart, using a structured questionnaire. At baseline (T1), all participants (n = 490; 381 women, 109 men) were employed. At T2, T3, and T4, the sample decreased to 413, 372, and 349 participants, respectively. Respondents were recruited using community advertising and from rheumatology and rehabilitation clinics. Work transitions considered were productivity losses (absenteeism, job disruptions), work changes (reduced hours, changing jobs), and leaving employment. Also measured were demographic, illness, work context, and psychological variables. Generalized estimation equations modeled predictors of work transitions over time. Although 63.1% of respondents remained employed throughout the study, work transitions were common (reported by 76.5% of participants). Productivity losses, especially job disruptions such as being unable to take on extra work, were the most frequently reported. Work transitions were related to subsequently making other work transitions, including leaving employment. Age, sex, education, activity limitations, control, depression, and arthritis-work spillover were also associated with work transitions. This study sheds light on a process of diverse employment changes that may occur in the lives of many individuals with arthritis. It emphasizes the interrelationships among work transitions, as well as other factors in predicting work transitions, and it provides insight into work changes that may signal impending difficulties with remaining employed.

  16. A protocol for the methodological steps used to evaluate the alignment of rehabilitation services in the Western Cape, South Africa with the National Rehabilitation Policy.

    Science.gov (United States)

    Mji, Gubela; Rhoda, Anthea; Statham, Sue; Joseph, Conran

    2017-03-14

    Rehabilitation medicine plays an integral part in attainment of optimal functioning after injury or disease. The National Rehabilitation Policy of South Africa (NRP) (2000) highlights the need for access to professional health care services, redistribution and optimal utilisation of resources and research in the field of disability and rehabilitation. The government further ratified the Convention on the Rights of Persons with Disabilities (CRPD) (2007), which validate the urgency in advancing the agenda of persons with disabilities. This paper outlines the methodological plan for evaluating rehabilitation services in the Western Cape, South Africa against the aims and objectives of the NRP as well as its principles and concepts. The evaluation process further focused on specific articles in the CRPD that were aligned with disability, health and rehabilitation. A mixed-method design was used to evaluate the alignment of rehabilitation services with the NRP in the Western Cape. Four rehabilitation study settings were selected to ensure that both inpatient and outpatient rehabilitation levels of care were covered at different contexts (rural and peri-urban). The sites were checked for the most prevalent rehabilitation-related conditions to ensure the identification of suitable instruments for measuring rehabilitation outcomes. Each study setting was linked to two researchers with one exploring the rehabilitation organizational structure of the sites and the other exploring the client outcomes after receiving rehabilitation services. Patients were evaluated at baseline and discharge, within seven days after admission and seven days prior to discharge. The evaluation was based on the rehabilitation organizational capacity to provide patient-oriented rehabilitation and the measurement of rehabilitation outcomes. Kaplan's framework of organisational capacity was used in the context of each study setting. For the measurement of service users' outcomes, the International

  17. Successive Transitions in Ecodesign

    DEFF Research Database (Denmark)

    Boks, Casper; McAloone, Tim C.

    2008-01-01

    , into acknowledged scientific research regarding technology transfer and commercialisation. This paper proposes that this maturing process took place through a number of transitions; this is illustrated by discussing characteristic aspects of each transition, together providing a historic account of how academic...

  18. Perspectives of Post-Acute Transition of Care for Cardiac Surgery Patients

    Directory of Open Access Journals (Sweden)

    Nicoleta Stoicea

    2017-11-01

    Full Text Available Post-acute care (PAC facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR services, caregiver burden, and the financial impact of care. The objective of this review is to examine existing models of cardiac transitional care, identify major challenges and social factors that affect PAC, and analyze the impact of current transitional care efforts and strategies implemented to improve health outcomes in this patient population. We intend to discuss successful methods to address the following aspects: hospital-PAC linkages, improved discharge planning, caregiver burden, and CR access and utilization through patient-centered programs. Regular home visits by healthcare providers result in decreased hospital readmission rates for patients utilizing home healthcare while improved hospital-PAC linkages reduced hospital readmissions by 25%. We conclude that widespread adoption of improvements in transitional care will play a key role in patient recovery and decrease hospital readmission, morbidity, and mortality.

  19. The long-term impacts of vocational rehabilitation

    OpenAIRE

    Westlie, Lars

    2008-01-01

    This paper investigates empirically how five different vocational rehabilitation (VR) programs affect the transition rate into employment, the consecutive monthly earnings and the employment duration. VR programs increase the employment probability of the participants, but this effect varies substantially between the different programs. VR programs also lead to more stable jobs while the impact on monthly earnings is of minor magnitude. The costs and revenues of the VR programs are calculated...

  20. The Long-Term Impacts of Vocational Rehabilitation

    OpenAIRE

    Westlie, Lars

    2008-01-01

    This paper investigates empirically how five different vocational rehabilitation (VR) programs affect the transition rate into employment, the consecutive monthly earnings and the employment duration. VR programs increase the employment probability of the participants, but this effect varies substantially between the different programs. VR programs also lead to more stable jobs while the impact on monthly earnings is of minor magnitude. The costs and revenues of the VR programs are calculated...

  1. Transitional Justice

    DEFF Research Database (Denmark)

    Gissel, Line Engbo

    This presentation builds on an earlier published article, 'Contemporary Transitional Justice: Normalising a Politics of Exception'. It argues that the field of transitional justice has undergone a shift in conceptualisation and hence practice. Transitional justice is presently understood to be th...

  2. A finger exoskeleton for rehabilitation and brain image study.

    Science.gov (United States)

    Tang, Zhenjin; Sugano, Shigeki; Iwata, Hiroyasu

    2013-06-01

    This paper introduces the design, fabrication and evaluation of the second generation prototype of a magnetic resonance compatible finger rehabilitation robot. It can not only be used as a finger rehabilitation training tool after a stroke, but also to study the brain's recovery process during the rehabilitation therapy (ReT). The mechanical design of the current generation has overcome the disadvantage in the previous version[13], which can't provide precise finger trajectories during flexion and extension motion varying with different finger joints' torques. In addition, in order to study the brain activation under different training strategies, three control modes have been developed, compared to only one control mode in the last prototype. The current prototype, like the last version, uses an ultrasonic motor as its actuator to enable the patient to do extension and flexion rehabilitation exercises in two degrees of freedom (DOF) for each finger. Finally, experiments have been carried out to evaluate the performances of this device.

  3. Modeling stroke rehabilitation processes using the Unified Modeling Language (UML).

    Science.gov (United States)

    Ferrante, Simona; Bonacina, Stefano; Pinciroli, Francesco

    2013-10-01

    In organising and providing rehabilitation procedures for stroke patients, the usual need for many refinements makes it inappropriate to attempt rigid standardisation, but greater detail is required concerning workflow. The aim of this study was to build a model of the post-stroke rehabilitation process. The model, implemented in the Unified Modeling Language, was grounded on international guidelines and refined following the clinical pathway adopted at local level by a specialized rehabilitation centre. The model describes the organisation of the rehabilitation delivery and it facilitates the monitoring of recovery during the process. Indeed, a system software was developed and tested to support clinicians in the digital administration of clinical scales. The model flexibility assures easy updating after process evolution. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. The development of the Pediatric Motivation Scale for rehabilitation.

    Science.gov (United States)

    Tatla, Sandy K; Jarus, Tal; Virji-Babul, Naznin; Holsti, Liisa

    2015-04-01

    Clinicians recognize that client motivation is key to optimizing rehabilitation; however, they are limited in its assessment by a paucity of motivation measures. This paper presents the preliminary psychometrics of the Pediatric Motivation Scale (PMOT) designed to measure motivation from a child's perspective. Content validity of the PMOT was measured through expert feedback (n = 12), and field testing ocurred with 41 children, 21 in rehabilitation and 20 healthy. Pearson product-moment correlations were used to analyze subscale correlations, test-retest reliability, and convergent validity with the Pediatric Volitional Questionnaire (PVQ). Internal consistency was measured using Cronbach's alpha. Preliminary psychometric evaluation indicates strong internal consistency for PMOT total (α = .96) and subscales (α = .79-.91). The PMOT and PVQ moderately correlated in the rehabilitation subsample (r = .71, p .05). Test-retest reliability was excellent (r = .97). This study provides preliminary psychometric evidence of the PMOT for children undergoing rehabilitation. These pilot findings warrant ongoing scale development.

  5. Alameda-Contra Costa Transit District (AC Transit) Fuel Cell Transit Buses: Preliminary Evaluation Results

    Energy Technology Data Exchange (ETDEWEB)

    Chandler, K.; Eudy, L.

    2007-03-01

    This report provides an evaluation of three prototype fuel cell-powered transit buses operating at AC Transit in Oakland, California, and six baseline diesel buses similar in design to the fuel cell buses.

  6. Using RFID Positioning Technology to Construct an Automatic Rehabilitation Scheduling Mechanism.

    Science.gov (United States)

    Wang, Ching-Sheng; Hung, Lun-Ping; Yen, Neil Y

    2016-01-01

    Accurately and efficiently identifying the location of patients during the course of rehabilitation is an important issue. Wireless transmission technology can reach this goal. Tracking technologies such as RFID (Radio frequency identification) can support process improvement and improve efficiencies of rehabilitation. There are few published models or methods to solve the problem of positioning and apply this technology in the rehabilitation center. We propose a mechanism to enhance the accuracy of positioning technology and provide information about turns and obstacles on the path; and user-centered services based on location-aware to enhanced quality care in rehabilitation environment. This paper outlines the requirements and the role of RFID in assisting rehabilitation environment. A prototype RFID hospital support tool is established. It is designed to provide assistance for monitoring rehabilitation patients. It can simultaneously calculate the rehabilitant's location and the duration of treatment, and automatically record the rehabilitation course of the rehabilitant, so as to improve the management efficiency of the rehabilitation program.

  7. Socially assistive robotics for post-stroke rehabilitation

    Directory of Open Access Journals (Sweden)

    Feil-Seifer David J

    2007-02-01

    Full Text Available Abstract Background Although there is a great deal of success in rehabilitative robotics applied to patient recovery post stroke, most of the research to date has dealt with providing physical assistance. However, new rehabilitation studies support the theory that not all therapy need be hands-on. We describe a new area, called socially assistive robotics, that focuses on non-contact patient/user assistance. We demonstrate the approach with an implemented and tested post-stroke recovery robot and discuss its potential for effectiveness. Results We describe a pilot study involving an autonomous assistive mobile robot that aids stroke patient rehabilitation by providing monitoring, encouragement, and reminders. The robot navigates autonomously, monitors the patient's arm activity, and helps the patient remember to follow a rehabilitation program. We also show preliminary results from a follow-up study that focused on the role of robot physical embodiment in a rehabilitation context. Conclusion We outline and discuss future experimental designs and factors toward the development of effective socially assistive post-stroke rehabilitation robots.

  8. [Accessibility and quality of rehabilitative services among migrants in Germany].

    Science.gov (United States)

    Brzoska, Patrick; Razum, Oliver

    2015-06-01

    Migrants comprise a large proportion of the population in Germany. As compared to non-migrants they are at a higher risk with respect tor occupational accidents, occupational diseases and early retirement due to disability. Tertiary preventive services such as rehabilitation, consequently, are of high relevance for this population group. We provide an overview of the accessibility and quality of preventive services among migrants residing in Germany using medical rehabilitation (tertiary prevention) as an example. We also present strategies which aim to improve health care for this population group. Summary of quantitative routine data analyses and of qualitative interviews with patients and health care professionals in rehabilitative care. Migrants utilize rehabilitative health care services less often than non-migrants. Those who undergo medical rehabilitation report a lower satisfaction with health care and show less favorable health outcomes than non-migrants. This, for instance, becomes evident in the occupational performance and subjective treatment outcome after rehabilitation. Socioeconomic, sociodemographic and health factors only partially explain these associations. In addition, there is evidence that migrants face various barriers which affect the accessibility and quality of health care services. Health care institutions have to provide services which are more sensitive to the heterogeneity of the population in order to reduce barriers in health care. Diversity management can contribute to this goal.

  9. Exoskeleton robots for upper-limb rehabilitation: state of the art and future prospects.

    Science.gov (United States)

    Lo, Ho Shing; Xie, Sheng Quan

    2012-04-01

    Current health services are struggling to provide optimal rehabilitation therapy to victims of stroke. This has motivated researchers to explore the use of robotic devices to provide rehabilitation therapy for strokepatients. This paper reviews the recent progress of upper limb exoskeleton robots for rehabilitation treatment of patients with neuromuscular disorders. Firstly, a brief introduction to rehabilitation robots will be given along with examples of existing commercial devices. The advancements in upper limb exoskeleton technology and the fundamental challenges in developing these devices are described. Potential areas for future research are discussed. Copyright © 2011 IPEM. Published by Elsevier Ltd. All rights reserved.

  10. Robotic arm skate for stroke rehabilitation.

    Science.gov (United States)

    Wong, Chee Kit; Jordan, Kimberlee; King, Marcus

    2011-01-01

    Upper limb paresis after stroke greatly affects the performance of Activities of Daily Living (ADL). Unfortunately, rehabilitation for upper limb impairment can have poor results. The current robot-assisted devices are expensive and not readily accessible for homecare. This paper presents the development of a low-cost tabletop robotic device for upper limb rehabilitation. Conceptually, patients perform computer-based goal-directed tasks using the robotic platform. Their progress is monitored and intervention, in the form of assistance or resistance, is introduced accordingly. A prototype platform is described. Experiments demonstrate the ability of the device to provide the necessary forces during movement exercises, in relation to task completion progress, device and target location. Appropriate exercises need to be developed before clinical trials can proceed. © 2011 CROWN

  11. Rehabilitation of individuals with intestinal ostomy.

    Science.gov (United States)

    Martins, Lívia Módolo; Sonobe, Helena Megumi; Vieira, Flávia De Siqueira; De Oliveira, Marissa Silva; Lenza, Nariman De Felício Bortucan; Da Silva Teles, André Aparecido

    2015-12-10

    This article will discuss an ethnographic study interpreting the rehabilitation experience of 15 individuals with an intestinal ostomy in Brazil, analysed using thematic analysis from the perspective of the sociology of health. The decoded meanings included: 'dealing with treatment and intestinal ostomy', and led to the theme 'the rehabilitation experience of patients with intestinal ostomy due to chronic illness', which addressed normality of life before intestinal illness, defining oneself and life, considering personal, family, social and therapeutic difficulties, and preparing to live with an intestinal ostomy, considering both the private and public spheres. This study will contribute to the specialised care provided in the various contexts of healthcare delivery, especially in relation to the humanisation of care of patients and implementation of appropriate strategies to meet the needs of patients.

  12. Vestibular rehabilitation: useful but not universally so.

    Science.gov (United States)

    Krebs, David E; Gill-Body, Kathleen M; Parker, Stephen W; Ramirez, Jose V; Wernick-Robinson, Mara

    2003-02-01

    Although vestibular rehabilitation (VR) is gaining popularity, few data support its utility in improving locomotor stability, and no good predictors exist of whom will benefit most. A double-blind, placebo-controlled randomized trial of vestibular rehabilitation was conducted at a large tertiary care hospital on 124 patients (59 +/- 18 years old) with unilateral (n = 51) or bilateral (n = 73) vestibular hypofunction, of whom 86 completed a 12-week intervention. Of these 86, 27 returned for long-term (1-year) follow-up testing. The primary outcome measure was locomotor stability. Group A (6 weeks of VR) significantly (P VR; there were no group differences at 1 year. Of the 86 who completed the intervention, 52 (61%) had clear locomotor gains. VR is helpful for most patients in providing locomotor stability, but further work is needed to determine the factors that prevent VR from being effective for all patients with vestibulopathy.

  13. Inpatient treatment time across disciplines in spinal cord injury rehabilitation

    Science.gov (United States)

    Whiteneck, Gale; Gassaway, Julie; Dijkers, Marcel; Backus, Deborah; Charlifue, Susan; Chen, David; Hammond, Flora; Hsieh, Ching-Hui; Smout, Randall J.

    2011-01-01

    Background/objective Length of stay (LOS) for rehabilitation treatment after spinal cord injury (SCI) has been documented extensively. However, there is almost no published research on the nature, extent, or intensity of the various treatments patients receive during their stay. This study aims at providing such information on a large sample of patients treated by specialty rehabilitation inpatient programs. Methods Six hundred patients with traumatic SCI admitted to six rehabilitation centers were enrolled. Time spent on various therapeutic activities was documented by each rehabilitation clinician after each patient encounter. Patients were grouped by neurologic level and completeness of injury. Total time spent by each rehabilitation discipline over a patient's stay and total minutes of treatment per week were calculated. Ordinary least squares stepwise regression models were used to identify patient and injury characteristics associated with time spent in rehabilitation treatment overall and within each discipline. Results Average LOS was 55 days (standard deviation 37), during which 180 (106) hours of treatment were received, or 24 (5) hours per week. Extensive variation was found in the amount of treatment received, between and within neurologic groups. Total hours of treatment provided throughout a patient's stay were primarily determined by LOS, which in turn was primarily predicted by medical acuity. Variation in minutes per week of treatment delivered by individual disciplines was predicted poorly by patient and injury characteristics. Conclusions Variations between and within SCI rehabilitation patient groups in LOS, minutes of treatment per week overall, and for each rehabilitation discipline are large. Variation in treatment intensity was not well explained by patient and injury characteristics. In accordance with practice-based evidence methodology, the next step in the SCIRehab study will be to determine which treatment interventions are related with

  14. Postacute rehabilitation quality of care: toward a shared conceptual framework.

    Science.gov (United States)

    Jesus, Tiago Silva; Hoenig, Helen

    2015-05-01

    There is substantial interest in mechanisms for measuring, reporting, and improving the quality of health care, including postacute care (PAC) and rehabilitation. Unfortunately, current activities generally are either too narrow or too poorly specified to reflect PAC rehabilitation quality of care. In part, this is caused by a lack of a shared conceptual understanding of what construes quality of care in PAC rehabilitation. This article presents the PAC-rehab quality framework: an evidence-based conceptual framework articulating elements specifically pertaining to PAC rehabilitation quality of care. The widely recognized Donabedian structure, process, and outcomes (SPO) model furnished the underlying structure for the PAC-rehab quality framework, and the International Classification of Functioning, Disability and Health (ICF) framed the functional outcomes. A comprehensive literature review provided the evidence base to specify elements within the SPO model and ICF-derived framework. A set of macrolevel-outcomes (functional performance, quality of life of patient and caregivers, consumers' experience, place of discharge, health care utilization) were defined for PAC rehabilitation and then related to their (1) immediate and intermediate outcomes, (2) underpinning care processes, (3) supportive team functioning and improvement processes, and (4) underlying care structures. The role of environmental factors and centrality of patients in the framework are explicated as well. Finally, we discuss why outcomes may best measure and reflect the quality of PAC rehabilitation. The PAC-rehab quality framework provides a conceptually sound, evidence-based framework appropriate for quality of care activities across the PAC rehabilitation continuum. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  15. REHABILITATION IN CARDIOLOGY AND CARDIOSURGERY

    Directory of Open Access Journals (Sweden)

    N. V. Galtseva

    2015-01-01

    Full Text Available At the present time effectiveness of rehabilitation programs after heart surgery, myocardial infarction, and in some cases for coronary artery disease (CAD is undeniable. According to the researches, physical exercises, which underlie cardio rehabilitation of patients with CAD, reduce cardiac mortality. In the review accumulated scientific data about modern approaches to cardio rehabilitation is discussed: goals, indications, contraindications, its organization, advantages. Controlled training in patients with CAD, making a complex program of cardio rehabilitation, kinds of control during cardio training are described in details. In this review the second phase of physical rehabilitation after cardiac surgery – a stationary phase, protocols of which are subjective and often contested, is considered. More frequently physical rehabilitation after coronary artery bypass surgery is doing breathing exercises, as there is data that physical exercises, in which tangential force vector in or around the sternum appears, should be avoided for at least 3 months after surgery. On the other hand, avoiding of heaving during the first weeks after surgery leads to more pronounced atrophy of the chest muscles. But there is data, according to which, early beginning of an adapted program of cardio rehabilitation (1–2 weeks after surgery is safely, it accelerates recovery and does not increase problems with the sternum. In this review the following idea is suggested: in order to follow the stages of rehabilitation after cardiac surgery it is necessary to start it on the stationary stage, and control of load rehabilitation programs must be carried out using hemodynamic changes during exercises, energy, SF-36 questionnaire. 

  16. Rehabilitative Games for Stroke Patients

    Directory of Open Access Journals (Sweden)

    A. Pyae

    2015-07-01

    Full Text Available Stroke is one of the major problems in medical and healthcare that can cause severe disability and death of patients especially for older population. Rehabilitation plays an important role in stroke therapy. However, most of the rehabilitative exercises are monotonous and tiring for the patients. For a particular time, they can easily get bored in doing these exercises. The role of patient’s motivation in rehabilitation is vital. Motivation and rehabilitative outcomes are strongly related. Digital games promise to help stroke patients to feel motivated and more engaged in rehabilitative training through motivational gameplay. Most of the commercial games available in the market are not well-designed for stroke patients and their motivational needs in rehabilitation. This study aims at understanding the motivational requirements of stroke patients in doing rehabilitative exercises and living in a post-stroke life. Based on the findings from the literature review, we report factors that can influence the stroke patients’ level of motivation such as social functioning, patient-therapist relationship, goal-setting, and music. These findings are insightful and useful for ideating and designing interactive motivation-driven games for stroke patients. The motivational factors of stroke patients in rehabilitation may help the game designers to design motivation-driven game contexts, contents, and gameplay. Moreover, these findings may also help healthcare professionals who concern stroke patient’s motivation in rehabilitative context. In this paper, we reported our Virtual Nursing Home (VNH concept and the games that we are currently developing and re-designing. Based on this literature review, we will present and test out the ideas how we can integrate these motivational factors in our future game design, development, and enhancement.

  17. Applying an ecological framework to understand transition pathways to post-secondary education for youth with physical disabilities.

    Science.gov (United States)

    Lindsay, Sally; Duncanson, Michelle; Niles-Campbell, Nadia; McDougall, Carolyn; Diederichs, Sara; Menna-Dack, Dolly

    2018-02-01

    The purpose of this study was to explore the experiences of youth with physical disabilities and clinicians who support them in their transition to post-secondary education (PSE). Most research on transition to PSE has focused on youth with intellectual disabilities while there is a lack of research on youth with physical disabilities. This study drew on 30 interviews with 20 youth with disabilities and 10 clinicians. We used Bronfrenbrenner's ecological framework to inform our analysis. Our results showed that there are several important individual skills that youth need to be successful in transitioning to PSE. Youth with disabilities experienced supports from peers and family that influence their transition to PSE. Several disability-specific issues (e.g., coping, self-care, disclosure, and accommodations) were often a barrier to transitioning to PSE. Clinicians and youth both reported that improved inter-professional collaboration and inter-agency partnerships were needed to enhance the transition experience. Societal attitudes (stigma and discrimination), policies, and the timing of transitions also influence youth's transition. Applying an ecological approach helped to provide a more holistic perspective of the PSE transitions and emphasizes the need to consider more than just preparing individuals but also where they are transitioned. Implications for rehabilitation Clinicians and educators should continue to promote the development of relevant life skills (e.g., self-advocacy, disclosure, and navigating public transportation) that youth need to succeed in post-secondary education. Clinicians should continue to educate and support youth regarding the process for disclosing their condition and how to request and set up accommodations in PSE. Clinicians should connect youth with disabilities to appropriate resources that can support them and continue to help them to set career goals and develop career plans. There is a critical need for improved inter

  18. Steps to Offering Low Vision Rehabilitation Services through Clinical Video Telehealth

    Science.gov (United States)

    Ihirig, Carolyn

    2016-01-01

    Telehealth clinical applications, which allow medical professionals to use telecommunications technologies to provide services to individuals remotely, continue to expand in areas such as low vision rehabilitation, where evaluations are provided to patients who live in rural areas. As with face-to-face low vision rehabilitation, the goal of…

  19. Outcomes report : provision of the gas tax fund and public transit fund

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-09-15

    The gas tax fund provides funding in support of the construction, rehabilitation and/or expansion of public infrastructure related to 7 key investment categories, including water; wastewater; solid waste; roads and bridges; transit; energy; and; capacity building. This report presented the environmental outcomes and output measures/indicators of the provision of the gas tax fund and public transit fund in Prince Edward Island (PEI). Indicators are a tool for monitoring or measuring the state of outcomes. The report provided background information on the indicators, data collection methods, and project descriptions such as project progress report and project types and characteristics. Municipal project data and indicators as well as provincial level indicators were also provided. Final outcomes were also discussed. It was concluded 31 projects directly contributed to the national objectives of cleaner air, reduced greenhouse gases and reduced energy use. refs., tabs., figs., appendices.

  20. Discourses in stroke rehabilitation as they present themselves in current physiotherapy and occupational therapy.

    Science.gov (United States)

    Kristensen, Hanne Kaae; Præstegaard, Jeanette; Ytterberg, Charlotte

    2017-02-01

    Aim This study aims to discuss current perceptions of rehabilitation and how present rehabilitation practice is affected by dominating discourses in Danish society by exploring discourses expressed in official publications and the constructed journal notes of occupational and physiotherapists' practice of stroke rehabilitation. Method The frame of reference is Fairclough's critical discourse analysis. The analysis comprises seven official documents relevant to stroke rehabilitation provided in Danish health services in 2012-2013. Also, notes written by occupational therapists and physiotherapists in medical records of 10 patients with a stroke diagnosis admitted to hospital in 2012. The documents included were read thoroughly. The texts were analyzed deductively, focusing on discursive practice on articulated understandings of rehabilitation, health practice approaches, and social practice. Results The dominating discourses seem to be Western neoliberalism organizational, medical and ethical discourses. The macro level of discourses consisted of political documents addressing rehabilitation nationally. The meso level mainly concerned medical discourses within stroke rehabilitation whereas the micro level represented local medical and ethical discourses. Conclusion The neoliberal discourse supports the medical discourse with strong emphasis on evidence-based interventions. In contrast to ethical discourses, documentation of rehabilitation practice marked more attention being paid to facilitating the patient's independence than to enabling the regaining of meaningful activities and participation. Implications for Rehabilitation Individualized rehabilitation must be organized with flexibility as it is a complex process Critical reflectiveness among health professionals is needed to provide individualized rehabilitation of high quality A broader range of stake holders, including patient organizations, are in demand within health policy making The discourses that

  1. 34 CFR 674.39 - Loan rehabilitation.

    Science.gov (United States)

    2010-07-01

    ... 34 Education 3 2010-07-01 2010-07-01 false Loan rehabilitation. 674.39 Section 674.39 Education..., DEPARTMENT OF EDUCATION FEDERAL PERKINS LOAN PROGRAM Terms of Loans § 674.39 Loan rehabilitation. (a) Each institution must establish a loan rehabilitation program for all borrowers for the purpose of rehabilitating...

  2. Successfully Improving Physical Activity Behavior After Rehabilitation

    NARCIS (Netherlands)

    van der Ploeg, Hidde P.; Streppel, Kitty R.M.; van der Beek, Allard J.; Woude, Luc H.V.; Vollenbroek-Hutten, Miriam Marie Rosé; van Harten, Willem H.; van Mechelen, Willem

    2007-01-01

    Purpose To determine the effects of the physical activity promotion programs Rehabilitation & Sports (R&S) and Active after Rehabilitation (AaR) on sport and daily physical activity 1 year after in- or outpatient rehabilitation. Design Subjects in intervention rehabilitation centers were randomized

  3. 78 FR 38840 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-06-28

    ... CFR Chapter III Final Priority--National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and Rehabilitative Services... Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers...

  4. 78 FR 34261 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-06-07

    ... CFR Chapter III Final Priority--National Institute on Disability and Rehabilitation Research--Rehabilitation Research and Training Centers AGENCY: Office of Special Education and Rehabilitative Services... Rehabilitative Services announces a priority for the Disability and Rehabilitation Research Projects and Centers...

  5. Patient perspectives on navigating the field of traumatic brain injury rehabilitation

    DEFF Research Database (Denmark)

    Graff, Heidi J.; Christensen, Ulla; Poulsen, Ingrid

    2017-01-01

    Purpose: This study aimed to provide an understanding of the lived experience of rehabilitation in adults with traumatic brain injury (TBI) from hospital discharge up to four years post-injury. Materials and methods: We used a qualitative explorative design with semi-structured in-depth interview...... systematic follow-up programs    • Age-appropriate rehabilitation facilities    • Inclusion of patient and family in the planning of long-term rehabilitation...

  6. The Competency Model for Professional Rehabilitation Nursing.

    Science.gov (United States)

    Vaughn, Stephanie; Mauk, Kristen L; Jacelon, Cynthia S; Larsen, Pamala D; Rye, Jill; Wintersgill, Wendy; Cave, Christine E; Dufresne, David

    2016-01-01

    Rehabilitation nursing is practiced in various settings along the healthcare continuum. No framework is noted in the literature that defines the necessary competencies of the rehabilitation nurse. To develop a Competency Model for Professional Rehabilitation Nursing and its application to clinical and educational practice. A seven-member Association of Rehabilitation Nurses (ARN) task force was convened; conducted a literature review, reviewed current and historical ARN documents, including the Strategic Plan, and developed a Competency Model for Professional Rehabilitation Nursing practice. The Competency Model for Professional Rehabilitation Nursing delineates four domains of rehabilitation nursing practice and essential role competencies. The Competency Model for Professional Rehabilitation Nursing addresses this diverse specialty practice in the current healthcare arena. This framework can be used to guide nurses practicing at different levels of proficiency in various settings. The Competency Model can be used as a structure for staff orientation, evaluation tools, clinical ladder components, role descriptions and rehabilitation nursing courses. © 2015 Association of Rehabilitation Nurses.

  7. Exoskeleton Technology in Rehabilitation: Towards an EMG-Based Orthosis System for Upper Limb Neuromotor Rehabilitation

    Directory of Open Access Journals (Sweden)

    Luis Manuel Vaca Benitez

    2013-01-01

    Full Text Available The rehabilitation of patients should not only be limited to the first phases during intense hospital care but also support and therapy should be guaranteed in later stages, especially during daily life activities if the patient’s state requires this. However, aid should only be given to the patient if needed and as much as it is required. To allow this, automatic self-initiated movement support and patient-cooperative control strategies have to be developed and integrated into assistive systems. In this work, we first give an overview of different kinds of neuromuscular diseases, review different forms of therapy, and explain possible fields of rehabilitation and benefits of robotic aided rehabilitation. Next, the mechanical design and control scheme of an upper limb orthosis for rehabilitation are presented. Two control models for the orthosis are explained which compute the triggering function and the level of assistance provided by the device. As input to the model fused sensor data from the orthosis and physiology data in terms of electromyography (EMG signals are used.

  8. Clinical effects of using HEXORR (Hand Exoskeleton Rehabilitation Robot) for movement therapy in stroke rehabilitation.

    Science.gov (United States)

    Godfrey, Sasha Blue; Holley, Rahsaan J; Lum, Peter S

    2013-11-01

    The goals of this pilot study were to quantify the clinical benefits of using the Hand Exoskeleton Rehabilitation Robot for hand rehabilitation after stroke and to determine the population best served by this intervention. Nine subjects with chronic stroke (one excluded from analysis) completed 18 sessions of training with the Hand Exoskeleton Rehabilitation Robot and a preevaluation, a postevaluation, and a 90-day clinical evaluation. Overall, the subjects improved in both range of motion and clinical measures. Compared with the preevaluation, the subjects showed significant improvements in range of motion, grip strength, and the hand component of the Fugl-Meyer (mean changes, 6.60 degrees, 8.84 percentage points, and 1.86 points, respectively). A subgroup of six subjects exhibited lower tone and received a higher dosage of training. These subjects had significant gains in grip strength, the hand component of the Fugl-Meyer, and the Action Research Arm Test (mean changes, 8.42 percentage points, 2.17 points, and 2.33 points, respectively). Future work is needed to better manage higher levels of hypertonia and provide more support to subjects with higher impairment levels; however, the current results support further study into the Hand Exoskeleton Rehabilitation Robot treatment.

  9. Lessons learned from early rehabilitation of complex trauma at the Royal Centre for Defence Medicine.

    Science.gov (United States)

    Pope, Sue; Vickerstaff, A L; Wareham, A P

    2017-04-01

    During the recent conflicts in Iraq and Afghanistan, substantial numbers of service personnel survived devastating injuries, presenting significant challenges for early rehabilitation at Queen Elizabeth Hospital Birmingham. Royal Centre for Defence Medicine personnel augmented NHS therapy provision, gaining significant experience in rehabilitating complex trauma. Multidisciplinary working was key to delivering this service, with a unique rehabilitation coordinating officer position established to manage the rehabilitation pathway. A military exercise rehabilitation instructor provided daily gym-based rehabilitation, developing exercise tolerance. Emphasis was placed on early independence, reducing pain, eliminating complications and optimising function. Innovative solutions and non-standard combinations of rehabilitation were required, with therapy working practices redesigned that, we believe, exceed provision elsewhere, including novel applications such as unique patient transfers, specialist seating, additional equipment, problem-solving teaching and early upper limb prosthetic provision. Active pain management allowed engagement in rehabilitation. With limited evidence available, therapeutic modalities attempting to alleviate phantom limb pain centred on patients' ability to engage in treatment. Finally, the requirement to measure change in early trauma rehabilitation was identified, leading to the development of the preprosthetic functional outcome measure. This article aims to document advances made, lessons learned, encourage debate and identify priorities for future research for military complex trauma rehabilitation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Rehabilitative and Assistive Technology: Overview

    Science.gov (United States)

    ... NICHD Research Information Find a Study More Information Pharmacology Condition Information NICHD Research Information Find a Study ... National Center for Medical Rehabilitation Research (NCMRR) Center History Funding Opportunity Announcements (FOAs) for NCMRR Partners Training & ...

  11. Multidisciplinary team care in rehabilitation

    DEFF Research Database (Denmark)

    Momsen, Anne-Mette; Rasmussen, Jens Ole; Nielsen, Claus Vinther

    2012-01-01

    Objectives: To systematically investigate current scientific evidence about the effectiveness of multidisciplinary team rehabilitation for different health problems. Data sources: A comprehensive literature search was conducted in Cochrane, Medline, DARE, Embase, and Cinahl databases, and research...... from existing systematic reviews was critically appraised and summarized. Study selection: Using the search terms "rehabilitation", "multidisciplinary teams" or "team care", references were identified for existing studies published after 2000 that examined multidisciplinary rehabilitation team care......, interventions, and findings. Data synthesis: A total of 14 reviews were included to summarize the findings of 12 different study populations. Evidence was found to support improved functioning following multidisciplinary rehabilitation team care for 10 of 12 different study population: elderly people, elderly...

  12. Considerations for designing robotic upper limb rehabilitation devices

    Science.gov (United States)

    Nadas, I.; Vaida, C.; Gherman, B.; Pisla, D.; Carbone, G.

    2017-12-01

    The present study highlights the advantages of robotic systems for post-stroke rehabilitation of the upper limb. The latest demographic studies illustrate a continuous increase of the average life span, which leads to a continuous increase of stroke incidents and patients requiring rehabilitation. Some studies estimate that by 2030 the number of physical therapists will be insufficient for the patients requiring physical rehabilitation, imposing a shift in the current methodologies. A viable option is the implementation of robotic systems that assist the patient in performing rehabilitation exercises, the physical therapist role being to establish the therapeutic program for each patient and monitor their individual progress. Using a set of clinical measurements for the upper limb motions, the analysis of rehabilitation robotic systems provides a comparative study between the motions required by clinicians and the ones that robotic systems perform for different therapeutic exercises. A critical analysis of existing robots is performed using several classifications: mechanical design, assistance type, actuation and power transmission, control systems and human robot interaction (HRI) strategies. This classification will determine a set of pre-requirements for the definition of new concepts and efficient solutions for robotic assisted rehabilitation therapy.

  13. Purposeful Activity in Psychiatric Rehabilitation: Is Neurogenesis a Key Player?

    Directory of Open Access Journals (Sweden)

    Joyce Siu-Chong Cheung

    2016-06-01

    Full Text Available Adult neurogenesis, defined as the generation of new neurons in adulthood, has been a fascinating discovery in neuroscience, as the continuously replenishing neuronal population provides a new perspective to understand neuroplasticity. Besides maintaining normal physiological function, neurogenesis also plays a key role in pathophysiology and symptomatology for psychiatric conditions. In the past decades, extensive effort has been spent on the understanding of the functional significance of neurogenesis in psychiatric conditions, mechanisms of pharmacological treatment, and discovery of novel drug candidates for different conditions. In a clinical situation, however, long-term rehabilitation treatment, in which occupational therapy is the key discipline, is a valuable, economical, and commonly used treatment alternative to psychotropic medications. Surprisingly, comparatively few studies have investigated the biological and neurogenic effects of different psychiatric rehabilitative treatments. To address the possible linkage between psychiatric rehabilitation and neurogenesis, this review discusses the role of neurogenesis in schizophrenia, major depression, and anxiety disorders. The review also discusses the potential neurogenic effect of currently used psychiatric rehabilitation treatments. With a better understanding of the biological effect of psychiatric rehabilitation methods and future translational studies, it is hoped that the therapeutic effect of psychiatric rehabilitation methods could be explained with a novel perspective. Furthermore, this knowledge will benefit future formulation of treatment methods, especially purposeful activities in occupational therapy, for the treatment of psychiatric disorders.

  14. Pelvic floor muscle rehabilitation using biofeedback.

    Science.gov (United States)

    Newman, Diane K

    2014-01-01

    Pelvic floor muscle exercises have been recommended for urinary incontinence since first described by obstetrician gynecologist Dr. Arnold Kegel more than six decades ago. These exercises are performed to strengthen pelvic floor muscles, provide urethral support to prevent urine leakage, and suppress urgency. In clinical urology practice, expert clinicians also teach patients how to relax the muscle to improve bladder emptying and relieve pelvic pain caused by muscle spasm. When treating lower urinary tract symptoms, an exercise training program combined with biofeedback therapy has been recommended as first-line treatment. This article provides clinical application of pelvic floor muscle rehabilitation using biofeedback as a technique to enhance pelvic floor muscle training.

  15. Patients' views on their decision making during inpatient rehabilitation after newly acquired spinal cord injury - A qualitative interview-based study

    NARCIS (Netherlands)

    Scheel-Sailer, Anke; Post, Marcel W.; Michel, Franz; Weidmann-Hügle, Tatjana; Baumann Hölzle, Ruth

    2017-01-01

    Introduction: Involving patients in decision making is a legal requirement in many countries, associated with better rehabilitation outcomes, but not easily accomplished during initial inpatient rehabilitation after severe trauma. Providing medical treatment according to the principles of shared

  16. Rehabilitation starts in the intensive care unit.

    Science.gov (United States)

    Rozeboom, Nathan; Parenteau, Kathy; Carratturo, Daniel

    2012-01-01

    Each year between 10 000 and 12 000 spinal cord injuries occur in the United States. Once injured, many of these patients will receive a portion of their care in an intensive care unit (ICU), where their treatment will begin. Harborview Medical Center in Seattle, Washington, provides comprehensive care to approximately 60 to 70 cervical spinal cord injuries each year. Because of many factors such as hemodynamic instability, pulmonary complications, and risk of infection, patients with cervical spinal cord injuries can spend up to 2 or more weeks in the ICU before they transfer to a rehabilitation unit. To achieve optimal outcomes, it is imperative that members of the interdisciplinary team work together in a consistent, goal-oriented, collaborative manner. This team includes physicians, nurses, respiratory therapists, physical and occupational therapists, speech pathologists, dieticians, and rehabilitation psychologists. An individual plan is developed for each patient and rehabilitation starts in the ICU as soon as the patient is medically stable. This article will highlight the management strategies used in the neuroscience ICU at Harborview Medical Center and will include a case study as an example of the typical experience for our patients with high cervical cord injury.

  17. Lessons from a Spawning Gravel Rehabilitation Program

    Science.gov (United States)

    Pasternack, G. B.; Wheaton, J. M.; Merz, J.

    2002-12-01

    Altered sediment and flow regimes in dammed and regulated rivers limit available spawning habitat to salmonids. River managers have attempted rehabilitation of spawning habitat with gravel augmentation and riffle construction projects, but often neglect well-established conceptual models of geomorphic and ecologic processes, let alone apply them in a predictive manner. Application of such models could not only improve rehabilitation projects, but also serve to further test and evaluate the underlying scientific theories against the rigors of real-world uncertainties. For the past two years a new science-based approach to rehabilitate spawning gravels for salmonids has been under development and testing to overcome these deficiencies. The approach includes a balance of science-based quantitative tools from multiple disciplines and qualitative local knowledge relevant to the region in which it has been applied. In 2001 and 2002 it was used to design and implement the placement of 907 and 2787 metric tons of gravel, respectively, on separate reaches of the lower Mokelumne River in Central California. A long-term monitoring program to quantify outcomes and assess sustainability is on-going. Lessons from these efforts are providing for adaptive management and will be presented.

  18. Creating the optimal conditions for rehabilitation research.

    Science.gov (United States)

    Bakheit, Abdel Magid

    2009-09-01

    Current evidence suggests that productivity in biomedical research depends on the support that the research group enjoys from its parent institution, the composition of the group and the personal attributes of its members and leader. Supportive institutions provide adequate physical resources and allow substantial uninterrupted time for research. The effectiveness of the research group asa whole is also strongly influenced by the group's structure, the professional competence of the group leader, his leadership style and his ability to foster collaboration with other research groups and organizations. There is a good case for a flexible leadership style that is modelled on the situational theory of leadership. In addition, the personal characteristics of the individual members of the research group influence the quality and quantity of the research output. Effective groups are made of motivated individuals with research training and skills that are relevant to the objectives of the research group. Rehabilitation research is fundamentally different from traditional biomedical research. This study discusses how the factors that influence productivity of biomedical research relate to rehabilitation science and practice and examines the conditions that are necessary to create and maintain an academic environment that is conducive to large volume,high-quality research in rehabilitation medicine.

  19. The Rehabilitation Medicine Scientist Training Program

    Science.gov (United States)

    Whyte, John; Boninger, Michael; Helkowski, Wendy; Braddom-Ritzler, Carolyn

    2016-01-01

    Physician scientists are seen as important in healthcare research. However, the number of physician scientists and their success in obtaining NIH funding have been declining for many years. The shortage of physician scientists in Physical Medicine and Rehabilitation is particularly severe, and can be attributed to many of the same factors that affect physician scientists in general, as well as to the lack of well developed models for research training. In 1995, the Rehabilitation Medicine Scientist Training Program (RMSTP) was funded by a K12 grant from the National Center of Medical Rehabilitation Research (NCMRR), as one strategy for increasing the number of research-productive physiatrists. The RMSTP's structure was revised in 2001 to improve the level of preparation of incoming trainees, and to provide a stronger central mentorship support network. Here we describe the original and revised structure of the RMSTP and review subjective and objective data on the productivity of the trainees who have completed the program. These data suggest that RMSTP trainees are, in general, successful in obtaining and maintaining academic faculty positions and that the productivity of the cohort trained after the revision, in particular, shows impressive growth after about 3 years of training. PMID:19847126

  20. Object and event recognition for stroke rehabilitation

    Science.gov (United States)

    Ghali, Ahmed; Cunningham, Andrew S.; Pridmore, Tony P.

    2003-06-01

    Stroke is a major cause of disability and health care expenditure around the world. Existing stroke rehabilitation methods can be effective but are costly and need to be improved. Even modest improvements in the effectiveness of rehabilitation techniques could produce large benefits in terms of quality of life. The work reported here is part of an ongoing effort to integrate virtual reality and machine vision technologies to produce innovative stroke rehabilitation methods. We describe a combined object recognition and event detection system that provides real time feedback to stroke patients performing everyday kitchen tasks necessary for independent living, e.g. making a cup of coffee. The image plane position of each object, including the patient"s hand, is monitored using histogram-based recognition methods. The relative positions of hand and objects are then reported to a task monitor that compares the patient"s actions against a model of the target task. A prototype system has been constructed and is currently undergoing technical and clinical evaluation.

  1. Recent Development of Rehabilitation Robots

    OpenAIRE

    Zhiqin Qian; Zhuming Bi

    2015-01-01

    We have conducted a critical review on the development of rehabilitation robots to identify the limitations of existing studies and clarify some promising research directions in this field. This paper is presented to summarize our findings and understanding. The demands for assistive technologies for elderly and disabled population have been discussed, the advantages and disadvantages of rehabilitation robots as assistive technologies have been explored, the issues involved in the development...

  2. [Postpartum pelvic floor muscle training and abdominal rehabilitation: Guidelines].

    Science.gov (United States)

    Deffieux, X; Vieillefosse, S; Billecocq, S; Battut, A; Nizard, J; Coulm, B; Thubert, T

    2015-12-01

    Provide guidelines for clinical practice concerning postpartum rehabilitation. Systematically review of the literature concerning postpartum pelvic floor muscle training and abdominal rehabilitation. Pelvic-floor rehabilitation using pelvic floor muscle contraction exercises is recommended to treat persistent urinary incontinence at 3 months postpartum (grade A), regardless of the type of incontinence. At least 3 guided sessions with a therapist is recommended, associated with pelvic floor muscle exercises at home. This postpartum rehabilitation improves short-term urinary incontinence (1 year) but not long-term (6-12 years). Early pelvic-floor rehabilitation (within 2 months following childbirth) is not recommended (grade C). Postpartum pelvic-floor rehabilitation in women presenting with anal incontinence, is associated with a lower prevalence of anal incontinence symptoms in short-term (1 year) (EL3) but not long-term (6 and 12) (EL3). Postpartum pelvic-floor rehabilitation is recommended to treat anal incontinence (grade C) but results are not maintained in medium or long term. No randomized trials have evaluated the pelvic-floor rehabilitation in asymptomatic women in order to prevent urinary or anal incontinence in medium or long term. It is therefore not recommended (expert consensus). Rehabilitation supervised by a therapist (physiotherapist or midwife) is not associated with better results than simple advice for voluntary contraction of the pelvic floor muscles to prevent/correct, in short term (6 months), a persistent prolapse 6 weeks postpartum (EL2), whether or not with a levator ani avulsion (EL3). Postpartum pelvic-floor rehabilitation is not associated with a decrease in the prevalence of dyspareunia at 1-year follow-up (EL3). Postpartum pelvic-floor rehabilitation guided by a therapist is therefore not recommended to treat or prevent prolapse (grade C) or dyspareunia (grade C). No randomized trials have evaluated the effect of pelvic

  3. International casemix and funding models: lessons for rehabilitation.

    Science.gov (United States)

    Turner-Stokes, Lynne; Sutch, Stephen; Dredge, Robert; Eagar, Kathy

    2012-03-01

    This series of articles for rehabilitation in practice aims to cover a knowledge element of the rehabilitation medicine curriculum. Nevertheless they are intended to be of interest to a multidisciplinary audience. The competency addressed in this article is 'An understanding of the different international models for funding of health care services and casemix systems, as exemplified by those in the US, Australia and the UK.' Payment for treatment in healthcare systems around the world is increasingly based on fixed tariff models to drive up efficiency and contain costs. Casemix classifications, however, must account adequately for the resource implications of varying case complexity. Rehabilitation poses some particular challenges for casemix development. The objectives of this educational narrative review are (a) to provide an overview of the development of casemix in rehabilitation, (b) to describe key characteristics of some well-established casemix and payment models in operation around the world and (c) to explore opportunities for future development arising from the lessons learned. Diagnosis alone does not adequately describe cost variation in rehabilitation. Functional dependency is considered a better cost indicator, and casemix classifications for inpatient rehabilitation in the United States and Australia rely on the Functional Independence Measure (FIM). Fixed episode-based prospective payment systems are shown to contain costs, but at the expense of poorer functional outcomes. More sophisticated models incorporating a mixture of episode and weighted per diem rates may offer greater flexibility to optimize outcome, while still providing incentive for throughput. The development of casemix in rehabilitation poses similar challenges for healthcare systems all around the world. Well-established casemix systems in the United States and Australia have afforded valuable lessons for other countries to learn from, but have not provided all the answers. A range

  4. 75 FR 21606 - Office of Special Education and Rehabilitative Services; Overview Information; Rehabilitation...

    Science.gov (United States)

    2010-04-26

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-9626... education and training for rehabilitation personnel; (3) Disseminate, in a cost-effective manner...

  5. Ambient Intelligence in Multimeda and Virtual Reality Environments for the rehabilitation

    Science.gov (United States)

    Benko, Attila; Cecilia, Sik Lanyi

    This chapter presents a general overview about the use of multimedia and virtual reality in rehabilitation and assistive and preventive healthcare. This chapter deals with multimedia, virtual reality applications based AI intended for use by medical doctors, nurses, special teachers and further interested persons. It describes methods how multimedia and virtual reality is able to assist their work. These include the areas how multimedia and virtual reality can help the patients everyday life and their rehabilitation. In the second part of the chapter we present the Virtual Therapy Room (VTR) a realized application for aphasic patients that was created for practicing communication and expressing emotions in a group therapy setting. The VTR shows a room that contains a virtual therapist and four virtual patients (avatars). The avatars are utilizing their knowledge base in order to answer the questions of the user providing an AI environment for the rehabilitation. The user of the VTR is the aphasic patient who has to solve the exercises. The picture that is relevant for the actual task appears on the virtual blackboard. Patient answers questions of the virtual therapist. Questions are about pictures describing an activity or an object in different levels. Patient can ask an avatar for answer. If the avatar knows the answer the avatars emotion changes to happy instead of sad. The avatar expresses its emotions in different dimensions. Its behavior, face-mimic, voice-tone and response also changes. The emotion system can be described as a deterministic finite automaton where places are emotion-states and the transition function of the automaton is derived from the input-response reaction of an avatar. Natural language processing techniques were also implemented in order to establish highquality human-computer interface windows for each of the avatars. Aphasic patients are able to interact with avatars via these interfaces. At the end of the chapter we visualize the

  6. The Recovery Process When Participating in Cancer Support and Rehabilitation Programs in Sweden

    Directory of Open Access Journals (Sweden)

    Christina Melin-Johansson

    2015-07-01

    Full Text Available The aim was to illuminate the meaning of participating in support and rehabilitation programs described by people diagnosed with cancer. Nineteen persons were interviewed in focus groups and face-to-face. Data were analyzed with a qualitative phenomenological hermeneutical method for researching lived experiences. Interpretation proceeded through three phases: naïve reading, structural analysis, and comprehensive understanding. Three themes were disclosed: receiving support for recovery when being most vulnerable, recapturing capabilities through supportive activities, and searching to find stability and well-being in a changed life situation. Participating in the programs was an existential transition from living in an unpredictable situation that was turned into something meaningful. Recovery did not mean the return to a state of normality; rather, it meant a continuing recovery from cancer treatments and symptoms involving recapturing capabilities and searching for a balance in a forever changed life. This study provides new insights about the experiences of participating in cancer support and rehabilitation programs.

  7. [Evidence based standards for rehabilitative therapy and work-related medical rehabilitation: are they compatible?: an expenditure analysis of treatment requirements].

    Science.gov (United States)

    Vorsatz, N; Brüggemann, S

    2011-06-01

    staffing levels. Rehabilitants are not exposed to undue strains, and staffing levels in rehabilitation centres are adequate - with the possible exception of social workers for MBOR. In future development of quality specifications for rehabilitation it remains pre-eminent to ensure an interlocking of the different requirements, in order to provide the rehabilitation centres with a comprehensible frame for the provision of care. © Georg Thieme Verlag KG Stuttgart · New York.

  8. [Cardiac rehabilitation with lifestyle counselling after myocardial infarction: it helps, but not everyone undergoes it].

    Science.gov (United States)

    Reulings, Petra G; van der Lans, Sylvia M

    2012-01-01

    A healthy lifestyle helps to reduce the risk of cardiovascular disease. This also applies after myocardial infarction (MI), as it considerably reduces the likelihood of relapse. One element of the cardiac rehabilitation process is lifestyle counselling. In 2010, the Dutch Health Care Inspectorate conducted a study into lifestyle counselling during the cardiac rehabilitation programme. The results showed that only a limited number of post-MI patients actually do take part in a cardiac rehabilitation programme. Furthermore, the lifestyle counselling which is provided during the programme is not being conducted entirely in accordance with the Dutch Cardiac Rehabilitation Practice Guideline; therefore, its effects on patient health can, and should, be improved. To this end, the cardiac rehabilitation centres are currently working on improving their programmes and the inspectorate will review the results in the latter part of 2012. Moreover, various initiatives have been taken to increase the level of participation in cardiac rehabilitation programmes.

  9. A New Application to Facilitate Post-Fire Recovery and Rehabilitation in Savanna Ecosystems

    Science.gov (United States)

    Carroll, Mark L.; Schnase, John L.; Weber, Keith T.; Brown, Molly E.; Gill, Roger L.; Haskett, George W.; Gardner, Tess A.

    2013-01-01

    The U.S. government spends an estimated $3billion per year to fight forest fires in the United States. Post-fire rehabilitation activities represent a small but essential portion of that total. The Rehabilitation Capability Convergence for Ecosystem Recovery (RECOVER) system is currently under development for Savanna ecosystems in the western U.S. The prototype of this system has been built and will have realworld testing during the summer 2013 fire season. When fully deployed, the RECOVER system will provide the emergency rehabilitation teams with critical and timely information for management decisions regarding stabilization and rehabilitation strategies.

  10. The development of multi-model rehabilitation training system for lower limb sitting function

    Science.gov (United States)

    Wu, Jianfeng; Sun, Yue; Wu, Qun

    2017-04-01

    The multi-model rehabilitation training system was manufactured according to the demands of patients' practical training. Through the use of the patient's exercise physiology information, the ability of muscle force and movement efficiency of the patient were identified. Following with medical rehabilitation therapy, the training model, a combination of active and passive training, was proposed to enhance the training efficiency and rehabilitation effect. Furthermore, taking the sitting movement training as an example, the research theory was applied in knee rehabilitation training. The results of the research provid technical support and practical reference to the relevant training equipment designs and clinical applications.

  11. [Development and importance of outpatient cardiac rehabilitation in German-speaking countries].

    Science.gov (United States)

    Benzer, W

    2014-07-01

    Cardiac rehabilitation is a coordinated treatment approach. The interdisciplinary team aims to provide the best possible physical and psychological outcomes for patients with cardiac diseases. Patients should be enable to independently resume work and and social life. Furthermore cardiac rehabilitation wants to limit or reverse the progress of cardiac disease through sustained health-related life habits. Cardiac rehabilitation significantly contributes to long-term success based on comprehensive care of cardiac patients. Outpatient cardiac rehabilitation has shown to be effective after myocardial infarction, coronary artery bypass grafting and chronic heart failure. However randomized controlled trials were performed only in Anglo-American countries. In these trials effects were observed mainly for exercise-based cardiac rehabilitation programs. Because the results have been derived from different program settings they cannot simply be translated to German-speaking countries. However, several cohort studies predominantly performed in Germany also revealed effects of inpatient and outpatient cardiac rehabilitation programs for German-speaking countries. The most recent results demonstrated a significant reduction of recurrent events in patients after inpatient cardiac rehabilitation. Following the current evidence concerning the effect of inpatient and outpatient cardiac rehabilitation programs particularly after myocardial infarction international guidelines provide Class I (USA) and IIa (Europe) recommendation for this treatment intervention.In contrast to Anglo-American countries cardiac rehabilitation in Austria, Germany and Switzerland was established at its beginning exclusively for inpatient programs. In addition more and more outpatient programs were introduced in the last decades. Nevertheless inpatient cardiac rehabilitation is still the most common program in German-speaking countries.Future challenges of cardiac rehabilitation should not address the

  12. Palliative care rehabilitation survey: a pilot study of patients' priorities for rehabilitation goals.

    Science.gov (United States)

    Schleinich, M A; Warren, S; Nekolaichuk, C; Kaasa, T; Watanabe, S

    2008-10-01

    Rehabilitation in palliative care is often overlooked. Settings that do consider occupational or physical therapy for palliative care patients often consult to therapists with competing caseloads. Few therapists specialise in palliative care, but nearly all ask, 'What needs doing'? and 'How well am I doing that'? No existing instruments address their questions. The objective is to develop and test a questionnaire for identifying patient goals and priorities for rehabilitation in palliative care. A questionnaire representing 11 domains of the Canadian Model of Occupational Performance was designed and pilot tested at four palliative care sites. Each question reflected a typical rehabilitation intervention in palliative care. Patients were asked to rate how important each of these interventions was on a numerical rating scale (0, not important-10, extremely important). Open-ended questions captured verbatim comments regarding thoughts of rehabilitation. The questionnaire was tested for test-retest reliability with two interviews approximately 1 week apart. Forty patients participated in the first interview and 32 in the second. Eight of eleven domain sub-scores achieved an intra-class correlation coefficient of 0.6 or higher. The highest means were for the physical (8.2), institutional (7.8) and self-care (7.8) domains on the first interview and for the spiritual domain (7.9) on the second interview. Suggestions are provided to shorten the questionnaire and strengthen validity. This work furthers the understanding of the role of rehabilitation in palliative care. It also illustrates the feasibility of involving palliative care patients in research that contributes to setting standards and measuring quality of service.

  13. Measure Guideline. Wood Window Repair, Rehabilitation, and Replacement

    Energy Technology Data Exchange (ETDEWEB)

    Baker, P. [Building Science Corporation, Somerville, MA (United States); Eng, P. [Building Science Corporation, Somerville, MA (United States)

    2012-12-01

    This measure guideline provides information and guidance on rehabilitating, retrofitting, and replacing existing window assemblies in residential construction. The intent is to provide information regarding means and methods to improve the energy and comfort performance of existing wood window assemblies in a way that takes into consideration component durability, in-service operation, and long term performance of the strategies.

  14. Transitional Care

    Science.gov (United States)

    Naylor, Mary; Keating, Stacen A.

    2008-01-01

    Transitional care encompasses a broad range of services and environments designed to promote the safe and timely passage of patients between levels of health care and across care settings. High-quality transitional care is especially important for older adults with multiple chronic conditions and complex therapeutic regimens, as well as for their…

  15. Developing a Rehabilitation Model of Breast Cancer Patients Through Literature Review and Hospital Rehabilitation Programs

    Directory of Open Access Journals (Sweden)

    Bok-Yae Chung, PhD, RN, APN

    2008-03-01

    Conclusion: Rehabilitation of breast cancer patients deserves special attention to achieve optimal quality of life. Health care professionals need to be educated about rehabilitation as an effective intervention.

  16. Mexican Americans Receive Less Intensive Stroke Rehabilitation Than Non-Hispanic Whites.

    Science.gov (United States)

    Morgenstern, Lewis B; Sais, Emma; Fuentes, Michael; Ifejika, Nneka L; Jiang, Xiaqing; Horn, Susan D; Case, Erin; Lisabeth, Lynda D

    2017-06-01

    Mexican Americans (MAs) have worse neurological, functional, and cognitive outcomes after stroke. Stroke rehabilitation is important for good outcome. In a population-based study, we sought to determine whether allocation of stroke rehabilitation services differed by ethnicity. Patients with stroke were identified as part of the Brain Attack Surveillance in Corpus Christi (BASIC) project, TX, USA. Cases were validated by physicians using source documentation. Patients were followed prospectively for 3 months after stroke to determine rehabilitation services and transitions. Descriptive statistics were used to depict the study population. Continuous baseline variables were compared using 2 sample t tests or Wilcoxon rank-sum tests by ethnicity. Categorical baseline variables were compared using χ(2) tests. Ethnic comparisons of rehabilitation services were compared using χ(2) tests, Fisher's exact tests, and logistic regression. Seventy-two subjects (50 MA and 22 non-Hispanic white [NHW]) were followed. Mean age, NHW-69 (SD 13), MA-66 (SD 11) years, sex (NHW 55% male, MA 50% male) and median presenting National Institutes of Health Stroke Scale did not differ significantly. There were no ethnic differences among the proportion of patients who were sent home without any rehabilitation services (P=0.9). Among those who received rehabilitation, NHWs were more likely to get inpatient rehabilitation (73%) compared with MAs (30%), P=0.016. MAs (51%) were much more likely to receive home rehabilitation services compared with NHWs (0%) (P=0.0017). In this population-based study, MAs were more likely to receive home-based rehabilitation, whereas NHWs were more likely to get inpatient rehabilitation. This disparity may, in part, explain the worse stroke outcome in MAs. © 2017 American Heart Association, Inc.

  17. [Physicians' and medical students' knowledge on rehabilitation].

    Science.gov (United States)

    Dénes, Zoltán; Fazekas, Gábor; Zsiga, Katalin; Péter, Orsolya

    2012-06-17

    There are few data on the rehabilitation knowledge of medical specialists and medical students. Assessment of the rehabilitation knowledge of medical specialists working in general hospitals and of final year medical students. A paper form survey was performed using a questionnaire containing seven multiple choice questions and three definitions. Questionnaires were filled in independently on the spot. The three answering groups were physicians (specialized in orthopedic surgery, neurology or neurosurgery) working in a general hospital that had a rehabilitation ward, final year medical students from Semmelweis University, and trainees in rehabilitation medicine. The survey was voluntary and anonymous. Forty physicians, 42 students and 39 rehabilitation trainees filled in the questionnaire. Half of the students gave correct answers to questions about rehabilitation specialization, the existing university chairs, the percentage of people with disabilities in Hungary, and the way of sending patients for rehabilitation consultation. The number of beds designed for rehabilitation was unknown, but with regard to the existence of regulation by law the rights of people with disabilities were well-known by all groups. Very few were able to define the basic categories (rehabilitation, disability). Rehabilitation knowledge of physicians was not better than that of students, but rehabilitation trainees were better informed. According to findings of the authors, students and physicians do not have enough rehabilitation knowledge to perform medical activities adequately. Enlargement of the medical curriculum with basic rehabilitation knowledge is essential. A rehabilitation training course is necessary for physicians to be better equipped to carry out their daily hospital work.

  18. Rehabilitative ultrasound imaging: understanding the technology and its applications.

    Science.gov (United States)

    Whittaker, Jackie L; Teyhen, Deydre S; Elliott, James M; Cook, Katy; Langevin, Helene M; Dahl, Haldis H; Stokes, Maria

    2007-08-01

    The use of ultrasound imaging by physical therapists is growing in popularity. This commentary has 2 aims. The first is to introduce the concept of rehabilitative ultrasound imaging (RUSI), provide a definition of the scope of this emerging tool in regard to the physical therapy profession, and describe how this relates to the larger field of medical ultrasound imaging. The second aim is to provide an overview of basic ultrasound imaging and instrumentation principles, including an understanding of the various modes and applications of the technology with respect to neuromusculoskeletal rehabilitation and in relation to other common imaging modalities.

  19. Cardiac rehabilitation costs.

    Science.gov (United States)

    Moghei, Mahshid; Turk-Adawi, Karam; Isaranuwatchai, Wanrudee; Sarrafzadegan, Nizal; Oh, Paul; Chessex, Caroline; Grace, Sherry L

    2017-10-01

    Despite the clinical benefits of cardiac rehabilitation (CR) and its cost-effectiveness, it is not widely received. Arguably, capacity could be greatly increased if lower-cost models were implemented. The aims of this review were to describe: the costs associated with CR delivery, approaches to reduce these costs, and associated implications. Upon finalizing the PICO statement, information scientists were enlisted to develop the search strategy of MEDLINE, Embase, CDSR, Google Scholar and Scopus. Citations identified were considered for inclusion by the first author. Extracted cost data were summarized in tabular format and qualitatively synthesized. There is wide variability in the cost of CR delivery around the world, and patients pay out-of-pocket for some or all of services in 55% of countries. Supervised CR costs in high-income countries ranged from PPP$294 (Purchasing Power Parity; 2016 United States Dollars) in the United Kingdom to PPP$12,409 in Italy, and in middle-income countries ranged from PPP$146 in Venezuela to PPP$1095 in Brazil. Costs relate to facilities, personnel, and session dose. Delivering CR using information and communication technology (mean cost PPP$753/patient/program), lowering the dose and using lower-cost personnel and equipment are important strategies to consider in containing costs, however few explicitly low-cost models are available in the literature. More research is needed regarding the costs to deliver CR in community settings, the cost-effectiveness of CR in most countries, and the economic impact of return-to-work with CR participation. A low-cost model of CR should be standardized and tested for efficacy across multiple healthcare systems. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Health Services Research in Rehabilitation and Disability-The Time is Now.

    Science.gov (United States)

    Graham, James E; Middleton, Addie; Roberts, Pamela; Mallinson, Trudy; Prvu-Bettger, Janet

    2018-01-01

    Policy drives practice, and health services research (HSR) is at the intersection of policy, practice, and patient outcomes. HSR specific to rehabilitation and disability is particularly needed. As rehabilitation researchers and providers, we are uniquely positioned to provide the evidence that guides reforms targeting rehabilitative care. We have the expertise to define the value of rehabilitation in a policy-relevant context. HSR is a powerful tool for providing this evidence. We need to continue building capacity for conducting rigorous, timely rehabilitation-related HSR. Fostering stakeholder engagement in these research efforts will ensure we maintain a patient-centered focus as we address the "Triple Aim" of better care, better health, and better value. In this Special Communication we discuss the role of rehabilitation researchers in HSR. We also provide information on current resources available in our field for conducting HSR and identify gaps for capacity building and future research. Health care reforms are a reality, and through HSR we can give rehabilitation a strong voice during these transformative times. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  1. Can the outcome of pelvic-floor rehabilitation in patients with fecal incontinence be predicted?

    NARCIS (Netherlands)

    M.P. Terra (Maaike); M. Deutekom (Marije); A.C. Dobben (Annette); C.G.M.I. Baeten; L.W.M. Janssen (Lucas); G.E. Boeckxstaens (Guy); A.F. Engel (Alexander); R.J.F. Felt-Bersma; J.F.W. Slors; M.F. Gerhards (Michael); A.B. Bijnen (Bart); E. Everhardt; W.R. Schouten (Ruud); B. Berghmans; P.M.M. Bossuyt (Patrick); J. Stoker (Jacob)

    2008-01-01

    textabstractPurpose: Pelvic-floor rehabilitation does not provide the same degree of relief in all fecal incontinent patients. We aimed at studying prospectively the ability of tests to predict the outcome of pelvic-floor rehabilitation in patients with fecal incontinence. Materials and methods: Two

  2. 76 FR 19753 - Applications for New Awards; Vocational Rehabilitation Services Projects for American Indians...

    Science.gov (United States)

    2011-04-08

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF EDUCATION... AGENCY: Office of Special Education and Rehabilitative Services, Department of Education. ACTION: Notice...: The purpose of this program is to provide vocational rehabilitation (VR) services to American Indians...

  3. 75 FR 34298 - Office of Special Education and Rehabilitative Services; Overview Information; Vocational...

    Science.gov (United States)

    2010-06-16

    .... 75, No. 115 / Wednesday, June 16, 2010 / Notices#0;#0; ] DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview Information; Vocational Rehabilitation Services Projects for... Opportunity Description Purpose of Program: The purpose of this program is to provide vocational...

  4. Are different groups of cancer patients offered rehabilitation to the same extent?

    DEFF Research Database (Denmark)

    Ross, Lone; Petersen, Morten Aagaard; Johnsen, Anna Thit

    2012-01-01

    The number of cancer survivors is growing and cancer is now viewed as a chronic disease. This has highlighted the importance of providing adequate rehabilitation to prevent physical, psychological, and social sequelae of cancer. However, it is unclear whether those in need of rehabilitation...

  5. Vocational Rehabilitation Services for Blind Persons: The Experience of Sibling Twins.

    Science.gov (United States)

    Hale, L.; And Others

    1991-01-01

    This study reports the very different reactions and choices of legally blind twin sisters who were provided services through the Mississippi Vocational Rehabilitation for the Blind agency. Emphasis is on the importance of individual differences and variables, such as personality, over which the rehabilitation agency has no control. (DB)

  6. Outpatient pulmonary rehabilitation - rehabilitation models and shortcomings in outpatient aftercare.

    Science.gov (United States)

    Korczak, Dieter; Huber, Beate; Steinhauser, Gerlinde; Dietl, Markus

    2010-07-29

    The chronic obstructive pulmonary disease (COPD) and the bronchial asthma are widespread diseases. They need long-lasting and sustainable rehabilitation. The goal of this HTA is to describe the present supply and the economic relevance of out-patient pulmonary rehabilitation in conjunction with its social aspects. A further target is to derivate options for actions in the health-care system and possible research necessities. Relevant publications are identified by means of a structured search in 37 database accessed through the German Institute of Medical Documentation and Information (DIMDI). In addition a manual search of identified reference lists has been done. The present report includes German and English literature published from 2004 to 2009. The methodological quality was assessed by two independent researchers according to pre-defined quality criteria of evidence based medicine. Among 860 publications 31 medical studies, four economic studies and 13 ethical studies meet the inclusion criteria. The studies cover rehabilitation programmes in 19 countries. The majority of them has a high level of evidence (1A to 2C). The pulmonary rehabilitation programmes differ by the setting (in-patient, out-patient, in-home, community-based), by the length of intervention (from two weeks to 36 months), by the way and the frequency of intervention and by the duration of the follow-up treatment. Overall out-patient rehabilitation programmes achieve the same positive effects for COPD patients as in-patient programmes do. This is especially true for physical performance and health related quality of life. There are only a few studies dealing with asthma. Therefore, valid statements cannot be given. The results for cost-effectiveness are not distinct enough. Goals of pulmonary rehabilitation like prevention and adequate treatment of acute exacerbations, the minimisation of hospitalisation and the reduction of mortality are attained in out-patient as well as in in

  7. Geriatric rehabilitation of stroke patients in nursing homes: a study protocol

    Directory of Open Access Journals (Sweden)

    Geurts Alexander CH

    2010-03-01

    second follow-up is three months after discharge in patients who rehabilitated successfully, and assesses functional status, behavior, and quality of life. All instruments used in this study have shown to be valid and reliable in rehabilitation research or are recommended by the Netherlands Heart Foundation guidelines for stroke rehabilitation. Data will be analyzed using SPSS 16.0. Besides descriptive analyses, both univariate and multivariate analyses will be performed with the purpose of identifying associated factors as well as their unique contribution to determining successful rehabilitation. Discussion This study will provide more information about geriatric stroke rehabilitation in Dutch nursing homes. To our knowledge, this is the first large study that focuses on the determinants of success of geriatric stroke rehabilitation in nursing home patients.

  8. Rehabilitation therapy of Duchenne muscular dystrophy

    Directory of Open Access Journals (Sweden)

    ZHANG Cheng

    2012-06-01

    Full Text Available It is very important that the rehabilitation therapy of Duchenne muscular dystrophy (DMD can improve the quality of life and delay the disease progression. There are the guidelines for DMD rehabilitation therapy in some countries, but it is not emphasized by clinical doctors in our country. According to our experiences to DMD rehabilitation therapy, we reviewed the progress of DMD rehabilitation therapy. It includes the clinical stages and characteristics of DMD, the general principle and the common therapy methods of DMD rehabilitation. We hope this review may increase recognizing to DMD rehabilitation therapy for the clinical doctors and DMD family members.

  9. National Institutes of Health Research Plan on Rehabilitation.

    Science.gov (United States)

    2017-04-01

    One in five Americans experiences disability that affects their daily function because of impairments in mobility, cognitive function, sensory impairment, or communication impairment. The need for rehabilitation strategies to optimize function and reduce disability is a clear priority for research to address this public health challenge. The National Institutes of Health (NIH) recently published a Research Plan on Rehabilitation that provides a set of priorities to guide the field over the next 5 years. The plan was developed with input from multiple Institutes and Centers within the NIH, the National Advisory Board for Medical Rehabilitation Research, and the public. This article provides an overview of the need for this research plan, an outline of its development, and a listing of six priority areas for research. The NIH is committed to working with all stakeholder communities engaged in rehabilitation research to track progress made on these priorities and to work to advance the science of medical rehabilitation. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  10. Identifying Risk Factors for Elder Falls in Geriatric Rehabilitation in Israel.

    Science.gov (United States)

    Ben Natan, Merav; Heyman, Neomi; Ben Israel, Joshua

    2016-01-01

    To identify risk factors for elder falls in a geriatric rehabilitation center in Israel. Retrospective chart review study. Four hundred and twelve medical records of inpatients in geriatric rehabilitation were retrospectively analyzed to compare between elders who sustained falls and those who did not. Of elders hospitalized during this year, 14% sustained falls. Fallers included a high proportion of males, with little comorbidity, not obese, and cardiovascular patients. Falls occurred frequently during patients' first week at the facility, mostly during the daytime. The falls occurred frequently in patients' rooms, and a common scenario was a fall during transition. The research findings single out patients who are allegedly at a lower risk of falls than more complex patients. Caregivers in geriatric rehabilitation settings should pay attention to patients who are allegedly at a lower risk of falls than more complex patients, and to cardiovascular patients in particular. © 2014 Association of Rehabilitation Nurses.

  11. Ageism in stroke rehabilitation studies.

    Science.gov (United States)

    Gaynor, Eva Joan; Geoghegan, Sheena Elizabeth; O'Neill, Desmond

    2014-05-01

    stroke is predominantly a disease of older people. While age bias has been demonstrated in studies of pharmacological therapeutic interventions in stroke, the extent of discrimination by age in stroke rehabilitation studies is unknown. The aim of this study was to systematically review the literature to assess the extent of ageism in stroke rehabilitation studies. all randomised control trials (RCT) on stroke rehabilitation entered in the Cochrane database which reported mean age were included. Patient gender and exclusion criteria were also recorded. of 241 RCT's identified, 182 were eligible for inclusion. The mean age of all patients was 64.3, almost a decade younger than those seen by stroke physicians in daily practice in global terms, and 11-12 years younger than encountered in hospital practice in the British Isles. Almost half (46%) of trials excluded patients with cognitive impairment, almost one-quarter (23%) patients with dysphasia and one-eighth (13%) excluded patients with multiple strokes. we have identified a clear difference in the mean age of those included in stroke rehabilitation studies compared with the international mean age of stroke. In addition, a quarter of trials excluded dysphasic patients which may indicate omission of more severe strokes. This means that the evidence base for stroke rehabilitation is deficient in terms of matching the characteristics of patients encountered in clinical practice, and a more representative sample of older people and those with significant disability must be included in future trials.

  12. Core Training and Rehabilitation in Horses.

    Science.gov (United States)

    Clayton, Hilary M

    2016-04-01

    The central body axis or core is a key component in controlling body posture and providing a stable platform for limb movements and generation of locomotor forces. Persistent dysfunction of the deep stabilizing muscles seems to be common in horses indicating a need for core training exercises to restore normal function. Core training should be performed throughout the horse's athletic career to maintain a healthy back and used therapeutically when back pain is identified. This article reviews the structure and function of the equine thoracolumbar spine with special reference to function, dysfunction, conditioning, and rehabilitation of the core musculature. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Development of a home-based training program for post-ward geriatric rehabilitation patients with cognitive impairment: study protocol of a randomized-controlled trail.

    Science.gov (United States)

    Bongartz, Martin; Kiss, Rainer; Ullrich, Phoebe; Eckert, Tobias; Bauer, Jürgen; Hauer, Klaus

    2017-09-12

    Geriatric patients with cognitive impairment (CI) show an increased risk for a negative rehabilitation outcome and reduced functional recovery following inpatient rehabilitation. Despite this obvious demand, evidence-based training programs at the transition from rehabilitation to the home environments are lacking. The aim of this study is to evaluate the efficacy of a feasible and cost-effective home-based training program to improve motor performance and to promote physical activity, specifically-tailored for post-ward geriatric patients with CI. A sample of 101 geriatric patients with mild to moderate stage CI following ward-based rehabilitation will be recruited for a blinded, randomized controlled trial with two arms. The intervention group will conduct a 12 week home-based training, consisting of (1) Exercises to improve strength/power, and postural control; (2) Individual walking trails to enhance physical activity; (3) Implementation of patient-specific motivational strategies to promote behavioral changes. The control group will conduct 12 weeks of unspecific flexibility exercise. Both groups will complete a baseline measurement before starting the program, at the end of the intervention, and after 24 weeks for follow-up. Sensor-based as well as questionnaire-based measures will be applied to comprehensively assess intervention effects. Primary outcomes document motor performance, assessed by the Short Physical Performance Battery, and level of physical activity (PA), as assessed by duration of active episodes (i.e., sum of standing and walking). Secondary outcomes include various medical, psycho-social, various PA and motor outcomes, including sensor-based assessment as well as cost effectiveness. Our study is among the first to provide home-based training in geriatric patients with CI at the transition from a rehabilitation unit to the home environment. The program offers several unique approaches, e.g., a comprehensive and innovative assessment

  14. Virtual rehabilitation for multiple sclerosis using a kinect-based system: randomized controlled trial.

    Science.gov (United States)

    Lozano-Quilis, Jose-Antonio; Gil-Gómez, Hermenegildo; Gil-Gómez, Jose-Antonio; Albiol-Pérez, Sergio; Palacios-Navarro, Guillermo; Fardoun, Habib M; Mashat, Abdulfattah S

    2014-11-12

    The methods used for the motor rehabilitation of patients with neurological disorders include a number of different rehabilitation exercises. For patients who have been diagnosed with multiple sclerosis (MS), the performance of motor rehabilitation exercises is essential. Nevertheless, this rehabilitation may be tedious, negatively influencing patients' motivation and adherence to treatment. We present RemoviEM, a system based on Kinect that uses virtual reality (VR) and natural user interfaces (NUI) to offer patients with MS an intuitive and motivating way to perform several motor rehabilitation exercises. It offers therapists a new motor rehabilitation tool for the rehabilitation process, providing feedback on the patient's progress. Moreover, it is a low-cost system, a feature that can facilitate its integration in clinical rehabilitation centers. A randomized and controlled single blinded study was carried out to assess the influence of a Kinect-based virtual rehabilitation system on the balance rehabilitation of patients with MS. This study describes RemoviEM and evaluates its effectiveness compared to standard rehabilitation. To achieve this objective, a clinical trial was carried out. Eleven patients from a MS association participated in the clinical trial. The mean age was 44.82 (SD 10.44) and the mean time from diagnosis (years) was 9.77 (SD 10.40). Clinical effectiveness was evaluated using clinical balance scales. Significant group-by-time interaction was detected in the scores of the Berg Balance Scale (P=.011) and the Anterior Reach Test in standing position (P=.011). Post-hoc analysis showed greater improvement in the experimental group for these variables than in the control group for these variables. The Suitability Evaluation Questionnaire (SEQ) showed good results in usability, acceptance, security, and safety for the evaluated system. The results obtained suggest that RemoviEM represents a motivational and effective alternative to traditional

  15. deal Rehabilitation Programme after Anterior Cruciate Ligament Injury: Review of Evidence

    Directory of Open Access Journals (Sweden)

    Adeel Nazir AHMAD

    2016-03-01

    Full Text Available Knee injuries are the second most common musculoskeletal injuries in primary care, with anterior cruciate the most commonly injured ligament. It is caused by contact / non - contact and accelerating/decelerating twisting injury of the knee. Typical presentation includes trauma with pain and swellin g, with laxity of the knee joint. Management includes rehabilitation alone or surgery combined with rehabilitation. Pre - surgery rehabilitation with graded physiotherapy programme results in improved postoperative recovery, reduced pain, swelling, better s tability and improved range of movement. No consensus exists on an ideal rehabilitation programme, as various factors, including injury to other knee structures, choice of graft, type of surgery performed and patient preference exist. Rehabilitation includ es accelerated vs. conservative, closed vs. open kinetic chain and techniques involving bracing, neuromuscular training and cryotherapy. Ideal personalised rehabilitation plan should include educating athletes to improve adherence, providing realistic stra tegies and approximate time frame for a return to sport. Studies support accelerated rehabilitation before and after surgery, in a clinic and home setting, with combined kinetic exercises. Accelerated rehabilitation protocol involving exercises to increas e muscle strength, knee ROM and proprioception along with reducing pain, inflammation and swelling can lead to better knee stability and a less complicated rehabilitation course.

  16. Injured athletes' rehabilitation beliefs and subjective well-being: the contribution of hope and social support.

    Science.gov (United States)

    Lu, Frank J H; Hsu, Yawen

    2013-01-01

    Injuries are a significant problem in the world of sports. Hope and social support are very important features in providing psychological help as people face life challenges such as sport injuries. To examine how hope and social support uniquely and jointly predict postinjury rehabilitation beliefs, rehabilitation behavior, and subjective well-being. Cross-sectional study. Four sports-injury rehabilitation centers of local universities in Taiwan. A total of 224 injured Taiwanese collegiate student-athletes. The Trait Hope Scale, the Sports Injury Rehabilitation Beliefs Survey, the Satisfaction with Life Scale, the Positive Affective and Negative Affective Scale, and the Multidimensional Scale of Perceived Social Support were completed by participants after they received their regular rehabilitation treatment. We conducted hierarchical regressions and found that social support and 2 types of hope in injured athletes predicted their rehabilitation beliefs and subjective well-being. However, only hope agency predicted their rehabilitation behavior. Also, hope and social support had an interactive effect on the prediction of subjective well-being; for participants with low hope pathways, the perception of more social support was associated with higher levels of subjective well-being, whereas social support had only a relatively low association with subjective well-being among participants with high hope pathways. Enhancing hope perceptions and strengthening injured athletes' social support during rehabilitation are beneficial to rehabilitation behavior and subjective well-being.

  17. Reviewing the Evidence: In Pursuit of a Framework for Parkinson Disease Rehabilitation with Games.

    Science.gov (United States)

    Tece Bayrak, Aslihan; Wünsche, Burkhard; Lutteroth, Christof

    2016-01-01

    Exercise gaming has been receiving a significant interest from both consumers and researchers. Be it for the purposes of weight loss, physical fitness or even just enjoyment, the potential of games to support rehabilitation has also been under investigation for a while. Due to our aging society, game based therapies could be a solution for optimizing resources and reducing rehabilitation costs. This paper aims to discuss the potential capacity of games as systems to enhance the relation of physical exercise and cognition for the rehabilitation of Parkinson Disease. Our investigation demonstrates that there is no established methodology for games in rehabilitation of Parkinson's addressing how games can encapsulate physical exercise strategies while providing safety, continuous monitoring and cognitive development exercises in facilitation of rehabilitation. Since rehabilitation with games is trending, yet to be developed rehabilitation strategies would benefit from new insights into the relationship between game worlds, physical exercise and motor-cognitive training. Therefore, it is useful to do further research into realizing (1) a relational model that demonstrates the relation between game world (composed of game features including formal game elements, audio-visual features, mechanics and dynamics), motor skills, cognition and physical exercise for both generic and specific rehabilitation purposes, (2) a structured task creation approach for game features that reconciles specific rehabilitation outcomes, correct level of engagement, task difficulty and safety requirements for target demographic.

  18. Injured Athletes' Rehabilitation Beliefs and Subjective Well-Being: The Contribution of Hope and Social Support

    Science.gov (United States)

    Lu, Frank J. H; Hsu, Yawen

    2013-01-01

    Context Injuries are a significant problem in the world of sports. Hope and social support are very important features in providing psychological help as people face life challenges such as sport injuries. Objective To examine how hope and social support uniquely and jointly predict postinjury rehabilitation beliefs, rehabilitation behavior, and subjective well-being. Design Cross-sectional study. Setting Four sports-injury rehabilitation centers of local universities in Taiwan. Participants A total of 224 injured Taiwanese collegiate student-athletes. Main Outcomes Measure(s) The Trait Hope Scale, the Sports Injury Rehabilitation Beliefs Survey, the Satisfaction with Life Scale, the Positive Affective and Negative Affective Scale, and the Multidimensional Scale of Perceived Social Support were completed by participants after they received their regular rehabilitation treatment. Results We conducted hierarchical regressions and found that social support and 2 types of hope in injured athletes predicted their rehabilitation beliefs and subjective well-being. However, only hope agency predicted their rehabilitation behavior. Also, hope and social support had an interactive effect on the prediction of subjective well-being; for participants with low hope pathways, the perception of more social support was associated with higher levels of subjective well-being, whereas social support had only a relatively low association with subjective well-being among participants with high hope pathways. Conclusions Enhancing hope perceptions and strengthening injured athletes' social support during rehabilitation are beneficial to rehabilitation behavior and subjective well-being. PMID:23672330

  19. Transitional determinacies.

    Science.gov (United States)

    Luelsdorff, P A

    1992-01-01

    In classic generative grammar a distinction is drawn between linguistic 'competence' and linguistic 'performance', the former referring to linguistic knowledge, the latter to how linguistic knowledge is used. However, this controversial differentiation obscures the additional dichotomy between linguistic knowledge for production and linguistic knowledge for recognition. In this article it is shown that production and recognition differ, that recognition is not simply the inverse of production, and that the derivation of production from recognition and recognition from production require a small set of generalizable 'transitional determinacies'. Secondly, it is shown that transitional determinacies explain the difference between 'overt' and 'covert' recognition recently observed in prosopagnosics, patients unable to recognize familiar faces. Prosopagnosics and normals are found to differ in their transitional determinacies, such that prosopagnosics require more binders (precisors) for covert recognition than normals. In general, it is concluded that transitional determinacies are as necessary to the theory of grammar as determinacies themselves.

  20. Stroke survivors' experiences of rehabilitation

    DEFF Research Database (Denmark)

    Peoples, Hanne; Satink, Ton; Steultjens, Esther

    2011-01-01

    INTRODUCTION: The aim was to obtain the best available knowledge on stroke survivors' experiences of rehabilitation. The increase in demands for accountability in health care and acknowledgement of the importance of client participation in health decisions calls for systematic ways of integrating...... survivors' experiences of rehabilitation in a clinical setting. Data analysis entailed extracting, editing, grouping, and abstracting findings. RESULTS: Twelve studies were included. One theme, "Power and Empowerment" and six subcategories were identified: 1) Coping with a new situation, 2) Informational...... needs, 3) Physical and non-physical needs, 4) Being personally valued and treated with respect, 5) Collaboration with health care professionals and 6) Assuming responsibility and seizing control. DISCUSSION: The synthesis showed that stroke survivors' experiences of rehabilitation reflected individual...

  1. Research in Danish cancer rehabilitation

    DEFF Research Database (Denmark)

    Høybye, Mette Terp; Dalton, Susanne Oksbjerg; Christensen, Jane

    2008-01-01

    of the cancer survivors with respect to cancer site, sociodemographic variables, social network, lifestyle, self-rated health and the prevalence of cancer-related late effects. The study is part of the FOCARE research project, in which the long-term effects of the rehabilitation programme are evaluated...... systematically. The study is based on data from a self-administered baseline questionnaire filled in by 2 174 cancer survivors who registered for a 1-week, publicly paid rehabilitation retreat and were invited to participate in the FOCARE study in the period 25 November 2002 to 31 December 2005. The response...... experience considerably reduced physical health, possibly as late physical effects of treatment. The problems reported by the cancer survivors suggest that cancer rehabilitation should include these aspects of living after cancer and take account of differences among cancer survivors with regard to cancer...

  2. [Work-Related Medical Rehabilitation].

    Science.gov (United States)

    Bethge, M

    2017-02-01

    Work-related medical rehabilitation (WMR) is a strategy to improve work participation in patients with poor work ability. This review summarizes the state of knowledge on WMR. The prevalence of poor work ability and corresponding need for WMR is high (musculoskeletal disorders: 43%; mental disorders: 57%). The meta-analysis of randomized controlled trials in patients with musculoskeletal disorders shows better return to work outcomes after one year in favor of WMR patients than compared to patients participating in usual medical rehabilitation. The amount of work-related measures in rehabilitation was clearly increased during recent years. A direct involvement of the workplace and a closer cooperation with employers and occupational health physicians may further improve the outcomes of WMR. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Connecticut Transit (CTTRANSIT) Fuel Cell Transit Bus: Preliminary Evaluation Results

    Energy Technology Data Exchange (ETDEWEB)

    Chandler, K.; Eudy, L.

    2008-10-01

    This report provides preliminary results from a National Renewable Energy Laboratory evaluation of a protoptye fuel cell transit bus operating at Connecticut Transit in Hartford. Included are descriptions of the planned fuel cell bus demonstration and equipment; early results and agency experience are also provided.

  4. [Supported own initiative of rehabilitation patients ("new credo") - a successful model?].

    Science.gov (United States)

    Deck, R; Schramm, S; Hüppe, A

    2012-10-01

    In recent years, rehabilitation aftercare has become an important topic in rehabilitation research and practice. This development was initiated by the lack of long-term effects after rehabilitation treatment and by the deficits identified in several reviews of aftercare recommendations and of actual practice of aftercare. Against this background, a new aftercare strategy was developed, the "New Credo", which focused aftercare from the beginning of rehabilitation treatment. A substantial element of the concept is the resumption and maintenance of physical activity in everyday life of the rehabilitation patient. The goal of the present study was the evaluation of this concept in a sample of patients with chronic back pain. The "New Credo" was evaluated in a multi-centre, prospective controlled longitudinal study with 3 points of measurement (before and after rehab as well as after 12 months). 6 rehabilitation clinics in Schleswig-Holstein were included in the intervention arm (IG, 3 clinics) and in the control arm (CG, 3 clinics), participants were rehabilitants with chronic back pain. The clinics in the intervention arm implemented "the New Credo" in accordance with their local conditions. During the study period they were provided with a person who was responsible for managing aftercare activities for patients. Participants in the CG received standard rehabilitation treatment according to general guidelines. Restriction of social participation, disability days and restriction in functional capacity in everyday life were defined as primary outcomes. Complete data were available for 166 rehabilitants in the IG and 368 in the CG. At the end of rehabilitation rehabilitants in the IG reported significantly higher use of treatment offerings and more intensive preparation for the time after rehabilitation treatment than rehabilitants in the CG. Rehabilitants in the IG found recommendations for the time after treatment significantly better than those in the CG. As expected

  5. Clinical designs of recent robot rehabilitation trials.

    Science.gov (United States)

    Lo, Albert C

    2012-11-01

    Rehabilitation robots are increasingly being tested and promoted for clinical neurorehabilitation. Compared with conventional and manual methods, robots allow for a variety of advantages, particularly in the areas of interventional control and the ability to provide a high volume of facilitated movement. Since 1997, there have been more than 60 clinical trials reporting the use of two dozen different robots for neurorehabilitation. Although there are a number of smaller pilot studies, there are only few larger clinical trials. There may be a number of reasons why pilot robot studies do not materialize into larger studies. Beyond devices that failed to perform as intended, what are the clinical design issues that have limited these studies? Some basic considerations include randomization, inclusion of a control group, power calculation based on a clinically meaningful outcome, and finally, reproducible descriptions of the intervention being tested. Although many of these issues are general challenges presented for all rehabilitation studies, there are clinical design features that would likely greatly improve interpretation of results and better position robot devices toward the next clinical trial step. On the other hand, the absence of these elements, even in the setting of a pilot study, may significantly hamper the interpretation of results and not yield sufficient information on treatment effects, adverse event rates, dropout rate, and so on, to allow further testing to proceed to follow-up Food and Drug Administration phase II and III studies. Development of rehabilitation robots for clinical use needs to occur hand in hand with well-conducted clinical trials to provide evidence of efficacy while also taking into account costs.

  6. 77 FR 24934 - Proposed Priority-National Institute on Disability and Rehabilitation Research-Disability and...

    Science.gov (United States)

    2012-04-26

    ...). Among persons 25 to 54 years of age during the recent recession, the unemployment rate of persons with a...). These differences in employment and unemployment rates exist across all socio-demographic groups... employment outcomes for transition-aged youth. (vi) Vocational rehabilitation (VR) practices that result in...

  7. Punjabi Sikh patients' cardiac rehabilitation experiences following myocardial infarction: a qualitative analysis.

    Science.gov (United States)

    Galdas, Paul M; Kang, H Bindy K

    2010-11-01

    To explore the cardiac rehabilitation experiences of Punjabi Sikh patients post myocardial infarction. Punjabi Sikh people are at significantly higher risk of mortality from myocardial infarction compared with those of European descent. Punjabi Sikh patients' participation in cardiac rehabilitation post myocardial infarction is therefore likely to yield considerable benefits. However, uptake of cardiac rehabilitation by South Asian people has been reported to be modest. Previous investigators have seldom provided insight into experiences of Punjabi Sikh patients post myocardial infarction and the steps that can be taken to improve the appropriateness of cardiac rehabilitation programmes for this at-risk patient group. Interpretive qualitative design. In-depth interviews, based on the McGill Illness Narrative Interview schedule, with 15 Punjabi Sikh patients post myocardial infarction attending a cardiac rehabilitation programme in British Columbia, Canada, were conducted; thematic analysis using grounded theory methods of coding and constant comparative analysis was employed. Four mutually exclusive themes emerged relating to the salient aspects of participants' cardiac rehabilitation experience: 'making sense of the diagnosis', 'practical dietary advice', 'ongoing interaction with peers and the multi-disciplinary team' and 'transport and attendance'. The themes identified point towards some of the ingredients necessary for providing culturally appropriate cardiac rehabilitation interventions for Punjabi Sikh patients following myocardial infarction. The findings highlight the importance of providing culturally relevant rehabilitation advice about diet and lifestyle changes and providing time for ongoing dialogue with support from health care professionals and peers. The findings from this study also illustrate the need to avoid generalisations about the impact religious beliefs may have on South Asian individuals' willingness to adhere to cardiac rehabilitation

  8. Que Sucede? Manual Informativo Sobre Rehabilitacion y Educacion Especial en Costa Rica (What's Happening? Informative Manual on Rehabilitation and Special Education in Costa Rica).

    Science.gov (United States)

    de Mezerville, Gaston; And Others

    The manual, in Spanish, provides descriptions of rehabilitation, medical, and special education services; centers and institutions which offer physical and mental rehabilitation services; and lists of professionals and advocacy organizations in Costa Rica. Part 1 includes an overview of rehabilitation and special education, a short history of…

  9. Rehabilitation interventions for cancer survivors

    DEFF Research Database (Denmark)

    Hansen, Helle Ploug; Tjørnhøj-Thomsen, Tine; Johansen, Christoffer

    2011-01-01

    BACKGROUND: Today more and more people survive cancer. Cancer survivors need help to recover both from the cancer and the treatment. Rehabilitative interventions have been set up to meet their needs. However, there are studies that report no major effects following careful, targeted intervention...... parameters in rehabilitation courses for cancer survivors in Denmark. METHODS: The study was based on an ethnographic fieldwork with participant observation at nine week-long courses, on in-depth interviews and on written sources. Fieldwork is well-suited for studying interventions in context, such as social...

  10. THE REHABILITATION MANAGEMENT OF LYMPHEDEMA

    Directory of Open Access Journals (Sweden)

    OJOGA Florina

    2015-05-01

    Full Text Available Lymphedema is an important pathology for rehabilitation medecine, especially for the patients who underwent a mastectomy for breast cancer. His frequency is higher when mastectomy is combined with lymph node disection and irradiation of the lymph nodes. Symptoms include heaviness, numbness, pain, stiffness and weakness in the affected limb. Complications of lymphedema include infections such as cellulitis, erysipelas and lymphangitis. Treatment must be instituted as soon as possible and preventive measures are essential. The rehabilitation treatment consists of skin care measures, manual lymphatic massage, elastic compression of the affected limb and kinetotherapy.

  11. Rehabilitation of the muscular dystrophies.

    Science.gov (United States)

    Pangilinan, Percival H; Hornyak, Joseph E

    2013-01-01

    The muscular dystrophies (MD) are a heterogeneous group of inherited disorders characterized by findings on muscle biopsy. In general, they feature progressive muscle wasting and weakness. In addition to the musculoskeletal system, direct and indirect effects can be seen in a variety of organ systems. These issues create challenges in patients with MD for ambulation and mobility, self-care, pain, fatigue, and community involvement. Because of its progressive nature and wide variety of pathophysiological mechanisms, patients with MD require individualized rehabilitation care. This chapter reviews specific rehabilitation needs and treatment of patients with MD. Copyright © 2013 Elsevier B.V. All rights reserved.

  12. Early rehabilitation and participation in focus

    DEFF Research Database (Denmark)

    Pallesen, Hanne; Buhl, Inge; Roenn-Smidt, Helle

    2016-01-01

    Early neurorehabilitation is an interdisciplinary field. Thus, in order to eliminate unnecessary barriers for individuals with severe acquired brain injury in early rehabilitation, we need rehabilitation science that supports both quantitative and qualitative research methods. Participation can...

  13. Early rehabilitation and participation in focus

    DEFF Research Database (Denmark)

    Pallesen, Hanne; Buhl, Inge; Roenn-Smidt, Helle

    2016-01-01

    Early neurorehabilitation is an interdisciplinary field. Thus, in order to eliminate unnecessary barriers for individuals with severe acquired brain injury in early rehabilitation, we need rehabilitation science that supports both quantitative and qualitative research methods. Participation can b...

  14. Stroke Rehabilitation: What Research is Being Done?

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Stroke Rehabilitation What Research is Being Done? Past Issues / ... Table of Contents To Find Out More MedlinePlus: Stroke Rehabilitation medlineplus.gov/strokerehabilitation.html National Institute of ...

  15. African Journal of Physiotherapy and Rehabilitation Sciences ...

    African Journals Online (AJOL)

    African Journal of Physiotherapy and Rehabilitation Sciences: Journal Sponsorship. Journal Home > About the Journal > African Journal of Physiotherapy and Rehabilitation Sciences: Journal Sponsorship. Log in or Register to get access to full text downloads.

  16. Archives: African Journal of Physiotherapy and Rehabilitation ...

    African Journals Online (AJOL)

    Items 1 - 7 of 7 ... Archives: African Journal of Physiotherapy and Rehabilitation Sciences. Journal Home > Archives: African Journal of Physiotherapy and Rehabilitation Sciences. Log in or Register to get access to full text downloads.

  17. Rehabilitation Counseling with the Visually Impaired.

    Science.gov (United States)

    Vander Kolk, Charles J.

    1983-01-01

    Guidelines for rehabilitation counselors working with legally blind individuals focus on approaches to overcome mobility and communication barriers, socialization training, understanding social and self perceptions, rehabilitation assessment and planning, and techniques useful to field and facility counselors. (CL)

  18. Cancer rehabilitation: increasing awareness and removing barriers.

    Science.gov (United States)

    Paul, Kelly; Buschbacher, Ralph

    2011-05-01

    It has been more than 30 years since Lehman et al. published research identifying rehabilitation problems encountered at different cancer sites, the need for rehabilitation services, and gaps in the delivery of rehabilitation care. The lack of identification of patient problems and the lack of appropriate referral by physicians unfamiliar with the concept of rehabilitation were identified as primary barriers to optimal delivery of rehabilitation care. These are frustratingly the same barriers to cancer rehabilitation we see today. Recommendations have been made for finding better methods for identifying and managing the broader effects of cancer and its treatment and for integrating a more holistic interdisciplinary approach during and after the treatment of patients with cancer. The purpose of this supplement was to increase awareness of the role of rehabilitation in cancer care among the public and among medical professionals, as well as to stimulate further interest and training in the field of cancer rehabilitation.

  19. What To Expect During Pulmonary Rehabilitation

    Science.gov (United States)

    ... NHLBI on Twitter. What To Expect During Pulmonary Rehabilitation Pulmonary rehabilitation (PR) can have many parts, and not all ... your endurance and muscle strength, so you're better able to carry out daily activities. The plan ...

  20. A review of technological and clinical aspects of robot-aided rehabilitation of upper-extremity after stroke.

    Science.gov (United States)

    Babaiasl, Mahdieh; Mahdioun, Seyyed Hamed; Jaryani, Poorya; Yazdani, Mojtaba

    2016-01-01

    Cerebrovascular accident (CVA) or stroke is one of the leading causes of disability and loss of motor function. Millions of people around the world are effected by it each year. Stroke results in disabled arm function. Restoration of arm function is essential to regaining activities of daily living (ADL). Along with traditional rehabilitation methods, robot-aided therapy has emerged in recent years. Robot-aided rehabilitation is more intensive, of longer duration and more repetitive. Using robots, repetitive dull exercises can turn into a more challenging and motivating tasks such as games. Besides, robots can provide a quantitative measure of the rehabilitation progress. This article overviews the terms used in robot-aided upper-limb rehabilitation. It continues by investigating the requirements for rehabilitation robots. Then the most outstanding works in robot-aided upper-limb rehabilitation and their control schemes have been investigated. The clinical outcomes of the built robots are also given that demonstrates the usability of these robots in real-life applications and their acceptance. This article summarizes a review done along with a research on the design, simulation and control of a robot for use in upper-limb rehabilitation after stroke. Implications for Rehabilitation Reviewing common terms in rehabilitation of upper limb using robots Reviewing rehabilitation robots built up to date Reviewing clinical outcomes of the mentioned rehabilitation robots.