WorldWideScience

Sample records for rehabilitation faster improving

  1. Function after spinal treatment, exercise and rehabilitation (FASTER): improving the functional outcome of spinal surgery.

    Science.gov (United States)

    McGregor, A H; Doré, C J; Morris, T P; Morris, S; Jamrozik, K

    2010-01-26

    The life-time incidence of low back pain is high and diagnoses of spinal stenosis and disc prolapse are increasing. Consequently, there is a steady rise in surgical interventions for these conditions. Current evidence suggests that while the success of surgery is incomplete, it is superior to conservative interventions. A recent survey indicates that there are large differences in the type and intensity of rehabilitation, if any, provided after spinal surgery as well as in the restrictions and advice given to patients in the post-operative period. This trial will test the hypothesis that functional outcome following two common spinal operations can be improved by a programme of post-operative rehabilitation that combines professional support and advice with graded active exercise and/or an educational booklet based on evidence-based messages and advice. The study design is a multi-centre, factorial, randomised controlled trial with patients stratified by surgeon and operative procedure. The trial will compare the effectiveness and cost-effectiveness of a rehabilitation programme and an education booklet for the postoperative management of patients undergoing discectomy or lateral nerve root decompression, each compared with "usual care"using a 2 x 2 factorial design. The trial will create 4 sub-groups; rehabilitation-only, booklet-only, rehabilitation-plus-booklet, and usual care only. The trial aims to recruit 344 patients, which equates to 86 patients in each of the four sub-groups. All patients will be assessed for functional ability (through the Oswestry Disability Index - a disease specific functional questionnaire), pain (using visual analogue scales), and satisfaction pre-operatively and then at 6 weeks, 3, 6 and 9 months and 1 year post-operatively. This will be complemented by a formal analysis of cost-effectiveness. This trial will determine whether the outcome of spinal surgery can be enhanced by either a post-operative rehabilitation programme or an

  2. Item hierarchy-based analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke.

    Science.gov (United States)

    Roorda, Leo D; Green, John R; Houwink, Annemieke; Bagley, Pam J; Smith, Jane; Molenaar, Ivo W; Geurts, Alexander C

    2012-06-01

    To enable improved interpretation of the total score and faster scoring of the Rivermead Mobility Index (RMI) by studying item ordering or hierarchy and formulating start-and-stop rules in patients after stroke. Cohort study. Rehabilitation center in the Netherlands; stroke rehabilitation units and the community in the United Kingdom. Item hierarchy of the RMI was studied in an initial group of patients (n=620; mean age ± SD, 69.2±12.5y; 297 [48%] men; 304 [49%] left hemisphere lesion, and 269 [43%] right hemisphere lesion), and the adequacy of the item hierarchy-based start-and-stop rules was checked in a second group of patients (n=237; mean age ± SD, 60.0±11.3y; 139 [59%] men; 103 [44%] left hemisphere lesion, and 93 [39%] right hemisphere lesion) undergoing rehabilitation after stroke. Not applicable. Mokken scale analysis was used to investigate the fit of the double monotonicity model, indicating hierarchical item ordering. The percentages of patients with a difference between the RMI total score and the scores based on the start-and-stop rules were calculated to check the adequacy of these rules. The RMI had good fit of the double monotonicity model (coefficient H(T)=.87). The interpretation of the total score improved. Item hierarchy-based start-and-stop rules were formulated. The percentages of patients with a difference between the RMI total score and the score based on the recommended start-and-stop rules were 3% and 5%, respectively. Ten of the original 15 items had to be scored after applying the start-and-stop rules. Item hierarchy was established, enabling improved interpretation and faster scoring of the RMI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Technology improves upper extremity rehabilitation.

    Science.gov (United States)

    Kowalczewski, Jan; Prochazka, Arthur

    2011-01-01

    Stroke survivors with hemiparesis and spinal cord injury (SCI) survivors with tetraplegia find it difficult or impossible to perform many activities of daily life. There is growing evidence that intensive exercise therapy, especially when supplemented with functional electrical stimulation (FES), can improve upper extremity function, but delivering the treatment can be costly, particularly after recipients leave rehabilitation facilities. Recently, there has been a growing level of interest among researchers and healthcare policymakers to deliver upper extremity treatments to people in their homes using in-home teletherapy (IHT). The few studies that have been carried out so far have encountered a variety of logistical and technical problems, not least the difficulty of conducting properly controlled and blinded protocols that satisfy the requirements of high-level evidence-based research. In most cases, the equipment and communications technology were not designed for individuals with upper extremity disability. It is clear that exercise therapy combined with interventions such as FES, supervised over the Internet, will soon be adopted worldwide in one form or another. Therefore it is timely that researchers, clinicians, and healthcare planners interested in assessing IHT be aware of the pros and cons of the new technology and the factors involved in designing appropriate studies of it. It is crucial to understand the technical barriers, the role of telesupervisors, the motor improvements that participants can reasonably expect and the process of optimizing IHT-exercise therapy protocols to maximize the benefits of the emerging technology. Copyright © 2011 Elsevier B.V. All rights reserved.

  4. 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)—a member of the U.S. Department of Energy’s Partnership for Home Innovation Building America research team—to rehabilitate 418 low-income multifamily rental apartments located at 14 properties in Georgia (International Energy Conservation Code Climate Zones 2–4). These 22-year-old units with individual utility meters were arranged in row house or townhouse style. Rehabilitation plans were developed using a process prescribed by the U.S. Department of Agriculture (USDA) Rural Development program, which partially funded the building upgrades. The USDA is responsible for building, upgrading, and subsidizing housing in rural areas nationwide; this housing includes more than 14,000 existing multifamily housing developments. In 2012, more than $100 million in grants and loans were allocated for that purpose.

  5. 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.

  6. Using implementation tools to design and conduct quality improvement projects for faster and more effective improvement.

    Science.gov (United States)

    Ovretveit, John; Mittman, Brian; Rubenstein, Lisa; Ganz, David A

    2017-10-09

    Purpose The purpose of this paper is to enable improvers to use recent knowledge from implementation science to carry out improvement changes more effectively. It also highlights the importance of converting research findings into practical tools and guidance for improvers so as to make research easier to apply in practice. Design/methodology/approach This study provides an illustration of how a quality improvement (QI) team project can make use of recent findings from implementation research so as to make their improvement changes more effective and sustainable. The guidance is based on a review and synthesis of improvement and implementation methods. Findings The paper illustrates how research can help a quality project team in the phases of problem definition and preparation, in design and planning, in implementation, and in sustaining and spreading a QI. Examples of the use of different ideas and methods are cited where they exist. Research limitations/implications The example is illustrative and there is little limited experimental evidence of whether using all the steps and tools in the one approach proposed do enable a quality team to be more effective. Evidence supporting individual guidance proposals is cited where it exists. Practical implications If the steps proposed and illustrated in the paper were followed, it is possible that quality projects could avoid waste by ensuring the conditions they need for success are in place, and sustain and spread improvement changes more effectively. Social implications More patients could benefit more quickly from more effective implementation of proven interventions. Originality/value The paper is the first to describe how improvement and implementation science can be combined in a tangible way that practical improvers can use in their projects. It shows how QI project teams can take advantage of recent advances in improvement and implementation science to make their work more effective and sustainable.

  7. Improving rehabilitation treatment in a local setting : a case study of prosthetic rehabilitation

    NARCIS (Netherlands)

    van Twillert, Sacha; Postema, Klaas; Geertzen, Jan H. B.; Hemminga, Titia; Lettinga, Ant T.

    2009-01-01

    Objective: To contribute to the discussion on the research-practice gap by illustrating obstacles and opportunities that arise in an evidence-informed improvement process of prosthetic rehabilitation in a local setting. Setting: Dutch rehabilitation centre. Presupposition: The improvement process

  8. PET/CT Biograph trademark Sensation 16. Performance improvement using faster electronics

    International Nuclear Information System (INIS)

    Martinez, M.J.; Schwaiger, M.; Ziegler, S.I.; Bercier, Y.

    2006-01-01

    Aim: the new PET/CT biograph sensation 16 (BS16) tomographs have faster detector electronics which allow a reduced timing coincidence window and an increased lower energy threshold (from 350 to 400 keV). This paper evaluates the performance of the BS16 PET scanner before and after the Pico-3D electronics upgrade. Methods: four NEMA NU 2-2001 protocols, (i) spatial resolution, (ii) scatter fraction, count losses and random measurement, (iii) sensitivity, and (iv) image quality, have been performed. Results: a considerable change in both PET count-rate performance and image quality is observed after electronics upgrade. The new scatter fraction obtained using Pico-3D electronics showed a 14% decrease compared to that obtained with the previous electronics. At the typical patient background activity (5.3 kBq/ml), the new scatter fraction was approximately 0.42. The noise equivalent count-rate (R NEC ) performance was also improved. The value at which the R NEC curve peaked, increased from 3.7 . 10 4 s -1 at 14 kBq/ml to 6.4 . 10 4 s -1 at 21 kBq/ml (2R-NEC rate). Likewise, the peak true count-rate value increased from 1.9 . 10 5 s -1 at 22 kBq/ml to 3.4 . 10 5 s -1 at 33 kBq/ml. An average increase of 45% in contrast was observed for hot spheres when using AW-OSEM (4ix8s) as the reconstruction algorithm. For cold spheres, the average increase was 12%. Conclusion: the performance of the PET scanners in the BS16 tomographs is improved by the optimization of the signal processing. The narrower energy and timing coincidence windows lead to a considerable increase of signal-to-noise ratio. The existing combination of fast detectors and adapted electronics in the BS16 tomographs allow imaging protocols with reduced acquisition time, providing higher patient throughput. (orig.)

  9. Community-Based Rehabilitation to Improve Stroke Survivors' Rehabilitation Participation and Functional Recovery.

    Science.gov (United States)

    Ru, Xiaojuan; Dai, Hong; Jiang, Bin; Li, Ninghua; Zhao, Xingquan; Hong, Zhen; He, Li; Wang, Wenzhi

    2017-07-01

    The aim of this study was to evaluate the effectiveness of a community-based rehabilitation appropriate technique (CRAT) intervention program in increasing rehabilitation participation and improving functional recovery of stroke survivors. This study followed a quasi-experimental design. In each of 5 centers servicing approximately 50,000 individuals, 2 communities were designated as either the intervention or control community. A CRAT intervention program, including 2-year rehabilitation education and 3-month CRAT treatment, was regularly implemented in the intervention communities, whereas there was no special intervention in the control community. Two sampling surveys, at baseline and after intervention, were administered to evaluate the rehabilitation activity undertaken. In intervention communities, stroke survivor's motor function, daily activity, and social activity were evaluated pretreatment and posttreatment, using the Fugl-Meyer Motor Function Assessment, Barthel index, and Social Functional Activities Questionnaire. The proportion of individuals participating in rehabilitation-related activity was increased significantly (P rehabilitation (P 0.05). Community-based rehabilitation appropriate technique increases rehabilitation participation rates and enhances motor function, daily activity, and social activity of stroke survivors.

  10. National health expenditure projections, 2013-23: faster growth expected with expanded coverage and improving economy.

    Science.gov (United States)

    Sisko, Andrea M; Keehan, Sean P; Cuckler, Gigi A; Madison, Andrew J; Smith, Sheila D; Wolfe, Christian J; Stone, Devin A; Lizonitz, Joseph M; Poisal, John A

    2014-10-01

    In 2013 health spending growth is expected to have remained slow, at 3.6 percent, as a result of the sluggish economic recovery, the effects of sequestration, and continued increases in private health insurance cost-sharing requirements. The combined effects of the Affordable Care Act's coverage expansions, faster economic growth, and population aging are expected to fuel health spending growth this year and thereafter (5.6 percent in 2014 and 6.0 percent per year for 2015-23). However, the average rate of increase through 2023 is projected to be slower than the 7.2 percent average growth experienced during 1990-2008. Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013-23, the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023. Project HOPE—The People-to-People Health Foundation, Inc.

  11. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression.

    Science.gov (United States)

    Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H

    2017-10-27

    The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

  12. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

    Science.gov (United States)

    Grahn, Patrik; Pálsdóttir, Anna María; Ottosson, Johan; Jonsdottir, Ingibjörg H.

    2017-01-01

    The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work. PMID:29076997

  13. Longer Nature-Based Rehabilitation May Contribute to a Faster Return to Work in Patients with Reactions to Severe Stress and/or Depression

    Directory of Open Access Journals (Sweden)

    Patrik Grahn

    2017-10-01

    Full Text Available The global burden of depression and stress-related mental disorders is substantial, and constitutes a major need for effective rehabilitation. Can nature-based rehabilitation help people return to work? Objective: To study if the length of a nature-based rehabilitation program affects the outcome with regard to return to work one year after the onset of the program, in a group of patients with long-term reactions to severe stress and/or depression. Methods: A prospective, quasi-experimental study comparing results from 8-, 12-, and 24-week periods of rehabilitation. The rehabilitation of 106 participants was carried out by a multimodal rehabilitation team in a specially designed rehabilitation garden. Return to work data were collected before the intervention and one year after the start of rehabilitation. In addition, data were collected regarding self-assessed occupational competence, personal control, and sense of coherence. As many as 68% of the participants returned to work or participated in job training or work-oriented measures, full- or part-time, after one year. Participants with a longer period of rehabilitation reported better results on occupational competence, and were more likely to participate in paid work, full-time or part-time, one year after rehabilitation. Study outcomes indicate that a longer rehabilitation period in a rehabilitation garden increases the possibility of a return to paid work.

  14. Outpatient rehabilitation as an intervention to improve employees' physical capacity.

    Science.gov (United States)

    Ojala, Birgitta; Nygård, Clas-Håkan; Nikkari, Seppo T

    2016-01-01

    The aging of the workforce poses new challenges for maintaining work ability. Because of limited information on the effectiveness of vocational rehabilitation performed in traditional inpatient programs, extended interest in outpatient rehabilitation has risen in the past few years. We examined the effects of a new outpatient rehabilitation program where every participant defined their own goals to improve work ability by the aid of a goal-oriented multi-professional team. This report will focus on the employees' physical capacity during a nine-month program. A total of 605 municipal employees from different production areas of the City of Tampere took part in the outpatient rehabilitation program, implemented by the occupational health unit. Groups of 12 employees participated in eight one-day sessions at intervals of two to three weeks; the final follow-up was 9 months from the beginning. Submaximal aerobic capacity was tested by a calibrated cycle ergometer with a commercial program (Aino Fitware pro, Helsinki, Finland). Musculoskeletal tests assessed muscle strength, balance and mobility. During the 9-month follow-up of the rehabilitation program, the employees' physical capacity was improved. The follow-up test scores from a total of 329 employees were significantly higher in the submaximal aerobic capacity test (p health situation to take part in physical capacity tests; however they took part in the intervention. The new outpatient rehabilitation program organized by the occupational health unit had a positive influence on employees' physical capacity during a nine-month follow up.

  15. Which patients improve the most from arthritis rehabilitation?

    DEFF Research Database (Denmark)

    Hagel, Sofia; Lindqvist, Elisabet; Petersson, Ingemar F

    2014-01-01

    Objective: To study health-related quality of life (HRQoL) in arthritis rehabilitation performed by multidisciplinary teams in patients with chronic inflammatory arthritis. Predictors of change in health-related quality of life and the proportion of patients with clinical improvement were investi...

  16. Parenteral structured triglyceride emulsion improves nitrogen balance and is cleared faster from the blood in moderately catabolic patients.

    Science.gov (United States)

    Kruimel, J W; Naber, T H; van der Vliet, J A; Carneheim, C; Katan, M B; Jansen, J B

    2001-01-01

    Most postoperative patients lose net protein mass, which reflects loss of muscle tissue and organ function. Perioperative parenteral nutrition may reduce the loss of protein, but in general, with conventional lipid emulsions a waste of protein still remains. We compared the effects on nitrogen balance of an emulsion containing structured triglycerides, a new type of synthesized triglycerides, with an emulsion of a physical mixture of medium- and long-chain triglycerides as part of parenteral feeding in moderately catabolic patients. The first 5 days after placement of an aortic prosthesis patients received total parenteral nutrition (TPN) providing 0.2 g of nitrogen per kg body weight per day; energy requirement was calculated using Harris and Benedict's equation, adding 300 kcal per day for activity. Twelve patients were treated with the structured triglyceride emulsion and 13 patients with the emulsion of the physical mixture of medium- and long-chain triglycerides. The design was a randomized, double-blind parallel study. In the patients who completed the study, the mean cumulative nitrogen balance over the first 5 postoperative days was -8+/-2 g in 10 patients on the structured triglyceride emulsion and -21+/-4 g in 9 patients on the emulsion of the physical mixture of medium- and long-chain triglycerides; the mean difference was 13 g of nitrogen (95% confidence interval 4 to 22, p = .015) in favor of the structured triglyceride emulsion. On the first postoperative day serum triglyceride and plasma medium-chain free fatty acid levels increased less during infusion of the structured triglyceride emulsion than with the physical mixture emulsion. The parenteral structured triglyceride emulsion improves the nitrogen balance and is cleared faster from the blood, compared with the emulsion of the physical mixture of medium- and long-chain triglycerides, in moderately catabolic patients.

  17. Improving rehabilitation standards to meet changing community concerns: A history of uranium mine rehabilitation with particular reference to Northern Australia

    International Nuclear Information System (INIS)

    Waggitt, P.W.; Zapantis, A.

    2002-01-01

    Rehabilitation of land after mining is an issue that society has been wrestling with for at least 400 years. The issue is made even more emotive when the mineral extracted has been uranium. Over the past 50 years or so society has become ever more aware of the environment and the level of concern for proper environmental management has also increased. Today the community expects that mining in general, and uranium mining in particular, will be undertaken in an environmentally sensitive manner. As a consequence the expectations and standards for rehabilitation demanded by the community and regulators have been increasing and improving over time. Today the rehabilitation process is driven by issues of sustainable development, stakeholder involvement and consultation, inter-and intragenerational equity and a strong desire for environmental protection to be of the highest order. The paper describes this progressive improvement in rehabilitation standards using the uranium mines of northern Australia as case histories. (author)

  18. Writing faster Python

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    Did you know that Python preallocates integers from -5 to 257 ? Reusing them 1000 times, instead of allocating memory for a bigger integer, can save you a couple of milliseconds of code’s execution time. If you want to learn more about this kind of optimizations then, … well, probably this presentation is not for you :) Instead of going into such small details, I will talk about more "sane" ideas for writing faster code. After a very brief overview of how to optimize Python code (rule 1: don’t do this; rule 2: don’t do this yet; rule 3: ok, but what if I really want to do this ?), I will show simple and fast ways of measuring the execution time and finally, discuss examples of how some code structures could be improved. You will see: - What is the fastest way of removing duplicates from a list - How much faster your code is when you reuse the built-in functions instead of trying to reinvent the wheel - What is faster than the good ol’ for loop - If the lookup is faster in a list or a set (and w...

  19. Multidimensional improvements induced by an intensive obesity inpatients rehabilitation programme.

    Science.gov (United States)

    Giordano, Francesca; Berteotti, Michela; Budui, Simona; Calgaro, Nicole; Franceschini, Laura; Gilli, Federica; Masiero, Marina; Raschellà, Guido; Salvetti, Sabrina; Taddei, Micol; Schena, Federico; Busetto, Luca

    2017-06-01

    To analyse the short-term effectiveness of an intensive multidimensional inpatient programme specifically developed for patients with severe obesity. A multidisciplinary team managed a 3-week residential programme characterised by the integration of nutritional and physical rehabilitation with psychological and educational intervention. All patients consecutively admitted in 10 months were analysed at admission and discharge for changes in the following domains: anthropometry (weight, body mass index (BMI), waist and neck circumferences), cardiovascular risk factors (glycaemia, HbA1c, lipid profile, blood pressure), quality of life, eating behaviour, and physical performance (VO 2peak by incremental cycle ergometer test, 6-min walking test (6MWT), chair stands test). 136 subjects (61% females, median age 52.7 years) with obesity (mean BMI 43.2 kg/m 2 ) and multiple comorbidities were analysed. A 3.9% BMI reduction and a reduction in waist (-3.8%) and neck (-3.3%) circumferences were observed. Glycaemic control was achieved in 68% of patients with uncontrolled diabetes at admission. Blood pressure control was achieved in all patients with uncontrolled hypertension at admission. Total cholesterol (-16%), LDL-cholesterol (-19%) and triglycerides (-9%) were significantly reduced. Psychometric assessment showed improvements in quality of life perception and binge eating disorder. Finally, a significant improvement in physical performance (+4.7% improvement in VO 2peak , with longer distances in 6MWT and a higher number of standings) was observed. Our preliminary data prove that a 3-week programme determined a clinically significant multi-dimensional improvement in patients with severe obesity. Long-term follow-up data are needed to confirm the efficacy of our rehabilitation setting.

  20. 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...

  1. Implantable cardioverter defibrillator specific rehabilitation improves health cost outcomes

    DEFF Research Database (Denmark)

    Berg, Selina Kikkenborg; Zwisler, Ann-Dorthe; Koch, Mette Bjerrum

    2015-01-01

    OBJECTIVE: The Copenhagen Outpatient ProgrammE - implantable cardioverter defibrillator (COPE-ICD) trial included patients with implantable cardioverter defibrillators in a randomized controlled trial of rehabilitation. After 6-12 months significant differences were found in favour of the rehabil...... was -6,789 USD/-5,593 Euro in favour of rehabilitation. CONCLUSION: No long-term health outcome benefits were found for the rehabilitation programme. However, the rehabilitation programme resulted in a reduction in total attributable direct costs....... of the rehabilitation group for exercise capacity, general and mental health. The aim of this paper is to explore the long-term health effects and cost implications associated with the rehabilitation programme; more specifically, (i) to compare implantable cardioverter defibrillator therapy history and mortality...... between rehabilitation and usual care groups; (ii) to examine the difference between rehabilitation and usual care groups in terms of time to first admission; and (iii) to determine attributable direct costs. METHODS: Patients with first-time implantable cardioverter defibrillator implantation (n = 196...

  2. 75 FR 38510 - Office of Special Education and Rehabilitative Services; Personnel Development to Improve...

    Science.gov (United States)

    2010-07-02

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Personnel... word ``scholar'' in the Special Education Preservice Program Improvement Grants (84.325T) priority in....html . Dated: June 25, 2010. Alexa Posny, Assistant Secretary for Special Education and Rehabilitative...

  3. Increasing the amount of usual rehabilitation improves activity after stroke: a systematic review

    Directory of Open Access Journals (Sweden)

    Emma J Schneider

    2016-10-01

    Full Text Available Questions: In people receiving rehabilitation aimed at reducing activity limitations of the lower and/or upper limb after stroke, does adding extra rehabilitation (of the same content as the usual rehabilitation improve activity? What is the amount of extra rehabilitation that needs to be provided to achieve a beneficial effect? Design: Systematic review with meta-analysis of randomised trials. Participants: Adults aged 18 years or older that had a diagnosis of stroke. Intervention: Extra rehabilitation with the same content as usual rehabilitation aimed at reducing activity limitations of the lower and/or upper limb. Outcome measures: Activity measured as lower or upper limb ability. Results: A total of 14 studies, comprising 15 comparisons, met the inclusion criteria. Pooling data from all the included studies showed that extra rehabilitation improved activity immediately after the intervention period (SMD = 0.39, 95% CI 0.07 to 0.71, I2 = 66%. When only studies with a large increase in rehabilitation (> 100% were included, the effect was greater (SMD 0.59, 95% CI 0.23 to 0.94, I2 = 44%. There was a trend towards a positive relationship (r = 0.53, p = 0.09 between extra rehabilitation and improved activity. The turning point on the ROC curve of false versus true benefit (AUC = 0.88, p = 0.04 indicated that at least an extra 240% of rehabilitation was needed for significant likelihood that extra rehabilitation would improve activity. Conclusion: Increasing the amount of usual rehabilitation aimed at reducing activity limitations improves activity in people after stroke. The amount of extra rehabilitation that needs to be provided to achieve a beneficial effect is large. Trial registration: PROSPERO CRD42012003221. [Schneider EJ, Lannin NA, Ada L, Schmidt J (2016 Increasing the amount of usual rehabilitation improves activity after stroke: a systematic review. Journal of Physiotherapy 62: 182–187

  4. Predictors of improvement in observed functional ability in patients with fibromyalgia as an outcome of rehabilitation

    DEFF Research Database (Denmark)

    Amris, Kirstine; Luta, George; Christensen, Robin

    2016-01-01

    OBJECTIVE: To investigate predictors of improvement in observed ability to manage activities of daily living as an outcome of rehabilitation in fibromyalgia. METHODS: Exploratory analyses used data from the Interdisciplinary Rehabilitation and Evaluation Programme for Patients with Chronic...... Widespread Pain (the IMPROvE study); a randomized controlled trial including 191 females with fibromyalgia randomized (1:1) to rehabilitation or a waiting list. The primary outcome was observed activities of daily living ability evaluated with the Assessment of Motor and Process Skills (AMPS) 6 months post...

  5. IMPROVING THE REPORTING OF THERAPEUTIC EXERCISE INTERVENTIONS IN REHABILITATION RESEARCH.

    Science.gov (United States)

    Page, Phil; Hoogenboom, Barb; Voight, Michael

    2017-04-01

    The foundation of evidence-based practice lies in clinical research, which is based on the utilization of the scientific method. The scientific method requires that all details of the experiment be provided in publications to support replication of the study in order to evaluate and validate the results. More importantly, clinical research can only be translated into practice when researchers provide explicit details of the study. Too often, rehabilitation exercise intervention studies lack the appropriate detail to allow clinicians to replicate the exercise protocol in their patient populations. Therefore, the purpose of this clinical commentary is to provide guidelines for optimal reporting of therapeutic exercise interventions in rehabilitation research. 5.

  6. Urban waterfront rehabilitation: can it contribute to environmental improvements in the developing world?

    International Nuclear Information System (INIS)

    Vollmer, Derek

    2009-01-01

    This paper examines urban waterfront rehabilitation as a sustainable development strategy in Chinese cities. Though waterfront rehabilitation is increasingly being employed in developed world cities, the environmental benefits are not always clear. Nonetheless, China, like other developing countries, has shown interest in this strategy, for improving its local water quality, upgrading environmental management, and improving quality of life for urban residents. As developing world cities struggle to break from the traditional model of 'pollute first, clean up later', it is critical that they employ strategies which minimize or remediate environmental impacts while still promoting economic development. This paper analyzes three such projects: the Qinhuai River Environmental Improvement Project in Nanjing, the Suzhou Creek Rehabilitation in Shanghai, and the Wuli Lake Rehabilitation in Wuxi. A critical analysis indicates that these projects have served numerous purposes which contribute to the cities' sustainable development. Though waterways may not be restored to pristine conditions, the incremental improvements appear to be a necessary catalyst for sustainable urban development.

  7. Interventions to improve hearing aid use in adult auditory rehabilitation.

    Science.gov (United States)

    Barker, Fiona; Mackenzie, Emma; Elliott, Lynette; Jones, Simon; de Lusignan, Simon

    2016-08-18

    Acquired adult-onset hearing loss is a common long-term condition for which the most common intervention is hearing aid fitting. However, up to 40% of people fitted with a hearing aid either fail to use it or may not gain optimal benefit from it. This is an update of a review first published in The Cochrane Library in 2014. To assess the long-term effectiveness of interventions to promote the use of hearing aids in adults with acquired hearing loss fitted with at least one hearing aid. The Cochrane ENT Information Specialist searched the Cochrane ENT Trials Register; Central Register of Controlled Trials (CENTRAL 2016, Issue 5); PubMed; EMBASE; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 13 June 2016. We included randomised controlled trials (RCTs) of interventions designed to improve or promote hearing aid use in adults with acquired hearing loss compared with usual care or another intervention. We excluded interventions that compared hearing aid technology. We classified interventions according to the 'chronic care model' (CCM). The primary outcomes were hearing aid use (measured as adherence or daily hours of use) and adverse effects (inappropriate advice or clinical practice, or patient complaints). Secondary patient-reported outcomes included quality of life, hearing handicap, hearing aid benefit and communication. Outcomes were measured over the short ( 12 to quality of evidence to be very low or low for the primary outcomes where data were available.The majority of participants were over 65 years of age with mild to moderate adult-onset hearing loss. There was a mix of new and experienced hearing aid users. Six of the studies (287 participants) assessed long-term outcomes.All 37 studies tested interventions that could be classified using the CCM as self-management support (ways to help someone to manage their hearing loss and hearing aid(s) better by giving

  8. Shared governance: a way to improve the care in an inpatient rehabilitation facility.

    Science.gov (United States)

    Torres, Audrey; Kunishige, Nalani; Morimoto, Denise; Hanzawa, Tracie; Ebesu, Mike; Fernandez, John; Nohara, Lynne; SanAgustin, Eliseo; Borg, Stephanie

    2015-01-01

    Rehabilitation care is specialized and individualized requiring effective and efficient communication to achieve optimal patient outcomes. To examine how effective implementation of shared governance could improve care delivery, promote patient-centered care, and improve patient outcomes. The shared governance approach included all members of the rehabilitation team (i.e., physical therapist, occupational therapist, speech therapist, registered nurse and nurse aide) and was implemented over 6 months. The major end products of this shared governance effort were improved staff communication, problem solving, patient outcomes, and staff satisfaction on our stroke and brain injury unit. When effectively implemented and sustained, shared governance between all rehabilitation team stakeholders can increase the effectiveness of communication along with more positive patient and staff outcomes. © 2014 Association of Rehabilitation Nurses.

  9. Kidney Rehabilitation Technology by Improving Blood Flow and Nerve Activation

    International Nuclear Information System (INIS)

    Mohd Jamil Hashim

    2016-01-01

    The rehabilitation of kidney is impossible from doctors point of view. Kidney failure happens when nephron in kidney fail to filter blood and water. Two major causes of kidney failure. First is the shrinkage of kidney and the second is the blockage of kidney medulla. Kidney shrinkage is because nephron damage due to long term diabetes (Nephrology expert point of view). Whereas blockage of kidney is due to food consume which in turn build up deposit at the blood duct connecting to the medulla. Experiment specimen own body. The rehabilitation methodology is to build up your blood flow system and nerve activation. Result from the study is through analyzing blood components such as creatinine, hemoglobin, urea and potassium. Conclusion, creatinine value has lowered and kidney shrinkage has normalize to its original size. It is hopeful I regain my health 100 % when my GFR reading achieved below 100. (author)

  10. Vagus nerve stimulation during rehabilitative training improves forelimb strength following ischemic stroke.

    Science.gov (United States)

    Khodaparast, N; Hays, S A; Sloan, A M; Hulsey, D R; Ruiz, A; Pantoja, M; Rennaker, R L; Kilgard, M P

    2013-12-01

    Upper limb impairment is a common debilitating consequence of ischemic stroke. Physical rehabilitation after stroke enhances neuroplasticity and improves limb function, but does not typically restore normal movement. We have recently developed a novel method that uses vagus nerve stimulation (VNS) paired with forelimb movements to drive specific, long-lasting map plasticity in rat primary motor cortex. Here we report that VNS paired with rehabilitative training can enhance recovery of forelimb force generation following infarction of primary motor cortex in rats. Quantitative measures of forelimb function returned to pre-lesion levels when VNS was delivered during rehab training. Intensive rehab training without VNS failed to restore function back to pre-lesion levels. Animals that received VNS during rehab improved twice as much as rats that received the same rehabilitation without VNS. VNS delivered during physical rehabilitation represents a novel method that may provide long-lasting benefits towards stroke recovery. © 2013.

  11. Tai Chi and vestibular rehabilitation improve vestibulopathic gait via different neuromuscular mechanisms: Preliminary report

    Directory of Open Access Journals (Sweden)

    Parker Stephen W

    2005-02-01

    Full Text Available Abstract Background Vestibular rehabilitation (VR is a well-accepted exercise program intended to remedy balance impairment caused by damage to the peripheral vestibular system. Alternative therapies, such as Tai Chi (TC, have recently gained popularity as a treatment for balance impairment. Although VR and TC can benefit people with vestibulopathy, the degree to which gait improvements may be related to neuromuscular adaptations of the lower extremities for the two different therapies are unknown. Methods We examined the relationship between lower extremity neuromuscular function and trunk control in 36 older adults with vestibulopathy, randomized to 10 weeks of either VR or TC exercise. Time-distance measures (gait speed, step length, stance duration and step width, lower extremity sagittal plane mechanical energy expenditures (MEE, and trunk sagittal and frontal plane kinematics (peak and range of linear and angular velocity, were measured. Results Although gait time-distance measures were improved in both groups following treatment, no significant between-groups differences were observed for the MEE and trunk kinematic measures. Significant within groups changes, however, were observed. The TC group significantly increased ankle MEE contribution and decreased hip MEE contribution to total leg MEE, while no significant changes were found within the VR group. The TC group exhibited a positive relationship between change in leg MEE and change in trunk velocity peak and range, while the VR group exhibited a negative relationship. Conclusion Gait function improved in both groups consistent with expectations of the interventions. Differences in each group's response to therapy appear to suggest that improved gait function may be due to different neuromuscular adaptations resulting from the different interventions. The TC group's improvements were associated with reorganized lower extremity neuromuscular patterns, which appear to promote a faster

  12. Longer - Faster - Purer

    CERN Multimedia

    Caroline Duc

    2013-01-01

    The MR-ToF-MS, a new ion trap, has been integrated into ISOLTRAP, the experiment that performs accurate mass measurements on short-lived nuclides produced at ISOLDE. When used as a mass separator and spectrometer, it extends ISOLTRAP’s experimental reach towards the limits of nuclear stability.   Susanne Kreim, the ISOLTRAP local group leader at CERN in front of a part of the ISOLTRAP device. When mass measurement experiments like ISOLTRAP* are placed in an on-line radioactive ion-beam facility they face a major challenge: the efficient and fast transfer of the nuclide of interest to the location where the mass measurement is performed. The biggest yield of one selected nuclide, without contaminants, needs to be transferred to the set-up as quickly as possible in order to measure its mass with the greatest precision. Recently, the ISOLTRAP collaboration installed a new device that provides a faster separation of isobars.** It has significantly improved ISOLTRAP’s purificat...

  13. Dynamics of muscle strength improvement during isokinetic rehabilitation of athletes with ACL rupture and chondromalacia patellae.

    Science.gov (United States)

    Desnica Bakrac, N

    2003-03-01

    To assess quantitatively dynamics and extent of the increase in muscle strength during isokinetic rehabilitation. daily measurements of muscle strength; detailed testing at the beginning and at the end of rehabilitation. Cybex Rehabilitation Center, Zagreb. 44 athletes (31 m, 13 F, age 16-35), 3 injury-defined groups: athletes with ACL rupture (non-reconstructed and reconstructed) and chondromalacia patellae. all subjects underwent isokinetic rehabilitation on Cybex Orthotron KT2 device, using individually designed protocols (extension and flexion exercises, concentric muscle contractions, 15 treatments). monitoring of daily progress on rehabilitation device and detailed testing on diagnostic device. All patients showed considerable improvement. Muscle strength improved on average 141% (SD=110) in ACL-reconstructed group, 144% (SD=130) for chondromalacia patellae group and 150% (SD=74) for ACL-non-reconstructed group, comparing to initial strength. Dynamic status tested on Cybex Otrhotron diagnostic device prior and after rehabilitation strongly correlated with final progress monitored on the rehabilitation device. Isokinetic rehabilitation is a quick and effective method in treating knee injuries in athletes. Both types of objective criteria have shown significant increase in muscle strength. The improvement of muscle strength was on the average 149% (SD=101), which is about 10% daily for 15 treatments. The greatest progress, 19% per day, occurred during first five days. The athletes were able to resume their sport activities as follows: patients from chondromalacia patellae group, and most of them from the non-reconstructed ACL group were back in competition within a month, while 75% from the ACL reconstructed group came back within 3 months, and the rest of them within 5 months.

  14. Technology-Based Rehabilitation to Improve Communication after Acquired Brain Injury

    Directory of Open Access Journals (Sweden)

    Carrie A. Des Roches

    2017-07-01

    Full Text Available The utilization of technology has allowed for several advances in aphasia rehabilitation for individuals with acquired brain injury. Thirty-one previous studies that provide technology-based language or language and cognitive rehabilitation are examined in terms of the domains addressed, the types of treatments that were provided, details about the methods and the results, including which types of outcomes are reported. From this, we address questions about how different aspects of the delivery of treatment can influence rehabilitation outcomes, such as whether the treatment was standardized or tailored, whether the participants were prescribed homework or not, and whether intensity was varied. Results differed by these aspects of treatment delivery but ultimately the studies demonstrated consistent improvement on various outcome measures. With these aspects of technology-based treatment in mind, the ultimate goal of personalized rehabilitation is discussed.

  15. Technology-Based Rehabilitation to Improve Communication after Acquired Brain Injury.

    Science.gov (United States)

    Des Roches, Carrie A; Kiran, Swathi

    2017-01-01

    The utilization of technology has allowed for several advances in aphasia rehabilitation for individuals with acquired brain injury. Thirty-one previous studies that provide technology-based language or language and cognitive rehabilitation are examined in terms of the domains addressed, the types of treatments that were provided, details about the methods and the results, including which types of outcomes are reported. From this, we address questions about how different aspects of the delivery of treatment can influence rehabilitation outcomes, such as whether the treatment was standardized or tailored, whether the participants were prescribed homework or not, and whether intensity was varied. Results differed by these aspects of treatment delivery but ultimately the studies demonstrated consistent improvement on various outcome measures. With these aspects of technology-based treatment in mind, the ultimate goal of personalized rehabilitation is discussed.

  16. Key Characteristics of Rehabilitation Quality Improvement Publications: Scoping Review From 2010 to 2016.

    Science.gov (United States)

    Jesus, Tiago S; Papadimitriou, Christina; Pinho, Cátia S; Hoenig, Helen

    2017-09-28

    To characterize the peer-reviewed quality improvement (QI) literature in rehabilitation. Five electronic databases were searched for English-language articles from 2010 to 2016. Keywords for QI and safety management were searched for in combination with keywords for rehabilitation content and journals. Secondary searches (eg, references-list scanning) were also performed. Two reviewers independently selected articles using working definitions of rehabilitation and QI study types; of 1016 references, 112 full texts were assessed for eligibility. Reported study characteristics including study focus, study setting, use of inferential statistics, stated limitations, and use of improvement cycles and theoretical models were extracted by 1 reviewer, with a second reviewer consulted whenever inferences or interpretation were involved. Fifty-nine empirical rehabilitation QI studies were found: 43 reporting on local QI activities, 7 reporting on QI effectiveness research, 8 reporting on QI facilitators or barriers, and 1 systematic review of a specific topic. The number of publications had significant yearly growth between 2010 and 2016 (P=.03). Among the 43 reports on local QI activities, 23.3% did not explicitly report any study limitations; 39.5% did not used inferential statistics to measure the QI impact; 95.3% did not cite/mention the appropriate reporting guidelines; only 18.6% reported multiple QI cycles; just over 50% reported using a model to guide the QI activity; and only 7% reported the use of a particular theoretical model. Study sites and focuses were diverse; however, nearly a third (30.2%) examined early mobilization in intensive care units. The number of empirical, peer-reviewed rehabilitation QI publications is growing but remains a tiny fraction of rehabilitation research publications. Rehabilitation QI studies could be strengthened by greater use of extant models and theory to guide the QI work, consistent reporting of study limitations, and use of

  17. Fixation Improvement through Biofeedback Rehabilitation in Stargardt Disease

    Directory of Open Access Journals (Sweden)

    G. Scuderi

    2016-01-01

    Full Text Available Stargardt disease is the most common hereditary macular degeneration in juveniles. It is characterized by macular dystrophy associated with loss of central vision in the first or second decade of life, a “beaten-metal” appearance in the fovea or parafoveal region, yellowish flecks around the macula or in posterior area of the retina, progressive atrophy of the bilateral foveal retinal pigment epithelium, and the “dark choroid” sign on fundus fluorescein angiography in most cases. We report a case of Stargardt disease in a 26-year-old Caucasian female submitted to rehabilitative training with microperimetry MP-1 to find a new preferred retinal locus (PRL and to train her to better her quality of life. Best corrected visual acuity, mean retinal sensitivity, fixation, bivariate contour ellipse area, and speed reading were evaluated before and after the training and results were discussed.

  18. Protein-energy malnutrition in the rehabilitation setting: Evidence to improve identification.

    Science.gov (United States)

    Marshall, Skye

    2016-04-01

    Methods of identifying malnutrition in the rehabilitation setting require further examination so that patient outcomes may be improved. The purpose of this narrative review was to: (1) examine the defining characteristics of malnutrition, starvation, sarcopenia and cachexia; (2) review the validity of nutrition screening tools and nutrition assessment tools in the rehabilitation setting; and (3) determine the prevalence of malnutrition in the rehabilitation setting by geographical region and method of diagnosis. A narrative review was conducted drawing upon international literature. Starvation represents one form of malnutrition. Inadequate energy and protein intake are the critical factor in the aetiology of malnutrition, which is distinct from sarcopenia and cachexia. Eight nutrition screening tools and two nutrition assessment tools have been evaluated for criterion validity in the rehabilitation setting, and consideration must be given to the resources of the facility and the patient group in order to select the appropriate tool. The prevalence of malnutrition in the rehabilitation setting ranges from 14-65% worldwide with the highest prevalence reported in rural, European and Australian settings. Malnutrition is highly prevalent in the rehabilitation setting, and consideration must be given to the patient group when determining the most appropriate method of identification so that resources may be used efficaciously and the chance of misdiagnosis minimised. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  19. Use of a Smartphone for Improved Self-Management of Pulmonary Rehabilitation

    Directory of Open Access Journals (Sweden)

    A. Marshall

    2008-01-01

    Full Text Available Patients suffering from chronic respiratory disease need to follow a rehabilitative exercise programme, in order to self-manage their illness and improve quality of life. Adherence to the programme is highly dependent on professional support from a physiotherapist and hence declines when patients seek to self-manage in the home. A number of requirements were identified for a Smartphone-based application in which patients are supported remotely and given automatic feedback during exercise. An application is described which will improve adherence during pulmonary rehabilitation.

  20. Rehabilitation that incorporates virtual reality is more effective than standard rehabilitation for improving walking speed, balance and mobility after stroke: a systematic review

    Directory of Open Access Journals (Sweden)

    Davide Corbetta

    2015-07-01

    Full Text Available Question: In people after stroke, does virtual reality based rehabilitation (VRBR improve walking speed, balance and mobility more than the same duration of standard rehabilitation? In people after stroke, does adding extra VRBR to standard rehabilitation improve the effects on gait, balance and mobility? Design: Systematic review with meta-analysis of randomised trials. Participants: Adults with a clinical diagnosis of stroke. Intervention: Eligible trials had to include one these comparisons: VRBR replacing some or all of standard rehabilitation or VRBR used as extra rehabilitation time added to a standard rehabilitation regimen. Outcome measures: Walking speed, balance, mobility and adverse events. Results: In total, 15 trials involving 341 participants were included. When VRBR replaced some or all of the standard rehabilitation, there were statistically significant benefits in walking speed (MD 0.15 m/s, 95% CI 0.10 to 0.19, balance (MD 2.1 points on the Berg Balance Scale, 95% CI 1.8 to 2.5 and mobility (MD 2.3 seconds on the Timed Up and Go test, 95% CI 1.2 to 3.4. When VRBR was added to standard rehabilitation, mobility showed a significant benefit (0.7 seconds on the Timed Up and Go test, 95% CI 0.4 to 1.1, but insufficient evidence was found to comment about walking speed (one trial and balance (high heterogeneity. Conclusion: Substituting some or all of a standard rehabilitation regimen with VRBR elicits greater benefits in walking speed, balance and mobility in people with stroke. Although the benefits are small, the extra cost of applying virtual reality to standard rehabilitation is also small, especially when spread over many patients in a clinic. Adding extra VRBR time to standard rehabilitation also has some benefits; further research is needed to determine if these benefits are clinically worthwhile. [Corbetta D, Imeri F, Gatti R (2015 Rehabilitation that incorporates virtual reality is more effective than standard

  1. Methods to improve rehabilitation of patients following breast cancer surgery: a review of systematic reviews

    Directory of Open Access Journals (Sweden)

    Loh SY

    2015-03-01

    Full Text Available Siew Yim Loh, Aisya Nadia Musa Department of Rehabilitation Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia Context: Breast cancer is the most prevalent cancer amongst women but it has the highest survival rates amongst all cancer. Rehabilitation therapy of post-treatment effects from cancer and its treatment is needed to improve functioning and quality of life. This review investigated the range of methods for improving physical, psychosocial, occupational, and social wellbeing in women with breast cancer after receiving breast cancer surgery. Method: A search for articles published in English between the years 2009 and 2014 was carried out using The Cochrane Database of Systematic Reviews, the Database of Abstracts of Reviews of Effects, PubMed, and ScienceDirect. Search terms included: ‘breast cancer’, ‘breast carcinoma’, ‘surgery’, ‘mastectomy’, ‘lumpectomy’, ‘breast conservation’, ‘axillary lymph node dissection’, ‘rehabilitation’, 'therapy’, ‘physiotherapy’, ‘occupational therapy’, ‘psychological’, ‘psychosocial’, ‘psychotherapy’, ‘exercise’, ‘physical activity’, ‘cognitive’, ‘occupational’, ‘alternative’, ‘complementary’, and ‘systematic review’. Study selection: Systematic reviews on the effectiveness of rehabilitation methods in improving post-operative physical, and psychological outcomes for breast cancer were selected. Sixteen articles met all the eligibility criteria and were included in the review. Data extraction: Included review year, study aim, total number of participants included, and results. Data synthesis: Evidence for exercise rehabilitation is predominantly in the improvement of shoulder mobility and limb strength. Inconclusive results exist for a range of rehabilitation methods (physical, psycho-education, nutritional, alternative-complementary methods for addressing the domains of psychosocial, cognitive, and

  2. Lower Limb Exoskeleton for Rehabilitation with Improved Postural Equilibrium

    Directory of Open Access Journals (Sweden)

    Giuseppe Menga

    2018-06-01

    Full Text Available In this work we present a lower limb haptic exoskeleton suitable for patient rehabilitation, specifically in the presence of illness on postural equilibrium. Exoskeletons have been mostly conceived to increase strength, while in this work patient compliance with postural equilibrium enhancement is embedded. This is achieved with two hierarchical feedback loops. The internal one, closing the loop on the joint space of the exoskeleton offers compliance to the patient in the neighborhood of a reference posture. It exploits mechanical admittance control in a position loop, measuring the patient’s Electro Miographical (EMG signals. The problem is solved using multi variable robust control theory with a two degrees of freedom setting. A second control loop is superimposed on the first one, operating on the Cartesian space so as to guarantee postural equilibrium. It controls the patient’s Center of Gravity (COG and Zero Moment Point (ZMP by moving the internal loop reference. Special attention has been devoted to the mechanical multi-chain model of the exoskeleton which exploits Kane’s method using the Autolev symbolic computational environment. The aspects covered are: the switching system between single and double stance, the system’s non-holonomic nature, dependent and independent joint angles, redundancy in the torque controls and balancing weight in double stance. Physical experiments to validate the compliance method based on admittance control have been performed on an elbow joint at first. Then, to further validate the haptic interaction with the patient in a realistic situation, experiments have been conducted on a first exoskeleton prototype, while the overall system has been simulated in a realistic case study.

  3. Urban waterfront rehabilitation: can it contribute to environmental improvements in the developing world?

    Energy Technology Data Exchange (ETDEWEB)

    Vollmer, Derek [National Academies, 500 5th Street NW, Washington, DC 20001 (United States)], E-mail: dvollmer@nas.edu

    2009-04-15

    This paper examines urban waterfront rehabilitation as a sustainable development strategy in Chinese cities. Though waterfront rehabilitation is increasingly being employed in developed world cities, the environmental benefits are not always clear. Nonetheless, China, like other developing countries, has shown interest in this strategy, for improving its local water quality, upgrading environmental management, and improving quality of life for urban residents. As developing world cities struggle to break from the traditional model of 'pollute first, clean up later', it is critical that they employ strategies which minimize or remediate environmental impacts while still promoting economic development. This paper analyzes three such projects: the Qinhuai River Environmental Improvement Project in Nanjing, the Suzhou Creek Rehabilitation in Shanghai, and the Wuli Lake Rehabilitation in Wuxi. A critical analysis indicates that these projects have served numerous purposes which contribute to the cities' sustainable development. Though waterways may not be restored to pristine conditions, the incremental improvements appear to be a necessary catalyst for sustainable urban development.

  4. Preparing for faster filling

    CERN Multimedia

    CERN Bulletin

    2010-01-01

    Following the programmed technical stop last week, operators focussed on preparing the machine for faster filling, which includes multibunch injection and a faster pre-cycle phase.   The LHC1 screen shot during the first multibunch injection operation. The LHC operational schedule incorporates a technical stop for preventive maintenance roughly every six weeks of stable operation, during which several interventions on the various machines are carried out. Last week these included the replacement of a faulty magnet in the SPS pre-accelerator, which required the subsequent re-setting of the system of particle extraction and transfer to the LHC. At the end of last week, all the machines were handed back for operation and work could start on accommodating all the changes made into the complex systems in order for normal operation to be resumed. These ‘recovery’ operations continued through the weekend and into this week. At the beginning of this week, operators succeeded in pro...

  5. Bribes for Faster Delivery

    OpenAIRE

    Sanyal, Amal

    2000-01-01

    The paper models the practice of charging bribes for faster delivery of essential services in third world countries. It then examines the possibility of curbing corruption by supervision, and secondly, by introducing competition among delivery agents. It is argued that a supervisory solution eludes the problem because no hard evidence of the reduction of corruption can be established for this type of offenses. It is also shown that using more than one supplier cannot eliminate the practice, a...

  6. Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia

    2016-01-01

    part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. MAIN MEASURES: Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome...... score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D™ quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training...... and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective....

  7. Improvement and Neuroplasticity after Combined Rehabilitation to Forced Grasping

    Directory of Open Access Journals (Sweden)

    Michiko Arima

    2017-01-01

    Full Text Available The grasp reflex is a distressing symptom but the need to treat or suppress it has rarely been discussed in the literature. We report the case of a 17-year-old man who had suffered cerebral infarction of the right putamen and temporal lobe 10 years previously. Forced grasping of the hemiparetic left upper limb was improved after a unique combined treatment. Botulinum toxin type A (BTX-A was first injected into the left biceps, wrist flexor muscles, and finger flexor muscles. Forced grasping was reduced along with spasticity of the upper limb. In addition, repetitive facilitative exercise and object-related training were performed under low-amplitude continuous neuromuscular electrical stimulation. Since this 2-week treatment improved upper limb function, we compared brain activities, as measured by near-infrared spectroscopy during finger pinching, before and after the combined treatment. Brain activities in the ipsilesional sensorimotor cortex (SMC and medial frontal cortex (MFC during pinching under electrical stimulation after treatment were greater than those before. The results suggest that training under electrical stimulation after BTX-A treatment may modulate the activities of the ipsilesional SMC and MFC and lead to functional improvement of the affected upper limb with forced grasping.

  8. Interactive rehabilitation system for improvement of balance therapies in people with cerebral palsy.

    Science.gov (United States)

    Jaume-i-Capó, Antoni; Martínez-Bueso, Pau; Moyà-Alcover, Biel; Varona, Javier

    2014-03-01

    The present study covers a new experimental system, designed to improve the balance and postural control of adults with cerebral palsy. This system is based on a serious game for balance rehabilitation therapy, designed using the prototype development paradigm and features for rehabilitation with serious games: feedback, adaptability, motivational elements, and monitoring. In addition, the employed interaction technology is based on computer vision because motor rehabilitation consists of body movements that can be recorded, and because vision capture technology is noninvasive and can be used for clients who have difficulties in holding physical devices. Previous research has indicated that serious games help to motivate clients in therapy sessions; however, there remains a paucity of clinical evidence involving functionality. We rigorously evaluated the effects of physiotherapy treatment on balance and gait function of adult subjects with cerebral palsy undergoing our experimental system. A 24-week physiotherapy intervention program was conducted with nine adults from a cerebral palsy center who exercised weekly in 20-min sessions. Findings demonstrated a significant increase in balance and gait function scores resulting in indicators of greater independence for our participating adults. Scores improved from 16 to 21 points in a scale of 28, according to the Tinetti Scale for risk of falls, moving from high fall risk to moderate fall risk. Our promising results indicate that our experimental system is feasible for balance rehabilitation therapy.

  9. Pulmonary rehabilitation improves exercise capacity and dyspnea in air pollution-related respiratory disease.

    Science.gov (United States)

    Miyamoto, Naomi; Senjyu, Hideaki; Tanaka, Takako; Asai, Masaharu; Yanagita, Yorihide; Yano, Yudai; Nishinakagawa, Tsuyoshi; Kotaki, Kenji; Kitagawa, Chika; Rikitomi, Naoto; Kozu, Ryo; Honda, Sumihisa

    2014-01-01

    Air pollution in Japan caused respiratory disease, such as chronic bronchitis and asthma, in many individuals in the 1960s. Although air pollution has decreased, many victims of air pollution-related respiratory disease are limited in their activities of daily living because of respiratory symptoms. The purpose of this study was to evaluate the efficacy of pulmonary rehabilitation in victims of air pollution-related chronic bronchitis or asthma. Subjects were enrolled in a 12-week (2-week inpatient followed by 10-week outpatient) pulmonary rehabilitation program. The program comprised conditioning, strength training, endurance training, and patient education. We assessed the Modified Medical Research Council (MMRC) dyspnea grade, pulmonary function, peripheral muscle force, incremental shuttle walk distance (ISWD), and physical activity at baseline and immediately after the program. Twenty-nine subjects (mean age 74.2 ± 10.1 years, 11 males) completed the program, including 11 subjects with COPD and 18 subjects with asthma. Following rehabilitation, the participants (n = 29) showed significant improvements in MMRC dyspnea grade, vital capacity % predicted, quadriceps force and ISWD (all P pollution-related asthma. In conclusion, we recommend that patients with chronic bronchitis or asthma, resulting from exposure to air pollution, are referred for pulmonary rehabilitation.

  10. A Scoping Review of Clinical Practice Improvement Methodology Use in Rehabilitation

    Directory of Open Access Journals (Sweden)

    Marie-Eve Lamontagne

    2016-01-01

    Full Text Available Context The Clinical Practice Improvement (CPI approach is a methodological and quality improvement approach that has emerged and is gaining in popularity. However, there is no systematic description of its use or the determinants of its practice in rehabilitation settings. Method We performed a scoping review of the use of CPI methodology in rehabilitation settings. Results A total of 103 articles were reviewed. We found evidence of 13 initiatives involving CPI with six different populations. A total of 335 citations of determinants were found, with 68.7% related to CPI itself. Little information was found about what type of external and internal environment, individual characteristics and implementation process might facilitate or hinder the use of CPI. Conclusion Given the growing popularity of this methodological approach, CPI initiatives would gain from increasing knowledge of the determinants of its success and incorporating them in future implementation.

  11. Zero bugs and program faster

    CERN Document Server

    Thompson, Kate

    2015-01-01

    A book about programming, improving skill, and avoiding mistakes. The author spent two years researching every bug avoidance technique she could find. This book contains the best of them. If you want to program faster, with fewer bugs, and write more secure code, buy this book! "This is the best book I have ever read." - Anonymous reviewer "Four score and seven years ago this book helped me debug my server code." -Abraham Lincoln "Would my Javascript have memory leaks without this book? Would fishes fly without water?" -Socrates "This book is the greatest victory since the Spanish Armada, and the best about programming." -Queen Elizabeth

  12. Design strategies to improve patient motivation during robot-aided rehabilitation

    Directory of Open Access Journals (Sweden)

    Carrozza M Chiara

    2007-02-01

    Full Text Available Abstract Background Motivation is an important factor in rehabilitation and frequently used as a determinant of rehabilitation outcome. Several factors can influence patient motivation and so improve exercise adherence. This paper presents the design of two robot devices for use in the rehabilitation of upper limb movements, that can motivate patients during the execution of the assigned motor tasks by enhancing the gaming aspects of rehabilitation. In addition, a regular review of the obtained performance can reinforce in patients' minds the importance of exercising and encourage them to continue, so improving their motivation and consequently adherence to the program. In view of this, we also developed an evaluation metric that could characterize the rate of improvement and quantify the changes in the obtained performance. Methods Two groups (G1, n = 8 and G2, n = 12 of patients with chronic stroke were enrolled in a 3-week rehabilitation program including standard physical therapy (45 min. daily plus treatment by means of robot devices (40 min., twice daily respectively for wrist (G1 and elbow-shoulder movements (G2. Both groups were evaluated by means of standard clinical assessment scales and the new robot measured evaluation metric. Patients' motivation was assessed in 9/12 G2 patients by means of the Intrinsic Motivation Inventory (IMI questionnaire. Results Both groups reduced their motor deficit and showed a significant improvement in clinical scales and the robot measured parameters. The IMI assessed in G2 patients showed high scores for interest, usefulness and importance subscales and low values for tension and pain subscales. Conclusion Thanks to the design features of the two robot devices the therapist could easily adapt training to the individual by selecting different difficulty levels of the motor task tailored to each patient's disability. The gaming aspects incorporated in the two rehabilitation robots helped maintain

  13. A Structured Rehabilitation Protocol for Improved Multifunctional Prosthetic Control: A Case Study

    OpenAIRE

    Roche, Aidan Dominic; Vujaklija, Ivan; Amsüss, Sebastian; Sturma, Agnes; Göbel, Peter; Farina, Dario; Aszmann, Oskar C.

    2015-01-01

    Advances in robotic systems have resulted in prostheses for the upper limb that can produce multifunctional movements. However, these sophisticated systems require upper limb amputees to learn complex control schemes. Humans have the ability to learn new movements through imitation and other learning strategies. This protocol describes a structured rehabilitation method, which includes imitation, repetition, and reinforcement learning, and aims to assess if this method can improve multifuncti...

  14. An oral hygiene protocol improves oral health for patients in inpatient stroke rehabilitation.

    Science.gov (United States)

    Murray, Joanne; Scholten, Ingrid

    2018-03-01

    To determine whether a simple oral hygiene protocol improves the oral health of inpatients in stroke rehabilitation. Poor oral health can lead to serious complications, such as pneumonia. The comorbidities associated with stroke, such as dysphagia, hemiparesis and cognitive impairment, can further impede independent oral care. International stroke guidelines recommend routine oral care but stop short of detailing specific regimes. The oral health assessment tool (OHAT) was conducted by speech-language pathologists with 100 patients with and without dysphagia in three metropolitan inpatient stroke rehabilitation facilities. A simple nurse-led oral hygiene regime was then implemented with all participants, which included twice daily tooth brushing and mouth rinsing after lunch, and oral health was measured again one week later. Initially, dysphagia was negatively associated with OHAT scores, and independence for oral hygiene was positively associated with oral health. After one week of a simple oral hygiene regime, the OHAT scores available for 89 participants indicated an improvement on average for all participants. In particular, 59% of participants with dysphagia had an improvement of 1 or more points. None of the participants developed pneumonia. A simple, inexpensive oral hygiene regime resulted in positive outcomes for patients with and without dysphagia in inpatient stroke rehabilitation settings. Oral health assessments and oral hygiene regimes that are simple to implement by the interdisciplinary team can be incorporated into standard stroke care with positive effect. © 2017 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  15. Balance circuit classes to improve balance among rehabilitation inpatients: a protocol for a randomised controlled trial.

    Science.gov (United States)

    Treacy, Daniel; Schurr, Karl; Sherrington, Catherine

    2013-07-20

    Impaired balance and mobility are common among rehabilitation inpatients. Poor balance and mobility lead to an increased risk of falling. Specific balance exercise has been shown to improve balance and reduce falls within the community setting. However few studies have measured the effects of balance exercises on balance within the inpatient setting. A single centre, randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. One hundred and sixty two patients admitted to the general rehabilitation ward at Bankstown-Lidcombe Hospital will be recruited. Eligible participants will have no medical contraindications to exercise and will be able to: fully weight bear; stand unaided independently for at least 30 seconds; and participate in group therapy sessions with minimal supervision. Participants will be randomly allocated to an intervention group or usual-care control group. Both groups will receive standard rehabilitation intervention that includes physiotherapy mobility training and exercise for at least two hours on each week day. The intervention group will also receive six 1-hour circuit classes of supervised balance exercises designed to maximise the ability to make postural adjustments in standing, stepping and walking. The primary outcome is balance. Balance will be assessed by measuring the total time the participant can stand unsupported in five different positions; feet apart, feet together, semi-tandem, tandem and single-leg-stance. Secondary outcomes include mobility, self reported physical functioning, falls and hospital readmissions. Performance on the outcome measures will be assessed before randomisation and at two-weeks and three-months after randomisation by physiotherapists unaware of intervention group allocation. This study will determine the impact of additional balance circuit classes on balance among rehabilitation inpatients. The results will provide essential information to guide evidence

  16. Rehabilitation in home care is associated with functional improvement and preferred discharge.

    Science.gov (United States)

    Cook, Richard J; Berg, Katherine; Lee, Ker-Ai; Poss, Jeffrey W; Hirdes, John P; Stolee, Paul

    2013-06-01

    To investigate the impact of physiotherapy (PT) and occupational therapy (OT) services on long-stay home care patients with musculoskeletal disorders. Observational study. Home care programs. All long-stay home care patients between 2003 and 2008 (N=99,764) with musculoskeletal disorders who received a baseline Resident Assessment Instrument for Home Care assessment, 1 follow-up assessment, and had discharge or death records. PT and OT. The effects of PT and OT services on transitions in functional state, discharge from home care with service plans complete, institutionalization, and death were assessed via multistate Markov models. Home care patients with deficiencies in instrumental activities of daily living and/or activities of daily living at baseline and who received home-based rehabilitation had significantly increased odds of showing functional improvements by their next assessment (for a state 3 to state 2 transition: odds ratio [OR]=1.17; 95% confidence interval [CI], 1.10-1.26; Pfunding for health care services, it is essential to provide the right services at the right time in a cost-effective manner. Long-stay home care patients who receive rehabilitation at home have improved outcomes and lower utilization of costly health services. Our findings suggest that investment in PT and OT services for relatively short periods may provide savings to the health care system over the longer term. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  17. No improvement in distress and quality of life following psychosocial cancer rehabilitation. A randomised trial

    DEFF Research Database (Denmark)

    Rottmann, Nina; Dalton, Susanne Oksbjerg; Bidstrup, Pernille Envold

    2012-01-01

    of life (EORTC QLQ-C30) from baseline to 1 and 6 months' follow-up were measured. Analyses were adjusted for baseline scores of outcome, cancer site, time since diagnosis, gender, age and education. Results: Of 507 patients, 452 were included in the analyses, 404 completed the 1-month and 394 the 6-month......Objective: Rehabilitation programmes are intended to help cancer patients achieve optimal functioning and live independently. We evaluated whether a psychosocial rehabilitation course was effective in relieving cancer patients' distress and improving their well-being. Methods: Patients with breast......, prostate or colorectal cancer diagnosed within 2 years who had finished primary treatment were randomised to usual care or a 6-day residential course of lectures, discussions and peer groups on issues related to treatment and living with cancer. Changes in self-reported distress (POMS-Sf) and quality...

  18. Improved functional outcome after hip fracture is associated with duration of rehabilitation, but not with waiting time for rehabilitation

    DEFF Research Database (Denmark)

    Pedersen, Tonny Jaeger; Bogh, Louise Nicole Bie; Lauritsen, Jens Martin

    2017-01-01

    INTRODUCTION: The aim of this study was to explore the relationship between “waiting time to onset of municipal rehabilitation”, “length of municipal rehabilitation” and the attained level of function four months after the hip fracture. METHODS: Among a consecutive series of 156 patients, the 116...... duration of municipal rehabilitation and outcome, also at four months. No marked differences in these results were found when subgrouped by pre-fracture level of function as assessed with the Barthel-20 index. CONCLUSIONS: Waiting times from hospital discharge to initiation of municipal rehabilitation...... seems not to correlate with functional level four months after the hip fracture. In contrast, the amount of municipal rehabilitation time does correlate with a better functional level four months after the hip fracture. Furthermore, large-sample studies are warranted to clarify this relationship....

  19. Fee-for-service cancer rehabilitation programs improve health-related quality of life.

    Science.gov (United States)

    Kirkham, A A; Neil-Sztramko, S E; Morgan, J; Hodson, S; Weller, S; McRae, T; Campbell, K L

    2016-08-01

    Rigorously applied exercise interventions undertaken in a research setting result in improved health-related quality of life (hrqol) in cancer survivors, but research to demonstrate effective translation of that research to practice is needed. The objective of the present study was to determine the effect of fee-for-service cancer rehabilitation programs in the community on hrqol and on self-reported physical activity and its correlates. After enrolment and 17 ± 4 weeks later, new clients (n = 48) to two fee-for-service cancer rehabilitation programs completed the 36-Item Short Form Health Survey (rand-36: rand Corporation, Santa Monica, CA, U.S.A.), the Godin Leisure-Time Exercise Questionnaire, and questions about physical activity correlates. Normal fee-for-service operations were maintained, including a fitness assessment and individualized exercise programs supervised in a group or one-on-one setting, with no minimum attendance required. Fees were associated with the assessment and with each exercise session. Of the 48 participants, 36 (75%) completed both questionnaires. Improvements in the physical functioning, role physical, pain, and energy/fatigue scales on the rand-36 exceeded minimally important differences and were of a magnitude similar to improvements reported in structured, rigorously applied, and free research interventions. Self-reported levels of vigorous-intensity (p = 0.021), but not moderate-intensity (p = 0.831) physical activity increased. The number of perceived barriers to exercise (p = 0.035) and the prevalence of fatigue as a barrier (p = 0.003) decreased. Exercise self-efficacy improved only in participants who attended 11 or more sessions (p = 0.002). Exercise enjoyment did not change (p = 0.629). Enrolment in fee-for-service cancer rehabilitation programs results in meaningful improvements in hrqol comparable to those reported by research interventions, among other benefits. The fee-for-service model could be an effective model for

  20. Changes in serum growth factors in stroke rehabilitation patients and their relation to hemiparesis improvement.

    Science.gov (United States)

    Okazaki, Hideto; Beppu, Hidehiko; Mizutani, Kenmei; Okamoto, Sayaka; Sonoda, Shigeru

    2014-07-01

    Predicting recovery from hemiparesis after stroke is important for rehabilitation. A few recent studies reported that the levels of some growth factors shortly after stroke were positively correlated with the clinical outcomes during the chronic phase. The aim of this study was to examine the relationships between the serum levels of growth factors (vascular endothelial growth factor [VEGF], insulin-like growth factor-I [IGF-I], and hepatocyte growth factor [HGF]) and improvement in hemiparesis in stroke patients who received rehabilitation in a postacute rehabilitation hospital. Subjects were 32 stroke patients (cerebral infarction: 21 and intracerebral hemorrhage [ICH]: 11). We measured serum levels of VEGF, IGF-I, and HGF and 5 items of the Stroke Impairment Assessment Set (SIAS) for hemiparesis on admission and at discharge. Age-matched healthy subjects (n=15) served as controls. Serum levels of VEGF and HGF in cerebral infarct patients on admission were higher than those in control subjects, and the serum levels of IGF-I in stroke patients were lower than those in controls. The level of HGF in ICH patients on admission was negatively correlated with gains in SIAS, and higher outliers in HGF concentration were correlated with lower gains in SIAS. Focusing on the extremely high levels of these factors may be a predictor of the low recovery from hemiparesis after stroke. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  1. SWOT analysis of a pediatric rehabilitation programme: a participatory evaluation fostering quality improvement.

    Science.gov (United States)

    Camden, Chantal; Swaine, Bonnie; Tétreault, Sylvie; Bergeron, Sophie

    2009-01-01

    To present the results of a strengths, weaknesses, opportunities and threats (SWOT) analysis used as part of a process aimed at reorganising services provided within a pediatric rehabilitation programme (PRP) in Quebec, Canada and to report the perceptions of the planning committee members regarding the usefulness of the SWOT in this process. Thirty-six service providers working in the PRP completed a SWOT questionnaire and reported what they felt worked and what did not work in the existing model of care. Their responses were used by a planning committee over a 12-month period to assist in the development of a new service delivery model. Committee members shared their thoughts about the usefulness of the SWOT. Current programme strengths included favourable organisational climate and interdisciplinary work whereas weaknesses included lack of psychosocial support to families and long waiting times for children. Opportunities included working with community partners, whereas fear of losing professional autonomy with the new service model was a threat. The SWOT results helped the planning committee redefine the programme goals and make decisions to improve service coordination. SWOT analysis was deemed as a very useful tool to help guide service reorganisation. SWOT analysis appears to be an interesting evaluation tool to promote awareness among service providers regarding the current functioning of a rehabilitation programme. It fosters their active participation in the reorganisation of a new service delivery model for pediatric rehabilitation.

  2. Health-Improving Rehabilitation Program of Pysical Education at Higher School

    Directory of Open Access Journals (Sweden)

    V. M. Naskalov

    2013-01-01

    Full Text Available The research is aimed to explore the efficiency of innovative technologies and increase the health-improving effect as a result of physical training in ecologically unfavorable conditions. A health-improving rehabilitation program, containing a set of modern means of physical rehabilitation and recreation in combination with physical exercises, was worked out to carry out the pedagogical experiment. The program includes the hydromassage, stretching exercises with biomechanical stimulation and exercises for developing weightlifting abilities. Apart from this, the interval hypoxic training was used in ‘artificially created’ favorable ecological conditions for detoxication. The students at Polotsk State University took part in the experiment. Among the assessment criteria applied by the author, there are generally acknowledged methods identifying the development of physical qualities, external respiration functions, body fat and other components composition. The experiment revealed that the innovative program had enhanced the health-improving effect compared to the traditional training programs, which was expressed by the statistically valid increase of the students’ speed- strength characteristics, flexibility, external respiration functions as well as the body fat decrease. Therefore, in order to increase a health-improving effect of physical training, the author recommends considering the specific ecological and hygienic conditions of a particular region to create the corresponding programs for group and individual health protection and recovery. The research findings can be used in physical education process at universities situated in the regions with unfavorable ecological conditions. 

  3. The effect of a rehabilitation nursing intervention model on improving the comprehensive health status of patients with hand burns.

    Science.gov (United States)

    Li, Lin; Dai, Jia-Xi; Xu, Le; Huang, Zhen-Xia; Pan, Qiong; Zhang, Xi; Jiang, Mei-Yun; Chen, Zhao-Hong

    2017-06-01

    To observe the effect of a rehabilitation intervention on the comprehensive health status of patients with hand burns. Most studies of hand-burn patients have focused on functional recovery. There have been no studies involving a biological-psychological-social rehabilitation model of hand-burn patients. A randomized controlled design was used. Patients with hand burns were recruited to the study, and sixty patients participated. Participants were separated into two groups: (1) The rehabilitation intervention model group (n=30) completed the rehabilitation intervention model, which included the following measures: enhanced social support, intensive health education, comprehensive psychological intervention, and graded exercise. (2) The control group (n=30) completed routine treatment. Intervention lasted 5 weeks. Analysis of variance (ANOVA) and Student's t test were conducted. The rehabilitation intervention group had significantly better scores than the control group for comprehensive health, physical function, psychological function, social function, and general health. The differences between the index scores of the two groups were statistically significant. The rehabilitation intervention improved the comprehensive health status of patients with hand burns and has favorable clinical application. The comprehensive rehabilitation intervention model used here provides scientific guidance for medical staff aiming to improve the integrated health status of hand-burn patients and accelerate their recovery. What does this paper contribute to the wider global clinical community? Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  4. Improving excellence in scoliosis rehabilitation: a controlled study of matched pairs.

    Science.gov (United States)

    Weiss, H-R; Klein, R

    2006-01-01

    Physiotherapy programmes so far mainly address the lateral deformity of scoliosis, a few aim at the correction of rotation and only very few address the sagittal profile. Meanwhile, there is evidence that correction forces applied in the sagittal plane are also able to correct the scoliotic deformity in the coronal and frontal planes. So it should be possible to improve excellence in scoliosis rehabilitation by the implementation of exercises to correct the sagittal deformity in scoliosis patients. An exercise programme (physio-logic exercises) aiming at a physiologic sagittal profile was developed to add to the programme applied at the centre or to replace certain exercises or exercising positions. To test the hypothesis that physio-logic exercises improve the outcome of Scoliosis Intensive Rehabilitation (SIR), the following study design was chosen: Prospective controlled trial of pairs of patients with idiopathic scoliosis matched by sex, age, Cobb angle and curve pattern. There were 18 patients in the treatment group (SIR + physio-logic exercises) and 18 patients in the control group (SIR only), all in matched pairs. Average Cobb angle in the treatment group was 34.5 degrees (SD 7.8) Cobb angle in the control group was 31.6 degrees (SD 5.8). Age in the treatment group was at average 15.3 years (SD 1.1) and in the control group 14.7 years (SD 1.3). Thirteen of the 18 patients in either group had a brace. Outcome parameter: average lateral deviation (mm), average surface rotation ( degrees ) and maximum Kyphosis angle ( degrees ) as evaluated with the help of surface topography (Formetric-system). Lateral deviation (mm) decreased significantly after the performance of the physio-logic programme and highly significantly in the physio-logic ADL posture; however, it was not significant after completion of the whole rehabilitation programme (2.3 vs 0.3 mm in the controls). Surface rotation improved at average 1.2 degrees in the treatment group and 0.8 degrees in the

  5. Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool

    Science.gov (United States)

    2016-10-01

    quality of life , and cognitive function. This design will allow us to assess the efficacy of IQ as a customizable balance treatment in TBI, and to...VANJHCS.  As  such,  we  have   explored  additional  avenues  and  are   working  closely  with  the  dedicated...AWARD NUMBER: W81XWH-14-2-0150 TITLE: Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool PRINCIPAL

  6. Vagus nerve stimulation delivered during motor rehabilitation improves recovery in a rat model of stroke.

    Science.gov (United States)

    Khodaparast, Navid; Hays, Seth A; Sloan, Andrew M; Fayyaz, Tabbassum; Hulsey, Daniel R; Rennaker, Robert L; Kilgard, Michael P

    2014-09-01

    Neural plasticity is widely believed to support functional recovery following brain damage. Vagus nerve stimulation paired with different forelimb movements causes long-lasting map plasticity in rat primary motor cortex that is specific to the paired movement. We tested the hypothesis that repeatedly pairing vagus nerve stimulation with upper forelimb movements would improve recovery of motor function in a rat model of stroke. Rats were separated into 3 groups: vagus nerve stimulation during rehabilitation (rehab), vagus nerve stimulation after rehab, and rehab alone. Animals underwent 4 training stages: shaping (motor skill learning), prelesion training, postlesion training, and therapeutic training. Rats were given a unilateral ischemic lesion within motor cortex and implanted with a left vagus nerve cuff. Animals were allowed 1 week of recovery before postlesion baseline training. During the therapeutic training stage, rats received vagus nerve stimulation paired with each successful trial. All 17 trained rats demonstrated significant contralateral forelimb impairment when performing a bradykinesia assessment task. Forelimb function was recovered completely to prelesion levels when vagus nerve stimulation was delivered during rehab training. Alternatively, intensive rehab training alone (without stimulation) failed to restore function to prelesion levels. Delivering the same amount of stimulation after rehab training did not yield improvements compared with rehab alone. These results demonstrate that vagus nerve stimulation repeatedly paired with successful forelimb movements can improve recovery after motor cortex ischemia and may be a viable option for stroke rehabilitation. © The Author(s) 2014.

  7. An Overview of Cancer Rehabilitation and Exercise in the Literature: Promoting Increased Referrals to Improve Oncology Outcomes

    Directory of Open Access Journals (Sweden)

    Leslie J. Waltke

    2014-08-01

    Full Text Available Medical management for malignant neoplastic diseases includes surgery, chemotherapy, radiation, and hormonal and biological therapies. Each of these antineoplastic interventions has unique impacts on physiological, musculoskeletal and functional performance. Cancer rehabilitation is the area of physical medicine responsible for addressing impairments associated with cancer treatment and survivorship, advanced disease and end of life. Although it is expected that more than one-half of persons being treated for cancer will suffer moderate pain and physical and functional decline, and that most will describe fatigue, referrals to rehabilitation are traditionally low. Evidence suggests that referrals to rehabilitation before, during and after treatment for neoplastic disease may improve physiological and functional performance, quality of life and survival outcomes. Oncology practitioners are encouraged to refer patients undergoing cancer treatment to a rehabilitation professional at the peridiagnosis period.

  8. Extended cardiac rehabilitation for socially vulnerable patients improves attendance and outcome

    DEFF Research Database (Denmark)

    Nielsen, Kirsten Melgaard; Meillier, Lucette Kirsten; Larsen, Mogens Lytken

    2013-01-01

    Patients living alone or having a low socioeconomic status are likely to quit cardiac rehabilitation. We aimed to compare patients being offered extended rehabilitation (ERP) with those being offered standard rehabilitation (SRP) as concerns 1) attendance rates and 2) achievement of treatment goals...

  9. Using the Virtual Reality-Cognitive Rehabilitation Approach to Improve Contextual Processing in Children with Autism

    Directory of Open Access Journals (Sweden)

    Michelle Wang

    2013-01-01

    Full Text Available Background. This pilot study investigated the efficacy of a novel virtual reality-cognitive rehabilitation (VR-CR intervention to improve contextual processing of objects in children with autism. Previous research supports that children with autism show deficits in contextual processing, as well as deficits in its elementary components: abstraction and cognitive flexibility. Methods. Four children with autism participated in a multiple-baseline, single-subject study. The children were taught how to see objects in context by reinforcing attention to pivotal contextual information. Results. All children demonstrated statistically significant improvements in contextual processing and cognitive flexibility. Mixed results were found on the control test and changes in context-related behaviours. Conclusions. Larger-scale studies are warranted to determine the effectiveness and usability in comprehensive educational programs.

  10. Neurologic music therapy improves executive function and emotional adjustment in traumatic brain injury rehabilitation.

    Science.gov (United States)

    Thaut, Michael H; Gardiner, James C; Holmberg, Dawn; Horwitz, Javan; Kent, Luanne; Andrews, Garrett; Donelan, Beth; McIntosh, Gerald R

    2009-07-01

    This study examined the immediate effects of neurologic music therapy (NMT) on cognitive functioning and emotional adjustment with brain-injured persons. Four treatment sessions were held, during which participants were given a pre-test, participated in 30 min of NMT that focused on one aspect of rehabilitation (attention, memory, executive function, or emotional adjustment), which was followed by post-testing. Control participants engaged in a pre-test, 30 min of rest, and then a post-test. Treatment participants showed improvement in executive function and overall emotional adjustment, and lessening of depression, sensation seeking, and anxiety. Control participants improved in emotional adjustment and lessening of hostility, but showed decreases in measures of memory, positive affect, and sensation seeking.

  11. The role of music therapy in rehabilitation: improving aphasia and beyond.

    Science.gov (United States)

    Leonardi, Simona; Cacciola, Alberto; De Luca, Rosaria; Aragona, Bianca; Andronaco, Veronica; Milardi, Demetrio; Bramanti, Placido; Calabrò, Rocco Salvatore

    2018-01-01

    Music is part of the human nature, and it is also philogenically relevant to language evolution. Language and music are bound together in the enhancement of important social functions, such as communication, cooperation and social cohesion. In the last few years, there has been growing evidence that music and music therapy may improve communication skills (but not only) in different neurological disorders. One of the plausible reasons concerning the rational use of sound and music in neurorehabilitation is the possibility to stimulate brain areas involved in emotional processing and motor control, such as the fronto-parietal network. In this narrative review, we are going to describe the role of music therapy in improving aphasia and other neurological disorders, underlying the reasons why this tool could be effective in rehabilitative settings, especially in individuals affected by stroke.

  12. Using the Virtual Reality-Cognitive Rehabilitation Approach to Improve Contextual Processing in Children with Autism

    Science.gov (United States)

    Reid, Denise

    2013-01-01

    Background. This pilot study investigated the efficacy of a novel virtual reality-cognitive rehabilitation (VR-CR) intervention to improve contextual processing of objects in children with autism. Previous research supports that children with autism show deficits in contextual processing, as well as deficits in its elementary components: abstraction and cognitive flexibility. Methods. Four children with autism participated in a multiple-baseline, single-subject study. The children were taught how to see objects in context by reinforcing attention to pivotal contextual information. Results. All children demonstrated statistically significant improvements in contextual processing and cognitive flexibility. Mixed results were found on the control test and changes in context-related behaviours. Conclusions. Larger-scale studies are warranted to determine the effectiveness and usability in comprehensive educational programs. PMID:24324379

  13. Does robot-assisted gait rehabilitation improve balance in stroke patients? A systematic review.

    Science.gov (United States)

    Swinnen, Eva; Beckwée, David; Meeusen, Romain; Baeyens, Jean-Pierre; Kerckhofs, Eric

    2014-01-01

    The aim of this systematic review was to summarize the improvements in balance after robot-assisted gait training (RAGT) in stroke patients. Two databases were searched: PubMed and Web of Knowledge. The most important key words are "stroke," "RAGT," "balance," "Lokomat," and "gait trainer." Studies were included if stroke patients were involved in RAGT protocols, and balance was determined as an outcome measurement. The articles were checked for methodological quality by 2 reviewers (Cohen's κ = 0.72). Nine studies were included (7 true experimental and 2 pre-experimental studies; methodological quality score, 56%-81%). In total, 229 subacute or chronic stroke patients (70.5% male) were involved in RAGT (3 to 5 times per week, 3 to 10 weeks, 12 to 25 sessions). In 5 studies, the gait trainer was used; in 2, the Lokomat was used; in 1 study, a single-joint wearable knee orthosis was used; and in 1 study, the AutoAmbulator was used. Eight studies compared RAGT with other gait rehabilitation methods. Significant improvements (no to large effect sizes, Cohen's d = 0.01 to 3.01) in balance scores measured with the Berg Balance Scale, the Tinetti test, postural sway tests, and the Timed Up and Go test were found after RAGT. No significant differences in balance between the intervention and control groups were reported. RAGT can lead to improvements in balance in stroke patients; however, it is not clear whether the improvements are greater compared with those associated with other gait rehabilitation methods. Because a limited number of studies are available, more specific research (eg, randomized controlled trials with larger, specific populations) is necessary to draw stronger conclusions.

  14. Improving patient and carer communication, multidisciplinary team working and goal-setting in stroke rehabilitation.

    Science.gov (United States)

    Monaghan, J; Channell, K; McDowell, D; Sharma, A K

    2005-03-01

    To determine the extent to which three forms of multidisciplinary team (MDT) care in stroke rehabilitation meet the standards set by the United Kingdom National Service Framework (NSF). Consecutive assessment of the three forms of care was completed. The study included three groups of 25 stroke inpatients on the stroke rehabilitation ward. (1) A standard weekly MDT meeting using a standard form for documentation; (2) a standard MDT meeting using a newly devised form; and (3) a novel MDT ward round using the new form, and attended by doctors. MDT ward rounds result in significantly better consideration of patients' needs (median 7 per patient compared with 0 and 5 in phases one and two), enhanced SMART (specific, measurable, achievable, realistic and time framed) goal-setting (median 3 per patient compared to 1 in phases one and two); greater patient involvement (12 patients compared to 0 and 4 in phases one and two); and improved team working (measured using the team climate inventory) than do MDT meetings. In the present study, standard weekly MDT meetings did not meet the standards set for MDT care by the NSF. The use of a MDT ward round allows these standards to be achieved.

  15. Improved Haptic Linear Lines for Better Movement Accuracy in Upper Limb Rehabilitation

    Directory of Open Access Journals (Sweden)

    Joan De Boeck

    2012-01-01

    Full Text Available Force feedback has proven to be beneficial in the domain of robot-assisted rehabilitation. According to the patients' personal needs, the generated forces may either be used to assist, support, or oppose their movements. In our current research project, we focus onto the upper limb training for MS (multiple sclerosis and CVA (cerebrovascular accident patients, in which a basic building block to implement many rehabilitation exercises was found. This building block is a haptic linear path: a second-order continuous path, defined by a list of points in space. Earlier, different attempts have been investigated to realize haptic linear paths. In order to have a good training quality, it is important that the haptic simulation is continuous up to the second derivative while the patient is enforced to follow the path tightly, even when low or no guiding forces are provided. In this paper, we describe our best solution to these haptic linear paths, discuss the weaknesses found in practice, and propose and validate an improvement.

  16. Improving self-efficacy in spinal cord injury patients through "design thinking" rehabilitation workshops.

    Science.gov (United States)

    Wolstenholme, Daniel; Downes, Tom; Leaver, Jackie; Partridge, Rebecca; Langley, Joseph

    2014-01-01

    Advances in surgical and medical management have significantly reduced the length of time that patients with spinal cord injury (SCI) have to stay in hospital, but has left patients with potentially less time to psychologically adjust. Following a pilot in 2012, this project was designed to test the effect of "design thinking" workshops on the self-efficacy of people undergoing rehabilitation following spinal injuries. Design thinking is about understanding the approaches and methods that designers use and then applying these to think creatively about problems and suggest ways to solve them. In this instance, design thinking is not about designing new products (although the approaches can be used to do this) but about developing a long term creative and explorative mind-set through skills such as lateral thinking, prototyping and verbal and visual communication. The principles of "design thinking" have underpinned design education and practice for many years, it is also recognised in business and innovation for example, but a literature review indicated that there was no evidence of it being used in rehabilitation or spinal injury settings. Twenty participants took part in the study; 13 (65%) were male and the average age was 37 years (range 16 to 72). Statistically significant improvements were seen for EQ-5D score (t = -3.13, p = 0.007) and Patient Activation Measure score (t = -3.85, p = 0.001). Other outcome measures improved but not statistically. There were no statistical effects on length of stay or readmission rates, but qualitative interviews indicated improved patient experience.

  17. Functional improvements following the use of the NVT Vision Rehabilitation program for patients with hemianopia following stroke.

    Science.gov (United States)

    Hayes, Allison; Chen, Celia S; Clarke, Gayle; Thompson, Annette

    2012-01-01

    The incidence of visual deficits following stroke ranges from 20%-68% and has significant impact on activities of daily living. The NVT system is a compensatory visual scanning training program that consists of combined static and mobility training and transfer to activities of daily living. The study aims to evaluate functional changes following the NVT program for people who have homonymous hemianopia (HH) following stroke. Interventional case series of 13 consecutive participants with HH undergoing NVT vision rehabilitation. The primary outcome measure was the number of targets missed on a standardized Mobility Assessment Course (MAC). Other outcome measures included assessment of visual scanning, vision specific Quality of Life questionnaires and reading performance. The average number of targets (sd) missed on the MAC course was 39.6 ± 20.9% before intervention, 27.5 ± 16.3% immediately post intervention and 20.8 ± 15.5% at 3 months post rehabilitation. The study showed a statistically significant trend in improvement in mobility related subscales of National Eye Institute Visual Function Questionnaire-NEI VFQ-25 (p=0.003) and the Veteran Affairs Low Vision Visual Function Questionnaire-VA LVFQ-48 (p=0.036) at 3 months post rehabilitation. The NVT intervention resulted in functional improvements in mobility post rehabilitation. The NVT training showed improvement in vision specific quality of life. There is a need for standardised vision therapy intervention, in conjunction with existing rehabilitation services, for patients with stroke and traumatic brain injury.

  18. Better and faster velocity pulsatility assessment in cerebral white matter perforating arteries with 7T quantitative flow MRI through improved slice profile, acquisition scheme, and postprocessing

    NARCIS (Netherlands)

    Geurts, LJ; Biessels, Geert Jan; Luijten, Peter; Zwanenburg, Jaco

    2018-01-01

    PURPOSE: A previously published cardiac-gated 2D Qflow protocol at 7 T in cerebral perforating arteries was optimized to reduce velocity underestimation and improve temporal resolution. METHODS: First, the signal-to-noise ratio (SNR) gain of the velocity measurement (SNRv ) was tested for two signal

  19. Dexamphetamine improves upper extremity outcome during rehabilitation after stroke: a pilot randomized controlled trial.

    Science.gov (United States)

    Schuster, Corina; Maunz, Gerd; Lutz, Karin; Kischka, Udo; Sturzenegger, Rolf; Ettlin, Thierry

    2011-10-01

    For early inpatient stroke rehabilitation, the effectiveness of amphetamine combined with physiotherapy varies across studies. To investigate whether the recovery of activities of daily living (ADL, primary outcome) and motor function (secondary outcome) can be improved by dexamphetamine added to physiotherapy. In a double-blind, placebo-controlled trial, 16 patients, from 918 who were screened, were randomized to the experimental group (EG, dexamphetamine + physiotherapy) or control group (CG, placebo + physiotherapy). Both groups received multidisciplinary inpatient rehabilitation. Dexamphetamine (10 mg oral) or placebo was administered 2 days per week before physiotherapy. ADL and motor function were measured using the Chedoke-McMaster Stroke Assessment (CMSA) twice during baseline, every week during the 5-week treatment period, and at follow-up 1 week, 6 months, and 12 months after intervention. The majority of ineligible patients had too little paresis, were on anticoagulants, or had a stroke >60 days prior to entry. Participants (EG, n = 7, age 70.3 ± 10 years, 5 women, 37.9 ± 9 days after stroke; CG, n = 9, age 65.2 ± 17 years, 3 women, 40.3 ± 9 days after stroke) did not differ at baseline except for the leg subscale. Analysis of variance from baseline to 1 week follow-up revealed significant improvements in favor of EG for subscales ADL (P = .023) and arm function (P = .020) at end of treatment. No adverse events were detected. In this small trial that was based on prior positive trials, significant gains in ADL and arm function suggest that the dose and timing of dexamphetamine can augment physiotherapy. Effect size calculation suggests inclusion of at least 25 patients per group in future studies.

  20. Improvements of visual X-ray inspection with optimized digital detector technology. Faster and more reliable inspection with High Dynamic Radiology (HDR)

    International Nuclear Information System (INIS)

    Bavendiek, Klaus

    2010-01-01

    Improvements in speed and contrast resolution of Digital Detector Arrays (DDA) and significant higher power of X-Ray tubes in combination with a small focal spot open the door to an improved visual inspection of castings for automotive and aerospace applications. The result is a film-like image quality of castings in a live view. For the new image quality the x-ray parameter have to be optimized in energy and the subject contrast has to be increased to avoid that flaws are covered by the noise in the image. HDR - high dynamic radiology - expands the local contrast in the image and transfers the grey values to the range the human inspector can separate. Due to the movement in the image the inspector gets a glas-like impression of the object and the flaws allowing him to do a decision about the 3D position of a flaw in the object. (orig.)

  1. Stroke rehabilitation.

    Science.gov (United States)

    Langhorne, Peter; Bernhardt, Julie; Kwakkel, Gert

    2011-05-14

    Stroke is a common, serious, and disabling global health-care problem, and rehabilitation is a major part of patient care. There is evidence to support rehabilitation in well coordinated multidisciplinary stroke units or through provision of early supported provision of discharge teams. Potentially beneficial treatment options for motor recovery of the arm include constraint-induced movement therapy and robotics. Promising interventions that could be beneficial to improve aspects of gait include fitness training, high-intensity therapy, and repetitive-task training. Repetitive-task training might also improve transfer functions. Occupational therapy can improve activities of daily living; however, information about the clinical effect of various strategies of cognitive rehabilitation and strategies for aphasia and dysarthria is scarce. Several large trials of rehabilitation practice and of novel therapies (eg, stem-cell therapy, repetitive transcranial magnetic stimulation, virtual reality, robotic therapies, and drug augmentation) are underway to inform future practice. Copyright © 2011 Elsevier Ltd. All rights reserved.

  2. Adaptive mixed reality rehabilitation improves quality of reaching movements more than traditional reaching therapy following stroke.

    Science.gov (United States)

    Duff, Margaret; Chen, Yinpeng; Cheng, Long; Liu, Sheng-Min; Blake, Paul; Wolf, Steven L; Rikakis, Thanassis

    2013-05-01

    Adaptive mixed reality rehabilitation (AMRR) is a novel integration of motion capture technology and high-level media computing that provides precise kinematic measurements and engaging multimodal feedback for self-assessment during a therapeutic task. We describe the first proof-of-concept study to compare outcomes of AMRR and traditional upper-extremity physical therapy. Two groups of participants with chronic stroke received either a month of AMRR therapy (n = 11) or matched dosing of traditional repetitive task therapy (n = 10). Participants were right handed, between 35 and 85 years old, and could independently reach to and at least partially grasp an object in front of them. Upper-extremity clinical scale scores and kinematic performances were measured before and after treatment. Both groups showed increased function after therapy, demonstrated by statistically significant improvements in Wolf Motor Function Test and upper-extremity Fugl-Meyer Assessment (FMA) scores, with the traditional therapy group improving significantly more on the FMA. However, only participants who received AMRR therapy showed a consistent improvement in kinematic measurements, both for the trained task of reaching to grasp a cone and the untrained task of reaching to push a lighted button. AMRR may be useful in improving both functionality and the kinematics of reaching. Further study is needed to determine if AMRR therapy induces long-term changes in movement quality that foster better functional recovery.

  3. Cognitive rehabilitation: an important tool in disability improvement after brain injuries

    OpenAIRE

    Ioana Stanescu; Gabriela Dogaru

    2016-01-01

    Cognitive rehabilitation is as an important goal of rehabilitation therapy, which aims to help the person with neurological disability to acquire the highest level of cognitive functioning and of functional autonomy. Cognitive impairments in memory, language, judgement, attention, visuo-spatial perception are important blocks in acquiring functional independence. Cognitive rehabilitation therapy is “a systematic, functionally oriented service of therapeutic cognitive activities directed to ...

  4. Better and faster velocity pulsatility assessment in cerebral white matter perforating arteries with 7T quantitative flow MRI through improved slice profile, acquisition scheme, and postprocessing.

    Science.gov (United States)

    Geurts, Lennart; Biessels, Geert Jan; Luijten, Peter; Zwanenburg, Jaco

    2018-03-01

    A previously published cardiac-gated 2D Qflow protocol at 7 T in cerebral perforating arteries was optimized to reduce velocity underestimation and improve temporal resolution. First, the signal-to-noise ratio (SNR) gain of the velocity measurement (SNR v ) was tested for two signal averages versus one. Second, the decrease in velocity underestimation with a tilted optimized nonsaturating excitation (TONE) pulse was tested. Third, the decrease in pulsatility index (PI) underestimation through improved temporal resolution was tested. Test-retest agreement was measured for the resulting acquisition in older volunteers (mean age 63 years), and the results were compared with the other volunteers (mean age 26 years). Using two signal averages increased SNR v by only 12% (P = 0.04), probably due to motion of the subvoxel-size arteries. The TONE decreased velocity underestimation, thereby increasing the mean velocity from 0.52 to 0.67 cm/s (P < 0.001). The PI increased substantially with increasing temporal resolution. The test-retest agreement showed good coefficients of repeatability of 0.18 cm/s for velocity and 0.14 for PI. The measured velocity was lower in the older group: 0.42 versus 0.51 cm/s (P = 0.05). The optimized sequence yields better velocity and PI estimates in small vessels, has twice as good test-retest agreement, and has a suitable scan time for use in patients. Magn Reson Med 79:1473-1482, 2018. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for Magnetic Resonance in Medicine. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. © 2017 The Authors Magnetic Resonance in Medicine published by Wiley Periodicals, Inc. on behalf of International Society for

  5. Walking but not barking improves verb recovery: implications for action observation treatment in aphasia rehabilitation.

    Directory of Open Access Journals (Sweden)

    Paola Marangolo

    Full Text Available Recent studies have shown that action observation treatment without concomitant verbal cue has a positive impact on the recovery of verb retrieval deficits in aphasic patients. In agreement with an embodied cognition viewpoint, a hypothesis has been advanced that gestures and language form a single communication system and words whose retrieval is facilitated by gestures are semantically represented through sensory-motor features. However, it is still an open question as to what extent this treatment approach works. Results from the recovery of motor deficits have suggested that action observation promotes motor recovery only for actions that are part of the motor repertoire of the observer. The aim of the present experiment was to further investigate the role of action observation treatment in verb recovery. In particular, we contrasted the effects induced by observing human actions (e.g. dancing, kicking, pointing, eating versus non human actions (e.g. barking, printing. Seven chronic aphasic patients with a selective deficit in verb retrieval underwent an intensive rehabilitation training that included five daily sessions over two consecutive weeks. Each subject was asked to carefully observe 115 video-clips of actions, one at a time and, after observing them, they had to produce the corresponding verb. Two groups of actions were randomly presented: humans versus nonhuman actions. In all patients, significant improvement in verb retrieval was found only by observing video-clips of human actions. Moreover, follow-up testing revealed long-term verb recovery that was still present two months after the two treatments had ended. In support of the multimodal concept representation's proposal, we suggest that just the observation of actions pertaining to the human motor repertoire is an effective rehabilitation approach for verb recovery.

  6. Rehabilitation Interventions for Improving Social Participation After Stroke: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Obembe, Adebimpe O; Eng, Janice J

    2016-05-01

    Despite the fact that social participation is considered a pivotal outcome of a successful recovery after stroke, there has been little attention on the impact of activities and services on this important domain. To present a systematic review and meta-analysis from randomized controlled trials (RCTs) on the effects of rehabilitation interventions on social participation after stroke. A total of 8 electronic databases were searched for relevant RCTs that evaluated the effects of an intervention on the outcome of social participation after stroke. Reference lists of selected articles were hand searched to identify further relevant studies. The methodological quality of the studies was assessed using the Physiotherapy Evidence Database Scale. Standardized mean differences (SMDs) and confidence intervals (CIs) were estimated using fixed- and random-effect models. In all, 24 RCTs involving 2042 stroke survivors were identified and reviewed, and 21 were included in the meta-analysis. There was a small beneficial effect of interventions that utilized exercise on social participation (10 studies; SMD = 0.43; 95% CI = 0.09, 0.78;P= .01) immediately after the program ended. Exercise in combination with other interventions (13 studies; SMD = 0.34; 95% CI = 0.10, 0.58;P= .006) also resulted in beneficial effects. No significant effect was observed for interventions that involved support services over 9 studies (SMD = 0.09 [95% CI = -0.04, 0.21];I(2)= 0%;P= .16). The included studies provide evidence that rehabilitation interventions may be effective in improving social participation after stroke, especially if exercise is one of the components. © The Author(s) 2015.

  7. Balance and ambulation improvements in individuals with chronic incomplete spinal cord injury using locomotor training-based rehabilitation.

    Science.gov (United States)

    Harkema, Susan J; Schmidt-Read, Mary; Lorenz, Douglas J; Edgerton, V Reggie; Behrman, Andrea L

    2012-09-01

    To evaluate the effects of intensive locomotor training on balance and ambulatory function at enrollment and discharge during outpatient rehabilitation after incomplete SCI. Prospective observational cohort. Seven outpatient rehabilitation centers from the Christopher and Dana Reeve Foundation NeuroRecovery Network (NRN). Patients (N=196) with American Spinal Injury Association Impairment Scale (AIS) grade C or D SCI who received at least 20 locomotor training treatment sessions in the NRN. Intensive locomotor training, including step training using body-weight support and manual facilitation on a treadmill followed by overground assessment and community integration. Berg Balance Scale; Six-Minute Walk Test; 10-Meter Walk Test. Outcome measures at enrollment showed high variability between patients with AIS grades C and D. Significant improvement from enrollment to final evaluation was observed in balance and walking measures for patients with AIS grades C and D. The magnitude of improvement significantly differed between AIS groups for all measures. Time since SCI was not associated significantly with outcome measures at enrollment, but was related inversely to levels of improvement. Significant variability in baseline values of functional outcome measures is evident after SCI in individuals with AIS grades C and D and significant functional recovery can continue to occur even years after injury when provided with locomotor training. These results indicate that rehabilitation, which provides intensive activity-based therapy, can result in functional improvements in individuals with chronic incomplete SCI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Improving cardiovascular care through outpatient cardiac rehabilitation: an analysis of payment models that would improve quality and promote use.

    Science.gov (United States)

    Mead, Holly; Grantham, Sarah; Siegel, Bruce

    2014-01-01

    Much attention has been paid to improving the care of patients with cardiovascular disease by focusing attention on delivery system redesign and payment reforms that encompass the healthcare spectrum, from an acute episode to maintenance of care. However, 1 area of cardiovascular disease care that has received little attention in the advancement of quality is cardiac rehabilitation (CR), a comprehensive secondary prevention program that is significantly underused despite evidence-based guidelines that recommending its use. The purpose of this article was to analyze the applicability of 2 payment and reimbursement models-pay-for-performance and bundled payments for episodes of care--that can promote the use of CR. We conclude that a payment model combining elements of both pay-for-performance and episodes of care would increase the use of CR, which would both improve quality and increase efficiency in cardiac care. Specific elements would need to be clearly defined, however, including: (a) how an episode is defined, (b) how to hold providers accountable for the care they provider, (c) how to encourage participation among CR providers, and (d) how to determine an equitable distribution of payment. Demonstrations testing new payment models must be implemented to generate empirical evidence that a melded pay-for-performance and episode-based care payment model will improve quality and efficiency.

  9. Does clinical rehabilitation impose sufficient cardiorespiratory strain to improve aerobic fitness?

    NARCIS (Netherlands)

    Koopman, A.D.; Eken, M.M.; van Bezeij, T.; Valent, L.; Houdijk, J.H.P.

    2013-01-01

    Objective: To investigate the cardiorespiratory strain experienced by patients over a day and during different types of rehabilitation therapies during a clinical rehabilitation programme. In addition, to investigate the use of the Borg scale as an instrument to monitor exercise intensity. Design:

  10. Stroke rehabilitation at home before and after discharge reduced disability and improved quality of life: a randomised controlled trial.

    Science.gov (United States)

    Rasmussen, Rune Skovgaard; Østergaard, Ann; Kjær, Pia; Skerris, Anja; Skou, Christina; Christoffersen, Jane; Seest, Line Skou; Poulsen, Mai Bang; Rønholt, Finn; Overgaard, Karsten

    2016-03-01

    To evaluate if home-based rehabilitation of inpatients improved outcome compared to standard care. Interventional, randomised, safety/efficacy open-label trial. University hospital stroke unit in collaboration with three municipalities. Seventy-one eligible stroke patients (41 women) with focal neurological deficits hospitalised in a stroke unit for more than three days and in need of rehabilitation. Thirty-eight patients were randomised to home-based rehabilitation during hospitalization and for up to four weeks after discharge to replace part of usual treatment and rehabilitation services. Thirty-three control patients received treatment and rehabilitation following usual guidelines for the treatment of stroke patients. Ninety days post-stroke the modified Rankin Scale score was the primary endpoint. Other outcome measures were the modified Barthel-100 Index, Motor Assessment Scale, CT-50 Cognitive Test, EuroQol-5D, Body Mass Index and treatment-associated economy. Thirty-one intervention and 30 control patients completed the study. Patients in the intervention group achieved better modified Rankin Scale score (Intervention median = 2, IQR = 2-3; Control median = 3, IQR = 2-4; P=0.04). EuroQol-5D quality of life median scores were improved in intervention patients (Intervention median = 0.77, IQR = 0.66-0.79; Control median = 0.66, IQR = 0.56 - 0.72; P=0.03). The total amount of home-based training in minutes highly correlated with mRS, Barthel, Motor Assessment Scale and EuroQol-5D™ scores (P-values ranging from Prehabilitation reduced disability and increased quality of life. Compared to standard care, home-based stroke rehabilitation was more cost-effective. © The Author(s) 2015.

  11. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  12. Cardiac rehabilitation: a good measure to improve quality of life in peri- and postmenopausal women with microvascular angina

    Directory of Open Access Journals (Sweden)

    Wojciech Szot

    2015-05-01

    Full Text Available Cardiac Syndrome X (CSX was considered a stable coronary syndrome, yet due to its nature, CSX symptoms often have a great impact on patients’ Quality of Life (QoL. According to ESC 2013 stable coronary artery disease criteria, CSX was replaced by Microvascular Angina (MA.Unfortunately, most CSX or MA patients, after classical angina (involving main coronary vessels has been ruled out, often do not receive proper treatment. Indications for pharmacological treatment of MA patients were introduced only recently. Another problematic issue is that scientists describing the pathophysiology of both CSX and MA stress a lack of a deeper insight into the multifactorial etiology of the source of pain associated with this disease. In the presented article we have attempted to study the influence of cardiac rehabilitation (3 months programme on the QoL of patients recognized as suffering from MA, as well as to check if changes in myocardial perfusion in these patients at baseline and after completion of cardiac rehabilitation match changes in their QoL. Therefore, after screening 436 women for MA, we studied 55 of them who were confirmed as having MA and who agreed to participate in the study. Exercise tests, Myocardial Perfusion Imaging, and QoL questionnaires were studied at baseline and after completing 3 months period of cardiac rehabilitation. Results were subsequently compared, which showed a link between improved perfusion score in SPECT study and improved overall physical capacity, on one hand, and improved QoL score on the other. These results confirm that cardiac rehabilitation is a very useful treatment option for MA patients. It seems that training during cardiac rehabilitation is a very important factor (improved physical efficiency –> increase in self-belief, and that taking into consideration the multifactor pathophysiology of pain, it is connected with a better quality of life for MA patients.

  13. Exergames versus self-regulated exercises with instruction leaflets to improve adherence during geriatric rehabilitation: a randomized controlled trial

    OpenAIRE

    Oesch, Peter; Kool, Jan; Fernandez-Luque, Luis; Brox, Ellen; Evertsen, Gunn; Civit, Anton; Hilfiker, Roger; Bachmann, Stefan

    2017-01-01

    Background Improving mobility in elderly persons is a primary goal in geriatric rehabilitation. Self-regulated exercises with instruction leaflets are used to increase training volume but adherence is often low. Exergames may improve adherence. This study therefore compared exergames with self-regulated exercise using instruction leaflets. The primary outcome was adherence. Secondary outcomes were enjoyment, motivation and balance during walking. Methods Design: single center parallel group n...

  14. Exergames versus self-regulated exercises with instruction leaflets to improve adherence during geriatric rehabilitation: a randomized controlled trial.

    OpenAIRE

    Oesch, Peter; Kool, Jan; Fernandez-Luque, Luis; Brox, Ellen; Evertsen, Gunn; Civit, Anton; Hilfiker, Roger; Bachmann, Stefan

    2017-01-01

    BACKGROUND Improving mobility in elderly persons is a primary goal in geriatric rehabilitation. Self-regulated exercises with instruction leaflets are used to increase training volume but adherence is often low. Exergames may improve adherence. This study therefore compared exergames with self-regulated exercise using instruction leaflets. The primary outcome was adherence. Secondary outcomes were enjoyment, motivation and balance during walking. METHODS Design: single center para...

  15. 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...

  16. Improving the education in the field of patient autonomy in rehabilitation doctors working with engineers

    Directory of Open Access Journals (Sweden)

    Bliuc Roxana Elena

    2017-01-01

    Full Text Available The present study analyzes the use of bioethical expertise of Romanian rehabilitation doctors working in a hospital for engineering professionals, the Romanian Railways Clinical Hospital Iasi. The knowledge of the specific legislation by the medical personnel, proper communication, shared decision making and the use of informed consent are essential for effective healthcare provided to engineers, a group of professionals with a great contribution to the development of rehabilitation robotics and medical technology.

  17. Using the UKROC dataset to make the case for resources to improve cost-efficiency in neurological rehabilitation.

    Science.gov (United States)

    Turner-Stokes, Lynne; Poppleton, Rob; Williams, Heather; Schoewenaars, Katie; Badwan, Derar

    2012-01-01

    A key challenge for providers and commissioners of rehabilitation services is to find optimal balance between service costs and outcomes. This article presents a "real-life" application of the UK Rehabilitation Outcomes Collaborative (UKROC) dataset. We undertook a comparative cohort analysis of case-episode data (n = 173) from two specialist neurological rehabilitation units (A and B), to compare the cost-efficiency of two service models. (i) Demographics, casemix and levels of functional dependency on admission and discharge were broadly similar for the two units. (ii) The mean length of stay for Unit A was 1.5 times longer than Unit B, which had 85% higher levels of therapy staffing in relation to occupied bed days so despite higher bed-day costs, Unit B was 20% more cost-efficient overall, for similar gain. (iii) Following analysis, engagement with service commissioners led to successful negotiation of a business plan for service reconfiguration with increased staffing levels for Unit A and further development of local community rehabilitation services. (i) Lower front-end service costs do not always signify optimal cost-efficiency. (ii) Analysis of routinely collected clinical data can be used to engage commissioners and to make the case for resources to maximise efficiency and improve patient care.

  18. 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.

  19. 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

  20. Importance of early physical rehabilitation in improving functional state of vegetative nervous system of women with postmastectomy syndrome

    Directory of Open Access Journals (Sweden)

    Tatiana Odynets

    2016-02-01

    Full Text Available Purpose: to determine the expediency of early application of physical rehabilitation to improve the functional state of vegetative nervous system of women with postmastectomy syndrome. Material & Methods: theoretical analysis of scientific and methodical literature, analysis of heart rate variability, methods of mathematical statistics. The study involved 135 women with postmastectomy syndrome who underwent radical mastectomy for Madden. Results: at the end of the research value of high-frequency component of the spectrum was significantly higher in women MG1 compared to MG on 257,72 ms² (p<0,01 and the stress index was lower on 107,01 c. u (p<0,001. Conclusions: the feasibility of early rehabilitation intervention to improve the functional state of the autonomic nervous system is not detected during the year classes on problem-oriented programs.

  1. Compressing bitmap indexes for faster search operations

    International Nuclear Information System (INIS)

    Wu, Kesheng; Otoo, Ekow J.; Shoshani, Arie

    2002-01-01

    In this paper, we study the effects of compression on bitmap indexes. The main operations on the bitmaps during query processing are bitwise logical operations such as AND, OR, NOT, etc. Using the general purpose compression schemes, such as gzip, the logical operations on the compressed bitmaps are much slower than on the uncompressed bitmaps. Specialized compression schemes, like the byte-aligned bitmap code(BBC), are usually faster in performing logical operations than the general purpose schemes, but in many cases they are still orders of magnitude slower than the uncompressed scheme. To make the compressed bitmap indexes operate more efficiently, we designed a CPU-friendly scheme which we refer to as the word-aligned hybrid code (WAH). Tests on both synthetic and real application data show that the new scheme significantly outperforms well-known compression schemes at a modest increase in storage space. Compared to BBC, a scheme well-known for its operational efficiency, WAH performs logical operations about 12 times faster and uses only 60 percent more space. Compared to the uncompressed scheme, in most test cases WAH is faster while still using less space. We further verified with additional tests that the improvement in logical operation speed translates to similar improvement in query processing speed

  2. Compressing bitmap indexes for faster search operations

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Kesheng; Otoo, Ekow J.; Shoshani, Arie

    2002-04-25

    In this paper, we study the effects of compression on bitmap indexes. The main operations on the bitmaps during query processing are bitwise logical operations such as AND, OR, NOT, etc. Using the general purpose compression schemes, such as gzip, the logical operations on the compressed bitmaps are much slower than on the uncompressed bitmaps. Specialized compression schemes, like the byte-aligned bitmap code(BBC), are usually faster in performing logical operations than the general purpose schemes, but in many cases they are still orders of magnitude slower than the uncompressed scheme. To make the compressed bitmap indexes operate more efficiently, we designed a CPU-friendly scheme which we refer to as the word-aligned hybrid code (WAH). Tests on both synthetic and real application data show that the new scheme significantly outperforms well-known compression schemes at a modest increase in storage space. Compared to BBC, a scheme well-known for its operational efficiency, WAH performs logical operations about 12 times faster and uses only 60 percent more space. Compared to the uncompressed scheme, in most test cases WAH is faster while still using less space. We further verified with additional tests that the improvement in logical operation speed translates to similar improvement in query processing speed.

  3. Faster than Nyquist signaling algorithms to silicon

    CERN Document Server

    Dasalukunte, Deepak; Rusek, Fredrik; Anderson, John B

    2014-01-01

    This book addresses the challenges and design trade-offs arising during the hardware design of Faster-than-Nyquist (FTN) signaling transceivers. The authors describe how to design for coexistence between the FTN system described and Orthogonal frequency-division multiplexing (OFDM) systems, enabling readers to design FTN specific processing blocks as add-ons to the conventional transceiver chain.   • Provides a comprehensive introduction to Faster-than-Nyquist (FTN) signaling transceivers, covering both theory and hardware implementation; • Enables readers to design systems that achieve bandwidth efficiency by making better use of the available spectrum resources; • Describes design techniques to achieve 2x improvement in bandwidth usage with similar performance as that of an OFDM system.  

  4. Size matters: bigger is faster.

    Science.gov (United States)

    Sereno, Sara C; O'Donnell, Patrick J; Sereno, Margaret E

    2009-06-01

    A largely unexplored aspect of lexical access in visual word recognition is "semantic size"--namely, the real-world size of an object to which a word refers. A total of 42 participants performed a lexical decision task on concrete nouns denoting either big or small objects (e.g., bookcase or teaspoon). Items were matched pairwise on relevant lexical dimensions. Participants' reaction times were reliably faster to semantically "big" versus "small" words. The results are discussed in terms of possible mechanisms, including more active representations for "big" words, due to the ecological importance attributed to large objects in the environment and the relative speed of neural responses to large objects.

  5. Improvements in Key Cardiopulmonary Exercise Testing Variables Following Cardiac Rehabilitation in Patients With Coronary Artery Disease.

    Science.gov (United States)

    Popovic, Dejana; Kumar, Nikhil; Chaudhry, Sundeep; Bagai, Akshay; Arena, Ross; Kumar, Naresh

    2018-05-11

    Improvements in cardiorespiratory fitness (VO2peak) post-cardiac rehabilitation (post-CR) are used to gauge therapeutic efficacy. The aim of the present study was to assess the effect of supervised CR on other cardiopulmonary exercise testing (CPX) variables, specifically those that reflect ventilatory efficiency and VO2 changes in relation to changes in work rate (WR). Patients (n = 142; mean age 63 ± 9 y; 23% female) with coronary artery disease (CAD) participated in supervised CR for 3 to 6 mo completing 60 ± 17 sessions (range: 32-96 sessions), with intensity derived from the baseline CPX. CPX was completed at baseline and post-CR on a cycle ergometer. The minimum heart rate (HR) during cycling was set 5 to 10 beats/min above the HR at ventilatory anaerobic threshold (VAT) while the maximum HR remained below the ischemic threshold observed during CPX, and this intensity was maintained for 25 min. VO2peak, peak O2 pulse, the minute ventilation/carbon dioxide production (VE/VCO2) slope, the oxygen uptake efficiency slope (OUES), and the ΔVO2/ΔWR slope were determined at baseline and post-CR. Following CR, there were significant improvements (all P < .001) in VO2peak (17.7 ± 4.7 mL/kg/min vs 20.9 ± 5.4 mL/kg/min), peak O2 pulse (11.6 ± 3.2 mL/beat vs 13.4 ± 3.6 mL/beat), VE/VCO2 slope (28.4 ± 5.3 vs 27.5 ± 4.7), OUES (1.8 ± 0.5 vs 2.0 ± 0.6), and ΔVO2/ΔWR slope (9.1 ± 1.2 mL/min/W vs 9.6 ± 1.1 mL/min/W). Key markers of ventilatory efficiency and VO2 kinetics during CPX significantly improve following CR. Expanding the list of variables assessed via CPX may provide better resolution in validation of CR therapeutic efficacy in patients with CAD.

  6. Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review

    Directory of Open Access Journals (Sweden)

    Andrea M Bruder

    2017-10-01

    Registration: CRD42016041818. [Bruder AM, Shields N, Dodd KJ, Taylor NF (2017 Prescribed exercise programs may not be effective in reducing impairments and improving activity during upper limb fracture rehabilitation: a systematic review. Journal of Physiotherapy 63: 205–220

  7. Improvement of myocardial perfusion detected by 201Tl scintigraphy on cardiac rehabilitation for patients with coronary artery disease

    International Nuclear Information System (INIS)

    Li, Linxue; Nohara, Ryuji; Makita, Shigeru

    1996-01-01

    The effect of cardiac rehabilitation (mean 70±48 months) on myocardial perfusion was assessed using thallium-201 ( 201 Tl) exercise study in 63 patients with coronary artery disease (CAD). Subjects were those in a rehabilitation group (Rh=42) participating in supervised sports training two to three times per week and the control group (Ct=21) not taking active daily exercise. The interval between two 201 Tl SPECT studies was 19±16 months. After physical training, total duration of the exercise test increased from 443±112 to 536±121 seconds (+19%) in the Rh group, and from 484±129 to 432±115 seconds in the Ct group (-10.7%) (p 2 to 269.8±58 x 10 2 in the Rh group and decreased from 218.7±40 x 10 2 to 216.6±76 x 10 2 (p 201 Tl myocardial perfusion defect on exercise improved more in 54.8% (stress 59.5%, rest 35.7%) in the Rh group than in the Ct group (9.5%, p 201 Tl perfusion defect decreased from 68 (23.1%) to 49 regions (16.7%) of 294 total myocardial regions in the Rh group on exercise. However. it increased from 39 (26.5%) to 44 (29.9%) regions of 147 regions in the Ct group (p<0.01). Thus, cardiac rehabilitation increases exercise tolerance with improvement of myocardial perfusion. suggesting that cardiac rehabilitation is an advisable and effective treatment for patients with ischemic heart disease. (author)

  8. Slow light brings faster communications

    International Nuclear Information System (INIS)

    Gauthier, D.

    2006-01-01

    Two teams of researchers have managed to significantly reduce the speed of light in an optical fibre, which could open the door to all-optical routers for telecommunications, as Daniel Gauthier explains. Optical engineers around the globe are working hard to meet the ever-growing demand for higher-speed information networks, and the latest systems being developed operate at rates close to 160 GB per second - which is over 100 times quicker than the fastest broadband services currently available and a world away from the 56 kb per second dial-up connections of the early years of the Internet. Paradoxically, it seems that making light travel slower rather than faster might be the best way to meet these high-speed challenges. (U.K.)

  9. Treatment and rehabilitation on a stroke unit improves 5-year survival. A community-based study

    DEFF Research Database (Denmark)

    Jørgensen, H S; Kammersgaard, L P; Nakayama, H

    1999-01-01

    We have previously reported a marked reduction in mortality up to 1 year after treatment and rehabilitation on a stroke unit versus on general neurological and medical wards in unselected stroke patients. In the present study we wanted to test the hypothesis that this mortality-reducing effect...

  10. Relationship between Improvements in Physical Measures and Patient Satisfaction in Rehabilitation after Total Knee Arthroplasty

    Science.gov (United States)

    Nazzal, Mahmoud I.; Bashaireh, Khaldoon H.; Alomari, Mahmoud A.; Nazzal, Mohammad S.; Maayah, Mikhled F.; Mesmar, Mohammad

    2012-01-01

    The aim of this study was to examine patient satisfaction with rehabilitation after total knee arthroplasty (TKA). Fifty-six patients, aged 45-77 years, were enrolled in a post-TKA comprehensive therapy program focusing on knee strengthening and functional activities. The program lasted 3 months and was conducted for 1 h, twice a day, 5 days per…

  11. Improving Balance in TBI Using a Low-Cost Customized Virtual Reality Rehabilitation Tool

    Science.gov (United States)

    2017-10-01

    Journal publications. Larkin, M. (2017). Exploring...virtual environments for cognitive and physical rehabilitation. The Journal on Active Aging. 16(5): 44-51.] § Books or other non-periodical, one...Memory, and Immersion and PTSD! Keynote Address at the Annual Conference of the Institute for Functional Medicine. Los Angeles, California, June,

  12. A real time biofeedback using Kinect and Wii to improve gait for post-total knee replacement rehabilitation: a case study report.

    Science.gov (United States)

    Levinger, Pazit; Zeina, Daniel; Teshome, Assefa K; Skinner, Elizabeth; Begg, Rezaul; Abbott, John Haxby

    2016-01-01

    This study aimed to develop a low-cost real-time biofeedback system to assist with rehabilitation for patients following total knee replacement (TKR) and to assess its feasibility of use in a post-TKR patient case study design with a comparison group. The biofeedback system consisted of Microsoft Kinect(TM) and Nintendo Wii balance board with a dedicated software. A six-week inpatient rehabilitation program was augmented by biofeedback and tested in a single patient following TKR. Three patients underwent a six weeks standard rehabilitation with no biofeedback and served as a control group. Gait, function and pain were assessed and compared before and after the rehabilitation. The biofeedback software incorporated real time visual feedback to correct limb alignment, movement pattern and weight distribution. Improvements in pain, function and quality of life were observed in both groups. The strong improvement in the knee moment pattern demonstrated in the case study indicates feasibility of the biofeedback-augmented intervention. This novel biofeedback software has used simple commercially accessible equipment that can be feasibly incorporated to augment a post-TKR rehabilitation program. Our preliminary results indicate the potential of this biofeedback-assisted rehabilitation to improve knee function during gait. Research is required to test this hypothesis. Implications for Rehabilitation The real-time biofeedback system developed integrated custom-made software and simple low-cost commercially accessible equipment such as Kinect and Wii board to provide augmented information during rehabilitation following TKR. The software incorporated key rehabilitation principles and visual feedback to correct alignment of the lower legs, pelvic and trunk as well as providing feedback on limbs weight distribution. The case study patient demonstrated greater improvement in their knee function where a more normal biphasic knee moment was achieved following the six

  13. Adults with idiopathic scoliosis improve disability after motor and cognitive rehabilitation: results of a randomised controlled trial.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Cazzaniga, Daniele; Rocca, Barbara; Motta, Lorenzo; Cerri, Cesare; Brayda-Bruno, Marco; Lovi, Alessio

    2016-10-01

    To evaluate the effects of motor and cognitive rehabilitation on disability in adults with idiopathic scoliosis at lower risk of progression. 130 adults with idiopathic scoliosis (main curve rehabilitation programme consisting of active self-correction, task-oriented exercises and cognitive-behavioural therapy (experimental group, 65 subjects, mean age of 51.6, females 48) or general physiotherapy consisting of active and passive mobilizations, stretching, and strengthening exercises of the spinal muscles (control group, 65 subjects, mean age of 51.7, females 46). Before, at the end, and 12 months after treatment, each participant completed the Oswestry disability index (ODI) (primary outcome), the Tampa scale for kinesiophobia, the pain catastrophizing scale, a pain numerical rating scale, and the Scoliosis Research Society-22 Patient Questionnaire. Radiological (Cobb angle) and clinical deformity (angle of trunk rotation) changes were also investigated. A linear mixed model for repeated measures was used for each outcome. Significant effects of time, group, and time by group interaction were found for all outcome measures (P cognitive rehabilitation also led to improvements in dysfunctional thoughts, pain, and quality of life. Changes were maintained for at least 1 year.

  14. Benefits of rehabilitation with implants in masticatory function: is patient perception of change in accordance with the real improvement?

    Science.gov (United States)

    Vieira, Rogeria Acedo; Melo, Ana Cláudia Moreira; Budel, Lucimara A; Gama, Josiane Cristina; de Mattias Sartori, Ivete Aparecida; Thomé, Geninho

    2014-06-01

    This study aimed to compare the index of satisfaction and masticatory function of edentulous patients before and after rehabilitation and to evaluate if patients' perception of the changes in their oral health status is in agreement with the results of masticatory performance test. Fourteen edentulous patients were rehabilitated with lower implant-supported fixed prosthesis and upper removable dentures. Index of satisfaction and masticatory capacity (subjective analysis) and performance test (objective analysis) were evaluated before and 20 days and 8 months after rehabilitation. The patients were asked to respond a yes/no masticatory capacity questionnaire and to rate their oral satisfaction on a 0 to 10 Visual Analogue Scale (VAS). Masticatory performance test comprised the ability of the individual to pulverize an artificial test food (Optocal), after 20 and 40 masticatory strokes. When baseline answers were compared to answers 8 months after treatment, all questions, excepting the ones that considered pain and social disability, were statistically different. Wilcoxon test was used to compare index of satisfaction before and after treatment. All answers showed statistically significant differences, excluding the one that referred to ease of cleaning the prostheses. Considering the masticatory performance test, Student t test (normally distributed) and Wilcoxon test (non-normally distributed) were used to test the null hypothesis that the weight of the particles of the test food left in sieves were equal in all times of evaluation. In the larger sieve with 20 cycles, statistically significant differences were observed between baseline and 8 months, 20 days and 8 months. With 40 strokes, baseline and 20 days, baseline and 8 months and 20 days and 8 months showed significant differences. It was concluded that oral rehabilitation leads to better masticatory function in edentulous patients and there is a coincidence between patient perception and real improvement on

  15. Rehabilitation for improved cognition in patients with stress-related exhaustion disorder

    DEFF Research Database (Denmark)

    Malmberg Gavelin, Hanna; Eskilsson, Therese; Boraxbekk, Carl-Johan

    2018-01-01

    Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled...... trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating...... in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive...

  16. Improving Upper Extremity Function and Quality of Life with a Tongue Driven Exoskeleton: A Pilot Study Quantifying Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Stephen N. Housley

    2017-01-01

    Full Text Available Stroke is a leading cause of long-term disability around the world. Many survivors experience upper extremity (UE impairment with few rehabilitation opportunities, secondary to a lack of voluntary muscle control. We developed a novel rehabilitation paradigm (TDS-HM that uses a Tongue Drive System (TDS to control a UE robotic device (Hand Mentor: HM while engaging with an interactive user interface. In this study, six stroke survivors with moderate to severe UE impairment completed 15 two-hour sessions of TDS-HM training over five weeks. Participants were instructed to move their paretic arm, with synchronized tongue commands to track a target waveform while using visual feedback to make accurate movements. Following TDS-HM training, significant improvements in tracking performance translated into improvements in the UE portion of the Fugl-Meyer Motor Assessment, range of motion, and all subscores for the Stroke Impact Scale. Regression modeling found daily training time to be a significant predictor of decreases in tracking error, indicating the presence of a potential dose-response relationship. The results of this pilot study indicate that the TDS-HM system can elicit significant improvements in moderate to severely impaired stroke survivors. This pilot study gives preliminary insight into the volume of treatment time required to improve outcomes.

  17. Instrumental or Physical-Exercise Rehabilitation of Balance Improves Both Balance and Gait in Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Marica Giardini

    2018-01-01

    Full Text Available We hypothesised that rehabilitation specifically addressing balance in Parkinson’s disease patients might improve not only balance but locomotion as well. Two balance-training protocols (standing on a moving platform and traditional balance exercises were assessed by assigning patients to two groups (Platform, n=15, and Exercises, n=17. The platform moved periodically in the anteroposterior, laterolateral, and oblique direction, with and without vision in different trials. Balance exercises were based on the Otago Exercise Program. Both platform and exercise sessions were administered from easy to difficult. Outcome measures were (a balancing behaviour, assessed by both Index of Stability (IS on platform and Mini-BESTest, and (b gait, assessed by both baropodometry and Timed Up and Go (TUG test. Falls Efficacy Scale-International (FES-I and Parkinson’s Disease Questionnaire (PDQ-8 were administered. Both groups exhibited better balance control, as assessed both by IS and by Mini-BESTest. Gait speed at baropodometry also improved in both groups, while TUG was less sensitive to improvement. Scores of FES-I and PDQ-8 showed a marginal improvement. A four-week treatment featuring no gait training but focused on challenging balance tasks produces considerable gait enhancement in mildly to moderately affected patients. Walking problems in PD depend on postural instability and are successfully relieved by appropriate balance rehabilitation. This trial is registered with ClinicalTrials.gov NCT03314597.

  18. Improving Synchronization and Functional Connectivity in Autism Spectrum Disorders through Plasticity-Induced Rehabilitation Training

    Science.gov (United States)

    2011-08-01

    theory  of   mind :  evidence  from...Faces  in  2  and  4-­‐Year-­‐Old   Children  with   Autism  Spectrum  Disorder.   J.Autism  Dev.Disord..   Hadjikhani,  N...Connectivity in Autism Spectrum Disorders through Plasticity-Induced Rehabilitation Training PRINCIPAL INVESTIGATOR: Jaime A. Pineda,

  19. Rehabilitation Program Integrating Virtual Environment to Improve Orientation and Mobility Skills for People Who Are Blind.

    Science.gov (United States)

    Lahav, Orly; Schloerb, David W; Srinivasan, Mandayam A

    2015-01-01

    This paper presents the integration of a virtual environment (BlindAid) in an orientation and mobility rehabilitation program as a training aid for people who are blind. BlindAid allows the users to interact with different virtual structures and objects through auditory and haptic feedback. This research explores if and how use of the BlindAid in conjunction with a rehabilitation program can help people who are blind train themselves in familiar and unfamiliar spaces. The study, focused on nine participants who were congenitally, adventitiously, and newly blind, during their orientation and mobility rehabilitation program at the Carroll Center for the Blind (Newton, Massachusetts, USA). The research was implemented using virtual environment (VE) exploration tasks and orientation tasks in virtual environments and real spaces. The methodology encompassed both qualitative and quantitative methods, including interviews, a questionnaire, videotape recording, and user computer logs. The results demonstrated that the BlindAid training gave participants additional time to explore the virtual environment systematically. Secondly, it helped elucidate several issues concerning the potential strengths of the BlindAid system as a training aid for orientation and mobility for both adults and teenagers who are congenitally, adventitiously, and newly blind.

  20. Home-based pulmonary rehabilitation improves clinical features and systemic inflammation in chronic obstructive pulmonary disease patients

    Directory of Open Access Journals (Sweden)

    Nascimento ESP

    2015-03-01

    Full Text Available Eloisa Sanches Pereira do Nascimento,1 Luciana Maria Malosá Sampaio,1 Fabiana Sobral Peixoto-Souza,1 Fernanda Dultra Dias,1 Evelim Leal Freitas Dantas Gomes,1 Flavia Regina Greiffo,2 Ana Paula Ligeiro de Oliveira,2 Roberto Stirbulov,3 Rodolfo Paula Vieira,2 Dirceu Costa11Laboratory of Functional Respiratory Evaluation (LARESP, 2Laboratory of Pulmonary and Exercise Immunology (LABPEI, Nove de Julho University (UNINOVE, São Paulo, SP, Brazil; 3Department of Pneumology, Santa Casa University Hospital, São Paulo, SP, BrazilAbstract: Chronic obstructive pulmonary disease (COPD is a respiratory disease characterized by chronic airflow limitation that leads beyond the pulmonary changes to important systemic effects. COPD is characterized by pulmonary and systemic inflammation. However, increases in the levels of inflammatory cytokines in plasma are found even when the disease is stable. Pulmonary rehabilitation improves physical exercise capacity and quality of life and decreases dyspnea. The aim of this study was to evaluate whether a home-based pulmonary rehabilitation (HBPR program improves exercise tolerance in COPD patients, as well as health-related quality of life and systemic inflammation. This prospective study was conducted at the Laboratory of Functional Respiratory Evaluation, Nove de Julho University, São Paulo, Brazil. After anamnesis, patients were subjected to evaluations of health-related quality of life and dyspnea, spirometry, respiratory muscle strength, upper limbs incremental test, incremental shuttle walk test, and blood test for quantification of systemic inflammatory markers (interleukin [IL]-6 and IL-8. At the end of the evaluations, patients received a booklet containing the physical exercises to be performed at home, three times per week for 8 consecutive weeks. Around 25 patients were enrolled, and 14 completed the pre- and post-HBPR ratings. There was a significant increase in the walked distance and the maximal

  1. Dohsa Treatment to Improve Balance in Elderly People: An Evaluation of a Family-Based Rehabilitation Programme

    Directory of Open Access Journals (Sweden)

    Asghar Dadkhah

    2007-09-01

    Full Text Available Objectives: In this research we evaluate an individually family-based Dohsa exercise programme of balance in the aged people and its effect on self confidence for performing common daily tasks with less falling could be influenced by training. Methods: From a residential care center, five aged person were participated in this study. They were trained by Dohsa method for six weeks. Two types of Dohsa-hou were used: Relaxation and Tate-kei. Tate-kei was the task which required them to control their body vertically against gravity. Results: The results indicated that most of them had improved their balance and their confidence for doing their daily activities without falling in a better way. Discussion: The Dohsa family based rehabilitation program could improve their balance and increase their activity by not falling down. The family based programme can be a useful program for rehabilitation therapists in their therapy with aged people to improve their life skills and well beings.

  2. Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

    Energy Technology Data Exchange (ETDEWEB)

    El Demerdash, Salah [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Khorshid, Hazem, E-mail: hazemkhorshid@yahoo.com [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salah, Iman; Abdel-Rahman, Mohamed A. [Department of Cardiology, Ain Shams University Hospital, Cairo (Egypt); Salem, Alaa M. [Department of Internal Medicine, Medical Division, National Research Centre, Cairo (Egypt)

    2015-07-15

    Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

  3. Cardiac rehabilitation improves the ischemic burden in patients with ischemic heart disease who are not suitable for revascularization

    International Nuclear Information System (INIS)

    El Demerdash, Salah; Khorshid, Hazem; Salah, Iman; Abdel-Rahman, Mohamed A.; Salem, Alaa M.

    2015-01-01

    Background: Ischemic heart diseases including stable angina & acute events, represent a huge burden on both the individual & the society and represent an important source of disability. Aim: We aimed to identify the effect of cardiac rehabilitation program (CRP) on the ischemic burden in patients with ischemic heart disease (IHD) unsuitable for coronary revascularization. Methods: The study included 40 patients with IHD who were not suitable for coronary revascularization either by PCI or CABG (due to unsuitable coronary anatomy, co morbidities, high surgical/procedural risk or patient preference). All patients were subjected to sophisticated CRP protocols, including patient education, nutritional, medical, psychological and sexual counseling and group smoking cessation. All patients participated in low intensity exercise program twice weekly. The patient’s symptoms, vitals and medications were evaluated at each visit and clinical and laboratory data, echocardiography and stress myocardial perfusion imaging (SPECT) were evaluated before and 3 months after the end of the study. Results: The mean age was 56.8 ± 3.1 years and only 2 patients (5%) were females. 22 (55%) patients were diabetic, 21 (53%) were hypertensive and 30 (75%) were smokers. It was found that 3 months after completion of CRP, there was a significant decrease in BMI (30.3 ± 2.9 vs. 31.2 ± 1.9, p < 0.001), and mean blood pressure (93.4 ± 11 vs. 105 ± 10.6 mmHg, p < 0.001). There was also a favorable effect on lipid profile and a significant improvement of the functional capacity in terms of NYHA functional class (2.1 ± 0.62 vs. 1.4 ± 0.6, p < 0.001). Despite that wall motion score index did not significantly change after CRP, there was a strong trend toward a better ejection fraction (53.7 ± 7.8 vs. 54.5 ± 6.3 %, p = 0.06) and significant improvement of Canadian cardiovascular class (1.42 ± 0.6 vs. 1.95 ± 0.5, p < 0.001) post CRP. Importantly, the difference between the SPECT

  4. A neural tracking and motor control approach to improve rehabilitation of upper limb movements

    Directory of Open Access Journals (Sweden)

    Schmid Maurizio

    2008-02-01

    Full Text Available Abstract Background Restoration of upper limb movements in subjects recovering from stroke is an essential keystone in rehabilitative practices. Rehabilitation of arm movements, in fact, is usually a far more difficult one as compared to that of lower extremities. For these reasons, researchers are developing new methods and technologies so that the rehabilitative process could be more accurate, rapid and easily accepted by the patient. This paper introduces the proof of concept for a new non-invasive FES-assisted rehabilitation system for the upper limb, called smartFES (sFES, where the electrical stimulation is controlled by a biologically inspired neural inverse dynamics model, fed by the kinematic information associated with the execution of a planar goal-oriented movement. More specifically, this work details two steps of the proposed system: an ad hoc markerless motion analysis algorithm for the estimation of kinematics, and a neural controller that drives a synthetic arm. The vision of the entire system is to acquire kinematics from the analysis of video sequences during planar arm movements and to use it together with a neural inverse dynamics model able to provide the patient with the electrical stimulation patterns needed to perform the movement with the assisted limb. Methods The markerless motion tracking system aims at localizing and monitoring the arm movement by tracking its silhouette. It uses a specifically designed motion estimation method, that we named Neural Snakes, which predicts the arm contour deformation as a first step for a silhouette extraction algorithm. The starting and ending points of the arm movement feed an Artificial Neural Controller, enclosing the muscular Hill's model, which solves the inverse dynamics to obtain the FES patterns needed to move a simulated arm from the starting point to the desired point. Both position error with respect to the requested arm trajectory and comparison between curvature factors

  5. Relationship marketing and disadvantaged health care segments: using internal marketing to improve the vocational rehabilitation process.

    Science.gov (United States)

    Peltier, James W; Scovotti, Carol

    2004-01-01

    The purpose of vocational rehabilitation (VR) is to provide disabled individuals with the training and support services needed to assimilate into the workforce. This study incorporates concepts developed in the relationship marketing and internal marketing literature to determine the factors that influence overall satisfaction of vocational training services. Results underscore the importance of social and structural bonds that develop among the multiple stakeholders involved in the VR process. Satisfaction is also influenced by the design and equipment used in the facilities and the efficiency of initiating VR services. A highly reliable instrument to measure VR participant satisfaction is presented.

  6. Rehabilitation plus OnabotulinumtoxinA Improves Motor Function over OnabotulinumtoxinA Alone in Post-Stroke Upper Limb Spasticity: A Single-Blind, Randomized Trial

    Directory of Open Access Journals (Sweden)

    Deidre Devier

    2017-07-01

    Full Text Available Background: OnabotulinumtoxinA (BoNT-A can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. Methods: This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl–Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. Results: The ‘rehab’ group significantly improved on the Fugl–Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67 while the ‘no rehab’ group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006. This improvement was largely driven by the upper extremity “movement” subscale, which showed that the ‘rehab’ group was improving (Visit 1 = 33, Visit 5 = 37 while the ‘no rehab’ group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034. Conclusions: Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.

  7. Rehabilitation plus OnabotulinumtoxinA Improves Motor Function over OnabotulinumtoxinA Alone in Post-Stroke Upper Limb Spasticity: A Single-Blind, Randomized Trial.

    Science.gov (United States)

    Devier, Deidre; Harnar, JoAnn; Lopez, Leandro; Brashear, Allison; Graham, Glenn

    2017-07-11

    OnabotulinumtoxinA (BoNT-A) can temporarily decrease spasticity following stroke, but whether there is an associated improvement in upper limb function is less clear. This study measured the benefit of adding weekly rehabilitation to a background of BoNT-A treatments for chronic upper limb spasticity following stroke. This was a multi-center clinical trial. Thirty-one patients with post-stroke upper limb spasticity were treated with BoNT-A. They were then randomly assigned to 24 weeks of weekly upper limb rehabilitation or no rehabilitation. They were injected up to two times, and followed for 24 weeks. The primary outcome was change in the Fugl-Meyer upper extremity score, which measures motor function, sensation, range of motion, coordination, and speed. The 'rehab' group significantly improved on the Fugl-Meyer upper extremity score (Visit 1 = 60, Visit 5 = 67) while the 'no rehab' group did not improve (Visit 1 = 59, Visit 5 = 59; p = 0.006). This improvement was largely driven by the upper extremity "movement" subscale, which showed that the 'rehab' group was improving (Visit 1 = 33, Visit 5 = 37) while the 'no rehab' group remained virtually unchanged (Visit 1 = 34, Visit 5 = 33; p = 0.034). Following injection of BoNT-A, adding a program of rehabilitation improved motor recovery compared to an injected group with no rehabilitation.

  8. Pulmonary rehabilitation improves only some domains of health-related quality of life measured by the Short Form-36 questionnaire

    Directory of Open Access Journals (Sweden)

    Chok Limsuwat

    2014-01-01

    Full Text Available Background: Pulmonary rehabilitation (PR has inconsistent effects on health-related quality of life (HRQL in patients with chronic lung diseases. We evaluated the effect of PR on HRQL outcomes using the 36-item short form of the medical outcomes (SF-36. Methods : We retrospectively reviewed the files of all patients who completed PR in 2010, 2011, and first half of 2012. We collected information on demographics, symptoms, pulmonary function tests, 6-minute walk tests (6-MWT, and responses on the SF-36 survey, including the physical component score (PCS and mental component score (MCS. Results: The study included 19 women and 22 men. The mean age was 69.8 ± 8.5 years. The diagnoses included chronic obstructive pulmonary disease (COPD; n = 31, asthma (n = 3, interstitial lung disease (n = 5, and obstructive sleep apnea (OSA; n = 2. The mean forced expiratory volume-one second (FEV1 was 1.16 ± 0.52 L (against 60.5 ± 15.9% of predicted value. There was a significant improvement in 6-MWT (P < 0.0001. The PCS improved post-PR from 33.8 to 34.5 (P = 0.02; the MCS did not change. Conclusion: These patients had low SF-36 scores compared to the general population; changes in scores after PR were low. These patients may need frequent HRQL assessment during rehabilitation, and PR programs should consider program modification in patients with small changes in mental health.

  9. Whakawhanaungatanga: the importance of culturally meaningful connections to improve uptake of pulmonary rehabilitation by Māori with COPD - a qualitative study.

    Science.gov (United States)

    Levack, William Mm; Jones, Bernadette; Grainger, Rebecca; Boland, Pauline; Brown, Melanie; Ingham, Tristram R

    2016-01-01

    Pulmonary rehabilitation is known to improve function and quality of life for people with chronic obstructive pulmonary disease (COPD). However, little research has been conducted on the influence of culture on experiences of pulmonary rehabilitation. This study examined factors influencing uptake of pulmonary rehabilitation by Māori with COPD in New Zealand. Grounded theory nested within kaupapa Māori methodology. Transcripts were analyzed from interviews and focus groups with 15 Māori and ten New Zealand non-Māori invited to attend pulmonary rehabilitation for COPD. Māori participants had either attended a mainstream hospital-based program, a community-based program designed "by Māori, for Māori", or had experienced both. Several factors influencing uptake of pulmonary rehabilitation were common to all participants regardless of ethnicity: 1) participants' past experiences (eg, of exercise; of health care systems), 2) attitudes and expectations, 3) access issues (eg, time, transport, and conflicting responsibilities), and 4) initial program experiences. These factors were moderated by the involvement of family and peers, interactions with health professionals, the way information on programs was presented, and by new illness events. For Māori, however, several additional factors were also identified relating to cultural experiences of pulmonary rehabilitation. In particular, Māori participants placed high value on whakawhanaungatanga: the making of culturally meaningful connections with others. Culturally appropriate communication and relationship building was deemed so important by some Māori participants that when it was absent, they felt strongly discouraged to attend pulmonary rehabilitation. Only the more holistic services offered a program in which they felt culturally safe and to which they were willing to return for ongoing rehabilitation. Lack of attention to cultural factors in the delivery of pulmonary rehabilitation may be a barrier to its

  10. Problem-Solving Therapy During Outpatient Stroke Rehabilitation Improves Coping and Health-Related Quality of Life: Randomized Controlled Trial.

    Science.gov (United States)

    Visser, Marieke M; Heijenbrok-Kal, Majanka H; Van't Spijker, Adriaan; Lannoo, Engelien; Busschbach, Jan J V; Ribbers, Gerard M

    2016-01-01

    This study investigated whether problem-solving therapy (PST) is an effective group intervention for improving coping strategy and health-related quality of life (HRQoL) in patients with stroke. In this multicenter randomized controlled trial, the intervention group received PST as add-on to standard outpatient rehabilitation, the control group received outpatient rehabilitation only. Measurements were performed at baseline, directly after the intervention, and 6 and 12 months later. Data were analyzed using linear-mixed models. Primary outcomes were task-oriented coping as measured by the Coping Inventory for Stressful Situations and psychosocial HRQoL as measured by the Stroke-Specific Quality of Life Scale. Secondary outcomes were the EuroQol EQ-5D-5L utility score, emotion-oriented and avoidant coping as measured by the Coping Inventory for Stressful Situations, problem-solving skills as measured by the Social Problem Solving Inventory-Revised, and depression as measured by the Center for Epidemiological Studies Depression Scale. Included were 166 patients with stroke, mean age 53.06 years (SD, 10.19), 53% men, median time poststroke 7.29 months (interquartile range, 4.90-10.61 months). Six months post intervention, the PST group showed significant improvement when compared with the control group in task-oriented coping (P=0.008), but not stroke-specific psychosocial HRQoL. Furthermore, avoidant coping (P=0.039) and the utility value for general HRQoL (P=0.034) improved more in the PST group than in the control after 6 months. PST seems to improve task-oriented coping but not disease-specific psychosocial HRQoL after stroke >6-month follow-up. Furthermore, we found indications that PST may improve generic HRQoL recovery and avoidant coping. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=2509. Unique identifier: CNTR2509. © 2015 American Heart Association, Inc.

  11. An improved model for provision of rural community-based health rehabilitation services in Vhembe District, Limpopo Province of South Africa

    Directory of Open Access Journals (Sweden)

    Rudzani E. Luruli

    2016-03-01

    Full Text Available Background: In 1991, Riakona Community Rehabilitation Programme initiated community-based rehabilitation (CBR in the Vhembe District of Limpopo Province. Subsequently, the South African government adopted the programme. Aim: The aim of the study was to suggest an improvement in the model of providing CBR services. Setting: The study was conducted in six rehabilitation centres located in hospitals in the Vhembe District in Limpopo Province of South Africa. Method: A mixed-mode research design with qualitative and quantitative elements was used to conduct the study. Content analysis, the chi-square test for Goodness of Fit and the Kruskal–Wallis and Mann–Whitney non-parametric tests were conducted. Results: The key determinants of client satisfaction with the services that the community rehabilitation workers rendered included provision of assistive devices and the adoption of a holistic approach to their work. Overall, satisfaction per domain for each one of the five domains of satisfaction scored less than 90%. More than 80% of clients were satisfied with empathy (83% and assurance (80% domains. Tangibles, reliability and responsiveness domains had scores of 78%, 72% and 67%, respectively. These results, together with the reasoning map of conceptual framework description, were used as the building blocks of the CBR model. Conclusion: The improved CBR model is useful for putting the programme into practice. This is particularly so for the CBR managers in the districts of the Limpopo Province. Keywords: client satisfaction, disability, community-based rehabilitation, community rehabilitation worker

  12. Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO - a randomized clinical trial.

    Science.gov (United States)

    Malmberg Gavelin, Hanna; Eskilsson, Therese; Boraxbekk, Carl-Johan; Josefsson, Maria; Stigsdotter Neely, Anna; Slunga Järvholm, Lisbeth

    2018-04-25

    Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity, and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.

  13. The patient education - Learning and Coping Strategies - improves adherence in cardiac rehabilitation (LC-REHAB)

    DEFF Research Database (Denmark)

    Lynggaard, Vibeke; Nielsen, Claus Vinther; Zwisler, Ann-Dorthe

    2017-01-01

    BACKGROUND: Despite proven benefits of cardiac rehabilitation (CR), adherence to CR remains suboptimal. This trial aimed to assess the impact of the patient education 'Learning and Coping Strategies' (LC) on patient adherence to an eight-week CR program. METHODS: 825 patients with ischaemic heart...... and education. Patients with heart failure, low levels of education and household income appear to benefit most from this adherence promoting intervention. TRIAL REGISTRATION: www.clinicaltrials.gov identifier NCT01668394....... disease or heart failure were open label randomised to either the LC arm (LC plus CR) or the control arm (CR alone) across three hospital units in Denmark. Both arms received same amount of training and education hours. LC consisted of individual clarifying interviews, participation of experienced...

  14. Rehabilitation of heat exchange equipment a key to power plant life extension and performance improvement

    Energy Technology Data Exchange (ETDEWEB)

    Taveau, F.; Huiban, A.M. [Alstom Power Heat Exchange, 78 - Velizy Villacoublay (France)

    2001-07-01

    With the current evolutions of the energy market and the life extension of the power plants, all the equipment initially supplied need one day or another partial or total rehabilitation. For heat exchange equipment, this includes the condensers, feed water heaters and various heat exchangers. Modernization is in particular necessary when in-service monitoring and periodic inspections show significant deteriorations of the tubes and cooling water leakages leading to forced outages or when tube and tube plate materials are no longer suited to cooling water characteristics or to updated specifications of the secondary system. Feedwater heaters and heat exchangers damaged by erosion/corrosion, vibrations, etc. can be re-designed, manufactured and replaced easily. The operation is more complex on condensers and requires technical surveys, study of alternative solutions and has a more direct impact on the global output of the power plant. That is why our conference will focus on the condenser refurbishment. (author)

  15. Rehabilitation of heat exchange equipment a key to power plant life extension and performance improvement

    International Nuclear Information System (INIS)

    Taveau, F.; Huiban, A.M.

    2001-01-01

    With the current evolutions of the energy market and the life extension of the power plants, all the equipment initially supplied need one day or another partial or total rehabilitation. For heat exchange equipment, this includes the condensers, feed water heaters and various heat exchangers. Modernization is in particular necessary when in-service monitoring and periodic inspections show significant deteriorations of the tubes and cooling water leakages leading to forced outages or when tube and tube plate materials are no longer suited to cooling water characteristics or to updated specifications of the secondary system. Feedwater heaters and heat exchangers damaged by erosion/corrosion, vibrations, etc. can be re-designed, manufactured and replaced easily. The operation is more complex on condensers and requires technical surveys, study of alternative solutions and has a more direct impact on the global output of the power plant. That is why our conference will focus on the condenser refurbishment. (author)

  16. A randomised controlled trial to improve general practitioners' services in cancer rehabilitation: Effects on general practitioners' proactivity and on patients' participation in rehabilitation activities

    DEFF Research Database (Denmark)

    Bergholdt, SH; Søndergaard, J; Larsen, PV

    2013-01-01

    by their GP reported by the patients and GPs, respectively, and patients' participation in rehabilitation activities. Methods. Cluster randomised controlled trial. All general practices in Denmark were randomised to an intervention group or to a control group (usual procedures). Patients were subsequently...

  17. A meta-analysis of mental health treatments and cardiac rehabilitation for improving clinical outcomes and depression among patients with coronary heart disease.

    Science.gov (United States)

    Rutledge, Thomas; Redwine, Laura S; Linke, Sarah E; Mills, Paul J

    2013-05-01

    To quantify the efficacy of mental health (antidepressants & psychotherapies) and cardiac rehabilitation treatments for improving secondary event risk and depression among patients with coronary heart disease (CHD). Using meta-analytic methods, we evaluated mental health and cardiac rehabilitation therapies for a) reducing secondary events and 2) improving depression severity in patients with CHD. Key word searches of PubMed and Psychlit databases and previous reviews identified relevant trials. Eighteen mental health trials evaluated secondary events and 22 trials evaluated depression reduction. Cardiac rehabilitation trials for the same categories numbered 17 and 13, respectively. Mental health treatments did not reduce total mortality (absolute risk reduction [ARR] = -0.001, confidence interval [95% CI] = -0.016 to 0.015; number needed to treat [NNT] = ∞), showed moderate efficacy for reducing CHD events (ARR = 0.029, 95% CI = 0.007 to 0.051; NNT = 34), and a medium effect size for improving depression (Cohen d = 0.297). Cardiac rehabilitation showed similar efficacy for treating depression (d = 0.23) and reducing CHD events (ARR = 0.017, 95% CI = 0.007 to 0.026; NNT = 59) and reduced total mortality (ARR = 0.016, 95% CI = 0.005 to 0.027; NNT = 63). Among patients with CHD, mental health treatments and cardiac rehabilitation may each reduce depression and CHD events, whereas cardiac rehabilitation is superior for reducing total mortality risk. The results support a continued role for mental health treatments and a larger role for mental health professionals in cardiac rehabilitation.

  18. Evaluation of Rehabilitation Strategies and Management Schemes for the Improvement of Mangrove Management Programs in Lingayen Gulf

    Directory of Open Access Journals (Sweden)

    Severino Salmo III

    2007-06-01

    Full Text Available We evaluated the mangrove rehabilitation strategies and management schemes in five municipalities in Lingayen Gulf (Bolinao, Anda, Bani, Alaminos and San Fernando. Mangrove planting appears to be the first and only option used in the area, ignoring other recommended management strategies, e.g. conservation, landscaping, and sustainable production. All planting sites were located in coastal fringes and are mostly monospeficic stands of the species Rhizophora mucronata. The planted mangroves were constrained by low seedling survival and stunted growth as probably caused by poor species-substrate matching, mono-species planting and pest infestations. Three management schemes were noted: community-managed (Bolinao and Anda, local government unit (LGU-managed (Alaminos and San Fernando, and co-managed between the LGU and the community (Bani. The community-managed mangrove areas have the benefits of voluntary efforts from community-based organizations in conducting daily management activities but were constrained with budgetary and logistical concerns. In contrast, both LGU-managed and co-managed areas received institutional and logistical supports from their respective municipal governments, but lacking community participation made mangrove management difficult. Almost two decades of mangrove management indeed helped improved the mangrove forest condition, at least in terms of forest structure. These projects demonstrated some level of success but also encountered several setbacks. Several lessons can be derived from these areas that can help improve the mangrove rehabilitation and management approaches in Lingayen Gulf. Among the recommendations are: (1 provide ordinance enacting the remaining natural secondary growth mangroves as marine protected areas, (2 promote planting in former mangrove areas by reverting abandoned, idled and unproductive aquaculture ponds to mangroves; (3 improve management schemes by formulating resource management plan

  19. Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes

    Directory of Open Access Journals (Sweden)

    Laetitia Peultier-Celli

    2017-11-01

    Full Text Available BackgroundInstability of the knee, related to anterior cruciate ligament injury, is treated by surgical reconstruction. During recovery, a loss of proprioceptive input can have a significant impact. Few studies have evaluated the benefits of rehabilitation of the knee in aquatic environment on functional outcomes.ObjectiveThis study aimed to compare an innovative rehabilitation protocol combining reduced conventional rehabilitation with aquatic rehabilitation, with a conventional rehabilitation, according to the National French Health Authority, in terms of kinetics, development of proprioceptive skills, and functional improvement of the knee.Methods67 patients, who were amateur or professional athletes, were randomized into two groups: 35 patients followed the conventional rehabilitation protocol (Gr1 and 32 patients followed the innovative rehabilitation protocol (Gr2. Patients were evaluated before surgery, and at 2 weeks, 1, 2, and 6 months after surgery using posturography, and evaluation of muscular strength, walking performance and proprioception. This study is multicenter, prospective, randomized, and controlled with a group of patients following conventional rehabilitation (level of evidence I.ResultsFor the same quality of postural control, Gr2 relied more on somesthesia than Gr1 at 6 months. The affected side had an impact on postural control and in particular on the preoperative lateralization, at 2 weeks and at 1 month. Lateralization depended on the affected knee, with less important lateralization in Gr2 preoperatively and at 1 month. The quadriceps muscular strength was higher in Gr2 than in Gr1 at 2 and 6 months and muscle strength of the external hamstring was greater in Gr2 than in Gr1 at 6 months. The isokinetic test showed a greater quadriceps muscular strength in Gr2. Gr2 showed a greater walking distance than Gr1 at one month. Gr2 showed an improvement in the proprioceptive capacities of the operated limb

  20. Does an early onset and continuous chain of rehabilitation improve the long-term functional outcome of patients with severe traumatic brain injury?

    Science.gov (United States)

    Andelic, Nada; Bautz-Holter, Erik; Ronning, Pal; Olafsen, Kjell; Sigurdardottir, Solrun; Schanke, Anne-Kristine; Sveen, Unni; Tornas, Sveinung; Sandhaug, Maria; Roe, Cecilie

    2012-01-01

    There are currently no international guidelines regarding treatment in the early rehabilitation phase for persons with severe traumatic brain injury (TBI), and only a few studies have investigated the effect of integrating rehabilitation into acute TBI care. The aim of the study was to evaluate whether a continuous chain of rehabilitation that begins with the acute phase could improve the functional outcome of severe TBI patients, compared to a broken chain of rehabilitation that starts in the sub-acute phase of TBI. A total of 61 surviving patients with severe TBI were included in a quasi-experimental study conducted at the Level I trauma center in Eastern Norway. In the study, 31 patients were in the early rehabilitation group (Group A) and 30 patients were in the delayed rehabilitation group (Group B). The functional outcomes were assessed 12 months post-injury with the Glasgow Outcome Scale Extended (GOSE) and the Disability Rating Scale (DRS). A favorable outcome (GOSE 6-8) occurred in 71% of the patients from Group A versus 37% in Group B (p=0.007). The DRS score was significantly better in Group A (p=0.03). The ordinal logistic regression analysis was used to quantify the relationship between the type of rehabilitation chain and the GOSE. A better GOSE outcome was found in patients from Group A (unadjusted OR 3.25 and adjusted OR 2.78, respectively). These results support the hypothesis that better functional outcome occurs in patients who receive early onset and a continuous chain of rehabilitation.

  1. A randomised controlled trial to improve the role of the general practitioner in cancer rehabilitation: effect on patients’ satisfaction with their general practitioners

    DEFF Research Database (Denmark)

    Bergholdt, Stinne Holm; Gilså Hansen, Dorte; Larsen, Pia Veldt

    2013-01-01

    ' rehabilitation course. OUTCOME MEASURES: 6 months after inclusion of the patient, patient satisfaction with their GP during the last 12 months in five different dimensions of GP care was assessed using the Danish version of the EuroPEP (European Patients Evaluate General Practice Care) questionnaire (DanPEP). 14....... Subgroup analysis of the patients with breast cancer showed statistically significant improvement of satisfaction with the GP in two of the five DanPEP dimensions. CONCLUSIONS: This complex intervention aiming at improving GPs' services in cancer rehabilitation had no impact on patient satisfaction. TRIAL...

  2. Fast Physics Testbed for the FASTER Project

    Energy Technology Data Exchange (ETDEWEB)

    Lin, W.; Liu, Y.; Hogan, R.; Neggers, R.; Jensen, M.; Fridlind, A.; Lin, Y.; Wolf, A.

    2010-03-15

    This poster describes the Fast Physics Testbed for the new FAst-physics System Testbed and Research (FASTER) project. The overall objective is to provide a convenient and comprehensive platform for fast turn-around model evaluation against ARM observations and to facilitate development of parameterizations for cloud-related fast processes represented in global climate models. The testbed features three major components: a single column model (SCM) testbed, an NWP-Testbed, and high-resolution modeling (HRM). The web-based SCM-Testbed features multiple SCMs from major climate modeling centers and aims to maximize the potential of SCM approach to enhance and accelerate the evaluation and improvement of fast physics parameterizations through continuous evaluation of existing and evolving models against historical as well as new/improved ARM and other complementary measurements. The NWP-Testbed aims to capitalize on the large pool of operational numerical weather prediction products. Continuous evaluations of NWP forecasts against observations at ARM sites are carried out to systematically identify the biases and skills of physical parameterizations under all weather conditions. The highresolution modeling (HRM) activities aim to simulate the fast processes at high resolution to aid in the understanding of the fast processes and their parameterizations. A four-tier HRM framework is established to augment the SCM- and NWP-Testbeds towards eventual improvement of the parameterizations.

  3. Data goes faster than ever

    CERN Multimedia

    Katarina Anthony

    2012-01-01

    Using store-bought computers and commercially available optical fibre lines, researchers from the California Institute of Technology (Caltech), the University of Victoria, the University of Michigan, CERN and Florida International University broke the world speed record for LHC data transfer. They caught the attention of HEP experiments worldwide – including the LHC – which rely on ever-improving technology to share their results.   The equipment used by the Caltech team to break the data transfer record. Photo credit: D. Foster. At November’s SuperComputing 2011 (SC11) convention in Seattle, the Caltech team sent LHC data between the University of Victoria and the Seattle exhibition floor at a full duplex speed of 186 gigabits per second on a 100 Gbps circuit provided by CANARIE and BCnet. This is a 10-fold increase compared with the current 10 gigabits per second circuits between CERN and each of the 11 major GRID Tier 1 centres that receive LHC data, and you ...

  4. D-amphetamine improves cognitive deficits and physical therapy promotes fine motor rehabilitation in a rat embolic stroke model

    DEFF Research Database (Denmark)

    Rasmussen, Rune Skovgaard; Overgaard, K; Hildebrandt-Eriksen, E S

    2006-01-01

    regarding gross motor performance. CONCLUSIONS: After embolization, physical therapy improved fine motor performance and D-amph accelerated rehabilitation of cognitive performance as observed in the rats of the THERAPY and D-AMPH groups. As a result of the administration of a high dose of D-amph, the rats......BACKGROUND AND PURPOSE: The purpose of this study was to examine the effects of D-amphetamine (D-amph) and physical therapy separately or combined on fine motor performance, gross motor performance and cognition after middle cerebral artery thromboembolization in rats. METHODS: Seventy-four rats...... on days 21-28 after surgery, rats of the SHAM and THERAPY groups had better fine motor performance than those of the CONTROL (P cognitive performance than CONTROL rats (P

  5. Improving neuro-oncological patients care: basic and practical concepts for nurse specialist in neuro-rehabilitation

    Directory of Open Access Journals (Sweden)

    Bartolo Michelangelo

    2012-10-01

    Full Text Available Abstract Background Neuro-oncological population well expresses the complexity of neurological disability due to the multiple neurological deficits that affect these patients. Moreover, due to the therapeutical opportunities survival times for patients with brain tumor have increased and more of these patients require rehabilitation care. The figure of nurse in the interdisciplinary specialty of neurorehabilitation is not clearly defined, even if their role in this setting is recognized as being critical and is expanding. The purpose of the study is to identify the standard competencies for neurorehabilitation nurses that could be taught by means of a specialization course. Methods A literature review was conducted with preference given to works published between January 2000 and December 2008 in English. The search strategy identified 523 non-duplicated references of which 271 titles were considered relevant. After reviewing the abstracts, 147 papers were selected and made available to a group of healthcare professionals who were requested to classify them in few conceptual main areas defining the relative topics. Results The following five main areas were identified: clinical aspects of nursing; nursing techniques; nursing methodology; relational and organisational models; legal aspects of nursing. The relative topics were included within each area. As educational method a structured course based on lectures and practical sessions was designed. Also multi-choices questions were developed in order to evaluate the participants’ level of knowledge, while a semi-structured interview was prepared to investigate students’ satisfaction. Conclusions Literature shows that the development of rehabilitation depends on the improvement of scientific and practical knowledge of health care professionals. This structured training course could be incorporated into undergraduate nursing education programmes and also be inserted into continuing education

  6. Exergames versus self-regulated exercises with instruction leaflets to improve adherence during geriatric rehabilitation: a randomized controlled trial.

    Science.gov (United States)

    Oesch, Peter; Kool, Jan; Fernandez-Luque, Luis; Brox, Ellen; Evertsen, Gunn; Civit, Anton; Hilfiker, Roger; Bachmann, Stefan

    2017-03-23

    Improving mobility in elderly persons is a primary goal in geriatric rehabilitation. Self-regulated exercises with instruction leaflets are used to increase training volume but adherence is often low. Exergames may improve adherence. This study therefore compared exergames with self-regulated exercise using instruction leaflets. The primary outcome was adherence. Secondary outcomes were enjoyment, motivation and balance during walking. Design: single center parallel group non-blinded randomized controlled trial with central stratified randomization. center for geriatric inpatient rehabilitation. Included were patients over 65 with mobility restrictions who were able to perform self-regulated exercise. Patients were assigned to self-regulated exercise using a) exergames on Windows Kinect® (exergame group EG) or b) instruction leaflets (conventional group CG). During two 30 min sessions physical therapists instructed self-regulated exercise to be conducted twice daily during thirty minutes during ten working days. Patients reported adherence (primary outcome), enjoyment and motivation daily. Balance during walking was measured blind before and after the treatment phase with an accelerometer. Analysis was by intention to treat. Repeated measures mixed models and Cohen's d effect sizes (ES, moderate if >0.5, large if > 0.8) with 95% CIs were used to evaluate between-group effects over time. Alpha was set at 0.05. From June 2014 to December 2015 217 patients were evaluated and 54 included, 26 in the EG and 28 in the CG. Adverse effects were observed in two patients in the EG who stopped because of pain during exercising. Adherence was comparable at day one (38 min. in the EG and 42 min. in the CG) and significantly higher in the CG at day 10 (54 min. in the CG while decreasing to 28 min. in the EG, p = 0.007, ES 0.94, 0.39-0.151). Benefits favoring the CG were also observed for enjoyment (p = 0.001, ES 0.88, 0.32 - 1.44) and motivation (p = 0

  7. The NHV rehabilitation services program improves long-term physical functioning in survivors of the 2008 Sichuan earthquake: a longitudinal quasi experiment.

    Directory of Open Access Journals (Sweden)

    Xia Zhang

    Full Text Available BACKGROUND: Long-term disability following natural disasters significantly burdens survivors and the impacted society. Nevertheless, medical rehabilitation programming has been historically neglected in disaster relief planning. 'NHV' is a rehabilitation services program comprised of non-governmental organizations (NGOs (N, local health departments (H, and professional rehabilitation volunteers (V which aims to improve long-term physical functioning in survivors of the 2008 Sichuan earthquake. We aimed to evaluate the effectiveness of the NHV program. METHODS/FINDINGS: 510 of 591 enrolled earthquake survivors participated in this longitudinal quasi-experimental study (86.3%. The early intervention group (NHV-E consisted of 298 survivors who received institutional-based rehabilitation (IBR followed by community-based rehabilitation (CBR; the late intervention group (NHV-L was comprised of 101 survivors who began rehabilitation one year later. The control group of 111 earthquake survivors did not receive IBR/CBR. Physical functioning was assessed using the Barthel Index (BI. Data were analyzed with a mixed-effects Tobit regression model. Physical functioning was significantly increased in the NHV-E and NHV-L groups at follow-up but not in the control group after adjustment for gender, age, type of injury, and time to measurement. We found significant effects of both NHV (11.14, 95% CI 9.0-13.3 and sponaneaous recovery (5.03; 95% CI 1.73-8.34. The effect of NHV-E (11.3, 95% CI 9.0-13.7 was marginally greater than that of NHV-L (10.7, 95% CI 7.9-13.6. It could, however, not be determined whether specific IBR or CBR program components were effective since individual component exposures were not evaluated. CONCLUSION: Our analysis shows that the NHV improved the long-term physical functioning of Sichuan earthquake survivors with disabling injuries. The comprehensive rehabilitation program benefitted the individual and society, rehabilitation services

  8. The NHV rehabilitation services program improves long-term physical functioning in survivors of the 2008 Sichuan earthquake: a longitudinal quasi experiment.

    Science.gov (United States)

    Zhang, Xia; Reinhardt, Jan D; Gosney, James E; Li, Jianan

    2013-01-01

    Long-term disability following natural disasters significantly burdens survivors and the impacted society. Nevertheless, medical rehabilitation programming has been historically neglected in disaster relief planning. 'NHV' is a rehabilitation services program comprised of non-governmental organizations (NGOs) (N), local health departments (H), and professional rehabilitation volunteers (V) which aims to improve long-term physical functioning in survivors of the 2008 Sichuan earthquake. We aimed to evaluate the effectiveness of the NHV program. 510 of 591 enrolled earthquake survivors participated in this longitudinal quasi-experimental study (86.3%). The early intervention group (NHV-E) consisted of 298 survivors who received institutional-based rehabilitation (IBR) followed by community-based rehabilitation (CBR); the late intervention group (NHV-L) was comprised of 101 survivors who began rehabilitation one year later. The control group of 111 earthquake survivors did not receive IBR/CBR. Physical functioning was assessed using the Barthel Index (BI). Data were analyzed with a mixed-effects Tobit regression model. Physical functioning was significantly increased in the NHV-E and NHV-L groups at follow-up but not in the control group after adjustment for gender, age, type of injury, and time to measurement. We found significant effects of both NHV (11.14, 95% CI 9.0-13.3) and sponaneaous recovery (5.03; 95% CI 1.73-8.34). The effect of NHV-E (11.3, 95% CI 9.0-13.7) was marginally greater than that of NHV-L (10.7, 95% CI 7.9-13.6). It could, however, not be determined whether specific IBR or CBR program components were effective since individual component exposures were not evaluated. Our analysis shows that the NHV improved the long-term physical functioning of Sichuan earthquake survivors with disabling injuries. The comprehensive rehabilitation program benefitted the individual and society, rehabilitation services in China, and international rehabilitation

  9. Improving the urban green system and green network through the rehabilitation of railway rust areas

    Directory of Open Access Journals (Sweden)

    Hutter Dóra

    2014-11-01

    Full Text Available The Industrial Revolution had a negative impact on both the city and the environment. By the second half of the 19th century, the urban erosion of industrial cities cried for direct intervention and curing. The methods developed either along an urban or an anti-urban philosophy: they resulted in the new models of green belt systems aimed at solving all the main urban problems with restructuring the urban fabric, controlling the urban spread into the rural landscape, the lack of green areas and open spaces for recreation and social life, and the lack of green spaces for ventilation. Nowadays, the major cities and capitals around the globe are competing for titles such as healthier, more liveable or even greener city. Given the unfortunate attributes of the urban structure in the historical cities, the development of new transportation sites or green areas is an extremely difficult issue. On the other hand, in the big cities, the brownfield sites are considered as reserve areas for sustainable urban development. Reusing the brownfields and rust areas is already a land saving urban development approach and in case of a complex and ecological urban rehabilitation it can underlie the development of an efficient urban green system and green network.

  10. Lower limb power rehabilitation (LLPR) using interactive video game for improvement of balance function in older people.

    Science.gov (United States)

    Chen, Po-Yin; Wei, Shun-Hwa; Hsieh, Wan-Ling; Cheen, Jang-Rong; Chen, Liang-Kung; Kao, Chung-Lan

    2012-01-01

    Declined balance functions have adverse effects on elderly population. Lower limbs muscle power training is currently an emerging concept in rehabilitation on individuals with decreased balance and mobility. In this prospective, controlled study, we used a human-computer interactive video-game-based rehabilitation device (LLPR) for training of lower limb muscle power in the elderly. Forty (aged >65 years) individuals were recruited from the community. Twenty participants in the exercise group received 30-min training, twice a week, using the LLPR system. The LLPR system allows participants to perform fast speed sit-to-stand (STS) movements. Twenty age-matched participants in the control group performed slow speed STS movements, as well as strengthening and balance exercises, with the same frequency and duration. The results were compared after 12 sessions (6 weeks) of training. The mechanical and time parameters during STS movement were measured using the LLPR system. Modified falls efficacy scale (MFES), Tinetti Performance-Oriented Mobility Assessment (POMA), function reach test, five times sit to stand (FTSS) and Timed Up and Go (TUG) were administered to participants as clinical assessments. Results showed that in the exercise group, all the mechanical and time parameters showed significant improvement. In control group, only the maximal vertical ground reaction force (MVGRF) improved significantly. For clinical assessments (balance, mobility, and self-confidence), exercise group showed significantly better scores. The STS movements in video-game-based training mimic real life situations which may help to transfer the training effects into daily activities. The effectiveness of lower limb muscle training is worthy of further investigation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  11. Combined Cognitive-Motor Rehabilitation in Virtual Reality Improves Motor Outcomes in Chronic Stroke – A Pilot Study

    Directory of Open Access Journals (Sweden)

    Ana L. Faria

    2018-05-01

    Full Text Available Stroke is one of the most common causes of acquired disability, leaving numerous adults with cognitive and motor impairments, and affecting patients’ capability to live independently. Virtual Reality (VR based methods for stroke rehabilitation have mainly focused on motor rehabilitation but there is increasing interest toward the integration of cognitive training for providing more effective solutions. Here we investigate the feasibility for stroke recovery of a virtual cognitive-motor task, the Reh@Task, which combines adapted arm reaching, and attention and memory training. 24 participants in the chronic stage of stroke, with cognitive and motor deficits, were allocated to one of two groups (VR, Control. Both groups were enrolled in conventional occupational therapy, which mostly involves motor training. Additionally, the VR group underwent training with the Reh@Task and the control group performed time-matched conventional occupational therapy. Motor and cognitive competences were assessed at baseline, end of treatment (1 month and at a 1-month follow-up through the Montreal Cognitive Assessment, Single Letter Cancelation, Digit Cancelation, Bells Test, Fugl-Meyer Assessment Test, Chedoke Arm and Hand Activity Inventory, Modified Ashworth Scale, and Barthel Index. Our results show that both groups improved in motor function over time, but the Reh@Task group displayed significantly higher between-group outcomes in the arm subpart of the Fugl-Meyer Assessment Test. Improvements in cognitive function were significant and similar in both groups. Overall, these results are supportive of the viability of VR tools that combine motor and cognitive training, such as the Reh@Task. Trial Registration: This trial was not registered because it is a small clinical study that addresses the feasibility of a prototype device.

  12. FASTER Test Reactor Preconceptual Design Report

    Energy Technology Data Exchange (ETDEWEB)

    Grandy, C. [Argonne National Lab. (ANL), Argonne, IL (United States); Belch, H. [Argonne National Lab. (ANL), Argonne, IL (United States); Brunett, A. J. [Argonne National Lab. (ANL), Argonne, IL (United States); Heidet, F. [Argonne National Lab. (ANL), Argonne, IL (United States); Hill, R. [Argonne National Lab. (ANL), Argonne, IL (United States); Hoffman, E. [Argonne National Lab. (ANL), Argonne, IL (United States); Jin, E. [Argonne National Lab. (ANL), Argonne, IL (United States); Mohamed, W. [Argonne National Lab. (ANL), Argonne, IL (United States); Moisseytsev, A. [Argonne National Lab. (ANL), Argonne, IL (United States); Passerini, S. [Argonne National Lab. (ANL), Argonne, IL (United States); Sienicki, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Sumner, T. [Argonne National Lab. (ANL), Argonne, IL (United States); Vilim, R. [Argonne National Lab. (ANL), Argonne, IL (United States); Hayes, S. [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-03-31

    The FASTER test reactor plant is a sodium-cooled fast spectrum test reactor that provides high levels of fast and thermal neutron flux for scientific research and development. The 120MWe FASTER reactor plant has a superheated steam power conversion system which provides electrical power to a local grid allowing for recovery of operating costs for the reactor plant.

  13. FASTER test reactor preconceptual design report summary

    Energy Technology Data Exchange (ETDEWEB)

    Grandy, C. [Argonne National Lab. (ANL), Argonne, IL (United States); Belch, H. [Argonne National Lab. (ANL), Argonne, IL (United States); Brunett, A. [Argonne National Lab. (ANL), Argonne, IL (United States); Heidet, F. [Argonne National Lab. (ANL), Argonne, IL (United States); Hill, R. [Argonne National Lab. (ANL), Argonne, IL (United States); Hoffman, E. [Argonne National Lab. (ANL), Argonne, IL (United States); Jin, E. [Argonne National Lab. (ANL), Argonne, IL (United States); Mohamed, W. [Argonne National Lab. (ANL), Argonne, IL (United States); Moisseytsev, A. [Argonne National Lab. (ANL), Argonne, IL (United States); Passerini, S. [Argonne National Lab. (ANL), Argonne, IL (United States); Sienicki, J. [Argonne National Lab. (ANL), Argonne, IL (United States); Sumner, T. [Argonne National Lab. (ANL), Argonne, IL (United States); Vilim, R. [Argonne National Lab. (ANL), Argonne, IL (United States); Hayes, Steven [Argonne National Lab. (ANL), Argonne, IL (United States)

    2016-02-29

    The FASTER reactor plant is a sodium-cooled fast spectrum test reactor that provides high levels of fast and thermal neutron flux for scientific research and development. The 120MWe FASTER reactor plant has a superheated steam power conversion system which provides electrical power to a local grid allowing for recovery of operating costs for the reactor plant.

  14. 78 FR 27038 - Final Priorities; National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-05-09

    ... settings, including the community, rehabilitation service- delivery institutions, vocational rehabilitation...) Vocational rehabilitation (VR) practices that contribute to improved employment outcomes for individuals with... or more priorities, we designate the type of each priority as absolute, competitive preference, or...

  15. The patient education - Learning and Coping Strategies - improves adherence in cardiac rehabilitation (LC-REHAB): A randomised controlled trial.

    Science.gov (United States)

    Lynggaard, Vibeke; Nielsen, Claus Vinther; Zwisler, Ann-Dorthe; Taylor, Rod S; May, Ole

    2017-06-01

    Despite proven benefits of cardiac rehabilitation (CR), adherence to CR remains suboptimal. This trial aimed to assess the impact of the patient education 'Learning and Coping Strategies' (LC) on patient adherence to an eight-week CR program. 825 patients with ischaemic heart disease or heart failure were open label randomised to either the LC arm (LC plus CR) or the control arm (CR alone) across three hospital units in Denmark. Both arms received same amount of training and education hours. LC consisted of individual clarifying interviews, participation of experienced patients as co-educators, situational, reflective and inductive teaching. The control arm received structured deductive teaching. The primary outcomes were patient adherence to at least 75% of the exercise training or education sessions. We tested for subgroup effects on the primary outcomes using interaction terms. The primary outcomes were compared across arms using logistic regression. More patients in the LC arm adhered to at least 75% of the exercise training sessions than control (80% versus 73%, adjusted odds ratio (OR):1.48; 95% CI:1.07 to 2.05, P=0.018) and 75% of education sessions (79% versus 70%, adjusted OR:1.61, 1.17 to 2.22, P=0.003). Some evidence of larger effects of LC on adherence was seen for patients with heart failure, low education and household income. Addition of LC strategies improved adherence in rehabilitation both in terms of exercise training and education. Patients with heart failure, low levels of education and household income appear to benefit most from this adherence promoting intervention. www.clinicaltrials.gov identifier NCT01668394. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Upper-body progressive resistance training improves strength and household physical activity performance in women attending cardiac rehabilitation.

    Science.gov (United States)

    Coke, Lola A; Staffileno, Beth A; Braun, Lynne T; Gulanick, Meg

    2008-01-01

    The purpose of this study was to examine the impact of moderate-intensity, progressive, upper-body resistance training (RT) on muscle strength and perceived performance of household physical activities (HPA) among women in cardiac rehabilitation. The 10-week, pretest-posttest, experiment randomized women to either usual care (UC) aerobic exercise or RT. Muscle strength for 5 upper-body RT exercises (chest press, shoulder press, biceps curl, lateral row, and triceps extension) was measured using the 1-Repetition Maximum Assessment. The RT group progressively increased weight lifted using 40%, 50%, and 60% of obtained 1-Repetition Maximum Assessment at 3-week intervals. Perceived performance of HPA was measured with the Kimble Household Activities Scale. The RT group (n = 16, mean age 64 +/- 11) significantly increased muscle strength in all 5 exercises in comparison with the UC group (n = 14, mean age 65 +/- 10) (chest press, 18% vs 11%; shoulder press, 24% vs 14%; biceps curl, 21% vs 12%; lateral row, 32% vs 9%; and triceps extension, 28% vs 20%, respectively). By study end, Household Activities Scale scores significantly increased (F = 13.878, P = .001) in the RT group (8.75 +/- 3.19 vs 11.25 +/- 2.14), whereas scores in the UC group decreased (8.60 +/- 3.11 vs 6.86 +/- 4.13). Progressive upper-body RT in women shows promise as an effective tool to increase muscle strength and improve the ability to perform HPA after a cardiac event. Beginning RT early after a cardiac event in a monitored cardiac rehabilitation environment can maximize the strengthening benefit.

  17. Feasibility study on rehabilitation and improvement of thermal power plants, district heating and heat supply system in Botosani City

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-03-01

    Discussions have been given on the improvement and modification project intended of saving energies and reducing greenhouse gas emission in the Botosani district heating and heat supplying facilities in Romania. Thirty years have elapsed since the building of the Botosani district heating and heat supplying facilities, whereas noticeable energy loss has occurred due to aged deterioration, such as thermal efficiency decrease, performance decrease, and hot water leakage due to piping corrosion. The present project is intended to improve the heat production and power generation facility efficiencies, and reduce the heat loss in heat transportation and distribution to less than 5%. The improvements will be implemented by replacing and rehabilitating the existing boilers, replacing the turbine generators, and replacing the transportation and distribution pipelines and heat exchangers. As a result of the discussions, the present project is estimated to result in annual fuel conservation of 35,820 tons of crude oil equivalent, and annual reduction of the greenhouse gas emission of 110,835 t-CO2. The total amount of the initial investment for the project would be 11.369 billion yen, and the payback period would be 12 years. The project will produce profit of 31.358 billion yen in 20 years, thus the project is financially feasible. (NEDO)

  18. Pilot Model of the Rehabilitating Treatment for Self-Esteem and Behavior in Adolescents with Dyslexia and Dysorthography by Improving Their Literacy

    Science.gov (United States)

    Zuppardo, Linda; Rodríguez Fuentes, Antonio; Serrano, Francisca

    2017-01-01

    Clinical and educational research has shown the emotional and motivational factors involved in learning difficulties. The main objective of this research is to propose a way to assess the effects of a rehabilitating treatment for self-esteem and behavior through improving literacy in a group of patients diagnosed with dyslexia and dysorthography.…

  19. Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement.

    Science.gov (United States)

    Bechi, M; Bosia, M; Spangaro, M; Buonocore, M; Cocchi, F; Pigoni, A; Piantanida, M; Guglielmino, C; Bianchi, L; Smeraldi, E; Cavallaro, R

    2015-11-01

    Neurocognitive and social cognitive impairments represent important treatment targets in schizophrenia, as they are significant predictors of functional outcome. Different rehabilitative interventions have recently been developed, addressing both cognitive and psychosocial domains. Although promising, results are still heterogeneous and predictors of treatment outcome are not yet identified. In this study we evaluated the efficacy of two newly developed social cognitive interventions, respectively based on the use of videotaped material and comic strips, combined with domain-specific Cognitive Remediation Therapy (CRT). We also analysed possible predictors of training outcome, including basal neurocognitive performance, the degree of cognitive improvement after CRT and psychopathological variables. Seventy-five patients with schizophrenia treated with CRT, were randomly assigned to: social cognitive training (SCT) group, Theory of Mind Intervention (ToMI) group, and active control group (ACG). ANOVAs showed that SCT and ToMI groups improved significantly in ToM measures, whereas the ACG did not. We reported no influences of neuropsychological measures and improvement after CRT on changes in ToM. Both paranoid and non-paranoid subjects improved significantly after ToMI and SCT, without differences between groups, despite the better performance in basal ToM found among paranoid patients. In the ACG only non-paranoid patients showed an improvement in non-verbal ToM. Results showed that both ToMI and SCT are effective in improving ToM in schizophrenia with no influence of neuropsychological domains. Our data also suggest that paranoid symptoms may discriminate between different types of ToM difficulties in schizophrenia.

  20. Rehabilitation of limb apraxia improves daily life activities in patients with stroke.

    Science.gov (United States)

    Smania, N; Aglioti, S M; Girardi, F; Tinazzi, M; Fiaschi, A; Cosentino, A; Corato, E

    2006-12-12

    We randomly assigned 33 patients with left hemisphere stroke, limb apraxia, and aphasia to an apraxia or a control (aphasia) treatment group. Before and after each treatment, patients underwent a comprehensive neuropsychological testing battery and a caregiver evaluation of patient's activities of daily life (ADL) independence. Apraxia severity was related with ADL independence. Control (aphasia) treatment improved patients' language and intelligence performance. Apraxia treatment specifically improved praxic function and ADL.

  1. Cardiac Rehabilitation Improves the QRS Fragmentation in Patients With ST Elevatıon Myocardial Infarction

    Directory of Open Access Journals (Sweden)

    Mustafa Bulut

    2015-09-01

    Conclusion: The existence of the fQRS decreases after CR in patients with STEMI especially in hypertensive individuals, which may be related to improved electrical stability in the myocardium as a predictor of increase in survival and decrease in major cardiac events.

  2. Using Reflective Learning to Improve the Impact of Continuing Education in the Context of Work Rehabilitation

    Science.gov (United States)

    Vachon, Brigitte; Durand, Marie-Jose; LeBlanc, Jeannette

    2010-01-01

    Reflective learning has been described as a promising approach for ameliorating the impact of continuing education (CE) programs. However, there are still very few studies that have investigated how occupational therapists use reflection to improve the integration of CE program content in their decision-making processes. The study objectives were…

  3. A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams

    OpenAIRE

    K?rner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; M?ller, Christian

    2017-01-01

    Purpose Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. Method A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient qu...

  4. Improvement in the quality of the catering service of a rehabilitation hospital.

    Science.gov (United States)

    Donini, L M; Castellaneta, E; De Guglielmi, S; De Felice, M R; Savina, C; Coletti, C; Paolini, M; Cannella, C

    2008-02-01

    Malnutrition due to undernutrition or overnutrition is highly prevalent in hospital in-patients and it decisively conditions patients clinical outcome. One of the most influencing factors of malnutrition in hospitalized patients is--at least in part--the Catering Service Quality. Is to verify, over a 5 year period, the course of the quality of the institutional Catering Service, verifying the effectiveness of the quality improvement process used. Quality control was performed by objective (meal order accuracy, proper distribution of food in trolleys, route time from the kitchen to the ward and time of food distribution, food weight and temperature, waste assessment) and subjective assessment (quality was measured by giving the patients a questionnaire after meals). The survey included: 572 meals and 591 interviews. A significant amount of "qualitative" errors (lack of respect for patient preferences or at the moment of supplying the food trolley) have been found. Over the time and the amount of patients that wasted a considerable amount of the portion served was considerably reduced food temperature have been improved. Also patient satisfaction with menu variability, portion size, temperature and cooking quality improved over time. The overall ratings of meals under observation improved too in fact, positive opinions ranged from 18% in 2002 to 48.3% in 2006. Ongoing research and quality verification, which include all catering service workers, yields a constant improvement in quality. Patients in healthcare settings should receive a service they appreciates, but it should be--at the same time--correct from a nutritional point of view. For this reason, it is necessary a continuous mediation between customers satisfaction and nutritionists work, dieticians and nursing staff. From this point of view the educational approach becomes essential to feed patient compliance to dietetic treatment that will continue after discharge.

  5. Improving the transparency of a rehabilitation robot by exploiting the cyclic behaviour of walking.

    Science.gov (United States)

    van Dijk, W; van der Kooij, H; Koopman, B; van Asseldonk, E H F; van der Kooij, H

    2013-06-01

    To promote active participation of neurological patients during robotic gait training, controllers, such as "assist as needed" or "cooperative control", are suggested. Apart from providing support, these controllers also require that the robot should be capable of resembling natural, unsupported, walking. This means that they should have a transparent mode, where the interaction forces between the human and the robot are minimal. Traditional feedback-control algorithms do not exploit the cyclic nature of walking to improve the transparency of the robot. The purpose of this study was to improve the transparent mode of robotic devices, by developing two controllers that use the rhythmic behavior of gait. Both controllers use adaptive frequency oscillators and kernel-based non-linear filters. Kernelbased non-linear filters can be used to estimate signals and their time derivatives, as a function of the gait phase. The first controller learns the motor angle, associated with a certain joint angle pattern, and acts as a feed-forward controller to improve the torque tracking (including the zero-torque mode). The second controller learns the state of the mechanical system and compensates for the dynamical effects (e.g. the acceleration of robot masses). Both controllers have been tested separately and in combination on a small subject population. Using the feedforward controller resulted in an improved torque tracking of at least 52 percent at the hip joint, and 61 percent at the knee joint. When both controllers were active simultaneously, the interaction power between the robot and the human leg was reduced by at least 40 percent at the thigh, and 43 percent at the shank. These results indicate that: if a robotic task is cyclic, the torque tracking and transparency can be improved by exploiting the predictions of adaptive frequency oscillator and kernel-based nonlinear filters.

  6. [Improvement in the efficiency of a rehabilitation service using Lean Healthcare methodology].

    Science.gov (United States)

    Pineda Dávila, S; Tinoco González, J

    2015-01-01

    The aim of this study was to evaluate the reduction in costs and the increase in time devoted to the patient, by applying Lean Healthcare methodology. A multidisciplinary team was formed, setting up three potential areas for improvement by performing a diagnostic process, including the storage and standardization of materials, and professional tasks in the therapeutic areas, by implementing three Lean tools: kanban, 5S and 2P. Stored material costs decreased by 43%, the cost of consumables per patient treated by 19%, and time dedicated to patient treatment increased by 7%. The processes were standardized and "muda" (wastefulness) was eliminated, thus reducing costs and increasing the value to the patient. All this demonstrates that it is possible to apply tools of industrial origin to the health sector, with the aim of improving the quality of care and achieve maximum efficiency. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  7. Long-Term Improvements After Multimodal Rehabilitation in Late Phase After Stroke: A Randomized Controlled Trial.

    Science.gov (United States)

    Bunketorp-Käll, Lina; Lundgren-Nilsson, Åsa; Samuelsson, Hans; Pekny, Tulen; Blomvé, Karin; Pekna, Marcela; Pekny, Milos; Blomstrand, Christian; Nilsson, Michael

    2017-07-01

    Treatments that improve function in late phase after stroke are urgently needed. We assessed whether multimodal interventions based on rhythm-and-music therapy or horse-riding therapy could lead to increased perceived recovery and functional improvement in a mixed population of individuals in late phase after stroke. Participants were assigned to rhythm-and-music therapy, horse-riding therapy, or control using concealed randomization, stratified with respect to sex and stroke laterality. Therapy was given twice a week for 12 weeks. The primary outcome was change in participants' perception of stroke recovery as assessed by the Stroke Impact Scale with an intention-to-treat analysis. Secondary objective outcome measures were changes in balance, gait, grip strength, and cognition. Blinded assessments were performed at baseline, postintervention, and at 3- and 6-month follow-up. One hundred twenty-three participants were assigned to rhythm-and-music therapy (n=41), horse-riding therapy (n=41), or control (n=41). Post-intervention, the perception of stroke recovery (mean change from baseline on a scale ranging from 1 to 100) was higher among rhythm-and-music therapy (5.2 [95% confidence interval, 0.79-9.61]) and horse-riding therapy participants (9.8 [95% confidence interval, 6.00-13.66]), compared with controls (-0.5 [-3.20 to 2.28]); P =0.001 (1-way ANOVA). The improvements were sustained in both intervention groups 6 months later, and corresponding gains were observed for the secondary outcomes. Multimodal interventions can improve long-term perception of recovery, as well as balance, gait, grip strength, and working memory in a mixed population of individuals in late phase after stroke. URL: http//www.ClinicalTrials.gov. Unique identifier: NCT01372059. © 2017 American Heart Association, Inc.

  8. Do psychosocial interventions improve rehabilitation outcomes after anterior cruciate ligament reconstruction? A systematic review.

    Science.gov (United States)

    Coronado, Rogelio A; Bird, Mackenzie L; Van Hoy, Erin E; Huston, Laura J; Spindler, Kurt P; Archer, Kristin R

    2018-03-01

    To examine the role of psychosocial interventions in improving patient-reported clinical outcomes, including return to sport/activity, and intermediary psychosocial factors after anterior cruciate ligament reconstruction. MEDLINE/PubMed, CINAHL, PsycINFO, and Web of Science were searched from each database's inception to March 2017 for published studies in patients after anterior cruciate ligament reconstruction. Studies were included if they reported on the effects of a postoperative psychosocial intervention on a patient-reported clinical measure of disability, function, pain, quality of life, return to sport/activity, or intermediary psychosocial factor. Data were extracted using a standardized form and summary effects from each article were compiled. The methodological quality of randomized trials was assessed using the Physiotherapy Evidence Database Scale and scores greater than 5/10 were considered high quality. A total of 893 articles were identified from the literature search. Of these, four randomized trials ( N = 210) met inclusion criteria. The four articles examined guided imagery and relaxation, coping modeling, and visual imagery as postoperative psychosocial interventions. Methodological quality scores of the studies ranged from 5 to 9. There were inconsistent findings for the additive benefit of psychosocial interventions for improving postoperative function, pain, or self-efficacy and limited evidence for improving postoperative quality of life, anxiety, or fear of reinjury. No study examined the effects of psychosocial interventions on return to sport/activity. Overall, there is limited evidence on the efficacy of postoperative psychosocial interventions for improving functional recovery after anterior cruciate ligament reconstruction.

  9. GABA Levels Are Decreased After Stroke and GABA Changes During Rehabilitation Correlate With Motor Improvement

    Science.gov (United States)

    Blicher, Jakob Udby; Near, Jamie; Næss-Schmidt, Erhard; Stagg, Charlotte J.; Johansen-Berg, Heidi; Nielsen, Jørgen Feldbæk; Østergaard, Leif; Ho, Yi-Ching Lynn

    2017-01-01

    Background and Objective γ-Aminobutyric acid (GABA) is the dominant inhibitory neurotransmitter in the brain and is important in motor learning. We aimed to measure GABA content in primary motor cortex poststroke (using GABA-edited magnetic resonance spectroscopy [MRS]) and in relation to motor recovery during 2 weeks of constraint-induced movement therapy (CIMT). Methods Twenty-one patients (3-12 months poststroke) and 20 healthy subjects were recruited. Magnetic resonance imaging structural T1 and GABA-edited MRS were performed at baseline and after CIMT, and once in healthy subjects. GABA:creatine (GABA:Cr) ratio was measured by GABA-edited MRS. Motor function was measured using Wolf Motor Function Test (WMFT). Results Baseline comparison between stroke patients (n = 19) and healthy subjects showed a significantly lower GABA:Cr ratio in stroke patients (P GABA relative to N-acetylaspartic acid (NAA; P = .03). After 2 weeks of CIMT patients improved significantly on WMFT, but no consistent change across the group was observed for the GABA:Cr ratio (n = 17). However, the extent of improvement on WMFT correlated significantly with the magnitude of GABA:Cr changes (P GABA:Cr ratio being associated with better improvements in motor function. Conclusions In patients 3 to 12 months poststroke, GABA levels are lower in the primary motor cortex than in healthy subjects. The observed association between GABA and recovery warrants further studies on the potential use of GABA MRS as a biomarker in poststroke recovery. PMID:25055837

  10. Are rehabilitation and/or care co-ordination interventions delivered in the community effective in reducing depression, facilitating participation and improving quality of life after stroke?

    Science.gov (United States)

    Graven, Christine; Brock, Kim; Hill, Keith; Joubert, Lynette

    2011-01-01

    To conduct a systematic review to explore the effectiveness of community-based rehabilitation interventions delivered by allied health professionals and/or nursing staff in reducing depression, facilitating participation and improving health-related quality of life (HRQoL) post-inpatient stroke rehabilitation. A search was conducted in the databases of MEDLINE, PEDro, CINAHL and the Cochrane Library. Publications were classified into categories based on the type of the interventions. Best evidence synthesis and meta-analysis were utilised to determine the level of evidence. Fifty-four studies were included in the review, and divided into nine broad intervention categories. Meta-analysis demonstrated significant reduction in depression with exercise interventions (n = 137; effect estimate SMD: -2.03, 95%CI: -3.22, -0.85). Community-based interventions targeting participation and leisure domains showed moderate evidence for improvement in global participation measures and HRQoL. Comprehensive rehabilitation demonstrated limited evidence for depression and participation, and strong evidence for HRQoL. There is limited to moderate evidence supporting some rehabilitation interventions in affecting the outcomes of depression, participation and HRQoL post-stroke. Heterogeneity of the studies made evidence synthesis difficult. Further consideration needs to be given to the type and timing of outcome measures selected to represent the domains of participation and HRQoL.

  11. Improvement of upper limb’s condition of women with post mastectomy syndrome with the help of problem-oriented program of physical rehabilitation

    Directory of Open Access Journals (Sweden)

    Y.A. Briskin

    2015-11-01

    Full Text Available Purpose: to determine effectiveness of problem-oriented program of women’s physical rehabilitation with post mastectomy syndrome in improvement of upper limb’s functional state. Material: 50 women with early symptoms of post mastectomy syndrome at stationary rehabilitation stage, who underwent radical mastectomy by Madden were involved in the research. Testing of movement amplitude in shoulder joint, swelling of upper limb and muscular strength of hand’s flexors was conducted on 2 nd day after surgery and at the end of stationary rehabilitation period (12-14 th day. Results: Main means of the authors’ program were: general and special physical exercises; static and dynamic breathing exercises; breathing through preloaded lips, controlled coughing, autogenic drainage, manual pressing, manual vibration; post-isometric relaxation; elements of labor therapy; lymphatic drainage massage and self massage; topical talks; consultations; auto training. The trainings were conducted individually 2-3 times a day; 20-30 minutes every session. The patients’ independent trainings included: fulfillment of therapeutic positions, self-massage, relaxation exercises and auto-training. Conclusions: application of problem-oriented physical rehabilitation program facilitates improvement of upper limb’s functional potentials of women with post mastectomy syndrome.

  12. Challenges and potential improvements in the admission process of patients with spinal cord injury in a specialized rehabilitation clinic - an interview based qualitative study of an interdisciplinary team.

    Science.gov (United States)

    Röthlisberger, Fabian; Boes, Stefan; Rubinelli, Sara; Schmitt, Klaus; Scheel-Sailer, Anke

    2017-06-26

    The admission process of patients to a hospital is the starting point for inpatient services. In order to optimize the quality of the health services provision, one needs a good understanding of the patient admission workflow in a clinic. The aim of this study was to identify challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic from the perspective of an interdisciplinary team of health professionals. Semi-structured interviews with eight health professionals (medical doctors, physical therapists, occupational therapists, nurses) at the Swiss Paraplegic Centre (acute and rehabilitation clinic) were conducted based on a maximum variety purposive sampling strategy. The interviews were analyzed using a thematic analysis approach. The interviewees described the challenges and potential improvements in this admission process, focusing on five themes. First, the characteristics of the patient with his/her health condition and personality and his/her family influence different areas in the admission process. Improvements in the exchange of information between the hospital and the patient could speed up and simplify the admission process. In addition, challenges and potential improvements were found concerning the rehabilitation planning, the organization of the admission process and the interdisciplinary work. This study identified five themes of challenges and potential improvements in the admission process of spinal cord injury patients at a specialized rehabilitation clinic. When planning adaptations of process steps in one of the areas, awareness of effects in other fields is necessary. Improved pre-admission information would be a first important step to optimize the admission process. A common IT-system providing an interdisciplinary overview and possibilities for interdisciplinary exchange would support the management of the admission process. Managers of other hospitals can supplement

  13. Institutionalized elderly rehabilitationimproving balance ability with a platform technology

    OpenAIRE

    Pimentel, Maria Manuela da Silva; Mendes, Eugénia; Novo, André; Preto, Leonel

    2015-01-01

    Ageing is associated with a decrease in the functionality of all organic systems. One factor that affects the quality of life in the elderly is the decrease of balance that sometimes leads to falls and consequently the fear of falling. In this sense, it is essential to try to mitigate this progressive degeneration. Wii is a platform technology and method that can be used to improve balance in elderly and thus enable them a better quality of life and well-being. Objective: To investigate wheth...

  14. Alberta Environment's weir safety program : options for rehabilitation to improve public safety : a case study of the Calgary weir

    Energy Technology Data Exchange (ETDEWEB)

    Blakely, D [Alberta Environment, Edmonton, AB (Canada)

    2009-07-01

    Alberta Environment Water Management Operations (WMO) owns and operates 46 dams and 800 kilometres of canals in Alberta. The WMO consists of 120 staff and several contract operators to take care of this infrastructure. Most of the infrastructure supplies water for irrigation use, which adds 5 billion dollars to the provincial economy annually. Other water uses include stock watering, domestic use, municipal use, recreational use and habitat. Alberta Environment's weir safety program was also discussed along with options for rehabilitation to improve public safety. A case study of Calgary's Weir Dam on the Bow River was highlighted. A brief history of the dam was offered and safety programs around provincially-owned weirs were discussed. Photographs were included to illustrate some of the additional safety measures at the Calgary weir, such as suspended safety buoys upstream of the boom directing paddlers to the portage trail, and signage on the river that can be activated when the boom is out. Typical river users on the Calgary Bow River and safety history at the Calgary Weir were discussed along with other topics such as the Calgary Bow River weir project criteria; project design progress; pre-feasibility options; scale modelling; final design analysis; construction funding; and proposed changes to the safety program for the new weir configuration. figs.

  15. Rehabilitation after stroke.

    Science.gov (United States)

    Knecht, Stefan; Hesse, Stefan; Oster, Peter

    2011-09-01

    Stroke is becoming more common in Germany as the population ages. Its long-term sequelae can be alleviated by early reperfusion in stroke units and by complication management and functional restoration in early-rehabilitation and rehabilitation centers. Selective review of the literature. Successful rehabilitation depends on systematic treatment by an interdisciplinary team of experienced specialists. In the area of functional restoration, there has been major progress in our understanding of the physiology of learning, relearning, training, and neuroenhancement. There have also been advances in supportive pharmacotherapy and robot technology. Well-organized acute and intermediate rehabilitation after stroke can provide patients with the best functional results attainable on the basis of our current scientific understanding. Further experimental and clinical studies will be needed to expand our knowledge and improve the efficacy of rehabilitation.

  16. 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 investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations. METHODS: We used a qualitative exploratory design, triangulating interviews and participant...... 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...

  17. Multisensory Rehabilitation Training Improves Spatial Perception in Totally but Not Partially Visually Deprived Children

    Directory of Open Access Journals (Sweden)

    Giulia Cappagli

    2017-10-01

    Full Text Available Since it has been shown that spatial development can be delayed in blind children, focused sensorimotor trainings that associate auditory and motor information might be used to prevent the risk of spatial-related developmental delays or impairments from an early age. With this aim, we proposed a new technological device based on the implicit link between action and perception: ABBI (Audio Bracelet for Blind Interaction is an audio bracelet that produces a sound when a movement occurs by allowing the substitution of the visuo-motor association with a new audio-motor association. In this study, we assessed the effects of an extensive but entertaining sensorimotor training with ABBI on the development of spatial hearing in a group of seven 3–5 years old children with congenital blindness (n = 2; light perception or no perception of light or low vision (n = 5; visual acuity range 1.1–1.7 LogMAR. The training required the participants to play several spatial games individually and/or together with the psychomotor therapist 1 h per week for 3 months: the spatial games consisted of exercises meant to train their ability to associate visual and motor-related signals from their body, in order to foster the development of multisensory processes. We measured spatial performance by asking participants to indicate the position of one single fixed (static condition or moving (dynamic condition sound source on a vertical sensorized surface. We found that spatial performance of congenitally blind but not low vision children is improved after the training, indicating that early interventions with the use of science-driven devices based on multisensory capabilities can provide consistent advancements in therapeutic interventions, improving the quality of life of children with visual disability.

  18. Improved work ability and return to work following vocational multidisciplinary rehabilitation of subjects on long-term sick leave

    OpenAIRE

    Braathen, Tore; Veiersted, Kaj Bo; Heggenes, Jan

    2007-01-01

    Objective: To evaluate a vocational multidisciplinary rehabilitation programme for patients on long-term sick leave with respect to their work ability and return to work. Methods: A multidisciplinary rehabilitation programme was administered to an intervention group of 183 patients on long-term sick leave (mean 12.2 months). Effects of the treatment were compared with a control group (n = 96) recruited from the national sickness insurance record of patients on sick leave of 6??2 month...

  19. Inpatient and outpatient cardiac rehabilitation programmes improve cardiometabolic risk in revascularized coronary patients with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Claudiu Avram

    2010-12-01

    Full Text Available The purpose of this paper is to evaluate cardiometabolic risk reduction of diabetic patients following coronary revascularizationprocedures after participation in outpatients or inpatients cardiac rehabilitation programmes. Materials and methods: weperformed a retrospective analytical study which included a group of 103 revascularized coronary patients with diabetesmellitus. Depending on participation in a cardiac rehabilitation program we have defined the following subgroups of patients:Group O (N=37 - attended the outpatient cardiac rehabilitation program; Group H (N=37 - attended the inpatient cardiacrehabilitation program; Group C (N=34 - did not participate in any cardiac rehabilitation program. Between those two momentsof assessment: T0 - revascularization / early post-revascularization and T1 - time of the interview (16±2.3 months afterrevascularization, patients in groups A and S participated in outpatient cardiac rehabilitation program (12 weeks, 3sessions/week of exercise training, with clinical and paraclinical evaluation scheduled at 1, 6, 12 months afterrevascularization, or inpatient cardiac rehabilitation program (3 weeks, intensive sessions, scheduled at 1, 3, 6 and 12months after revascularization. Results: at the end of the study, we found significant differences among the three groups forthe following parameters: body mass index (p=0.01, systolic blood pressure (p=0.002, total cholesterol (p<0.001, LDLcholesterol(p<0.001 and non-HDL cholesterol (p=0.004 in favor of groups A and S, that have participated in comprehensivecardiac rehabilitation programs. Conclusions: comprehensive cardiac rehabilitation programmes, performed outpatient orinpatient, are effective methods of reducing the high cardiometabolic risk, specific in revascularized coronary patients withdiabetes.

  20. A 12-week rehabilitation program improves body composition, pain sensation, and internal/external torques of baseball pitchers with shoulder impingement symptom.

    Science.gov (United States)

    Cha, Jun-Youl; Kim, Jae-Hak; Hong, Ju; Choi, Young-Tae; Kim, Min-Ho; Cho, Ji-Hyun; Ko, Il-Gyu; Jee, Yong-Seok

    2014-02-01

    The aim of this study was to investigate the effects of a 12-week rehabilitation program on body composition, shoulder pain, and isokinetic internal/external torques of pitchers with impingement syndrome. A total of 30 pitchers were divided into 2 groups: experimental group (EG, n = 16) and control group (CG, n= 14). The rehabilitation program consisted of physical therapy, warm-up, work-out, and cool-down. As results, body weight and fat mass of EG were decreased whereas muscle mass of EG was significantly increased after the experiment. The pain degrees in resting, normal daily activity, and strenuous activity on the numeric pain rating scale were significantly decreased in the EG. The internal and external peak torques (PTs) of uninvolved and involved sides of EG were increased in EG after 12 weeks. Such results provide a deficit ratio of both sides in EG close to normal values. The ratios of internal/external PTs in EG were also close to the reference values. The internal and external total works of both sides in EG were similar to the values of PT. The fatigue indices of internal and external rotators of both sides in EG were decreased. As a conclusion, a 12-week rehabilitation program reduced the shoulder pain, improved the body composition and enhanced the isokinetic shoulder internal/external rotators in EG with impingement symptoms. Also the study suggested that the rehabilitation program evened out the ratio between internal and external rotators and lowered the fatigue level after the experiment.

  1. Purposefulness of early application of physical rehabilitation means for improvement of external respiration system functional state of women with post mastectomies syndrome

    Directory of Open Access Journals (Sweden)

    Y.A. Briskin

    2015-12-01

    Full Text Available Purpose: to determine purposefulness of early application of physical rehabilitation means for improvement of external respiration system functional state of women with post mastectomies syndrome. Material: in the research 135 women with post mastectomies syndrome, who endured radical mastectomy by Madden, participated. Women of main groups were trained in compliance with appropriate programs during one year. Effectiveness of trainings was controlled after half of year. Admission to trainings was given by oncologist. Patients of these groups belonged to third clinical group. At the beginning of dispensary period the groups were equal by all indicators of external system function. Results: it was found that early rehabilitation is more effective exclusively for indicators of bronchial patency. Complex, personality oriented program included: aqua-fitness; conditional swimming; health related aerobic and Pilates. It was found that after half year training advantages of early physical rehabilitation were noticed only in indicators of forced exhale volume at first second. Conclusions: we stated importance of early rehabilitation trainings of women with post mastectomies syndrome.

  2. Virtual Reality Rehabilitation With Functional Electrical Stimulation Improves Upper Extremity Function in Patients With Chronic Stroke: A Pilot Randomized Controlled Study.

    Science.gov (United States)

    Lee, Stephanie Hyeyoung; Lee, Ji-Yeong; Kim, Mi-Young; Jeon, Yu-Jin; Kim, Suyoung; Shin, Joon-Ho

    2018-03-02

    To compare virtual reality (VR) combined with functional electrical stimulation (FES) with cyclic FES for improving upper extremity function and health-related quality of life in patients with chronic stroke. A pilot, randomized, single-blind, controlled trial. Stroke rehabilitation inpatient unit. Participants (N=48) with hemiplegia secondary to a unilateral stroke for >3 months and with a hemiplegic wrist extensor Medical Research Council scale score ranging from 1 to 3. FES was applied to the wrist extensors and finger extensors. A VR-based wearable rehabilitation device was used combined with FES and virtual activity-based training for the intervention group. The control group received cyclic FES only. Both groups completed 20 sessions over a 4-week period. Primary outcome measures were changes in Fugl-Meyer Assessment-Upper Extremity and Wolf Motor Function Test scores. Secondary outcome measures were changes in Box and Block Test, Jebsen-Taylor Hand Function Test, and Stroke Impact Scale scores. Assessments were performed at baseline (t0) and at 2 weeks (t1), 4 weeks (t4), and 8 weeks (t8). Between-group comparisons were evaluated using a repeated-measures analysis of variance. Forty-one participants were included in the analysis. Compared with FES alone, VR-FES produced a substantial increase in Fugl-Meyer Assessment-distal score (P=.011) and marginal improvement in Jebsen-Taylor Hand Function Test-gross score (P=.057). VR-FES produced greater, although nonsignificant, improvements in all other outcome measures, except in the Stroke Impact Scale-activities of daily living/instrumental activities of daily living score. FES with VR-based rehabilitation may be more effective than cyclic FES in improving distal upper extremity gross motor performance poststroke. Copyright © 2018 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. Review on design and control aspects of ankle rehabilitation robots.

    Science.gov (United States)

    Jamwal, Prashant K; Hussain, Shahid; Xie, Sheng Q

    2015-03-01

    Ankle rehabilitation robots can play an important role in improving outcomes of the rehabilitation treatment by assisting therapists and patients in number of ways. Consequently, few robot designs have been proposed by researchers which fall under either of the two categories, namely, wearable robots or platform-based robots. This paper presents a review of both kinds of ankle robots along with a brief analysis of their design, actuation and control approaches. While reviewing these designs it was observed that most of them are undesirably inspired by industrial robot designs. Taking note of the design concerns of current ankle robots, few improvements in the ankle robot designs have also been suggested. Conventional position control or force control approaches, being used in the existing ankle robots, have been reviewed. Apparently, opportunities of improvement also exist in the actuation as well as control of ankle robots. Subsequently, a discussion on most recent research in the development of novel actuators and advanced controllers based on appropriate physical and cognitive human-robot interaction has also been included in this review. Implications for Rehabilitation Ankle joint functions are restricted/impaired as a consequence of stroke or injury during sports or otherwise. Robots can help in reinstating functions faster and can also work as tool for recording rehabilitation data useful for further analysis. Evolution of ankle robots with respect to their design and control aspects has been discussed in the present paper and a novel design with futuristic control approach has been proposed.

  4. Magnitude of exercise capacity and quality of life improvement following repeat pulmonary rehabilitation in patients with COPD

    Directory of Open Access Journals (Sweden)

    Sandoz JS

    2017-04-01

    Full Text Available Jacqueline S Sandoz,1,2 Mary M Roberts,1,3,4 Jin-Gun Cho,1,3–5 John R Wheatley1,3–5 1Respiratory Ambulatory Care Service, Western Sydney Local Health District, NSW, Australia; 2Canadian Alternatives in Non-invasive Ventilation (CANVent Program, Ottawa Hospital Rehabilitation Centre, Division of Respiratory Medicine, Ottawa Hospital, Ontario, Canada; 3Department of Respiratory and Sleep Medicine, Westmead Hospital, 4Ludwig Engel Centre for Respiratory Research, Westmead Institute for Medical Research, 5Sydney Medical School, University of Sydney, Westmead, NSW, Australia Background: Maintenance and repeated pulmonary rehabilitation programs (PRPs for patients with COPD have attempted to prolong PRP benefits beyond 12–24 months. However, there is limited evidence as to the magnitude of benefit or the ideal interval between repeating the program under “real-world” conditions in which patients are referred based on clinical necessity. Therefore, we reviewed the effects of repeating PRP in a physician-referred cohort of patients with COPD. Methods: A total of 141 individuals with COPD completed PRP twice and 35 completed PRP three times over a 12-year period. We used linear mixed-effects models to quantify the magnitude and change in 6-minute walk distance (6MWD, St George’s Respiratory Questionnaire (SGRQ, and Hospital Anxiety and Depression Scale (HADS for each PRP. One-way analysis of variance with Tukey’s post hoc analysis compared the effects of different time intervals on 6MWD, SGRQ, and HADS between PRPs. Results: Despite 39 mL/year average decrease in forced expiratory volume in 1 second, overall 6MWD improved following each PRP (PRP1=58 m, P<0.0001; PRP2=42 m, P<0.0001; PRP3=32 m, P<0.003. Mean SGRQ decreased after PRP1 (-7.0 units; P<0.001 and PRP2 (-4.9 units;P<0.0001 but not after PRP3 (-3.2 units; P=0.10. HADS decreased after PRP1 (-1.9 units; P<0.0001 and PRP2 (-1.7 units; P=0.0001 but not after PRP3 (-0.4 units

  5. Responsiveness, minimal detectable change, and minimal clinically important difference of the Nottingham Extended Activities of Daily Living Scale in patients with improved performance after stroke rehabilitation.

    Science.gov (United States)

    Wu, Ching-yi; Chuang, Li-ling; Lin, Keh-chung; Lee, Shin-da; Hong, Wei-hsien

    2011-08-01

    To determine the responsiveness, minimal detectable change (MDC), and minimal clinically important differences (MCIDs) of the Nottingham Extended Activities of Daily Living (NEADL) scale and to assess percentages of patients' change scores exceeding the MDC and MCID after stroke rehabilitation. Secondary analyses of patients who received stroke rehabilitation therapy. Medical centers. Patients with stroke (N=78). Secondary analyses of patients who received 1 of 4 rehabilitation interventions. Responsiveness (standardized response mean [SRM]), 90% confidence that a change score at this threshold or higher is true and reliable rather than measurement error (MDC(90)), and MCID on the NEADL score and percentages of patients exceeding the MDC(90) and MCID. The SRM of the total NEADL scale was 1.3. The MDC(90) value for the total NEADL scale was 4.9, whereas minima and maxima of the MCID for total NEADL score were 2.4 and 6.1 points, respectively. Percentages of patients exceeding the MDC(90) and MCID of the total NEADL score were 50.0%, 73.1%, and 32.1%, respectively. The NEADL is a responsive instrument relevant for measuring change in instrumental activities of daily living after stroke rehabilitation. A patient's change score has to reach 4.9 points on the total to indicate a true change. The mean change score of a stroke group on the total NEADL scale should achieve 6.1 points to be regarded as clinically important. Our findings are based on patients with improved NEADL performance after they received specific interventions. Future research with larger sample sizes is warranted to validate these estimates. Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  6. Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment.

    Science.gov (United States)

    Lotfi, Younes; Rezazadeh, Nima; Moossavi, Abdollah; Haghgoo, Hojjat Allah; Rostami, Reza; Bakhshi, Enayatollah; Badfar, Faride; Moghadam, Sedigheh Farokhi; Sadeghi-Firoozabadi, Vahid; Khodabandelou, Yousef

    2017-12-01

    Balance function has been reported to be worse in ADHD children than in their normal peers. The present study hypothesized that an improvement in balance could result in better cognitive performance in children with ADHD and concurrent vestibular impairment. This study was designed to evaluate the effects of comprehensive vestibular rehabilitation therapy on the cognitive performance of children with combined ADHD and concurrent vestibular impairment. Subject were 54 children with combined ADHD. Those with severe vestibular impairment (n=33) were randomly assigned to two groups that were matched for age. A rehabilitation program comprising overall balance and gate, postural stability, and eye movement exercises was assigned to the intervention group. Subjects in the control group received no intervention for the same time period. Intervention was administered twice weekly for 12 weeks. Choice reaction time (CRT) and spatial working memory (SWM) subtypes of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were completed pre- and post-intervention to determine the effects of vestibular rehabilitation on the cognitive performance of the subjects with ADHD and concurrent vestibular impairment. ANCOVA was used to compare the test results of the intervention and control group post-test. The percentage of correct trial scores for the CRT achieved by the intervention group post-test increased significantly compared to those of the control group (p=0.029). The CRT mean latency scores were significantly prolonged in the intervention group following intervention (p=0.007) compared to the control group. No significant change was found in spatial functioning of the subjects with ADHD following 12 weeks of intervention (p>0.05). The study highlights the effect of vestibular rehabilitation on the cognitive performance of children with combined ADHD and concurrent vestibular disorder. The findings indicate that attention can be affected by early vestibular

  7. Improved functional capacity evaluation performance predicts successful return to work one year after completing a functional restoration rehabilitation program.

    Science.gov (United States)

    Fore, Lisa; Perez, Yoheli; Neblett, Randy; Asih, Sali; Mayer, Tom G; Gatchel, Robert J

    2015-04-01

    To evaluate whether functional capacity evaluation (FCE) scores are responsive to functional restoration treatment, and to assess the ability of FCEs at program discharge to predict work outcomes. An interdisciplinary cohort study of prospectively collected data. A functional restoration center. A consecutive sample of 354 patients with chronic disabling occupational musculoskeletal disorders (CDOMDs) completed a functional restoration program consisting of quantitatively directed exercise progression and multi-modal disability management with interdisciplinary medical supervision. Each patient participated in an FCE at admission and discharge from treatment. The results of each FCE yielded the physical demand level (PDL) at which patients were functioning. Patients were initially divided into 5 PDL groups, based on job-of-injury lifting, carrying, and pushing/pulling requirements, for the pre- to posttreatment responsiveness analyses. Patients were subsequently divided into 5 PDL groups, based on their performance on the FCE upon program completion. Outcome measures included admission-to-discharge changes in PDLs and 2 specific FCE lifting tasks: isokinetic lifting; and the Progressive Isoinertial Lifting Evaluation (PILE). Socioeconomic outcomes were also evaluated, including post-discharge work return and work retention 1-year after treatment completion. Overall, 96% of the patients demonstrated improvement in their PDLs from admission to discharge. A majority of patients (56%) were able to achieve a discharge PDL that was comparable to their estimated job-of-injury lifting requirement or higher (P work return (P work retention (P work return after treatment completion and work retention 1 year later. Copyright © 2015 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  8. From disability to ability: comprehensive rehabilitation providing a holistic functional improvement in a child with neglected neural tube defect.

    Science.gov (United States)

    Mishra, Kriti; Siddharth, V

    2017-09-25

    Neural Tube defects are one of the most common congenital disorders, presenting in a paediatric rehabilitation set-up. With its wide spectrum of clinical presentation and possible complications, the condition can significantly impact an individual's functional capacity and quality of life. The condition also affects the family of the child leaving them with a lifelong impairment to cope up with. Through this 16-year-old child, we shed light on the effects of providing rehabilitation, even at a later stage and its benefits. We also get a glimpse of difficulties in availing rehabilitation services in developing countries and the need to reach out many more neglected children like him with good functional abilities. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams.

    Directory of Open Access Journals (Sweden)

    Mirjam Körner

    Full Text Available Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC could improve both teamwork and patient-centeredness.A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters of different indication fields before (t1 and after (t2 the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis.In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010-.017, whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions.The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics' needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual

  10. A cluster-randomized controlled study to evaluate a team coaching concept for improving teamwork and patient-centeredness in rehabilitation teams.

    Science.gov (United States)

    Körner, Mirjam; Luzay, Leonie; Plewnia, Anne; Becker, Sonja; Rundel, Manfred; Zimmermann, Linda; Müller, Christian

    2017-01-01

    Although the relevance of interprofessional teamwork in the delivery of patient-centered care is well known, there is a lack of interventions for improving team interaction in the context of rehabilitation in Germany. The aim of the present study is to evaluate whether a specially developed team coaching concept (TCC) could improve both teamwork and patient-centeredness. A multicenter, cluster-randomized controlled intervention study was conducted with both staff and patient questionnaires. Data was collected at ten German rehabilitation clinics (five clusters) of different indication fields before (t1) and after (t2) the intervention. Intervention clinics received the TCC, while control clinics did not receive any treatment. Staff questionnaires were used to measure internal participation and other aspects of teamwork, such as team organization, while patient questionnaires assessed patient-centeredness. A multivariate analysis of variance was applied for data analysis. In order to analyze the effect of TCC on internal participation and teamwork, 305 questionnaires were included for t1 and 213 for t2 in the staff survey. In the patient survey, 523 questionnaires were included for t1 and 545 for t2. The TCC improved team organization, willingness to accept responsibility and knowledge integration according to staff, with small effect sizes (univariate: η2=.010-.017), whereas other parameters including internal participation, team leadership and cohesion did not improve due to the intervention. The patient survey did not show any improvements on the assessed dimensions. The TCC improved dimensions that were addressed directly by the approach and were linked to the clinics' needs, such as restructured team meetings and better exchange of information. The TCC can be used to improve team organization, willingness to accept responsibility, and knowledge integration in rehabilitation practice, but some further evaluation is needed to understand contextual factors and

  11. A personalized, intense physical rehabilitation program improves walking in people with multiple sclerosis presenting with different levels of disability: a retrospective cohort.

    Science.gov (United States)

    Kalron, Alon; Nitzani, Dalia; Magalashvili, David; Dolev, Mark; Menascu, Shay; Stern, Yael; Rosenblum, Uri; Pasitselsky, Diana; Frid, Lior; Zeilig, Gabi; Barmatz, Caroline; Givon, Uri; Achiron, Anat

    2015-03-04

    People with multiple sclerosis (PwMS) endure walking limitations. To address this restriction, various physical rehabilitation programs have been implemented with no consensus regarding their efficacy. Our objective was to report on the efficacy of an integrated tailored physical rehabilitation program on walking in people with multiple sclerosis categorized according to their level of neurological disability. Retrospective data were examined and analyzed. Specifically, data obtained from all patients who participated in the Multiple Sclerosis Center's 3 week rehabilitation program were extracted for in depth exploration. The personalized rehabilitation program included three major components modified according to the patient's specific impairments and functional needs: (a) goal directed physical therapy (b) moderately intense aerobic exercise training on a bicycle ergometer and (c) aquatic therapy chiefly oriented to body structures appropriate to movement. Gait outcome measurements included the 10 meter, 20 meter, Timed up and go and 2 minute walking tests measured pre and post the rehabilitation program. Three hundred and twelve people with relapsing-remitting multiple sclerosis were included in the final analysis. Patients were categorized into mild (n = 87), moderate (n = 104) and severely (n = 121) disabled groups. All clinical walking outcome measurements demonstrated statistically significant improvements, however, only an increase in the 2 minute walking test was above the minimal clinical difference value. The moderate and severe groups considerably improved compared to the mild gait disability group. Mean change scores (%) of the pre-post intervention period of the 2 minute walking test were 19.0 (S.E. = 3.4) in the moderate group, 16.2 (S.E. = 5.4) in the severe group and 10.9 (S.E. = 2.3) in the mild gait disability group. We presented comprehensive evidence verifying the effects of an intense goal-directed physical

  12. The importance of daily physical activity for improved exercise tolerance in heart failure patients with limited access to centre-based cardiac rehabilitation.

    Science.gov (United States)

    Sato, Noriaki; Origuchi, Hideki; Yamamoto, Umpei; Takanaga, Yasuhiro; Mohri, Masahiro

    2012-09-01

    Supervised cardiac rehabilitation provided at dedicated centres ameliorates exercise intolerance in patients with chronic heart failure. To correlate the amount of physical activity outside the hospital with improved exercise tolerance in patients with limited access to centre-based programs. Forty patients (median age 69 years) with stable heart failure due to systolic left ventricular dysfunction participated in cardiac rehabilitation once per week for five months. Using a validated single-axial accelerometer, the number of steps and physical activity-related energy expenditures on nonrehabilitation days were determined. Median (interquartile range) peak oxygen consumption was increased from 14.4 mL/kg/min (range 12.9 mL/kg/min to 17.8 mL/kg/min) to 16.4 mL/kg/min (range 13.9 mL/kg/min to 19.1 mL/kg/min); Pdaily number of steps (Pexercise time per day and time spent for light (≤3 metabolic equivalents) exercise, but not with time spent for moderate/vigorous (>3 metabolic equivalents) exercise. The number of steps and energy expenditures outside the hospital were correlated with improved exercise capacity. An accelerometer may be useful for guiding home-based cardiac rehabilitation.

  13. Motor Improvement of Skilled Forelimb Use Induced by Treatment with Growth Hormone and Rehabilitation Is Dependent on the Onset of the Treatment after Cortical Ablation

    Directory of Open Access Journals (Sweden)

    Margarita Heredia

    2018-01-01

    Full Text Available We previously demonstrated that the administration of GH immediately after severe motor cortex injury, in rats, followed by rehabilitation, improved the functionality of the affected limb and reexpressed nestin in the contralateral motor cortex. Here, we analyze whether these GH effects depend on a time window after the injury and on the reexpression of nestin and actin. Injured animals were treated with GH (0.15 mg/kg/day or vehicle, at days 7, 14, and 35 after cortical ablation. Rehabilitation was applied at short and long term (LTR after the lesion and then sacrificed. Nestin and actin were analyzed by immunoblotting in the contralateral motor cortex. Giving GH at days 7 or 35 after the lesion, but not 14 days after it, led to a remarkable improvement in the functionality of the affected paw. Contralateral nestin and actin reexpression was clearly higher in GH-treated animals, probably because compensatory brain plasticity was established. GH and immediate rehabilitation are key for repairing brain injuries, with the exception of a critical time period: GH treatment starting 14 days after the lesion. Our data also indicate that there is not a clear plateau in the recovery from a brain injury in agreement with our data in human patients.

  14. Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of depression and anxiety (the Danish IBBIS trial)

    DEFF Research Database (Denmark)

    Poulsen, Rie; Hoff, Andreas; Fisker, Jonas

    2017-01-01

    have depression and/or anxiety. There is no clear evidence that treatment alone will provide sufficient support for vocational recovery in this group. Integrated vocational and health care services have shown good effects on return to work in other, similar welfare contexts. The purpose of the IBBIS...... (Integrated Mental Health Care and Vocational Rehabilitation to Individuals on Sick Leave Due to Anxiety and Depression) interventions is to improve and hasten the process of return to employment for people in Denmark on sick leave because of depression and anxiety. METHODS/DESIGN: This three-arm, parallel......-group, randomized superiority trial has been set up to investigate the effectiveness of the IBBIS mental health care intervention and the integrated IBBIS mental health care and IBBIS vocational rehabilitation intervention for people on sick leave because of depression and/or anxiety in Denmark. The trial has...

  15. Pigeons home faster through polluted air

    OpenAIRE

    Zhongqiu Li; Franck Courchamp; Daniel T. Blumstein

    2016-01-01

    Air pollution, especially haze pollution, is creating health issues for both humans and other animals. However, remarkably little is known about how animals behaviourally respond to air pollution. We used multiple linear regression to analyse 415 pigeon races in the North China Plain, an area with considerable air pollution, and found that while the proportion of pigeons successfully homed was not influenced by air pollution, pigeons homed faster when the air was especially polluted. Our resu...

  16. Faster than light, slower than time

    International Nuclear Information System (INIS)

    Rucker, R.

    1981-01-01

    The problem with faster-than-light travel is that, in the framework of Special Relativity, it is logically equivalent to time-travel. The problem with time-travel is that it leads to two types of paradoxes. The paradoxes, and the various means of skirting them, are all discussed here. Virtually all the examples are drawn from science-fiction novels, which are a large and neglected source of thought-experiments. (Auth.)

  17. Improving Fall Risk Factor Identification and Documentation of Risk Reduction Strategies by Rehabilitation Therapists through Continuing Education

    Science.gov (United States)

    Karnes, Michele J.

    2011-01-01

    This static group comparison study determined that an educational intervention was effective in increasing fall risk factor assessment, documentation of fall risk factors, and strategies devised to reduce fall risk factors by rehabilitation therapists for their older adult outpatients in clinics. Results showed that experimental group identified…

  18. Ways of improving of medical and psychological rehabilitation of children with constitutional-exogenous obesity in hospital and sanatorium

    OpenAIRE

    Roytman, E.; Ershevskaya, A.; Pogrebnyak, L.

    2011-01-01

    We studied immediate and long-term effectiveness of integrated medical and psychological rehabilitation of children with constitutional-exogenous obesity (CEO) during the program «School of overweight child» in hospital and sanatorium according to the following parameters: body mass, percentage of fat mass (PFM), psychological changes, eating behavior and physical activity.

  19. Yoga-based postoperative cardiac rehabilitation program for improving quality of life and stress levels: Fifth-year follow-up through a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Eraballi Amaravathi

    2018-01-01

    Full Text Available Objectives: This study was aimed to assess the efficacy of yoga-based lifestyle program (YLSP in improving quality of life (QOL and stress levels in patients after 5 years of coronary artery bypass graft (CABG. Methodology: Three hundred patients posted for elective CABG in Narayana Hrudayalaya Super Speciality Hospital, Bengaluru, were randomized into two groups: YLSP and conventional lifestyle program (CLSP, and follow-up was done for 5 years. Intervention: In YLSP group, all practices of integrative approach of yoga therapy such as yama, niyama, asana, pranayama, and meditation were used as an add-on to conventional cardiac rehabilitation. The control group (CLSP continued conventional cardiac rehabilitation only. Outcome Measures: World Health Organization (WHO-QOL BREF Questionnaire, Perceived Stress Scale, Positive and Negative Affect Scale (PANAS, and Hospital Anxiety and Depression Scale (HADS were assessed before surgery and at the end of the 5th year after CABG. As data were not normally distributed, Mann–Whitney U-test was used for between-group comparisons and Wilcoxon's signed-rank test was used for within-group comparisons. Results: At the end of 5 years, mental health (P = 0.05, perceived stress (P = 0.01, and negative affect (NA (P = 0.05 have shown significant improvements. WHO-QOL BREF score has shown improvements in physical health (P = 0.046, environmental health (P = 0.04, perceived stress (P = 0.001, and NA (P = 0.02 in YLSP than CLSP. Positive affect has significantly improved in CLSP than YLSP. Other domains of WHO-QOL-BREF, PANAS, and HADS did not reveal any significant between-group differences. Conclusion: Addition of long-term YLSP to conventional cardiac rehabilitation brings better improvements in QOL and reduction in stress levels at the end of 5 years after CABG.

  20. Rehabilitation program based on sensorimotor recovery improves the static and dynamic balance and modifies the basal ganglia neurochemistry: A pilot 1H-MRS study on Parkinson's disease patients.

    Science.gov (United States)

    Delli Pizzi, Stefano; Bellomo, Rosa Grazia; Carmignano, Simona Maria; Ancona, Emilio; Franciotti, Raffaella; Supplizi, Marco; Barassi, Giovanni; Onofrj, Marco; Bonanni, Laura; Saggini, Raoul

    2017-12-01

    Rehabilitation interventions represent an alternative strategy to pharmacological treatment in order to slow or reverse some functional aspects of disability in Parkinson's disease (PD). To date, the neurophysiological mechanisms underlying rehabilitation-mediated improvement in PD patients are still poorly understood. Interestingly, growing evidence has highlighted a key role of the glutamate in neurogenesis and brain plasticity. The brain levels of glutamate, and of its precursor glutamine, can be detected in vivo and noninvasively as "Glx" by means of proton magnetic resonance spectroscopy (H-MRS). In the present pilot study, 7 PD patients with frequent falls and axial dystonia underwent 8-week rehabilitative protocol focused on sensorimotor improvement. Clinical evaluation and Glx quantification were performed before and after rehabilitation. The Glx assessment was focused on the basal ganglia in agreement with their key role in the motor functions. We found that the rehabilitation program improves the static and dynamic balance in PD patients, promoting a better global motor performance. Moreover, we observed that the levels of Glx within the left basal ganglia were higher after rehabilitation as compared with baseline. Thus, we posit that our sensorimotor rehabilitative protocol could stimulate the glutamate metabolism in basal ganglia and, in turn, neuroplasticity processes. We also hypothesize that these mechanisms could prepare the ground to restore the functional interaction among brain areas deputed to motor controls, which are affected in PD. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

  1. Video and computer-based interactive exercises are safe and improve task-specific balance in geriatric and neurological rehabilitation: a randomised trial

    Directory of Open Access Journals (Sweden)

    Maayken van den Berg

    2016-01-01

    Full Text Available Question: Does adding video/computer-based interactive exercises to inpatient geriatric and neurological rehabilitation improve mobility outcomes? Is it feasible and safe? Design: Randomised trial. Participants: Fifty-eight rehabilitation inpatients. Intervention: Physiotherapist-prescribed, tailored, video/computer-based interactive exercises for 1 hour on weekdays, mainly involving stepping and weight-shifting exercises. Outcome measures: The primary outcome was the Short Physical Performance Battery (0 to 3 at 2 weeks. Secondary outcomes were: Maximal Balance Range (mm; Step Test (step count; Rivermead Mobility Index (0 to 15; activity levels; Activity Measure for Post Acute Care Basic Mobility (18 to 72 and Daily Activity (15 to 60; Falls Efficacy Scale (10 to 40, ED5D utility score (0 to 1; Reintegration to Normal Living Index (0 to 100; System Usability Scale (0 to 100 and Physical Activity Enjoyment Scale (0 to 126. Safety was determined from adverse events during intervention. Results: At 2 weeks the between-group difference in the primary outcome (0.1, 95% CI –0.2 to 0.3 was not statistically significant. The intervention group performed significantly better than usual care for Maximal Balance Range (38 mm difference after baseline adjustment, 95% CI 6 to 69. Other secondary outcomes were not statistically significant. Fifty-eight (55% of the eligible patients agreed to participate, 25/29 (86% completed the intervention and 10 (39% attended > 70% of sessions, with a mean of 5.6 sessions (SD 3.3 attended and overall average duration of 4.5 hours (SD 3.1. Average scores were 62 (SD 21 for the System Usability Scale and 62 (SD 8 for the Physical Activity Enjoyment Scale. There were no adverse events. Conclusion: The addition of video/computer-based interactive exercises to usual rehabilitation is a safe and feasible way to increase exercise dose, but is not suitable for all. Adding the exercises to usual rehabilitation resulted in task

  2. Fast-track rehabilitation in elective colorectal surgery patients: a prospective clinical and immunological single-centre study.

    Science.gov (United States)

    Wichmann, Matthias W; Eben, Ricarda; Angele, Martin K; Brandenburg, Franzis; Goetz, Alwin E; Jauch, Karl-Walter

    2007-07-01

    Recent clinical data indicate that fast-track surgery (multimodal rehabilitation) leads to shorter postoperative length of hospital stay, faster recovery of gastrointestinal function as well as reduced morbidity and mortality rates. To date, no study has focused on the effects of fast-track surgery on postoperative immune function. This study was initiated to determine whether fast-track rehabilitation results in improved clinical and immunological outcome of patients undergoing colorectal surgery. Forty patients underwent either conventional or fast-track rehabilitation after colorectal surgery. In addition to clinical parameters (return of gastrointestinal function, food intake, pain score, complication rates and postoperative length of stay), we determined parameters of perioperative immunity by flow cytometry (lymphocyte subgroups) and enzyme-linked immunosorbent assay (interleukin-6). Our findings indicate a better-preserved cell-mediated immune function (T cells, T-helper cells, natural killer cells) after fast-track rehabilitation, whereas the pro-inflammatory response (C-reactive protein, interleukin-6) was unchanged in both study groups. Furthermore, we detected a significantly faster return of gastrointestinal function (first bowel movement P<0.001, food intake P<0.05), significantly reduced pain scores in the postoperative course (P < 0.05) and a significantly shorter length of postoperative stay (P<0.001) in patients undergoing fast-track rehabilitation. Fast-track rehabilitation after colorectal surgery results in better-preserved cell-mediated immunity when compared with conventional postoperative care. Furthermore, patients undergoing fast-track rehabilitation suffer from less pain and have a faster return of gastrointestinal function in the postoperative course. In addition, postoperative length of hospital stay was significantly shorter in fast-track patients.

  3. A dual-task home-based rehabilitation programme for improving balance control in patients with acquired brain injury: a single-blind, randomized controlled pilot study.

    Science.gov (United States)

    Peirone, Eliana; Goria, Paolo Filiberto; Anselmino, Arianna

    2014-04-01

    To evaluate the safety, feasibility and effectiveness of a dual-task home-based rehabilitation programme on balance impairments among adult patients with acquired brain injury. Single-blind, randomized controlled pilot study. Single rehabilitation centre. Sixteen participants between 12 and 18 months post-acquired brain injury with balance impairments and a score task home-based programme six days a week for seven weeks. The primary outcome measure was the Balance Evaluation System Test; secondary measures were the Activities-specific Balance Confidence Scale and Goal Attainment Scaling. At the end of the pilot study, the intervention group showed significantly greater improvement in Balance Evaluation System Test scores (17.87, SD 6.05) vs. the control group (5.5, SD 3.53; P = 0.008, r = 0.63). There was no significant difference in improvement in Activities-specific Balance Confidence Scale scores between the intervention group (25.25, SD 25.51) and the control group (7.00, SD 14.73; P = 0.11, r = 0.63). There was no significant improvement in Goal Attainment Scaling scores in the intervention (19.37, SD 9.03) vs. the control group (16.28, SD 6.58; P = 0.093, r = 0.63). This pilot study shows the safety, feasibility and short-term benefit of a dual-task home-based rehabilitation programme to improve balance control in patients with acquired brain injury. A sample size of 26 participants is required for a definitive study.

  4. Better Faster Noise with the GPU

    DEFF Research Database (Denmark)

    Wyvill, Geoff; Frisvad, Jeppe Revall

    Filtered noise [Perlin 1985] has, for twenty years, been a fundamental tool for creating functional texture and it has many other applications; for example, animating water waves or the motion of grass waving in the wind. Perlin noise suffers from a number of defects and there have been many atte...... attempts to create better or faster noise but Perlin’s ‘Gradient Noise’ has consistently proved to be the best compromise between speed and quality. Our objective was to create a better noise cheaply by use of the GPU....

  5. Evaluation of Rehabilitation Strategies and Management Schemes for the Improvement of Mangrove Management Programs in Lingayen Gulf

    OpenAIRE

    Severino Salmo III; Dante Torio; Janalezza Morvenna Esteban

    2007-01-01

    We evaluated the mangrove rehabilitation strategies and management schemes in five municipalities in Lingayen Gulf (Bolinao, Anda, Bani, Alaminos and San Fernando). Mangrove planting appears to be the first and only option used in the area, ignoring other recommended management strategies, e.g. conservation, landscaping, and sustainable production. All planting sites were located in coastal fringes and are mostly monospeficic stands of the species Rhizophora mucronata. The planted mangroves w...

  6. Perspectives on neurocognitive rehabilitation as an adjunct treatment for addictive disorders: From cognitive improvement to relapse prevention.

    Science.gov (United States)

    Rezapour, Tara; DeVito, Elise E; Sofuoglu, Mehmet; Ekhtiari, Hamed

    2016-01-01

    Addiction, as a brain disorder, can be defined with two distinct but interacting components: drug dependency and neurocognitive deficits. Most of the therapeutic interventions in addiction medicine, including pharmacological or psychosocial therapies, that are in clinical use have been mainly focused on directly addressing addictive behaviors, especially drug use and urges to use drugs. In the field of addiction treatment, it is often presumed that drug users' neurocognitive deficits will reverse following abstinence. However, in many cases, neurocognitive deficits are not fully ameliorated following sustained abstinence, and neurocognitive function may further deteriorate in early abstinence. It can be argued that many cognitive functions, such as sustained attention and executive control, are essential for full recovery and long-term abstinence from addiction. Recent advances in cognitive neuroscience have provided scientific foundations for neurocognitive rehabilitation as a means of facilitating recovery from drug addiction. Neurocognitive rehabilitation for drug addicted individuals could be implemented as part of addiction treatment, with highly flexible delivery methods including traditional "paper and pencil" testing, or computer-based technology via laptops, web-based, or smartphones in inpatient and outpatient settings. Despite this promise, there has been limited research into the potential efficacy of neurocognitive rehabilitation as a treatment for drug addiction. Further, many questions including the optimum treatment length, session duration, and necessary treatment adherence for treatment efficacy remain to be addressed. In this chapter, we first introduce cognitive rehabilitation as one of the potential areas to bridge the gap between cognitive neuroscience and addiction medicine, followed by an overview of current challenges and future directions. © 2016 Elsevier B.V. All rights reserved.

  7. Faster and Energy-Efficient Signed Multipliers

    Directory of Open Access Journals (Sweden)

    B. Ramkumar

    2013-01-01

    Full Text Available We demonstrate faster and energy-efficient column compression multiplication with very small area overheads by using a combination of two techniques: partition of the partial products into two parts for independent parallel column compression and acceleration of the final addition using new hybrid adder structures proposed here. Based on the proposed techniques, 8-b, 16-b, 32-b, and 64-b Wallace (W, Dadda (D, and HPM (H reduction tree based Baugh-Wooley multipliers are developed and compared with the regular W, D, H based Baugh-Wooley multipliers. The performances of the proposed multipliers are analyzed by evaluating the delay, area, and power, with 65 nm process technologies on interconnect and layout using industry standard design and layout tools. The result analysis shows that the 64-bit proposed multipliers are as much as 29%, 27%, and 21% faster than the regular W, D, H based Baugh-Wooley multipliers, respectively, with a maximum of only 2.4% power overhead. Also, the power-delay products (energy consumption of the proposed 16-b, 32-b, and 64-b multipliers are significantly lower than those of the regular Baugh-Wooley multiplier. Applicability of the proposed techniques to the Booth-Encoded multipliers is also discussed.

  8. Parkinson's patients' executive profile and goals they set for improvement: Why is cognitive rehabilitation not common practice?

    Science.gov (United States)

    Vlagsma, T T; Koerts, J; Fasotti, L; Tucha, O; van Laar, T; Dijkstra, H; Spikman, J M

    2016-01-01

    Impairments in executive functions (EF) are the core cognitive impairment in patients with Parkinson's disease (PD). Surprisingly, cognitive rehabilitation is not routinely offered to patients with PD. However, in patients with acquired brain injury (ABI), cognitive rehabilitation, in particular strategic executive training, is common practice and has been shown to be effective. In this study, we determined whether PD patients have different needs and aims with regard to strategic executive training than ABI patients, and whether possible differences might be a reason for not offering this kind of cognitive rehabilitation programme to patients with PD. Patients' needs and aims were operationalised by individually set goals, which were classified into domains of EF and daily life. In addition, patients with PD and ABI were compared on their cognitive, in particular EF, profile. Overall, PD patients' goals and cognitive profile were similar to those of patients with ABI. Therefore, based on the findings of this study, there is no reason to assume that strategic executive training cannot be part of standard therapy in PD. However, when strategic executive training is applied in clinical practice, disease-specific characteristics need to be taken into account.

  9. Rehabilitation nutrition for sarcopenia with disability: a combination of both rehabilitation and nutrition care management

    OpenAIRE

    Wakabayashi, Hidetaka; Sakuma, Kunihiro

    2014-01-01

    Malnutrition and sarcopenia often occur in rehabilitation settings. The prevalence of malnutrition and sarcopenia in older patients undergoing rehabilitation is 49–67 % and 40–46.5 %, respectively. Malnutrition and sarcopenia are associated with poorer rehabilitation outcome and physical function. Therefore, a combination of both rehabilitation and nutrition care management may improve outcome in disabled elderly with malnutrition and sarcopenia. The concept of rehabilitation nutrition as a c...

  10. Cardiac rehabilitation

    Science.gov (United States)

    ... rehab; Heart failure - cardiac rehab References Anderson L, Taylor RS. Cardiac rehabilitation for people with heart disease: ... of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed ...

  11. Social cognitive or learning theory use to improve self-efficacy in musculoskeletal rehabilitation: A systematic review and meta-analysis.

    Science.gov (United States)

    Ghazi, Cameron; Nyland, John; Whaley, Rumeal; Rogers, Thomas; Wera, Jeff; Henzman, Cameron

    2018-07-01

    To review the rehabilitation research methodological quality and intervention effectiveness of studies that used social cognitive or learning theory principles to improve self-efficacy in patients with orthopedic or musculoskeletal conditions. A systematic literature review and meta-analysis of peer reviewed studies published in English was performed using the OVID and SPORTDiscus databases. Initial search terms were "social cognitive theory" or "social learning theory" combined with "rehabilitation". From the 25 total studies that contributed to this review, 23 contributed patient outcome information and 20 contributed to effect size determination. Of 1947 total study participants, most (n = 1537, 78.9%) were women. Participants were primarily late middle-age (64.8 ± 17 years). Studies included participants with hip or knee osteoarthritis (OA) or who were post-hip or knee arthroplasty (11/25, 44%), post-femur or tibia fracture (6/25, 24%), adults in assisted living or inpatient rehabilitation facilities (2/25, 8%), independent community dwelling older adults (2/25, 8%), college-age recreational athletes post-sports injury (2/25, 8%), older women with osteoporosis risk (1/25, 4%) or middle-aged adults post-traumatic hand injury (1/25, 4%). For the 20 studies that contributed to effect size determination, a large overall mean effect size (Cohen's d = 0.98, 95% CI 0.42-1.86) was observed. Studies that used social cognitive or learning theory principles to improve self-efficacy in patients with orthopedic or musculoskeletal conditions generally displayed moderate to large effect sizes supporting this intervention. Sound research methodological quality and low risk of intervention-related injury or other adverse events were also generally observed. Findings suggest that these interventions may also benefit individuals with conditions that have not progressed to end-stage salvage surgery such as younger, more athletically active individuals for knee OA

  12. How balance task-specific training contributes to improving physical function in older subjects undergoing rehabilitation following hip fracture: a randomized controlled trial.

    Science.gov (United States)

    Monticone, Marco; Ambrosini, Emilia; Brunati, Roberto; Capone, Antonio; Pagliari, Giulia; Secci, Claudio; Zatti, Giovanni; Ferrante, Simona

    2018-03-01

    To evaluate the efficacy of a rehabilitation programme including balance task-specific training in improving physical function, pain, activities of daily living (ADL), balance and quality of life in subjects after a hip fracture. Randomized controlled trial. A total of 52 older subjects selected for internal fixation due to extra-capsular hip fracture were randomized to be included in an experimental ( n = 26) and control group ( n = 26). The experimental group underwent a rehabilitation programme based on balance task-specific training. The control group underwent general physiotherapy, including open kinetic chain exercises and walking training. Both groups individually followed programmes of 90-minute sessions five times/week for three weeks. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), a Pain Numerical Rating Scale, the Berg Balance Scale, the Functional Independence Measure and the 36-item Short-Form Health Survey. The participants were evaluated before and after training, and after 12 months. Significant effects of time, group and time × group were found for all outcome measures in favour of the experimental group. A clinically important between-group difference of 25 points was achieved after training and at follow-up in terms of the primary outcome (WOMAC function before treatment, after treatment and at follow-up was 84.8 (3.7), 39.8 (4.9) and 35.7 (6.2) for the experimental group and 80.9 (5.7), 65.2 (7.1) and 61.0 (11.1) for the control group). An inpatient rehabilitation programme based on balance task-specific training is useful in improving physical function, pain, ADL and quality of life in older patients after hip fracture.

  13. 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......, a paradigm shift is taking place and it is now increasingly acknowledged that exercise therapy is both safe and beneficial. Robot-assisted training is also attracting attention in multiple sclerosis rehabilitation. Several sophisticated commercial robots exist, but so far the number of scientific studies...... promising. This drug has been shown to improve walking ability in some patients with multiple sclerosis, associated with a reduction of patients' self-reported ambulatory disability. Rehabilitation strategies involving these different approaches, or combinations of them, may be of great use in improving...

  14. Balneotherapy in Psoriasis Rehabilitation.

    Science.gov (United States)

    Péter, Iván; Jagicza, Anna; Ajtay, Zénó; Boncz, Imre; Kiss, István; Szendi, Katalin; Kustán, Péter; Németh, Balázs

    2017-01-01

    This study aimed to report a balneotherapy-based psoriasis rehabilitation protocol and assess its effectivity. Eighty psoriatic patients who underwent a 3-week-long inward balneotherapy-based rehabilitation were enrolled. Psoriasis Area and Severity Index (PASI) score and high sensitivity C-reactive protein (CRP) were determined on admission and before discharge. The mean PASI score and CRP level -determined on admission and before discharge-decreased significantly after the 3-week-long rehabilitation 7.15±7.3 vs. 2.62±3.05 (p<0.001) and 4.1±3.8 vs. 3.5±3.1 (p=0.026). A negative correlation was found between PASI delta and the number of spa therapies received (r=-0.228). After completing the 3-week-long spa therapy based rehabilitation, both PASI score and CRP levels showed improvement of psoriasis. The complex spa therapy used during the rehabilitation is an effective tool to reduce the symptoms of psoriasis and improve the patient's well-being. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  15. Faster quantum chemistry simulation on fault-tolerant quantum computers

    International Nuclear Information System (INIS)

    Cody Jones, N; McMahon, Peter L; Yamamoto, Yoshihisa; Whitfield, James D; Yung, Man-Hong; Aspuru-Guzik, Alán; Van Meter, Rodney

    2012-01-01

    Quantum computers can in principle simulate quantum physics exponentially faster than their classical counterparts, but some technical hurdles remain. We propose methods which substantially improve the performance of a particular form of simulation, ab initio quantum chemistry, on fault-tolerant quantum computers; these methods generalize readily to other quantum simulation problems. Quantum teleportation plays a key role in these improvements and is used extensively as a computing resource. To improve execution time, we examine techniques for constructing arbitrary gates which perform substantially faster than circuits based on the conventional Solovay–Kitaev algorithm (Dawson and Nielsen 2006 Quantum Inform. Comput. 6 81). For a given approximation error ϵ, arbitrary single-qubit gates can be produced fault-tolerantly and using a restricted set of gates in time which is O(log ϵ) or O(log log ϵ); with sufficient parallel preparation of ancillas, constant average depth is possible using a method we call programmable ancilla rotations. Moreover, we construct and analyze efficient implementations of first- and second-quantized simulation algorithms using the fault-tolerant arbitrary gates and other techniques, such as implementing various subroutines in constant time. A specific example we analyze is the ground-state energy calculation for lithium hydride. (paper)

  16. Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial

    Directory of Open Access Journals (Sweden)

    Anderson José

    2016-04-01

    Full Text Available Question: Among people who are hospitalised for community-acquired pneumonia, does an inpatient exercise-based rehabilitation program improve functional outcomes, symptoms, quality of life and length of hospital stay more than a respiratory physiotherapy regimen? Design: Randomised trial with concealed allocation, intention-to-treat analysis and blinding of some outcomes. Participants: Forty-nine adults hospitalised for community-acquired pneumonia. Intervention: The experimental group (n = 32 underwent a physical training program that included warm-up, stretching, peripheral muscle strength training and walking at a controlled speed for 15 minutes. The control group (n = 17 underwent a respiratory physiotherapy regimen that included percussion, vibrocompression, respiratory exercises and free walking. The intervention regimens lasted 8 days. Outcome measures: The primary outcome was the Glittre Activities of Daily Living test, which assesses the time taken to complete a series of functional tasks (eg, rising from a chair, walking, stairs, lifting and bending. Secondary outcomes were distance walked in the incremental shuttle walk test, peripheral muscle strength, quality of life, dyspnoea, lung function, C-reactive protein and length of hospital stay. Measures were taken 1 day before and 1 day after the intervention period. Results: There was greater improvement in the experimental group than in the control group on the Glittre Activities of Daily Living test (mean between-group difference 39 seconds, 95% CI 20 to 59 and the incremental shuttle walk test (mean between-group difference 130 m, 95% CI 77 to 182. There were also significantly greater improvements in quality of life, dyspnoea and peripheral muscle strength in the experimental group than in the control group. There were no between-group differences in lung function, C-reactive protein or length of hospital stay. Conclusion: The improvement in functional outcomes after an

  17. 77 FR 8234 - National Institute on Disability and Rehabilitation Research-Disability and Rehabilitation...

    Science.gov (United States)

    2012-02-14

    ... seeks to: (1) Improve the quality and utility of disability and rehabilitation research; (2) determine...; (3) identify research gaps; (4) identify mechanisms of integrating research and practice; and (5... DEPARTMENT OF EDUCATION National Institute on Disability and Rehabilitation Research-- Disability...

  18. Oral supplement enriched in HMB combined with pulmonary rehabilitation improves body composition and health related quality of life in patients with bronchiectasis (Prospective, Randomised Study).

    Science.gov (United States)

    Olveira, Gabriel; Olveira, Casilda; Doña, Esperanza; Palenque, Francisco Javier; Porras, Nuria; Dorado, Antonio; Godoy, Ana M; Rubio-Martínez, Elehazara; Rojo-Martínez, Gemma; Martín-Valero, Rocío

    2016-10-01

    Pulmonary Rehabilitation (PR) is recommended for bronchiectasis but there is no data about its effect on body composition. The aim of this study is to assess the effect of Pulmonary Rehabilitation (PR) for 12 weeks in normally-nourished non-cystic-fibrosis bronchiectasis patients compared with the effect of PR plus a hyperproteic oral nutritional supplement enriched with beta-hydroxy-beta-methylbutyrate (HMB) on body composition, muscle strength, quality of life and serum biomarkers. single center randomized controlled trial, parallel treatment design: Participants were randomly assigned to receive PR for 12 weeks or PR plus ONS (PRONS) (one can per day). Outcome assessments were performed at baseline, 12 weeks and 24 weeks: body composition (Dual-energy X-Ray Absorptiometry (DEXA), mid-arm muscle circumference (MAMC), phase angle by Bio-impedance), health related quality of life (Spanish QOL-B-V3.0, Physical Functioning Scale), handgrip strength, diet questionnaire, and plasma levels of prealbumin, myostatin and somatomedin-c. Thirty patients were randomized (15 per group) without differences in clinical and respiratory variables. In the PRONS group bone mineral density (BMD), mean and maximum handgrip dynamometry, MAMC, QOLB and prealbumin were significantly increased from baseline at 12 and 24 weeks and Fat free Mass (FFM) and FFM index, at 12 weeks. In the PR group only mean handgrip dynamometry and prealbumin were significantly increased at 12 and 24 weeks. In both groups plasma myostatin was reduced at 12 weeks (without significant differences). The addition of a hyperproteic ONS enriched with HMB to Pulmonary Rehabilitation could improve body composition, BMD, muscle strength and health related quality of life in bronchiectasis patients. Clinical Trials Number NCT02048397. Copyright © 2015 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  19. Socially differentiated cardiac rehabilitation

    DEFF Research Database (Denmark)

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

    2012-01-01

    in recruitment and participation among low educated and socially vulnerable patients must be addressed to lower inequality in post-MI health. Our aim was to improve referral, attendance, and adherence rates among socially vulnerable patients by systematic screening and by offering a socially differentiated...... 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......%. Patients were equally distributed to the SRP and the ERP. No inequality was found in attendance and adherence among referred patients. Conclusions: It seems possible to overcome unequal referral, attendance, and adherence in cardiac rehabilitation by organisation of systematic screening and social...

  20. 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.

  1. Citius, Altius, Fortius: Faster, Higher, Stronger

    Science.gov (United States)

    2013-06-01

    males. For example, elite female athletes improved the national 100- meter sprint and 80- meter hurdle record by nearly two seconds. High jump was...improved by a third of a meter , and shot put and javelin improved by over 30 meters .52 Notably, the motivations of the CCP’s sports policy from 1949 to...per capita gross domestic product (GDP) was around 1,000 yuan in 1988,82 and a bonus for an academic in the space shuttle program was 400 yuan.83

  2. Rehabilitation costs

    Energy Technology Data Exchange (ETDEWEB)

    Kubo, Arthur S [BDM Corp., VA (United States); [Bikini Atoll Rehabilitation Committee, Berkeley, CA (United States)

    1986-07-01

    The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates.

  3. Rehabilitation costs

    International Nuclear Information System (INIS)

    Kubo, Arthur S.

    1986-01-01

    The costs of radioactivity contamination control and other matters relating to the resettlement of Bikin atoll were reviewed for Bikini Atoll Rehabilitation Committee by a panel of engineers which met in Berkeley, California on January 22-24, 1986. This Appendix presents the cost estimates

  4. A Lean Six Sigma quality improvement project to increase discharge paperwork completeness for admission to a comprehensive integrated inpatient rehabilitation program.

    Science.gov (United States)

    Neufeld, Nathan J; Hoyer, Erik H; Cabahug, Philippines; González-Fernández, Marlís; Mehta, Megha; Walker, N Colbey; Powers, Richard L; Mayer, R Samuel

    2013-01-01

    Lean Six Sigma (LSS) process analysis can be used to increase completeness of discharge summary reports used as a critical communication tool when a patient transitions between levels of care. The authors used the LSS methodology as an intervention to improve systems process. Over the course of the project, 8 required elements were analyzed in the discharge paperwork. The authors analyzed the discharge paperwork of patients (42 patients preintervention and 143 patients postintervention) of a comprehensive integrated inpatient rehabilitation program (CIIRP). Prior to this LSS project, 61.8% of required discharge elements were present. The intervention improved the completeness to 94.2% of the required elements. The percentage of charts that were 100% complete increased from 11.9% to 67.8%. LSS is a well-established process improvement methodology that can be used to make significant improvements in complex health care workflow issues. Specifically, the completeness of discharge documentation required for transition of care to CIIRP can be improved.

  5. Elastic coupling of limb joints enables faster bipedal walking

    Science.gov (United States)

    Dean, J.C.; Kuo, A.D.

    2008-01-01

    The passive dynamics of bipedal limbs alone are sufficient to produce a walking motion, without need for control. Humans augment these dynamics with muscles, actively coordinated to produce stable and economical walking. Present robots using passive dynamics walk much slower, perhaps because they lack elastic muscles that couple the joints. Elastic properties are well known to enhance running gaits, but their effect on walking has yet to be explored. Here we use a computational model of dynamic walking to show that elastic joint coupling can help to coordinate faster walking. In walking powered by trailing leg push-off, the model's speed is normally limited by a swing leg that moves too slowly to avoid stumbling. A uni-articular spring about the knee allows faster but uneconomical walking. A combination of uni-articular hip and knee springs can speed the legs for improved speed and economy, but not without the swing foot scuffing the ground. Bi-articular springs coupling the hips and knees can yield high economy and good ground clearance similar to humans. An important parameter is the knee-to-hip moment arm that greatly affects the existence and stability of gaits, and when selected appropriately can allow for a wide range of speeds. Elastic joint coupling may contribute to the economy and stability of human gait. PMID:18957360

  6. Improving the effectiveness of psychological interventions for depression and anxiety in the cardiac rehabilitation pathway using group-based metacognitive therapy (PATHWAY Group MCT): study protocol for a randomised controlled trial.

    Science.gov (United States)

    Wells, Adrian; McNicol, Kirsten; Reeves, David; Salmon, Peter; Davies, Linda; Heagerty, Anthony; Doherty, Patrick; McPhillips, Rebecca; Anderson, Rebecca; Faija, Cintia; Capobianco, Lora; Morley, Helen; Gaffney, Hannah; Shields, Gemma; Fisher, Peter

    2018-04-03

    Anxiety and depression are prevalent among cardiac rehabilitation patients but pharmacological and psychological treatments have limited effectiveness in this group. Furthermore, psychological interventions have not been systematically integrated into cardiac rehabilitation services despite being a strategic priority for the UK National Health Service. A promising new treatment, metacognitive therapy, may be well-suited to the needs of cardiac rehabilitation patients and has the potential to improve outcomes. It is based on the metacognitive model, which proposes that a thinking style dominated by rumination, worry and threat monitoring maintains emotional distress. Metacognitive therapy is highly effective at reducing this thinking style and alleviating anxiety and depression in mental health settings. This trial aims to evaluate the effectiveness and cost-effectiveness of group-based metacognitive therapy for cardiac rehabilitation patients with elevated anxiety and/or depressive symptoms. The PATHWAY Group-MCT trial is a multicentre, two-arm, single-blind, randomised controlled trial comparing the clinical- and cost-effectiveness of group-based metacognitive therapy plus usual cardiac rehabilitation to usual cardiac rehabilitation alone. Cardiac rehabilitation patients (target sample n = 332) with elevated anxiety and/or depressive symptoms will be recruited across five UK National Health Service Trusts. Participants randomised to the intervention arm will receive six weekly sessions of group-based metacognitive therapy delivered by either cardiac rehabilitation professionals or research nurses. The intervention and control groups will both be offered the usual cardiac rehabilitation programme within their Trust. The primary outcome is severity of anxiety and depressive symptoms at 4-month follow-up measured by the Hospital Anxiety and Depression Scale total score. Secondary outcomes are severity of anxiety/depression at 12-month follow-up, health

  7. 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 rehabilitation program was effective at improving the physical functioning, mobility, and balance of individuals after a 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.

  8. Using wireless technology in clinical practice: does feedback of daily walking activity improve walking outcomes of individuals receiving rehabilitation post-stroke? Study protocol for a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Regaining independent ambulation is the top priority for individuals recovering from stroke. Thus, physical rehabilitation post-stroke should focus on improving walking function and endurance. However, the amount of walking completed by individuals with stroke attending rehabilitation is far below that required for independent community ambulation. There has been increased interest in accelerometer-based monitoring of walking post-stroke. Walking monitoring could be integrated within the goal-setting process for those with ambulation goals in rehabilitation. The feedback from these devices can be downloaded to a computer to produce reports. The purpose of this study is to determine the effect of accelerometer-based feedback of daily walking activity during rehabilitation on the frequency and duration of walking post-stroke. Methods Participants will be randomly assigned to one of two groups: feedback or no feedback. Participants will wear accelerometers daily during in- and out-patient rehabilitation and, for participants in the feedback group, the participants’ treating physiotherapist will receive regular reports of walking activity. The primary outcome measures are the amount of daily walking completed, as measured using the accelerometers, and spatio-temporal characteristics of walking (e.g. walking speed). We will also examine goal attainment, satisfaction with progress towards goals, stroke self-efficacy, and community-integration. Discussion Increased walking activity during rehabilitation is expected to improve walking function and community re-integration following discharge. In addition, a focus on altering walking behaviour within the rehabilitation setting may lead to altered behaviour and increased activity patterns after discharge. Trial registration ClinicalTrials.gov NCT01521234 PMID:23865593

  9. Investigating the effect of Interventions on improving the Service Quality of Physiotherapy Clinic in Rehabilitation Faculty of Tabriz in 2011-2012

    Directory of Open Access Journals (Sweden)

    JS Tabrizi

    2014-03-01

    Full Text Available Background & Objective: Quality is the main indicator in assessing health system performance and service quality which refers to non-clinical aspect of health care. This study aims at surveying and improving service quality of delivered care in physiotherapy clinic of Tabriz rehabilitation faculty.Materials & Methods: The present study is an interventional one which collects the data from 324 patients and their coadjutors through a structured interview using a researcher made questionnaire. The questionnaire includes 7 questions in demographic factor and 38 ones in eleven aspects of service quality. The data was analyzed then using SPSS 16 and the obtained results were reported based on the mean (standard deviation for quantitative and frequency (percentages for qualitative variables.Results: In the pretest phase, the six aspects including choice of provider, safety, prevention and early detection, dignity, autonomy and availability had non-acceptable service quality scores but in the posttest phase, all the aspects improved significantly and the total service quality score improved from 8.58 to 9.83 (P<0.001.Conclusion: The obtained result indicated that the quality of delivered care could be improved through appropriate interventions. In addition, the acquired results could be used in the similar circumstances to create respectful environments for health care customers.

  10. Faster Fully-Dynamic minimum spanning forest

    DEFF Research Database (Denmark)

    Holm, Jacob; Rotenberg, Eva; Wulff-Nilsen, Christian

    2015-01-01

    We give a new data structure for the fully-dynamic minimum spanning forest problem in simple graphs. Edge updates are supported in O(log4 n/log logn) expected amortized time per operation, improving the O(log4 n) amortized bound of Holm et al. (STOC’98, JACM’01).We also provide a deterministic data...

  11. A Faster Algorithm for Computing Straight Skeletons

    KAUST Repository

    Mencel, Liam A.

    2014-01-01

    computation in O(n (log n) log r) time. It improves on the previously best known algorithm for this reduction, which is randomised, and runs in expected O(n √(h+1) log² n) time for a polygon with h holes. Using known motorcycle graph algorithms, our result

  12. 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

  13. Smart portable rehabilitation devices.

    Science.gov (United States)

    Mavroidis, Constantinos; Nikitczuk, Jason; Weinberg, Brian; Danaher, Gil; Jensen, Katherine; Pelletier, Philip; Prugnarola, Jennifer; Stuart, Ryan; Arango, Roberto; Leahey, Matt; Pavone, Robert; Provo, Andrew; Yasevac, Dan

    2005-07-12

    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). 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. Laboratory tests of the devices demonstrated that they were able to meet their design

  14. Inpatient rehabilitation improves functional capacity, peripheral muscle strength and quality of life in patients with community-acquired pneumonia: a randomised trial.

    Science.gov (United States)

    José, Anderson; Dal Corso, Simone

    2016-04-01

    Among people who are hospitalised for community-acquired pneumonia, does an inpatient exercise-based rehabilitation program improve functional outcomes, symptoms, quality of life and length of hospital stay more than a respiratory physiotherapy regimen? Randomised trial with concealed allocation, intention-to-treat analysis and blinding of some outcomes. Forty-nine adults hospitalised for community-acquired pneumonia. The experimental group (n=32) underwent a physical training program that included warm-up, stretching, peripheral muscle strength training and walking at a controlled speed for 15 minutes. The control group (n=17) underwent a respiratory physiotherapy regimen that included percussion, vibrocompression, respiratory exercises and free walking. The intervention regimens lasted 8 days. The primary outcome was the Glittre Activities of Daily Living test, which assesses the time taken to complete a series of functional tasks (eg, rising from a chair, walking, stairs, lifting and bending). Secondary outcomes were distance walked in the incremental shuttle walk test, peripheral muscle strength, quality of life, dyspnoea, lung function, C-reactive protein and length of hospital stay. Measures were taken 1 day before and 1 day after the intervention period. There was greater improvement in the experimental group than in the control group on the Glittre Activities of Daily Living test (mean between-group difference 39 seconds, 95% CI 20 to 59) and the incremental shuttle walk test (mean between-group difference 130 m, 95% CI 77 to 182). There were also significantly greater improvements in quality of life, dyspnoea and peripheral muscle strength in the experimental group than in the control group. There were no between-group differences in lung function, C-reactive protein or length of hospital stay. The improvement in functional outcomes after an inpatient rehabilitation program was greater than the improvement after standard respiratory physiotherapy. The

  15. A Faster Algorithm for Computing Straight Skeletons

    KAUST Repository

    Cheng, Siu-Wing

    2014-09-01

    We present a new algorithm for computing the straight skeleton of a polygon. For a polygon with n vertices, among which r are reflex vertices, we give a deterministic algorithm that reduces the straight skeleton computation to a motorcycle graph computation in O(n (logn)logr) time. It improves on the previously best known algorithm for this reduction, which is randomized, and runs in expected O(n√h+1log2n) time for a polygon with h holes. Using known motorcycle graph algorithms, our result yields improved time bounds for computing straight skeletons. In particular, we can compute the straight skeleton of a non-degenerate polygon in O(n (logn) logr + r 4/3 + ε ) time for any ε > 0. On degenerate input, our time bound increases to O(n (logn) logr + r 17/11 + ε ).

  16. A Faster Algorithm for Computing Straight Skeletons

    KAUST Repository

    Mencel, Liam A.

    2014-05-06

    We present a new algorithm for computing the straight skeleton of a polygon. For a polygon with n vertices, among which r are reflex vertices, we give a deterministic algorithm that reduces the straight skeleton computation to a motorcycle graph computation in O(n (log n) log r) time. It improves on the previously best known algorithm for this reduction, which is randomised, and runs in expected O(n √(h+1) log² n) time for a polygon with h holes. Using known motorcycle graph algorithms, our result yields improved time bounds for computing straight skeletons. In particular, we can compute the straight skeleton of a non-degenerate polygon in O(n (log n) log r + r^(4/3 + ε)) time for any ε > 0. On degenerate input, our time bound increases to O(n (log n) log r + r^(17/11 + ε))

  17. A Faster Algorithm for Computing Straight Skeletons

    KAUST Repository

    Cheng, Siu-Wing; Mencel, Liam A.; Vigneron, Antoine E.

    2014-01-01

    We present a new algorithm for computing the straight skeleton of a polygon. For a polygon with n vertices, among which r are reflex vertices, we give a deterministic algorithm that reduces the straight skeleton computation to a motorcycle graph computation in O(n (logn)logr) time. It improves on the previously best known algorithm for this reduction, which is randomized, and runs in expected O(n√h+1log2n) time for a polygon with h holes. Using known motorcycle graph algorithms, our result yields improved time bounds for computing straight skeletons. In particular, we can compute the straight skeleton of a non-degenerate polygon in O(n (logn) logr + r 4/3 + ε ) time for any ε > 0. On degenerate input, our time bound increases to O(n (logn) logr + r 17/11 + ε ).

  18. [Native plant resources to optimize the performances of forest rehabilitation in Mediterranean and tropical environment: some examples of nursing plant species that improve the soil mycorrhizal potential].

    Science.gov (United States)

    Duponnois, Robin; Ramanankierana, Heriniaina; Hafidi, Mohamed; Baohanta, Rondro; Baudoin, Ezékiel; Thioulouse, Jean; Sanguin, Hervé; Bâ, Amadou; Galiana, Antoine; Bally, René; Lebrun, Michel; Prin, Yves

    2013-01-01

    The overexploitation of natural resources, resulting in an increased need for arable lands by local populations, causes a serious dysfunction in the soil's biological functioning (mineral deficiency, salt stress, etc.). This dysfunction, worsened by the climatic conditions (drought), requires the implementation of ecological engineering strategies allowing the rehabilitation of degraded areas through the restoration of essential ecological services. The first symptoms of weathering processes of soil quality in tropical and Mediterranean environments result in an alteration of the plant cover structure with, in particular, the pauperization of plant species diversity and abundance. This degradation is accompanied by a weakening of soils and an increase of the impact of erosion on the surface layer resulting in reduced fertility of soils in terms of their physicochemical characteristics as well as their biological ones (e.g., soil microbes). Among the microbial components particularly sensitive to erosion, symbiotic microorganisms (rhizobia, Frankia, mycorrhizal fungi) are known to be key components in the main terrestrial biogeochemical cycles (C, N and P). Many studies have shown the importance of the management of these symbiotic microorganisms in rehabilitation and revegetation strategies of degraded environments, but also in improving the productivity of agrosystems. In particular, the selection of symbionts and their inoculation into the soil were strongly encouraged in recent decades. These inoculants were selected not only for their impact on the plant, but also for their ability to persist in the soil at the expense of the residual native microflora. The performance of this technique was thus evaluated on the plant cover, but its impact on soil microbial characteristics was totally ignored. The role of microbial diversity on productivity and stability (resistance, resilience, etc.) of eco- and agrosystems has been identified relatively recently and has led

  19. Faster and more accurate transport procedures for HZETRN

    International Nuclear Information System (INIS)

    Slaba, T.C.; Blattnig, S.R.; Badavi, F.F.

    2010-01-01

    The deterministic transport code HZETRN was developed for research scientists and design engineers studying the effects of space radiation on astronauts and instrumentation protected by various shielding materials and structures. In this work, several aspects of code verification are examined. First, a detailed derivation of the light particle (A ≤ 4) and heavy ion (A > 4) numerical marching algorithms used in HZETRN is given. References are given for components of the derivation that already exist in the literature, and discussions are given for details that may have been absent in the past. The present paper provides a complete description of the numerical methods currently used in the code and is identified as a key component of the verification process. Next, a new numerical method for light particle transport is presented, and improvements to the heavy ion transport algorithm are discussed. A summary of round-off error is also given, and the impact of this error on previously predicted exposure quantities is shown. Finally, a coupled convergence study is conducted by refining the discretization parameters (step-size and energy grid-size). From this study, it is shown that past efforts in quantifying the numerical error in HZETRN were hindered by single precision calculations and computational resources. It is determined that almost all of the discretization error in HZETRN is caused by the use of discretization parameters that violate a numerical convergence criterion related to charged target fragments below 50 AMeV. Total discretization errors are given for the old and new algorithms to 100 g/cm 2 in aluminum and water, and the improved accuracy of the new numerical methods is demonstrated. Run time comparisons between the old and new algorithms are given for one, two, and three layer slabs of 100 g/cm 2 of aluminum, polyethylene, and water. The new algorithms are found to be almost 100 times faster for solar particle event simulations and almost 10 times

  20. The order of exercise during concurrent training for rehabilitation does not alter acute genetic expression, mitochondrial enzyme activity or improvements in muscle function.

    Directory of Open Access Journals (Sweden)

    Lauren G MacNeil

    Full Text Available Concurrent exercise combines different modes of exercise (e.g., aerobic and resistance into one training protocol, providing stimuli meant to increase muscle strength, aerobic capacity and mass. As disuse is associated with decrements in strength, aerobic capacity and muscle size concurrent training is an attractive modality for rehabilitation. However, interference between the signaling pathways may result in preferential improvements for one of the exercise modes. We recruited 18 young adults (10 ♂, 8 ♀ to determine if order of exercise mode during concurrent training would differentially affect gene expression, protein content and measures of strength and aerobic capacity after 2 weeks of knee-brace induced disuse. Concurrent exercise sessions were performed 3x/week for 6 weeks at gradually increasing intensities either with endurance exercise preceding (END>RES or following (RES>END resistance exercise. Biopsies were collected from the vastus lateralis before, 3 h after the first exercise bout and 48 h after the end of training. Concurrent exercise altered the expression of genes involved in mitochondrial biogenesis (PGC-1α, PRC, PPARγ, hypertrophy (PGC-1α4, REDD2, Rheb and atrophy (MuRF-1, Runx1, increased electron transport chain complex protein content, citrate synthase and mitochondrial cytochrome c oxidase enzyme activity, muscle mass, maximum isometric strength and VO 2peak. However, the order in which exercise was completed (END>RES or RES>END only affected the protein content of mitochondrial complex II subunit. In conclusion, concurrent exercise training is an effective modality for the rehabilitation of the loss of skeletal muscle mass, maximum strength, and peak aerobic capacity resulting from disuse, regardless of the order in which the modes of exercise are performed.

  1. Improving Vocational Rehabilitation Access and Return to Work and Career Outcomes among African American Wounded Warriors, Gulf War, and Vietnam War Era Veterans with Disabilities: A White Paper Series

    Science.gov (United States)

    Moore, Corey L., Ed.: Johnson, Jean E., Ed.; Washington, Andre L., Ed.

    2011-01-01

    The purpose of this monograph is to present documents that discuss issues related to improving access to vocational rehabilitation services and return to work rates of African American Wounded Warriors, Gulf War and Vietnam War Era veterans with disabilities. This monograph also includes a review of relevant literature on barriers to employment…

  2. Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR): A Logic Model.

    Science.gov (United States)

    Gill, Simone V; Khetani, Mary A; Yinusa-Nyahkoon, Leanne; McManus, Beth; Gardiner, Paula M; Tickle-Degnen, Linda

    2017-07-01

    In a patient-centered care era, rehabilitation can benefit from researcher-clinician collaboration to effectively and efficiently produce the interdisciplinary science that is needed to improve patient-centered outcomes. The authors propose the use of the Forging Alliances in Interdisciplinary Rehabilitation Research (FAIRR) logic model to provide guidance to rehabilitation scientists and clinicians who are committed to growing their involvement in interdisciplinary rehabilitation research. We describe the importance and key characteristics of the FAIRR model for conducting interdisciplinary rehabilitation research.

  3. [Effectiveness of an educational program for respiratory rehabilitation of Chronic Obstructive Pulmonary Disease patients in Primary Care in improving the quality of life, symptoms, and clinical risk].

    Science.gov (United States)

    Blánquez Moreno, Cristina; Colungo Francia, Cristina; Alvira Balada, M Carme; Kostov, Belchin; González-de Paz, Luis; Sisó-Almirall, Antoni

    2017-10-04

    To determine the impact of an educational program to improve the management of chronic obstructive pulmonary disease (COPD) that contributes to an increase of the quality of life, exercise capacity, level of dyspnoea, and clinical risk. Intervention study without controls. Primary Healthcare Centre. 193 patients with COPD were invited, 73 accepted and 55 participated in the educational program. Respiratory rehabilitation educational program with basic concepts of pulmonary and respiratory pathophysiology, respiratory physiotherapy exercises, practical workshop on the use of the most frequent inhalation devices, understanding of chronic disease and self-care measures in case of exacerbation. The quality of life (the COPD assessment test), exercise tolerance (the Six-Minute Walk Test), rating of perceived exertion (Borg Dyspnoea Score) and clinical risk (BODE index) were assessed by means of validated questionnaires in Spanish. A total of 43 (78.2%) participants completed the program. An improvement in the quality of life by a mean of 3.3 points was observed (95%CI; 1.76-4.84). Just over half (53.5%) of the participants obtained a clinically relevant improvement. Participants also improved their physical exercise capacity at post-intervention by increasing the distance that they walked in 6min by a mean of 20.76m (95%CI; 2.57-38.95). Improvements in the level of dyspnoea and clinical risk were also observed. The educational program shows a statistically significant and clinically relevant improvement in the quality of life, fatigue, symptomatology, exercise capacity, level of dyspnoea, and clinical risk. The program is adaptable to the health care routine of healthcare centres. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  4. A Faster Algorithm for Computing Motorcycle Graphs

    KAUST Repository

    Vigneron, Antoine E.; Yan, Lie

    2014-01-01

    We present a new algorithm for computing motorcycle graphs that runs in (Formula presented.) time for any (Formula presented.), improving on all previously known algorithms. The main application of this result is to computing the straight skeleton of a polygon. It allows us to compute the straight skeleton of a non-degenerate polygon with (Formula presented.) holes in (Formula presented.) expected time. If all input coordinates are (Formula presented.)-bit rational numbers, we can compute the straight skeleton of a (possibly degenerate) polygon with (Formula presented.) holes in (Formula presented.) expected time. In particular, it means that we can compute the straight skeleton of a simple polygon in (Formula presented.) expected time if all input coordinates are (Formula presented.)-bit rationals, while all previously known algorithms have worst-case running time (Formula presented.). © 2014 Springer Science+Business Media New York.

  5. A Faster Algorithm for Computing Motorcycle Graphs

    KAUST Repository

    Vigneron, Antoine E.

    2014-08-29

    We present a new algorithm for computing motorcycle graphs that runs in (Formula presented.) time for any (Formula presented.), improving on all previously known algorithms. The main application of this result is to computing the straight skeleton of a polygon. It allows us to compute the straight skeleton of a non-degenerate polygon with (Formula presented.) holes in (Formula presented.) expected time. If all input coordinates are (Formula presented.)-bit rational numbers, we can compute the straight skeleton of a (possibly degenerate) polygon with (Formula presented.) holes in (Formula presented.) expected time. In particular, it means that we can compute the straight skeleton of a simple polygon in (Formula presented.) expected time if all input coordinates are (Formula presented.)-bit rationals, while all previously known algorithms have worst-case running time (Formula presented.). © 2014 Springer Science+Business Media New York.

  6. Rehabilitation and older people.

    OpenAIRE

    Young, J.

    1996-01-01

    Rehabilitation is concerned with lessening the impact of disabling conditions. These are particularly common in older people and considerable health gain can be achieved by successful rehabilitation. Hospital doctors and general practitioners should be aware of the core principles of rehabilitation, be able to recognise rehabilitation need in their patients, and have sufficient knowledge of their local rehabilitation services to trigger the referral process.

  7. Can cardiac rehabilitation programs improve functional capacity and left ventricular diastolic function in patients with mechanical reperfusion after ST elevation myocardial infarction?: A double-blind clinical trial

    Directory of Open Access Journals (Sweden)

    Allahyar Golabchi

    2012-10-01

    Full Text Available BACKGROUND: Current guidelines recommend cardiac rehabilitation programs (CRP as a means to improve functional status of patients after coronary revascularization. However, research supporting this recommendation has been limited and positive effects of CRP on diastolic function are controversial. The aim of this study was to examine the effects of an 8-week CRP on left ventricular diastolic function.    METHODS: This randomized, clinical trial included 29 men with ST elevation myocardial infarction (MI who had received reperfusion therapy, i.e. coronary artery bypass grafting (CABG or percutaneous coronary intervention (PCI. They were randomized to a training group (n = 15; mean age: 54.2 ± 9.04 years old and a control group (n = 14; mean age: 51.71 ± 6.98 years old. Patients in the training group performed an 8-week CRP with an intensity of 60-85% of maximum heart rate. Exercise sessions lasted 60-90 minutes and were held three times a week. At the start and end of the study, all patients performed symptom-limited exercise test based on Naughton treadmill protocol. Pulsed-wave Doppler echocardiography was also used to determine peak velocity of early (E and late (A waves, E/A ratios, and the deceleration time of E (DT.    RESULTS: Left ventricular diastolic indices (E, A, E/A ratio, DT did not change significantly after the CRP. Compared to baseline, patients in the training group had significant improvements in functional capacity (8.30 ± 1.30 vs. 9.7 ± 1.7 and maximum heart rate (118.50 ± 24.48 vs. 126.85 ± 22.75. Moreover, resting heart rate of the training group was significantly better than the control group at the end of the study (75.36 ± 7.94 vs. 79.80 ± 7.67; P < 0.001.    CONCLUSION: An 8-week CRP in post-MI patients revascularized with PCI or CABG led to improved exercise capacity. However, the CRP failed to enhance diastolic function.      Keywords: Cardiac Rehabilitation, Diastolic Function, Functional Capacity

  8. [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.

  9. DOE translation tool: Faster and better than ever

    International Nuclear Information System (INIS)

    El-Chakieh, T.; Vincent, C.

    2006-01-01

    CAE's constant push to advance power plant simulation practices involves continued investment in our technologies. This commitment has yielded many advances in our simulation technologies and tools to provide faster maintenance updates, easier process updates and higher fidelity models for power plant simulators. Through this quest, a comprehensive, self-contained and user-friendly DCS translation tool for plant control system emulation was created. The translation tool converts an ABB Advant AC160 and/or AC450 control system, used in both gas turbine-based, fossil and nuclear power plants, into Linux or Windows-based ROSE[reg] simulation schematics. The translation for a full combined-cycle gas turbine (CCGT) plant that comprises more than 5,300 function plans distributed over 15 nodes is processed in less than five hours on a dual 2.8Ghz Xeon Linux platform in comparison to the 12 hours required by CAE's previous translation tool. The translation process, using the plant configuration files, includes the parsing of the control algorithms, the databases, the graphic and the interconnection between nodes. A Linux or Windows API is then used to automatically populate the ROSE[reg] database. Without such a translation, tool or if ?stimulation? of real control system is not feasible or too costly, simulation of the DCS manually takes months of error prone manual coding. The translation can be performed for all the nodes constituting the configuration files of the whole plant DCS, or in order to provide faster maintenance updates and easier process updates, partial builds are possible at 3 levels: a. single schematic updates, b. multi-schematic updates and c. single node updates based on the user inputs into the Graphical User Interface. improvements including: - Process time reduction of over 60%; - All communication connections between nodes are fully automated; - New partial build for one schematic, a group of schematics or a single node; - Availability on PC

  10. Education of Physicians and Implementation of a Formal Referral System Can Improve Cardiac Rehabilitation Referral and Participation Rates after Percutaneous Coronary Intervention.

    Science.gov (United States)

    Dahhan, Ali; Maddox, William R; Krothapalli, Siva; Farmer, Matthew; Shah, Amit; Ford, Benjamin; Rhodes, Marc; Matthews, Laurie; Barnes, Vernon A; Sharma, Gyanendra K

    2015-08-01

    Cardiac rehabilitation (CR) is an effective preventive measure that remains underutilised in the United States. The study aimed to determine the CR referral rate (RR) after percutaneous coronary intervention (PCI) at an academic tertiary care centre, identify barriers to referral, and evaluate awareness of CR benefits and indications (CRBI) among cardiologists. Subsequently, it aimed to evaluate if an intervention consisting of physicians' education about CRBI and implementation of a formal CR referral system could improve RR and consequently participation rate (PR). Data were retrospectively collected for all consecutive patients who underwent PCI over 12 months. Referral rate was determined and variables were compared for differences between referred and non-referred patients. A questionnaire was distributed among the physicians in the Division of Cardiology to assess awareness of CRBI and referral practice patterns. After implementation of the intervention, data were collected retrospectively for consecutive patients who underwent PCI in the following six months. Referral rate and changes in PRs were determined. Prior to the intervention, RR was 17.6%. Different barriers were identified, but the questionnaire revealed lack of physicians' awareness of CRBI and inconsistent referral patterns. After the intervention, RR increased to 88.96% (Odds Ratio 37.73, 95% CI 21.34-66.70, pEducation of providers and implementation of a formal referral system can improve RR and PR. Published by Elsevier B.V.

  11. Strengthening rehabilitation services in Indonesia: A brief situation analysis.

    Science.gov (United States)

    Nugraha, Boya; Setyono, Garry Rahardian; Defi, Irma Ruslina; Gutenbrunner, Christoph

    2018-04-18

    People with disability (PWD) in Indonesia are often neglected by society. Improving their life situation towards full participation in society is crucial. As a health strategy, rehabilitation can improve func-tioning, quality of life and participation in society. However, rehabilitation services in Indonesia need improvement. Making a situation analysis of rehabilitation services and their provision in the country is a pre-requisite to taking any action towards improvement. This paper compiles available data related to disability and rehabilitation services in Indonesia, using the Rehabilitation Services Assessment Tool (RSAT) as a framework. Gaps in provision were analysed, resulting in the compilation of a list of generic recommendations to improve rehabilitation services in the country. Indonesia faces many challenges in rehabilitation services, including the health workforce and the provision of services. This situation analysis and list of generic recommendations may be used in further discussions with relevant stakeholders in the country to develop a national strategy to strengthen rehabilitation services.

  12. Rehabilitative bodywork

    DEFF Research Database (Denmark)

    Hansen, Agnete Meldgaard

    2016-01-01

    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...... 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...

  13. Vehicle parts detection based on Faster - RCNN with location constraints of vehicle parts feature point

    Science.gov (United States)

    Yang, Liqin; Sang, Nong; Gao, Changxin

    2018-03-01

    Vehicle parts detection plays an important role in public transportation safety and mobility. The detection of vehicle parts is to detect the position of each vehicle part. We propose a new approach by combining Faster RCNN and three level cascaded convolutional neural network (DCNN). The output of Faster RCNN is a series of bounding boxes with coordinate information, from which we can locate vehicle parts. DCNN can precisely predict feature point position, which is the center of vehicle part. We design an output strategy by combining these two results. There are two advantages for this. The quality of the bounding boxes are greatly improved, which means vehicle parts feature point position can be located more precise. Meanwhile we preserve the position relationship between vehicle parts and effectively improve the validity and reliability of the result. By using our algorithm, the performance of the vehicle parts detection improve obviously compared with Faster RCNN.

  14. Cancer rehabilitation in Austria--aspects of Physical Medicine and Rehabilitation.

    Science.gov (United States)

    Maehr, Bruno; Keilani, Mohammad; Wiltschke, Christoph; Hassler, Marco; Licht, Thomas; Marosi, Christine; Huetterer, Elisabeth; Cenik, Fadime; Crevenna, Richard

    2016-02-01

    In Austria, cancer rehabilitation is an important issue in the management of cancer patients. Survival rates and survival time of cancer patients are increasing, and cancer rehabilitation is an important part in the treatment and care of cancer patients with the goal to improve functional status, quality of life, and (social) participation. Today, in Austria there are approximately 600 beds for inpatient rehabilitation. The field of outpatient rehabilitation will maybe be expanded after evaluating the existing pilot projects. Beside other specialities, the field of Physical Medicine and Rehabilitation (PM&R) plays an important role in cancer rehabilitation. In cancer rehabilitation, especially activating modalities from PM&R such as exercise are very important and well-accepted parts to improve functional status, quality of life, and participation of patients.

  15. [Neuro-rehabilitation after stroke].

    Science.gov (United States)

    Murie-Fernández, M; Irimia, P; Martínez-Vila, E; John Meyer, M; Teasell, R

    2010-04-01

    the high incidence of stroke results in significant mortality and disability leading to immense health care costs. These costs lead to socioeconomic, budgetary, and staffing repercussions in developing countries. Improvements in stroke management focus mainly on acute neurological treatment, admission to stroke units, fibrinolytic treatment for ischaemic strokes and rehabilitation processes. Among these, rehabilitation has the longest therapeutic window, can be applied in both ischaemic and haemorrhagic strokes, and can improve functional outcomes months after stroke. Neurologists, because of their knowledge in neuroanatomy, physiopathology, neuro-pharmacology, and brain plasticity, are in an ideal position to actively participate in the neurorehabilitation process. Several processes have been shown to play a role in determining the efficacy of rehabilitation; time from stroke onset to rehabilitation admission and the duration and intensity of treatment. neurorehabilitation is a sub-speciality in which neurologists should be incorporated into multidisciplinary neurorehabilitation teams. Early time to rehabilitation admission and greater intensity and duration of treatment are associated with better functional outcomes, lower mortality/institutionalisation, and shorter length of stay. In order to be efficient, a concerted effort must be made to ensure patients receive neurorehabilitation treatment in a timely manner with appropriate intensity to maximize patient outcomes during both inpatient and outpatient rehabilitation. Published by Elservier España, S.L. All rights reserved.

  16. Cardiac Rehabilitation Series: Canada

    Science.gov (United States)

    Grace, Sherry L.; Bennett, Stephanie; Ardern, Chris I.; Clark, Alexander

    2015-01-01

    Cardiovascular disease is among the leading causes of mortality and morbidity in Canada. Cardiac rehabilitation (CR) has a long robust history here, and there are established clinical practice guidelines. While the effectiveness of CR in the Canadian context is clear, only 34% of eligible patients participate, and strategies to increase access for under-represented groups (e.g., women, ethnic minority groups) are not yet universally applied. Identified CR barriers include lack of referral and physician recommendation, travel and distance, and low perceived need. Indeed there is now a national policy position recommending systematic inpatient referral to CR in Canada. Recent development of 30 CR Quality Indicators and the burgeoning national CR registry will enable further measurement and improvement of the quality of CR care in Canada. Finally, the Canadian Association of CR is one of the founding members of the International Council of Cardiovascular Prevention and Rehabilitation, to promote CR globally. PMID:24607018

  17. 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 chronic...... obstructive pulmonary disease. Design/methodology/approach – Empirically, the paper is based on interviews with and observations of rehabilitation therapists and patients taking part in a Danish telerehabilitation programme. Theoretically, the paper draws on Science and Technology Studies. Findings...... one ends. Practical implications – Evaluations of telecare technologies should pay more attention to workand responsibility-related effects of introducing telecare in order better to account for predicted and unpredicted as well as desirable and undesirable socio-technical changes. Originality/value...

  18. Publication trends of study protocols in rehabilitation.

    Science.gov (United States)

    Jesus, Tiago S; Colquhoun, Heather L

    2017-09-04

    Growing evidence points for the need to publish study protocols in the health field. To observe whether the growing interest in publishing study protocols in the broader health field has been translated into increased publications of rehabilitation study protocols. Observational study using publication data and its indexation in PubMed. Not applicable. Not applicable. PubMed was searched with appropriate combinations of Medical Subject Headings up to December 2014. The effective presence of study protocols was manually screened. Regression models analyzed the yearly growth of publications. Two-sample Z-tests analyzed whether the proportion of Systematic Reviews (SRs) and Randomized Controlled Trials (RCTs) among study protocols differed from that of the same designs for the broader rehabilitation research. Up to December 2014, 746 publications of rehabilitation study protocols were identified, with an exponential growth since 2005 (r2=0.981; p<0.001). RCT protocols were the most common among rehabilitation study protocols (83%), while RCTs were significantly more prevalent among study protocols than among the broader rehabilitation research (83% vs. 35.8%; p<0.001). For SRs, the picture was reversed: significantly less common among study protocols (2.8% vs. 9.3%; p<0.001). Funding was more often reported by rehabilitation study protocols than the broader rehabilitation research (90% vs. 53.1%; p<0.001). Rehabilitation journals published a significantly lower share of rehabilitation study protocols than they did for the broader rehabilitation research (1.8% vs.16.7%; p<0.001). Identifying the reasons for these discrepancies and reverting unwarranted disparities (e.g. low rate of publication for rehabilitation SR protocols) are likely new avenues for rehabilitation research and its publication. SRs, particularly those aggregating RCT results, are considered the best standard of evidence to guide rehabilitation clinical practice; however, that standard can be improved

  19. 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

  20. Valuing Non-market Benefits of Rehabilitation of Hydrologic Cycle Improvements in the Anyangcheon Watershed: Using Mixed Logit Models

    Science.gov (United States)

    Yoo, J.; Kong, K.

    2010-12-01

    This research the findings from a discrete-choice experiment designed to estimate the economic benefits associated with the Anyangcheon watershed improvements in Rep. of Korea. The Anyangcheon watershed has suffered from streamflow depletion and poor stream quality, which often negatively affect instream and near-stream ecologic integrity, as well as water supply. Such distortions in the hydrologic cycle mainly result from rapid increase of impermeable area due to urbanization, decreases of baseflow runoff due to groundwater pumping, and reduced precipitation inputs driven by climate forcing. As well, combined sewer overflows and increase of non-point source pollution from urban regions decrease water quality. The appeal of choice experiments (CE) in economic analysis is that it is based on random utility theory (McFadden, 1974; Ben-Akiva and Lerman, 1985). In contrast to contingent valuation method (CVM), which asks people to choose between a base case and a specific alternative, CE asks people to choice between cases that are described by attributes. The attributes of this study were selected from hydrologic vulnerability components that represent flood damage possibility, instreamflow depletion, water quality deterioration, form of the watershed and tax. Their levels were divided into three grades include status quo. Two grades represented the ideal conditions. These scenarios were constructed from a 35 orthogonal main effect design. This design resulted in twenty-seven choice sets. The design had nine different choice scenarios presented to each respondent. The most popular choice models in use are the conditional logit (CNL). This model provides closed-form choice probability calculation. The shortcoming of CNL comes from irrelevant alternatives (IIA). In this paper, the mixed logit (ML) is applied to allow the coefficient’s variation for random taste heterogeneity in the population. The mixed logit model(with normal distributions for the attributes) fit the

  1. [Cardiac rehabilitation: current status and future challenges].

    Science.gov (United States)

    Hahmann, H W

    2012-02-01

    The goal of cardiac rehabilitation is to support heart patients using a multidisciplinary team in order to obtain the best possible physical and mental health and achieve long-term social reintegration. In addition to improving physical fitness, cardiac rehabilitation restores self-confidence, thus better equipping patients to deal with mental illness and improving their social reintegration ("participation"). Once the causes of disease have been identified and treated as effectively as possible, drug and lifestyle changes form the focus of cardiac rehabilitation measures. In particular diseases, rehabilitation offers the opportunity for targeted educational courses for diabetics or drug dose escalation, as well as special training for heart failure patients. A nationwide network of outpatient heart groups is available for targeted follow-up. Cardiac patients predominantly rehabilitated in follow-up rehabilitation are older and have greater morbidity than in the past; moreover, they generally come out of acute clinical care earlier and are discharged from hospital more quickly. The proportion of severely ill and multimorbid patients presents a diagnostic and therapeutic challenge in cardiac rehabilitation, although cardiac rehabilitation was not initially conceived for this patient group. The benefit of cardiac rehabilitation has been a well documented reduction in morbidity and mortality. However, hurdles remain, partly due to the patients themselves, partly due to the health insurers. Some insurance providers still refuse rehabilitation for non-ST-segment elevation infarction. In principle rehabilitation can be carried out in an inpatient or an outpatient setting. Specific allocation criteria have not yet been established, but the structure and process quality of outpatient rehabilitation should correspond to that of the inpatient setting. The choice between the two settings should be based on pragmatic criteria. Both settings should be possible for an individual

  2. Early exercise-based rehabilitation improves health-related quality of life and functional capacity after acute myocardial infarction: a randomized controlled trial.

    Science.gov (United States)

    Peixoto, Thatiana C A; Begot, Isis; Bolzan, Douglas W; Machado, Lais; Reis, Michel S; Papa, Valeria; Carvalho, Antonio C C; Arena, Ross; Gomes, Walter J; Guizilini, Solange

    2015-03-01

    The purpose of this study was to evaluate the influence of an early cardiac rehabilitation (CR) program on health-related quality of life (HRQL) and functional capacity in patients who recently experienced an acute myocardial infarction (AMI). This program was initiated in the inpatient setting and was followed by an unsupervised outpatient intervention. After the same inpatient care plan, low-risk patients who experienced an AMI were randomized into 2 groups: (1) a control group (CG) (n = 43) entailing usual care and (2) an intervention group (IG) (n = 45) entailing outpatient (unsupervised) CR primarily centered on a progressive walking program. Initially, all patients underwent a supervised exercise program with early mobilization beginning 12 hours after an AMI. On hospital discharge, all patients were classified according to cardiovascular risk. Quality of life was evaluated by the MacNew Heart Disease HRQL questionnaire 30 days after discharge. Functional capacity was determined by a 6-minute walk test (6MWT) distance on the day of inpatient discharge as well as 30 days afterward. The HRQL global score was higher in the IG compared with the CG 30 days after discharge (P exercises, initiated by supervised inpatient training and followed by an unsupervised outpatient program, improved HRQL and functional capacity in patients at low cardiovascular risk who recently experienced an AMI. Copyright © 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. Alberta Environment's weir safety program : options for rehabilitation to improve public safety : a case study of the Calgary weir

    Energy Technology Data Exchange (ETDEWEB)

    Blakely, D. [Alberta Environment, Edmonton, AB (Canada)

    2009-07-01

    Alberta Environment Water Management Operations (WMO) owns and operates 46 dams and 800 kilometres of canals in Alberta. The WMO consists of 120 staff and several contract operators to take care of this infrastructure. Most of the infrastructure supplies water for irrigation use, which adds 5 billion dollars to the provincial economy annually. Other water uses include stock watering, domestic use, municipal use, recreational use and habitat. Alberta Environment's weir safety program was also discussed along with options for rehabilitation to improve public safety. A case study of Calgary's Weir Dam on the Bow River was highlighted. A brief history of the dam was offered and safety programs around provincially-owned weirs were discussed. Photographs were included to illustrate some of the additional safety measures at the Calgary weir, such as suspended safety buoys upstream of the boom directing paddlers to the portage trail, and signage on the river that can be activated when the boom is out. Typical river users on the Calgary Bow River and safety history at the Calgary Weir were discussed along with other topics such as the Calgary Bow River weir project criteria; project design progress; pre-feasibility options; scale modelling; final design analysis; construction funding; and proposed changes to the safety program for the new weir configuration. figs.

  4. Alberta Environment's weir safety program : options for rehabilitation to improve public safety : a case study of the Calgary weir

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-07-01

    Alberta Environment's water management operations (WMO) own and operates 46 dams and 800 km of canals. This presentation discussed a rehabilitation program designed to improve the safety of the WMO's Calgary weir which was built in 1908 to encourage settlement in the province. The weir includes a 32 m wide sluiceway, a 2.5 m concrete weir, and a fish ladder. A portage trail has been built to accommodate canoes, and signs are posted to indicate the hazards associated with the weir. The WMO has also launched an advertising campaign to outline hazards to the general public. The WMO has a contract with the Calgary fire department (CFD) to maintain a safety boom and provide rescue operations at the weir. The weir project aims to accommodate access and safety while enhancing flood conveyance capabilities of the weir. The project will allow upstream passage for patrol boats operated by the Calgary fire department's aquatic rescue service. The final design of the weir will include a series of drops constructed downstream of the weir to create pool and riffle structures that will eliminate hydraulic rollers. Notches will be cut in the weir to regulate flows moving through the new low and high flow channels. Case studies of other low-head dams operated by the WMO were also presented. tabs., figs.

  5. Immediate Return to Ambulation and Improved Functional Capacity for Rehabilitation in Complex Regional Pain Syndrome following Early Implantation of a Spinal Cord Stimulation System

    Directory of Open Access Journals (Sweden)

    Brandon Jesse Goff

    2014-01-01

    Full Text Available Complex regional pain syndrome (CRPS is a neuropathic pain condition that is characterized by vasomotor, sensory, sudomotor, and motor symptoms. Spinal cord stimulation (SCS has been successfully utilized for the treatment of pain refractory to conventional therapies. We present a case of a previously highly functioning 54-year-old female who developed a rarely reported case of idiopathic CRPS of the right ankle which spontaneously occurred four months after an uncomplicated anterior cervical disc fusion. This condition resulted in severe pain and functional impairment that was unresponsive to pharmacological management. The patient’s rehabilitation was severely stymied by her excruciating pain. However, with the initiation of spinal cord stimulation, her pain was adequately controlled allowing for progression to full unassisted ambulation, advancing functional capacity, and improving quality of life. This case report supports the concept that rapid progression to neuromodulation, rather than delays that occur due to attempts at serial sympathetic blocks, may better control symptoms leading allowing for a more meaningful recovery.

  6. Innovations for competitiveness: European views on "better-faster-cheaper"

    Science.gov (United States)

    Atzei, A.; Groepper, P.; Novara, M.; Pseiner, K.

    1999-09-01

    The paper elaborates on " lessons learned" from two recent ESA workshops, one focussing on the role of Innovation in the competitiveness of the space sector and the second on technology and engineering aspects conducive to better, faster and cheaper space programmes. The paper focuses primarily on four major aspects, namely: a) the adaptations of industrial and public organisations to the global market needs; b) the understanding of the bottleneck factors limiting competitiveness; c) the trends toward new system architectures and new engineering and production methods; d) the understanding of the role of new technology in the future applications. Under the pressure of market forces and the influence of many global and regional players, applications of space systems and technology are becoming more and more competitive. It is well recognised that without major effort for innovation in industrial practices, organisations, R&D, marketing and financial approaches the European space sector will stagnate and loose its competence as well as its competitiveness. It is also recognised that a programme run according to the "better, faster, cheaper" philosophy relies on much closer integration of system design, development and verification, and draws heavily on a robust and comprehensive programme of technology development, which must run in parallel and off-line with respect to flight programmes. A company's innovation capabilities will determine its future competitive advantage (in time, cost, performance or value) and overall growth potential. Innovation must be a process that can be counted on to provide repetitive, sustainable, long-term performance improvements. As such, it needs not depend on great breakthroughs in technology and concepts (which are accidental and rare). Rather, it could be based on bold evolution through the establishment of know-how, application of best practices, process effectiveness and high standards, performance measurement, and attention to

  7. Shampoo-clay heals diaper rash faster than calendula officinalis.

    Science.gov (United States)

    Adib-Hajbaghery, Mohsen; Mahmoudi, Mansoreh; Mashaiekhi, Mahdi

    2014-06-01

    Diaper rash is one of the most common skin disorders of infancy and childhood. Some studies have shown that Shampoo-clay was effective to treat chronic dermatitis. Then, it is supposed that it may be effective in diaper rash; however, no published studies were found in this regard. This study aimed to compare the effects of Shampoo-clay (S.C) and Calendula officinalis (C.O) to improve infantile diaper rash. A randomized, double blind, parallel controlled, non-inferiority trial was conducted on 60 outpatient infants referred to health care centers or pediatric clinics in Khomein city and diagnosed with diaper rash. Patients were randomly assigned into two treatment groups including S.C group (n = 30) and C.O group (n = 30) by using one to one allocation ratio. The rate of complete recovery in three days was the primary outcome. Data was collected using a checklist and analyzed using t-test, Chi-square and Fisher's exact tests and risk ratio. Totally, 93.3% of lesions in the S.C group healed in the first 6 hours, while this rate was 40% in C.O group (P < 0.001). The healing ratio for improvement in the first 6 hours was 7 times more in the S.C group. In addition, 90% of infants in the SC group and 36.7% in the C.O group were improved completely in the first 3 days (P < 0.001). S.C was effective to heal diaper rash, and also had faster effects compared to C.O.

  8. Guidelines for postdoctoral training in rehabilitation psychology.

    Science.gov (United States)

    Stiers, William; Hanson, Stephanie; Turner, Aaron P; Stucky, Kirk; Barisa, Mark; Brownsberger, Mary; Van Tubbergen, Marie; Ashman, Teresa; Kuemmel, Angela

    2012-11-01

    This article describes the methods and results of a national conference that was held to (1) develop consensus guidelines about the structure and process of rehabilitation psychology postdoctoral training programs and (2) create a Council of Rehabilitation Psychology Postdoctoral Training Programs to promote training programs' abilities to implement the guidelines and to formally recognize programs in compliance with the guidelines. Forty-six conference participants were chosen to include important stakeholders in rehabilitation psychology, representatives of rehabilitation psychology training and practice communities, representatives of psychology accreditation and certification bodies, and persons involved in medical education practice and research. Consensus guidelines were developed for rehabilitation psychology postdoctoral training program structure and process and for establishing the Council of Rehabilitation Psychology Postdoctoral Training Programs. The Conference developed aspirational guidelines for postdoctoral education and training programs in applied rehabilitation psychology and established a Council of Rehabilitation Psychology Postdoctoral Training Programs as a means of promoting their adoption by training programs. These efforts are designed to promote quality, consistency, and excellence in the education and training of rehabilitation psychology practitioners and to promote competence in their practice. It is hoped that these efforts will stimulate discussion, assist in the development of improved teaching and evaluation methods, lead to interesting research questions, and generally facilitate the continued systematic development of the profession of rehabilitation psychology. PsycINFO Database Record (c) 2012 APA, all rights reserved

  9. A prospective interrupted time series study of interventions to improve the quality, rating, framing and structure of goal-setting in community-based brain injury rehabilitation.

    Science.gov (United States)

    Hassett, Leanne; Simpson, Grahame; Cotter, Rachel; Whiting, Diane; Hodgkinson, Adeline; Martin, Diane

    2015-04-01

    To investigate whether the introduction of an electronic goals system followed by staff training improved the quality, rating, framing and structure of goals written by a community-based brain injury rehabilitation team. Interrupted time series design. Two interventions were introduced six months apart. The first intervention comprised the introduction of an electronic goals system. The second intervention comprised a staff goal training workshop. An audit protocol was devised to evaluate the goals. A random selection of goal statements from the 12 months prior to the interventions (Time 1 baseline) were compared with all goal statements written after the introduction of the electronic goals system (Time 2) and staff training (Time 3). All goals were de-identified for client and time-period, and randomly ordered. A total of 745 goals (Time 1 n = 242; Time 2 n = 283; Time 3 n = 220) were evaluated. Compared with baseline, the introduction of the electronic goals system alone significantly increased goal rating, framing and structure (χ(2) tests 144.7, 18.9, 48.1, respectively, p goal quality, which was only a trend at Time 2, was statistically significant at Time 3 (χ(2) 15.0, p ≤ 001). The training also led to a further significant increase in the framing and structuring of goals over the electronic goals system (χ(2) 11.5, 12.5, respectively, p ≤ 0.001). An electronic goals system combined with staff training improved the quality, rating, framing and structure of goal statements. © The Author(s) 2014.

  10. Computer-aided cognitive rehabilitation improves cognitive performances and induces brain functional connectivity changes in relapsing remitting multiple sclerosis patients: an exploratory study.

    Science.gov (United States)

    Bonavita, S; Sacco, R; Della Corte, M; Esposito, S; Sparaco, M; d'Ambrosio, A; Docimo, R; Bisecco, A; Lavorgna, L; Corbo, D; Cirillo, S; Gallo, A; Esposito, F; Tedeschi, G

    2015-01-01

    To better understand the effects of short-term computer-based cognitive rehabilitation (cCR) on cognitive performances and default mode network (DMN) intrinsic functional connectivity (FC) in cognitively impaired relapsing remitting (RR) multiple sclerosis (MS) patients. Eighteen cognitively impaired RRMS patients underwent neuropsychological evaluation by the Rao's brief repeatable battery and resting-state functional magnetic resonance imaging to evaluate FC of the DMN before and after a short-term (8 weeks, twice a week) cCR. A control group of 14 cognitively impaired RRMS patients was assigned to an aspecific cognitive training (aCT), and underwent the same study protocol. Correlations between DMN and cognitive performances were also tested. After cCR, there was a significant improvement of the following tests: SDMT (p Color-Word Interference Test and FC in the PCC emerged. After aCT, the control group did not show any significant effect either on FC or neuropsychological tests. No significant differences were found in brain volumes and lesion load in both groups when comparing data acquired at baseline and after cCR or aCT. In cognitively impaired RRMS patients, cCR improves cognitive performances (i.e., processing speed and visual and verbal sustained memory), and increases FC in the PCC and IPC of the DMN. This exploratory study suggests that cCR may induce adaptive cortical reorganization favoring better cognitive performances, thus strengthening the value of cognitive exercise in the general perspective of building either cognitive or brain reserve.

  11. What is needed to implement a web-based audit and feedback intervention with outreach visits to improve care quality: A concept mapping study among cardiac rehabilitation teams.

    Science.gov (United States)

    van Engen-Verheul, Mariëtte M; Peek, Niels; Haafkens, Joke A; Joukes, Erik; Vromen, Tom; Jaspers, Monique W M; de Keizer, Nicolette F

    2017-01-01

    Evidence on successful quality improvement (QI) in health care requires quantitative information from randomized clinical trials (RCTs) on the effectiveness of QI interventions, but also qualitative information from professionals to understand factors influencing QI implementation. Using a structured qualitative approach, concept mapping, this study determines factors identified by cardiac rehabilitation (CR) teams on what is needed to successfully implement a web-based audit and feedback (A&F) intervention with outreach visits to improve the quality of CR care. Participants included 49 CR professionals from 18 Dutch CR centres who had worked with the A&F system during a RCT. In three focus group sessions participants formulated statements on factors needed to implement QI successfully. Subsequently, participants rated all statements for importance and feasibility and grouped them thematically. Multi dimensional scaling was used to produce a final concept map. Forty-two unique statements were formulated and grouped into five thematic clusters in the concept map. The cluster with the highest importance was QI team commitment, followed by organisational readiness, presence of an adequate A&F system, access to an external quality assessor, and future use and functionalities of the A&F system. Concept mapping appeared efficient and useful to understand contextual factors influencing QI implementation as perceived by healthcare teams. While presence of a web-based A&F system and external quality assessor were seen as instrumental for gaining insight into performance and formulating QI actions, QI team commitment and organisational readiness were perceived as essential to actually implement and carry out these actions. These two sociotechnical factors should be taken into account when implementing and evaluating the success of QI implementations in future research. Copyright © 2016. Published by Elsevier Ireland Ltd.

  12. Bird on Your Smartphone: How to make identification faster?

    Science.gov (United States)

    Hidayat, T.; Kurniawan, I. S.; Tapilow, F. S.

    2018-01-01

    Identification skills of students are needed in the field activities of animal ecology course. Good identification skills will help students to understand the traits, determine differences and similarities in order to naming of birds’ species. This study aims to describe the identification skill of students by using smart phone applications designed in such a way as a support in the field activities. Research method used was quasi experiment involving 60 students which were divided into two groups, one group that use smartphone applications (SA) and other group using a guidebook (GB). This study was carried out in the classroom and outside (the field). Instruments used in this research included tests and questionnaire. The identification skills were measured by tests, indicated by an average score (AS). The results showed that the identification skills of SA students were higher (AS = 3.12) than those of GB one (AS = 2.91). These results are in accordance with response of students. The most of students (90.08%) mentioned that the use of smart phone applications in identifying birds is helpful, more effective and convenience to make identification faster. For further implementation, however, performance of the smartphone used here need to be enhanced to improve the identification skills of students and for wider use.

  13. Skin graft donor site: a procedure for a faster healing.

    Science.gov (United States)

    Cuomo, Roberto; Grimaldi, Luca; Brandi, Cesare; Nisi, Giuseppe; D'Aniello, Carlo

    2017-10-23

    The authors want to evaluate the efficacy of fibrillary tabotamp dressing in skin graft-donor site. A comparison was made with Vaseline gauzes. Tabotamp is an absorbable haemostatic product of Ethicon (Johnson and Johnson) obtained by sterile and oxidized regenerated cellulose (Rayon). It is used for mild to moderate bleeding. 276 patients were subject to skin graft and divided into two group: Group A and Group B. The donor site of patients in Group A was medicated with fibrillary tabotamp, while the patients of Group B were medicated only with Vaseline gauze. We recorded infection, timing of healing, number of dressing change, the pain felt during and after the dressing change with visual analog scale (VAS) and a questionnaire. Patients allocated in Group A healed faster than the Group B. Questionnaires and VAS analysis showed lower pain felt, lower intake of pain drugs and lower infection rate in the Group A than the Group B. Analysis of coast showed lower dressing change in Group A than the Group B. We believe that the use of tabotamp is a very viable alternative to improve healing.

  14. Journal of Rehabilitation Research and Development.

    Science.gov (United States)

    1984-05-01

    unilateral above-knee amputees prosthetically rehabilitated; none were bedridden . Those walked with both a prosthesis with one of several types with one or...speeds, amputees walked faster with Oxygen Consumption of Elderly Persons With Bilat- hydraulic units, increasing cadence, rather than stride eral Below...logically less demanding for elderly bilateral below-knee mitted during the past twelve years, 103 subsequentl amputees than prosthetic ambulation, and

  15. Virtual reality in rehabilitation after stroke

    Directory of Open Access Journals (Sweden)

    Krasnova-Goleva V.V.

    2016-01-01

    Full Text Available After a stroke many people have serious problems in motion activity, decline in cognitive activity, as well as a number of psychological problems that may accompany the man for many years. Motivational rehabilitation component plays a decisive role in the process of recovery after suffering a stroke. At present one of the most successful methods of rehabilitation is considered to be a recovery through "observation-imitation”, because this method enhances the plasticity of the brain and, as a result, rehabilitation potential. Modern rehabilitation using virtual reality had demonstrated good results to improve motor and cognitive skills, as well as the psychological condition

  16. [Indications and approaches in rehabilitation with children].

    Science.gov (United States)

    Petermann, F; Bauer, C-P

    2011-04-01

    Against the background of rising prevalence of chronic diseases in childhood and adolescence, the rehabilitation of children and adolescents plays a major role in medical treatment. Early diagnosis and multimodal intervention are necessary to prevent a chronic course of disease and disease consequences for those affected and their families. In recent years, significant content and structural improvement of child and youth rehabilitation has been observed; currently some trends that affect not only the access to rehabilitation but also the quality of outcomes are becoming apparent. These include salutogenetic approaches, the development of specific diagnostic and treatment guidelines, the establishment of networks, integrated care, modularization, and flexibility of rehabilitation measures.

  17. Cortex Matures Faster in Youths With Highest IQ

    Science.gov (United States)

    ... NIH Cortex Matures Faster in Youths With Highest IQ Past Issues / Summer 2006 Table of Contents For ... on. Photo: Getty image (StockDisc) Youths with superior IQ are distinguished by how fast the thinking part ...

  18. Quantum mechanics and faster-than-light communication: methodological considerations

    International Nuclear Information System (INIS)

    Ghirardi, G.C.; Weber, T.

    1983-06-01

    A detailed quantum mechanical analysis of a recent proposal of faster than light communication through wave packet reduction is performed. The discussion allows us to focus on some methodological problems about critical investigations in physical theories. (author)

  19. 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

  20. [Neuroplasticity as a basis for early rehabilitation of stroke patients].

    Science.gov (United States)

    Putilina, M V

    2011-01-01

    The review is devoted to the current state of the problem of early rehabilitation of stroke patients. The rate of primary disability in patients after stroke is 3.2 per 10000 population but only 20% of previously working patients return to work. Early rehabilitation is treatment actions during a period following stroke. Adequate treatment during this period may decrease the extent of brain damage and improve disease outcome. The complexity of rehabilitation consists in using several complementary pharmacological and non-pharmacological rehabilitation measures. Appearance of new techniques of rehabilitation treatment aimed at neuroplasticity stimulation increases treatment potential of rehabilitative technologies.

  1. The Danish Cardiac Rehabilitation Database

    DEFF Research Database (Denmark)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne

    2016-01-01

    hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. CONCLUSION: The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD......AIM OF DATABASE: The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). STUDY POPULATION: Hospitalized patients with CHD with stenosis on coronary angiography treated...... with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date...

  2. Quality of Life and Assessment of Efficacy of Rehabilitation on Improvement of Quality of Llife and its Subtypes after PCI in Qom

    Directory of Open Access Journals (Sweden)

    Abolfazl Mozafari

    2015-08-01

    Full Text Available Abstract Background: Cardiovascular diseases is one of the most prevalent causes of mortality in all around the world accounting for high rates of decrease of physical function and daily work. The aim of this study is to assess the effect of cardiac rehabilitation on quality of life dimensions Percutanous Coronary Intervention (PCI patients. Materials and Methods: This clinical trial study was conducted on 96 patients in the rehabilitation unit in Qom. Half of patients put in the test group and the others remained as control. Data of all patients including of demographic parameter and questionnaire of quality of life before and after rehabilitation (in case and control groups were collected. Data analysis was done in SPSS 18by central statistical indices and frequency distribution as well as independent t-test, pair t-test ans Chi-square and p-value below than 0.05 was significant. Results: out of 96 patients, the mean age was 57.21±9.09 and 57.3± 10.89 years in case and control groups respectively and 70.8% were male and remains were female. There was significant relationship between quality of life and its subtypes except physical function (p<0.001. Moreover, difference between quality of life and six out of eight subtypes scores before and after rehabilitation in both groups was significant. Conclusion: it seems that cardiac rehabilitation after PCI affects quality of life.

  3. Among Patients Undergoing Ablative Treatment for Oral Cancer, Does the Provision of Oral Rehabilitation Improve the Quality of Life? A Review of the Current Literature.

    Science.gov (United States)

    Petrosyan, Vahe; Ball, Dimity; Harrison, Rebecca; Ameerally, Phillip

    2016-05-01

    The impact of oral cancer and its treatment is well documented; therefore, oral rehabilitation (OH; eg, with prosthetics, osseointegrated implants, etc) can be indicated to restore some level of form, function, and well-being. The purpose of this study was to review the current literature and evaluate the impact of OH on quality of life (QoL) after ablative surgery. A systematic literature search was conducted using EMBASE, MEDLINE, and PsychINFO. The study population was composed of all articles published from 2000 to 2015. To be included, studies had to use validated, specific head and neck QoL measurements (European Organization for Research and Treatment of Cancer QoL Head and Neck Module or University of Washington QoL Questionnaire). Only 8 articles met these inclusion criteria. In this review, OH was the primary predictor variable and QoL was the primary outcome variable. The 8 articles reviewed used a range of designs, including 1 randomized controlled trial, 3 prospective cohort studies, 3 case series, and 1 single-measurement cross-sectional descriptive study. Sample sizes were small (n = 26 to 102), and there was limited randomization and control of intervention and comparator groups. The overall level of evidence was weak. All studies showed a link between OH and QoL, but the results varied in significance (P < .01 to P = .95). Overall, there appears to be improvement in QoL to varying degrees after OH. However, a more systematic use of QoL measurements is needed before any definitive conclusions can be drawn. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  4. Pilot model of the rehabilitating treatment of self-esteem and behavior in adolescents with dyslexia and dysortography through their literate improvement

    Directory of Open Access Journals (Sweden)

    Linda Zuppardo

    2017-08-01

    Full Text Available Clinical and educational research has highlighted the emotional and motivational factors that characterize learning difficulties. The main objective of this research is to assess the effects of rehabilitative treatment on self-esteem and behavior in a group of patients diagnosed with dyslexia and dysortography. To 60 students with a diagnosis of dyslexia, at first, they will be given a battery of tests, to assess the emotional and behavioral profile. Afterwards, the experimental group will undergo a rehabilitation treatment that aspires to enhance the performance in reading and writing. In summary, the results show that, through an adequate rehabilitation course with the support of adequate instruments, dyslexic patients can achieve greater self-confidence and a consequent greater self-esteem.

  5. 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.

  6. 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.

  7. Does the addition of virtual reality training to a standard program of inpatient rehabilitation improve sitting balance ability and function after stroke? Protocol for a single-blind randomized controlled trial.

    Science.gov (United States)

    Sheehy, L; Taillon-Hobson, A; Sveistrup, H; Bilodeau, M; Fergusson, D; Levac, D; Finestone, H

    2016-03-31

    Sitting ability and function are commonly impaired after stroke. Balance training has been shown to be helpful, but abundant repetitions are required for optimal recovery and patients must be motivated to perform rehabilitation exercises repeatedly to maximize treatment intensity. Virtual reality training (VRT), which allows patients to interact with a virtual environment using computer software and hardware, is enjoyable and may encourage greater repetition of therapeutic exercises. However, the potential for VRT to promote sitting balance has not yet been explored. The objective of this study is to determine if supplemental VRT-based sitting balance exercises improve sitting balance ability and function in stroke rehabilitation inpatients. This is a single-site, single-blind, parallel-group randomized control trial. Seventy six stroke rehabilitation inpatients who cannot stand independently for greater than one minute but can sit for at least 20 minutes (including at least one minute without support) are being recruited from a tertiary-care dedicated stroke rehabilitation unit. Participants are randomly allocated to experimental or control groups. Both participate in 10-12 sessions of 30-45 minutes of VRT performed in sitting administered by a single physiotherapist, in addition to their traditional therapy. The experimental group plays five games which challenge sitting balance while the control group plays five games which minimize trunk lean. Outcome measures of sitting balance ability (Function in Sitting Test, Ottawa Sitting Scale, quantitative measures of postural sway) and function (Reaching Performance Scale, Wolf Motor Function Test, quantitative measures of the limits of stability) are administered prior to, immediately following, and one month following the intervention by a second physiotherapist blind to the participant's group allocation. The treatment of sitting balance post-stroke with VRT has not yet been explored. Results from the current study

  8. Rehabilitation interventions in multiple sclerosis: an overview.

    Science.gov (United States)

    Beer, Serafin; Khan, Fary; Kesselring, Jürg

    2012-09-01

    Multiple sclerosis is a complex, heterogeneous disease associated with long-term disability. Despite the availability of advanced disease-modifying and symptomatic therapies that may decrease activity and progression of disease and alleviate complaints to a certain extent, there is still a need for comprehensive rehabilitation interventions in order to reduce sequels and symptoms of the disease on personal activities and social participation to achieve the highest possible independence and the best quality of life. Timing and setting of rehabilitation interventions should be selected individually depending on disease phase, functional deficits, personal requirements, as well as specific goals. In addition, limitations and disease-specific characteristics that may influence rehabilitation outcome should be noted. Rehabilitation interventions should be considered early for maintaining functional capacity and reducing risk for losing important abilities or independence. Due to gradual failure of adaptive compensatory mechanisms along the course of disease, benefits of rehabilitation interventions are generally higher in earlier phases of MS. Inpatient and outpatient multidisciplinary rehabilitation has been shown to be beneficial in improving disability, participation and quality of life despite progression of the disease. Good evidence exists for different specific interventions improving physical and cognitive performance. Other important issues responsible for beneficial effects of comprehensive rehabilitation in MS include education, instruction, and information of patients and caregivers. Comprehensive assessment of health domains in MS patients using standardized framework and common language for describing the impact of disease at different levels, using International Classification of Functioning, Disability and Health (ICF) core sets may increase the knowledge of needs of these patients for more efficient and adapted rehabilitation interventions meeting these

  9. Effect of Cognitive Rehabilitation on Improving Cognitive Function and Activities of Daily Living among Elderly Patients with Stroke at Assiut University Hospital

    Science.gov (United States)

    Abd-Elaziz, Saieda Abd-Elhameed; Khedr, Eman M.; Ahmed, Hanaa Abd Elhakiem; Ibrahim, Hoda Diab Fahmy

    2015-01-01

    Cognitive impairment is a frequent consequence of stroke. The study aimed to measure the effect of cognitive rehabilitation of elderly patients with stroke on their cognitive function and activities of daily living. Quasi experimental research design were used in this study. This study was conducted at neuropsychiatric, physical medicine and…

  10. Effectiveness of rehabilitation interventions in improving emotional and functional status in hearing or visually impaired older adults : a systematic review with meta-analyses

    NARCIS (Netherlands)

    Roets-Merken, Lieve M.; Draskovic, Irena; Zuidema, Sytse U.; van Erp, Willemijn S.; Graff, Maud J. L.; Kempen, Gertrudis I. J. M.; Vernooij-Dassen, Myrra J. F. J.

    Objective: To assess the effectiveness of non-equipment based rehabilitation interventions for older adults with an age-related hearing or visual impairment. Data sources: We searched PubMed, EMBASE, PsychInfo, CINAHL, and the Cochrane Central Register of Controlled Trials. Review methods: Two

  11. Rehabilitation in Guillian Barre syndrome.

    Science.gov (United States)

    Khan, Fary

    2004-12-01

    Guillian Barre syndrome (GBS) is the most common form of neuromuscular paralysis. It mostly affects young people and can cause long-term residual disability. This article outlines the rehabilitation treatment for patients recovering from GBS. Recovery from GBS can be prolonged. Early rehabilitation intervention ensures medical stability, appropriate treatment and preventive measures to minimise long term complications. Specific problems include deep venous thrombosis prevention, complications of immobility, dysautonomia, de-afferent pain syndromes, muscle pain and fatigue. Longer-term issues include psychosocial adjustment, return to work and driving, and resumption of the role within the family and community. Effective communication between the GP and rehabilitation physicians is imperative for improved functional outcomes and successful social reintegration.

  12. 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 ...

  13. Advances in rehabilitation medicine.

    Science.gov (United States)

    Ng, Yee Sien; Chew, Effie; Samuel, Geoffrey S; Tan, Yeow Leng; Kong, Keng He

    2013-10-01

    Rehabilitation medicine is the medical specialty that integrates rehabilitation as its core therapeutic modality in disability management. More than a billion people worldwide are disabled, and the World Health Organization has developed the International Classification of Functioning, Disability and Health as a framework through which disability is addressed. Herein, we explore paradigm shifts in neurorehabilitation, with a focus on restoration, and provide overviews on developments in neuropharmacology, rehabilitation robotics, virtual reality, constraint-induced therapy and brain stimulation. We also discuss important issues in rehabilitation systems of care, including integrated care pathways, very early rehabilitation, early supported discharge and telerehabilitation. Finally, we highlight major new fields of rehabilitation such as spasticity management, frailty and geriatric rehabilitation, intensive care and cancer rehabilitation.

  14. Pipeline rehabilitation planning

    Energy Technology Data Exchange (ETDEWEB)

    Palmer-Jones, Roland; Hopkins, Phil; Eyre, David [PENSPEN (United Kingdom)

    2005-07-01

    An operator faced with an onshore pipeline that has extensive damage must consider the need for rehabilitation, the sort of rehabilitation to be used, and the rehabilitation schedule. This paper will consider pipeline rehabilitation based on the authors' experiences from recent projects, and recommend a simple strategy for planning pipeline rehabilitation. It will also consider rehabilitation options: external re-coating; internal lining; internal painting; programmed repairs. The main focus will be external re-coating. Consideration will be given to rehabilitation coating types, including tape wraps, epoxy, and polyurethane. Finally it will discuss different options for scheduling the rehabilitation of corrosion damage including: the statistical comparison of signals from inspection pigs; statistical comparison of selected measurements from inspection pigs and other inspections; the use of corrosion rates estimated for the mechanisms and conditions; expert judgement. (author)

  15. 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 ...

  16. 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 ...

  17. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... 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 Life After Pediatric Spinal Injury Dawn Sheaffer, MSW Rehabilitation ...

  18. 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.

  19. 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.

  20. Integrated mental health care and vocational rehabilitation to improve return to work rates for people on sick leave because of depression and anxiety (the Danish IBBIS trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Poulsen, Rie; Hoff, Andreas; Fisker, Jonas; Hjorthøj, Carsten; Eplov, Lene Falgaard

    2017-12-02

    Depression and anxiety are among the largest contributors to the global burden of disease and have negative effects on both the individual and society. Depression and anxiety are very likely to influence the individual's work ability, and up to 40% of the people on sick leave in Denmark have depression and/or anxiety. There is no clear evidence that treatment alone will provide sufficient support for vocational recovery in this group. Integrated vocational and health care services have shown good effects on return to work in other, similar welfare contexts. The purpose of the IBBIS (Integrated Mental Health Care and Vocational Rehabilitation to Individuals on Sick Leave Due to Anxiety and Depression) interventions is to improve and hasten the process of return to employment for people in Denmark on sick leave because of depression and anxiety. This three-arm, parallel-group, randomized superiority trial has been set up to investigate the effectiveness of the IBBIS mental health care intervention and the integrated IBBIS mental health care and IBBIS vocational rehabilitation intervention for people on sick leave because of depression and/or anxiety in Denmark. The trial has an investigator-initiated multicenter design. A total of 603 patients will be recruited from Danish job centers in 4 municipalities and randomly assigned to one of 3 groups: (1) IBBIS mental health care integrated with IBBIS vocational rehabilitation, (2) IBBIS mental health care and standard vocational rehabilitation, and (3) standard mental health care and standard vocational rehabilitation. The primary outcome is register-based return to work at 12 months. The secondary outcome measures are self-assessed level of depression (Beck Depression Inventory II), anxiety (Beck Anxiety Inventory), stress symptoms (Four-Dimensional Symptom Questionnaire), work and social functioning (Work and Social Adjustment Scale), and register-based recurrent sickness absence. This study will provide new knowledge

  1. Pulmonary Rehabilitation

    Science.gov (United States)

    ... Your PR team will teach you about the importance of vaccinations and other ways to prevent infections. ... of the program will show whether your symptoms, physical activity level, and quality of life have improved. If ...

  2. Experiences of recruiting to a pilot trial of Cardiac Rehabilitation In patients with Bowel cancer (CRIB) with an embedded process evaluation: lessons learned to improve recruitment.

    Science.gov (United States)

    Hubbard, Gill; Campbell, Anna; Davies, Zoe; Munro, Julie; Ireland, Aileen V; Leslie, Stephen; Watson, Angus Jm; Treweek, Shaun

    2015-01-01

    Recruitment to randomised controlled trials (RCTs) is a perennial problem. Calls have been made for trialists to make recruitment performance publicly available. This article presents our experience of recruiting to a pilot RCT of cardiac rehabilitation for patients with bowel cancer with an embedded process evaluation. Recruitment took place at three UK hospitals. Recruitment figures were based on the following: i) estimated number of patient admissions, ii) number of patients likely to meet inclusion criteria from clinician input and iii) recruitment rates in previous studies. The following recruitment procedure was used:Nurse assessed patients for eligibility.Patients signed a screening form indicating interest in and agreement to be approached by a researcher about the study.An appointment was made at which the patient signed a consent form and was randomised to the intervention or control group. Information about all patients considered for the study and subsequently included or excluded at each stage of the recruitment process and reasons given were recorded. There were variations in the time taken to award Research Management approval to run the study at the three sites (45-359 days). Sixty-two percent of the original recruitment estimate was reached. The main reason for under-recruitment was due to over-estimation of the number of patient admissions; other reasons were i) not assessing all patients for eligibility, ii) not completing a screening form for eligible patients and iii) patients who signed a screening form being lost to the study before consenting and randomisation. Pilot trials should not simply aim to improve recruitment estimates but should also identify factors likely to influence recruitment performance in a future trial and inform the development of that trial's recruitment strategies. Pilot trials are a crucial part of RCT design. Nevertheless, pilot trials are likely to be small scale, involving only a small number of sites, and

  3. Rehabilitation of disturbed land

    Energy Technology Data Exchange (ETDEWEB)

    Bell, L.C. [Australian Centre for Minesite Rehabilitation Research, Kenmore, Qld. (Australia)

    1996-12-31

    This chapter discusses the objectives of rehabilitation of lands in Australian disturbed by mining. It gives advice on rehabilitation planning and outlines the factors influencing post-mining land use and rehabilitation strategies, including climate, topography, hydrology, properties of soils, overburden and mineral processing wastes, flora and fauna and social considerations. Finally, the key elements of a rehabilitation plan are discussed, namely: landscape reconstruction; selective handling of overburden; and establishment and maintenance of a vegetative cover. 12 figs., 1 tab.

  4. New analytical approaches for faster or greener phytochemical analyses

    NARCIS (Netherlands)

    Shen, Y.

    2015-01-01

    Summary

    Chapter 1 provides a short introduction into the constraints of phytochemical analysis. In order to make them faster, less laborious and greener, there is a clear scope for miniaturized and simplified sample preparation, solvent-free extractions

  5. ZKBoo: Faster Zero-Knowledge for Boolean Circuits

    DEFF Research Database (Denmark)

    Giacomelli, Irene; Madsen, Jesper; Orlandi, Claudio

    2016-01-01

    variants of IKOS, which highlights their pros and cons for practically rele- vant soundness parameters; ◦ A generalization and simplification of their approach, which leads to faster Σ-protocols (that can be made non-interactive using the Fiat-Shamir heuristic) for state- ments of the form “I know x...

  6. Faster and timing-attack resistant AES-GCM

    NARCIS (Netherlands)

    Käsper, E.; Schwabe, P.; Clavier, C.; Gaj, K.

    2009-01-01

    We present a bitsliced implementation of AES encryption in counter mode for 64-bit Intel processors. Running at 7.59 cycles/byte on a Core 2, it is up to 25% faster than previous implementations, while simultaneously offering protection against timing attacks. In particular, it is the only

  7. Increasing the Capital Income Tax Leads to Faster Growth

    NARCIS (Netherlands)

    Uhlig, H.F.H.V.S.; Yanagawa, N.

    1994-01-01

    This paper shows that under rather mild conditions, higher capital income taxes lead to faster growth in an overlapping generations economy with endogenous growth. Government expenditures are financed with labor income taxes as well as capital income taxes. Since capital income accrues to the old,

  8. [Acute Care Rehabilitation is the First Link in a Chain of Rehabilitation Interventions].

    Science.gov (United States)

    Beyer, Joachim; Seidel, Egbert J

    2017-08-01

    An early, intensive rehabilitative therapy accelerates the recovery of the functions of patients. It contributes to a reduction in the complication rate as well as an improvement in physical and social functioning/participation in the long-term follow-up. Early rehabilitation must be strengthened on the basis of the existing structures: the creation and maintenance of adequately qualified early-stage rehabilitation facilities, at least in hospitals with priority and maximum supply contracts. Patients with long-term intensive care and polytrauma must be rehabilitated as soon as possible (intensive medical rehabilitation).Specialists in physical and rehabilitative medicine, rehabilitative geriatrists, neurologists, orthopaedists and accident surgeons and other regional physicians must cooperate in a targeted manner. Exclusion criteria using corresponding OPS codes must be canceled. Additional specialist physician groups (anesthetists and intensive care physicians, general practitioners, accident and thoracic surgeons, internists) must be sensitized to the importance of early rehabilitation.In the case of more than 500,000 hospital beds, 25,000 beds should be identified as age- and diagnosis-independent early-care beds in the country-specific bed-care plans. A cost-covering financing of the different, personal and cost-intensive early rehabilitation must be ensured. A phase model similar to the BAR guidelines for neurological-neurosurgical early rehabilitation is to be considered for other disease entities.In order to make the rehabilitation process as successful as possible, medical (acute) treatment, medical rehabilitation, occupational integration and social integration have to be understood as a holistic event and are effectively interrelated, as a continuous process which accompanies the entire disease phase-wise. For this purpose, a continuous case management or a rehabilitation guidance has to be established. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Rehabilitation of pure alexia

    DEFF Research Database (Denmark)

    Starrfelt, Randi; Ólafsdóttir, Rannveig Rós; Arendt, Ida-Marie

    2013-01-01

    that pure alexia was an easy target for rehabilitation efforts. We review the literature on rehabilitation of pure alexia from 1990 to the present, and find that patients differ widely on several dimensions like alexia severity, and associated deficits. Many patients reported to have pure alexia......-designed and controlled studies of rehabilitation of pure alexia....

  10. Optimization of physical rehabilitation in congenital clubfoot

    Directory of Open Access Journals (Sweden)

    M.L. Golovakha

    2013-09-01

    Full Text Available The aim of the study was to improve the results of treatment of children with typical form of congenital clubfoot by optimizing of physical rehabilitation. The study included the following objectives: to make the algorithm work with the child, to justify the basis of physical rehabilitation, to study its effects, to develop a framework of implementation and optimization of the physical rehabilitation of children with congenital clubfoot. In the course of the study were 62 children involved with the typical form of congenital clubfoot: the main group (n = 42 and control group (n = 42. Age children from 4 years to 7 years. Physical rehabilitation was a logical continuation of treatment. Optimization analysis was performed by clinical examination, radiometric data and indicators of functional methods of research. Comparative analysis of the results of the physical rehabilitation of children with congenital clubfoot in both groups showed a trend more pronounced positive changes in children the main group in all respects.

  11. Integrating rehabilitation engineering technology with biologics.

    Science.gov (United States)

    Collinger, Jennifer L; Dicianno, Brad E; Weber, Douglas J; Cui, Xinyan Tracy; Wang, Wei; Brienza, David M; Boninger, Michael L

    2011-06-01

    Rehabilitation engineers apply engineering principles to improve function or to solve challenges faced by persons with disabilities. It is critical to integrate the knowledge of biologics into the process of rehabilitation engineering to advance the field and maximize potential benefits to patients. Some applications in particular demonstrate the value of a symbiotic relationship between biologics and rehabilitation engineering. In this review we illustrate how researchers working with neural interfaces and integrated prosthetics, assistive technology, and biologics data collection are currently integrating these 2 fields. We also discuss the potential for further integration of biologics and rehabilitation engineering to deliver the best technologies and treatments to patients. Engineers and clinicians must work together to develop technologies that meet clinical needs and are accessible to the intended patient population. Copyright © 2011 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

  12. 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.

  13. Rehabilitation in osteoporotic vertebral fractures

    OpenAIRE

    Pratelli, Elisa; Cinotti, Irene; Pasquetti, Pietro

    2010-01-01

    Vertebral fractures occur particularly in osteoporotic patients due to an increased bone fragility. Vertebral fractures influence the quality of life, mobility and mortality. Preventive training exercises and proprioception reeducation can be utilised for improving posture, balance and level of daily function and for decreasing pain. Quality of life is improved even beyond the active training period. This mini review provides information based on the literature for the rehabilitation of osteo...

  14. Strategies for stroke rehabilitation.

    Science.gov (United States)

    Dobkin, Bruce H

    2004-09-01

    Rehabilitation after hemiplegic stroke has typically relied on the training of patients in compensatory strategies. The translation of neuroscientific research into care has led to new approaches and renewed promise for better outcomes. Improved motor control can progress with task-specific training incorporating increased use of proximal and distal movements during intensive practice of real-world activities. Functional gains are incorrectly said to plateau by 3-6 months. Many patients retain latent sensorimotor function that can be realised any time after stroke with a pulse of goal-directed therapy. The amount of practice probably best determines gains for a given level of residual movement ability. Clinicians should encourage patients to build greater strength, speed, endurance, and precision of multijoint movements on tasks that increase independence and enrich daily activity. Imaging tools may help clinicians determine the capacity of residual networks to respond to a therapeutic approach and help establish optimal dose-response curves for training. Promising adjunct approaches include practice with robotic devices or in a virtual environment, electrical stimulation to increase cortical excitability during training, and drugs to optimise molecular mechanisms for learning. Biological strategies for neural repair may augment rehabilitation in the next decade.

  15. Adaptive rehabilitation games.

    Science.gov (United States)

    Barzilay, Ouriel; Wolf, Alon

    2013-02-01

    In conventional neuromuscular rehabilitation, patients are required to perform biomechanical exercises to recover their neuromotor abilities. These physiotherapeutic tasks are defined by the physiotherapist, according to his estimate of the patient's pathologic neuromotor function. The definition of the task is mainly qualitative and it is often merely demonstrated to the patient as a gesture to reproduce. Success of the treatment relies then on the accuracy and repetition of the motor training. We propose a novel approach to neuromotor training by combining the advantages of a virtual reality platform with biofeedback information on the training subject from biometric equipment and with the computational power of artificial neural networks. In a calibration stage, the subject performs motor training on a known task to train the network. Once trained, the tuned network generates a new patient-specific task, based on the definition of the subject's expected performance dictated by the therapist. The system was tested for upper limb rehabilitation on healthy subjects. We measured a 33% improvement in the triceps performance (p = 0.027). The novelty of the proposed approach lies in its use of learning systems to the estimation of biological models. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. 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...

  17. Faster dissolution of PuO2 in nitrous media by means of electrolytic oxidation

    International Nuclear Information System (INIS)

    Baumgaertner, F.; Kim, J.I.; Luckner, N.; Brueckl, N.; Lieberer, E.

    1984-03-01

    The contribution shows that the dissolution of PuO 2 in HNO 3 can be accelerated considerably by means of electrolytic oxidation. A glass apparatus has been developed which uses platinum electrodes providing for sufficient contact between electrodes and solids. Increase of temperature, acid concentration, and electrode current density, and a good contact between electrode and metal oxide will improve the dissolution kinetics. The reaction could be made even faster by addition of Ce 4+ . (orig.) [de

  18. Learning to Play in a Day: Faster Deep Reinforcement Learning by Optimality Tightening

    OpenAIRE

    He, Frank S.; Liu, Yang; Schwing, Alexander G.; Peng, Jian

    2016-01-01

    We propose a novel training algorithm for reinforcement learning which combines the strength of deep Q-learning with a constrained optimization approach to tighten optimality and encourage faster reward propagation. Our novel technique makes deep reinforcement learning more practical by drastically reducing the training time. We evaluate the performance of our approach on the 49 games of the challenging Arcade Learning Environment, and report significant improvements in both training time and...

  19. Rehabilitation Robots: Concepts and Applications in Stroke Rehabilitation

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Ahmadi-Pajouh

    2017-02-01

    Full Text Available Robotics is a tool to assist human in different applications from industry to medicine. There are many reasons that human tends to use these machines. They are very reliable in repetitive, high precision, preprogrammed and high risk jobs in which human is not too good enough. In medicine, robotic applications are evolving so fast that in near future nobody can imagine a surgery without a robot involved. In Rehabilitation we have the same scenario; there are commercialized robots to assist disable people to eat and perform daily activities. There are also clinical rehabilitation robots which can train handicaps. They can help subjects as a passive tool that improves low level impairments such as rigidity. On the other hand robots can train brain as an active tool to have a better movement again. We will see how robots can help therapist to apply repetitive passive movements in quadriplegic subject (i.e. in Brunnstrom stages 1 to 3. On the other hand they can teach subjects how to complete a task in an active manner (i.e. in stages 5 and 6 which can facilitate neuroplasticity. There are different robots designed for different organs; for example rehabilitation of upper extremities (e.g. Gloreha or lower extremities (e.g. Lokomat. There are also exoskeleton robots to help subjects to grip objects and perform ADLs easily (e.g. Bioservo or help paraplegic patient to walk again (e.g. Rewalk. In this talk, we will also discuss about how robots are helping rehab specialist to improve standard protocols. For example we will show how action observation therapy, bimanual therapy, assistive active therapy, proprioceptive facilitation and passive mobilization therapy are realized using an upper extremity rehabilitation robot. Robotics is the future of technology and rehabilitation needs this technology. Be part of this technology!

  20. Multiple Object Tracking Using the Shortest Path Faster Association Algorithm

    Directory of Open Access Journals (Sweden)

    Zhenghao Xi

    2014-01-01

    Full Text Available To solve the persistently multiple object tracking in cluttered environments, this paper presents a novel tracking association approach based on the shortest path faster algorithm. First, the multiple object tracking is formulated as an integer programming problem of the flow network. Then we relax the integer programming to a standard linear programming problem. Therefore, the global optimum can be quickly obtained using the shortest path faster algorithm. The proposed method avoids the difficulties of integer programming, and it has a lower worst-case complexity than competing methods but better robustness and tracking accuracy in complex environments. Simulation results show that the proposed algorithm takes less time than other state-of-the-art methods and can operate in real time.

  1. Faster-X evolution: Theory and evidence from Drosophila.

    Science.gov (United States)

    Charlesworth, Brian; Campos, José L; Jackson, Benjamin C

    2018-02-12

    A faster rate of adaptive evolution of X-linked genes compared with autosomal genes can be caused by the fixation of recessive or partially recessive advantageous mutations, due to the full expression of X-linked mutations in hemizygous males. Other processes, including recombination rate and mutation rate differences between X chromosomes and autosomes, may also cause faster evolution of X-linked genes. We review population genetics theory concerning the expected relative values of variability and rates of evolution of X-linked and autosomal DNA sequences. The theoretical predictions are compared with data from population genomic studies of several species of Drosophila. We conclude that there is evidence for adaptive faster-X evolution of several classes of functionally significant nucleotides. We also find evidence for potential differences in mutation rates between X-linked and autosomal genes, due to differences in mutational bias towards GC to AT mutations. Many aspects of the data are consistent with the male hemizygosity model, although not all possible confounding factors can be excluded. © 2018 John Wiley & Sons Ltd.

  2. The faster-X effect: integrating theory and data.

    Science.gov (United States)

    Meisel, Richard P; Connallon, Tim

    2013-09-01

    Population genetics theory predicts that X (or Z) chromosomes could play disproportionate roles in speciation and evolutionary divergence, and recent genome-wide analyses have identified situations in which X or Z-linked divergence exceeds that on the autosomes (the so-called 'faster-X effect'). Here, we summarize the current state of both the theory and data surrounding the study of faster-X evolution. Our survey indicates that the faster-X effect is pervasive across a taxonomically diverse array of evolutionary lineages. These patterns could be informative of the dominance or recessivity of beneficial mutations and the nature of genetic variation acted upon by natural selection. We also identify several aspects of disagreement between these empirical results and the population genetic models used to interpret them. However, there are clearly delineated aspects of the problem for which additional modeling and collection of genomic data will address these discrepancies and provide novel insights into the population genetics of adaptation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Adrenaline in cardiac arrest: Prefilled syringes are faster.

    Science.gov (United States)

    Helm, Claire; Gillett, Mark

    2015-08-01

    Standard ampoules and prefilled syringes of adrenaline are widely available in Australasian EDs for use in cardiac arrest. We hypothesise that prefilled syringes can be administered more rapidly and accurately when compared with the two available standard ampoules. This is a triple arm superiority study comparing the time to i.v. administration and accuracy of dosing of three currently available preparations of adrenaline. In their standard packaging, prefilled syringes were on average more than 12 s faster to administer than the 1 mL 1:1000 ampoules and more than 16 s faster than the 10 mL 1:10,000 ampoules (P adrenaline utilising a Minijet (CSL Limited, Parkville, Victoria, Australia) is faster than using adrenaline in glass ampoules presented in their plastic packaging. Removing the plastic packaging from the 1 mL (1 mg) ampoule might result in more rapid administration similar to the Minijet. Resuscitation personnel requiring rapid access to adrenaline should consider storing it as either Minijets or ampoules devoid of packaging. These results might be extrapolatable to other clinical scenarios, including pre-hospital and anaesthesia, where other drugs are required for rapid use. © 2015 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

  4. Feasibility and Efficacy of the Nintendo Wii Gaming System to Improve Balance Performance Post-Stroke: Protocol of a Phase II Randomized Controlled Trial in an Inpatient Rehabilitation Setting.

    Science.gov (United States)

    Bower, Kelly J; Clark, Ross A; McGinley, Jennifer L; Martin, Clarissa L; Miller, Kimberly J

    2013-04-01

    Balance deficits following stroke are common and debilitating. Commercially available gaming systems, such as the Nintendo(®) (Kyoto, Japan) Wii™, have been widely adopted clinically; however, there is limited evidence supporting their feasibility and efficacy for improving balance performance following stroke. The aim of this trial is to investigate the clinical feasibility and efficacy of using the Nintendo Wii gaming system as an adjunct to standard care to improve balance performance following stroke in an inpatient rehabilitation setting. Thirty participants undergoing inpatient stroke rehabilitation will be recruited into this Phase II, single-blind, randomized controlled trial. Participants will be allocated into a Balance or Upper Limb Group, and both groups will perform activities using the Nintendo Wii in addition to their standard care. Participants will attend three 45-minute sessions per week, for a minimum of 2 and a maximum of 4 weeks. The main focus of the study is to investigate the feasibility of the intervention protocol. This will be evaluated through recruitment, retention, adherence, acceptability, and safety. The Step Test and Functional Reach Test will be the primary efficacy outcomes. Secondary outcomes will include force platform, mobility, and upper limb measures. Assessments will occur at baseline, 2 weeks, and 4 weeks after study entry. To the authors' knowledge, this will be the largest randomized clinical trial to investigate the feasibility and efficacy of the Nintendo Wii gaming system for improving balance performance in a stroke population. The results will inform the design of a Phase III multicenter trial.

  5. Rehabilitation Engineering: What is Rehabilitation Engineering?

    Science.gov (United States)

    ... Corner Strategic Plan Budget Advisory Council Staff Directory Careers History Visitor Information You are here Home » Science Education » Science Topics » Rehabilitation Engineering SCIENCE EDUCATION SCIENCE EDUCATION Science Topics Resource Links ...

  6. Medical Rehabilitation in Natural Disasters: A Review.

    Science.gov (United States)

    Khan, Fary; Amatya, Bhasker; Gosney, James; Rathore, Farooq A; Burkle, Frederick M

    2015-09-01

    To present an evidence-based overview of the effectiveness of medical rehabilitation intervention in natural disaster survivors and outcomes that are affected. A literature search was conducted using medical and health science electronic databases (PubMed, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, PsycINFO) up to September 2014. Two independent reviewers selected studies reporting outcomes for natural disaster survivors after medical rehabilitation that addressed functional restoration and participation. Two reviewers independently extracted data and assessed the methodologic quality of the studies using the Critical Appraisal Skills Program's appraisal tools. A meta-analysis was not possible because of heterogeneity among included trials; therefore, a narrative analysis was performed for best evidence synthesis. Ten studies (2 randomized controlled trials, 8 observational studies) investigated a variety of medical rehabilitation interventions for natural disaster survivors to evaluate best evidence to date. The interventions ranged from comprehensive multidisciplinary rehabilitation to community educational programs. Studies scored low on quality assessment because of methodologic limitations. The findings suggest some evidence for the effectiveness of inpatient rehabilitation in reducing disability and improving participation and quality of life and for community-based rehabilitation for participation. There were no data available for associated costs. The findings highlight the need to incorporate medical rehabilitation into response planning and disaster management for future natural catastrophes. Access to rehabilitation and investment in sustainable infrastructure and education are crucial. More methodologically robust studies are needed to build evidence for rehabilitation programs, cost-effectiveness, and outcome measurement in such settings. Copyright © 2015 American Congress of Rehabilitation Medicine

  7. HISTORY OF NEUROPSYCHOLOGICAL REHABILITATION

    Directory of Open Access Journals (Sweden)

    N. A. Varako

    2014-01-01

    Full Text Available ABSTRACT. The article reviews the history of neuropsychological rehabilitation. It begins with the description of first rehabilitation programs developed by Paul Broca and Shepherd Franz. Franz’s experimental work for motor recovery in monkeys and correlation between active movement or affected limb immobilization and rehabilitation outcomes are described in further details. Special focus is given on ideas of famous German neurologist and psychiatrist Kurt Goldstein, who laid the foundation for modern approach in rehabilitation. Goldstein developed the idea of connection between rehabilitation and patient’s daily life. He also pointed out the necessity of psychological care of patients with brain damage.Russian neuropsychological approach is presented by its founders L.S. Vygotskiy and A.R. Luriya. Aspects of higher mental processes structure and options of its correction such as “cognitive prosthesis” are described in the sense of the approach.Y. Ben-Yishay, G. Prigatano, B. Wilson represent neuropsychological rehabilitation of the second half of the 20th century. The idea of a holistic approach for rehabilitation consists of such important principles as patient’s active involvement in a process of rehabilitation, work of a special team of rehabilitation professionals, inclusion of patient’s family members. The short review of a new rehabilitation approach for patients in coma, vegetative states and critical patients under resuscitation is given. 

  8. A cluster randomised controlled trial evaluating the effectiveness of a structured pulmonary rehabilitation education programme for improving the health status of people with chronic obstructive pulmonary disease (COPD: The PRINCE Study protocol

    Directory of Open Access Journals (Sweden)

    Nichulain Martina

    2011-01-01

    Full Text Available Abstract Background A key strategy in improving care for people with chronic obstructive pulmonary disease (COPD is the provision of pulmonary rehabilitation programmes. Pulmonary rehabilitation programmes have been successful in improving patients' sense of dyspnoea and Health Related Quality of Life. However, the effectiveness of structured education pulmonary rehabilitation programmes delivered at the level of the general practice on the health status of people with COPD remains uncertain and there is a need for a robust and fair assessment of this. The PRINCE study will evaluate the effectiveness of a Structured Education Pulmonary Rehabilitation Programme (SEPRP, delivered at the level of the general practice, on the health status of people with COPD. Methods/Design The PRINCE Trial is a two-armed, single blind cluster randomised trial conducted in the primary care setting in Ireland. Randomisation to control and intervention is at the level of the General Practice. Participants in the intervention arm will receive a SEPRP and those allocated to the control arm will receive usual care. Delivery of the SEPRP will be by a practice nurse and physiotherapist in the General Practice (GP site. The primary outcome measure of the study will be health status as measured by the Chronic Respiratory Questionnaire (CRQ. Blinded outcome assessment will be undertaken at baseline and at twelve-fourteen weeks after completion of the programme. A comparison of outcomes between the intervention and control sites will be made to examine if differences exist and, if so, to what extent between control and experimental groups. Sample size calculations estimate that 32 practices with a minimum of 10 participants per practice are required, in total, to be randomised to control and intervention arms for power of at least 80% with alpha levels of 0.05, to determine a clinically significant change of 0.5 units in the CRQ. A cost effectiveness analysis will also be

  9. A cluster randomised controlled trial evaluating the effectiveness of a structured pulmonary rehabilitation education programme for improving the health status of people with chronic obstructive pulmonary disease (COPD): The PRINCE Study protocol.

    Science.gov (United States)

    Murphy, Kathy; Casey, Dympna; Devane, Declan; Cooney, Adeline; McCarthy, Bernard; Mee, Lorraine; Nichulain, Martina; Murphy, Andrew W; Newell, John; O' Shea, Eamon

    2011-01-18

    A key strategy in improving care for people with chronic obstructive pulmonary disease (COPD) is the provision of pulmonary rehabilitation programmes. Pulmonary rehabilitation programmes have been successful in improving patients' sense of dyspnoea and Health Related Quality of Life. However, the effectiveness of structured education pulmonary rehabilitation programmes delivered at the level of the general practice on the health status of people with COPD remains uncertain and there is a need for a robust and fair assessment of this. The PRINCE study will evaluate the effectiveness of a Structured Education Pulmonary Rehabilitation Programme (SEPRP), delivered at the level of the general practice, on the health status of people with COPD. The PRINCE Trial is a two-armed, single blind cluster randomised trial conducted in the primary care setting in Ireland. Randomisation to control and intervention is at the level of the General Practice. Participants in the intervention arm will receive a SEPRP and those allocated to the control arm will receive usual care. Delivery of the SEPRP will be by a practice nurse and physiotherapist in the General Practice (GP) site. The primary outcome measure of the study will be health status as measured by the Chronic Respiratory Questionnaire (CRQ). Blinded outcome assessment will be undertaken at baseline and at twelve-fourteen weeks after completion of the programme. A comparison of outcomes between the intervention and control sites will be made to examine if differences exist and, if so, to what extent between control and experimental groups. Sample size calculations estimate that 32 practices with a minimum of 10 participants per practice are required, in total, to be randomised to control and intervention arms for power of at least 80% with alpha levels of 0.05, to determine a clinically significant change of 0.5 units in the CRQ. A cost effectiveness analysis will also be conducted. The results of this trial are directly

  10. 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.

  11. Cardiac rehabilitation: a comprehensive review

    OpenAIRE

    Lear, Scott A; Ignaszewski, Andrew

    2001-01-01

    Abstract Cardiac rehabilitation (CR) is a commonly used treatment for men and women with cardiovascular disease. To date, no single study has conclusively demonstrated a comprehensive benefit of CR. Numerous individual studies, however, have demonstrated beneficial effects such as improved risk-factor profile, slower disease progression, decreased morbidity, and decreased mortality. This paper will review the evidence for the use of CR and discuss the implications and limitations of these stu...

  12. Continuous Positive Airway Pressure During Exercise Improves Walking Time in Patients Undergoing Inpatient Cardiac Rehabilitation After Coronary Artery Bypass Graft Surgery: A RANDOMIZED CONTROLLED TRIAL.

    Science.gov (United States)

    Pantoni, Camila Bianca Falasco; Di Thommazo-Luporini, Luciana; Mendes, Renata Gonçalves; Caruso, Flávia Cristina Rossi; Mezzalira, Daniel; Arena, Ross; Amaral-Neto, Othon; Catai, Aparecida Maria; Borghi-Silva, Audrey

    2016-01-01

    Continuous positive airway pressure (CPAP) has been used as an effective support to decrease the negative pulmonary effects of coronary artery bypass graft (CABG) surgery. However, it is unknown whether CPAP can positively influence patients undergoing CABG during exercise. This study evaluated the effectiveness of CPAP on the first day of ambulation after CABG in patients undergoing inpatient cardiac rehabilitation (CR). Fifty-four patients after CABG surgery were randomly assigned to receive either inpatient CR and CPAP (CPG) or standard CR without CPAP (CG). Cardiac rehabilitation included walking and CPAP pressures were set between 10 to 12 cmH2O. Participants were assessed on the first day of walking at rest and during walking. Outcome measures included breathing pattern variables, exercise time in seconds (ETs), dyspnea/leg effort ratings, and peripheral oxygen saturation (SpO2). Twenty-seven patients (13 CPG vs 14 CG) completed the study. Compared with walking without noninvasive ventilation assistance, CPAP increased ETs by 43.4 seconds (P = .040) during walking, promoted better thoracoabdominal coordination, increased ventilation during walking by 12.5 L/min (P = .001), increased SpO2 values at the end of walking by 2.6% (P = .016), and reduced dyspnea ratings by 1 point (P = .008). Continuous positive airway pressure can positively influence exercise tolerance, ventilatory function, and breathing pattern in response to a single bout of exercise after CABG.

  13. Telehealth, Wearable Sensors, and the Internet: Will They Improve Stroke Outcomes Through Increased Intensity of Therapy, Motivation, and Adherence to Rehabilitation Programs?

    Science.gov (United States)

    Burridge, Jane H; Lee, Alan Chong W; Turk, Ruth; Stokes, Maria; Whitall, Jill; Vaidyanathan, Ravi; Clatworthy, Phil; Hughes, Ann-Marie; Meagher, Claire; Franco, Enrico; Yardley, Lucy

    2017-07-01

    Stroke, predominantly a condition of older age, is a major cause of acquired disability in the global population and puts an increasing burden on health care resources. Clear evidence for the importance of intensity of therapy in optimizing functional outcomes is found in animal models, supported by neuroimaging and behavioral research, and strengthened by recent meta-analyses from multiple clinical trials. However, providing intensive therapy using conventional treatment paradigms is expensive and sometimes not feasible because of social and environmental factors. This article addresses the need for cost-effective increased intensity of practice and suggests potential benefits of telehealth (TH) as an innovative model of care in physical therapy. We provide an overview of TH and present evidence that a web-supported program, used in conjunction with constraint-induced therapy (CIT), can increase intensity and adherence to a rehabilitation regimen. The design and feasibility testing of this web-based program, "LifeCIT," is presented. We describe how wearable sensors can monitor activity and provide feedback to patients and therapists. The methodology for the development of a wearable device with embedded inertial and mechanomyographic sensors, algorithms to classify functional movement, and a graphical user interface to present meaningful data to patients to support a home exercise program is explained. We propose that wearable sensor technologies and TH programs have the potential to provide most-effective, intensive, home-based stroke rehabilitation.

  14. Rehabilitation of cortical blindness secondary to stroke.

    Science.gov (United States)

    Gaber, Tarek A-Z K

    2010-01-01

    Cortical blindness is a rare complication of posterior circulation stroke. However, its complex presentation with sensory, physical, cognitive and behavioural impairments makes it one of the most challenging. Appropriate approach from a rehabilitation standpoint was never reported. Our study aims to discuss the rehabilitation methods and outcomes of a cohort of patients with cortical blindness. The notes of all patients with cortical blindness referred to a local NHS rehabilitation service in the last 6~years were examined. Patients' demographics, presenting symptoms, scan findings, rehabilitation programmes and outcomes were documented. Seven patients presented to our service, six of them were males. The mean age was 63. Patients 1, 2 and 3 had total blindness with severe cognitive and behavioural impairments, wandering and akathisia. All of them failed to respond to any rehabilitation effort and the focus was on damage limitation. Pharmacological interventions had a modest impact on behaviour and sleep pattern. The 3 patients were discharged to a nursing facility. Patients 4, 5, 6 and 7 had partial blindness with variable severity. All of them suffered from significant memory impairment. However, none suffered from any behavioural, physical or other cognitive impairment. Rehabilitation efforts on 3 patients were carried out collaboratively between brain injury occupational therapists and sensory disability officers. All patients experienced significant improvement in handicap and they all maintained community placements. This small cohort of patients suggests that the rehabilitation philosophy and outcomes of these 2 distinct groups of either total or partial cortical blindness differ significantly.

  15. 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...

  16. Even Faster Web Sites Performance Best Practices for Web Developers

    CERN Document Server

    Souders, Steve

    2009-01-01

    Performance is critical to the success of any web site, and yet today's web applications push browsers to their limits with increasing amounts of rich content and heavy use of Ajax. In this book, Steve Souders, web performance evangelist at Google and former Chief Performance Yahoo!, provides valuable techniques to help you optimize your site's performance. Souders' previous book, the bestselling High Performance Web Sites, shocked the web development world by revealing that 80% of the time it takes for a web page to load is on the client side. In Even Faster Web Sites, Souders and eight exp

  17. Faster magnet sorting with a threshold acceptance algorithm

    International Nuclear Information System (INIS)

    Lidia, S.; Carr, R.

    1995-01-01

    We introduce here a new technique for sorting magnets to minimize the field errors in permanent magnet insertion devices. Simulated annealing has been used in this role, but we find the technique of threshold acceptance produces results of equal quality in less computer time. Threshold accepting would be of special value in designing very long insertion devices, such as long free electron lasers (FELs). Our application of threshold acceptance to magnet sorting showed that it converged to equivalently low values of the cost function, but that it converged significantly faster. We present typical cases showing time to convergence for various error tolerances, magnet numbers, and temperature schedules

  18. Robustness of a bisimulation-type faster-than preorder

    Directory of Open Access Journals (Sweden)

    Katrin Iltgen

    2009-11-01

    Full Text Available TACS is an extension of CCS where upper time bounds for delays can be specified. Luettgen and Vogler defined three variants of bismulation-type faster-than relations and showed that they all three lead to the same preorder, demonstrating the robustness of their approach. In the present paper, the operational semantics of TACS is extended; it is shown that two of the variants still give the same preorder as before, underlining robustness. An explanation is given why this result fails for the third variant. It is also shown that another variant, which mixes old and new operational semantics, can lead to smaller relations that prove the same preorder.

  19. CSRtrack Faster Calculation of 3-D CSR Effects

    CERN Document Server

    Dohlus, Martin

    2004-01-01

    CSRtrack is a new code for the simulation of Coherent Synchrotron radiation effects on the beam dynamics of linear accelerators. It incorporates the physics of our previous code, TraFiC4, and adds new algorithms for the calculation of the CSR fields. A one-dimensional projected method allows quick estimates and a greens function method allows 3D calculations about ten times faster than with the `direct' method. The tracking code is written in standard FORTRAN77 and has its own parser for comfortable input of calculation parameters and geometry. Phase space input and the analysis of the traced particle distribution is done with MATLAB interface programs.

  20. Faster magnet sorting with a threshold acceptance algorithm

    International Nuclear Information System (INIS)

    Lidia, S.

    1994-08-01

    The authors introduce here a new technique for sorting magnets to minimize the field errors in permanent magnet insertion devices. Simulated annealing has been used in this role, but they find the technique of threshold acceptance produces results of equal quality in less computer time. Threshold accepting would be of special value in designing very long insertion devices, such as long FEL's. Their application of threshold acceptance to magnet sorting showed that it converged to equivalently low values of the cost function, but that it converged significantly faster. They present typical cases showing time to convergence for various error tolerances, magnet numbers, and temperature schedules

  1. 20 Recipes for Programming MVC 3 Faster, Smarter Web Development

    CERN Document Server

    Munro, Jamie

    2011-01-01

    There's no need to reinvent the wheel every time you run into a problem with ASP.NET's Model-View-Controller (MVC) framework. This concise cookbook provides recipes to help you solve tasks many web developers encounter every day. Each recipe includes the C# code you need, along with a complete working example of how to implement the solution. Learn practical techniques for applying user authentication, providing faster page reloads, validating user data, filtering search results, and many other issues related to MVC3 development. These recipes help you: Restrict access to views with password

  2. How to Elect a Leader Faster than a Tournament

    OpenAIRE

    Alistarh, Dan; Gelashvili, Rati; Vladu, Adrian

    2014-01-01

    The problem of electing a leader from among $n$ contenders is one of the fundamental questions in distributed computing. In its simplest formulation, the task is as follows: given $n$ processors, all participants must eventually return a win or lose indication, such that a single contender may win. Despite a considerable amount of work on leader election, the following question is still open: can we elect a leader in an asynchronous fault-prone system faster than just running a $\\Theta(\\log n...

  3. Faster than light motion does not imply time travel

    International Nuclear Information System (INIS)

    Andréka, Hajnal; Madarász, Judit X; Németi, István; Székely, Gergely; Stannett, Mike

    2014-01-01

    Seeing the many examples in the literature of causality violations based on faster than light (FTL) signals one naturally thinks that FTL motion leads inevitably to the possibility of time travel. We show that this logical inference is invalid by demonstrating a model, based on (3+1)-dimensional Minkowski spacetime, in which FTL motion is permitted (in every direction without any limitation on speed) yet which does not admit time travel. Moreover, the Principle of Relativity is true in this model in the sense that all observers are equivalent. In short, FTL motion does not imply time travel after all. (paper)

  4. Athletic pubalgia and associated rehabilitation.

    Science.gov (United States)

    Ellsworth, Abigail A; Zoland, Mark P; Tyler, Timothy F

    2014-11-01

    information is obtained through MRI imaging and the diagnosis and treatment of inguinal disruption and athletic pubalgia becomes increasingly frequent, more research is warranted in this field to better improve the evidence based practice and rehabilitation of patients. 5.

  5. Virtual reality based rehabilitation speeds up functional recovery of the upper extremities after stroke: a randomized controlled pilot study in the acute phase of stroke using the rehabilitation gaming system.

    Science.gov (United States)

    da Silva Cameirão, Mónica; Bermúdez I Badia, Sergi; Duarte, Esther; Verschure, Paul F M J

    2011-01-01

    Given the incidence of stroke, the need has arisen to consider more self-managed rehabilitation approaches. A promising technology is Virtual Reality (VR). Thus far, however, it is not clear what the benefits of VR systems are when compared to conventional methods. Here we investigated the clinical impact of one such system, the Rehabilitation Gaming System (RGS), on the recovery time course of acute stroke. RGS combines concepts of action execution and observation with an automatic individualization of training. METHODS. Acute stroke patients (n = 8) used the RGS during 12 weeks in addition to conventional therapy. A control group (n = 8) performed a time matched alternative treatment, which consisted of intense occupational therapy or non-specific interactive games. RESULTS. At the end of the treatment, between-group comparisons showed that the RGS group displayed significantly improved performance in paretic arm speed that was matched by better performance in the arm subpart of the Fugl-Meyer Assessment Test and the Chedoke Arm and Hand Activity Inventory. In addition, the RGS group presented a significantly faster improvement over time for all the clinical scales during the treatment period. CONCLUSIONS. Our results suggest that rehabilitation with the RGS facilitates the functional recovery of the upper extremities and that this system is therefore a promising tool for stroke neurorehabilitation.

  6. Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

    Science.gov (United States)

    2013-06-19

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Technologies to Support Successful Aging with Disability under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

  7. Final priority; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priority.

    Science.gov (United States)

    2013-06-14

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority for a Rehabilitation Engineering Research Center (RERC) on Universal Interfaces and Information Technology Access under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). The Assistant Secretary may use this priority for a competition in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend to use this priority to improve outcomes for individuals with disabilities.

  8. 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.

  9. Critical Thinking Skills for Rehabilitation Professionals in the 21st Century

    Science.gov (United States)

    Lewis, Allen N.; King, Eric S.; Pitt, Jenelle S.; Getachew, Almaz; Shamburger, Aisha

    2010-01-01

    Critical thinking (CT) is an essential tool for rehabilitation professionals in the 21st century. Well developed CT skills are indicated for rehabilitation professionals in the new century to promote continuous quality improvement of the service delivery system. Such improvement will occur as rehabilitation professionals learn to routinely…

  10. Rehabilitating torture survivors

    DEFF Research Database (Denmark)

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

    2009-01-01

    survivors can be addressed from an evidence base generated both from traumatized and non-traumatized patient populations. Thus, trauma-focused cognitive behavioural therapy and/or eye movement desensitization and reprocessing, as well as interdisciplinary pain rehabilitation, should be components......, in December 2008. The main topics were: the context of torture; mental problems including psychotherapy; internet-based therapy and pharmaco-therapy; chronic pain; social integration and family; and functioning and rehabilitation. Available evidence highlights the importance of an interdisciplinary approach......, "Rehabilitating Torture Survivors", was organized by the Rehabilitation and Research Centre for Torture Victims (a rehabilitation clinic and global knowledge and research centre with government support) in collaboration with the Centre for Transcultural Psychiatry at Rigshospitalet in Copenhagen, Denmark...

  11. [Rehabilitation in rheumatology].

    Science.gov (United States)

    Luttosch, F; Baerwald, C

    2010-10-01

    Rehabilitation in rheumatology focuses on prevention of functional disorders of the musculoskeletal system, maintenance of working ability and prevention of care dependency. Drug treatment alone rarely results in long-term remission, therefore rehabilitative measures must be integrated into rheumatic care. Rehabilitative therapy in rheumatology includes physiotherapy, patient education and occupational therapy. Positive effects of physical therapy methods have been proven by various studies. Patient education and occupational therapy are important tools for stabilizing the course of the disease. To maintain positive rehabilitative results patients have to be involved in the selection of treatment measures and should take an active part in the long-term treatment process. Despite proven efficacy of physical measures there is evidence for a lack of utilization of rehabilitative therapy due to increasing cost pressure in the health care system which will further increase over time.

  12. Virtual rehabilitation--benefits and challenges.

    Science.gov (United States)

    Burdea, G C

    2003-01-01

    To discuss the advantages and disadvantages of rehabilitation applications of virtual reality. VR can be used as an enhancement to conventional therapy for patients with conditions ranging from musculoskeletal problems, to stroke-induced paralysis, to cognitive deficits. This approach is called "VR-augmented rehabilitation." Alternately, VR can replace conventional interventions altogether, in which case the rehabilitation is "VR-based." If the intervention is done at a distance, then it is called "telerehabilitation." Simulation exercises for post-stroke patients have been developed using a "teacher object" approach or a video game approach. Simulations for musculo-skeletal patients use virtual replicas of rehabilitation devices (such as rubber ball, power putty, peg board). Phobia-inducing virtual environments are prescribed for patients with cognitive deficits. VR-augmented rehabilitation has been shown effective for stroke patients in the chronic phase of the disease. VR-based rehabilitation has been improving patients with fear of flying, Vietnam syndrome, fear of heights, and chronic stroke patients. Telerehabilitation interventions using VR have improved musculo-skeletal and post-stroke patients, however less data is available at this time. Virtual reality presents significant advantages when applied to rehabilitation of patients with varied conditions. These advantages include patient motivation, adaptability and variability based on patient baseline, transparent data storage, online remote data access, economy of scale, reduced medical costs. Challenges in VR use for rehabilitation relate to lack of computer skills on the part of therapists, lack of support infrastructure, expensive equipment (initially), inadequate communication infrastructure (for telerehabilitation in rural areas), and patient safety concerns.

  13. Functional effects of treadmill-based gait training at faster speeds in stroke survivors: a prospective, single-group study.

    Science.gov (United States)

    Mohammadi, Roghayeh; Ershad, Navid; Rezayinejad, Marziyeh; Fatemi, Elham; Phadke, Chetan P

    2017-09-01

    To examine the functional effects of walking retraining at faster than self-selected speed (SSS). Ten individuals with chronic stroke participated in a 4-week training over a treadmill at walking speeds 40% faster than SSS, three times per week, 30 min/session. Outcome measures assessed before, after, and 2 months after the end of intervention were the Timed Up and Go, the 6-Minute Walk, the 10-Meter Walk test, the Modified Ashworth Scale, SSS, and fastest comfortable speed. After 4 weeks of training, all outcome measures showed clinically meaningful and statistically significant improvements (Ptraining. The results showed that a strategy of training at a speed 40% faster than SSS can improve functional activity in individuals with chronic stroke, with effects lasting up to 2 months after the intervention.

  14. 75 FR 47801 - Office of Special Education and Rehabilitative Services; Overview Information; Special...

    Science.gov (United States)

    2010-08-09

    ... DEPARTMENT OF EDUCATION Office of Special Education and Rehabilitative Services; Overview Information; Special Demonstration Programs--Model Demonstration Projects To Improve Outcomes for Individuals.... Alexa Posny, Assistant Secretary for Special Education and Rehabilitative Services. [FR Doc. 2010-19585...

  15. Health-related quality of life following blind rehabilitation.

    Science.gov (United States)

    Kuyk, Thomas; Liu, Lei; Elliott, Jeffry L; Grubbs, Hartley E; Owsley, Cynthia; McGwin, Gerald; Griffin, Russell L; Fuhr, Patti S

    2008-05-01

    The purpose of this study was to investigate the effect of residential blind rehabilitation on patients' vision-targeted health-related quality of life (HRQOL) and general physical and mental function. The National Eye Institute 25-item Visual Function Questionnaire (NEI VFQ) plus appendix questions, the 12-item Short-Form Health Survey (SF-12), Hope Scale and Coopersmith self-esteem inventory were administered to 206 legally blind veterans prior to their entering a residential (in-patient) blind rehabilitation program and again to 185 and 176 of the original cohort at 2 and 6 months after completion of the rehabilitation program, respectively. Data on visual acuity, visual field extent, contrast sensitivity and scanning ability were also collected. The duration of the in-patient rehabilitation programs ranged from 11 to 109 days. Questionnaire scores were compared pre-rehabilitation and post-rehabilitation. Following rehabilitation there was a significant improvement in nine of 11 NEI VFQ subscales and in a composite score at both the 2- and 6-month post-rehabilitation intervals. Mental health (SF-12) and self esteem also improved significantly although physical health ratings declined over the course of the study (approximately 10 months). Residential blind rehabilitation appears to improve patients' self-reported vision-targeted HRQOL, self-esteem and mental health aspects of generic HRQOL.

  16. A multi-centre randomised controlled trial of rehabilitation aimed at improving outdoor mobility for people after stroke: Study protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Logan Pip A

    2012-06-01

    Full Text Available Abstract Background Up to 42% of all stroke patients do not get out of the house as much as they would like. This can impede a person’s quality of life. This study is testing the clinical effectiveness and cost effectiveness of a new outdoor mobility rehabilitation intervention by comparing it to usual care. Methods/design This is a multi-centre parallel group individually randomised, controlled trial. At least 506 participants will be recruited through 15 primary and secondary care settings and will be eligible if they are over 18 years of age, have had a stroke and wish to get out of the house more often. Participants are being randomly allocated to either the intervention group or the control group. Intervention group participants receive up to 12 rehabilitation outdoor mobility sessions over up to four months. The main component of the intervention is repeated practice of outdoor mobility with a therapist. Control group participants are receiving the usual intervention for outdoor mobility limitations: verbal advice and provision of leaflets provided over one session. Outcome measures are being collected using postal questionnaires, travel calendars and by independent assessors. The primary outcome measure is the Social Function domain of the SF36v2 quality of life assessment six months after recruitment. The secondary outcome measures include: functional ability, mobility, the number of journeys (monthly travel diaries, satisfaction with outdoor mobility, mood, health-related quality of life, resource use of health and social care. Carer mood information is also being collected. The mean Social Function score of the SF-36v2 will be compared between treatment arms using a multiple membership form of mixed effects multiple regression analysis adjusting for centre (as a fixed effect, age and baseline Social Function score as covariates and therapist as a multiple membership random effect. Regression coefficients and 95% confidence

  17. Final priority; National Institute on Disability and Rehabilitation Research--Rehabilitation Engineering Research Centers. Final priority.

    Science.gov (United States)

    2014-07-09

    The Assistant Secretary for Special Education and Rehabilitative Services announces a priority under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce a priority for a Rehabilitation Engineering Research Center (RERC) on Improving the Accessibility, Usability, and Performance of Technology for Individuals who are Deaf or Hard of Hearing. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to focus research attention on an area of national need. We intend the priority to contribute to improving the accessibility, usability, and performance of technology for individuals who are deaf or hard of hearing.

  18. The impact of patient's weight on post-stroke rehabilitation.

    Science.gov (United States)

    Kalichman, Leonid; Alperovitch-Najenson, Deborah; Treger, Iuly

    2016-08-01

    Purpose To evaluate the influence of patient's weight on rehabilitation outcomes in first-event stroke patients. Design Retrospective, observational comparative study. 102 first-time stroke male and female patients admitted to the 52-bed neurology rehabilitation department in a rehabilitation hospital were included in the study. Body mass index (BMI), Functional Independence Measure (FIM) on admission and at discharge, as well as the delta-FIM (FIM on admission - FIM at discharge) were evaluated. The Kruskal-Wallis test was used to compare the FIM and the NIHSS scores between BMI groups (normal, overweight, moderate and severe obesity). Results A statistically significant negative correlation (rho = -0.20, p = 0.049) was found between FIM change and BMI, that remained significant after adjustments for age, sex and hospitalisation days. No difference was found between groups in FIM or NIHSS change between BMI groups. Conclusions In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. Further investigations are needed to identify the functional parameters affected by the patients' BMI. Implications for Rehabilitation In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients' BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. New rehabilitation strategies should be designed to improve the functional outcomes of rehabilitation of obese patients.

  19. 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.

  20. Implementation of Clinical Quality Management for Rehabilitation in Malaysia.

    Science.gov (United States)

    Engkasan, Julia Patrick; Stucki, Gerold; Ali, Sadeeq; Yusof, Yusniza Mohd; Hussain, Hafez; Latif, Lydia Abdul

    2018-04-18

    In February 2017, the World Health Organization (WHO) launched its historic "Rehabilitation 2030: A Call for Action". Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO's Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO) Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia). The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF) is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.

  1. Implementation of Clinical Quality Management for Rehabilitation in Malaysia

    Directory of Open Access Journals (Sweden)

    Julia Patrick Engkasan

    2017-11-01

    Full Text Available In February 2017, the World Health Organization (WHO launched its historic ”Rehabilitation 2030: A Call for Action”. Scaling up rehabilitation in health systems requires concerted action across all 6 components of WHO’s Health Systems Framework. For rehabilitation, information about functioning is essential, as it is required for effective rehabilitation at all levels of the health system. What is missing is a countrywide demonstration project involving the implementation of a clinical quality management system for the continuous improvement of rehabilitation, both at the level of clinical care for individual patients and at the level of rehabilitation service provision. Consequently, the Department of Rehabilitation Medicine at the University of Malaya and University Malaya Medical Centre, together with the Cheras Rehabilitation Hospital of the Ministry of Health, and the Social Security Organisation (SOCSO Rehabilitation Centre in Malacca, Malaysia, initiated a project to develop a Malaysian-wide clinical quality management system for rehabilitation (CQM-R Malaysia. The objective of this paper is to describe CQM-R Malaysia. First, a conceptual description of a CQM-R based on the International Classification of Functioning, Disability and Health (ICF is set out. The methods, results and conclusions of a situation analysis conducted in January 2017 are then reported. Finally, the building blocks and implementation action plan developed for CQM-R Malaysia are presented.

  2. A rehabilitation training partnership in Madagascar.

    Science.gov (United States)

    Andrianabela, Sonia; Hariharan, Ram; Ford, Helen L; Chamberlain, M Anne

    2015-09-01

    We describe here the development of a mid-level training programme for doctors in Madagascar to direct regional and national rehabilitation services. Eight doctors enrolled and all gained their diplomas and have gone on to form the Association of Physical and Rehabilitation Medicine of Madagascar, which is leading further training and service developments. The course was specific to Madagascar's needs, and was devised according to the vision of the senior rehabilitation specialist in the Ministry of Health in Madagascar with support from the University of Antananarivo. The syllabus was developed with a senior Rehabilitation Medicine consultant responsible for setting up a comprehensive range of services and teaching in a University teaching hospital in the UK. Major barriers to success include the economic and political situation in Madagascar, which worsened steadily over the period of the training, the lack of resources for health, rehabilitation and rehabilitation workshops, and the withdrawal of aid. The sustainability of the training and the improved services that have been initiated will be evaluated, but these will be influenced by the situation of the country. It is hoped that this description of a highly practical training using modern teaching methods will be of use in other low-resource countries. Much of the teaching input was given by clinicians from a UK teaching hospital, and this resource will continue to be needed.

  3. 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...... 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....

  4. Immersive virtual reality improves movement patterns in patients after ACL reconstruction: implications for enhanced criteria-based return-to-sport rehabilitation.

    Science.gov (United States)

    Gokeler, Alli; Bisschop, Marsha; Myer, Gregory D; Benjaminse, Anne; Dijkstra, Pieter U; van Keeken, Helco G; van Raay, Jos J A M; Burgerhof, Johannes G M; Otten, Egbert

    2016-07-01

    The purpose of this study was to evaluate the influence of immersion in a virtual reality environment on knee biomechanics in patients after ACL reconstruction (ACLR). It was hypothesized that virtual reality techniques aimed to change attentional focus would influence altered knee flexion angle, knee extension moment and peak vertical ground reaction force (vGRF) in patients following ACLR. Twenty athletes following ACLR and 20 healthy controls (CTRL) performed a step-down task in both a non-virtual reality environment and a virtual reality environment displaying a pedestrian traffic scene. A motion analysis system and force plates were used to measure kinematics and kinetics during a step-down task to analyse each single-leg landing. A significant main effect was found for environment for knee flexion excursion (P = n.s.). Significant interaction differences were found between environment and groups for vGRF (P = 0.004), knee moment (P virtual reality environment on knee biomechanics in patients after ACLR compared with controls. Patients after ACLR immersed in virtual reality environment demonstrated knee joint biomechanics that approximate those of CTRL. The results of this study indicate that a realistic virtual reality scenario may distract patients after ACLR from conscious motor control. Application of clinically available technology may aid in current rehabilitation programmes to target altered movement patterns after ACLR. Diagnostic study, Level III.

  5. [Clinical observation on improvement of motion range of cervical spine of patients with cervical spondylotic radiculopathy treated with rotation-traction manipulation and neck pain particles and cervical neck pain rehabilitation exercises].

    Science.gov (United States)

    Zhen, Peng-Chao; Zhu, Li-Guo; Gao, Jing-Hua; Yu, Jie; Feng, Min-Shan; Wei, Xu; Wang, Shang-Quan

    2010-10-01

    To observe the effects of two different therapies on patients whose cervical function were restricted due to cervical spondylotic radiculopathy. Form April 2008 to October 2009, 71 cases with cervical spondylotic radiculopathy were divided into group A (36 cases) and group B (35 cases). Among them, 22 cases were male and 49 cases were female, ranging in age form 45 to 65 years with an average of 52.27 years, course of disease was from 3 days to 5 years. The patients in group A were treated with rotation-traction manipulation, neck pain particles and cervical rehabilitation exercises; and the patients in group B were treated with cervical traction, Diclofenac sodium sustained release tablets and wearing neck collar. Theapeutic time was two weeks. The cervical anteflexion, extension, left and right lateral bending, left and right rotative activity were measured by helmet-style activities instrument before and after treatment (at the 1, 3, 5, 7, 9, 11, 13 days and 1 month after treatment respectively). There were no difference between two groups in cervical activity in all directions before treatment (P > 0.05). Compared with the beginning, cervical anteflexion and extension showed significant difference at the 5th day after treatment in group A (P cervical anteflexion showed significant difference at the 13th day after treatment (P 0.05); cervical extension showed significant difference at the 7th day after treatment compared with the beginning (P cervical anteflexion, left and right lateral bending, left and right rotative activity showed significant difference at the 1 month after treatment (P pain particles and cervical rehabilitation exercises in treating cervicalspondylotic radiculopathy have quick effect to improve the activities of cervical anteflexion, extension, left lateral bending, and have durable effect to improve the activities of cervical spine in all directions.

  6. Motor Rehabilitation Using Kinect: A Systematic Review.

    Science.gov (United States)

    Da Gama, Alana; Fallavollita, Pascal; Teichrieb, Veronica; Navab, Nassir

    2015-04-01

    Interactive systems are being developed with the intention to help in the engagement of patients on various therapies. Amid the recent technological advances, Kinect™ from Microsoft (Redmond, WA) has helped pave the way on how user interaction technology facilitates and complements many clinical applications. In order to examine the actual status of Kinect developments for rehabilitation, this article presents a systematic review of articles that involve interactive, evaluative, and technical advances related to motor rehabilitation. Systematic research was performed in the IEEE Xplore and PubMed databases using the key word combination "Kinect AND rehabilitation" with the following inclusion criteria: (1) English language, (2) page number >4, (3) Kinect system for assistive interaction or clinical evaluation, or (4) Kinect system for improvement or evaluation of the sensor tracking or movement recognition. Quality assessment was performed by QualSyst standards. In total, 109 articles were found in the database research, from which 31 were included in the review: 13 were focused on the development of assistive systems for rehabilitation, 3 in evaluation, 3 in the applicability category, 7 on validation of Kinect anatomic and clinical evaluation, and 5 on improvement techniques. Quality analysis of all included articles is also presented with their respective QualSyst checklist scores. Research and development possibilities and future works with the Kinect for rehabilitation application are extensive. Methodological improvements when performing studies on this area need to be further investigated.

  7. Early intensive rehabilitation after oral cancer treatment.

    Science.gov (United States)

    Bschorer, Maximilian; Schneider, Daniel; Hennig, Matthias; Frank, Bernd; Schön, Gerhard; Heiland, Max; Bschorer, Reinhard

    2018-06-01

    The treatment of oral cancer requires an effective rehabilitation strategy such as an early intensive rehabilitation (EIR) program. The medical records and data of 41 patients who participated in an EIR program and 20 control group patients were analyzed. These patients all underwent surgical resection of the primary tumor followed by microsurgical reconstruction using free flaps. The length of stay (LOS) at the acute care hospital was compared between the two groups. Four indexes were used to evaluate the effectiveness of the EIR program. EIR patients stayed an average of 11.6 fewer days at the acute care hospital. All indexes showed significant improvements (p < 0.001). The Barthel Index (BI) and the Early Intensive Rehabilitation Barthel Index (EIR-BI) improved by 36.0 and 103.6 points, respectively. At discharge, the Bogenhausener Dysphagia Score (BODS) had improved to a score of 11.0 compared to the 13.9 at admission. EIR patients had a Work Ability Index (WAI) score of 25.7. Length of stay at the acute care hospital can be reduced using early intensive rehabilitation if patients are transferred to an intensive rehabilitation clinic early. Copyright © 2018 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Application physiotherapy in rehabilitation rheumatoid arthritis

    Directory of Open Access Journals (Sweden)

    Angela Nogas

    2017-02-01

    National University of Water and Environmental Engineering   Abstract Background: Rheumatoid arthritis is one of the most common forms of inflammatory diseases of the joints. The disease leads to deformation, then to destruction of the diseased joint and to disability. Physiotherapy is used for the treatment and rehabilitation of rheumatoid arthritis. It is assumed that physiotherapy treatments that promote remission of the disease, improve the quality of patients’ life, create the necessary conditions for comprehensive rehabilitation programs. Objective: Systematic’s review conducting of studies that assess the effect of physiotherapy in the rehabilitation of patients with rheumatoid arthritis. Methods: Theoretical analysis of scientific and methodical literature, methods of analysis, synthesis, generalization. Results: To reduce inflammation in the joints is performed UV of affected joints weak or medium erythermal or middle erythermal doses used UHF therapy. UHF-therapy prescribed to the area of joint in I or II dose, duration 10 min., the course – 5-8 treatments. For patients with minimal activity is added electrophoresis NSAIDs. Electrophoresis aspirin is applied on the affected joints (every day, the course – 10-12 procedures, which favorably affect the course of rheumatoid arthritis. Conclusions: Physical therapy can reduce pain and stiffness in the joints, prevent deformity and restore function, improve independence and quality of life. State of the art is a major incentive to develop new activities in the treatment and rehabilitation of patients with rheumatoid arthritis to improve joint functional activity and their physical health.   Keywords: rheumatoid arthritis, physiotherapy, rehabilitation, hydrotherapy.

  9. 78 FR 38840 - Final Priority-National Institute on Disability and Rehabilitation Research-Rehabilitation...

    Science.gov (United States)

    2013-06-28

    ... attention on areas of national need. We intend this priority to improve outcomes among individuals with... improve the effectiveness of services authorized under the Rehabilitation Act of 1973, as amended... assistance, and information to improve the outcomes of individuals with disabilities who live in rural areas...

  10. Effects of different rehabilitation models on erythrocyte deformability and nitrite plus nitrate as end-products of nitric oxide levels in elderly women.

    Science.gov (United States)

    Filar-Mierzwa, Katarzyna; Wójcik, Barbara; Marchewka, Anna; Dąbrowski, Zbigniew; Superata, Jerzy; Wiśniowski, Zdzisław

    2017-12-01

    The aim of the present study was to analyze the effects of two rehabilitation protocols, dance movement therapy exercises (DMT) and general rehabilitation exercises (GRE), on erythrocyte deformability and plasma levels of nitrite plus nitrate as end products of nitric oxide (NOx) in elderly women. The study included 39 women aged 61-82 years, subjected to either GRE (n = 20) or DMT (n = 19). Women were subjected to 5-months programs of GRE and DMT, with each session lasting no longer than 45-50 min, and the intensity of exercising corresponding to no more than 40-60% of heart rate reserve. Plasma levels of NOx were determined spectrophotometrically before and at the end of the intervention. A significant increase in the total nitrate/nitrite concentration from 1.341 μmol/L to 1.590 μmol/L (7.3%) was observed in women subjected to the DMT rehabilitation program. Furthermore, an increase in erythrocyte deformability was observed in this group at shear stress 0.30. No significant difference was found between the pre- and post-rehabilitation NOx levels of women participating in the GRE program. Participation in DMT rehabilitation program might be reflected by an increase in plasma NOx levels and an improvement of erythrocyte deformability at lesser shear stress, and thus could potentially result in better vascular function. DMT should be offered to older adults, especially to persons who do not find conventional forms of rehabilitation as attractive, as they might refrain from physical activity and suffer from a faster decline in nitric oxide production. Geriatr Gerontol Int 2017; 17: 2479-2484. © 2017 Japan Geriatrics Society.

  11. [Rehabilitation for digestive and metabolic diseases. Quo vadis?].

    Science.gov (United States)

    Stockbrugger, R; Rosemeyer, D; Armbrecht, U

    2010-10-01

    The position of rehabilitation in gastroenterology, hepatology and metabolic diseases has changed little in the last 25 years. Initial improvements in quality are oriented more to the content of rehabilitative measures and less to organizational basic conditions. Nevertheless, there is an urgent need for action if rehabilitation medicine is to achieve an equivalent and recognized position in the interaction between primary care and other medical specialties. In this article suggestions for expedient prerequisites and utilization options of rehabilitation in the fields of hepatogastroenterology and metabolism will be presented, which are also oriented to the exemplary implemented concepts from Sweden and The Netherlands.

  12. Clinical Holistic Medicine: Holistic Rehabilitation

    Directory of Open Access Journals (Sweden)

    Søren Ventegodt

    2005-01-01

    Full Text Available Quality of life, health, and ability are often lost at the same time and most often in one decaying existential movement over 5 or 10 years. This “lost life” is mostly too slow to be felt as life threatening, but once awakened to reality, it provokes the deepest of fears in patients: the fear of death itself and destruction of our mere existence. The horrible experience of having “lost life””, often without even noticing how it happened, can be turned into a strong motivation for improvement. Personal development is about finding the life deeply hidden within in order to induce revitalization and rehabilitation. Rehabilitation is about philosophy of life with the integration of the repressed painful feelings and emotions from the past and the letting go of the associated negative beliefs and decisions. The holistic medical toolbox builds on existential theories (the quality of life theories, the life mission theory, the theory of character, the theory of talent, and the holistic process theory and seems to have the power to rehabilitate the purpose of life, the character of the person, and fundamental existential dimensions of man: (1 love; (2 strength of mind, feelings, and body; and 3 joy, gender, and sexuality; allowing the person once again to express and realize his talents and full potential. The principles of rehabilitation are not very different from other healing, but the task is often more demanding for the holistic physician as the motivation and resources often are very low and the treatment can take many years.

  13. Building a Knowledge to Action Program in Stroke Rehabilitation.

    Science.gov (United States)

    Janzen, Shannon; McIntyre, Amanda; Richardson, Marina; Britt, Eileen; Teasell, Robert

    2016-09-01

    The knowledge to action (KTA) process proposed by Graham et al (2006) is a framework to facilitate the development and application of research evidence into clinical practice. The KTA process consists of the knowledge creation cycle and the action cycle. The Evidence Based Review of Stroke Rehabilitation is a foundational part of the knowledge creation cycle and has helped guide the development of best practice recommendations in stroke. The Rehabilitation Knowledge to Action Project is an audit-feedback process for the clinical implementation of best practice guidelines, which follows the action cycle. The objective of this review was to: (1) contextualize the Evidence Based Review of Stroke Rehabilitation and Rehabilitation Knowledge to Action Project within the KTA model and (2) show how this process led to improved evidence-based practice in stroke rehabilitation. Through this process, a single centre was able to change clinical practice and promote a culture that supports the use of evidence-based practices in stroke rehabilitation.

  14. Move faster, think later: Women who play action video games have quicker visually-guided responses with later onset visuomotor-related brain activity.

    Science.gov (United States)

    Gorbet, Diana J; Sergio, Lauren E

    2018-01-01

    A history of action video game (AVG) playing is associated with improvements in several visuospatial and attention-related skills and these improvements may be transferable to unrelated tasks. These facts make video games a potential medium for skill-training and rehabilitation. However, examinations of the neural correlates underlying these observations are almost non-existent in the visuomotor system. Further, the vast majority of studies on the effects of a history of AVG play have been done using almost exclusively male participants. Therefore, to begin to fill these gaps in the literature, we present findings from two experiments. In the first, we use functional MRI to examine brain activity in experienced, female AVG players during visually-guided reaching. In the second, we examine the kinematics of visually-guided reaching in this population. Imaging data demonstrate that relative to women who do not play, AVG players have less motor-related preparatory activity in the cuneus, middle occipital gyrus, and cerebellum. This decrease is correlated with estimates of time spent playing. Further, these correlations are strongest during the performance of a visuomotor mapping that spatially dissociates eye and arm movements. However, further examinations of the full time-course of visuomotor-related activity in the AVG players revealed that the decreased activity during motor preparation likely results from a later onset of activity in AVG players, which occurs closer to beginning motor execution relative to the non-playing group. Further, the data presented here suggest that this later onset of preparatory activity represents greater neural efficiency that is associated with faster visually-guided responses.

  15. Move faster, think later: Women who play action video games have quicker visually-guided responses with later onset visuomotor-related brain activity

    Science.gov (United States)

    Gorbet, Diana J.; Sergio, Lauren E.

    2018-01-01

    A history of action video game (AVG) playing is associated with improvements in several visuospatial and attention-related skills and these improvements may be transferable to unrelated tasks. These facts make video games a potential medium for skill-training and rehabilitation. However, examinations of the neural correlates underlying these observations are almost non-existent in the visuomotor system. Further, the vast majority of studies on the effects of a history of AVG play have been done using almost exclusively male participants. Therefore, to begin to fill these gaps in the literature, we present findings from two experiments. In the first, we use functional MRI to examine brain activity in experienced, female AVG players during visually-guided reaching. In the second, we examine the kinematics of visually-guided reaching in this population. Imaging data demonstrate that relative to women who do not play, AVG players have less motor-related preparatory activity in the cuneus, middle occipital gyrus, and cerebellum. This decrease is correlated with estimates of time spent playing. Further, these correlations are strongest during the performance of a visuomotor mapping that spatially dissociates eye and arm movements. However, further examinations of the full time-course of visuomotor-related activity in the AVG players revealed that the decreased activity during motor preparation likely results from a later onset of activity in AVG players, which occurs closer to beginning motor execution relative to the non-playing group. Further, the data presented here suggest that this later onset of preparatory activity represents greater neural efficiency that is associated with faster visually-guided responses. PMID:29364891

  16. Rehabilitation of schizophrenic patients.

    Science.gov (United States)

    Gunatilake, S; Ananth, J; Parameswaran, S; Brown, S; Silva, W

    2004-01-01

    Schizophrenia is a maldevelopmental disorder of the brain that manifests in positive, negative, cognitive and affective symptoms. Currently, the mainstay of treatment involves pharmacotherapy. The limitations of antipsychotic treatment are that they can only control symptoms and cannot cure the illness, and 20% of patients do not respond, thus leading to the requirement of maintenance treatment. Patients that do respond continue to have disabling residual symptoms such as amotivation and isolation, maladaptive behavior, and impaired social functioning. These symptoms prevent patients from attaining educational, occupational, and social roles. Psychosocial interventions and models of quality of life in schizophrenia are based on the notion that increases in psychosocial functioning will be related to improvement in subjective experiences, such as self-esteem and satisfaction with life. The comparative effect of specific treatment methods and the additional benefits of multiple treatments need to be explored. Diversified techniques have also been employed, such as shaping, cognitive process therapy, mastery-oriented skill training, motivation and enhancement. Issues in designing psychosocial interventions and the role of various professionals in providing such interventions need to be carefully considered. Predictor variables and the indications for particular therapies in an individual need to be explored. Generalizability of the gains made by rehabilitation/recovery is also an important consideration. Patients in jail, chronic mental hospitals, private facilities, and the Veterans Administration system are all different in their ability to benefit, their motivations, and the severity of their psychopathology. Therefore, it is very difficult to generalize findings from one setting to another.

  17. Rum Jungle rehabilitation project

    International Nuclear Information System (INIS)

    Kraatz, M.; Appelegate, R.J.

    1992-01-01

    In the late 1960's and 1970's it was recognised that pollutants emanating from the abandoned Rum jungle uranium mine in the Northern Territory of Australia were responsible for severe environmental degradation of the Finniss River system. Products of acid mine drainage and low level radioactive material released from the tailings dam resulted in the virtual absence of flora and fauna species for ten kilometres downstream of the mine. In 1982 a joint Federal and Northern Territory government project was established to rehabilitate the abandoned Rum Jungle site. This project successfully achieved a major reduction in surface water pollution, public health hazard, (including radiation levels), pollution levels in the Open Cut water bodies and aesthetic improvement, including revegetation. Monitoring of the site is continuing up to the present date to determine the ongoing success of the project. This includes evaluation of the surface water quality, chemical activity and water balance within the overburden heaps, groundwater hydrology and an assessment of revegetation success, erosion control structures and cover stability. This document presents the results of monitoring activities conducted between 1986 and 1988 and outlines management and maintenance programs during that time. 36 refs., 40 figs., 47 tabs., 11 ills

  18. Faster Double-Size Bipartite Multiplication out of Montgomery Multipliers

    Science.gov (United States)

    Yoshino, Masayuki; Okeya, Katsuyuki; Vuillaume, Camille

    This paper proposes novel algorithms for computing double-size modular multiplications with few modulus-dependent precomputations. Low-end devices such as smartcards are usually equipped with hardware Montgomery multipliers. However, due to progresses of mathematical attacks, security institutions such as NIST have steadily demanded longer bit-lengths for public-key cryptography, making the multipliers quickly obsolete. In an attempt to extend the lifespan of such multipliers, double-size techniques compute modular multiplications with twice the bit-length of the multipliers. Techniques are known for extending the bit-length of classical Euclidean multipliers, of Montgomery multipliers and the combination thereof, namely bipartite multipliers. However, unlike classical and bipartite multiplications, Montgomery multiplications involve modulus-dependent precomputations, which amount to a large part of an RSA encryption or signature verification. The proposed double-size technique simulates double-size multiplications based on single-size Montgomery multipliers, and yet precomputations are essentially free: in an 2048-bit RSA encryption or signature verification with public exponent e=216+1, the proposal with a 1024-bit Montgomery multiplier is at least 1.5 times faster than previous double-size Montgomery multiplications.

  19. A piece of paper falling faster than free fall

    International Nuclear Information System (INIS)

    Vera, F; Rivera, R

    2011-01-01

    We report a simple experiment that clearly demonstrates a common error in the explanation of the classic experiment where a small piece of paper is put over a book and the system is let fall. This classic demonstration is used in introductory physics courses to show that after eliminating the friction force with the air, the piece of paper falls with acceleration g. To test if the paper falls behind the book in a nearly free fall motion or if it is dragged by the book, we designed a version of this experiment that includes a ball and a piece of paper over a book that is forced to fall using elastic cords. We recorded a video of our experiment using a high-speed video camera at 300 frames per second that shows that the book and the paper fall faster than the ball, which falls well behind the book with an acceleration approximately equal to g. Our experiment shows that the piece of paper is dragged behind the book and therefore the paper and book demonstration should not be used to show that all objects fall with acceleration g independently of their mass.

  20. Higher Resolution and Faster MRI of 31Phosphorus in Bone

    Science.gov (United States)

    Frey, Merideth; Barrett, Sean; Sethna, Zachary; Insogna, Karl; Vanhouten, Joshua

    2013-03-01

    Probing the internal composition of bone on the sub-100 μm length scale is important to study normal features and to look for signs of disease. However, few useful non-destructive techniques are available to evaluate changes in the bone mineral chemical structure and functional micro-architecture on the interior of bones. MRI would be an excellent candidate, but bone is a particularly challenging tissue to study given the relatively low water density, wider linewidths of its solid components leading to low spatial resolution, and the long imaging time compared to conventional 1H MRI. Our lab has recently made advances in obtaining high spatial resolution (sub-400 μm)3 three-dimensional 31Phosphorus MRI of bone through use of the quadratic echo line-narrowing sequence (1). In this talk, we describe our current results using proton decoupling to push this technique even further towards the factor of 1000 increase in spatial resolution imposed by fundamental limits. We also discuss our work to speed up imaging through novel, faster reconstruction algorithms that can reconstruct the desired image from very sparse data sets. (1) M. Frey, et al. PNAS 109: 5190 (2012).

  1. Hexagonal undersampling for faster MRI near metallic implants.

    Science.gov (United States)

    Sveinsson, Bragi; Worters, Pauline W; Gold, Garry E; Hargreaves, Brian A

    2015-02-01

    Slice encoding for metal artifact correction acquires a three-dimensional image of each excited slice with view-angle tilting to reduce slice and readout direction artifacts respectively, but requires additional imaging time. The purpose of this study was to provide a technique for faster imaging around metallic implants by undersampling k-space. Assuming that areas of slice distortion are localized, hexagonal sampling can reduce imaging time by 50% compared with conventional scans. This work demonstrates this technique by comparisons of fully sampled images with undersampled images, either from simulations from fully acquired data or from data actually undersampled during acquisition, in patients and phantoms. Hexagonal sampling is also shown to be compatible with parallel imaging and partial Fourier acquisitions. Image quality was evaluated using a structural similarity (SSIM) index. Images acquired with hexagonal undersampling had no visible difference in artifact suppression from fully sampled images. The SSIM index indicated high similarity to fully sampled images in all cases. The study demonstrates the ability to reduce scan time by undersampling without compromising image quality. © 2014 Wiley Periodicals, Inc.

  2. A piece of paper falling faster than free fall

    Energy Technology Data Exchange (ETDEWEB)

    Vera, F; Rivera, R, E-mail: fvera@ucv.cl [Instituto de Fisica, Pontificia Universidad Catolica de ValparaIso, Av. Universidad 330, Curauma, ValparaIso (Chile)

    2011-09-15

    We report a simple experiment that clearly demonstrates a common error in the explanation of the classic experiment where a small piece of paper is put over a book and the system is let fall. This classic demonstration is used in introductory physics courses to show that after eliminating the friction force with the air, the piece of paper falls with acceleration g. To test if the paper falls behind the book in a nearly free fall motion or if it is dragged by the book, we designed a version of this experiment that includes a ball and a piece of paper over a book that is forced to fall using elastic cords. We recorded a video of our experiment using a high-speed video camera at 300 frames per second that shows that the book and the paper fall faster than the ball, which falls well behind the book with an acceleration approximately equal to g. Our experiment shows that the piece of paper is dragged behind the book and therefore the paper and book demonstration should not be used to show that all objects fall with acceleration g independently of their mass.

  3. Learning Faster by Discovering and Exploiting Object Similarities

    Directory of Open Access Journals (Sweden)

    Tadej Janež

    2013-03-01

    Full Text Available In this paper we explore the question: “Is it possible to speed up the learning process of an autonomous agent by performing experiments in a more complex environment (i.e., an environment with a greater number of different objects?” To this end, we use a simple robotic domain, where the robot has to learn a qualitative model predicting the change in the robot's distance to an object. To quantify the environment's complexity, we defined cardinal complexity as the number of objects in the robot's world, and behavioural complexity as the number of objects' distinct behaviours. We propose Error reduction merging (ERM, a new learning method that automatically discovers similarities in the structure of the agent's environment. ERM identifies different types of objects solely from the data measured and merges the observations of objects that behave in the same or similar way in order to speed up the agent's learning. We performed a series of experiments in worlds of increasing complexity. The results in our simple domain indicate that ERM was capable of discovering structural similarities in the data which indeed made the learning faster, clearly superior to conventional learning. This observed trend occurred with various machine learning algorithms used inside the ERM method.

  4. Causal events enter awareness faster than non-causal events

    Directory of Open Access Journals (Sweden)

    Pieter Moors

    2017-01-01

    Full Text Available Philosophers have long argued that causality cannot be directly observed but requires a conscious inference (Hume, 1967. Albert Michotte however developed numerous visual phenomena in which people seemed to perceive causality akin to primary visual properties like colour or motion (Michotte, 1946. Michotte claimed that the perception of causality did not require a conscious, deliberate inference but, working over 70 years ago, he did not have access to the experimental methods to test this claim. Here we employ Continuous Flash Suppression (CFS—an interocular suppression technique to render stimuli invisible (Tsuchiya & Koch, 2005—to test whether causal events enter awareness faster than non-causal events. We presented observers with ‘causal’ and ‘non-causal’ events, and found consistent evidence that participants become aware of causal events more rapidly than non-causal events. Our results suggest that, whilst causality must be inferred from sensory evidence, this inference might be computed at low levels of perceptual processing, and does not depend on a deliberative conscious evaluation of the stimulus. This work therefore supports Michotte’s contention that, like colour or motion, causality is an immediate property of our perception of the world.

  5. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... of Spinal Cord Injury Rehabilitation Kristine Cichowski, MS Occupational Therapy after Spinal Cord Injury Katie Powell, OT ... does not provide medical advice, recommend or endorse health care products or services, or control the information ...

  6. 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 ...

  7. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Rehabilitation Institute of Chicago play_arrow What's the most important thing for families to know right away? ... a spinal cord injury? play_arrow How do most patients learn the nature of their spinal cord ...

  8. Rehabilitation in Managing MS

    Science.gov (United States)

    ... at home and in the office. They recommend strategic modifications to the home and workplace to ensure accessibility, safety and convenience. Occupational therapists also evaluate and treat problems with thinking and memory . Cognitive rehabilitation Neuropsychologists — as well as ...

  9. Post-Stroke Rehabilitation

    Science.gov (United States)

    ... language has been compromised. There is a strong consensus among rehabilitation experts that the most important element ... the brain are damaged, causing the transmission of false signals that result in the sensation of pain ...

  10. Rehabilitation and Prosthetic Services

    Science.gov (United States)

    ... Review Resources AT Education Blind Rehab Chiropractic Service Polytrauma/TBI Prosthetics & Sensory Aids Recreation Therapy More Health ... Military Sexual Trauma PTSD Research (MIRECC) Military Exposures Polytrauma Rehabilitation Spinal Cord Injury Telehealth Womens Health Issues ...

  11. 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, ...

  12. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Injury Facts and Figures Care and Treatment After SCI Spinal Cord Injury Rehabilitation Pediatric Spinal Cord Injuries Video Library SCI Medical Experts People Living with SCI Personal Experiences ...

  13. Overview of Rehabilitation

    Science.gov (United States)

    ... final outcome of rehabilitation depends on the person's motivation. Some people delay recovery to gain attention from ... the form of a living will, a durable power of attorney, or both. If people have an ...

  14. Health rehabilitation-94

    International Nuclear Information System (INIS)

    Zotov, V.P.

    1994-01-01

    The reports are connected wit urgent problems of health rehabilitation. The experience of different non-medical complex actions on support and renewing of ChNPP personnel and Slavutich town inhabitants functional working capability is generalized

  15. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Topic 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 David ...

  16. 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 ...

  17. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... RN Pediatric Injuries Pediatric Spinal Cord Injury 101 Lawrence Vogel, MD The Basics of Pediatric SCI Rehabilitation ... Rogers, PT Recreational Therapy after Spinal Cord Injury Jennifer Piatt, PhD Kristine Cichowski, MS Read Bio Founding ...

  18. 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 ...

  19. 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 ...

  20. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Topic 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 ...

  1. Motivational Rehabilitation using Serious Games

    OpenAIRE

    Antoni Jaume i Capó; Javier Varona Gómez; Gabriel Moyà; Francisco Perales

    2013-01-01

    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 pre...

  2. 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

    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...... are vague. Purpose: The purpose was to examine the use of outcome measures used in clinical practice in the transition from hospital to home-based rehabilitation. Methods/Analysis: A questionnaire were sent to the heads of 26 hospitals discharging patients with stroke and 52 municipalities' health services...... rehabilitation, especially in the transition between hospital and home-based rehabilitation. A nationwide, interprofessional and intersectional group is currently discussing recommendations for the use of outcome measures in stroke rehabilitation. Results from this group will be presented at the conference...

  3. Does Mobile Care ('mCare') Improve Quality of Life and Treatment Satisfaction Among Service Members Rehabilitating in the Community? Results from a 36-Wk, Randomized Controlled Trial.

    Science.gov (United States)

    Little, Jeanette R; Pavliscsak, Holly H; Cooper, Mabel R; Goldstein, Lois A; Fonda, Stephanie J

    2018-03-01

    Research has shown that mobile phones can help with management of numerous health problems. As an adjunct to care management provided to injured service members rehabilitating in their communities, particularly those with mild traumatic brain injury (mTBI), post-traumatic stress (PTS), and/or behavioral health problems, the Army developed a mobile phone application called "mCare." This study examined whether service members who received mCare had higher well-being, were more satisfied with their care, and viewed mCare as a valuable part of their care management as compared with their counterparts who received standard care management alone, and whether those with mTBI, PTS, and/or behavioral health problems benefited differently from mCare. In-processing service members at four community-based warrior transition units were recruited for participation in a 36-wk, randomized, controlled trial and allocated to receive standard care management plus mCare (n = 95) or standard care management alone (n = 87). Participants in the mCare group received daily questionnaires, tips, and appointment reminders. All participants were asked to complete the General Well-being Schedule (GWS) at baseline, 12, 24, and 36 wk, and the Case Management Quality Questionnaire (CMQQ) at 12, 24, and 36 wk. All participants and care managers were approached to complete interviews about the usability/likeability of mCare or standard care management. The analyses tested for group differences in completion of the intervention, graphed means for the GWS and CMQQ by group/subgroup, and statistically compared the longitudinal trends in these outcomes using mixed models in which group, time, and group*time were included as regression variables. The analyses also tallied interview responses and identified thematic quotes. The study protocol was reviewed and approved by the Walter Reed National Military Medical Center's Institutional Review Board. Estimated rate of change in GWS scores was -2

  4. 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

  5. A systematic review of exercise and psychosocial rehabilitation interventions to improve health-related outcomes in patients with bladder cancer undergoing radical cystectomy.

    Science.gov (United States)

    Rammant, Elke; Decaestecker, Karel; Bultijnck, Renée; Sundahl, Nora; Ost, Piet; Pauwels, Nele S; Deforche, Benedicte; Pieters, Ronny; Fonteyne, Valérie

    2018-05-01

    Summarizing the evidence on the effects of pre- and postoperative exercise and psychosocial rehabilitation interventions on patient-reported outcomes (PROs) and physical fitness in bladder cancer patients undergoing radical cystectomy. The Cochrane Central Register of Controlled Trials, MEDLINE, Embase, Web of Science and the Physiotherapy Evidence Database were searched independently by two authors from inception until 10 November 2017. Cited references of the studies and citing references retrieved via Web of Science were also checked. Randomized controlled trials (RCTs) and non-randomized studies assessing effects of exercise and psychosocial interventions in bladder cancer patients undergoing radical cystectomy were eligible. Primary outcome measures were PROs and physical fitness. Risk of bias was assessed using the Cochrane Collaboration tool and the Newcastle-Ottawa Scale. Five RCTs (three exercise and two psychosocial studies) and one non-randomized psychosocial study comprising 317 bladder cancer patients were included. Timing of the intervention was preoperative ( n = 2), postoperative ( n = 2) or both pre- and postoperative ( n = 2). Positive effects of exercise were found for physical fitness ( n = 3), some health-related quality-of-life (HRQoL) domains ( n = 2), personal activities in daily living ( n = 1) and muscle strength ( n = 1). Psychosocial interventions showed positive effects on anxiety ( n = 1), fatigue ( n = 1), depression ( n = 1), HRQoL ( n = 1) and posttraumatic growth ( n = 1). Quality assessment showed most shortcomings with sample sizes and strong heterogeneity was observed between studies. The evidence relating to the effects of exercise in bladder cancer is very limited and is even less for psychosocial interventions.

  6. The effectiveness of community-based rehabilitation as a strategy for improving quality of life and disaster resilience for children with disability in rural Zimbabwe

    Directory of Open Access Journals (Sweden)

    Pathias P. Bongo

    2018-04-01

    Full Text Available The study aimed to investigate the effectiveness of the community-based rehabilitation (CBR project in Ward 20 of Chipinge in Zimbabwe and ascertain the positive district changes in the quality of life and disaster resilience of children with disability. Effectiveness involved examining the role of the parents of children with disabilities and the general community in the CBR programme, the extent to which children living with disabilities (CWDs have been empowered to live quality life and access basic social services and evaluate whether local resources and capacities were being utilised. Data were collected through key informant interviews, document analysis and focus group discussions. The CBR model borrows heavily from rights-based approaches to development. Its practical application is problematic because of difficulties in defining issues such as participation and the ability of developing and poor communities to generate resources for these programmes. The study found that factors that hinder the effectives of CBR programmes included continuous dependence on donor funding, lack of political will by government and local authorities to commit financial resources towards CBR implementation and unreliable referral systems for access of services for children with disability. Gaps identified include establishing appropriate context-specific strategies that suit developing countries. The government and local authorities should prioritise resource allocation for marginalised groups such as people with disabilities. Civil society should not be the major and only source of funding for CBR. Extensive consultations should be made to adapt the CBR model to the socio-economic context of developing countries. The referral system for access to services for CWDs should be strengthened.

  7. Inpatient or outpatient rehabilitation after herniated disc surgery? - Setting-specific preferences, participation and outcome of rehabilitation.

    Science.gov (United States)

    Löbner, Margrit; Luppa, Melanie; Konnopka, Alexander; Meisel, Hans J; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; Angermeyer, Matthias C; König, Hans-Helmut; Riedel-Heller, Steffi G

    2014-01-01

    To examine rehabilitation preferences, participation and determinants for the choice of a certain rehabilitation setting (inpatient vs. outpatient) and setting-specific rehabilitation outcomes. The longitudinal observational study referred to 534 consecutive disc surgery patients (18-55 years). Face-to-face baseline interviews took place about 3.6 days after disc surgery during acute hospital stay. 486 patients also participated in a follow-up interview via telephone three months later (dropout-rate: 9%). The following instruments were used: depression and anxiety (Hospital Anxiety and Depression Scale), pain intensity (numeric analog scale), health-related quality of life (Short Form 36 Health Survey), subjective prognosis of gainful employment (SPE-scale) as well as questions on rehabilitation attendance, return to work, and amount of sick leave days. The vast majority of patients undergoing surgery for a herniated disc attended a post-hospital rehabilitation treatment program (93%). Thereby two-thirds of these patients took part in an inpatient rehabilitation program (67.9%). Physical, psychological, vocational and health-related quality of life characteristics differed widely before as well as after rehabilitation depending on the setting. Inpatient rehabilitees were significantly older, reported more pain, worse physical quality of life, more anxiety and depression and a worse subjective prognosis of gainful employment before rehabilitation. Pre-rehabilitation differences remained significant after rehabilitation. More than half of the outpatient rehabilitees (56%) compared to only one third of the inpatient rehabilitees (33%) returned to work three months after disc surgery (p<.001). The results suggest a "pre-selection" of patients with better health status in outpatient rehabilitation. Gaining better knowledge about setting-specific selection processes may help optimizing rehabilitation allocation procedures and improve rehabilitation effects such as return

  8. Inpatient or Outpatient Rehabilitation after Herniated Disc Surgery? – Setting-Specific Preferences, Participation and Outcome of Rehabilitation

    Science.gov (United States)

    Löbner, Margrit; Luppa, Melanie; Konnopka, Alexander; Meisel, Hans J.; Günther, Lutz; Meixensberger, Jürgen; Stengler, Katarina; Angermeyer, Matthias C.; König, Hans-Helmut; Riedel-Heller, Steffi G.

    2014-01-01

    improve rehabilitation effects such as return to work. PMID:24598904

  9. Inpatient or outpatient rehabilitation after herniated disc surgery? - Setting-specific preferences, participation and outcome of rehabilitation.

    Directory of Open Access Journals (Sweden)

    Margrit Löbner

    and improve rehabilitation effects such as return to work.

  10. 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

  11. The Danish Cardiac Rehabilitation Database.

    Science.gov (United States)

    Zwisler, Ann-Dorthe; Rossau, Henriette Knold; Nakano, Anne; Foghmar, Sussie; Eichhorst, Regina; Prescott, Eva; Cerqueira, Charlotte; Soja, Anne Merete Boas; Gislason, Gunnar H; Larsen, Mogens Lytken; Andersen, Ulla Overgaard; Gustafsson, Ida; Thomsen, Kristian K; Boye Hansen, Lene; Hammer, Signe; Viggers, Lone; Christensen, Bo; Kvist, Birgitte; Lindström Egholm, Cecilie; May, Ole

    2016-01-01

    The Danish Cardiac Rehabilitation Database (DHRD) aims to improve the quality of cardiac rehabilitation (CR) to the benefit of patients with coronary heart disease (CHD). Hospitalized patients with CHD with stenosis on coronary angiography treated with percutaneous coronary intervention, coronary artery bypass grafting, or medication alone. Reporting is mandatory for all hospitals in Denmark delivering CR. The database was initially implemented in 2013 and was fully running from August 14, 2015, thus comprising data at a patient level from the latter date onward. Patient-level data are registered by clinicians at the time of entry to CR directly into an online system with simultaneous linkage to other central patient registers. Follow-up data are entered after 6 months. The main variables collected are related to key outcome and performance indicators of CR: referral and adherence, lifestyle, patient-related outcome measures, risk factor control, and medication. Program-level online data are collected every third year. Based on administrative data, approximately 14,000 patients with CHD are hospitalized at 35 hospitals annually, with 75% receiving one or more outpatient rehabilitation services by 2015. The database has not yet been running for a full year, which explains the use of approximations. The DHRD is an online, national quality improvement database on CR, aimed at patients with CHD. Mandatory registration of data at both patient level as well as program level is done on the database. DHRD aims to systematically monitor the quality of CR over time, in order to improve the quality of CR throughout Denmark to benefit patients.

  12. Visual Motion Processing Subserves Faster Visuomotor Reaction in Badminton Players.

    Science.gov (United States)

    Hülsdünker, Thorben; Strüder, Heiko K; Mierau, Andreas

    2017-06-01

    Athletes participating in ball or racquet sports have to respond to visual stimuli under critical time pressure. Previous studies used visual contrast stimuli to determine visual perception and visuomotor reaction in athletes and nonathletes; however, ball and racquet sports are characterized by motion rather than contrast visual cues. Because visual contrast and motion signals are processed in different cortical regions, this study aimed to determine differences in perception and processing of visual motion between athletes and nonathletes. Twenty-five skilled badminton players and 28 age-matched nonathletic controls participated in this study. Using a 64-channel EEG system, we investigated visual motion perception/processing in the motion-sensitive middle temporal (MT) cortical area in response to radial motion of different velocities. In a simple visuomotor reaction task, visuomotor transformation in Brodmann area 6 (BA6) and BA4 as well as muscular activation (EMG onset) and visuomotor reaction time (VMRT) were investigated. Stimulus- and response-locked potentials were determined to differentiate between perceptual and motor-related processes. As compared with nonathletes, athletes showed earlier EMG onset times (217 vs 178 ms, P < 0.001), accompanied by a faster VMRT (274 vs 243 ms, P < 0.001). Furthermore, athletes showed an earlier stimulus-locked peak activation of MT (200 vs 182 ms, P = 0.002) and BA6 (161 vs 137 ms, P = 0.009). Response-locked peak activation in MT was later in athletes (-7 vs 26 ms, P < 0.001), whereas no group differences were observed in BA6 and BA4. Multiple regression analyses with stimulus- and response-locked cortical potentials predicted EMG onset (r = 0.83) and VMRT (r = 0.77). The athletes' superior visuomotor performance in response to visual motion is primarily related to visual perception and, to a minor degree, to motor-related processes.

  13. Construction Management: Building Schools Faster in the International Marketplace

    Science.gov (United States)

    Scarano, Joseph J.

    1976-01-01

    Construction management accelerates school construction, increases quality and labor productivity, lowers costs, and offers developing nations an opportunity to improve their own management capabilities. (MLF)

  14. Reasons for holding a Consensus Conference on neuropsychological rehabilitation in adult patients.

    Science.gov (United States)

    Làdavass, E; Paolucci, S; Umiltà, C

    2011-03-01

    Neuropsychological deficits are common in various cerebrovascular, neurodegenerative and traumatic pathologies. Neuropsychological rehabilitation refers to a set of interventions that aim to improve a person's ability to perform cognitive tasks by retraining previously learned skills and teaching compensatory strategies. However, today there are some relevant points that need of further investigations. In 2007, a Task Force was set up under the auspices of several scientific societies that operate in the field of psychology, neuropsychology, rehabilitation and neurology (AIP, GIRN, SIMFER, SIN, SINP, and SPAN) with the aim to clarify the theoretical background of neuropsychological rehabilitation and to assess the diagnostic instruments and the treatments available to date. This consensus conference (CC), using methods derived from those of Evidence-Based-Medicine (EMB), evaluated several points, including: a) legal aspects; b) epidemiological aspects; c) neuropsychological rehabilitation of attentional and executive disorders; d) neuropsychological rehabilitation of speech/language disorders; e) neuropsychological rehabilitation of visual field defects; f) neuropsychological rehabilitation of neglect; g) neuropsychological rehabilitation of memory disorders; h) cognitive rehabilitation of arm apraxia; i) neuropsychological rehabilitation of Alzheimer disease; j) rehabilitation of multiple sclerosis; k) rehabilitation of severe brain injuries; l) rehabilitation of mild to moderate brain injuries; m) rehabilitation of behavioral disorders in severe brain injuries. Then, CC submitted to a specific Jury a final report with summary tables and questions. The final meeting of the Jury was held in Siena in February 2010.

  15. Faster Smith-Waterman database searches with inter-sequence SIMD parallelisation

    Directory of Open Access Journals (Sweden)

    Rognes Torbjørn

    2011-06-01

    Full Text Available Abstract Background The Smith-Waterman algorithm for local sequence alignment is more sensitive than heuristic methods for database searching, but also more time-consuming. The fastest approach to parallelisation with SIMD technology has previously been described by Farrar in 2007. The aim of this study was to explore whether further speed could be gained by other approaches to parallelisation. Results A faster approach and implementation is described and benchmarked. In the new tool SWIPE, residues from sixteen different database sequences are compared in parallel to one query residue. Using a 375 residue query sequence a speed of 106 billion cell updates per second (GCUPS was achieved on a dual Intel Xeon X5650 six-core processor system, which is over six times more rapid than software based on Farrar's 'striped' approach. SWIPE was about 2.5 times faster when the programs used only a single thread. For shorter queries, the increase in speed was larger. SWIPE was about twice as fast as BLAST when using the BLOSUM50 score matrix, while BLAST was about twice as fast as SWIPE for the BLOSUM62 matrix. The software is designed for 64 bit Linux on processors with SSSE3. Source code is available from http://dna.uio.no/swipe/ under the GNU Affero General Public License. Conclusions Efficient parallelisation using SIMD on standard hardware makes it possible to run Smith-Waterman database searches more than six times faster than before. The approach described here could significantly widen the potential application of Smith-Waterman searches. Other applications that require optimal local alignment scores could also benefit from improved performance.

  16. Paying more for faster care? Individuals' attitude toward price-based priority access in health care.

    Science.gov (United States)

    Benning, Tim M; Dellaert, Benedict G C

    2013-05-01

    Increased competition in the health care sector has led hospitals and other health care institutions to experiment with new access allocation policies that move away from traditional expert based allocation of care to price-based priority access (i.e., the option to pay more for faster care). To date, little is known about individuals' attitude toward price-based priority access and the evaluation process underlying this attitude. This paper addresses the role of individuals' evaluations of collective health outcomes as an important driver of their attitude toward (price-based) allocation policies in health care. The authors investigate how individuals evaluate price-based priority access by means of scenario-based survey data collected in a representative sample from the Dutch population (N = 1464). They find that (a) offering individuals the opportunity to pay for faster care negatively affects their evaluations of both the total and distributional collective health outcome achieved, (b) however, when health care supply is not restricted (i.e., when treatment can be offered outside versus within the regular working hours of the hospital) offering price-based priority access affects total collective health outcome evaluations positively instead of negatively, but it does not change distributional collective health outcome evaluations. Furthermore, (c) the type of health care treatment (i.e., life saving liver transplantation treatment vs. life improving cosmetic ear correction treatment - priced at the same level to the individual) moderates the effect of collective health outcome evaluations on individuals' attitude toward allocation policies. For policy makers and hospital managers the results presented in this article are helpful because they provide a better understanding of what drives individuals' preferences for health care allocation policies. In particular, the results show that policies based on the "paying more for faster care" principle are more

  17. Faster Smith-Waterman database searches with inter-sequence SIMD parallelisation.

    Science.gov (United States)

    Rognes, Torbjørn

    2011-06-01

    The Smith-Waterman algorithm for local sequence alignment is more sensitive than heuristic methods for database searching, but also more time-consuming. The fastest approach to parallelisation with SIMD technology has previously been described by Farrar in 2007. The aim of this study was to explore whether further speed could be gained by other approaches to parallelisation. A faster approach and implementation is described and benchmarked. In the new tool SWIPE, residues from sixteen different database sequences are compared in parallel to one query residue. Using a 375 residue query sequence a speed of 106 billion cell updates per second (GCUPS) was achieved on a dual Intel Xeon X5650 six-core processor system, which is over six times more rapid than software based on Farrar's 'striped' approach. SWIPE was about 2.5 times faster when the programs used only a single thread. For shorter queries, the increase in speed was larger. SWIPE was about twice as fast as BLAST when using the BLOSUM50 score matrix, while BLAST was about twice as fast as SWIPE for the BLOSUM62 matrix. The software is designed for 64 bit Linux on processors with SSSE3. Source code is available from http://dna.uio.no/swipe/ under the GNU Affero General Public License. Efficient parallelisation using SIMD on standard hardware makes it possible to run Smith-Waterman database searches more than six times faster than before. The approach described here could significantly widen the potential application of Smith-Waterman searches. Other applications that require optimal local alignment scores could also benefit from improved performance.

  18. [Rehabilitation evaluation on post-stroke abnormal movement pattern prevented and treated with acupuncture and rehabilitation].

    Science.gov (United States)

    Zhang, Hui-min; Tang, Qiang

    2011-06-01

    To explore the impacts of acupuncture and rehabilitation on post-stroke abnormal patterns of limb movement and evaluate them via rehabilitation method. Ninety cases of post-stroke movement disorder were randomly divided into an acupuncture-rehabilitation group, a body acupuncture group and a medication group, 30 cases in each group. In medication group, the conventional medication in neurological department was administered. In acupuncture-rehabilitation group and body acupuncture group, on the basis of the therapy as medication group, scalp acupuncture (such as parietal area and anterior parietal area, etc.), rehabilitation training and traditional body acupuncture [such as Jianyu (LI 15) and Fengshi (GB 31),etc.] were supplemented. The continuous electric stimulation was applied in body acupuncture group. The treatment lasted for 8 weeks. The assessment of clinical efficacy, Fugl-Meyer score, Modified Ashworth scale (MAS), range of motion (ROM) and shoulder pain score were taken as observation indices for rehabilitation evaluation before and after treatment in each group. The effective rate was 93.1% (27/29) in acupuncture-rehabilitation group, which was superior to 66.7% (20/30) in body acupuncture group and 57.1% (16/28) in control group (both Prehabilitation group were significantly superior to those in body acupuncture group and medication group (Prehabilitation therapy and traditional body acupuncture remarkably improve in post-stroke movement disorder. But acupuncture and rehabilitation therapy is apparently superior to traditional body acupuncture. This therapy can effectively prevent and treat post-stroke abnormal patterns and it is greatly significant in the improvement of survival quality for the patients.

  19. Final priorities; National Institute on Disability and Rehabilitation Research--Disability and Rehabilitation Research Projects and Centers Program--Rehabilitation Engineering Research Centers. Final priorities.

    Science.gov (United States)

    2013-06-11

    The Assistant Secretary for Special Education and Rehabilitative Services announces priorities under the Disability and Rehabilitation Research Projects and Centers Program administered by the National Institute on Disability and Rehabilitation Research (NIDRR). Specifically, we announce priorities for a Rehabilitation Engineering Research Center (RERC) on Rehabilitation Strategies, Techniques, and Interventions (Priority 1), Information and Communication Technologies Access (Priority 2), Individual Mobility and Manipulation (Priority 3), and Physical Access and Transportation (Priority 4). The Assistant Secretary may use one or more of these priorities for competitions in fiscal year (FY) 2013 and later years. We take this action to focus research attention on areas of national need. We intend these priorities to improve community living and participation, health and function, and employment outcomes of individuals with disabilities.

  20. 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

  1. A faster technique for rendering meshes in multiple display systems

    Science.gov (United States)

    Hand, Randall E.; Moorhead, Robert J., II

    2003-05-01

    Level of detail algorithms have widely been implemented in architectural VR walkthroughs and video games, but have not had widespread use in VR terrain visualization systems. This thesis explains a set of optimizations to allow most current level of detail algorithms run in the types of multiple display systems used in VR. It improves both the visual quality of the system through use of graphics hardware acceleration, and improves the framerate and running time through moifications to the computaitons that drive the algorithms. Using ROAM as a testbed, results show improvements between 10% and 100% on varying machines.

  2. Standards in Neurological Rehabilitation, June 1997

    Directory of Open Access Journals (Sweden)

    Michael P. Barnes

    1997-01-01

    Full Text Available The European Federation of Neurological Societies (EFNS Scientific Panel on Neurorehabilitation established a Task Force on standards in neurological rehabilitation in June 1996. The remit for the Task Force was to: (1 produce a report on the state of neurological rehabilitation across Europe; and (2 recommend standards for the provision of neurological services for disabled people. The main conclusions of the Task Force were as follows: (1 A questionnaire circulated to each European member country has indicated a significant lack of adequate neurological rehabilitation facilities across Europe. Very few countries have any established network of neurological rehabilitation centres. Few countries have adequately trained neurological rehabilitation physicians, therapists or nurses. Such poor facilities should be seen in the context of the large numbers and increasing prevalence of people with neurological disabilities. (2 The Task Force has summarized the significant benefits that can follow from the establishment of a dedicated and cost effective neurological rehabilitation service including functional improvement, reduction of unnecessary complications, better coordination and use of limited resources, improved opportunities for education, training and research and a clear point of contact for the disabled person. (3 The Task Force recommends minimum standards for the prevention of neurological disability including access to health education, genetic counselling and emergency resources. The Task Force also encourages governments to invest in improved legislation for accident prevention. (4 The Task Force has outlined some minimum standards for the staffing of a neurological rehabilitation service including improved training both for neurologists and rehabilitation physicians. Such training could include a cross-national training programme both for physicians and other health care staff. (5 The Task Force supports a two-tier system of

  3. Rehabilitation of Patients Following Myocardial Infarction.

    Science.gov (United States)

    Blumenthal, James A.; Emery, Charles F.

    1988-01-01

    Examines three behavioral strategies in cardiac rehabilitation (CR) for formal treatment for physical and psychosocial sequelae of myocardial infarction (MI): exercise therapy, Type A modification, and nonspecific psychological therapies. Concludes CR improves the quality of life among post-MI patients, but does not prolong life or significantly…

  4. 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.

  5. Simple Obstacle Avoidance Algorithm for Rehabilitation Robots

    NARCIS (Netherlands)

    Stuyt, Floran H.A.; Römer, GertWillem R.B.E.; Stuyt, Harry .J.A.

    2007-01-01

    The efficiency of a rehabilitation robot is improved by offering record-and-replay to operate the robot. While automatically moving to a stored target (replay) collisions of the robot with obstacles in its work space must be avoided. A simple, though effective, generic and deterministic algorithm

  6. Rehabilitation in multiple sclerosis.

    Science.gov (United States)

    Kubsik-Gidlewska, Anna M; Klimkiewicz, Paulina; Klimkiewicz, Robert; Janczewska, Katarzyna; Woldańska-Okońska, Marta

    2017-07-01

    The aim of the study is to present a strategy of rehabilitation in multiple sclerosis on the basis of the latest developments in the field of physiotherapy. The publications on the problem discuss a wide range of methods of physiotherapy that can be used in order to reduce the degree of disability and alleviate the symptoms associated with the disease. The complexity of the disease, the difficulty in determining the appropriate treatment and a wide range of symptoms require a comprehensive approach to the patient, which would include both pharmacology and neurorehabilitation. Rehabilitation, which includes psychotherapy and symptomatic therapy, is regarded nowadays as the best form of treatment for multiple sclerosis. An indepth diagnostic assessment of functional status and prognosis should be carried out before the start of the rehabilitation process. The prognosis should take into account the mental state, the neurological status and the awareness of the patient. The kinesiotherapy program in multiple sclerosis is based on a gradation of physiotherapy which assumes a gradual transition from basic movements to more complex ones till global functions are obtained. The most appropriate form of treatment is functional rehabilitation combined with physical procedures. Recent reports indicate the need for aerobic training to be included in the rehabilitation program. The introduction of physical activities, regardless of the severity of the disease, will reduce the negative effects of akinesia, and thus increase the functional capabilities of all body systems.

  7. They all like it hot: faster cleanup of contaminated soil and groundwater

    Energy Technology Data Exchange (ETDEWEB)

    Newmark, R., LLNL

    1998-03-01

    Clean up a greasy kitchen spill with cold water and the going is slow. Us hot water instead and progress improves markedly. So it makes sense that cleanup of greasy underground contaminants such as gasoline might go faster if hot water or steam were somehow added to the process. The Environmental Protection Agency named hundreds of sites to the Superfund list - sites that have been contaminated with petroleum products or petroleum products or solvents. Elsewhere across the country, thousands of properties not identified on federal cleanup lists are contaminated as well. Given that under current regulations, underground accumulations of solvent and hydrocarbon contaminants (the most serious cause of groundwater pollution) must be cleaned up, finding a rapid and effective method of removing them is imperative. In the early 1990`s, in collaboration with the School of Engineering at the University of California at Berkeley, Lawrence Livermore developed dynamic underground stripping. This method for treating underground contaminants with heat is much faster and more effective than traditional treatment methods.

  8. 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.

  9. Implant rehabilitation of partial maxillectomy edentulous patient

    Science.gov (United States)

    Gowda, Mahesh E.; Mohan, Murali S.; Verma, Kamal; Roy, I. D.

    2013-01-01

    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. PMID:24124314

  10. Customizable Rehabilitation Lower Limb Exoskeleton System

    Directory of Open Access Journals (Sweden)

    Riaan Stopforth

    2012-10-01

    Full Text Available Disabled people require assistance with the motion of their lower limbs to improve rehabilitation. Exoskeletons used for lower limb rehabilitation are highly priced and are not affordable to the lowerincome sector of the population. This paper describes an exoskeleton lower limb system that was designed keeping in mind that the cost must be as low as possible. The forward kinematic system that is used must be a simplified model to decrease computational time, yet allow the exoskeleton to be adjustable according to the patient's leg dimensions.

  11. 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.

  12. The rehabilitation of Whites overburden heap

    International Nuclear Information System (INIS)

    Allen, C.G.

    1984-01-01

    The Rum Jungle uranium mine was closed in 1971. Environmental studies have identified sources of heavy metal and acid pollution and a rehabilitation strategy for the mine site has been proposed. The objectives of the program are the significant reduction of heavy metal pollution being released by the various overburden heaps, open cuts and the tailings dam to the East Finniss River; the significant improvement of the aesthetic environment of the site; and the reduction in public health hazards at the mine. The rehabilitation strategy includes recontouring, covering, draining and revegetating the overburden heap

  13. Georgia - Improved Learning Environment

    Data.gov (United States)

    Millennium Challenge Corporation — The school rehabilitation activity seeks to decrease student and teacher absenteeism, increase students’ time on task, and, ultimately, improve learning and labor...

  14. [The challenge of improving evidence-based therapy adherence in the secondary prevention of coronary artery disease: the next frontier of cardiac rehabilitation].

    Science.gov (United States)

    Scardi, Sabino; Mazzone, Carmine; Umari, Paolo

    2009-06-01

    Non-adherence to prescribed drug regimens is an increasing medical problem affecting physicians and patients and contribute to negative outcomes, such as the increased risk of subsequent cardiovascular events. Analysis of various patient populations shows that the choice of drug, its tolerability and the duration of treatment influence the non-adherence. Intervention is required toward patients and health-care providers to improve medication adherence. This review deals about the prevalence of non-adherence to therapy after medical and surgical cardiac event, the risk factors affecting non-adherence and the strategies to implement it. Interventions that may successfully improve adherence should include improved physician compliance with guidelines, patient education and patient reminders, frequent visits or telephone calls from staff, simplification of the patient's drug regimen by reducing the number of pills and daily doses. Since single interventions do not appear efficaceous, it is necessary to establish multiple interventions simultaneously addressing a number of barriers to adherence.

  15. Pulmonary rehabilitation in lung transplant candidates.

    Science.gov (United States)

    Li, Melinda; Mathur, Sunita; Chowdhury, Noori A; Helm, Denise; Singer, Lianne G

    2013-06-01

    While awaiting lung transplantation, candidates may participate in pulmonary rehabilitation to improve their fitness for surgery. However, pulmonary rehabilitation outcomes have not been systematically evaluated in lung transplant candidates. This investigation was a retrospective cohort study of 345 pre-transplant pulmonary rehabilitation participants who received a lung transplant between January 2004 and June 2009 and had available pre-transplant exercise data. Data extracted included: 6-minute walk tests at standard intervals; exercise training details; health-related quality-of-life (HRQL) measures; and early post-transplant outcomes. Paired t-tests were used to examine changes in the 6MW distance (6MWD), exercise training volume and HRQL during the pre-transplant period. We evaluated the association between pre-transplant 6MWD and transplant hospitalization outcomes. The final 6MWD prior to transplantation was only 15 m less than the listing 6MWD (n = 200; p = 0.002). Exercise training volumes increased slightly from the start of the pulmonary rehabilitation program until transplant: treadmill, increase 0.69 ml/kg/min (n = 238; p volumes are well preserved among lung transplant candidates participating in pulmonary rehabilitation, even in the setting of severe, progressive lung disease. Participants with greater exercise capacity prior to transplantation have more favorable early post-transplant outcomes. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  16. Naturalness and Place in River Rehabilitation

    Directory of Open Access Journals (Sweden)

    Kirstie Fryirs

    2009-06-01

    Full Text Available An authentic approach to river rehabilitation emphasizes concerns for the natural values of a given place. As landscape considerations fashion the physical template upon which biotic associations take place, various geomorphic issues must be addressed in framing rehabilitation activities that strive to improve river health. An open-ended approach to river classification promotes applications that appreciate the values of a given river, rather than pigeonholing reality. As the geomorphic structure of some rivers is naturally simple, promoting heterogeneity as a basis for management may not always be appropriate. Efforts to protect unique attributes of river systems must be balanced with procedures that look after common features. Concerns for ecosystem functionality must relate to the behavioral regime of a given river, remembering that some rivers are inherently sensitive to disturbance. Responses to human disturbance must be viewed in relation to natural variability, recognizing how spatial relationships in a catchment, and responses to past disturbances, fashion the operation of contemporary fluxes. These fluxes, in turn, influence what is achievable in the rehabilitation of a given reach. Given the inherently adjusting and evolutionary nature of river systems, notional endpoints do not provide an appropriate basis upon which to promote concepts of naturalness and place in the rehabilitation process. These themes are drawn together to promote rehabilitation practices that relate to the natural values of each river system, in preference to applications of "cookbook" measures that build upon textbook geomorphology.

  17. Cardiac rehabilitation: an effective secondary prevention intervention.

    Science.gov (United States)

    Milligan, Fiona

    A combination of quantitative and qualitative research was used to determine the effectiveness of a cardiac rehabilitation (CR) programme in a cohort of patients referred to the service at a London hospital. Quantitative data analysis provided evidence of effectiveness of participation in CR in reduced hospital readmission rates and use of recognised pharmacological management strategies. Self-reported physical activity levels and quality of life (QOL) in individuals who participated in the cardiac rehabilitation programme were qualitatively measured with questionnaires. Results provided evidence of benefit in continued participation in exercise. However, there was no evidence of benefit to QOL status post participation at 1 year. A p-value of 0.001 provided significant statistical evidence supporting the hypothesis of benefit in continued participation in exercise in participants following attendance at a cardiac rehabilitation programme. QOL status; a statistically significant p-value of 0.001 rejected the hypothesis (H1) of benefit. This would imply that participation CR programmes does not appear to provide sustained benefits in QOL. A number of moderating variables were suggested as explaining the finding such as homogeneity of respondents, age, mood bias and the timeframe of 1 year between participation in rehabilitation and self-reporting. CR appears to be an effective but time-limited intervention in relation to improvements in QOL. Collaborative working partnerships between specialist interventions, such as CR with chronic disease management strategies may provide greater sustainability of benefits gained from participation in cardiac rehabilitation programmes.

  18. Hamstring Muscle Injuries, a Rehabilitation Protocol Purpose.

    Science.gov (United States)

    Valle, Xavier; L Tol, Johannes; Hamilton, Bruce; Rodas, Gil; Malliaras, Peter; Malliaropoulos, Nikos; Rizo, Vicenc; Moreno, Marcel; Jardi, Jaume

    2015-12-01

    Hamstring acute muscle injuries are prevalent in several sports including AFL football (Australian Football League), sprinting and soccer, and are often associated with prolonged time away from sport. In response to this, research into prevention and management of hamstring injury has increased, but epidemiological data shows no decline in injury and re-injury rates, suggesting that rehabilitation programs and return to play (RTP) criteria have to be improved. There continues to be a lack of consensus regarding how to assess performance, recovery and readiness to RTP, following hamstring strain injury. The aim of this paper was to propose rehabilitation protocol for hamstring muscle injuries based on current basic science and research knowledge regarding injury demographics and management options. Criteria-based (subjective and objective) progression through the rehabilitation program will be outlined along with exercises for each phase, from initial injury to RTP.

  19. Inequality in rehabilitation

    DEFF Research Database (Denmark)

    Guldager, Rikke; Poulsen, Ingrid

    OBJECTIVES: The overall Ph.d.-study aims to investigate rehabilitation trajectories in adult patients with traumatic brain injury (TBI) and stroke, and to describe mechanisms behind the institutionalized (health care) part of inequality in health with emphasis on interfaces and critical transitions...... from time of accident to twelve month follow-up. The case study aims to explore the process of rehabilitation in a high status patient, related to professions in healthcare. The focus is on how a high status patient is perceived and handled in organizations and among professions, and strategies applied...... by the patient and relatives. METHODS: Observation and qualitative interview has been conducted of one patient following the patients’ trajectories though different phases of the rehabilitation process during admission at Traumatic Brain Unit. Interdisciplinary meetings are regarded as key elements...

  20. Ragged Chute rehabilitation project

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, Paul; Slopek, Richard [Canadian Projects Ltd., Calgary, (Canada); Guzwell, Robert [TransAlta, Calgary, (Canada)

    2010-07-01

    The Ragged Chute development, located in northern Ontario, was originally constructed to provide compressed air to a local silver mining company. It was composed of a free overflow spillway, the air plant intake, a concrete gravity retaining wall and an earthfill dyke abutment. The advantage of the river flow and the head developed by the dam for the air plant was recently put to use by the addition of a hydro plant. This paper provided an overview of the use of the river flow over the years and described the recent rehabilitation work being done to upgrade the installations to current dam safety standards. Site inspections were carried out in 2006 as part of the dam safety review to assess the overall condition of the structures. The major operation of the rehabilitation work involved the upgrading of the original fixed crest spillway with a new labyrinth spillway structure. Canadian Hydro completed the dam safety safety rehabilitation work by October 2009.

  1. Tundra Rehabilitation in Alaska's Arctic

    Science.gov (United States)

    Lynn, L. A.

    2012-12-01

    Oil exploration in Alaska's Arctic has been conducted for more than 40 years, resulting in over 3,640 ha of gravel fill placed for roads, pads, and airstrips to support the industry. Likewise, tundra disturbance from burying power lines and by tundra vehicle travel are also common. Rehabilitation of disturbed sites began around 2002, with well over 150 ha that has been previously treated or is currently being rehabilitated. Two primary goals of rehabilitation efforts have been 1) revegetation by indigenous species, and 2) limiting thermokarst. Early efforts were concerned that removing gravel and having exposed bare ground would lead to extensive subsidence and eolian erosion. Native grass cultivars (e.g. Poa glauca, Arctagrostis latifolia, and Festuca rubra) were seeded to create vegetation cover quickly with the expectation that these grasses would survive only temporarily. The root masses and leaf litter were also expected to trap indigenous seed to enhance natural recolonization by indigenous plants. Due to the remote location of these sites, many of which are only accessible by helicopter, most are visited only two to three times following cultivation treatments, providing a limited data pool. At many sites, the total live seeded grass cover declined about 15% over the first 5¬-6 years (from around 30% to 15% cover), while total live indigenous vascular cover increased from no or trace cover to an average of 10% cover in that time. Cover of indigenous vascular plants at sites that were not seeded with native grass cultivars averaged just less than 10% after 10 years, showing no appreciable difference between the two approaches. Final surface elevations at the sites affect local hydrology and soil moisture. Other factors that influence the success of vegetation cover are proximity to the Arctic coast (salt effects), depth of remaining gravel, and changes in characteristics of the near-surface soil. Further development of rehabilitation techniques and the

  2. Functional Assessment in Transition and Rehabilitation for Adolescents and Adults with Learning Disorders.

    Science.gov (United States)

    Bullis, Michael, Ed.; Davis, Cheryl D., Ed.

    This manual is based on a 3-year, federally funded program, Project FASTER (Functional Assessment Services for Transition, Education, and Rehabilitation), that developed functional assessment procedures and provided assessment services to adolescents and adults with learning or behavioral disorders who were involved in school-based transition…

  3. Rehabilitation Engineering Sourcebook [and] Rehabilitation Engineering Sourcebook Supplement I.

    Science.gov (United States)

    Institute for Information Studies, Falls Church, VA.

    Intended for use by rehabilitation counselors and work supervisors, the sourcebook contains 173 problems and solutions provided by rehabilitation engineering. A section titled "Guidelines for Formulating Problem Statements" is intended to summarize the most effective ways for either disabled individuals or rehabilitation practitioners to…

  4. [Domiciliary rehabilitation: an innovative form of outpatient medical rehabilitation].

    Science.gov (United States)

    Schmidt-Ohlemann, M; Schweizer, C

    2009-02-01

    Domiciliary rehabilitation is an innovative form of outpatient medical rehabilitation. All components of service provision are delivered in the rehabilitant's home by a multidisciplinary team headed by a physician. The key context factors in the rehab process can be taken into account firsthand. The target group of domiciliary rehabilitation consists of multimorbid patients with severe functional limitations and complex assistance needs, whose rehabilitation options would be poor without this outreach service. Here, as suggested by the WHO concept of functional health, the interaction between health condition and environmental factors is kept in view much better than in other forms of rehabilitation. The positive effects and the efficiency of the rehabilitation measures provided can be assessed very well at a high descriptive level. This fact had been a precondition for legal establishment of domiciliary rehabilitation as a regular service. Domiciliary rehabilitation not only complies with key demands in the health and social policy fields, such as priority of outpatient over inpatient treatment or rehabilitation to precede and accompany long term care, it also constitutes an alternative concept challenging the traditional inpatient rehabilitation approach. The patient, hence, no longer is to fit into the institutional framework of outpatient or inpatient rehabilitation, but the team will fit into the specifics of the patient's unique social and material situation.

  5. Cardiac rehabilitation with a nurse case manager (GoHeart) across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study.

    Science.gov (United States)

    Hansen, Vibeke Brogaard; Maindal, Helle Terkildsen

    2014-01-01

    In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR). The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM). A one-year follow-up study. A CR programme (GoHeart) was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF) ≥45%). Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS)) were assessed at admission (phase IIa), at three months at discharge (phase IIb) and at one-year follow-up (phase III). Intention-to-treat and predefined subgroup analysis on sex was performed. Of 241 patients, 183 (75.9%) were included (mean age 63.8 years). At discharge improvements were found in total-cholesterol (p management (p < 0.001), Health status Short Form 12 version (SF12; physical; p < 0.001 and mental; p < 0.01) and in depression symptoms (p < 0.01). At one-year follow-up these outcomes were maintained; additionally there was improvement in body mass index (BMI; p < 0.05), and high density lipoprotein (HDL; p < 0.05). There were no sex differences. CR shared between local and regional health authorities led by a NCM (GoHeart) improves risk factors, self-care and psychosocial factors. Further improvements in most variables were at one-year follow-up.

  6. The Danish Cardiac Rehabilitation Database

    Directory of Open Access Journals (Sweden)

    Zwisler AD

    2016-10-01

    Full Text Available Ann-Dorthe Zwisler,1 Henriette Knold Rossau,1 Anne Nakano,2,3 Sussie Foghmar,4 Regina Eichhorst,5 Eva Prescott,6 Charlotte Cerqueira,7 Anne Merete Boas Soja,4 Gunnar H Gislason,8–10 Mogens Lytken Larsen,5 Ulla Overgaard Andersen,11 Ida Gustafsson,4 Kristian K Thomsen,12 Lene Boye Hansen,13 Signe Hammer,14 Lone Viggers,15 Bo Christensen,16 Birgitte Kvist,17 Cecilie Lindström Egholm,18 Ole May19 On behalf of the Working Group of Preventive Cardiology and Rehabilitation, Danish Society of Cardiology, and the Working Group of Cardiac Clinical Registries, Danish Society of Cardiology 1Danish Centre for Rehabilitation and Palliative Care, Odense University Hospital and University of Southern Denmark, Odense, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3Registry Support Centre (West – Clinical Quality Improvement & Health Informatics, Aarhus, 4Department of Cardiology, Copenhagen University Hospital, Hvidovre, 5Department of Cardiology, Aalborg University Hospital, Aalborg, 6Department of Cardiology, Bispebjerg Hospital, University of Copenhagen, Copenhagen, 7Registry Support Centre (East – Epidemiology and Biostatistics, Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, 8Department of Cardiology, Copenhagen University Hospital Gentofte, Hellerup, 9The Danish Heart Foundation, Copenhagen, 10The National Institute of Public Health, University of Southern Denmark, 11Department of Cardiology, Holbaek Hospital, University of Copenhagen, Copenhagen, 12Department of Cardiology, Hospital of Southwest Jutland, Esbjerg, 13Department of Cardiology, Gentofte Hospital, Gentofte, 14Department of Occupational Therapy and Physiotherapy, Herlev Hospital, Herlev, 15Department of Nutrition, Regional Hospital West Jutland, Holstebro, 16Department of General Medicine, School of Public Health, Aarhus University, Aarhus, 17Department of Health Care and Prevention, Municipality of Frederikshavn, Frederikshavn, 18

  7. [Dysphagia and swallowing rehabilitation].

    Science.gov (United States)

    Shigematsu, Takashi; Fujishima, Ichiro

    2015-02-01

    Dysphagia is a life-threatening disorder caused by many medical conditions such as stroke, neurological disorders, tumors, etc. The symptoms of dysphagia are quite variable and diagnosed by observation or through screening involving instrumental swallowing examinations such as video-fluoroscopy and video-endoscopy, to determine functional severity and treatment-prognosis. Direct- and indirect-therapy is used with and without food, respectively. Swallowing rehabilitation is very effective, and could be used in conjunction with compensatory techniques. Here we present an overview of dysphagia and swallowing rehabilitation.

  8. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features on this page, ... to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may determine that you ...

  9. Urban Telemedicine: The Applicability of Teleburns in the Rehabilitative Phase.

    Science.gov (United States)

    Liu, Yuk Ming; Mathews, Katie; Vardanian, Andrew; Bozkurt, Taylan; Schneider, Jeffrey C; Hefner, Jaye; Schulz, John T; Fagan, Shawn P; Goverman, Jeremy

    Telemedicine has been successfully used in many areas of medicine, including triage and evaluation of the acute burn patient. The utility of telemedicine during the rehabilitative phase of burn care has yet to be evaluated; therefore, we expanded our telemedicine program to link our burn center with a rehabilitation facility. The goal of this project was to demonstrate cost-effective improvements in the transition and quality of care. A retrospective review was performed on all patients enrolled in our telemedicine/rehabilitation program between March 2013 and March 2014. Data collected included total number of encounters, visits, type of visit, physician time, and readmissions. Transportation costs were based on local ambulance rates between the two facilities. The impact of telemedicine was evaluated with respect to the time saved for the physician, burn center, and burn clinic, as well as rehabilitative days saved. A patient satisfaction survey was also administered. A total of 29 patients participated in 73 virtual visits through the telemedicine project. Virtual visits included new consults, preoperative evaluations, and postoperative follow-ups. A total of 146 ambulance transports were averted during the study period, totaling $101,110. Virtual visits saved 6.8 outpatient burn clinic days, or 73 clinic appointments of 30-min duration. The ability to perform more outpatient surgery resulted in 80 inpatient bed days saved at the burn hospital. The rehabilitation hospital saved an average of 2 to 3 patient days secondary to unnecessary travel. Satisfaction surveys demonstrated patient satisfaction with the encounters, primarily related to time saved. The decrease in travel time for the patient from the rehabilitation hospital to outpatient burn clinic improved adherence to the rehabilitation care plan and resulted in increased throughput at the rehabilitation facility. Videoconferencing between a burn center and rehabilitation hospital streamlined patient care

  10. Computer-assisted technologies used in oral rehabilitation and the clinical documentation of alleged advantages - a systematic review.

    Science.gov (United States)

    Jokstad, A

    2017-04-01

    The objective of this systematic review is to identify current computer-assisted technologies used for managing patients with a need to re-establish craniofacial appearance, subjective discomfort and stomatognathic function, and the extent of their clinical documentation. Electronic search strategies were used for locating clinical studies in MEDLINE through PubMed and in the Cochrane library, and in the grey literature through searches on Google Scholar. The searches for commercial digital products for use in oral rehabilitation resulted in identifying 225 products per November 2016, used for patient diagnostics, communication and therapy purposes, and for other computer-assisted applications in context with oral rehabilitation. About one-third of these products were described in about 350 papers reporting from clinical human studies. The great majority of digital products for use in oral rehabilitation has no clinical documentation at all, while the products from a distinct minority of manufacturers have frequently appeared in more or less scientific reports. Moore's law apply also to digital dentistry, which predicts that the capacity of microprocessors will continue to become faster and with lower cost per performance unit, and innovative software programs will harness these improvements in performance. The net effect is the noticeable short product life cycle of digital products developed for use in oral rehabilitation and often lack of supportive clinical documentation. Nonetheless, clinicians must request clinically meaningful information about new digital products to assess net benefits for the patients or the dental professionals and not accept only technological verbiage as a basis for product purchases. © 2017 John Wiley & Sons Ltd.

  11. Objective assessment of cortical activity changes in stroke patients before and after hand rehabilitation with and without botulinum toxin injection

    Directory of Open Access Journals (Sweden)

    Omnia A Abu-Bakr

    2017-01-01

    Conclusion BTX injection in spastic muscles of the wrist and hand, followed by a rehabilitation program led to greater clinical and functional improvement compared with implementing the rehabilitation program alone.

  12. EFFECTS OF FUNCTIONAL ELECTRICAL STIMULATION IN REHABILITATION WITH HEMIPARESIS PATIENTS

    Science.gov (United States)

    Tanović, Edina

    2009-01-01

    Cerebrovascular accident is a focal neurological deficiency occurring suddenly and lasting for more than 24 hours. The purpose of our work is to determine the role of the functional electrical simulation (FES) in the rehabilitation of patients with hemiparesis, which occurred as a consequence of a cerebrovascular accident. This study includes the analysis of two groups of 40 patients with hemiparesis (20 patients with deep hemiparesis and 20 patients with light hemi- paresis), a control group which was only treated with kinesiotherapy and a tested group which was treated with kinesiotherapy and functional electrical stimulation. Both groups of patients were analyzed in respect to their sex and age. Additional analysis of the walking function was completed in accordance with the BI and RAP index. The analysis of the basic demographical data demonstrated that there is no significant difference between the control and tested group. The patients of both groups are equal in respect of age and sex. After 4 weeks of rehabilitation of patients with deep and light hemiparesis there were no statistically significant differences between the groups after evaluation by the BI index. However, a statistically significant difference was noted between the groups by the RAP index among patients with deep hemiparesis. After 8 weeks of rehabilitation the group of patients who were treated with kinesiotherapy and functional electrical stimulation showed better statistically significant results of rehabilitation in respect to the control group with both the BI index and the RAP index (p<0,001). In conclusion, we can state that the patients in rehabilitation after a cerebrovascular accident require rehabilitation longer than 4 weeks. Walking rehabilitation after stroke is faster and more successful if we used functional electrical stimulation, in combination with kinesiotherapy, in patients with disabled extremities. PMID:19284395

  13. Drought evolution: greater and faster impacts on blue water than on green water

    Science.gov (United States)

    Destouni, G.; Orth, R.

    2017-12-01

    Drought propagates through the terrestrial water cycle, affecting different interlinked geospheres which have so far been mostly investigated separately and without direct comparison. By use of comprehensive multi-decadal data from >400 near-natural catchments along a steep climate gradient across Europe we here analyze drought propagation from precipitation (deficits) through soil moisture to runoff (blue water) and evapotranspiration (green water). We show that soil-moisture droughts reduce runoff stronger and faster than evapotranspiration. While runoff responds within weeks, evapotranspiration can be unaffected for months, or even entirely as in central and northern Europe. Understanding these different drought pathways towards blue and green water resources contributes to improve food and water security and offers early warning potential to mitigate (future) drought impacts on society and ecosystems.

  14. 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

  15. Complex rehabilitation and the clinical condition of working rheumatoid arthritis patients: does cryotherapy always overtop traditional rehabilitation?

    Science.gov (United States)

    Księżopolska-Orłowska, Krystyna; Pacholec, Anna; Jędryka-Góral, Anna; Bugajska, Joanna; Sadura-Sieklucka, Teresa; Kowalik, Katarzyna; Pawłowska-Cyprysiak, Karolina; Łastowiecka-Moras, Elżbieta

    2016-01-01

    Rehabilitation slows the progress of rheumatoid arthritis (RA) and prevents progression of disability. This study aimed to compare the impact of two rehabilitation programmes on pain, disease activity, locomotor function, global health and work ability forecast in RA patients. Sixty-four employed women aged 24-65 years participated in the study. All patients underwent individual and instrumental kinesiotherapy. Thirty-two patients underwent cryogenic chamber therapy and local cryotherapy as well as non-weight-bearing, instrumental and individual kinesiotherapy. The remaining 32 patients received traditional rehabilitation in the form of electromagnetic and instrumental therapy, individual and pool-based non-weight-bearing kinesiotherapy. Rehabilitation lasted 3 weeks. Patients were examined three times: prior to rehabilitation, after 3 weeks of therapy and 3 months after completion of rehabilitation. The following study instruments were used: to assess disease activity: DAS-28; functional impairment: HAQ-DI; pain severity: VAS; patients' overall well-being: a scale from 0 to 100 (Global Health Index); and patients' own prognosis of fitness for work: the 6th question from Work Ability Index (WAI). Statistical analysis of data was performed using the STATISTICA 8.0 package. Mixed-design two-way analysis of variance was used for hypothesis testing. All patients improved after rehabilitation. The group of patients those who underwent cryotherapy had improved DAS-28, HAQ-DI, VAS and global health scores immediately following the 3-week rehabilitation programme (p cryotherapy resulted in greater improvement in disease activity DAS-28 [F(2,105) = 5.700; p = 0.007; η(2) = 0.084] and HAQ-DI locomotor function scores [F(2,109) = 6.771; p = 0.003; η(2) = 0.098] compared to traditional rehabilitation. The impact of both forms of rehabilitation on patients' own prognosis of work ability in the next 2 years was not significant. Results of patients who underwent

  16. 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.

  17. Faster but not smarter: effects of caffeine and caffeine withdrawal on alertness and performance.

    Science.gov (United States)

    Rogers, Peter J; Heatherley, Susan V; Mullings, Emma L; Smith, Jessica E

    2013-03-01

    Despite 100 years of psychopharmacological research, the extent to which caffeine consumption benefits human functioning remains unclear. To measure the effects of overnight caffeine abstinence and caffeine administration as a function of level of habitual caffeine consumption. Medium-high (n = 212) and non-low (n = 157) caffeine consumers completed self-report measures and computer-based tasks before (starting at 10:30 AM) and after double-blind treatment with either caffeine (100 mg, then 150 mg) or placebo. The first treatment was given at 11:15 AM and the second at 12:45 PM, with post-treatment measures repeated twice between 1:45 PM and 3:30 PM. Caffeine withdrawal was associated with some detrimental effects at 10:30 AM, and more severe effects, including greater sleepiness, lower mental alertness, and poorer performance on simple reaction time, choice reaction time and recognition memory tasks, later in the afternoon. Caffeine improved these measures in medium-high consumers but, apart from decreasing sleepiness, had little effect on them in non-low consumers. The failure of caffeine to increase mental alertness and improve mental performance in non-low consumers was related to a substantial caffeine-induced increase in anxiety/jitteriness that offset the benefit of decreased sleepiness. Caffeine enhanced physical performance (faster tapping speed and faster simple and choice reaction times) in both medium-high and non-low consumers. While caffeine benefits motor performance and tolerance develops to its tendency to increase anxiety/jitteriness, tolerance to its effects on sleepiness means that frequent consumption fails to enhance mental alertness and mental performance.

  18. Crossroads in aphasia rehabilitation

    NARCIS (Netherlands)

    W.M.E. van de Sandt-Koenderman (Mieke)

    2007-01-01

    textabstractThis thesis focusses on two types of aphasia rehabilitation, cognitive linguistic treatment (CLT) and AAC (Augmentative and Alternative Communication) training. In a study of the effect of nonlinguistic variables on the outcome of CLT, it was shown, that neuropsychological data

  19. Basics of SCI Rehabilitation

    Medline Plus

    Full Text Available ... Abuse and Spinal Cord Injury Allen Heinemann, PhD How Peer Counseling Works Julie Gassaway, MS, RN Pediatric Injuries Pediatric Spinal ... difficult obstacle to overcome in rehabilitation? play_arrow How soon should people return to school or work after a spinal cord injury? play_arrow What’s ...

  20. Medicare and Medicaid programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; electronic reporting pilot; Inpatient Rehabilitation Facilities Quality Reporting Program; revision to Quality Improvement Organization regulations. Final rule with comment period.

    Science.gov (United States)

    2012-11-15

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2013 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program, the ASC Quality Reporting (ASCQR) Program, and the Inpatient Rehabilitation Facility (IRF) Quality Reporting Program. We are continuing the electronic reporting pilot for the Electronic Health Record (EHR) Incentive Program, and revising the various regulations governing Quality Improvement Organizations (QIOs), including the secure transmittal of electronic medical information, beneficiary complaint resolution and notification processes, and technical changes. The technical changes to the QIO regulations reflect CMS' commitment to the general principles of the President's Executive Order on Regulatory Reform, Executive Order 13563 (January 18, 2011).

  1. The contemporary coal industry: dancing to faster music

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R. [World Coal Institute, London (United Kingdom)

    1997-09-01

    Within a framework that supports sustainable development, the issues of changing coal markets, environmental policy and climate change, and the positive marketing of coal as a solution to energy demand are discussed. Changes affect both domestic and international markets, and each subset of the market is different. In Europe, coal consumption is declining in contrast with expanding Asian energy markets. Clean coal technologies improve efficiency and make coal more acceptable. The greatest reductions in carbon dioxide emissions can be realized within the least efficient areas of coal consumption, in particular the domestic markets in Asia, eastern Europe, and Africa.

  2. Knowledge Translation: The Bridging Function of Cochrane Rehabilitation.

    Science.gov (United States)

    Negrini, Stefano; Gimigliano, Francesca; Arienti, Chiara; Kiekens, Carlotte

    2017-12-12

    Cochrane Rehabilitation is aimed to ensure that all rehabilitation professionals can apply Evidence Based Clinical Practice and take decisions according to the best and most appropriate evidence in this specific field, combining the best available evidence as gathered by high-quality Cochrane systematic reviews, with their own clinical expertise and the values of patients. This mission can be pursued through knowledge translation. The aim of this article is to shortly present what knowledge translation is, how and why Cochrane (previously known as Cochrane Collaboration) is trying to reorganize itself in light of knowledge translation, and the relevance that this process has for Cochrane Rehabilitation and in the end for the whole world of rehabilitation. It is well known how it is difficult to effectively apply in everyday life what we would like to do and to apply the scientific knowledge in the clinical field: this is called the know-do gap. In the field of evidence-based medicine, where Cochrane belongs, it has been proven that high-quality evidence is not consistently applied in practice. A solution to these problems is the so-called knowledge translation. In this context, Cochrane Rehabilitation is organized to provide the best possible knowledge translation in both directions (bridging function), obviously toward the world of rehabilitation (spreading reviews), but also to the Cochrane community (production of reviews significant for rehabilitation). Cochrane is now strongly pushing to improve its knowledge translation activities, and this creates a strong base for Cochrane Rehabilitation work, focused not only on spreading the evidence but also on improving its production to make it more meaningful for the world of rehabilitation. Copyright © 2017 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  3. 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.

  4. Challenges of rehabilitation case mix measurement in Ontario hospitals.

    Science.gov (United States)

    Sutherland, Jason Murray; Walker, Jan

    2008-03-01

    Case mix classification systems have been adopted in many countries as a method to manage and finance healthcare in acute care settings; the most popular systems are based on diagnosis related groups. The most successful of those case mix systems differentiate patient types by reflecting both the intensity of resources consumed and patient acuity. Case mix systems for use with non-acute hospital activity have not been as wide-spread; other than in the United States, little attention has been directed towards case mix classification for rehabilitation activity. In a province with over 13 million inhabitants with 2496 rehabilitation beds, inpatient rehabilitation is an important component of hospital care in Ontario, Canada, and consists of the spectrum of intensive rehabilitation activities intended to restore function. Although case mix adjusted activity has been the currency in Ontario's Integrated Population Based Allocation hospital funding formula, rehabilitation activity has not been subjected to case mix measurement. A project to examine case mix classification for adult inpatient rehabilitation activity was initiated by the Ontario Ministry of Health and Long-Term Care whose outcome was a case mix system and associated cost weights that would result in rehabilitation activity being incorporated into the hospital funding formula. The process described in this study provides Ontario's provincial government with a case mix classification system for adult inpatient rehabilitation activity although there remain areas for improvement.

  5. Query-dependent banding (QDB for faster RNA similarity searches.

    Directory of Open Access Journals (Sweden)

    Eric P Nawrocki

    2007-03-01

    Full Text Available When searching sequence databases for RNAs, it is desirable to score both primary sequence and RNA secondary structure similarity. Covariance models (CMs are probabilistic models well-suited for RNA similarity search applications. However, the computational complexity of CM dynamic programming alignment algorithms has limited their practical application. Here we describe an acceleration method called query-dependent banding (QDB, which uses the probabilistic query CM to precalculate regions of the dynamic programming lattice that have negligible probability, independently of the target database. We have implemented QDB in the freely available Infernal software package. QDB reduces the average case time complexity of CM alignment from LN(2.4 to LN(1.3 for a query RNA of N residues and a target database of L residues, resulting in a 4-fold speedup for typical RNA queries. Combined with other improvements to Infernal, including informative mixture Dirichlet priors on model parameters, benchmarks also show increased sensitivity and specificity resulting from improved parameterization.

  6. COMPARISON OF REHABILITATION POLICIES IN LITHUANIA AND THE UNITED KINGDOM

    Directory of Open Access Journals (Sweden)

    Danguolė Jankauskienė

    2017-03-01

    Full Text Available The article analyses the formation, implementation and evaluation of rehabilitation policy in Lithuania and the United Kingdom through a comparative analysis and two empirical sociological qualitative studies. The following scientific problematic issues were raised: what is the situation in the field of rehabilitation policy formation, development and assessment in the historical perspective in Lithuania and the United Kingdom, what are the advantages and disadvantages of the implementation of rehabilitation policy in Lithuania and the UK, and what are the possibilities to change and improve the formation and implementation of rehabilitation policy. A comparative analysis of the principles of development, financing, legal regulation, advantages and disadvantages has been carried out, using scientific publications, reports, publications of foreign research papers, legal acts as well as qualitative researches of experts in Lithuania and the United Kingdom. Rehabilitation policies have been found to have similarities in the United Kingdom and Lithuania, but they are quite different as well. Lithuania developed its rehabilitation policy in a relatively short time in all areas of development amid a rapidly changing environment, with effective legal regulation, ambitious measures and limited resources. The United Kingdom’s rehabilitation policy has a much longer history; it changed in many ways to adapt to the needs of patients and society. It is based on the approach to the patient as an individual having a particular disorder, and the rehabilitation system promotes an individual rehab program in which the patient is an active participant and can even contribute to the plan, select services they need, and control the rehabilitation budget assigned to them. The system of rehabilitation policy between Lithuania and the UK varies considerably. In the UK, the focus is on the improvement of rehabilitation policy, working with communities, introducing

  7. 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.

  8. Psychiatric Assessment and Rehabilitation of Burn Patients

    Directory of Open Access Journals (Sweden)

    Süleyman Akarsu

    2017-03-01

    Full Text Available Objective: Psychiatric rehabilitation has gained significance owing to improved healthcare facilities for burn injuries and decreased mortality/ morbidity rates. Burn traumas may result in psychiatric signs such as denial, anger, guilt, confusion, disgrace, anxiety, distress, and nervousness. Psychiatric disorders such as delirium, depression, anxiety, post-traumatic stress disorder, and sexual problems can also be encountered. Therefore, it is necessary to look for these signs and disorders through regular sessions with burn patients and appropriate psychometric tests. This study aims at examining the process of psychological rehabilitation for burn patients in light of the current literature. Material and Methods: This study has been carried out in the light of the main and current literature review. The study intends to put forth the data observed in the course of the psychological diagnosis, treatment and rehabilitation of burn patients. The study has been conducted in accordance with the Helsinki Declaration Guidelines. Results: Treatment and rehabilitation process requires a multidisciplinary teamwork that consists of physicians, dieticians, psychologists, social service specialists, and other healthcare workers who can meet the needs of burn patients and their families. It is necessary for the team to contribute both to the hospitalization process and the social environment of the patients and their families. Conclusion: It is observed that the quality of life of these patients can be considerably improved with the effective assessment of psychiatric signs that occur during or after the injury and with appropriate treatment methods.

  9. Early Rehabilitation After Stroke: a Narrative Review.

    Science.gov (United States)

    Coleman, Elisheva R; Moudgal, Rohitha; Lang, Kathryn; Hyacinth, Hyacinth I; Awosika, Oluwole O; Kissela, Brett M; Feng, Wuwei

    2017-11-07

    Despite current rehabilitative strategies, stroke remains a leading cause of disability in the USA. There is a window of enhanced neuroplasticity early after stroke, during which the brain's dynamic response to injury is heightened and rehabilitation might be particularly effective. This review summarizes the evidence of the existence of this plastic window, and the evidence regarding safety and efficacy of early rehabilitative strategies for several stroke domain-specific deficits. Overall, trials of rehabilitation in the first 2 weeks after stroke are scarce. In the realm of very early mobilization, one large and one small trial found potential harm from mobilizing patients within the first 24 h after stroke, and only one small trial found benefit in doing so. For the upper extremity, constraint-induced movement therapy appears to have benefit when started within 2 weeks of stroke. Evidence for non-invasive brain stimulation in the acute period remains scant and inconclusive. For aphasia, the evidence is mixed, but intensive early therapy might be of benefit for patients with severe aphasia. Mirror therapy begun early after stroke shows promise for the alleviation of neglect. Novel approaches to treating dysphagia early after stroke appear promising, but the high rate of spontaneous improvement makes their benefit difficult to gauge. The optimal time to begin rehabilitation after a stroke remains unsettled, though the evidence is mounting that for at least some deficits, initiation of rehabilitative strategies within the first 2 weeks of stroke is beneficial. Commencing intensive therapy in the first 24 h may be harmful.

  10. Virtual reality rehabilitation for stroke patients: Recent review and research issues

    Science.gov (United States)

    Arip, Eza Surya Mohd; Ismail, Waidah; Nordin, Md Jan; Radman, Abduljalil

    2017-11-01

    Stroke is one of the main causes of disability in the world. In order for stroke survivors to reduce their disability, they need to go through a rehabilitation process to regain back their independence and improve their quality of life. To guide patients in their rehabilitation process and improve their receptiveness in performing repetitive exercises, a new rehabilitation training program using Virtual Reality (VR) technology has been introduced. This has attracted many researchers to explore more on VR technology as a new tool for stroke patient's rehabilitation. This paper presents a review on existing VR systems that have been developed for stroke rehabilitation. First, recent VR systems utilized for rehabilitation after stroke are delineated and categorized. Each of these categories concludes with a discussion on limitations and any issues that arise from it. Finally, a concise summary with significant findings and future possibilities in VR rehabilitation research is presented in table format.

  11. Faster Algorithms for Computing Longest Common Increasing Subsequences

    DEFF Research Database (Denmark)

    Kutz, Martin; Brodal, Gerth Stølting; Kaligosi, Kanela

    2011-01-01

    of the alphabet, and Sort is the time to sort each input sequence. For k⩾3 length-n sequences we present an algorithm which improves the previous best bound by more than a factor k for many inputs. In both cases, our algorithms are conceptually quite simple but rely on existing sophisticated data structures......We present algorithms for finding a longest common increasing subsequence of two or more input sequences. For two sequences of lengths n and m, where m⩾n, we present an algorithm with an output-dependent expected running time of and O(m) space, where ℓ is the length of an LCIS, σ is the size....... Finally, we introduce the problem of longest common weakly-increasing (or non-decreasing) subsequences (LCWIS), for which we present an -time algorithm for the 3-letter alphabet case. For the extensively studied longest common subsequence problem, comparable speedups have not been achieved for small...

  12. Simple scaling for faster tracking simulation in accelerator multiparticle dynamics

    International Nuclear Information System (INIS)

    MacLachlan, J.A.

    2001-01-01

    Macroparticle tracking is a direct and attractive approach to following the evolution of a phase space distribution. When the particles interact through short range wake fields or when inter-particle force is included, calculations of this kind require a large number of macroparticles. It is possible to reduce both the number of macroparticles required and the number of tracking steps per unit simulated time by employing a simple scaling which can be inferred directly from the single-particle equations of motion. In many cases of practical importance the speed of calculation improves with the fourth power of the scaling constant. Scaling has been implemented in an existing longitudinal tracking code; early experience supports the concept and promises major time savings. Limitations on the scaling are discussed

  13. Rehabilitation time before disability pension

    Directory of Open Access Journals (Sweden)

    Støver Morten

    2012-10-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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.

  14. 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.

  15. Quantum Monte Carlo: Faster, More Reliable, And More Accurate

    Science.gov (United States)

    Anderson, Amos Gerald

    2010-06-01

    The Schrodinger Equation has been available for about 83 years, but today, we still strain to apply it accurately to molecules of interest. The difficulty is not theoretical in nature, but practical, since we're held back by lack of sufficient computing power. Consequently, effort is applied to find acceptable approximations to facilitate real time solutions. In the meantime, computer technology has begun rapidly advancing and changing the way we think about efficient algorithms. For those who can reorganize their formulas to take advantage of these changes and thereby lift some approximations, incredible new opportunities await. Over the last decade, we've seen the emergence of a new kind of computer processor, the graphics card. Designed to accelerate computer games by optimizing quantity instead of quality in processor, they have become of sufficient quality to be useful to some scientists. In this thesis, we explore the first known use of a graphics card to computational chemistry by rewriting our Quantum Monte Carlo software into the requisite "data parallel" formalism. We find that notwithstanding precision considerations, we are able to speed up our software by about a factor of 6. The success of a Quantum Monte Carlo calculation depends on more than just processing power. It also requires the scientist to carefully design the trial wavefunction used to guide simulated electrons. We have studied the use of Generalized Valence Bond wavefunctions to simply, and yet effectively, captured the essential static correlation in atoms and molecules. Furthermore, we have developed significantly improved two particle correlation functions, designed with both flexibility and simplicity considerations, representing an effective and reliable way to add the necessary dynamic correlation. Lastly, we present our method for stabilizing the statistical nature of the calculation, by manipulating configuration weights, thus facilitating efficient and robust calculations. Our

  16. Evaluation of functional outcomes of physical rehabilitation and medical complications in spinal cord injury victims of the Sichuan earthquake.

    Science.gov (United States)

    Li, Yongqiang; Reinhardt, Jan D; Gosney, James E; Zhang, Xia; Hu, Xiaorong; Chen, Sijing; Ding, Mingpu; Li, Jianan

    2012-06-01

    To characterize a spinal cord injury (SCI) population from the 2008 Sichuan earthquake in China; to evaluate functional outcomes of physical rehabilitation interventions; to assess potential determinants of rehabilitation effectiveness; and to assess medical complications and management outcomes. A total of 51 earthquake victims with SCI were enrolled and underwent rehabilitation programming. Functional rehabilitation outcomes included ambulation ability, wheelchair mobility and activities of daily living (ADL) assessed with the Modified Barthel Index at the beginning and end of rehabilitation. Effectiveness of rehabilitation and the effect of other predictors were evaluated by mixed effects regression. Outcomes of medical complication management were determined by comparison of the incidence of respective complications at the beginning and end of rehabilitation. Ambulation, wheelchair mobility and ADL were significantly improved with rehabilitation programming. Both earlier rescue and earlier onset of rehabilitation were significant positive predictors of rehabilitation effectiveness, whereas delayed onset of rehabilitation combined with prolonged time to rescue resulted in a lesser positive effect. Medical complications were managed effectively in 63% (pressure ulcers) to 85% (deep vein thrombosis) of patients during rehabilitation. Earthquake victims with SCI may achieve significantly improved functional rehabilitation functional outcomes on a formal, institutional-based physical rehabilitation programme.

  17. 75 FR 27327 - National Institute on Disability and Rehabilitation Research (NIDRR)-Disability and...

    Science.gov (United States)

    2010-05-14

    ... action to focus research attention on areas of national need. We intend this priority to improve... seeks to: (1) Improve the quality and utility of disability and rehabilitation research; (2) foster an... programs to improve rehabilitation outcomes for underserved populations; (4) identify research gaps; (5...

  18. Effect of a group-based rehabilitation programme on glycaemic control and cardiovascular risk factors in type 2 diabetes patients: The Copenhagen Type 2 Diabetes Rehabilitation Project

    DEFF Research Database (Denmark)

    Vadstrup, Eva Soelberg; Frølich, Anne; Perrild, Hans Jørgen Duckert

    2011-01-01

    To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes.......To compare the effectiveness of a group-based rehabilitation programme with an individual counselling programme at improving glycaemic control and cardiovascular risk factors among patients with type 2 diabetes....

  19. Evaluating the effect of a web-based quality improvement system with feedback and outreach visits on guideline concordance in the field of cardiac rehabilitation: rationale and study protocol.

    Science.gov (United States)

    van Engen-Verheul, Mariëtte M; de Keizer, Nicolette F; van der Veer, Sabine N; Kemps, Hareld M C; Scholte op Reimer, Wilma J M; Jaspers, Monique W M; Peek, Niels

    2014-12-31

    Implementation of clinical practice guidelines into daily care is hampered by a variety of barriers related to professional knowledge and collaboration in teams and organizations. To improve guideline concordance by changing the clinical decision-making behavior of professionals, computerized decision support (CDS) has been shown to be one of the most effective instruments. However, to address barriers at the organizational level, additional interventions are needed. Continuous monitoring and systematic improvement of quality are increasingly used to achieve change at this level in complex health care systems. The study aims to assess the effectiveness of a web-based quality improvement (QI) system with indicator-based performance feedback and educational outreach visits to overcome organizational barriers for guideline concordance in multidisciplinary teams in the field of cardiac rehabilitation (CR). A multicenter cluster-randomized trial with a balanced incomplete block design will be conducted in 18 Dutch CR clinics using an electronic patient record with CDS at the point of care. The intervention consists of (i) periodic performance feedback on quality indicators for CR and (ii) educational outreach visits to support local multidisciplinary QI teams focussing on systematically improving the care they provide. The intervention is supported by a web-based system which provides an overview of the feedback and facilitates development and monitoring of local QI plans. The primary outcome will be concordance to national CR guidelines with respect to the CR needs assessment and therapy indication procedure. Secondary outcomes are changes in performance of CR clinics as measured by structure, process and outcome indicators, and changes in practice variation on these indicators. We will also conduct a qualitative process evaluation (concept-mapping methodology) to assess experiences from participating CR clinics and to gain insight into factors which influence the

  20. Faster Increases in Human Life Expectancy Could Lead to Slower Population Aging

    Science.gov (United States)

    2015-01-01

    Counterintuitively, faster increases in human life expectancy could lead to slower population aging. The conventional view that faster increases in human life expectancy would lead to faster population aging is based on the assumption that people become old at a fixed chronological age. A preferable alternative is to base measures of aging on people’s time left to death, because this is more closely related to the characteristics that are associated with old age. Using this alternative interpretation, we show that faster increases in life expectancy would lead to slower population aging. Among other things, this finding affects the assessment of the speed at which countries will age. PMID:25876033

  1. Soft robotics: a review and progress towards faster and higher torque actuators (presentation video)

    Science.gov (United States)

    Shepherd, Robert

    2014-03-01

    Last year, nearly 160,000 industrial robots were shipped worldwide—into a total market valued at 26 Bn (including hardware, software, and peripherals).[1] Service robots for professional (e.g., defense, medical, agriculture) and personal (e.g., household, handicap assistance, toys, and education) use accounted for 16,000 units, 3.4 Bn and 3,000,000 units, $1.2 Bn respectively.[1] The vast majority of these robotic systems use fully actuated, rigid components that take little advantage of passive dynamics. Soft robotics is a field that is taking advantage of compliant actuators and passive dynamics to achieve several goals: reduced design, manufacturing and control complexity, improved energy efficiency, more sophisticated motions, and safe human-machine interactions to name a few. The potential for societal impact is immense. In some instances, soft actuators have achieved commercial success; however, large scale adoption will require improved methods of controlling non-linear systems, greater reliability in their function, and increased utility from faster and more forceful actuation. In my talk, I will describe efforts from my work in the Whitesides group at Harvard to prove sophisticated motions in these machines using simple controls, as well capabilities unique to soft machines. I will also describe the potential for combinations of different classes of soft actuators (e.g., electrically and pneumatically actuated systems) to improve the utility of soft robots. 1. World Robotics - Industrial Robots 2013, 2013, International Federation of Robotics.

  2. A light and faster regional convolutional neural network for object detection in optical remote sensing images

    Science.gov (United States)

    Ding, Peng; Zhang, Ye; Deng, Wei-Jian; Jia, Ping; Kuijper, Arjan

    2018-07-01

    Detection of objects from satellite optical remote sensing images is very important for many commercial and governmental applications. With the development of deep convolutional neural networks (deep CNNs), the field of object detection has seen tremendous advances. Currently, objects in satellite remote sensing images can be detected using deep CNNs. In general, optical remote sensing images contain many dense and small objects, and the use of the original Faster Regional CNN framework does not yield a suitably high precision. Therefore, after careful analysis we adopt dense convoluted networks, a multi-scale representation and various combinations of improvement schemes to enhance the structure of the base VGG16-Net for improving the precision. We propose an approach to reduce the test-time (detection time) and memory requirements. To validate the effectiveness of our approach, we perform experiments using satellite remote sensing image datasets of aircraft and automobiles. The results show that the improved network structure can detect objects in satellite optical remote sensing images more accurately and efficiently.

  3. The Development of Functional Overreaching Is Associated with a Faster Heart Rate Recovery in Endurance Athletes.

    Directory of Open Access Journals (Sweden)

    Anaël Aubry

    Full Text Available The aim of the study was to investigate whether heart rate recovery (HRR may represent an effective marker of functional overreaching (f-OR in endurance athletes.Thirty-one experienced male triathletes were tested (10 control and 21 overload subjects before (Pre, and immediately after an overload training period (Mid and after a 2-week taper (Post. Physiological responses were assessed during an incremental cycling protocol to exhaustion, including heart rate, catecholamine release and blood lactate concentration. Ten participants from the overload group developed signs of f-OR at Mid (i.e. -2.1 ± 0.8% change in performance associated with concomitant high perceived fatigue. Additionally, only the f-OR group demonstrated a 99% chance of increase in HRR during the overload period (+8 ± 5 bpm, large effect size. Concomitantly, this group also revealed a >80% chance of decreasing blood lactate (-11 ± 14%, large, plasma norepinephrine (-12 ± 37%, small and plasma epinephrine peak concentrations (-51 ± 22%, moderate. These blood measures returned to baseline levels at Post. HRR change was negatively correlated to changes in performance, peak HR and peak blood metabolites concentrations.These findings suggest that i a faster HRR is not systematically associated with improved physical performance, ii changes in HRR should be interpreted in the context of the specific training phase, the athletes perceived level of fatigue and the performance response; and, iii the faster HRR associated with f-OR may be induced by a decreased central command and by a lower chemoreflex activity.

  4. Inpatient rehabilitation outcomes of patients with apraxia after stroke.

    Science.gov (United States)

    Wu, Andy J; Burgard, Emily; Radel, Jeff

    2014-01-01

    Stroke-induced paresis commands much attention during rehabilitation; other stroke-related consequences receive less consideration. Apraxia is a stroke disorder that may have important implications for rehabilitation and recovery. To investigate association of apraxia with stroke rehabilitation outcomes during inpatient rehabilitation. This cohort study compared patients with and without apraxia after a first left hemispheric stroke. All study patients received standard of care. Clinical measures were the Functional Independence Measure (FIM) and the upper extremity section of the Fugl-Meyer Assessment (FMA) administered upon admission and at discharge. Length of stay was also documented. Florida Apraxia Battery subtests were used to classify patients with apraxia. Fifteen patients were included in this study, 10 of whom had apraxia. Data analysis revealed that patients with apraxia exhibited improvement from admission to discharge in clinical measures; however, admission FIM score was significantly lower compared to patients without apraxia. There was no statistically significant difference between groups on FMA score, length of stay, or amount of change on clinical measures. This study of acute patients found those with apraxia to be significantly less independent upon admission to inpatient rehabilitation compared to patients without apraxia. Although both groups improved a similar amount during rehabilitation, patients with apraxia discharged at a level of independence comparable to patients without apraxia upon admission. Such disparity in independence is of concern, and apraxia as a factor in stroke rehabilitation and recovery deserves further attention.

  5. Materials at 200 mph: Making NASCAR Faster and Safer

    Science.gov (United States)

    Leslie-Pelecky, Diandra

    2008-03-01

    You cannot win a NASCAR race without understanding science.ootnotetextDiandra Leslie-Pelecky, The Physics of NASCAR (Dutton, New York City, 2008). Materials play important roles in improving performance, as well as ensuring safety. On the performance side, NASCAR limits the materials race car scientists and engineers can use to limit ownership costs. `Exotic metals' are not allowed, so controlling microstructure and nanostructure are important tools. Compacted Graphite Iron, a cast iron in which magnesium additions produce interlocking microscale graphite reinforcements, makes engine blocks stronger and lighter. NASCAR's new car design employs a composite called Tegris^TM that has 70 percent of the strength of carbon fiber composites at about 10 percent of the cost. The most important role of materials in racing is safety. Drivers wear firesuits made of polymers that carbonize (providing thermal protection) and expand (reducing oxygen access) when heated. Catalytic materials originally developed for space-based CO2 lasers filter air for drivers during races. Although materials help cars go fast, they also help cars slow down safely---important because the kinetic energy of a race car going 180 mph is nine times greater than that of a passenger car going 60 mph. Energy-absorbing foams in the cars and on the tracks control energy dissipation during accidents. To say that most NASCAR fans (and there are estimated to be 75 million of them) are passionate about their sport is an understatement. NASCAR fans understand that science and engineering are integral to keeping their drivers safe and helping their teams win. Their passion for racing gives us a great opportunity to share our passion for science with them. NASCAR^ is a registered trademark of the National Association for Stock Car Auto Racing, Inc. Tegris^TM is a trademark of Milliken & Company.

  6. Faster, Stronger, Healthier: Adolescent-Stated Reasons for Dietary Supplementation.

    Science.gov (United States)

    Zdešar Kotnik, Katja; Jurak, Gregor; Starc, Gregor; Golja, Petra

    Examine the underlying reasons and sources of recommendation for dietary supplement (DS) use among adolescents. Cross-sectional analysis of children's development in Slovenia in September to October, 2014. Nationally recruited sample. Adolescents aged 14-19 years enrolled in 15 high schools (n = 1,463). Reasons for and sources of recommendation for DS use, sports club membership, sports discipline, and extent of physical activity (PA) were self-reported data. Chi-square test of independence was performed to compare the prevalence of DS use between groups with different extents of PA and nonathletes/athletes, referring to 11 different reasons and 9 different sources of recommendation for DS use. Use of DS was widespread among adolescents (69%), athletes (76%), and nonathletes (66%). Higher prevalence of supplementation was observed in males, who justified it use for sports performance enhancement and better development and function of muscles. In contrast, females emphasized immune system improvement. Higher extent of PA was associated with a higher prevalence of DS use. This was especially evident in males, who participated in team sports. A high percentage of adolescents (41%) decided on their own to use DS and because of advice from parents or relatives (30%). Several reasons for the widespread use of DS in adolescents were associated with sports participation. Therefore, educational programs regarding DS use should be targeted primarily to adolescents and their parents who are involved in sports, and especially team sports. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

  7. The urban lighting in the rehabilitation of the minor historical centre. The design scenarios for the architectural valorisation and the energy efficiency improvement of the urban environment

    Directory of Open Access Journals (Sweden)

    Pierluigi De Berardinis

    2015-12-01

    Full Text Available In the last decades, the topic of lighting of the historical minor centres is taking a prominent role in the cultural debate on the urban recovery interventions, because of the development of a greater awareness of the regenerative potential role that a careful planning system of urban lighting can take in this context. The latter, which had a purely functional role in the past, has recently taken a figurative and emotional role, associated with the vision of the urban light scene during the night and its valorization. The study of light, therefore, has inevitably turned into an instrument of knowledge and critical interpretation of the urban spaces, aimed both to functional recovery of the lighting network technology, and the regeneration of the urban image and its night scenes. The needs that this sector should satisfy are multiple and, sometimes, conflicting: the need for road safety, the reduction of light pollution, the need for energy and cost savings. The research aims to define an operative methodology to deal with the light planning in complex contexts as the minor historical centers, in which the concept of transformation of the urban scene clashes directly with the concept of preserving the identity features of the places and its constructive values and materials. Among the goals, there is therefore the aim of highlighting the main gaps in the network, due both to plant engineering reasons and to the obsolescence of the existing lighting fixtures. We operatively work in the urban voids system field, as spaces that characterize the urban scene. Through the knowledge of their dominant features it is possible to preserve their identity and, at the same time, enhance their singularity, with a suitable lighting project, which requires the study of materials, colors and consumption. The purpose is to promote an urban development, able to produce positive economic, social and cultural effects, oriented to improve the quality of life, as well

  8. Rehabilitation technology services and employment outcomes among consumers using division of rehabilitation services.

    Science.gov (United States)

    Sprong, Matthew Evan; Dallas, Bryan; Paul, Erina; Xia, Michelle

    2018-05-03

    The primary goal of the study was to evaluate how the use of rehabilitation technology impacted closure status for consumers receiving services in fiscal year (FY) 2014. Rehabilitation Service Administration (RSA-911) Case Service Report FY 2014 archival dataset was obtained from the U.S. Department of Education (2014) and secondary analyses was performed for this study. RSA-911 archival data is updated on an annual basis and consists of all state-federal rehabilitation consumers who were served in the specific fiscal year. The dataset contains information related to each consumer's demographic information (e.g. age, gender, race) and other supplemental information (e.g. weekly earnings at closure, cause of disability, services provided). A multiple logistic regression analysis was utilized and revealed that white consumers receiving rehabilitation technology (RT) services have significantly higher closure rate than consumers of other races, RT services differ by the employment status at application, RT services differ by the type of disability, educational level at application for people receiving RT services did predict closure status (i.e. exiting with an employment outcome), IEP status did not predict closure status, weekly earnings at application did predict closure status and the interaction effect between IEP and RT services is statistically significant. The odds ratio (ORs) were presented at the 95% confidence interval (CI). Vocational rehabilitation counselors needs training to correctly identify appropriate RT services for consumers, so that the likelihood of exiting with an employment outcome is obtained. Implications for Rehabilitation RT services significantly improved their chances of successful employment compared to those who did not receive RT services. Education at closure would also have some significant impact on employment outcomes. Training in Assistive Technology (AT) for Vocational Rehabilitation counselors will assist in the proper

  9. Ambivalence in rehabilitation: thematic analysis of the experiences of lower limb amputated veterans.

    Science.gov (United States)

    Christensen, Jan; Langberg, Henning; Doherty, Patrick; Egerod, Ingrid

    2017-06-20

    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 investigate those factors influential in achieving successful rehabilitation, including interprofessional collaboration between different sectors involved in the rehabilitation of veterans with lower limb amputations. We used a qualitative exploratory design, triangulating interviews and participant 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. 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 according to the context. The second theme illustrated the frustration of negotiating military versus civilian mindsets during rehabilitation and lack of coordination between the public healthcare system, municipal services and the military. Veterans live with shifting identities after returning to civilian life, increasing their awareness of the transition from active service to a new life as a civilian. During rehabilitation, it is important to acknowledge the disparities between the military and civilian mindsets and to integrate the different sets of values, such as structure versus autonomy. IMPLICATIONS FOR REHABILITATION Recommendations for the improvement of rehabilitation of amputated veterans include: Rehabilitation professionals working with veterans should focus on abilities instead of

  10. Exercise-based cardiac rehabilitation in twelve European countries results of the European cardiac rehabilitation registry

    DEFF Research Database (Denmark)

    Benzer, Werner; Rauch, Bernhard; Schmid, Jean-Paul

    2017-01-01

    AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR...

  11. 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.

  12. Rehabilitation at Olympic Dam

    International Nuclear Information System (INIS)

    Chandler, W.P.; Middleton, B.A.

    1986-01-01

    Rehabilitation work on areas denuded of vegetation during the exploration phase of the Olympic Dam project was used to test various methods for regeneration of vegetation cover in the arid zone. The test work carried out on drill pads and access tracks has indicated that, with adequate site preparation, natural regeneration is the most economical and effective method to ensure post-operational stability of the affected land-forms. An on-going monitoring regime, utilising a computer data base, has been set up to allow year-to-year comparison of rehabilitation effectiveness. The database also provides a catalogue of initial colonising plants and a measure of variations in species diversity with time

  13. 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.

  14. Evaluation of evidence within occupational therapy in stroke rehabilitation

    DEFF Research Database (Denmark)

    Kristensen, Hanne Kaae; Persson, Dennis; Nygren, Carita

    2010-01-01

    therapy intervention related to the use of everyday life occupations and client-centred practice within stroke rehabilitation. Design: Systematic searches of research studies published in English during 2000-2007 in peer-reviewed journals were undertaken. Thirty-nine articles and one Cochrane review were...... after rehabilitation. There is also considerable evidence for the use of everyday life occupations in occupational therapy. Occupational therapy was evaluated as an important aspect of stroke rehabilitation improving outcomes in everyday life occupations including activities of daily living (ADL...

  15. Rehabilitation and indigenous peoples: the Māori experience.

    Science.gov (United States)

    Harwood, Matire

    2010-01-01

    Indigenous peoples often have the worst health status in comparison to non-indigenous people in their own nations; urgent action to address the health inequities for indigenous people is required. The role of rehabilitation in addressing health and disability inequities is particularly important due to the health need of indigenous peoples; the unequal distribution of health determinants; and disparities in access to, quality of care through and outcomes following rehabilitation. This article will present a perspective for Māori, the indigenous peoples of New Zealand, on a framework for improving rehabilitation services for Māori and ultimately their health and wellbeing.

  16. 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

  17. Cardiac rehabilitation with a nurse case manager (GoHeart across local and regional health authorities improves risk factors, self-care and psychosocial outcomes. A one-year follow-up study

    Directory of Open Access Journals (Sweden)

    Vibeke Brogaard Hansen

    2014-10-01

    Full Text Available Objectives In Denmark, the local and regional health authorities share responsibility for cardiac rehabilitation (CR. The objective was to assess effectiveness of CR across sectors coordinated by a nurse case manager (NCM. Design A one-year follow-up study. Setting A CR programme (GoHeart was evaluated in a cohort at Lillebaelt Hospital Vejle, DK from 2010 to 2011. Participants Consecutive patients admitted to CR were included. The inclusion criteria were the event of acute myocardial infarction or stable angina and invasive revascularization (left ventricular ejection fraction (LVEF ≥45%. Main outcome measures Cardiac risk factors, stratified self-care and self-reported psychosocial factors (SF12 and Hospital Anxiety and Depression Scale (HADS were assessed at admission (phase IIa, at three months at discharge (phase IIb and at one-year follow-up (phase III. Intention-to-treat and predefined subgroup analysis on sex was performed. Results Of 241 patients, 183 (75.9% were included (mean age 63.8 years. At discharge improvements were found in total-cholesterol ( p  < 0.001, low density lipoprotein (LDL; p  < 0.001, functional capacities (metabolic equivalent of tasks (METS, p  < 0.01, self-care management ( p  < 0.001, Health status Short Form 12 version (SF12; physical; p  < 0.001 and men